This is Here After and I'm your host, Megan Divine. This week's show is a repeat performance. We'll be back with season two soon enough, but for right now, enjoy this episode and visit the back catalog of episodes two while you're at it. This is Here After and I'm your host, Megan Divine. Each week we tackle big questions from therapists, caregivers, and other helpful folks that let us explore how to show up after life goes horribly wrong. This week showing up to the full catastrophe of caregiving personally and professionally with incredibly special guests Cotion, Paileey Ellison, and Robert Chodo Campbell, founders of the New York Zen Center for Contemplative Care. Don't miss this one, friends, We'll be right back after this first break. Before we get started, one quick note, well, I hope you find a lot of useful information in our time here together. This show is not a substitute for skilled support with a license mental health provider or for professional supervision related to your work. Hey friends, I'm going to keep my intro here brief today, at least brief from me, because I want to use all the time we possibly have available for you to hear from both of our guests on the show today. Two people I love and admire and respect so much Coach and Paley Ellison and Choto. Robert Campbell Coach and Paley Ellison is an author, Zen teacher, young and psychotherapist, and certified chaplaincy educator. He and Robert Schoto Campbell co founded the New York Zen Center for Contemplative Care, which offers contemplative approaches to care through education, personal caregiving, and Zen practice. Through the Center, they provide a lot of resources and education, but I know them best to their Contemplative Medicine Fellowship, a year long training for physicians, nurse practitioners, and physician assistants who want to lead a change in the culture of care. You can probably tell that I am reading that directly off of their website because I want to make sure I describe it correctly. But there are two of the kindest, most ful people I have ever met, and I know a lot of people. But enough about me. Let's get to our guests. Coach and Choto, thank you so much for being here. It's a delight to be here. It's such a delight to be here, especially For me, I get to sit next to my husband of twenty years. I get to be in front of all your beautiful faces. Can believe, Tanya and Megan. It's just a beautiful, beautiful, beautiful way to begin my day. I cheat. The afternoon time is elastic. I'm already getting that faces choto. What are you talking about? This is supposed to be a brief intro and he's doing that thing where he just you know, you roll your your hands over the off screen, off screen, you roller hands off screen. You can have a little unbelievable what's your intro moment? God, I'm so glad to have you so coaching. The last time that you and I were in a gathering together, it was probably we've probably done it since, but it was like April, sort of height of the early pandemic in New York City, and I remember it was an online event, obviously pandemic, and you were in the middle of speaking, and suddenly the sirens behind you sort of drowned out your voice, and you just stopped and closed your eyes, and you said so sweetly to the audience, every siren is a chance to practice. And you took a beat, and then you just rolled along with whatever you had been saying about being present at the bedside of the suffering or the dying or those facing difficult medical stories. It was such a beautiful moment, and I actually told our producers here that when I said that, I was probably gonna cry, because I do cry every single episode because I'm a human with feelings. But that moment, for me really encapsulates what the two of you do. Right, just when humanity intersects with the moment that we're in, that's really where the two of you shine. I don't really have a question there, but like, that's what I feel about you too. One of the other things that comes to mind when we hear the sirens on twenty third Street is we often will say to students or members in the zendom at that time, you know, let's all just hope that whoever is in an ambulance gets the hospital in time. Let's hope that the technicians in the ambulance can do everything they can to save this life. And when the fire engines go by, it's the same thing. It's hope to get there on time to save members. In total. Yeah, it's just that that moment of connection, right, I think I picked up from you saying that in caution that one of Simon goes by, I just like close my eyes for a second and say good luck for everyone, right, the person in the vehicle, the family and friends that surround that, the people who are driving that vehicle, and the people at the medical facilities who will receive them, right, all of those concentric rings in that moment. I think that what's so striking is that our life is filled with what are sometimes called interruptions and annoyances or you know, the fly and ointment or whatever it is. And whether it's a siren or you know, someone not responding to you in the way that you wished it was, or get it receiving a diagnosis that you wish you didn't receive, or someone has died that you wish didn't die. To me, the opportunity is always saying, well, this is what's happening, and how do I actually receive it and welcome what's here, whether it's a siren or a wail from our own chest, because we're just missing and yearning for someone who has died, you know, thinking about you know a friend of ours, Stanley, and and he was in the grocery store aisle and picking up a tomato, and he burst into tears because the smell of the tomato reminded him of his wife who had died twenty years before. And there's no interruption, and after he wept, he just said, look at this tomato. I love what you said about concentric circles, because when we were with someone who is dying or someone who is suffering in the hospital, we often think that all the attention and usually ninety percent of the attention should be focused on the patient of the person in the hospital, but we forget the speaking of concentric circles, we forget about the care givers. We forget about the nurses, aids, the home held days, the doctors, the janitor that brings, you know, the cleans the room, the person that brings the food to the room, as well as all the family members. Of course, we tend to forget all the people involved in one patient's care. So I love that idea in the illustration that you're bringing up concentric circles, and it just continue to ripple out. And if you consider, for instance, the home health date or the nurse's assistant in a nursing home who has maybe two three hours of travel to get to where they need to go. How does that affect ripple out into the family when usually as a female, when she gets home after taking four bus rides or two bus rides or a subway in a bus ride, and she's exhausted, and she has to make dinner and she has to take care of the kids. So it's not just about the one person and one identified patients, shall we say? So that concentric circle is really important to keep in mind. That's what's occurring. And it brings up from me this idea that invisible and not invisible web of helpers that we just expect them to keep helping, right, We just expect them to sort of be machinery of help, right, or or helpful machines and just keep going. And I love what you said there. Total like often women in these positions and they come home and they have to serve more and they have to keep going. And certainly, now like none of this stuff with the pressure on the health care professions, none of the stuff is new. But seeing all of this trauma and stress and death and loss and suffering on top of old systemic fractures like this is really what I wanted to have you here with us today to talk about, Like I think in my in my notes too, I was like, I feel like we need to have a conversation inside the apocalypse for those networks of helpers, the therapists and the home health aids and