On Developing a New Meditation–

I have been given the opportunity to develop a meditation that will be presented on a global basis in honor of Gandhi’s birthday at the end of August.  I will be ‘trying out’ some thoughts on this blog.

Most meditations begin with a reference to breathing. They may center on observing the breath, the in and out flow of air. Some will emphasize the observation of thoughts and feelings, the letting go and returning to an awareness of the breath. Other meditations will be contemplations on a topic: compassion, forgiveness, gratitude.

I observe that there are two distinct, almost paradoxical aspects of breathing–the voluntary and the involuntary. We will all breathe whether we are aware of it or not.  Otherwise no one would have survived one night of sleep. Also, we cannot hold our breathe indefinitely–we will grab an inhalation before we pass out.

But there is clearly the voluntary aspect of breathing–we can choose to breathe slowly and rhythmically or quickly. We can decide to breathe deeply or shallowly. So, these two aspects of breathing are paradoxical yet complementary.

The metaphysical metaphor is this–our entire lives are balanced between the paradox of chance and choice. We didn’t consciously will ourselves into being and it is unlikely that most of us will decide precisely when to die. In between is a life filled with suffering and joy–occurrences and situations, experiences which will test our abilities to the extreme.

As we breathe, become aware that we exist from breath to breath–that we are continually being re-created. Our lives are that precarious.  We breath in the awareness that our lives are imperfect, that the world presents us with pain and grief at times. Be aware, however, that we can help in some small measure, heal the suffering.

As we breathe, realize that this is not punishment but opportunity. Helping ourselves overcome suffering requires that we breathe for others. In the process of healing others, we heal ourselves and the world.
Realize that each breathe brings the potential for transformation and change. Become aware that we are offered an opportunity to turn the next moment into a creation of beauty, of joy or of emptiness and despair.

As we breathe, relax into the awareness that we do not have total control over what will happen to us, our loved-ones, the world. We are a part of a greater whole.  Our contribution to it is essential, yet limited. We can only do the best we can from breath to breath. We need to let go of our insistence that we can control our lives totally. On the other hand, we need to be aware that we need to be present to affect change.

So as we breath in and out, observe a feeling of joy well up from within us
It is a feeling of joining the multitude of other beings, of participating both passively and actively in the life of the universe.

End of Life Concerns–continued

It would clearly be an understatement to emphasize that these are extremely complex and controversial issues. And just as clearly, each case should be evaluated on an individual basis.

Still, there are additional aspects of this topic which cry out for exposure–one is the attitude of ‘health-care providers’. In the past we were often known as ‘physicians’ or ‘doctors’ but HMOs/managed care have ‘managed’ to lump us together with everyone who contributes to the entire system. This is not to demean the role of nurses, assistants, technicians, podiatrists, chiropractors etc. But it is a subtle way of diminishing the role that the physician traditionally assumed in the world of healing .

My point is that families at these difficult times will often turn for guidance to physicians who, infortunately, are often woefully incapable of dealing with them. The reasons are multi-factorial:  1] physicians are not trained to deal with such issues, 2] physicians are personally conflicted over their own beliefs regarding end of life care, 3] some physicians feel obligated to impose their own personal beliefs on families, and 4] sadly, some physicians only see the possibility of ordering or performing procedures on the elderly which will provide them with additional income.

It is extremely unfortunate that physicians are frequently incapable of dealing with these powerful emotional, medical and ethical issues. We receive almost no training regarding these issues in our medical education. There is an implicit assumption that we will somehow gather ‘wisdom’ in this area over years of clinical practice.  I have seen little evidence for this assumption.

There is another essential point I would like to make regarding feeding tubes [PEG] in the elderly.  Families are under the mistaken impression that to withhold tube feedings is to ‘starve’ their loved-ones. I don’t believe that this is the case at all. In fact I believe that the dying patient does not eat because they have no desire to do so. The actual process of dying is poorly understood by medical science, but I do believe that we can approximate an understanding of this loss of appetite [anorexia] by recalling how we felt during a severe viral syndrome.  Most can remember how impossible it would have been to even force ourselves to eat.  I believe that a dying individual has no appetite whatsoever. Furthermore, instituting tube feedings may actually cause discomfort, nausea and suffering!

