cpap-marilynmonroeLately going to sleep felt as though I were at a cinema playing The Bourne Trilogy in a continuous fast-forward loop, in other words, chaotic, confusing and pointless. The only rest from these disturbed dreams were the multiple trips to the bathroom in the night. Ah, how I missed those childhood sleeps, when I woke with my eyelids glued shut, surprised that so many hours had passed by without my knowing. Oh, I employed all the usual tricks of good sleep hygiene: no TV one hour before bed, meditation, no eating four hours before bedtime, sleep in a dark quiet room, experimented with pillows and posture. All these things helped for a time but the disturbed sleep got gradually worse. Then my cardiologist insisted I go for an overnight sleep study. No, he did not advice me, he booked the appointment and ordered me to go. My cardiologist has been known to use threats, blackmail, waterboarding, whatever it takes to get his patients to do right and I love him for it.

Off I went to the sleep lab, which did not take long as it was literally across the street from my home. The technician joked that perhaps I could sleep in my own bed and he would run the tubes and wires out the window and into mine. I had enough tubes and wiring attached on my scalp and my legs to bring Frankenstein back from the dead. Throughout the night the technician monitored every twitch, each turn, my heart rate and my breathing. When the results were analyzed by my newly appointed sleep specialist (I now have so many doctors in my circle of acquaintance that I should qualify as upper middle class) it surprised no one who has heard me snore that I had severe Sleep Apnea. About once every minute I stop breathing in my sleep, which explained the disturbing dreams, my mind actually needed me roused so we could breathe again. The way my throat, jaws and gullet have shifted with age, even just lying supine causes my breathing to constrict. Though the young can also experience sleep apnea, it does become more problematic as one gets past age fifty.

“There is nothing else for it,” she said, “you will have be on a CPAP machine for the rest of your life.” I yelled NOOOOOO!!!, then picked up my chair and smashed it through her surgery window. My neighbor, an old man of eighty-five, has one of those CPAP devices. When he dresses for bed he wears Hazmat headgear attached to a Hoover vacuum cleaner circa 1952. He says the noise from his sleep machine keeps him up all night. He is a cardiac survivor and long term, untreated sleep breathing obstruction was a major factor in his heart disease so he puts up with it.

Much for the same reason, I reluctantly went to be fitted for a CPAP machine. Being the Luddite that I am (no cellphone) it was a genuine surprise to me that technology has come a long way. The new CPAP devices are quiet and portable. The mask I chose resembles an oxygen tube they put under your nose when you go in for surgery.

Over the months there were a few side effects that I resolved through research. CPAP machines can make you gassy, high pressure air is being forced into your nose and throat to keep your air passages open, and you can’t help accidentally swallowing some of it into your stomach. The built-in humidifier can get steamy in the summer if you don’t turn it down (resulting in wet mouth). In the winter you might get the sniffles if you forget to turn up the humidifier for the season. But these glitches are minor compared to the uninterrupted and restful sleep I am now enjoying.

They say one in five adults live with untreated sleep-disordered-breathing (SDB). SDB has been blamed for early onset of beastly conditions such as Parkinson’s, Alzheimers, and diabetes, as well as traffic accidents and obesity. Luckily, treatment is getting slicker and more practical, though it is still shamefully unsexy. When Marilyn Monroe was asked what she wore to bed, she replied, “Channel Number 5.” We now know Marilyn had a sleep disorder which led to her depression. Had she forgone her sexiness for CPAP therapy she might well have replied, “Why, a Resmed Airsense 10.” And she could have survived to a ripe old age!



Strong mind, strong body?

Strong mind, strong body?

When Toronto’s combative Mayor announced his cancer diagnosis, a chorus of sympathy arose from supporters (few) and detractors (many) alike. They sang from the same hymn book, so to speak: “He is a fighter, he will beat this.”  It is a sentiment I hear routinely at the cancer hospital from the families of patients. Once upon a time the mind-body connection was the stuff of fairy tale. Yogis trampled upon by herds of elephants and surviving unscathed. Daredevils chained in underwater cages escaping certain deaths. Mind over matter, we were told to our amazement.

Now, the whole notion of mind-body and healing has come to be accepted as mainstream. (Thank you, Deepak Chopra. Take a bow, Miss Oprah). The problem is, in our haste to be enlightened, have we failed to think things through?

