Do We Need A New Word for ‘Forgiveness’?

I understand the power of forgiveness.  It releases us from the negative energy which holds us to those who have harmed us. To persist in ill will towards any other human being usually damages us much more than the intended target.  The Chinese proverb says that if you hate someone, you might as well dig two graves speaks to this truth.

Yet I can’t help but believe that forgiveness implies the repentance on the part of the one who has injured the other. Without genuine repentance, true forgiveness seems extremely difficult if not impossible to experience.

Some might accuse me of not being ‘spiritually advanced’ enough to be able to forgive those who have purposefully hurt or injured me or my loved  ones even in the absence of their repentance.

My sincere response is that to me the term forgivenss implies a tacit acceptance of the injurious action.  I don’t believe it is metaphysically useful or even reasonable to accept an evil action on this basis.

Instead, I can state that I can show compassion towards someone who has injured me or my loved ones.  I can do this out of sense of pity–that the other is so deluded or deranged that they can justify their own acts of evil and not feel that they have done anything wrong.

Karma will take care of such actions and the law of give and take, of balance will answer such behavior.

My feelings of compassion/pity allow me to release my feelings of anger or desire for revenge.  I am no longer tied to that ‘other’ who has perpetrated an act of brutality or vengeance on me or my loved ones.

So let’s strive to come up with a new word for forgiveness, one that does not diminish the power of an evil act, or take the perpetrator ‘off the hook’ but frees us from the trap of hatred or thoughts of revenge..

The Metaphysics of Medicine

In preparation for my talk next Wednesday April 9th at Albert Einstein College of Medicine [my alma mater] I have been pondering the relationship between metaphysics and medicine.

Metaphysics, the philosophical inquiry into the nature of reality, has two subdivisions. Ontology refers to the actual truth about something–what it actually IS.  Epistemology refers to the process by which we obtain knowledge of something, a believe, a knowing. It has to do with how our minds work and how the mind filters and creates our sense of reality.

19th century philosopher Immanuel Kant is often credited with ending the way metaphysics had been approached.  He was the first to distinguish between what he  referred to as the  noumen the ‘thing itself’ and the phenomenon which is what we perceive to be the ‘thing’.

He was essentially speaking of ontology and epistemology.

I am extending this analogy or metaphor to the practice of medicine.  The ontologic component is the actual disease process itself.  What it truly IS.  The epistemologic approach is the process of coming to make a diagnosis and determine what we believe the diagnosis to be.

In the real world, it is the epistemologic approach that has meaning.  As physicians we often struggle to put the clues together in order to make a diagnosis.  Often we are frustrated by our inability to grasp the nature of the disease process. Human beings are infinitely complex and the awareness of the relationship between the body, mind and spirit only exacerbates the difficulties.

Often we make assumptions about what is wrong, presumptive diagnoses which enable us to begin treatment.  We depend on feedback from the patient, how they are responding, to gauge our progress.  It is hardly the rational, logical, hard-core scientific approach that many would desire.  But it is the best we can do.  Our epistemology requires us to use intuition, logic, and feedback from a cooperative patient in order to approach the ontologic truth.

Our epistemology may lead us to improve the patient without truly knowing for sure what the ontology  of their diseases process actually was.

But in the real world and as desperately as we would like to know what we are treating, we would rather have a successful outcome without knowing than the opposite.

We would gladly sacrifice the ontology for a successful epistemology.


I’m not afraid to die……I just don’t want to be there when it happens..’

Woody Allen’s straightforward quote describes the ambivalence that surrounds the subject. We are afraid of death…but is this necessary? Does it have to be so powerfully debilitating.

Known more formally as thanatophobia, like most fears it is based on a reasonable desire to avoid the source of the fear–namely death.  It is understandable that we should fear death, particularly because we believe that it will bring the end of what we know and offer the potential for the unknown.  It will clearly bring change–but exactly what kind is uncertain. Uncertainty brings fear because it brings lack of control, chaos and this is clearly frightening.

One consequence of the fear of death is the fear of dying itself.  The process  brings concerns–will we or our loved-ones suffer?  And what comes next?  Will there be survival of consciousness, or oblivion.  And, under certain circumstances, it may be difficult to choose which option is preferred!

For those who suffer from physical or psychological pain, oblivion might seem the ultimate good. For others, the vast majority, the desire to continue in some conscious state seems preferable.

Another aspect of the fear of death is the fear of aging.  Aging makes death seem closer, less easily denied or suppressed. And the consequence of this fear is to ‘warehouse’ the aged.  Our society does not venerate the elderly–on the contrary, they ship them off to nursing homes, away from the public’s perspective, point of view.

