Wednesday, June 22, 2011

The Party of a Lifetime and the Virus That Caused It

The photo album has been in this house for twenty-five years.  I found it stashed away in the meditation room upstairs with about fifteen other yellowed, crumbling volumes of photographs.  I'm not sure whose photo albums they are.  Some may have been taken and collected by staff over the years, others appear to be personal albums from patients who passed away, and who had no one willing to store the memories for an indefinite time.

Monday, June 20, 2011

Thank You for Littering

My recent trip to Mexico ended up being a lesson in impermanence.  We visited the ruins at Monte Alban, Mitla, and Teotihaucan, whose perforated historical documentations have archeologists scratching their heads as to what actually happened there.  A bulk of these civilizations' traces had been reclaimed by nature, because, for the most part, they biodegraded.  In addition to this tidbit of the transience of things, my airplane reading happened to be Cradle to Cradle by William McDonough and Michael Braungart, who recommend a paradigm shift from "being less bad" to a "production of good waste".  In other words, instead of believing that our waste must be destructive in nature, we should consider Nature's model of waste as food.  Biodegradable waste is not waste, but nutrient.

Now, back in San Francisco with McDonough and Braungart's words fresh in my head, I encountered one of those irritating little events that all business owners are familiar with:  I ran out of business cards.  But, knowing that the blitz-white, ink-jet matte card paper from Avery contains petroleum-based chemicals to give it that sleek patina, and that these chemicals may be thrown into the recycling without being made for recycling, I started thinking of another solution.  After all, the life cycle of my business card in the age of smartphones is pathetically short.  As soon as my information is entered into a Contacts list, my business card becomes trash: bent, stained, and discarded into a landfill.

The result is shown above:  my business leaf.  I gathered eucalyptus leaves from the park across from my apartment and wrote on them with Sharpie pens, which are non-toxic and contain only a fraction of a percentage of the harmful chemicals of a wet newspaper leaching onto the sidewalk.  So, if I happen to run into you and give you my leaf, then please save my email address... and thank you for littering.

Sunday, April 10, 2011

Can Acupuncture Cure My Astrology?

If you would be so kind and allow me to indulge briefly in some astro-jargon:  A Mars return is an astrological event which apparently happens to each of us every two years.  When we are born, the position of Mars – and all the planets, for that matter – becomes part of who we are.  And since Mars' orbit lasts roughly two years, a phase of re-definition of the planet's meaning hits us on the same schedule.  We are most familiar with the sun's position in our charts, as in "What's your sign?", and a solar return is also known as a birthday.   Somewhat well-known in certain circles is the Saturn return.  This is recognized as a major event that takes place between the ages of 28 and 30 in which nearly all aspects of life may be turned upside down (read: relationship, health, and job turbulence).

According to the charts, I have a Mars return coming up very soon.  I did some research to find out more about what I can expect.  In laymen's terms:  A period of high physical energy, increased inclination for conflict and accidents, a greater probability of run-ins with authority figures, particularly men, and a deconstruction of perceived conventions which I will soon discover are defunct.  Having more energy is always appealing, but unfortunately the rest of the forecast doesn't really sound like an easy weekend.

On the other side of this equation is another energy system:  my twice-weekly appointment with my favorite local acupuncturist Diana Vuong, whom I have known for almost ten years.  Her knowledge of the meridians extends beyond the body; she can also relate discontents with your health to nature and the cosmos.  Not that she means to be a mystic, it is merely a result of her very thorough training in China.  For example, just as the year is divided into the zodiac in western astrology, traditional Chinese medicine divides the year by the organs:  Fall is lung season, Spring is kidney season, and so forth.  Babies born in the fall, for example, tend to be more susceptible to weakness of the lungs.  

Knowing this, would it be possible for Diana to diagnose that I'm experiencing a Mars return?  Would my pulse be different, my elements be too hot or dry, and my liver chi be stagnated?  Furthermore, would she be able to counteract Mars in my body with needles and herbs that strengthen, say, Venus and the Moon?  And by cooling my life energies, could she spare me from potential hardships which might teach me about the nature of Mars?