Whenever a terminal diagnosis is given, it is warm and fuzzy to believe that  my loved one (or I) will beat the odds because he is strong-willed, or because she has the faith of a saint. We somehow take is as gospel that there is a kind of jihad going on between the body (which is falling apart) and the mind (which is struggling to keep it together). So the logic goes, think postive thoughts, stay cheerful and determined, and this fatal illness will be defeated. What we conveniently ignore is that the body is born with its own destiny: it is in our DNA. Yes, a happy mind is good for your well-being, but worry does not grow tumors in the brain, hatred does not clog up the arteries of the heart. Were wishes indeed powerful enough to overcome DNA, trust me, I would be six-foot four! And if being “young at heart” were enough, Viagra need never have been invented.

Think of all the thousands of hospitals in the world: almost every patient who enters their double doors have some pretty solid reasons to live (children, youth, or simply the universal urge to survive) yet not every patient will leave the hospital alive. I once heard a patient (a Jehovah’s Witness), say to his roommate, (a Hindu), that if he were to accept Jesus as his saviour his cancer would vanish. (Hey buddy, then how come you are also tethered to a chemotherapy IV?) If we could cure ourselves based upon will, or the power of faith, cemeteries need never exist.

Where the mind does have a gigantic clout however, is in our habits, which have everything to do with healing. A mind trained in self-discipline will effortlessly adhere to a medication regime. A self-controlled mind will exercise the body without fuss, it will not struggle to choose nutritionally beneficial foods, and perhaps most importantly, such a mind will shut off when rest is required. If, on the other hand, say your mind fights obesity and fails, perhaps it is powerless to keep its promises to stop drinking into alcoholic stupors (or crack-laced tirades). Seriously, can such a mind be considered “strong” enough to fight a fatal diagnosis? (Are you listening Toronto?)

I am reminded of my late guru, the great Swami Chinmayanda, who, when I met him, was globetrotting with three-quarters of his heart dead. The last cardiologist who examined him exclaimed: Why is this man even alive?  Those of us lucky enough to have observed him closely knew the reason. His was a very strong mind indeed, his discipline was the opposite of that of Toronto’s mayor. He could catnap at will, he could slow his heart rate to almost nothing, make his breathing almost invisible. I had the opportunity to quiz him about his seemingly miraculous control over his body. He shrugged his shoulders and said, “The body will do what it needs to. Rise above it. Don’t get too concerned.” His words sounded abstract at the time, but strangely personal.

Little did I know then that twenty years later I would be in a coma with the same cardiac condition as his. Many factors helped me but key among them were years of training in disciplining my mind. As long the mind is in conflict with the habits of the body, it will bring pain. His words helped me to accept the outcome of the body, whatever it might be. My mind reached a place of quietude which, ironically, calmed my heart rate enough for the body to recover.

Sadly, I have witnessed patients struggle to the bitter end because their mind was never trained to let go of the body. Any kind of conflict is painful, be it the struggle to adapt habits or the conflict to deny the inevitable. They died in greater agony than was necessary.

There is indeed a body-mind synergy but it exists at the foundation of the conscious mind. With practice anyone can learn to access the common foundation of both the body and the mind through ending conflict. In other words by learning to let go gracefully, the miraculous is possible. Though even this has its limits. Ultimately, Swami Chinmayananda’s body succumbed to its destiny. None is immortal. There is nothing any of us can do except learn to be at peace with this. Now that is strength.





Is Imperfection A Blessing?

December 23, 2013

DSCN2329_1304The dinner table looked fabulous. The centerpiece was formal yet festive. The cutlery sparkled and its layout would have made the butler on Downtown Abbey proud. Each dish served tasted exactly as it was supposed to and the conversation flowed as easily as the wine. Then one of the guests returned from the bathroom and requested a  toilet plunger. Never a good thing! Amidst all this sophistication, despite the attention to perfection, the drains chose to back up grease and gunk.

At first it felt like a slap in the face. But the more I thought about it the more grateful I was for this toilet disaster. That night, before I retreated to bed, I sat for a few minutes to empty my mind of the day’s events. This has been my routine for many years and I find it helps me to sleep well. Except on occasions when the day goes all too perfectly. Days when there is an abundance of joy, it is very difficult to turn my back on the day and retreat into the rest of sleep. The mind wants to relive the day. Despite a tired body’s demands, the mind recalls again and again each and every perfect moment.

On this night, even though the evening was a great success otherwise, I was able to shut it out from my mind because of this one mishap. So might there have been a technique for getting a good night’s sleep thrown up the drain along with the debris? Perhaps the secret to unwinding, the trick to falling into effortless sleep might be to find the small failures in the greater successes, the little sadness contained in that triumphant news. Oh I don’t mean one should cultivate an unhealthy pessimism, merely that whenever we desire to unburden the mind, we can use this little trick to stop it from ruminating uncontrollably.

