Lately I turn off the radio for the morning drive. I sit and practice strong back, soft belly. There is nothing to do here but drive as well as I can. This bridge from morning sit, and then morning solitude has become a way to get into the world with practice. The other cars are there, with their own driver’s agenda. Hurried, plodding, taking their pace from others – they all engage with the other cars and my driving is a way to be me and care for them. If I am attentive to just driving as well as I can, doing my task, paying attention to the world, I am caring for them and accepting them where they are. In the strange absence of face to face contact, this is a liberating practice. There is nothing else to do. All of them, these cars operated by people I’ll never know, they are my path, like the wind on a walk they push me along or hold me back.

But my job, in my car, is just to be with them and do my work as well as possible, no matter what their issues are.

Driving is a tremendous place of practice.

I have crawled through people. Through creation’s glorious sculpture half intact and half rendered unrecognizable by the crude forces of man and nature, by laws of physics barely understood by Newton mixed with the randomness of who and what survives one day versus the next. These explorations stay with me and mount up demanding attention, some reconciliation between before and now and after that we imagine and therefore insist is possible. I know of no such reconciliation, no catharsis, no meaningfulness to be found in this destruction. I am simply witness to it and a participant in whatever happens going forward, randomly assigned by schedules and choices made weeks, months, years and even generations ago. I am there/here in all those moments and all the moments going forward after the event, whether I believe it true or not. This is called being a doctor. A surgeon. A lover of life and people and anatomy and the mess it all adds up to.

my dog teaches me all the time

when to rest, when to work, and how to enjoy the warmth and comfort of the fire

she is a blessing

“The essential method of cleansing is difficult to fathom. The method is itself the essential meaning. Attaining the way is the method.”

It is not that there is only one way. It is also not that there is every imaginable way. There is only one way: the way of doing all things is the doing from the inside. Doing from the outside is doing with thinking, and this is not the way. The correct way is neither normative nor anarchy. To do something correctly there is not doing, but only the being-doing. Doing something correctly means no boundary between the object and the self and the action.

There is a story of Michelangelo sitting and staring at the faulty piece of marble that would become The David for days on end. He was asked, “What are you doing?”

“I’m looking for what’s inside.” He was becoming the marble.

His sculpting is the becoming, the being-doing Dogen is describing in the ritual of defecation and wiping. For Dogen, wiping your butt was as holy as sculpting The David. The rules of the cleansing neither matter nor can be discarded. How will you pay attention as if your life depends on it without rules? If you can do so there are no rules. “The method itself is the essential meaning.” Nothing to see here – move along into your own self.

If you go to the Academia and look at Michelangelo’s David, you first walk through the incomplete works of his other sculptures. To go from seeing these partially done chunks of stone – a little here, a little there – done in fits and starts and with the notion there was nothing more to say on this day, but that there would be more, much more on some other day …

To turn from those to seeing the perfectly accomplished monument to humanity at the end of the hall is to see someone at work toiling with process and the imperfections of each second-to-second-to-second to seeing God standing at the end of the hall. At once complete and perfect, without the hint of the struggle of the work, even as if effort and progress toward the end in front of you is an inconceivable concept … it is intoxicating and magical and makes one forget the effort of life. Before perfection, struggle; after perfection, struggle. But the other perfection you see lies and says, “no, in this marble you can exist in perfection eternally”

It also asks you – DARES you thus: “Can you perfect your idea?” And that dare comes even before the thoughts about the subject matter itself … perhaps that is the final genius of the work and the artist … and, also, perhaps that is only the story I create. Regardless, if there was a single human creation to be saved for the future species to understand us, this is the piece. Some equations of physics, some Bach, and this marble. And, of course, there is Cleansing.

Dogen says you are your own creation in progress. Perfect it with every breath, every spoon to mouth, every wiping. “The method itself is the essential meaning.”

“Cleansing”, from Dogen: Treasury of the True Dharma Eye. Kasuaki Tanahashi Ed. Shambhala Publications, Boston, Massachusetts, 2010.

Lisa Feldman-Barrett says our brain’s job is to predict what is going to happen next in the world so we can appropriately allocate resources. Run and hide, stay still, or relax quietly with friends: our ability to successfully decide which is essential for our survival. Kahneman says our brain accomplishes this in two ways: making up stories (System 1) and solving problems (System 2). The problem is we make up stories about the world in front of us for best fit, or most plausible, rather than scrutinize for accuracy. We don’t want to solve problems, cause that takes effort, so we make up stories and proofread them with Sys2 for egregious errors. Part of what fits or seems plausible to us, however, is based on the stories we have constructed in the past. And those stories, since they are not entirely accurate, but only had to be close enough, are filled with inaccuracies that become biases. Worse, biases are formed simply by sloppy story telling to begin with … and there you have the recursive loop of suffering Dogen calls “picking and choosing”.

This is not a bad thing. It just is the thing our brains do – make up stories about the world for our survival. The problem isn’t the suffering it causes – the problem is how good it is. We are FANTASTIC story tellers. It seems to me that most creativity derives simply from the ability of the conscious mind (Kahneman’s System 2) to spur the fabricating mind (System 1) on and on. This explains why so many creative artists gravitate toward substances, or lifestyles that are somewhat out of the norm. They are stoking System 2 to spur System 1 (the Storyteller). “Go farther, and farther, make up more!” Sys2 says, and only later edits in ways that can catalyze even more from Sys1. Creativity is the great byproduct of how our minds work, and the fundamental beauty of that is we have used stories for all of humanity to bind us together as families, tribes, societies and civilizations. We are the great storytellers of the Universe, through music, art, physics, and every other realm.

But that is just the story that makes sense to me. I don’t really know.