the people who serve the food and work in the kitchens, and the doctors and the social workers, and what we keep asking them to bear and how do we even talk about not being able to bear that anymore? And honestly, you know, normally, when I have a guest on the show, I sort through the listener questions and I find things that intersect with the guests so that we can open up those conversations. And this time, as I was preparing, I just found myself saying, like, I don't know what to say about this stuff. I don't know what to say about the compounded weight on the I don't know communities, legions, legions maybe of people we lean on for help, And where are they supposed to lean for help when we keep looking for them to show up and serve and show up and serve and show up and serve and not stop. This is something that we hold so dear to our hearts, you know, and I think that one of the things that we've been concerned about these folks for a long time, you know, Chatter and I have been teaching in particular physicians for fifteen years and working with them and really figuring out how what's useful, how do we learn how to drop into ourselves and in particular physicians ahead of the highest rates of suicide, divorce, drug and alcohol abuse as well as one of the unique things is that as the most people leave that profession of being of doctoring. So we've been deeply concerned and then when the pandemic hit, we realized that we needed to do something that we needed to meet that need, and so we created this Fellowship in Contemplative Medicine, this year long fellowship for physicians, nurse practitioners and physician assistance to really address the roots of suffering, what the causes of their suffering are, how to pivot and what is the path? And so it's based on the fore noble truths of the Buddha and really looking at which is such a rare thing, is looking at our intra personal lives, like how are we inside of ourselves and our inner personal like how are our relationships going, like what are we actually doing when we get home? And then you know a third of it is also clinical work. But really, in some ways I feel like the call of this time has been part of the call of the medicine of this time, is to remember we only have one life. You know, there's so much focus on work life balance, and but really we have one life, and how are we in that life. We want to come back just for a moment to the importance of noticing the key give us in the home. It's something like seventy percent of key give us in the home of family members. And we have a support group four keg givers. We meet once every two weeks. And one of the key give us a couple of a couple of months ago, said something so profound. Both her parents have Alzheimer's and the daughter she does the errand she makes the food, She go the a T M machine, but she does everything that you need that the parents are asking of her. And one afternoon she just turned around, she said, I am not your robot mom. Can you imagine that what she had to go through it to get to that point where she said, I am not your robot mom. I need to take care of myself. I mean that it's so for me that it is so heartbreak to be diminished in such a way by her own parents, and to think about the suffering of the parents too with the Alzheimer's. You know that that obviously they were loving parents at one point, because she's taking care of them. But that kind of shift in relationships is so important, Coach, she was speaking of the relationships from these doctors that come into the profession hearts open, wanting to serve, wanting to do the best that they can, and slowly turn into these not all but of course slowly turned into these workhorses that go home and their relationships for their family changed. For a clod. We're in the middle of a huge crisis. It reminds me of just that that reductive binary that we applied to all aspects of being human. Right, that if you are called to be of service, you must be at service to your own detriment forever and ever our men right, And that there is no time culturally speaking, socially speaking, or in the workplace, there's no time for you to say I need a break, I need to stop. We don't support that. Instead, we come in and we say like, well, you got into this for a reason, and you need to draw on your passion for this so that you can stay resilient. Or in terms of a caregiver and the home a family member, it's like drawing the love that you had for them and give back and give back. So this is all something that that is a really big topic. We're going to go to a quick break and we're going to come back and I bet we're going to talk more about it. Welcome back everybody. That reductive binary of humanness, right that you are supposed to give and give and give and give and give and give and give and say thank you for being depleted like that, that really messes up so many things. I think that's one of the reasons why we've been really thinking about language. And you know, we have a habit of talking about caregivers, right, so it makes this one person just giving, giving, giving, giving, giving, It's kind of almost like a Michie. And so we've been really reflecting on language and really moving from caregiver to care partner because I feel like in many ways that that is actually moving to centering generosity, which for us is a different way of thinking about care. If we think about generosity, which is giving and receiving equally, so we're actually nourishing ourselves. And if we're not actually including ourselves in the circle of care, then what kind of care are we offer. We're the agent, we're the one so coming to the bedside or the zoom side, whatever it is, to show up. If we're not nourishing ourselves, we're just bringing that depletion to the relationship. Yeah, I mean again with this keg, the keg of the support groups that we have. They come in for the you know, it's an hour and a half of being together and you'll have a group and say, eight people with one commonality. I'm exhausted. I don't know how much longer I can do this. Even often is voiced, I love my mom, I love my dad, but it's time. It's been sick for so long. And I hate to say this, but if they died, it would be a huge relief for me and my family, and I love them so much. But this is unbearable. And within seven and I'm exhausted, and they'll be and you know, without a blink, the rest of the group we're saying, yeah, I understand the relief, the relief. So this is you know, this is also a huge, huge question that we have. What are we doing to take care the care partners? And you know, very little, yeah, very little, we share that same approach. We're telling the truth about it is the most powerful act we have currently available, right because we're so often rushing people out of their exhaustion or speaking their tiredness or their irritation, right, reminding people to be resilient, all of these things that we do. And so even just that ability or the welcoming of the truth in that situation does something I also so I wonder about. You know, we're speaking about family caregivers. This same sort of deficit of generosity shows up in all of the caregiving professions. So how do we start talking to you know, the social worker at the hospital or the internist who just they can't take a moment to be generous with themselves, They can't ask their colleagues to be generous with them and take care of each other, because we're all working from such such a deep deficit that like, there is effort involved in caring for yourself. And I can hear the frustration and so many people I speak with and here from I don't have the energy to figure out what I need to do to take care of myself. And this is yet another another one of those unsolvable challenges. Here what do we do there? I don't know they're quite buy into that we teach doctor isn't a care? You know what, they'll come because they'll come. In that statement, I don't have time and a time to rushly, you know, I to see you know, fifteen patients