 As a long-time meditator I appreciate the bliss of mental stillness, the other-worldly peace of inner nothingness. In the beginning I too used to be frustrated by daily upsets and routine worries. Strange that novices always seem to give attention to negating the bad stuff. They struggle to forget the unpleasant encounters, they labor to push back stressful memories. But in my experience, the ugliness of life is much easier to reject, it is the pleasant and the perfect that seems to take up permanent residence in the mind.

I can’t count how many young cancer patients I have encountered who are fearful of death precisely because they grieve the loss of all the happiness they have previously enjoyed. Not a one of them regrets leaving behind financial worries or the physical misery of old age. It is the love of their families they mourn to leave. It is the absence from their daughter’s graduation, the non-attendance at the son’s wedding that brings emotional pain. Misery is something we forget naturally because our pride forbids us from revisiting old failures. Yet we indulge in what I will call crudely (but aptly) mental masturbation upon the happy successes in our life. Unable to let go of the happy and the beautiful, we then  complain: meditation is so, so difficult.  

The other day I wished a patient at the hospital a Merry Christmas simply out of polite habit. He glared back at me with a frown and then said, “Everyone is pressuring everyone else to have a perfect Christmas.” He then collapsed exhausted into his bed. I understood his frustration. Christmas, more than any other holiday, is supposed to be greeting card perfect: a light dusting of snow, a warm fire, a cheerful array of gifts under the tree and of course, congenial family sharing quality time together. No wonder Christmas has the highest suicide rate of the year. Many have no one in their lives. Some are too sick or too poor. And those of us who will attempt a Disney celebration will encounter clogged drains and other disasters.

And thank heavens for them. They are reminders of the imperfection of daily life. No matter how carefully we plan, we just can never shut out the ugliness. I was rather amused by a news snippet about the six-hundred-million-dollar lottery jackpot in the US recently. The news report suggested the lucky winner could purchase a Fijian island with his or her winnings. The unchallenged implication was that with enough money one could buy oneself a piece of paradise. What an awful idea.

Anyone who has experienced the perfect stillness of the mind will attest that that itself is paradise.

Famous Last Words?

December 2, 2013

A merry widow

A merry widow

“I told you I don’t want to talk about this any more,” Irving shouts into his cellphone, the strain of which unleashes a coughing fit. I hand him a glass of ice water from his lunch tray which, as usual, is uneaten but thoroughly picked over. The old and the sick seldom have good appetites. “And the same to you too!” he shuts off the phone and throws it upon the bed. “Damn gold digger!” A green knot of veins threatens to burst through the paper skin of his neck.

A television is speaking in the background; it is set to one of those 24/7 news channels that continuously run a scroll of the stock market numbers. His red-rimmed lizard eyes dart back and forth catching the scroll. Wiithout looking away he reaches for his vial of pills, but knocks them over. As I pick them up off the floor he again coughs heavily, then apologizes by saying he has been a four-packs-a-day smoker since he was a teenager. Irving is in the end stages of terminal emphysema.

“Doesn’t matter,” he swings his naked legs from the side of the bed like a petulant child. “I’m eighty-six. Its not as if I’d have  more years without it.” They are as pale and fragile as dessert grass. After a moments pause, he has another little moan about his wife, with whom he had been quarreling over the phone. “I’m not even dead yet and already she is decorating her next home in her head.” She is much younger than him. I imagine her as a classic trophy wife, all jeweled and coiffed as she escorted him to his soirees with politicians and CEOs. Hard to imagine that this frail Gecko of a man once held sway over the destinies of people like me.

Mid-sentence he is distracted by the television. “Damn, Blackberry is down again.” It turns out a chunk of his fortune is invested in those stocks. By the the time the nurse brings the replacements for his pills, he has clear forgotten about them. “What are these for? I already took my pills.” I remind him that he had not. I rewind the events to when he ended his phone conversation. “Oh that gold digging floozy.” He sets off on another tirade about her, and then back to complaining about the bouncing Blackberry stocks.

By the end my visit the tone of his voice has softened. “Will you come and see me again?” I promise him that I will, and true to my word, I begin my next shift by heading to his floor. I am surprised to see that another man is occupying his room, sleeping in his bed. I locate a nurse and ask if Irving was discharged. “No,” the nurse gives me one of those apologetic, pursed smiles. “He passed away.” As volunteers we expect to lose patients, but we still feel a certain sadness about it. As I walk away I couldn’t help wonder, what were his last words? “That damn gold digger!” or perhaps his last thoughts were about the future of Blackberry? I can’t decide which is sadder: that he is gone, or that he spent his last days and hours stressing the banal?

