The world of meditation can be confusing.  We may feel it is important to meditate.  We understand it is a way of accessing our deeper spiritual self.

But which approach should we adopt? Should we seek a mantra?  Should we return to the breath and observe our thoughts and feelings as in mindfulness meditation?  Should we take on the suffering of the world in Buddhist tradition?  Should we fill ourselves with white light and form a protective shell around ourselves? Should we combine sounds with finger touch?

Perhaps  the simplest meditation grounds us to the ultimate truth, the awareness that we are alive and that life is a precious gift.

I had first heard of this while taking lessons in Kabbalah from a Rabbi more than twenty years ago in a private home. 

Simply breath in and out slowly through the nose with the following awareness:  we are breathing beings.  As opposed to plants who exchange carbon dioxide and oxygen through pores and "breathe" continuously  we literally survive from inspiration to the next inspiration.  Although breathing does not require conscious effort, fail to take the next breath…. and we die.

We can visualize God, the Universe, Supreme Intelligence, Brahman etc. as willfully choosing to keep us alive from breath to breath.  We allow God to assist us as we fill our lungs on the inspiration and accept our breath on the expiration.  

We are immediately struck by the  truth that life is both fragile and precious.  We are humbled by the awareness our own mortality.

We recognize that what bothers us in life, what worries us, stresses us, confounds us and causes us suffering pales in comparison with the simple gift of being alive. 

Instead of tying ourselves up in the profusion of details, multitasking, schedules, aggravations, time constraints,  everything we believe we must be and must have, just feel the simplicity and power of a single breath.

We can begin to understand that despite our strenuous efforts to control our destiny and the destinies of those we love, we are ultimately merely breathing beings whose own hold on life is temporary and fragile.

We can let go of our frenetic efforts to make sense of the chaos of life.  We can accept what life brings us with a sense of new priorities. 

We find serenity in the beauty and simplicity of just being and surrender to what is beyond our ability to control.

 Each  breath reminds us of the possibility of transformation and change. Each breath represents the opportunity to begin our lives anew.  Each breath is a simple but profound gift for which we can only offer our humble gratitude.

The simple awareness of the breath grounds us to the truth of existence.

It is a meditation on humility, acceptance and of gratitude as we surrender to the grand mystery of life itself.



A MEDIUM’S READING PREDICTS N D E– My Patient’s Experience

The following personal experience from one of my patients I'll call Jeanette exhibits two separate but related paranormal experiences. The first was an inadvertent reading by a medium who predicted a subsequent NDE.

In order to give it some meaningful context it I need to relate it as I heard it from her.

Jeanette described driving alone on a wet highway on a moonless night.  Going around a curve she lost control of the car.  It seemed to spin slowly and then she experienced heading down a dark tunnel towards a woman of light.

The woman was not elderly and looked familiar to her, like her aunt, but she knew she did not really know who she was.  She had a white dress and white hat on and was beaming love towards her.  Although she knew she had two young children at home, Jeanette could not help but be attracted to this woman . As Jeanette approached closer, she turned away from her.  She knew she could come no closer. Jeanette felt herself retreating from the woman and awoke in pain in the ICU.

She had suffered multiple bone fractures but was alive.  Her father hovered over her.  Although in pain she felt compelled to describe her experience to him.  Jeanette was young and had never heard of a near-death experience.  She described the woman precisely as she saw her.

Her father was breathless.  With trembling fingers he reached deep within his valet and pulled out an old black and white photo.  "Yes, that's the woman I saw", Jeanette exclaimed.

Her father shook his head.  "I can't believe what you're saying.  This is a picture of your real grandmother who died before you where born. She was buried in a white dress and wore a white hat.  The woman you call Grandma is a step grandmother.  We never thought to tell you."