in and now whatever we say, actually, you know what it takes one minute? Stand still, where are your feet there on the floor, ground yourself, take a breath. I am here in this moment, in this moment, I'm giving myself permission to stop. And it can take one minute. We stay three minutes, it is preferable, but one minute will do it before I go to the next patient or to the next encounter. It's just and then moving on that good mount up to say, I don't know, it's thirty minutes a day. So for thirty minutes of your day, you've stopped, You've noticed what's happening in your body, you've noticed what's happening to your breath, and you've come back to center. So People often think that you have to meditate, it's gonna be thirty minutes and I don't have time. Well they don't for the most part. One minute everyone has. I love that, thank you. That's something that I try to act us and even I forget that. We get into that cycle of depletion and think, oh crap, right, like, oh, this means that I need to make myself healthy food, which means I need to find time to go to the grocery store and make sure that I get this and this, and then I have to come home and then the dog needs this. That sort of rapid cycling of the mind that says I can't, I can't, I can't, I can't, And it really is that brief one minute of connection. One of the things when I when I speak at hospitals back when we used to do things in person, When I speak at hospitals and very often speaking to nurses who see a lot of death and suffering and they don't have time to, you know, have a decompression session with their colleagues to talk about how hard it was to watch that kid die. What can we do, Like, what's the medicine that we need in there? It's that moment of grounding and centering you spoke about, and a moment of connection, whether that's with our own selves or with the people around us. And that's like, you know, I can't do it now because I'm nobody will see me on air. But the thing that I often encourage people in those fast paced environments to do is put one hand on their heart and make eye contact with somebody split second. There is something so medicinal in that communal acknowledgement of the moment, even if that's all you have time for. Just as important is to remember that this moment of stopping and grounding one song doesn't have to be limited to the our work hours. We can do this on our day off, we can do this on a weekend, if anyone has a weekend. But to be able to just in the midst of enjoyment, in the midst of shopping with our favorite things, looking at the tomatoes, whatever it is, to be able to go and that trains us, trains the mind to come to stands to stop. So I wouldn't just concentrate totally on the work environment, also in the whole environment, hiking, whatever it is, just take a moment here and It's like a moment of sabbath, you know, of actually taking a moment to be at one with where you are. And many of us think, you know that that whole thing about self care and self care of this and get manicure, watch Netflix or whatever that is, and all those things could be fun. But I think that how do we make time to not do even if it's that moment that we're talking about, you know? And I was thinking about nurses too and how to Tota and I were on impatient oncology, you know, which you know, mostly is the people are many of them will die. And when they died, you know, there was just this accumulative trauma on the staff because people love these people, and people said, we don't have time to do one more I we don't have time to do anything, and we realize, like what we do, Actually we have three minutes. We can get in a circle and say this person has died. What did you miss about them? What did you love about them? And everyone world, Yeah, everyone can say one thing, and it was so healing. We often are investing in habits that are depleting more than were investing in habits that actually are nourishing. So to me, it's also about how do we just get conscious? And that's one of the things that I'm just loving about our fellows is that they're learning about how to undo and to remember what they care about most. And then that's one thing is awareness, but then the crucial thing is learning how to put it into action. So seeing them really changing, like learning to look at their partner in the eyes, learning to look at their children, learning to look at themselves in the mirror, like who's there, you know, And it's so beautiful to see them actually changing. And but I think that change only happens when we crossed the threshold of awareness. We all kind of know what's off. But it's amazing to see when people say, I know it's off, and I'm going to practice and not be good at making a new groove. So excited. I love that those those creating habits that actually feed you. I think divorcing that like I I hear the things that you're suggesting in the things that you're saying, and I can hear people sort of saying, but that's not going to fix anything. What like sort of that collapsed despair and despondency, like what is this one overly simple tool going to do about the reality of this life and the death and the suffering and the constant fatigue in the exhaustion. And it's sort of that, you know, Davy and Goliath moment, what do I have of? And I love how you framed that as like, try it and see, try it and see. This is an experiment. It's going to wake you up to the reality of your life and the reality of suffering around you, and the reality of the suffering of the world. And it may spark some moment of what can I do? What can I do when I take the attention totally away from myself? What can I do to change the situation? The austen How do I advocate for myself? How do I advocate for the for the staff? Do I advocate sometimes for the patient? So it's not so self centric that one minute may evoke a moment of clarity and it may be you know what, I don't need this bullshit. I'm out of here. I need to take care of myself. I'm done with this ship. Don't end up being over tired and being doubly being under paid. I'm done with being treated like a robot. To use that way again, or maybe you know what. I love my job. I love this job. I just need to focus on that minute, that moment of clarity when I realized I've exhausted it. Yeah, I'm so exhausted. How can I get help my husband, from my wife, from my from my kids, just one thing? So I don't buy that the one minute stopping well not well, it's not about fixing anything. It's about being aware. So much in this world we cannot fix, but we can be aware of it. And what do we do with that awareness? Exactly? We can change the world. And that that complaint, Oh that's not gonna work. Oh that's you know, like it's so popular, right, and now we hear that I try that, I've tried that, I tried. I tried it once. You know. It just reminds me of this story where this guy goes up to this meditation teacher, Jack Cornfield and the airport. He's like, if you're Jack Gornfield and they're in the Miami Airport and he's like, I happened to be and he said, you know, I went to something about meditation with you, like thirty years ago. And he's like, oh, how was that? And He's like, it was horrible, didn't work. He's like, but the funniest thing. I was on the gurney going in for open heart surgery, and suddenly that was the only thing that made sense. And I'm so grateful, like I was able to come back to myself. So I think that there's something so amazing about our lack of receptivity to change. We resist change, we resist death, we resist actually reality of how things are changing and how do we just in some way, it's like, have a bit of playfulness around that voice of like it's not gonna work. It's like, I hear you grumpy, you know, I hear you, jaded part I hear you, I see you, I love you, and step out aside a little time sharing the psyche. Yeah, it's such a popular voice, you know, that kind of dissenting of change because we're so in some ways addicted to our suffering. In some ways, that's a voice of depletion