Death is very rarely (if ever) the way it is in the movies: all angel choir and violin crescendo. More routinely there is a cacophony of  arguments, stress, and worries for a future in which you have no part. I think many of us have a fantasy that our last words will be something profound.

“It is very beautiful over there,” said Thomas Edison on the moment of his death. “I see a black light,” reported Victor Hugo. We imagine in our dying breath the mystery of life will be self-evident. Perhaps one may commune with his or her personal god. But as I walk away from Irving’s last place of unrest, I wonder if that is even a realistic expectation?

I mean, many people do not have the same luxury as Irving had had: death will come to many unexpectedly. As it did for a healthy young woman named Soraya Nanji. She was crossing the street on one of the busiest intersections in Toronto. “Well, have a great trip,” she wished her friend on the cellphone. A truck hit her. She was dead.

Over her grave, mourners wished her, “Rest in peace.” And perhaps Irving’s merry widow might raise of glass wishing him the same. But shouldn’t we have wished them that while they were still alive?

outofboodySandy is young, bubbly and very sick. Once in a while I get to meet a patient as thoughtful about her sickness as Sandy. She, like many other heart patients and trauma survivors, have experienced what is commonly (and wrongly in my opinion) known as Out-of body experiences, or OBEs.

You break through the limits of your own body’s senses. You experience sights, sounds, memories and feelings that do not belong to your own body or mind. You inhabit the universal and that includes your body lying there on the bed. In fact I think the term out-of-body is an oxymoron because in this state of hypersensitivity you experience sensations within your own body much more acutely. Once you have experienced the world from this perspective, you cannot ever see the world in the same way again.

Out-of-body experiences, or OBEs, happen spontaneously during extreme trauma such as car accidents, or during medical events such as heart attacks. They can also be induced through hallucinogens such as LSD or anesthetics. More commonly, they are a byproduct of meditation practices, or through lucid dreaming with the aim of taking a trip into the subtle worlds.

In my lost youth I eagerly devoured the books of Robert Monroe on Astral Projection. The idea of taking mystical journeys fascinated me and though I never experienced what he claimed I would in his books, I did have my first taste of meditation. I would lie still, enter a catatonic state where my body was asleep but my mind was fully alert. It was a scary sensation at first, a feeling of being trapped, yearning to escape. In this state it occurred to me for the first time that the mind might be a separate entity from the body. Gradually, with practice, the mind is encouraged to lose its fear of roaming away from the body. It is something it naturally does during dreams. OBEs are fully-conscious dream-like experiences.

Modern neurology has attempted to debunk OBEs by inducing them in subjects. By stimulating various parts of the brain electronically, they hope to prove that OBEs are a simple neurological phenomena. But they miss the point because they are asking the wrong questions. What they should be asking is: Does the mind live inside the body? Or does the body live inside the mind?

Sandy and I sat for two hours exchanging ghost stories. She recalled visitations from the departed as glowing, warm presences without the human form or costumes (O how Hollywood has that wrong). As fascinating as ghost stories are, they reaffirm the revelation of OBEs that the mind and body are indeed separate entities. During her procedure Sandy saw prayers from her church members ascending towards her (another very common phenomena). While in this state neither she nor any other OBE experiencers felt threatened or afraid. To a man they report a feeling of deep peace and joy. Much more than that, they feel a wholeness with others after they survive the OBE itself. They are more empathetic in significant and unalterable ways. Surely, there is more at play here than stimulated neurons?

For me the experience of OBE was prolonged and I experienced different degrees of it. The times when my heart stopped completely, the experiences were more intense and vivid to other times during the coma, I heard, saw, felt events happening outside of my hospital room. Events I was later able to verify with the people saying, doing, experiencing them. Yet I was aware of my body the whole time. To this day I question this accepted notion that the mind resides within the body. It felt so natural, so normal to be wondering around while the body lay there tethered to tubes and machinery that I think it is the body that resides within the mind.

The mind is this enormous, shapeless presence that houses this body. The very fact that OBEs happen to so many people, of all ages and in every culture, proves that OBEs are a clue to the reality of our existence. To me this is what is worth investigating. It is unfortunate that this term has entered into everyday speech as a way of describing extraordinary desserts, dresses, film stars. (“When Brad Pitt looked at me I thought I was having an out-of-body experience.”).