We worship  youth, which leads to  the obsession with youth culture and their often mindless endeavors.  Maintaining physical fitness, even cosmetic surgery, is not necessarily a ‘negative’ undertaking.  When it becomes obsessional, however, all-consuming, and leads us to ignore and deny the reality of aging and the problems of the aged–then we are deluding ourselves, our vulnerable elderly and our own future. .

The denial of death often leads us to disregard our own preparation for death–from lack of wills, advance directives, lack of insurance.
We fail to discuss end-of-life issues and palliative care. We push for medical testing, procedures, drugs for our dying relatives in a vain, irrational hope that they will improve and regain that which can never be.

We need to seek the help of those who are wise in the ways of compassionate death when it is appropriate.  Hospice is often the path of love for those who are in the process of dying.

In our desire to keep them ‘alive’ we actually produce meaningless suffering for our loved-ones. Why must they die in a hospital, an ICU, with ivs, catheters, on a respirator, with a feeding tube?

We need to face death as the natural outcome of life. We need to honor the process that is as inevitable as the night which follows day.  We need to put our own fears aside, our anguish over the loss of a loved-one, and make decisions that are in their best interest.  For those whose brains, minds and bodies are irretrievably spent, death can be a blessing.

We must never let our fear of death deprive those we love of the dignity to die in peace.

More to come on death……


Preparing for my lecture this Sunday on Death. No, I am not depressed at all.  In fact I am elated.  I can’t wait to tackle it.  Sadly, the topic remains taboo among most of us.  We are so uncomfortable with the subject that we just deny its power over us. 

The fear that we suppress will re-surface as a phobia.  Our inability to deal with the reality of death results in rather strange, unintended and unrecognized consequences. Ernest Becker believed that the denial of death resulted in much of the attitudes and aspirations of modern society.  The desire to become rich, famous, successful. The desire to have children.  The pre-occupation with materialism, the use of alcohol and drugs–all could be seen as mechanisms for denying the metaphysical truth of our own mortality.

Facing death, especially for those who understand that there is a spiritual dimension to reality, is surprisingly liberating. Facing our secret fears allows us to realize that we can survive them.  They loose power over our subconscious when we face them down and see them evaporate like mist before our eyes.

Discussing death is not morbid at all. It is like discussing birth or any of the developmental steps in between.  It is reality and why should we live a delusion? Facing death gives meaning to every precious moment of this life.

Knowing that existence and love survive death is an added plus.

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The near-death experience [NDE] is hardly a new concept. First named in his 1975 work Life After Life, Raymond Moody was but one of many researchers and investigators to explore its nature and metaphysical significance.

It is interesting to note that he had Elisabeth Kubler-Ross write the preface to this book in which she ‘bemoans’ the fact that she had investigated over 20,000 cases but had not written about it or named it.

Numerous other first-hand experiences emerged in the form of books, films, articles. The New Age exploded with personal descriptions of the NDE.  This was followed, of course, by the hard-core skeptics who have waged a relentless war against the spiritual significance of the NDE.  They have asserted that it is essentially a hallucination caused by lack of oxygen to the brain, or too much carbon dioxide or to an anesthetic or any other insult to the brain.

The problem with these attacks is–they don’t really explain the phenomenon or how a ‘damaged’ brain can produce such consistent, nearly permanent memories. A recent discussion with a patient about her own ‘mini’ NDE will explain further.  To paraphrase: Years ago I was operated on in the middle of the night for massive gynecological bleeding.  I was in the recovery room as everyone was leaving but began to bleed once again.  I went into shock and everyone was panicking.  I next recall floating out of my body and could ‘see’ the gynecologist about to leave the hospital.  It was about 2am and he couldn’t wait to get out and get some sleep.  But strangely, he hesitated at the door.  There was no one around  him either. I can’t explain why, but he did.  Just then he heard the stat page from the recovery room regarding my worsening condition.  It was strange that I felt so peaceful, so detached from what was happening to my physical body.  The next thing I recall was in the recovery again, after he had re-operated on me to stop the bleeding.  About a week later I mentioned what had happened and how he hesitated before leaving the hospital that night.  He was speechless and just shook his head.  He remembered hesitating but couldn’t explain why.  It seemed clear to me that if he would have left the hospital, I probably wouldn’t have made it.

Now, this NDE did not provide many of the typically described phenomena, the visitation with deceased relatives, the dark tunnel, the white light.  And I have described other cases in my book Meta-Physician on Call For Better Health.  But what struck me was the simplicity and truth to this experience.  There is no way to explain the out-of body perception that this woman had.  No appeal to physiologic or chemical disorders can explain how she could have ‘seen’ the gynecologist and his hesitation at that moment.  No skeptic can offer ‘explanations’ for what happened.

Sometimes we just have to accept the most logical, though perplexing and metaphysically challenging conclusion: that our consciousness can exist independently of our physical body.  Does lead one to accept the existence of our soul? Perhaps.  Do you have a better explanation?