that I have nothing in me to try these things, these things can't possibly work. That is seeing that voice as a voice of depletion. H We've been talking so much about caregivers and showing up in the moments and the power of that telling the truth to yourself and telling the truth to others. So, as educators and as practitioners, if you had sort of, okay, one succinct, sort of pithy message that you wanted to give to other educators and other practitioners, what do you think? What do you wish other educators and practitioners would know, either about grief or exhaustion or telling the truth. What do you wish they would know? You can't put it all in one bucket. There's no succinct answer. There's no same answer for each person. Grief is unique to each of us. We all do it differently. We're all grieving differently for different things. Oftentimes, you know, people are thinking they've lost a partner or child, or we could be grieving for the loss of a dog, the loss of any pet, for the loss of any animal. Grieving can be the loss of the job, you know, the loss of a home. So we can't always assume that there's like one pet answer, one pat recommendation to deal with grief. So, for me, the pithy, if you like to use that word, is take a look. What is it really about remembering the moment or a period of grief can touching to so many other grief experiences. You know, It's like it's the domino effect, just like the my cat died and I'm direct on beyond beyond sadness and has realized, why am I thinking about my mom? Why am I thinking about X, Y and Z? Why am I thinking about that person? I haven't processed my grief from twenty years ago. So how do I say to someone you know, recognize the grief of what it is in this moment, and recognize the grief of what else it could be. It's not always want, it's not always so you have to not get stuck in some idea. I agree. I think that makes sense for grief in our own lives and also as educators and those who show up to serve people who are in really difficult times of their lives, is to wander into it and be curious, rather than thinking we know all of the answers or that there are any answer. So I think that's a really beautiful place for us to sort of come full circle with the beginning of our conversation into this conversation about curiosity and experimentation with what it means to be fully human and fully here, even in the moments when you don't feel like you can be fully here. Friends, thank you so much for being here. I'm going to link to all of the places that people can find you, and the fellowship and all of those things, but tell our listeners right now where they can find you individually and collectively and anything else you need them to know before we get into our questions to carry with you after the break. So the New York and Center for Contemplative Carry Confine us at zencre dot org and at New York Zen Center at New York's and Center for Instagram and Coach and Paley Ellison at Coach and Really Elson for Instagram and Toto Campbell Zerology than or applications for the Fellowship open soon. For the Contemplative Medicine Fellowship are currently open is open enrollment, and so we're already filling up for the next cohort. And we have a podcast it's called end Care and you can find an Apple podcasts oh and our books Awake Up, the Bedside, Contemplative Teachings and Patative and End of Life Care and my book co Hearted, Slowed Down, Help Out, Wake Up. Both of those books can be found anywhere that books are sold excellent. Each week I leave you with questions to carry with you until we meet again. It's part of that whole. This awkward stuff gets easier with practice. Thing. But this week we are not wasting an opportunity to hear from our guests with their questions to carry with you. So one of the things that I invite you to do this week is to reflect on what else is true? And so when you find yourself caught in some thought about a sadness or an anger or grief, just to invite the question what else is true? For me? This is a way to learn how to widen out, not to bypass anything, not to deny anything, but to actually allow ourselves to ground ourselves right where we are. I remember walking down the street the other day, just feeling so sorrowful and looking up in the sky into seeing the birds flying above and the branches, the bare branches framing the sky, like that was also true, So that finding how do you drop down and widen out and find what else is true? Is it really overused sentence or cliche? Wake up and smell the coffee. I like to ask you to wake up and smell and notice and see whatever is in front of you. You're walking down the street, a lady or gentleman with a stroller and baby walking towards you. Notice that moment of look at that beautiful baby, or that that baby doesn't stop crying. Why isn't the parents taking care of it? Just notice? Noticed dogsh it on the sidewalk. Notice the beauty of the buzz are beginning to appear now in the spring or whatever the time of year is. But to really notice what is in front of you from your home, on the way to work. What is it like to step onto the bus, the transition from the sidewalk to the bus. The people on the bus who are today notice them. Don't get stuck in your iPhone. You have a pose whatever it is. Be fully awake to your life, to each moment of your life, because it's short. In my meditations, I say, each in breath is bringing life into the body, and each outbreath is a small day. The last thing we do, it's die on the ExHAM when we done. The last thing we do is ExHAM ah. So on each breath. Where is you are in your life right now? I want to know how to send your questions into me to maybe answer in the future show. This show is nothing without your questions. It is literally a Q and a show. I use your questions to talk about the wider world. So if you have a question, I guarantee that at least a thousand other people have the same question. There's no empirical evidence for that number, so don't quote me. But I'm sure whatever you're wrestling with, other people are wrestling with it too. So bring me your questions, your clinical questions, your frustrations about caregiving or life, anything that you're really wrestling with, and you could use a script for let's talk it out. Call us at three to three six four three three seven six eight and leave a voicemail. If you missed it, you can find that number in the show notes or visit us at Megan Divine dot c O. If you'd rather send an email, you can do that right on the website Megan Divine dot c O. We want to hear from you. This show, this world needs your questions. Together, we can make things better even when we can't make them right. You know how most people are gonna scam through their podcast app looking for a new thing. They're going to see the show description for Hereafter and think I don't want to talk about that stuff. Well, here's where you come in your reviews. Let people know it really isn't all that bad. In here we talk about heavy stuff, but it's in the service of making things better or for everyone, So everyone needs to listen. Spread the word in your workplace, in your social world on social media and click through to leave a review. Subscribe to the show, download episodes, and send in your questions. Want more Here After? Grief education doesn't just belong to end of life issues. Life is full of losses, from everyday disappointments to events that clearly divide life into before and after. Learning how to talk about all that without cliches or platitudes or simplistic think positive posters is an important skill for everyone. Find trainings, workshops, books and resources for every human trying to make their way in the world after something goes horribly wrong at Megan Divine dot c O. Hereafter with Megan Divine is written and produced by me Megan Divine. Executive producer is Amy Brown, co produced by Kimberly Cowen, Tanya Jujas, and Elizabeth Fosio. Edited by Houston Tilly and st video support by Chris Uren. Music provided by Wave Crush h