This phrase means so much more.

monstorMy neighbor Frank is young, successful, and good-looking. He drives a nice car, has a lovely condo, good friends. You’d expect he should be happy, care-free and content? But no. The other day he was parking his car in our building’s underground when he noticed a room he did not recognize. Has this been newly installed, he thought? The door was painted green and appeared to have a peep hole at the centre of it. Very strange.

As he lay in bed that night he just could not fall asleep. What was in the room? Why is it there all of a sudden? Who uses it?

The next morning, on his way to work, he pulled out his cellphone and snapped a few pictures of it. He showed the pictures to a few of the neighbours but none of us offered any explanations that satiated him. “Why don’t you ask the front desk, Frank?” we said. Frank couldn’t do that, for he suspected the purpose of the room was nefarious. We shrugged our shoulders and carried on with our lives. But not Frank.

He has decided that the room is a secret bar used by our building’s management, all of course on the residents’ dime. Seriously, that is what he believes. He is quiet sane otherwise, but this conspiracy theory has really robbed him of his sense. He has now made it his mission to expose management’s dirty little secret. He brought it up at the Annual General Meeting in front of most of the building’s residents. Oh we snickered and mocked, but Frank kept grilling the management as though he were Jimmy Stewart determined to get at the truth.

While his plight is amusing, sadly he is not alone. Everyone of us at some time or other finds we are taken over by an idea. An idea entirely fabricated by our imagination. An idea that is preposterous to others, but it is an indelible truth as far as we are concerned. It is idiomatically known as making a Frankenstein’s Monster. And just as the monster the Dr. Frankenstein created got out of control and destroyed its creator, we saw Frank being overwhelmed and undermined by his own fabrication. It reminded me of those feelings from when I was student.

There was one teacher I was convinced hated and loathed me. I was used to being the teacher’s pet so I was very unsettled at this idea. This teacher was extra strict with me. I was chided for the most minor transgressions. Other students would stroll in late and he would say nothing. I was late the once and he walked out of the class “because if no one is interested I will not waste my time.” I took it all very personally. It caused me untold distress. I found it hard to concentrate on the subject during his class. All I could think about was, ‘why does he hate me?”

It took me years to understand that he never hated me, nor disliked me. I had been such a model pupil that he found my transgressions less tolerable than those of the lost causes. In affect, he was biased towards me. He saw my strengths as punctuality, doing the right thing, never making waves. The other students had other strengths but these were mine and it distressed him to see me neglect them. I could have had a happier time in his class had I not created that Frankenstein’s Monster. Monsters are always scary to the point they leave you unable to function. When that monster is of your creation, it is particularly unfortunate. My grades suffered, I was deeply unhappy, I felt falling sick. It was a monster indeed.

None of us are immune. I know of a woman whose marriage ended because she suspected her husband was cheating on her. It turns out he wasn’t but her paranoia drove a wedge in the marriage nevertheless. I now wonder what is the engine driving this process? Is it perhaps a type of vanity? Underneath that paranoia is a notion of uniqueness. That I know something no one else was smart enough to figure out. I am being singled out for unfair (special) treatment. That zeal to unmask the conspiracy is really the veracity of pride, with its subliminal sense of self-superiority. Secret liquor rooms, hateful teachers, unfaithful spouses, the conspiracies may be many, but the outcome is always the same. We end up defeated, humiliated, and drained of energy.

It is impossible to ever be free of them, nor is it desirable. You could be right: there might actually be a liquor stash, a bigoted teacher, a cheating spouse. But what is possible is to learn from these past episodes. Having gone through that one years ago has made me vigilant to them. Now I question their validity more stringently. I see them more objectively. For that I am grateful to that teacher.

Trapped with no way out.

Trapped with no way out.

By law, all buildings are required to have a way out, in case of an emergency. So do smart businesses, because the good-times will one day come to an end. But what about in relationships? In our jobs? Our living arrangements?

In my family we collect citizenships the way others collect Royal Doulton. That is because we have been refugees and do not trust any one country to honor their obligation to us. The regimes we serve might fall. Prosperity can turn on a dime. We know from experience that people who look different and have strange names are favorite scapegoats. So we keep a second passport updated.

It is a family lesson I have carried over into other aspects of my life also. Throughout my working life, I kept my resume updated. In the old days (before internet) I’d scan the job classifieds daily, just to keep my options open.