I often will emphasize to conflicted families  that they attempt to regard the best interest of their loved-one rather than their own inability to  cope with the stress of their death.

My suggestion is that each and every family member expresses an opinion in the matter to attempt to keep in mind the best interest of their loved-ones and to allow them to die peacefully and with ‘dignity’. This is an often used but rarely discussed concept. I can only express my own opinion that having a confused loved-one struggling with their tubes and iv’s and having to be sedated or restrained in order to offer them these end of life ‘services’ is hardly dignified or compassionate.

I first suggest that society as a whole, develop a deep an awareness of what should be obvious, but is not—the inevitability of physical death, in the impermanence of all things.

End of Life Concerns–Let’s Begin the Discussion

A recent hospital conversation with several nurses over the use or abuse of feeding tubes in demented patients has rekindled my focus on the topic of ‘end of life’ matters.

Several years ago I participated in a conference on establishing a Palliative Care Committe at JFK Medical Center in Edison NJ.  The need for such a committee is beyond doubt. The committee’s function is to advise and consult on hosptialized patients who are terminally ill and yet who still undergo extensive medical testing as well as procedures which will do nothing to ensure their survival. In fact, I believe, such testing and procedures actually induce suffering in these individuals who are rapidly and irrevocably approaching  death.

The topic extends to the deeper discussion of death and dying.  It is one which is extremely controversial with multiple opinions voiced from all corners of the religious, scientific and spiritual realms. On an individual basis, families grapple with heart-rending decisions about when to allow a ‘DNR [do not rescussitate order] or whether to allow feeding tubes to be inserted in their loved ones only to prolong an existence without real substance.

We are not talking about euthanasia here. Dr Jack Kevorkian need not be the topic of discussion. No one needs to actively hasten the death of any human being. But we must, on a societal level, begin a serious and earnest discussion of how to deal with the dying.

This is a topic which is truly metaphysical in nature. It forces all of us to confront our beliefs on life, death, dying and what happens after death. It forces us to come to terms with the inevitability of death, an issue for which many in our culture are in complete denial.

Problems arise on a practical level when patients arrive to a hospital without any ‘advanced directive’ representing their personal wishes regarding end of life procedures.  Even worse, however, family members often disregard the advanced directives and impose their wishes on their relatives who are incapacitated and unable to direct their own future.

Within families, there can be disagreements on how to handle their dying relative. Some will insist that ‘everything’ be done, regardless of whether is is reasonable, will prolong their relative’s survival, or will induced suffering in them.

Some may point to religious reasons for insisting that no tests or therapies be witheld. Others may be reflecting their own deep fears of losing a loved-one regardless of their condition.  When dealing with families in distress over such issues I will often ask them to disregard their own feelings about losing their loved one and try to do what is best for them at this delicate and crucial time in their life.

Those families with a belief in a soul and its survival after physical death, should tap into that belief at these times. They should be encouraged to discuss their beliefs, fears and re-focus on their loved-ones and what is in their best interest.

It is not irrelevant or crass to point out that a huge amount of health-care dollars are spent on terminal patients whose length and quality of life are not advanced or enhanced by these activities. I will state my opinion that this ‘waste’ in limited financial resources would be better served in promoting the health care of younger, more viable individuals who presently are not receiving health care at all.

This is not a harsh or unfeeling statement. When my own Mother was in the process of dying last summer, my family agreed to allow her to pass away at home, without an iv or with a feeding tube.  She passed peacefully and serenely in her sleep and I will never regret the decision not to hospitalize her or have a feeding tube inserted.

This topic is so important that it deserves to be front and center in the consciousness of all Americans and be offered for public debate. All forms of media, Oprah included, should be exposing the issue for what it is–engrossed in the issue of life and death itself.