This is Here After and I'm your host, Megan Divine. This week's show is a repeat performance. We'll be back with season two soon enough, but for right now, enjoy this episode and visit the back catalog of episodes two while you're at it. This is Here After and I'm your host, Megan Divine. Each week we tackle big questions from therapists, caregivers, and other helpful folks that let us explore how to show up after life goes horribly wrong. This week showing up to the full catastrophe of caregiving personally and professionally with incredibly special guests Cotion, Paileey Ellison, and Robert Chodo Campbell, founders of the New York Zen Center for Contemplative Care. Don't miss this one, friends, We'll be right back after this first break. Before we get started, one quick note, well, I hope you find a lot of useful information in our time here together. This show is not a substitute for skilled support with a license mental health provider or for professional supervision related to your work. Hey friends, I'm going to keep my intro here brief today, at least brief from me, because I want to use all the time we possibly have available for you to hear from both of our guests on the show today. Two people I love and admire and respect so much Coach and Paley Ellison and Choto. Robert Campbell Coach and Paley Ellison is an author, Zen teacher, young and psychotherapist, and certified chaplaincy educator. He and Robert Schoto Campbell co founded the New York Zen Center for Contemplative Care, which offers contemplative approaches to care through education, personal caregiving, and Zen practice. Through the Center, they provide a lot of resources and education, but I know them best to their Contemplative Medicine Fellowship, a year long training for physicians, nurse practitioners, and physician assistants who want to lead a change in the culture of care. You can probably tell that I am reading that directly off of their website because I want to make sure I describe it correctly. But there are two of the kindest, most ful people I have ever met, and I know a lot of people. But enough about me. Let's get to our guests. Coach and Choto, thank you so much for being here. It's a delight to be here. It's such a delight to be here, especially For me, I get to sit next to my husband of twenty years. I get to be in front of all your beautiful faces. Can believe, Tanya and Megan. It's just a beautiful, beautiful, beautiful way to begin my day. I cheat. The afternoon time is elastic. I'm already getting that faces choto. What are you talking about? This is supposed to be a brief intro and he's doing that thing where he just you know, you roll your your hands over the off screen, off screen, you roller hands off screen. You can have a little unbelievable what's your intro moment? God, I'm so glad to have you so coaching. The last time that you and I were in a gathering together, it was probably we've probably done it since, but it was like April, sort of height of the early pandemic in New York City, and I remember it was an online event, obviously pandemic, and you were in the middle of speaking, and suddenly the sirens behind you sort of drowned out your voice, and you just stopped and closed your eyes, and you said so sweetly to the audience, every siren is a chance to practice. And you took a beat, and then you just rolled along with whatever you had been saying about being present at the bedside of the suffering or the dying or those facing difficult medical stories. It was such a beautiful moment, and I actually told our producers here that when I said that, I was probably gonna cry, because I do cry every single episode because I'm a human with feelings. But that moment, for me really encapsulates what the two of you do. Right, just when humanity intersects with the moment that we're in, that's really where the two of you shine. I don't really have a question there, but like, that's what I feel about you too. One of the other things that comes to mind when we hear the sirens on twenty third Street is we often will say to students or members in the zendom at that time, you know, let's all just hope that whoever is in an ambulance gets the hospital in time. Let's hope that the technicians in the ambulance can do everything they can to save this life. And when the fire engines go by, it's the same thing. It's hope to get there on time to save members. In total. Yeah, it's just that that moment of connection, right, I think I picked up from you saying that in caution that one of Simon goes by, I just like close my eyes for a second and say good luck for everyone, right, the person in the vehicle, the family and friends that surround that, the people who are driving that vehicle, and the people at the medical facilities who will receive them, right, all of those concentric rings in that moment. I think that what's so striking is that our life is filled with what are sometimes called interruptions and annoyances or you know, the fly and ointment or whatever it is. And whether it's a siren or you know, someone not responding to you in the way that you wished it was, or get it receiving a diagnosis that you wish you didn't receive, or someone has died that you wish didn't die. To me, the opportunity is always saying, well, this is what's happening, and how do I actually receive it and welcome what's here, whether it's a siren or a wail from our own chest, because we're just missing and yearning for someone who has died, you know, thinking about you know a friend of ours, Stanley, and and he was in the grocery store aisle and picking up a tomato, and he burst into tears because the smell of the tomato reminded him of his wife who had died twenty years before. And there's no interruption, and after he wept, he just said, look at this tomato. I love what you said about concentric circles, because when we were with someone who is dying or someone who is suffering in the hospital, we often think that all the attention and usually ninety percent of the attention should be focused on the patient of the person in the hospital, but we forget the speaking of concentric circles, we forget about the care givers. We forget about the nurses, aids, the home held days, the doctors, the janitor that brings, you know, the cleans the room, the person that brings the food to the room, as well as all the family members. Of course, we tend to forget all the people involved in one patient's care. So I love that idea in the illustration that you're bringing up concentric circles, and it just continue to ripple out. And if you consider, for instance, the home health date or the nurse's assistant in a nursing home who has maybe two three hours of travel to get to where they need to go. How does that affect ripple out into the family when usually as a female, when she gets home after taking four bus rides or two bus rides or a subway in a bus ride, and she's exhausted, and she has to make dinner and she has to take care of the kids. So it's not just about the one person and one identified patients, shall we say? So that concentric circle is really important to keep in mind. That's what's occurring. And it brings up from me this idea that invisible and not invisible web of helpers that we just expect them to keep helping, right, We just expect them to sort of be machinery of help, right, or or helpful machines and just keep going. And I love what you said there. Total like often women in these positions and they come home and they have to serve more and they have to keep going. And certainly, now like none of this stuff with the pressure on the health care professions, none of the stuff is new. But seeing all of this trauma and stress and death and loss and suffering on top of old systemic fractures like this is really what I wanted to have you here with us today to talk about, Like I think in my in my notes too, I was like, I feel like we need to have a conversation inside the apocalypse for those networks of helpers, the therapists and the home health aids and