I am going to give it a try starting this week.  I will let you know if and how Diana's treatments abate the affects of the red planet's return.

Visit these links:
Excellent acupuncture in Downtown San Francisco: 
Diana Vuong, LAc

Humanistic astrology in San Francisco:
Jessica Murray is a woman who possesses the wisdom of the ages.  And I know that she would have my hide for writing so simplistically about astrology.  What she teaches is infinitely more complex.  Highly recommended.

Wednesday, April 6, 2011

Rolfing and Body Weight Part 2: The Vocabulary of Beauty

"You know something strange," the woman in my office started to tell me, "Ever since I started getting my Rolfing sessions, people keep asking me if I've lost weight.  But I haven't.  I keep getting comments like 'You look great!  Did you lose weight?'  What's going on?"

This happens, I've heard about it many times.  People who receive Rolfing do look better, and most of the time it has nothing to do with weight.  But our society lacks the proper, sophisticated vocabulary to talk about wellness and health.  Instead, we are bombarded by media that grunts in the primitive binary language of "fat" and "thin", and the only verbs are "lose" and "gain."  Thus, we observe the phenomenon that the word "thin" is equated with "beautiful."  It is no wonder, then, that words that relate to body weight are the only words most people have to talk about our appearance.  That said, it is true that some people who go through the Rolfing series not only feel longer and lighter, they also look longer and lighter.  For example, it certainly flatters the figure when the shoulders aren't hugging the ears anymore.

In any case, I'd like to introduce a few words to your vocabulary that refine the concept of looking good.  They are also words that we Rolfers use amongst each other to describe what we see.

"Embodied."  To be embodied is such an important part of holistic wellness that a good third of the Rolfing training is dedicated to this, called Embodiment.  It means "inhabiting the body", or, in daily speak, "being present."  We all know what someone is like when they are emotionally absent, but we Rolfers can also detect when someone is physically absent in their bodies, even in localized parts of their bodies.  A person who is not embodied can be described as stiff, out-of-touch, or awkward.  People who are embodied, on the other hand, are graceful, expressive, and possess something called body awareness.

"Oxygenated."  Also commonly known as "glowing."  We commonly witness oxygenation on a person's face, maybe after a yoga class or eating a bountiful green salad.  But true oxygenation is more than just rosy cheeks; it's an overall peachy, supple complexion (compared to the middle-aged smoker's pallid skin).  Individual body parts can also be inadvertently deprived of oxygen through muscle tension or bad posture so that they fail to glow.  I see this most often in lower legs and feet, or even in lumbar regions of the back, as well as, of course, the face.  During a Rolfing series, as the body's magnificent parts begin to co-operate, not only is there greater embodiment, but also a visible quality of glowing as the legs, back, and other hitherto neglected muscle groups are flooded with oxygen.  Often referred to as "looking younger."

"Innervation."  Innervation is the biological process of nerve growth and maintenance that leads to grace and mobility.  Imagine that you have one room in the house which you never use.  Eventually, dust accumulates, and over time you find that it's economical to turn off the electricity and heating in that room to save energy.  It turns out that your body thinks the same way about nerves and tissues:  Use it, or start shutting it down.  So when parts of your body are immobile, why continue supplying those muscles and tendons with expensive nerves?  I see this most often in people's feet, which have sometimes been so cooped up in shoes that they become stiff and paddle-like even in their leisure time.  The result: the person hobbles like a stick figure.  However, Rolfing not only restores long-lost movement, but also gives the entire body function.  Thus, once a person begins using the foot properly in walking, the entire body above it moves more gracefully. 

"Range of motion."  We usually only hear this in relation to shoulders, hips, and neck.  But is also applies to all the hundreds of joints in your body that add up to how you function and move.  Your diaphragm also has a range of motion, in all directions, and a decrease affects how much oxygen you breathe in.  There is also range of motion in the spine, which should undulate with every step.  When the many articulating surfaces of the spine become immobile, people start to lurch or hobble.  Rolfing releases this, so I often observe my clients becoming slinkier and more fluid.