These are issues that must be discussed openly on an individual family level and on a national level. There may not be one correct or unanimous decision.  But until it is raised, it will continue to be painfully and poorly experienced by one and all.

Meta-Physician On Call–musings 2: Fuel for the Journey–The Experiences

I am in the process of trying to explain to myself as well as others how and why I came to write the book.  Why bother to do all of this in the first place?  I clearly admit I have spent innumerable hours writing and thinking and speaking about the nature of reality. But why and how did this all come about in the first place?

My answer, I suppose, has to do with my own profound metaphysical transformation–from a hard-core agnostic to someone who seriously believes in a spiritual reality. The path has not been based upon rational arguments [the philosophical understanding of metaphysics], nor by the pronouncements of religious sages,prophets and leaders,  but by the extraordinary spiritual experiences of individuals who are sincere, honest and credible.

Some may still find it difficult to comprehend how and why I have been so moved by these anecdotes.  My response is that they are too real to be denied. They are shockingly common as well. They come in a variety of forms and from individuals of all backgrounds and beliefs.  What they do is simply this–the provide evidence for a spiritual reality to existence.  They offer me evidence that life is not random, or meaningless or without purpose.

Whether they fall into the category of near-death experience, after-death communication, reincarnation stories or the medium experience, they are also profoundly entertaining.  There is even a tendency to fixate on them, to seek more and more evidence for their truth, to become obsessed with evidence for ‘life after death’ and for a paranormal reality.

But that would be a mistake, I believe.  Spiritual traditions ranging from Kabbalah to Buddhism, Hinduism, Christian and Islamic mystics all report a spiritual reality. Yet they also warn against becoming engrossed in these altered states of consciousness.  They can become traps for our own egos.  People who have apparently been gifted with psychic or medium ability may be tempted to view themselves as spiritually advanced, encouraging others to follow their teachings.

Yet the lesson which time and again has been emphasized by truly advanced masters and avatars is this–‘cultivate altered traits, not altered states’.  This means, be less concerned about the abilities to transcend this physical reality and more concerned about living a life based on the performance of spiritual deeds.

The attitude of compassion, love, kindness, charity, understanding, altruism and sharing are the pathways towards spiritual liberation and advancement.  There is a Buddhist legend about a monk who meditated for years until he could levitate and transport his body across a small river.  His delight in announcing this feat to Siddhartha Gautama, the Buddha himself, knew no bounds.  But instead of being impressed, the Buddha asked. ‘why did you waste so much time learning to levitate, you could have taken a boat!’  The lesson here was simple.  Learning to perform advanced states of consciousness should not be exercises in ego gratification. The time would have been better spent learning and practicing compassion for all beings.

These stories are interesting, even compelling and they have provided the fuel for my metaphysical journey. But they are neither the purpose of the trip, nor the destination. Learning to live a fuller, more joyous and healthier life is the motivation for doing all of this. All are encouraged to manifest their own itinerary.

Meta-Physician On-Call…..musings 1

Over the next few weeks to months I will be obligated to review the manuscript that Greenwood Publishing has agreed to turn into a book. It will give me the opportunity to reflect on the entire process and truly come to terms with it.  It has happened more quickly than I imagined and have been told by those who know the book business that this is rather unusual.

I will hope to do some traveling and lecturing around the time of the book release in December of this year and will be looking for venues so if there are any suggestions, please email me.

My only concern about the book, so far, is its selling price.  At nearly $45 I feel that it may deter prospective readers from purchasing it. Needless to say, I had no input at all in this aspect of the process. I did shoot an email to the publisher reflecting my position, but I have little hope of any change.  These are corporate/business decisions whose rationale are deemed inappropriate for any input from the writer. 

This does not change my deep gratitude to Greenwood Publishing Group/Praeger for their decision to publish me in the first place. I also am aware that their target market are libraries and universities and perhaps this is the reason for the sticker shock.

That aside, having a book published by a well-respected publisher will hopefully enable me to get to the next level in this journey–to have entree to more lecturing and speaking engagements.  Hopefully, that will become a second career for me. At present, however, I have no intention of leaving my practice.  It is a source of me real-time metaphysical journey.