the people who serve the food and work in the kitchens, and the doctors and the social workers, and what we keep asking them to bear and how do we even talk about not being able to bear that anymore? And honestly, you know, normally, when I have a guest on the show, I sort through the listener questions and I find things that intersect with the guests so that we can open up those conversations. And this time, as I was preparing, I just found myself saying, like, I don't know what to say about this stuff. I don't know what to say about the compounded weight on the I don't know communities, legions, legions maybe of people we lean on for help, And where are they supposed to lean for help when we keep looking for them to show up and serve and show up and serve and show up and serve and not stop. This is something that we hold so dear to our hearts, you know, and I think that one of the things that we've been concerned about these folks for a long time, you know, Chatter and I have been teaching in particular physicians for fifteen years and working with them and really figuring out how what's useful, how do we learn how to drop into ourselves and in particular physicians ahead of the highest rates of suicide, divorce, drug and alcohol abuse as well as one of the unique things is that as the most people leave that profession of being of doctoring. So we've been deeply concerned and then when the pandemic hit, we realized that we needed to do something that we needed to meet that need, and so we created this Fellowship in Contemplative Medicine, this year long fellowship for physicians, nurse practitioners and physician assistance to really address the roots of suffering, what the causes of their suffering are, how to pivot and what is the path? And so it's based on the fore noble truths of the Buddha and really looking at which is such a rare thing, is looking at our intra personal lives, like how are we inside of ourselves and our inner personal like how are our relationships going, like what are we actually doing when we get home? And then you know a third of it is also clinical work. But really, in some ways I feel like the call of this time has been part of the call of the medicine of this time, is to remember we only have one life. You know, there's so much focus on work life balance, and but really we have one life, and how are we in that life. We want to come back just for a moment to the importance of noticing the key give us in the home. It's something like seventy percent of key give us in the home of family members. And we have a support group four keg givers. We meet once every two weeks. And one of the key give us a couple of a couple of months ago, said something so profound. Both her parents have Alzheimer's and the daughter she does the errand she makes the food, She go the a T M machine, but she does everything that you need that the parents are asking of her. And one afternoon she just turned around, she said, I am not your robot mom. Can you imagine that what she had to go through it to get to that point where she said, I am not your robot mom. I need to take care of myself. I mean that it's so for me that it is so heartbreak to be diminished in such a way by her own parents, and to think about the suffering of the parents too with the Alzheimer's. You know that that obviously they were loving parents at one point, because she's taking care of them. But that kind of shift in relationships is so important, Coach, she was speaking of the relationships from these doctors that come into the profession hearts open, wanting to serve, wanting to do the best that they can, and slowly turn into these not all but of course slowly turned into these workhorses that go home and their relationships for their family changed. For a clod. We're in the middle of a huge crisis. It reminds me of just that that reductive binary that we applied to all aspects of being human. Right, that if you are called to be of service, you must be at service to your own detriment forever and ever our men right, And that there is no time culturally speaking, socially speaking, or in the workplace, there's no time for you to say I need a break, I need to stop. We don't support that. Instead, we come in and we say like, well, you got into this for a reason, and you need to draw on your passion for this so that you can stay resilient. Or in terms of a caregiver and the home a family member, it's like drawing the love that you had for them and give back and give back. So this is all something that that is a really big topic. We're going to go to a quick break and we're going to come back and I bet we're going to talk more about it. Welcome back everybody. That reductive binary of humanness, right that you are supposed to give and give and give and give and give and give and give and say thank you for being depleted like that, that really messes up so many things. I think that's one of the reasons why we've been really thinking about language. And you know, we have a habit of talking about caregivers, right, so it makes this one person just giving, giving, giving, giving, giving, It's kind of almost like a Michie. And so we've been really reflecting on language and really moving from caregiver to care partner because I feel like in many ways that that is actually moving to centering generosity, which for us is a different way of thinking about care. If we think about generosity, which is giving and receiving equally, so we're actually nourishing ourselves. And if we're not actually including ourselves in the circle of care, then what kind of care are we offer. We're the agent, we're the one so coming to the bedside or the zoom side, whatever it is, to show up. If we're not nourishing ourselves, we're just bringing that depletion to the relationship. Yeah, I mean again with this keg, the keg of the support groups that we have. They come in for the you know, it's an hour and a half of being together and you'll have a group and say, eight people with one commonality. I'm exhausted. I don't know how much longer I can do this. Even often is voiced, I love my mom, I love my dad, but it's time. It's been sick for so long. And I hate to say this, but if they died, it would be a huge relief for me and my family, and I love them so much. But this is unbearable. And within seven and I'm exhausted, and they'll be and you know, without a blink, the rest of the group we're saying, yeah, I understand the relief, the relief. So this is you know, this is also a huge, huge question that we have. What are we doing to take care the care partners? And you know, very little, yeah, very little, we share that same approach. We're telling the truth about it is the most powerful act we have currently available, right because we're so often rushing people out of their exhaustion or speaking their tiredness or their irritation, right, reminding people to be resilient, all of these things that we do. And so even just that ability or the welcoming of the truth in that situation does something I also so I wonder about. You know, we're speaking about family caregivers. This same sort of deficit of generosity shows up in all of the caregiving professions. So how do we start talking to you know, the social worker at the hospital or the internist who just they can't take a moment to be generous with themselves, They can't ask their colleagues to be generous with them and take care of each other, because we're all working from such such a deep deficit that like, there is effort involved in caring for yourself. And I can hear the frustration and so many people I speak with and here from I don't have the energy to figure out what I need to do to take care of myself. And this is yet another another one of those unsolvable challenges. Here what do we do there? I don't know they're quite buy into that we teach doctor isn't a care? You know what, they'll come because they'll come. In that statement, I don't have time and a time to rushly, you know, I to see you know, fifteen patients