Does graceful, slinky, supple, and fluid all sound good?  I agree, and I'm grateful that bringing these qualities into other people's lives is my job.

"Well, you certainly look embodied today!"

Sunday, March 20, 2011

The Hospice Front: House of Morphine

"When do we reach land?"  The elderly gentleman in the armchair asked me.  He was wearing plaid flannel pyjamas and blue house slippers.  His metal walker was situated next to him.  We were in the dining room downstairs at Coming Home Hospice, a little yellow house located across the street from Most Holy Redeemer Church in San Francisco's Castro district.  I had just introduced myself to the patient.  He was new here, apparently suffering from dementia, and with his question I realized that he believed we were all passengers on a boat.

So I replied, "Saturday."

"Aren't we supposed to be off the coast of Mexico?"

"Yes.  We're going to dock in Los Angeles in two days."

The conversation continued, and I found myself surfing upon the story lines of his reality.  We were cruising along the Pacific Coast with two other (invisible) couples, and he was supposed to pick up a friend's boat in San Diego.

By definition, a hospice patient has six months or less to live.  This end-of-life diagnosis from a physician is required for admission to such a facility, which delivers 24-hour medical supervision and personal care that loved ones are unable to provide.  Some patients outlive this diagnosis and may reside at hospice for a year or more, but nevertheless the average hospice stay in our fair city is a mere eleven days.  Therefore, whenever I meet someone at Coming Home, I expect that our acquaintance will be brief.

Such conversations like the one with the cruise-ship passenger in the dining room are common.  In my short time at the hospice so far, I've had lengthy conversations with patients who believed that they were living in a 100-unit apartment building with noisy neighbors (quaint Coming Home has a mere fifteen beds), or who were permanently suspended in the 1940s, or who communicate with invisible people and animals in the room.  Some of the patients are young, and many are alert and clear-headed for a while, but for most of them, the combination of dementia, the exhaustion from their illness (mostly cancer), and the effects of medications slips them into their own private dimensions where a visitor can only join for the ride.  

In speaking with the dying, I wish I were as graceful as the hospice nurses and other employees at Coming Home.  But after talking with a handful of patients, they have taught me one thing very quickly:  Accept their reality.

To put it briefly, the last weeks and days of life are not the time to argue with someone.  Thus, if a patient thinks that the room is crawling with black-and-white puppies, then let it be.  If she believes that there is a Mexican fiesta making its way down the corridor, then she's right.  By the same token, if the patient believes that his or her end-stage cancer will be cured against all odds, and is looking forward to "moving back home and going back to work", then I play along.  I never ask them about their illness.  If they want to tell me why they're dying, they will.  And some even insist that they are healthy.  But there is no point in correcting their reality to fit mine.

We also have to assume that someone has already attempted to steer the patients' reality back to the middle lane.  The most obvious response of family and friends to so-called jibberish is "Honey, what are you talking about?  You're going crazy."  And indeed, some patients at Coming Home apologize to me for speaking nonsense or being a little nutty, or perhaps even rave about the "grooviest trip" they've ever been on, and still others have no short-term memory left so they meet me for the first time every week.  In any case, they can't help it.  So the best one can do is explore their worlds with them.

Then comes the day when the fantastical adventures vanish and the talking, clear or hazy, ceases.  I arrive at the hospice and check in with the nurse in the staff room to ask if any particular patient needs attention.  And often the answer is something like, "The patient in 206 is actively dying."  Active dying is the body's natural process of shutting down its systems in predictable stages: refusing food, rapid weight loss, cooling of extremities, periodic agitation, shortening of breaths.  No more talking, nor more eye contact, and ever dwindling consciousness.  Only labored breathing and foggy gazing into the distance.  And no turning back towards life.  So my duty is to sit with that patient in silence because often times he or she has no one else.  We all envision ourselves dying in the company of loved ones, but a hospice is where patients come when if don't have anyone.  Thus, I may be their company on that day.  I go to their room, pull up a chair, place my hand on their hand or arm, and wait.