My preliminary thoughts are to do a real lecture tour rather than consider it a ‘book’ tour.  I am uncomfortable with the idea of just ‘selling’ the book per se. I would rather provide some substance in the form of a lecture and allow those who are interested to pick up the book as well.

Perhaps this is not what most writers do but I did attend a so-called lecture by Candace Pert last year.  I deeply respect her contribution to the world of mind/body/spirit with her scientific advancements in PSI [psychoneuroimmunology].  But I was disappointed in her presentation.  It seemed rather casual, personal, even silly at times. She pointed out family members and friends in the audience but spent little time really explaining what she has accomplished.  It seemed as if the entire point of the evening was to sign and sell her book.

I don’t want to do that and hypocrisy is not one of those qualities that I admire.

The Foundation of Happiness

My fascination with the notion of happiness as a state of being that can be acquired through awareness and training continues.  Buddhist monk and scientists Mattieu Ricard in his book Happiness explores this topic. This is hardly a new perspective for this spiritual tradition.  The Dalai Lama and others have written extensively about it as well.

Happiness as a state of being is also a state of consciousness or mind. What is difficult for most of us to comprehend is–it is not based upon our immediate experiences of the world. Peace and equanimity is acquired through deep thought, contemplation, meditation and the awareness that the mind can be trained to achieve a degree of contentment.

Pleasures and pleasant experiences should be cultivated and appreciated. But they do not equate with a deep sense of inner serenity. Material acquisitions give temporary pleasure and are not to be rejected per se. Just be aware that the obsessional drive to achieve this transitory jolts of joy can become addictions, leading away from happiness.

External experiences are like the wave on the surface of the sea. The deep waters of contentment and happiness remain unmoved.

One particularly powerful example of happiness relates to its foundation–compassion for others, love for the wellbeing of others, a sense of connection with the universe. There are those who pervert the notion of happiness by feeling exalted by acts of violence, hatred, and destruction of others.  Their ‘rush’ is an emotional response often based upon distorted views of reality. These can never bring true happiness because their foundation is corrupt.

In the movie Age of Innocence [1993] based on Edith Warton’s novel, there is a love affair between two individuals played by Michelle Pfeifer and Daniel Day-Lewis. Acting on their love may seem like an inevitable release for each of them.  Pfeiffer’s character, however, refuses despite her strong desire to do so because she understands that others will suffer as a consequence of their actions.  She has the wisdom to state that no love built on the ruins of the feelings of others can ultimately survive.

The perversion of a serial killer, a sexual miscreant, a suicide bomber, may all offer the perpetrator an immediate feeling of ecstatic release.  These individuals may even rationalize their actions as providing them with the feelings of joy that they are driven to revel in. This feeling can never be the basis of true happiness.

Ultimately happiness is an idealized goal which will rarely be obtained.  But we can all approach closer towards it, once we recognize that it is possible to do so.

It’s Back….

As of this AM–meta-md.com is back functioning. I want to thank my son Seth for his efforts. To me this is more mysterious than metaphysics but it only proves that we all view the world from our own perspective.

Although I am attempting to adopt the optimists point of view, I am not totally convinced that the blogosphere will not decide to play with me in the future. [Isn’t the attribution of will to unthinking forces the source of religious belief?]

At an rate, I hope the present situation persists and I hope to not bore the readers with such mundane concerns.

Thanks again for your indulgence.

Can Meaning Arise Out of Suffering?

This metaphysical question is a derivative of the last blog–regarding purpose in life.  It is rather obvious to all that life offers more than enough opportunities for pain and suffering. Buddha recognized it as the foundation of existence in this world.  The alleviation or transformation of suffering became the goal of not only Buddhism but most spiritual tradtions.

In the Judeo-Christian lexicon, the name of Job represents the man who suffered yet did not lose faith. Unable to rationalize the horrendous onslaught of personal tragedy, Job ultimately found some solace in accepting the mystery of God’s actions.