After she recovered Jeanette was suddenly shaken by a memory of an event which had occurred two or three years before.  Her girlfriend had asked her to drive her to have a psychic//medium reading.  Jeanette had no interest in having her own reading but the medium looked her in the eyes, grabbed her hands and said, "You have a grandmother in spirit who will save you from a car accident."  Jeanette laughed and told her that both her grandmothers were still alive.  The medium said, "honey, someone isn't tell you the truth".

Jeanette walked away from the experience with more skepticism than ever.  "Boy, did she blow that one", Jeanette stated.

Only after her own NDE did she recall that quick but powerful reading from the woman who accurately predicted what would occur

KARMA & INTENTION — Terrorism & Dead Children

Let's state the obvious–killing of any kind is a regrettable, horrific act.  But, as in all actions,  there are degrees of karmic consequences.  Killing someone in self-defense is not the same as premeditated murder. Accidental killing is not the karmic equivalent of planned, dispassionate slaughter.

Is there a moral equivalency to the liquidation of  innocent Jewish children in Toulouse France and the accidental death of Palestinian children during Israeli retaliation for rocket attacks?  Mohammed Merah apparently thought so. I think not.

Karma is powerfully derived from the notions of motivation and intention.  Kavanah is the Kabbalistic term for intention.

When noncombatant / civilian deaths occur during military action there should be a response of regret and revulsion.  They were clearly not the intended target.

 When Israeli (or American military actions) result in the death of civilians (adult or children) there is an immediate reaction–regret and condolences for the unintended deaths.  When soldiers deviate from accepted standards of military conduct (as in recent killing of Afghan civilians) there is immediate and harsh response from the American military itself. It is what civilized people and nations do when accidental killing occurs or when rogue individuals transgress.

When innocent Jewish civilians are deliberately slaughtered by Islamic fundamentalists, there is no offer of regret.  In fact Mohammad Merah's only regret was that he could not have killed (and video taped)  more. 

The notion that the purposeful, intentional murder of innocent human beings will bring heavenly reward is the most, obscene,  perverted notion of spirituality that is imaginable.  Even Hitler never made such an assumption for his actions.

Perhaps this represents the clash of cultures.  But what does that really mean?  I'm afraid it is quite clear.  Barbaric, inexcusable actions need no explanation.  And by the way, did I miss the news of world wide Muslim condemnation for this horrific act? Any religion which makes excuses for such actions needs serious self-examination if it is to claim spiritual validity.

Hell has a special place for such murderers.  But if hell doesn't exist, karma will take care of it. 

At the very least the life review every soul experiences after death is the perfect justice.  Every experience, every act we have committed and its impact on other souls is experienced and felt through the eyes and mind of the victim.

Hope Merah is enjoying his.





What will become of the state of health care in this country when large number of "older" doctors leave practice?  

The trend is for this exodus of my generation of physicians to continue unabated over the next few decades.  I saw the earlier version of this phenomenon occur beginning in the generation of doctors that preceded me.  They were literally shocked by the radical changes in medicine, the rise of managed care companies, the government intrusion into the private practice of medicine, insurance companies dictating drugs that could or could not be prescribed, the increasing antagonism, even threatening attitude of patients towards them, the continued threat of litigation and malpractice trials.

Well now it may be my generation's turn.  It's sad on many levels.  After 32 years of practice I truly believe that I am a better physician now than anytime in my career.

I've seen more.  I've been humbled by the inexplicable, unpredictable nature of health and disease. I've been continually amazed by the variability of disease as it affects any one individual.

 I have faced my own personal adversities in life.  I understand from a deeply felt perspective what stress and loss can do to a person's overall health. I recognize the subtlety and difficulty in trying to help a sick human being.  

The longer I practice the more humble I become in the face of human suffering. I understand the relationship between the mind, body and soul.  I fully comprehend how "dis-ease" leads to disease. And am still awed by the variety and variation by which it occurs.

And I, too, have felt the strangling weight of bureaucratic red tape, federal and state mandates, electronic medical records in which documentation is more important than healing, insurance company badgering, patient malpractice claims over unavoidable circumstances, the unfettered, inappropriate intrusion of the state board of medical  examiners over areas they deem their own.