“But you can’t do the same in a marriage,” my friend protested. She argued it would be disloyal and disrespectful to her vows of in sickness/health, richer/poorer etc. She may be right. Though I do have to question why is it that women stay in abusive relationships. Can it be that they feel backed into a corner? They have no exit strategy? My mother ensured each of her daughters had a career before her marriage. She advised each of them to maintain a separate savings account after marriage, just in case. She was a feminist before it was fashionable.

Over the years I have known several friends who stopped calling once they entered a serious relationship. They got loved up. Suddenly they needed no one other their current partner. They were complete. A couple of years later, the phone calls would resume. They’d start with a hasty apology for not having kept in touch, then quickly proceed to their emotion pain at losing the latest love of their life. “He turned out to be a louse,” one might complain. “She was  a control freak,” another lamented. That little love cocoon they had created at the start of their relationship gradually felt like a cage, with no way out.

It may seem cynical to keep an exit strategy in relationships, but it is realistic. This too shall pass, declares the wisdom of the ancients. We this fact comforting when faced with the flu or a seat on the bus beside a sweaty fat man, but we don’t want to heed the full message of that wisdom when we are happy, rich and loved. We delude ourselves that we are the exception to nature’s law of what goes up must come down.

Lately I have been thinking a lot about resilience. I work with two communities at the opposite ends of resilience. I love my geriatrics who have survived world wars, revolutions and untold personal tragedies. They stoically summon the resilience to cope with their latest medical misfortune. At the other end are the homeless guys, many of whom once had dynamic, successful lives. Yet each man has had one fateful failing; for some it was drugs and alcohol, for others it was gambling and a for a few it was a criminal mistake. I wonder why they were unable to withstand that fateful failing, when the geriatrics have withstood many more?

Can the answer be, resilience? If so, what is the secret to cultivating this quality? I believe resilience is about planning for all eventualities. In other words, having an exit strategy.

Of course the ultimate exit is death itself. Seven years ago, when I was handed a virtual death sentence, I was advised not to dwell on it too much. My experience has been that accepting my mortality has brought about a heightened awareness of life. That in planning for death, I have tidied up my life. In working to delay the coming of death, I am eating better, breathing better, sleeping better. I no longer fear the vagaries of life. I do not see myself as its victim. Because I have an exit strategy.

The Quest For Sound Sleep

January 28, 2013


Drifting Off. John Everett Millais’ Ophelia

Oh to sleep like a teenager again! How I miss the capacity to fall asleep on cue, and more importantly, stay asleep until, well, lunch. If only my bladder would co-operate. It demands (and I mean a collection agent demand) that I empty it at 3.00 a.m. sharp. Then there is the problem of noise. Teenage me once slept in a Manhattan nightclub with my head against the speaker. Now any passing garbage (and garbage truck) is enough to break the ironically named sound sleep.

I wish there were a magic bullet. A simple one-size-fits-all solution. But alas, the reasons for poor quality sleep are as countless as the sheep.  What I did discover is a process whereby anyone can help himself.

I begin with the most urgent. When one or more of the body’s physiology is in disharmony, the first symptom is poor sleep. It is the body’s alarm for danger. Consult a reliable physician for any underlying health issues. But, good luck with that. I have found most physicians to be shamelessly dismissive about sleep apnea, pre-diabetes and other ill harbingers. (Perhaps because as interns they worked for months without any sleep). I had to train myself as my own GP (I even purchased a white lab coat). I researched. I quizzed family members (we have enough professionals to open our own hospital). I surfed the net. I read a book or two (okay, two dozen).

Next, I beautified my environment. It may seem like stating the obvious that a clean, tidy bedroom is conducive to good sleep, but in my experience (don’t ask me how I know) for some people the bedroom is the messiest room in the house. The other day I saw a homeless man fast asleep in the island of a highway, in the middle of morning rush hour yet! For about two seconds it made me question whether environment is at all important. I realized he was passed out from intoxication. For the rest of us, proper furniture placement, high end bedding, ambient lighting, pleasant scents and soothing sounds all contribute their little bit. More subtlety, it suggests to the mind that sleep is a luxurious pleasure to be enjoyed. Though I am thrifty in other ways, I do invest in high-thread count sheets and orthopedic pillows.

Thirdly, find yourself a nice temporary bed companion. The least expensive, and definitely the least clingy, is a diary. I used to keep mine on my bedside stand and each morning I recorded the quality and quantity of sleep. I stopped only once it improved significantly. In it I also used to note the main points of previous day. It is a basic but neglected fact that the quality of your sleep is a reflection of your waking hours. Try this simple test: spend the day at a rock concert, indulge in wild orgies, eat a dozen varieties of jalapeno, then observe the quality of your sleep. You get the idea. Sleep is so holistic that it is affected by every other aspect of your waking life, from your stress levels to your nutrition and leisure activities. In disciplining one’s sleep, one ends up disciplining every other aspect of one’s life. People seem to forget that waking and sleep are two sides of the same coin.