When the last hours arrive, the nurses coming into the room subtly shift gears, and the morphine flows freely.  Many of the residents are cancer patients whose tumors have grown invasively large, pressing excrutiatingly on organs and nerves.  Pain management is the goal now, and more than ever, this is no time to argue; a dying patient in pain cannot be wrong.  And for non-cancer patients, the discomfort of fluids accumulating in the throat and lungs as organs shut down is likewise relieved by the magic liquid morphine.  The patients are monitered closely for groans, grimaces, and writhing, all non-verbal signs that another oral milliliter is necessary, administered by the nurses who are intimately acquainted with the stages of dying.

When was the most recent whimper?  Is she gripping her fists?  How long are the pauses between breaths?  The hospice staff is watching as they deftly flutter from room to room on their rounds, and sometimes the nurse will sit with the patient for an hour or so.  It is an incredible thing to watch.  As the patient's body knows exactly how nature has programmed it to die, the hospice workers help to bring them in gently for their final adventure.

Monday, February 7, 2011

Tango for Life: Treating Alzheimer's with the Ocho

The Ocho Step may save you.

Americans are slowly waking up to the daunting reality of Alzheimer's.  In the family of cognitive illnesses that strike the elderly, Alzheimer's is the mother of all dementiae.  At the moment, an estimated 5 million Americans live with it, compared to 1 million patients with HIV, and with the gradually escalating age of the Baby Boomers, this number is projected to hit 10 million by 2050.  It's an illness which devastates the patient and exhausts the caretakers for a time-span of anywhere from five to twenty years.  And there's no cure.

Thus, a few weeks ago, when I found myself in a conversation with an Alzheimer's researcher, I was excited.  Surely, she had to be in the know of the cutting-edge developments.  I therefore couldn't resist asking her, "So, what are the most promising avenues for treating Alzheimer's?"

I expected some variation on the usual list of jargon: crossword puzzles, musical instruments, foreign languages, and a sprinkle of ApoE4.  But her answer surprised me.
"Well," she started, sounding exasperated from a years of tedious research, "It's been pretty bleak, but what has shown the most promise until now is tango."

Really?  Tango?  She even proceeded to back up her answer scientifically.  "It's the combination of complex movement and mental stimulation" which appears to provide a veritable soup of nutrients that prevent brain cells from hardening into the infamous amyloid plaques that characterize Alzheimer's.

Furthermore, a dance is not just a dance.  In recent studies on mobility, memory, cognition, and depression, tango consistently equaled or significantly outperformed American Walz, Foxtrot, and even Tai Chi in reducing symptoms.  This would be because of the endless intricacies of tango which continuously challenge the brain at all levels.

Listen to this touching report on tango, including an interview with Dr Patricia McKinley, a professor for kinesiology at McGill University, on PRI's The World with Richard Reynolds.  It will make you want to get your dance shoes on and learn the Ocho, for your future.

To see local tango afficionados from twenty-something to seventy-something showing off their √©lan, I highly encourage you to stop by Adolfo Caszarry's Thursday night Milongas, held weekly at San Francisco's Verdi Club.  A free class for beginners takes place before the party begins.

Thursday, January 27, 2011

The Hardest Cold Call: Dispatch from the Hospice Front

Coming Home Hospice at 115 Diamond in San Francisco's Castro neighborhood.

You think that cold-calling a potential employer during a recession is hard?  Then try this on for comparison: the first day working at a hospice.

Firstly, I'll clarify exactly what hospice is.  A hospice is a facility for the care of terminally ill patients who have been diagnosed with six months or less to live.  The average stay at hospice is 35 days.  Besides the length of stay, hospice differs from a nursing home in that hospice medicine – medical care for people who are at the ends of their lives – is geared towards patients who don't have much time left.  Pain medication may be given in higher doses, treatments can be specified for end-of-life symptoms, and, at the decision of the patient, family, and doctors, no aggressive curative treatments will be undertaken (commonly chemotherapy, surgery, or antibiotics).