Yet despite the difficulties I have promised myself not to succumb.  To give in is to accept defeat.  I remind myself that this profession remains worthwhile as long as one patient appreciates what I do and can still do. 

So for now I'll let my white hair and my white coat lead the way.



This is a rather convoluted story but hopefully it will resonate with some of you.

A synchronicity is defined as a "meaningful coincidence".  Carl Jung was impressed by the significance of such "meaningful coincidences" which implied some deeper purpose or reason for their coming to be.  When we find meaning in coincidences we should not reject them as pure chance.  Perhaps there are reasons for their occurrence.  Perhaps our awareness of their coming together brings deeper meaning to our lives. Perhaps they offer us lessons to be learned.  At the very least they are compelling and interesting if not entertaining.  So begins the following story.

My medium friend Lynn Milano told me of a recent reading she had done in which a woman I'll call Joan connected with an old and dear friend who had passed on.   After supplying her with some personal details which only Joan could validate, Lynn described an image in her mind's eye which was quite unusual–an enormous elephant.

She reluctantly mentioned this image to her Joan who smiled broadly.   She completely understood.  She told Lynn that she and her friend had grown  up in a small town in Canada and that there had been a statue of large elephant there.

This immediately rang some deep, fragmentary memory of mine.  I thought that a massive elephant named Jumbo had died in a small town and a huge replica had been built in its memory.

I googled Jumbo and sure enough the information was fascinating.  Indeed a circus elephant named Jumbo had been hit by a train and died in the small town of St. Thomas in Ontario Canada.  The story was that the name Jumbo was a combination of two Swahili words and that subsequently the word jumbo entered the English language.  P.T. Barnum has spent 1o thousand dollars for the elephant who died in 1885.   In 1985 and enormous replica of Jumbo was unveiled in the small town.

I needed to confirm whether Joan had lived in this small town of St. Thomas.  I asked Lynn to try to contact her to confirm all of this.

Lynn called me back.  Indeed Joan and her friend had grown up in St. Thomas.  The statue was a perfect validation that Lynn had connected with her friend.  When Lynn explained who I was and why I was interested, Joan immediately revealed that I had performed a colonoscopy on her only two days before.

She had been unaware of my interest in spirituality and the paranormal.

When she returns to my office for follow up, we will have more to speak about than her procedure.


I must begin the discussion of ADCs (after-death communications) with the usual caveat and statement. 

This experience comes first hand from reliable witnesses.  I personally know this couple  for over 25 years.  This satisfies the credibility quotient  I have written about previously.  The reliability and honesty of any experience is only as as valid and valuable as the individuals involved.

I will paraphrase the story.   Mrs. Goldman was an elderly woman, a Holocaust survivor who developed dementia late in life.  She died in Hospice at a nearby hospital.  Before her death her children gave her a picture of her favorite jewelry box, one she had for many decades.  They kept the real box in her home.

After she passed away her daughter-in-law diligently searched "every inch" of her home for it.  It was missing.  All the contents of the house were put in boxes to be sold off at a garage sale.  Many individuals went through the contents of the boxes.  No jewelry box could be found. 

Finally her son David removed mezzuzahs (Jewish prayers wrapped in small metal containers and placed on doorposts) from the home.  It was completely empty and David silently spoke with his mother.  This was no longer to be their home.  David also asked his mother to pray for David's grandson in Israel recently diagnosed with leukemia.

For some reason David took a last quick look into the empty living room.  To his shock the jewelry box was sitting alone in the middle of  the empty floor.

He photographed it.  

There is no rational explanation for its sudden appearance.  It is simply and profoundly a physical manifestation of a missing personal object.  It is an after death communication from his deceased mother

End of story.


THE LAST GOOD WAR — Recalling Conversations with Frank

It has been just over a year since my father Frank passed from this physical world. Although I understand that love never dies I cannot help but miss him.

