Remembering Lee

I wanted to write a post remembering some of the teachings of Dr. Lee Lipsenthal, a physician, healer, shamanic journey leader, and a loving husband and father. Dr. Lee was one of the lecturers during the HEART elective this past April and I think it appropriate this weekend to recount some of the lessons he instilled in the HEARTies just a few months ago. I reopened my journal from the elective for the first time since I left that sacred space April 24th and share now all that I wrote down with a fiery passion and so much love during his series of lectures.

Dr. Lee told us the following: "When you have heard that I have passed away, know that I passed away happy and surrounded by all my loved ones." Lee's whole-hearted acceptance of mortality and the end of life was so striking during the elective and he gave so many reasons for this powerful peace of mind. He expressed gratitude for an incredible wife and children, for living exactly the way he wanted to, with an appreciation for the beauty before, behind, beneath, above and around him. Why fear death when you did all that you wanted to do and soaked up every wild and precious moment? Lee routinely told himself, "Today is a good day to die" and I regularly practice this with my Stephie. Live each day to its fullest.

Lee also inspired us to follow our hearts with the following ancient quote from the Far East: "Do that which feeds your soul, while you chop wood and carry water." Most of us have to make a living in some way and consider finances at some point, but always remember your passions and live them fully. This saying is so grounding and allows one to focus on what is truly important. For me this is my life partner Stephie Wei Li and the joy for life that we share as two merged beings.

"Do you want to be good or to you want to be whole," Lee asked. Are you trying to meet unrealistic expectations and goals at the expense of your whole being? Allow yourself to simply be and let those pressures placed on you in many of the roles in your life slip away. If you allow yourself to be whole, everything else will follow.

Give gratitude for your teachers. Lee had us write a list of teachers in our life and I was amazed at how many people have played such a formative role in my life. Gratitude leads to happiness and I give thanks at the end of every day with my love Stephie for our wonderful life we lead.

Stay connected with a daily ritual. There are many ways to connect with the collective unconciousness and to ground oneself. Pick one and practice it regularly. I routinely use prayer, meditation, song and chanting, yoga and breath work. Music and breath are incredible vehicles to reach the unconciousness as Lee so prominently demonstrated during the shamanic journey he took us on. 

Be responsible to the patient and not for the patient. Be a great teacher and let the patient make their own decisions.

Teach your children how to learn and not what to do specifically.

Use the energy and enthusiasm of a 5 year old and the intellect of a 30 year old. 

Dont let the perfect get in the way of the good.

Cutting down hours does not prevent burnout but changing personality structure does.

When you say no to others, you say yes to yourself. 

"My goal is obsolescence. For the wisdom of the group, not me."

Thank you Lee for your incredible life lessons. You will be dearly missed, but your love and lessons live on in all the lives you touched.

Great quotes

"Meditation allows you to be more of who you really are." - Will Kabat-Zinn

"The heart of Buddhism is compassion and the heart of compassion is self-compassion." -Tara Brach

Sweethearts forever

♥

I went on the Spirit Rock Young Adult Retreat a few weeks back.

I will add to this post but in the meantime, here are some photos from my experience:

thhttp://www.mettalovingkindness.com nice site my fellow retreatant made. May you be well. May you be at peace. May you happy. May you be free.

http://www.dharmaseed.org/retreats/ ask S or J for password to listen to dharma talks from the retreat (4 of them. all amazing). Or feel free to browse the site. Tons of amazing resources.

Biggest take home message for me: loving-kindness and compassion toward self and others = where it's at. :) Liberation through mindfulness. With awareness comes choice. And "Dreams become reality one choice at a time," as it written on the beautiful bracelet from Mama Menke.

Well, off to bed as my sleeping schedule is slightly off lol. Have to be at the ICU in a few hours. More on ICU later. I'm having an amazing time. One of the most meaningful aspects is just being with patients and their families. Something that delights me daily: seeing my patients wake up from being sedated and on the ventilator. It's like I get to witness this beautiful birth and welcome them back into the waking world. I can't help but smile. It's so beautiful! It's so amazing too...so many of the patients in the ICU are suspended between this world and the next. Such a delicate balance. Some will stay with us and some will transition on. I give thanks for this amazing ICU rotation. I can't believe how it's flown by. I have one more week left and then I return to Portland. The teaching has been amazing. Another highlights has been the stellar communication. My resident and attendings communicate so so well with the families. It makes all the difference. Dr. Harless, the course director and director of critical care, has really set the tone and created a wonderful place for faculty, staff and patients. Dang.

K gnite!