You see, that is how it works. And Shakyamuni’s revelation was that our delight in the stories we tell, when anything more than fleeting, causes suffering one way or another. Dogen, to me, is like a great acting teacher. Stop reading the story, stop writing the story, and be the story, he says, over and over again. Just be the story of the meal, the cleaning up, the holding of hands, the music (actually Dogen didn’t appear to be much for music) … whatever it is, just be the story and let someone else witness it. This is a deceptively difficult proposition, precisely because our poor brains will keep making up stories as they cannot help but do.

Zazen is the exercise of stepping into your own story, not picking or choosing the one you want, but just stepping into the story you are.

References:

Feldman Barrett, Lisa: How emotions are made. Houghton Mifflin Harcourt, New York, 2017.

Kahneman, Daniel: Thinking, Fast and Slow. Farrar Straus and Giroux, New York, 2011.

I have wrestled again
once more to a draw
with leaden cravings
I do not even try to swim to the surface
but grab at them and gasp for air. There
is no surface of which I am aware.
Why do you hold me down? I scream
at them and her, all the while clinging
on as if there was dear life.

And then I see the surface of the water
and am shocked that it exists.
And I find that I can float after all.
Still I swim, sinking now and then
but continually coming up for air.
This sweet air of awareness
is blessed by the water of life.

What can we do but swim?
There is no escape from the water
just the sleeping and then diving back in.
The floating is marvelous. The water surrounds all of us.
We are connected by it, made of it and in it,
and we return to it at the end. This floating
is dear life – swimming with all beings. 

Come,
and swim.

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I am against raising awareness.

Awareness is objectifying and distancing. Awareness is only a doorway. It demands nothing of you and is completely noncommital. You are free to stay on your side of the door and that is distance. You are free to walk away with indifference, disgust or outright denial. And you do it. Every day we all do it. Reflect on that karmic burden, and then ….

Walk through the door. Attend the event of what is happening not just to you but to the other, whether rock or mouse or man.

PAY attention. Its all there, isn’t it? paying attention requires you give up something. To whom do you make the payment? Let that question sit for a moment. In some sense you give it to the other, whether it is an object, a creation, or a being – and really, what isn’t all three? What rock doesn’t have the covering of life on it? What isn’t worth something from you, since you are nothing without it?

You pay to get into the game, and once you are there you aren’t just a spectator. The very act of attending makes you part of the game. And you wind up more rather than less. How is that?

You depend on everything you see that is beautiful, everything you hear that is annoying and everything you smell that revolts you. Those are you as much as your last brilliant artstic impulse and your next fart. All these things are indeed boundless fields.

Thats it really. Just pay attention. It is an act of love. When you pay attention you are there to become the work that must be done and you are that work with the other. Tilll the soil, hold the hand, sing the song.

Here is the last – pay attention to yourself as much as the other. Your self will call you when it needs you and you must pay attention to that too. Riddle me that accounting – where does the love, the ability to pay attention to yourself, from where does that emerge? Who are you paying then? That is emotional cold fusion my friend. Find the stillness or the noise and try it. See what energy emerges.

Pay attention.

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there is only the work of being helpful.

to be such, first you must listen.

to listen, you must first be still in your mind and body; then there is no decision to make, just a need to be met.

meet the need – that is all the work there is.

then rest. 

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Sometimes when I’m working I am struggling. There is tissue in front of me – part of a person – a mixture of normal and abnormal anatomy. I work to restore order, to recreate anatomy as perfectly as needed to best restore function. This is a strange and sometimes stressful job. Often there is great worry in the midst of it – will this really go back where it needs to go? will the body I’m working on know the difference if it does? Bodies are strange. Some are bothered by imperfections and some are not. In the middle of fixing, you can’t know, however, if this particular body will be bothered and sometimes you just struggle based on the best available evidence and the prevailing wisdom that closer to normal anatomy is better. Well, I struggle anyway. A millimeter closer here, a millimeter closer there, i slowly move the pieces back to where they belong. And there is blood, always in the way, distracting you from the task at hand. And nerves. Things you have to respect and work around gently. Struggling with delicacy, combining great effort with tenderness, creates focus and tension that I do not often feel consciously. Then I bark at someone who is trying to help and doesn’t know how and even as I am doing this I recognize the piece of shit that I’m becoming in snapping at them. 

When these cases are over, something happens in my head. I can feel this strange and eery sense of thickness in my head. Its similar to the feeling you get after a very hard workout, when your body just wants to be still for a bit and recover. The front half of my head feels that way. Stop. Recover. No attention can be paid now, to anything. We are rebooting. 

The times I am struggling the most are when there is some element of time pressure in the work. I’ve worked with deadlines in all sorts of fields before, but the time pressure with a body open in front of you is different. Almost every minute the thought “I might not be able to fix you” crosses my mind. Its like I’m running into a burning building to save my kids. And every few seconds longer I’m there and I’ve not saved them they are closer to dying. I could lay down there myself and let go, but I can’t leave them. That is the struggle. Often this struggle comes in the form of a double-down time pressure – This person is open in front of me, and I’m supposed to be somewhere else – meeting my wife for dinner, picking up daughters, etc. and these are like Sophie’s Choice in my head. Of course I know they are not that, but that pressure of only being able to save one being I love – the patient or my family – is my pressure of finding a way to beat Sophie’s Choice, to find a way to save both. Sometimes I do, and sometimes I do not.

The punch in the gut is when I get to my family my brain is not there. Not in a conscious way. My attention is turned off. And then I have only saved one. In the midst of only saving one, the resident has succumbed to “friendly fire”. Or I miss the time with my family, and there is fury at home. 

this is the life of a surgeon

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