I particularly think about conversations we had regarding war. He was a World War II veteran, wounded with a purple heart and bronze star. He spent several years in and out of hospitals with multiple surgeries on his left leg. As a result he carried fragments of German steel in his leg and could never bend his left knee.

We spoke of politics and contemporary wars–of Iraq, Afghanistan, of past wars such as Vietnam and Korea. We agreed that World War II was the last "good war". How to define a "good war"? World events at the time clearly demonstrated the horrific aggressive and destructive actions of the German war machine under Hitler. The fall of Europe and England was a direct threat to our own security. This was even before the entire picture of the Holocaust had even occurred or was known about. If someone lost a loved one in combat during that war, there was a good chance that the ultimate sacrifice could be seen as having a higher purpose. In other words, their loved one did not die in vain. There was a reason to risk their life and ultimately pay the highest price for it.

Sadly, the wars that followed seemed pitifully weak on justification. Of course our country entered each one of them with some self-proclaimed higher purpose. In hindsight they seem pitifully contrived. What frightened us both was the apparent stupidity of those entrusted with the decisions regarding life and death of young Americans.

Did we not learn anything from the fiasco of Vietnam? There was senseless slaughter on both sides with ultimately the nation of Vietnam surviving and thriving according to its own path.

"Saving the world against Communist expansion", "weapons of mass destruction", "nation building"…..are we f–king nuts? What expert on the Middle East and Islamic culture thought for one minute that we, the great Western infidel would be welcomed into Iraq or Afghanistan? Is anyone shocked that we are leaving each with our tails between our legs? US soldiers in each place cannot justify our presence or their sacrifice even to themselves. Once there they only think of surviving and protecting their buddies.

We spoke of Eisenhower's admonition about the Military-Industrial Complex. Generals make their careers during times of war. Billions of dollars are spent and industrial giants reap huge profits when their planes, ships, rockets and weapons are utilized. The cost in human misery and suffering seems to be the least concern.

The last "good war" also brought to an end American complete, unquestioning faith in the decisions our leaders to enter war.  Is it any great surprise that we have lost confidence in their intelligence (both kinds) and that we question everything they do?

War is hell but passivity in the face of aggression and threat of destruction by an enemy is foolish. Those who give their lives in the defense of this nation are heroes. But it would be much easier to accept their loss if we would believe their sacrifice had been for a "good war".

HUMAN NATURE —- Let The Kids Lead The Way

Drive the streets of Manhattan, dodging careening cabs, jaywalking pedestrians, bike riders plowing through red lights, trucks double and triple parked along the curb and it might seem hard to believe that human beings are altruistic and cooperative by nature.  But according to a recent article in the New York Times by Sindyan N. Bhanoo, this is the case.

It was a study of pre-school children versus young chimps and monkeys who were presented with puzzles which required cooperative efforts and shared rewards for achievements.  Young humans did it, monkeys and chimps did not.

They relate this tendency to cooperate among our own with the concept of teaching.    We share our culture, our knowledge with others and this leads to a cumulative fund of knowledge and expertise.  That is why each generations of human beings do  not have to re-invent the wheel.

Of course human consciousness has at its disposal language both oral and written.  This allows us to teach each other when no one else is around.  But these studies reveal that at our core, as young children, we innately help each other to learn.

So despite our general impression of our kind as aggressive, bellicose, xenophobic, genocidal, obnoxious and competitive, there may just be a good side to us after all.

We can only hope so.   In any case it wouldn't hurt to remind ourselves that we aren't all bad all the time.  Just watch the kids.


 A recent Wall Street Journal article discussed how some members of the medical profession regard their own dying. The point of the article was that some physicians, aware of their own prognosis as well as the difficulty and/or futility of chemotherapy and surgery, elect to live their remaining days without any of it.   

There truly is value in seeking quality in the days of your life rather than the quantity.