An Epic Conversation

From 7:49 pm on September 10th until 4:04 am on September 11th Joshie and Stephie talked with one another on their life partner communicating devices (what some people may call a cell phone). This epic conversation spanned over 1/3 of a day, more than the typical 8 hour work day, over 1/6 of the entire weekend (including sleeping time), more than 495 minutes (thank goodness for the unlimited weekend minutes), and the time it takes for the moon to rise and then set (which Joshie had the opportunity to see). One of the most incredible parts of the experience was how natural the conversation flowed the entire time! We talked about everything under the sun and moon from how precious it is to confide in one another after long days in the hospital to the beauty and power of buddhism and it's accompanying message of compassion. It was the most beautiful of conversations and I am continually blown away by the similarity of our viewpoints and our appeciation for life. We live life in the same natural, compassionate, loving, spiritual way and the entire relationship comes straight from the cosmos and the creator of the universe. Thank you my love for the most amazing life together. Each moment is so wild and precious and I am soaking it all in like a sunflower on a beautiful clear and light filled day.


I love this woman:

"Children Learn What They Live"

If a child lives with criticism, he learns to condemn.
If a child lives with hostility, he learns to fight.
If a child lives with ridicule, he learns to be shy.
If a child lives with shame, he learns to feel guilty.
If a child lives with tolerance, he learns to be patient.
If a child lives with encouragement, he learns confidence.
If a child lives with praise, he learns to appreciate.
If a child lives with fairness, he learns justice.
If a child lives with security, he learns to have faith.
If a child lives with approval, he learns to like himself.
If a child lives with acceptance and friendship,
She learns to find love in the world.

~By Dorothy Law Neite

Beautiful. :)

The Marionberry

The Marionberry 

Heart shaped treat

Red with texture

Eyes closed
Mouth open

Small bite

Lays on the tongue

Melts with ease

Sweetness hits 

The lips tingling

So succulent

Sugary delight

Lasts for minutes

Subtly leaves.

Thank you love

For the daily sweetness

That you bring

Into my life

Your sweetness

Lasts an eternity. 

ERASH 2012

Why have many of the fourth year med students been itching lately? What are all these murmurs of a pesty dermatologic condition going around the wards, in clinics and in hospital cafeterias? Well folks its been all about ERASH the last few weeks. After a quick walk-by-consult with one of the dermatologists I think I may have some definitive information for you.

ERASH: A erythematous, pruritic eruption on the distal phalanges and forearms bilaterally. Blister formation is possible but rare. It is not uncommon however to also experience nervous itching of the arms, back, neck and scalp.
Pathogenesis: Lengthy hours at the computer and late night proofreading.
DDx: Love sickness.
Rx: Topical corticosteroids until ERAS has been completed.
Prognosis: Excellent post application submission.

Hope that clears up any confusion about ERASH (no pun intended).
Love,
Dr. J and S

I See You! I.C.U. :)

I just got off the phone with the most amazing man ever: Joshiepoo! I’m on my ICU rotation, and it has been challenging in a lot of ways. It has also been incredibly educational, enjoyable, and broadening. I will speak briefly about the challenges first. First, it has been difficult to be here at times because it reminds me of being in the ICU with Daddy during his last few days with us here in his physical form. The sights, sounds, smells, feelings are just so familiar….I have experienced a roller coaster of emotions….fear, anxiety, discomfort, sadness, but also (and more often) curiosity, compassion, peace, joy, and relief. I try to let go and be present with all the feelings, sensations, thoughts, and mind states that come up. I try to let my breath anchor me….to breathe my way back into mindfulness. I think often of Rumi’s Guest House poem, welcoming all that comes up.

The Guest House (sorry formatting a little messed up)

This being human is a guest house. Every morning a new arrival. A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor. Welcome and entertain them all! Even if they're a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honorably. He may be clearing you out for some new delight. The dark thought, the shame, the malice, meet them at the door laughing, and invite them in. Be grateful for whoever comes, because each has been sent as a guide from beyond.

This rotation has been a gift, even after only three days. I felt really nervous and insecure about my clinical skills and knowledge having taken time off. I noticed in me a fear of being back fully in medicine, and yet I knew that the best way to get back into it was to go all the way, to dive in, to go for the full immersion experience. And this is it. I’m here. And I’m noticing how much I’m enjoying it. I get to work with really excellent, intelligent, kind, dynamic physician/PA/nurse/RT/pharmacist/etc. teachers. Everyone is sooo welcoming and goes out of their way to teach. The environment is very collegial and cooperative. I love that every day we have Multi-disciplinary Rounds to talk about all the patients in the unit. As the name implies, we have physicians, PAs (physician assistants), nurses, social workers, palliative care doctors, dieticians, (students hehe yay!), and pharmacists. It’s a form of integrative medicine for sure!