A hospice is a a place where dying people live.  And I'll tell you about my first day volunteering at one of them.

The staff at Coming Home Hospice in San Francisco, a quaint former convent in the Castro, consists of nurses, social workers, and doctors, as well as cooks and housekeeping staff.  Then there are patient-care volunteers whose job it is to make the rounds and talk to any residents who are lonely.  Last week, that was me. 

I showed up for my first shift knowing that I wouldn't receive many instructions, as the staff are busy and so volunteers are left on their own.  However, the head nurse informed me, with a sympathetic wrinkle to her forehead, that one resident was "actively dying" (systematic organ failure, analogous to a computer shutting down its programs) and although he wouldn't be responsive to a visitor, I should sit with him.  I walked into his room.  The blinds were pulled so the morning sun only came in faintly through the slats.  A very thin man was sleeping, breathing  heavily in a hospital bed where his willlowy arms and legs were virtually lost in the folds of the blanket.  I said his name, to which he didn't respond, and sat in a chair next to him.  There was nothing to do but be with him and listen to his rattling breath.  I was waiting for the grass to grow, and he was waiting for death to come.

One hour past.  I left his room to walk around the residence.  Breakfast had just been served, and through the doorways of the single-occupancy rooms, I could see that tray tables with the remains of eggs, oatmeal, and coffee stood beside the patients' beds.  The rooms are arranged such that the patients have a view of the window, meaning that I couldn't see their faces from the doorway. 

But from where I stood, it seemed like they were all asleep, maybe taking a post-breakfast nap.  Most of the residents were older, and all were thin.  None of them looked like they wanted to talk to me. 

I returned to the first floor, where I encountered Rich, the hospice director.  He asked how I was doing.  I told him that the residents all appeared to be sleeping.  He nodded, curled one side of his mouth upward and said, "You never know, you just never know."

Never know what?  It took me a while to understand.  But then I realized that he meant we never know if a dying patient, who is restricted to a hospital bed, is sleeping or could indeed use some company.  Imagine the following scenario and you will also understand:  you are given the prognosis of having less than six months to live.  Your body is failing you, you can't stay at home anymore, and so you move (or are moved, by your family) into a residence where nurses can tend to you around the clock.  Not many people come to visit, and within a very short amount of time – even a week – the monotonous passage of days eludes you until it is impossible to say how long you've been there.

So, the best you can do is close your eyes.  And hope that you sleep.

A hospice resident who appears to be "resting", therefore, could be seen like a telephone receiver in its cradle.  I had to learn – gently – to pick up the phone and see if anyone was there who wanted to talk.  I'd have to learn to walk into a room, pull up a chair, introduce myself to the closed eyes of a patient, and be ready for a grateful response, or a grumpy answer, or no answer at all.  It was like a cold call to the spirit of a dying person.

I will periodically report on my volunteer service at Coming Home Hospice.

Thursday, January 13, 2011

Happy New Year!

 I wish all of you a healthy and prosperous 2011.

Please note the following announcements:

  • As always, I support performing artists and educators, as they are often people who benefit greatly from Rolfing but are often discouraged by the price of bodywork.  This year, I am offering a special package for a reduced rate to complete a Rolfing 10-session series by July 31, 2011.  Please see here or  contact me for details if you are an artist or educator, or if you know someone who would qualify.  I look forward to helping those who contribute to this city's liveliness.
  • Some of you already know that as part of my Buddhist practice I am involved in (and fascinated by) end-of-life care.  This year I am volunteering at Coming Home Hospice in San Francisco, which has been one of the nation's role models in providing compassionate care for terminal patients and their families for 23 years.  I am happy to talk to you about my experience and about end-of-life care in general, so feel free to drop me a note.  If you would like to donate to Coming Home Hospice, visit their homepage here.