It is a fascinating look into the practices of some physicians.  I, for one, can understand how this might be the best approach to my own dying process.  But life is often more complex and difficult than that.  Some physicians, equally aware of the scientific data and literature on survival of various cancers, may still elect to be "very" aggressive when it comes to the health of themselves or their loved ones.

In his book Healing Lessons    by Sidney Winawer, well respected professor of gastroenterology details the trials and tribulations of his own wife's struggle with gastric cancer.   Well aware of the evidenced-based recommended treatments, the undocumented alternative options, the radical and unsubstantiated claims of other modalities, Winawer could not refuse his wife any of them.  Knowing the unlikely outcome from such alternative treatments, he agreed to them.  He could not allow his wife to lose ALL hope.

So the topic is far from closed.  Some doctors will choose to die without the toxicity and suffering that often accompanies chemotherapy.  Others will try any treatment that is held to be of some use.  

All of us pray for the day when therapy will be more tolerable–when the benefit of treatment outweighs the risk and suffering.  And there has been great progress made in targeting treatment to specific cancer proteins, selectively killing malignant cells rather than ravaging the entire body.

The truth is that we are like everyone else.  Knowing better doesn't mean doing better.  But we can do better for ourselves and others.  Objectively look at the evidence.  Does a "response" to chemo mean one year, one month or one week.

What is the toxicity and more specifically how will WE react to treatment?  If there is one observation that more than 30 years of clinical practice has demonstrated to me it is this—everyone is unique.  Everyone responds differently to every treatment.

We (patient and doctor) must respect that truth.  Can we begin a course of therapy and then choose whether or not to continue?

Unfortunately for doctors as well as everone else, we are humbled in the face of death.

THE SUBWAY FANTASY — How Radical Islam Was Transformed by NYC

Allow me the following fantasy……

An Islamic extremist, Abduhl,  arrives in NYC on a student visa.  He is 20 years old and was raised in the Palestinian territories.  He was recruited by Hamas as a young man and received training from a Taliban camp in central Afghanistan.  He has been raised and indoctrinated to see the enemy as Christian or Jewish inhabitants of the Western world.  Raised on extreme Islam he is now in the belly of the beast–New York City.  It represents all that he has been taught to despise–capitalism, Western values, women walking around without head scarfs, tempting and testing a religious man's desire.  And furthermore it has a large powerful Jewish population.  It is Satan's playground and Abduhl has arrived to bring it down.

He has been educated in the mechanics of destruction.  He knows who to meet, how to locate operatives in NYC who will assist him in his goal.  He must learn about this evil City, understand why it is Satan's own.  He must establish a residence, attend classes, blend in.  He shaves his beard and adopts Western clothes.  He despises the way he looks but understands the higher purpose.

He begins to travel the subways of New York City.

He is immediately taken by the variety of human beings who travel these subterranean hollows.  He observes the crowded cars.  There are African-Americans standing alongside Asians.  There are teenagers with their Ipods.  There are business men with suits and briefcases.  There are whites, Hispanics, Asians, African-Americans. They stand next to each other.  Each in their own world. 

He spies the Hasidic Jews with their black hats and long beards.  He sees one with his woman and five children.  The woman has her head covered.  He sees an Asian appearing man in maroon robes and sandals.  He notices an attractive blond in her early thirties reading her Ipad.

At each station the subway doors slide open.  People leave, others enter.  It is a continuous process.  New faces. The mixture on his train changes but one thing never does–the incredible variety of colors, faces, ages.  He sees some Muslim women with head scarves and children enter the train.  He watches carefully but no one seems to offer more than a glance.  The women are sitting next to a Hasidic man.  He glances briefly at one of their children.  They look at him.

No one seems concerned.  Everyone is engrossed in themselves or the person they came on with. The continuous flow–a sea of diversity.  No one angry.  No one seems threatened.

He leaves at his subway stop.  He wanders around for hours.  He feels relaxed for the first time in many years.  He decides that he likes being here.  He changes his mind.

I told you this was a fantasy.  But if it could happen, it would happen in NYC.