Something I’m really appreciating, too, is that this is Western Medicine at its best. What I mean is that I believe that one of the major strengths of allopathic medicine is acute and critical care. I feel that non-allopathic modalities and health systems really shine with chronic issues and preventative health. All these systems complement each other so beautifully, and I think that learning this medicine here, now, is so very important. With some of these patients, the only thing that can help them might be Western Medicine. Now some may argue that all these interventions aren’t natural or that they shouldn’t be done in the first place. I respect their views too. This is valid. Still, in our day and age, and to be a truly integrative, holistic physician, I feel it is imperative that I learn this medicine well. Keeping this in mind and thinking of my larger goals really drives me. And I have been so humbled and inspired by my interactions with my teachers here already. For instance, this morning, my colleague gave a presentation in which she quoted her attending physician, a surgeon. He stated that “You make your money by what you do to patients. You make your reputation by what you don’t do to patients.” I love this! Contrary to some stereotypes, most surgeons I’ve met have not been “knife-happy” but have been incredibly thoughtful and only operate when indicated. In fact, on the first day of surgery, my chief resident said, “98% of the care we do takes place before and after the OR. Only 2% takes place on the operating table.” I digress somewhat, but this quote spawned a whole conversation on favorite doctor quotes, and my course director shared this quote:

“There are three kinds of languages for physicians:
1. The language of anatomy, physiology, and pathology (in other words the language of the basic sciences and the pathophysiology of health and disease).
2. The language of clinical medicine (all the terms we say in clinic and in the hospital, the language spoken between physicians and other health care workers as we actually practice medicine).
3. The language of patients. How we convey what’s going on to patients and their families.”

My course director stressed that he believes this third language is the most important and is unfortunately, often overlooked in our education. How insightful of him to share this!! This is especially important in the ICU where patients are so sick. I feel thankful that at OHSU, this third language has been very intentionally taught to us, both explicitly and implicitly. We had sessions on practicing translating complex medical jargon into “lay speech.” More importantly, we are surrounded by soooo many amazing role models who really embody this aspect of the practice of medicine. This is the true art of medicine, and I feel so blessed to have worked with so many artists! :) I’m thrilled that here, too, in Bend, there are so many insightful, communicative, thoughtful, socially intelligent physicians and role models. Especially in the ICU, patients and their families are so vulnerable and really look to their medical team to support them and provide them with information. In only three days here, I’ve learned so much about the art and science of medicine thanks to my wonderful teachers.

Why am I writing all this on Joshie and Stephie’s blog you ask? Well, I felt inspired to write this after speaking with Joshie. He is my daily inspiration, my light, my love. I feel his presence all the time, and I am constantly thinking of him in MN, picturing what he might be doing in each moment. It’s been so amazing: several times now one of us will call the other and the other will happen to be free in those exact moments! It’s gotten kind of uncanny and crazy beyond coincidence...specifically because I’m on ICU and he’s on surgical pathology! We have about 10 free minutes the whole day. It’s wild, and yet not that surprising at this point hehe. :)

I’m just so thankful for you, Baby. I love talking to you, thinking of you, holding you in my heart and mind. Seeing photos of you (thanks for all the wonderful photos and vids throughout the day!). Seeing photos of your scrumptious food hehe. I’m so excited to see you in two days! Okay sorry for anyone else who’s reading this. I realize that it’s kind of strange to be writing a love note publicly like this. Forgive me? :)

Really though, I am ever so grateful to have Joshie in my life and to be able to talk about anything and everything with him. As I described above, certain aspects of this rotation are challenging for me, but Joshie gives me strength and helps me find the opportunities for learning, growth and transformation in this experience. Thank you, Darling!

I’ll end with a cartoon that I found online today. Someone had a photo up of a Notre Dame cheerleader holding a sign upside down. I cringe whenever I see it. Loyal Irish fan that I am, I covered it up with this new image. :)

I’ve also posted this quote at my desk.

Finally, here’s an image of the office in which I work (with the other physicians and PA):

Hard to read but it says, “Doctor. Walk In. Man or Beast” and to the right, “Bona Fide Physician with Degree. Animals doctored when time permits. Elixirs, splints, remedies, trusses. House calls only if needed.” I love it! Such a great group with which to work! :)

Goodnight! Here's another one of the above Mary Oliver quote. :) Quotes are so lovely!

Addendum: I forgot to mention that one thing I really appreciate about this rotation is the opportunity to be working with these patients, many of whom stand at the threshold between this world and the next. It's such a privilege just being here...this work is remarkable, sacred. This is true out of the ICU as well. Patients teach us so much about grace, bravery, fearlessness, and our own humanity.