in and now whatever we say, actually, you know what it takes one minute? Stand still, where are your feet there on the floor, ground yourself, take a breath. I am here in this moment, in this moment, I'm giving myself permission to stop. And it can take one minute. We stay three minutes, it is preferable, but one minute will do it before I go to the next patient or to the next encounter. It's just and then moving on that good mount up to say, I don't know, it's thirty minutes a day. So for thirty minutes of your day, you've stopped, You've noticed what's happening in your body, you've noticed what's happening to your breath, and you've come back to center. So People often think that you have to meditate, it's gonna be thirty minutes and I don't have time. Well they don't for the most part. One minute everyone has. I love that, thank you. That's something that I try to act us and even I forget that. We get into that cycle of depletion and think, oh crap, right, like, oh, this means that I need to make myself healthy food, which means I need to find time to go to the grocery store and make sure that I get this and this, and then I have to come home and then the dog needs this. That sort of rapid cycling of the mind that says I can't, I can't, I can't, I can't, And it really is that brief one minute of connection. One of the things when I when I speak at hospitals back when we used to do things in person, When I speak at hospitals and very often speaking to nurses who see a lot of death and suffering and they don't have time to, you know, have a decompression session with their colleagues to talk about how hard it was to watch that kid die. What can we do, Like, what's the medicine that we need in there? It's that moment of grounding and centering you spoke about, and a moment of connection, whether that's with our own selves or with the people around us. And that's like, you know, I can't do it now because I'm nobody will see me on air. But the thing that I often encourage people in those fast paced environments to do is put one hand on their heart and make eye contact with somebody split second. There is something so medicinal in that communal acknowledgement of the moment, even if that's all you have time for. Just as important is to remember that this moment of stopping and grounding one song doesn't have to be limited to the our work hours. We can do this on our day off, we can do this on a weekend, if anyone has a weekend. But to be able to just in the midst of enjoyment, in the midst of shopping with our favorite things, looking at the tomatoes, whatever it is, to be able to go and that trains us, trains the mind to come to stands to stop. So I wouldn't just concentrate totally on the work environment, also in the whole environment, hiking, whatever it is, just take a moment here and It's like a moment of sabbath, you know, of actually taking a moment to be at one with where you are. And many of us think, you know that that whole thing about self care and self care of this and get manicure, watch Netflix or whatever that is, and all those things could be fun. But I think that how do we make time to not do even if it's that moment that we're talking about, you know? And I was thinking about nurses too and how to Tota and I were on impatient oncology, you know, which you know, mostly is the people are many of them will die. And when they died, you know, there was just this accumulative trauma on the staff because people love these people, and people said, we don't have time to do one more I we don't have time to do anything, and we realize, like what we do, Actually we have three minutes. We can get in a circle and say this person has died. What did you miss about them? What did you love about them? And everyone world, Yeah, everyone can say one thing, and it was so healing. We often are investing in habits that are depleting more than were investing in habits that actually are nourishing. So to me, it's also about how do we just get conscious? And that's one of the things that I'm just loving about our fellows is that they're learning about how to undo and to remember what they care about most. And then that's one thing is awareness, but then the crucial thing is learning how to put it into action. So seeing them really changing, like learning to look at their partner in the eyes, learning to look at their children, learning to look at themselves in the mirror, like who's there, you know, And it's so beautiful to see them actually changing. And but I think that change only happens when we crossed the threshold of awareness. We all kind of know what's off. But it's amazing to see when people say, I know it's off, and I'm going to practice and not be good at making a new groove. So excited. I love that those those creating habits that actually feed you. I think divorcing that like I I hear the things that you're suggesting in the things that you're saying, and I can hear people sort of saying, but that's not going to fix anything. What like sort of that collapsed despair and despondency, like what is this one overly simple tool going to do about the reality of this life and the death and the suffering and the constant fatigue in the exhaustion. And it's sort of that, you know, Davy and Goliath moment, what do I have of? And I love how you framed that as like, try it and see, try it and see. This is an experiment. It's going to wake you up to the reality of your life and the reality of suffering around you, and the reality of the suffering of the world. And it may spark some moment of what can I do? What can I do when I take the attention totally away from myself? What can I do to change the situation? The austen How do I advocate for myself? How do I advocate for the for the staff? Do I advocate sometimes for the patient? So it's not so self centric that one minute may evoke a moment of clarity and it may be you know what, I don't need this bullshit. I'm out of here. I need to take care of myself. I'm done with this ship. Don't end up being over tired and being doubly being under paid. I'm done with being treated like a robot. To use that way again, or maybe you know what. I love my job. I love this job. I just need to focus on that minute, that moment of clarity when I realized I've exhausted it. Yeah, I'm so exhausted. How can I get help my husband, from my wife, from my from my kids, just one thing? So I don't buy that the one minute stopping well not well, it's not about fixing anything. It's about being aware. So much in this world we cannot fix, but we can be aware of it. And what do we do with that awareness? Exactly? We can change the world. And that that complaint, Oh that's not gonna work. Oh that's you know, like it's so popular, right, and now we hear that I try that, I've tried that, I tried. I tried it once. You know. It just reminds me of this story where this guy goes up to this meditation teacher, Jack Cornfield and the airport. He's like, if you're Jack Gornfield and they're in the Miami Airport and he's like, I happened to be and he said, you know, I went to something about meditation with you, like thirty years ago. And he's like, oh, how was that? And He's like, it was horrible, didn't work. He's like, but the funniest thing. I was on the gurney going in for open heart surgery, and suddenly that was the only thing that made sense. And I'm so grateful, like I was able to come back to myself. So I think that there's something so amazing about our lack of receptivity to change. We resist change, we resist death, we resist actually reality of how things are changing and how do we just in some way, it's like, have a bit of playfulness around that voice of like it's not gonna work. It's like, I hear you grumpy, you know, I hear you, jaded part I hear you, I see you, I love you, and step out aside a little time sharing the psyche. Yeah, it's such a popular voice, you know, that kind of dissenting of change because we're so in some ways addicted to our suffering. In some ways, that's a voice of depletion