The other night I was at dinner party where we were eating till 11.00 p.m. It was a rich, starchy supper, topped off with coffee and a sugary dessert (the host threatened us with espresso). Needless to say sleep was difficult that night. I generally avoid nighttime snacking and also suppers such as pasta, rice and potatoes, which turn liquid a few hours after digestion. Breads on the other hand absorb liquids and are an aide in sleeping through the night. The nocturnal digestion of starch activates insulin, causing blood sugar levels to dip, which then prompts the adrenaline to fire up. Presto, you are wide awake at 4.00 a.m. for no good reason.

It is infuriating. The more annoyed I get, the harder it is to fall back asleep. Now I play a trick on my own mind. I discovered 3.00 a.m. is the perfect solitude for mediation. It beats being angry at the interruption of sleep. This change in attitude has helped me fall back asleep much more quickly. Failing that, it has led to some deep, deep meditative states. Win-win I say.

Not surprising really because sleep and meditation are not dissimilar. Sleep is also an altered state of consciousness. The same skills, the same dedication and the same vigilance cultivated in meditation come in handy in attaining better sleep.

And so I observe my bedtime rituals rather earnestly. It works because the human mind is highly habitual. I avoid violent TV just before bed, specially the news. I find reading before bed a better option, though never fiction. Fiction is designed to put images in your head. I prefer philosophical writings that blow my mind wonderfully out of day’s cares.

If that sounds suspiciously like an endorsement for a life of awareness, that’s because it is. Of course the quest for good sleep (just like the quest for love or happiness) is never-ending. It has to be fine tuned daily according to life’s changing demands.

Sweet dreams.

The Power Of Listening

January 21, 2013

Listening is the best ear ornament.

Listening is the prettiest ear ornament.

This is a true story. After my friend died I telephoned her credit card company to cancel her card. The Customer Service Rep who was mechanically sticking to his script replied, “I’m sorry sir, but only the cardholder can make changes to that account.”  Isn’t this what we find most frustrating about public service personnel: they don’t listen!

There is a reason why I patronize this one barber shop instead of a dozen others in my neighborhood: my barber Pat knows the art of listening. While I am waiting for him to finish with his present client, I enjoy watching his effortless way of prompting the gentleman in his chair to speak. Pat is chameleon-like in his ability to become all things to all people.

It’s a trick that served me well this week. I was visiting with one of my geriatric patients when she revealed to me that she was feeling rather depressed. Earlier that day her oncologist had advised her that her cancer had spread to her lymph nodes and because she was eight-four, there was not much that could be done. I did not know what to say to make her feel better. I remembered Pat and decided to just be a blank page. I gave her loving attention but allowed her to be comfortable with her silences. Slowly, haltingly, she opened up about her fears and anxieties. By the time her niece arrived for a visit, she was back to her smiling, stoic self. As I was leaving she sincerely thanked me for “our little chat”. I had hardly said a word.

I see around me young people voluntarily tuning out the world on the sidewalks of downtown with their ubiquitous Ipod. There are people crossing busy streets while texting on their cellphones. Does anyone listen anymore?

As a writer I appreciate that the truth of good fiction resides in the inferences and the nuances between the words. Perhaps people read less literature nowadays because we have forgotten this benefit of skillful listening. I was reminded of this fact this week at the homeless shelter. A long-haired, bearded man sat in my chair requesting a haircut. He had a slight Indian accent and as he spoke I was impressed by his vocabulary and clarity of thought. He was obviously an intelligent and educated man. Inbetween my small talk I gently cued him to speak about how he had ended up living on  the streets. He was cagey. Usually the men I barber are eager to unburden their story. He said he had inadvertently thrown away all of his I.D. and that was the reason he was homeless. I asked no more. I understood he was in Canada illegally. He was playing the system. As much as his words tried to conceal this fact, the silence inbetween had told the truth.

The pay offs are plenty in relationships but the real prize is in solitude. These days everyone is interested in ‘meditation’ without being clear about what that entails. Meditation is nothing but the skill of listening to yourself. The real reason your mind keeps chattering is because you do not listen, hence it keeps repeating the same verbiage over and over again. When we learn to listen to ourselves, our sleep is more restful, with less crazy dreams.

