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I eagerly anticipate returning To Bethany Spirituality center this week to resume the Wisdom School Experience with Cynthia Bourgeault and the crowd from the eastern seaboard.  It will be our second gathering. 

The first was one of the most memorable experiences I have participated in.  I went with some trepidation because I had not been practicing Centering Prayer as much as I had wanted and felt like I might be  a bit behind everyone else.  The bottomline is no one but you and God knows what happens to you when you “sit” and we were not there to dissect our practice or share our practice experience.  

We came for all sorts of reasons.  What we experienced was something very special and unique.  From all sorts of backgrounds and geographic locations we spent five days living the Benedictine Rule  of prayer, mindful work, healthy eating, learning and silence while living in community.  Guided by very wise and articulate Cynthia, we looked at our relationship with  God in a very different way.  God is within us and not outside of us and the way to God is through quiet centering prayer–Surrendering to God, resting in the arms of God, and trusting that God knows best what we need and will sort it all out if we just allow and Be.  Easier said than done sometimes.
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We explored the concept of Perennial Philosophy–”There is no God, but God”. The One who comes to us in the way that we need to see or hear, accepting of all.  We explored the idea of the spiritual journey that all of us on earth are on–but how we are all in different states of awareness about that journey and at different places along the path and that it is all ok.  We practiced chanting and I learned how physical that kind of music making can be–effecting every cell of the body.  We started to learn Turning prayer–something we will return to this next time. 

 

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Preparation for breast cancer surgery starts long before the patient reaches the operating room for both the patient and the surgeon. 

I have made it a habit to call patients at home with the cancer biopsy diagnosis as soon as it is available to us—usually within 48 hours.  Most of the time, I have performed the biopsy myself in the office using minimally invasive techniques and have developed a rapport with the patient. 

Chit-chatting about things that are important to the patient e.g., children, grandchildren– while doing the procedure helps me develop that rapport (as well as serving to distract the patient from what I am doing).  

 

I know that a phone call may not be the perfect way to give “bad news”, but on balance it seems the best way.  These women are waiting for the answer.   The phone call resolves the uncertainty immediately. 

The patients are at home in a private, safe environment, usually with family and friends to offer hugs and support.  And they don’t have to be concerned about walking out through my waiting room stunned with tear stained eyes.

Another real benefit is that when they do come into the office, the shock and sadness have receded somewhat and they’re in a much better position to talk about just how we’re going to take care of this problem. 

I don’t want the cancer diagnosis to be a surprise to patient.  If I am fairly certain that a mass is cancer, I will tell them that early on.  That concern eases the transition to a diagnosis. It also lets them know that I will be honest with them.  In my experience, most people don’t want things sugar coated – they want an honest opinion. 

Having said no sugar coating, I do always try and find something positive to say about the diagnosis, and  – believe it or not -  you can. 

If it is small, or noninvasive, I emphasize that.  I emphasize that the breast can usually be conserved.   

If it is Estrogen receptor positive, I emphasize the better long term prognosis and the ability to treat with hormone blocking agents. 

If it is an aggressive tumor, I emphasize the better response to chemotherapy because the cells are more rapidly multiplying and have more cell cycles for chemo to work its magic.    

After that phone call with a brief discussion of options and outlook, I meet with the patient and her family or friends in the office within a day or two for a very intensive discussion.  As you can imagine, it’s a very intensive discussion.

We discuss surgical treatment options and map out in general terms what lies ahead.  I break it down into phases of treatment—surgery, post surgery adjuvant therapy, and long term treatment.

I focus on the “one step at a time plan”, which really does make sense.  Otherwise, it overwhelms very quickly.

After the technical questions are answered, we get down to the heart and soul of the matter.  Patients are understandably anxious and wary.  I try and set a few psychological ground rules.  I tell them that having breast cancer is not a death sentence.  Yes, I say the word death out loud so it is not hovering unspoken in the room. 

I ask them to stop imagining scenarios that may never happen.  I emphasize that thoughts are powerful and your body can’t tell the difference in what is real or imagined.  By that, I mean that different emotions cause the release of different chemicals from the brain.  Imagined trauma releases the same chemicals as real trauma and has the same negative effect on the body.  That is not what a body already under stress needs. 

Women say I can’t help it—it is just the way I am.  I ask them to try and at least identify when they find themselves going into that worry mode—and say to themselves—STOP–DON’T GO THERE—to exercise the control they really have. 