that I have nothing in me to try these things, these things can't possibly work. That is seeing that voice as a voice of depletion. H We've been talking so much about caregivers and showing up in the moments and the power of that telling the truth to yourself and telling the truth to others. So, as educators and as practitioners, if you had sort of, okay, one succinct, sort of pithy message that you wanted to give to other educators and other practitioners, what do you think? What do you wish other educators and practitioners would know, either about grief or exhaustion or telling the truth. What do you wish they would know? You can't put it all in one bucket. There's no succinct answer. There's no same answer for each person. Grief is unique to each of us. We all do it differently. We're all grieving differently for different things. Oftentimes, you know, people are thinking they've lost a partner or child, or we could be grieving for the loss of a dog, the loss of any pet, for the loss of any animal. Grieving can be the loss of the job, you know, the loss of a home. So we can't always assume that there's like one pet answer, one pat recommendation to deal with grief. So, for me, the pithy, if you like to use that word, is take a look. What is it really about remembering the moment or a period of grief can touching to so many other grief experiences. You know, It's like it's the domino effect, just like the my cat died and I'm direct on beyond beyond sadness and has realized, why am I thinking about my mom? Why am I thinking about X, Y and Z? Why am I thinking about that person? I haven't processed my grief from twenty years ago. So how do I say to someone you know, recognize the grief of what it is in this moment, and recognize the grief of what else it could be. It's not always want, it's not always so you have to not get stuck in some idea. I agree. I think that makes sense for grief in our own lives and also as educators and those who show up to serve people who are in really difficult times of their lives, is to wander into it and be curious, rather than thinking we know all of the answers or that there are any answer. So I think that's a really beautiful place for us to sort of come full circle with the beginning of our conversation into this conversation about curiosity and experimentation with what it means to be fully human and fully here, even in the moments when you don't feel like you can be fully here. Friends, thank you so much for being here. I'm going to link to all of the places that people can find you, and the fellowship and all of those things, but tell our listeners right now where they can find you individually and collectively and anything else you need them to know before we get into our questions to carry with you after the break. So the New York and Center for Contemplative Carry Confine us at zencre dot org and at New York Zen Center at New York's and Center for Instagram and Coach and Paley Ellison at Coach and Really Elson for Instagram and Toto Campbell Zerology than or applications for the Fellowship open soon. For the Contemplative Medicine Fellowship are currently open is open enrollment, and so we're already filling up for the next cohort. And we have a podcast it's called end Care and you can find an Apple podcasts oh and our books Awake Up, the Bedside, Contemplative Teachings and Patative and End of Life Care and my book co Hearted, Slowed Down, Help Out, Wake Up. Both of those books can be found anywhere that books are sold excellent. Each week I leave you with questions to carry with you until we meet again. It's part of that whole. This awkward stuff gets easier with practice. Thing. But this week we are not wasting an opportunity to hear from our guests with their questions to carry with you. So one of the things that I invite you to do this week is to reflect on what else is true? And so when you find yourself caught in some thought about a sadness or an anger or grief, just to invite the question what else is true? For me? This is a way to learn how to widen out, not to bypass anything, not to deny anything, but to actually allow ourselves to ground ourselves right where we are. I remember walking down the street the other day, just feeling so sorrowful and looking up in the sky into seeing the birds flying above and the branches, the bare branches framing the sky, like that was also true, So that finding how do you drop down and widen out and find what else is true? Is it really overused sentence or cliche? Wake up and smell the coffee. I like to ask you to wake up and smell and notice and see whatever is in front of you. You're walking down the street, a lady or gentleman with a stroller and baby walking towards you. Notice that moment of look at that beautiful baby, or that that baby doesn't stop crying. Why isn't the parents taking care of it? Just notice? Noticed dogsh it on the sidewalk. Notice the beauty of the buzz are beginning to appear now in the spring or whatever the time of year is. But to really notice what is in front of you from your home, on the way to work. What is it like to step onto the bus, the transition from the sidewalk to the bus. The people on the bus who are today notice them. Don't get stuck in your iPhone. You have a pose whatever it is. Be fully awake to your life, to each moment of your life, because it's short. In my meditations, I say, each in breath is bringing life into the body, and each outbreath is a small day. The last thing we do, it's die on the ExHAM when we done. The last thing we do is ExHAM ah. So on each breath. Where is you are in your life right now? I want to know how to send your questions into me to maybe answer in the future show. This show is nothing without your questions. It is literally a Q and a show. I use your questions to talk about the wider world. So if you have a question, I guarantee that at least a thousand other people have the same question. There's no empirical evidence for that number, so don't quote me. But I'm sure whatever you're wrestling with, other people are wrestling with it too. So bring me your questions, your clinical questions, your frustrations about caregiving or life, anything that you're really wrestling with, and you could use a script for let's talk it out. Call us at three to three six four three three seven six eight and leave a voicemail. If you missed it, you can find that number in the show notes or visit us at Megan Divine dot c O. If you'd rather send an email, you can do that right on the website Megan Divine dot c O. We want to hear from you. This show, this world needs your questions. Together, we can make things better even when we can't make them right. You know how most people are gonna scam through their podcast app looking for a new thing. They're going to see the show description for Hereafter and think I don't want to talk about that stuff. Well, here's where you come in your reviews. Let people know it really isn't all that bad. In here we talk about heavy stuff, but it's in the service of making things better or for everyone, So everyone needs to listen. Spread the word in your workplace, in your social world on social media and click through to leave a review. Subscribe to the show, download episodes, and send in your questions. Want more Here After? Grief education doesn't just belong to end of life issues. Life is full of losses, from everyday disappointments to events that clearly divide life into before and after. Learning how to talk about all that without cliches or platitudes or simplistic think positive posters is an important skill for everyone. Find trainings, workshops, books and resources for every human trying to make their way in the world after something goes horribly wrong at Megan Divine dot c O. Hereafter with Megan Divine is written and produced by me Megan Divine. Executive producer is Amy Brown, co produced by Kimberly Cowen, Tanya Jujas, and Elizabeth Fosio. Edited by Houston Tilly and st video support by Chris Uren. Music provided by Wave Crush h