Many years ago I met a master of silence during a retreat in Northern California. Though his height was modest, he seemed to tower higher than the sequoias around us. It was his gaze. Intense, penetrating and personal. I felt naked in his presence. His ability to answer my questions the instant they arose in my mind astounded me. I was sitting in the front row of the tent, waiting, along with a hundred others, for him to begin speaking when I silently wondered to myself if he really could read my mind. He abruptly turned his head in my direction, looked me in the eyes and said, “I am not interested in reading the confusion in your mind.”

His name was Swami Chinamayanda, and he went on to say that people often marvel that he reads minds but really, he just knows how to listen. He gives attention to the pauses, the silences, and we supply him the rest. I understood what he meant because at that time I had the privilege of living with a cat. The only way I could anticipate her moods and her needs was by slowing down, learning to give silent attention. Just watch any mother with a newborn and it is a skill she soon acquires.

Excuse me while I plug in my Ipod before I cross the street and text at the same time. And thanks for listening.

No wonder he looks unhappy.

Sleepless nights, tossing and turning: you just can’t get that man (or woman) out of your head. It could be a persistent bully, or it could be an irritating colleague. Either way he or she gets under your skin like an itchy bug, burrowing deeper and deeper into your consciousness. The more you think about him, the more entrenched he becomes. One memory links to another, one incident finds a connection to a previous ones. Soon a pattern emerges about your experiences with this person. Your imagination expertly weaves a narrative, constructing an invincible giant of a monster out of him. Whether that person entered your system by invitation (as a friend who turned enemy), or barged in uninvited, it never ends well.

I once had an underling at work who was irritation in human form. He was lazy, stupid, insolent and enjoyed undermining my work–imagine a stubborn toddler and age him by fifty years. At first I thought I must be imagining it, making a monster out of a molehill. It turned out HR had a six-inch thick file on him. Many of his previous supervisors had determined to terminate his employment. Yet he prevailed. I worked for the military you see, and his previous supervisors had all been officers who were deployed after a couple of years. They were lucky. It got to the point where the very sight of him tensed me up. His voice was as grating as nails on chalkboard. The mention of his name was enough to raise my blood pressure, accelerate my heart rate. At that point I could not leave him behind at the office. He followed me home, was never far behind in my leisure and he even took up residence in my dreams. It was because of him, I believe, I had my heart attack. The military finally succeeded in getting rid of him after that, but it was too late for me.

Looking back on this unhappy time I realize now that what irks me the most was my inability then to control my emotions. I wish I’d had a mental concierge, like the one at my condo building— 24/7 security who screens all potential visitors. Wouldn’t it be wonderful to have such a guard at the gate of my consciousness, questioning each visitor whether he or she has any rights of entry. Because once an interloper gains accesses to your inner sanctum, he wrecks havoc with your peace of mind. With it out goes your intelligence, your wisdom, your clarity and your objectivity.

This happens routinely in romantic relationships also. During the dating phase everyone is on his best behavior. All is sweetness and light. You spend sleepless nights weaving intricate portraits of the beloved in your mind. You soon get attached. Then he or she dissapoints you. In love or in hate, either way, you’re screwed, buddy.

Sometimes it isn’t even anyone you know personally. What about that annoying celebrity who refuses to go away? (I’d give an example of one but there are so many to chose from). Politicians like Rush Limbaugh and Ann Coulter make a career out of getting under people’s skin. A friend even complained to me about a television drama he had seen. The situation portrayed was so horrific to him, it kept him up for two consecutive nights. With the pervasiveness of social media our mind is no longer a private sanctuary, it is a public dumping ground where anyone from casual strangers to fictional personalities are free to dump their garbage.  So what can we do to install that doorman at the entrance of the mind?

By giving attention –by attention what I mean is a detached, non-judgmental examination, bringing all of your energies, every last ounce of it, into observing the machinations of the emotions. Think of it as watching a cinema. Careful though. Don’t watch it as the film’s director, shaping the contents. Nor as a censor, suppressing parts you find offensive. And please don’t be a film critic, running commentary on what you observe. Rather, watch like a dedicated movie fan, seated comfortably on a velvet chair, pop-corn in hand, enjoying in the darkness of the mind this melodrama unfold. You know it is make-believe, nothing to get too worked up about, but you are interested, you care what is going on.

It is a skill, and like any other skill, it takes time to master, but is worth the effort. Haven’t we all put in time and effort into the things that are worthwhile? Education, careers, family? This skill is the start of intelligent living. Out of the seven billion on this planet, you will become one of the rare few living a mature, rational way of life.

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