I also use the phrase coined by one of my favorite authors Joan Borysenko—don’t AWFULIZE!  Patients often will smile at that and get the point.  

This does not mean that a woman should not grieve for herself and the effect that this illness will have on her family. It does not mean she has to be continually positive.  She needs to be able to express the emotions of the moment openly and honestly.  Sometimes it takes a good cry in the arms of a loved one to accomplish this task.

We end this session together with gift giving.  My practice provides a copy of Dr. Susan Love’s breast book to our breast cancer patients.  My own book is on the way. 

I also give them a guided meditation that I recorded to use repetitively before their surgery.  This teaches about the relaxation response—an innate antidote to the stress response we are all so familiar with and leads them on a pleasant journey which helps decrease blood pressure, pulse rate, respiratory rate and decreased stress hormone response. 

The second part leads the patient in a progressive muscle relaxation and speaks of a being part of a loving universe. 

I tell them about studies that have shown a benefit in decreasing perioperative anxiety, blood pressure levels during surgery, postoperative pain requirements, and length of hospital stays in patients who practice these techniques.  

One of my patients has also started a nonprofit organization called Positively Pink that provides a lovely bag of gifts – from journals, to soothing music, to healing books –  because she wanted every patient diagnosed with breast cancer in our town to know that they were being thought of. 

This gift giving often brings the patient to tears—a random act of kindness.  I encourage patients who have a spiritual practice to step up their activity—whether it is yoga, rosary praying, or prayer circles. 

And so the journey begins.   
         

 

 

 

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Surgeons, in my opinion, are very special people, but very left brain, concrete and visual.  We seek instant gratification.  We want to see the pathology that causes the belly ache.  We glow with satisfaction witnessing how well the appendectomy patient feels after the nasty appendix is gone—even with an incision. 

I tend to be particularly stubborn. It takes something as dramatic as a lightning bolt to change my way of seeing the world.  In the early 90’s, the lightening bolt hit me.  My husband, also a surgeon and visionary dragged me—almost kicking and screaming to a Tony Robbins seminar in East Brunswick, New Jersey.  The participants were  1000 wild and crazy New York City- Bruce Springsteenish kind of crowd.  The seminar included a FIREWALK?!

I agreed to go to the seminar, but I would never—NO WAY-ever, ever think about doing a  Firewalk.

I had no idea what was in store for me.  Tony Robbins is frighteningly charismatic with his physical (6 feet 7 inches) stature, stage presence and movie star good looks.  Halfway through his dynamic discourse, there was no way I was NOT going to do the Firewalk.    I went to the bathroom, took off my flammable pantyhose and tied up my long skirt so it and I would not go up in smoke.  

The mesmerizing part of the evening began with the lighting of the huge bonfire in the hotel parking lot that would eventually burn down to be our hot coals.

Tony led us all in a guided meditation where we imagined ourselves at our physical best.  I had just learned how to row a scull and felt quite accomplished.  It had not come easy to me.  I envisioned myself gliding through the water– oars entering the water without a splash, the seat of the racing shell gliding back as the strength of my legs added to the movement through the water.   I held that feeling of accomplishment in my cellular memory able to be recalled at will.  I was coach to  create a power move that would help recall that memory.  Mine was bringing my fist down through the air and saying to myself—YES!

We were then given our very specific instructions.   Maintaining our meditative state, we (all 1000 of us) walked in silence through the halls.  Primeval drums played in the background.  We were told to look forward as we walked, not look down at the hot coals, and chant the mantra—Cool Moss, Cool Moss, Cool Moss…..

In the dark, in state, I recalled my power move and lined up behind a row of burning embers and walked for ten feet– chanting, looking forward, slowly, deliberately, listening to the rhythm of the drums.  As I walked, there was no sensation of heat, no pain and when finished—no blisters.

How can that happen?  How can one walk on hot coals and not hurt? 

That is what changed my life—the amazing power of our minds to influence pain perception and change the body’s normal physical reaction to hot, burning coals.  If that could happen, what else was possible?  It turned my left brain mind upside down and it has remained open to possibility since that time.  I paid attention to the reports of melanoma patients living longer after learning relaxation techniques and end stage breast cancer patients living longer after learning meditation techniques with peer support.  A new and exciting phase of medicine was opening up for me.

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