I’m not convinced that many of us could be the modern day ‘Job’.  Yet we will all face suffering to more or less an extent. How we are able to deal with it will ultimately determine how much ‘suffering’ is derived from the inevitable pain of loss and disappointment.

This brings me to describe how one of my patients, a middle aged woman I’ll call Sara who, it seems, has begun to find meaning from the depths of her own suffering.  She lost her only child in a motor vehicle accident while in college. Her suffering has been inconsolable.  She has sought and received spiritual signs from him, yet this has brought only minimal and transitory relief for her.

Now, more than five years later I have noticed a change.  She has become the confidante and advisor of college age boys who are about the age of her deceased son.  It took her a while to even be able to speak to such young men.  The reminder that her son was gone was too powerfully evoked by such encounters.

Yet she now has found that she can offer them some personal wisdom that brings them back to hertime and again.   Others have told friends that she is an individual who will listen without judgment and offer practical, healing advice.  She told me that she believes her son is often speaking through her.

Whatever.  She now acknowledges that she could never have found herself engaged in such a rewarding and satisfying endeavor if she had not worked her way out of her abyss of suffering.

Of course none of us seek pain and suffering.  But that will not be the problem–it will find us.  Can we work our way through it? Perhaps one way is to use the suffering as a tool to help others. It offers us a way to attempt to make sense of the senseless.  It connects us to other people. It is the answer to finding contentment and joy in our lives. It is tikkun , the repair of the world, of our own fragmented souls.  And it is done by helping heal the world around us.

I humbly submit that it offers me more meaning than does the Book of Job.


Did the title of this posting at least get your attention? Don’t all metaphysicians seek answers to this most primal question?  Do we seek fame, fortune, adulation, attention for their own sake? Or more likely, as vain attempts to assuage our fear of dissolution and nonexistence? Do we ponder how or if we will ‘make our mark’ in this world.  Do we desire to leave behind some tangible evidence that we existed?  Is ‘fifteen minutes’ of fame what we need to achieve?

Well perhaps we are striving for the wrong end. Perhaps we need to step back from our own lives, our desires, our goals, our need to move forward, to succeed in the public arena, to become something more than what we are.

Perhaps we can reconsider what is important in life, what our purpose for being truly is.  Consider some of the spiritual traditions–Buddhism, Kabbalah, mystical Christianity, Hinduism, Islam.  They actively maintain that trying of achieve fame, ego -gratification, are forms of idol worship. They insist that humility is a virtue.  Now isn’t that a rare commodity in our society?

Perhaps our goals need to be more modest–yet more profound.  Is naming a building after yourself the path to immortality?  What about anonymous charity? What about acts of kindness performed one-on-one without fanfare and audience?

I am reminded of some paragraphs from Michael Newton’s books.  I do not recall whether this was from Destiny of Souls or Journey of Souls.  It involves the assessment of the stage of development of the souls of the individuals he hypnotized. Many had believed that they were ‘old’ souls.  That they were rather advanced and on their path towards liberation.  Most of them were incorrect, Newton discovered, after placing them in deep hypnosis.

In fact he claimed that one of the most advanced souls was actually, in this lifetime, a simple waitress who worked at a remote truck stop in the Southwest desert.  Apparently, she served a deep love and compassion for her customers along with their apple pie and coffee.

The Baal Shem Tov, the Kabbalistic founder of the Hasidic movement reportedly spoke of the powerful nature of divine joy.  If anyone was touched by that awareness and was able to transmit that light to one other being in their lifetime, and if that individiual was enlightened by that encounter, that ONE act would justify that individual’s entire life or incarnation in that physical form.

So just perhaps we should re-evaluate what we consider to be necessary, important or crucial in our lives.  Perhaps the purpose of life is far more simple, but more profound than we could ever imagine. Perhaps just being there for others, which is a healing path of being, is our ultimate purpose here.  The rest may be interesting, even entertaining, but rather inconsequential in the big picture of existence.