Category Archives: PHILOSOPHY


I just re-read one of my favorite novels of all time, Adam Bede by Mary Ann Sanders, who wrote under the name George Eliot. It was published in 1859, yet I find much of it so relevant even today. Maybe timeless is the best term.

Most of us have been hit at one time or another by blinding, paralyzing grief. And the longer we live, the more losses we face. Some of us want nothing better than to “get back to where we were” and have things “go back to normal”. This author has a lovely description to gently move us away from that wish, in describing the gift of growing tenderness and compassion that can spring forth from our sorrow:

“For Adam, though you see him quite master of himself, working hard and delighting in his work after his inborn inalienable nature, had not outlived his sorrow – had not felt it slip from him as a temporary burthen, and leave him the same man again. Do any of us? God forbid. It would be a poor result for all our anguish and our wrestling, if we gain nothing but our old selves at the end of it – if we could return to the same blind loves, the same self-confident blame, the same frivolous gossip over blighted human lives, the same feeble sense of that Unknown towards which we have sent forth irrepressible cries in our loneliness. Let us rather be thankful that our sorrow lives on in us as an indestructible force, only changing its form, as forces do, and passing from pain into sympathy – the one poor word which includes all our best insight and our best love.”


Most of us can remember quite a few mistakes we have made – ones we may (or may not) be able to laugh at from a safe distance. At the time, we may have felt ashamed or embarrassed. Some of us stay mad at ourselves, or wish we could go back in time. Why do some of us tend to beat ourselves up, while others seem to have more resilience to laugh at themselves, forgive themselves, pick themselves up and move on – and even try again. I am not talking about gross moral failures, violent crimes, or abusive behaviors, of course. People with no remorse for such things are simply psychopaths. I am talking about everyday mistakes. Just the I Messed Up variety of human behavior. For interpreters, the wrong word. Misstating something. Making a poor choice about whether and how to intervene. Mixing up our schedule. I should have known that! I shouldn’t have done that! I can’t believe I did that! Argh!

Many in my generation were raised to think we are not allowed to make mistakes. We must show remorse, and even shame, for the tiniest of transgressions, like spilling milk or not finishing all the food on our plate. Luckily, no matter how long it seemed to last, our childhoods end, and we become adults. We are free from all those voices trying to shape us into responsible adults with harsh talk! Unfortunately, though, there is this funny thing called internalizing. And for many adults, we have a really mean parent who lives in our head, our harshest critic, whose job seems to be to keep us in line by beating us up! How terrible this voice can be if we allow it to drone on in the background like elevator music. We don’t like it, of course, and it is irritating, but in the case of harsh self-talk, scientists are now finding it actually harms us. I am repeating in case your inner critic tells you they are “keeping you from failing” – that inner critic is harmful, not helpful.

Consider the image of a tight fist. It is held up as a threatening image, and it may even be shaken in your face as a warning. You feel particularly happy? Ha! Your inner meanie might like to wipe that smile off your face! You feel a bit weepy? Whiner! That inner critic is standing by to give you something to cry about! Nobody cares! So knock it off! What are you waiting for? A knuckle sandwich? But wait, there is a second image available. A soft, and open hand. Inviting. Curious. Welcoming. Trusting. Forgiving. One that cuts you some slack, and forgives you for your very human frailty. Ready not to slap or punch, but to hold you, lead you, and comfort you. A hand that believes in you, and is with you all along. A soft and open hand. You have two of them available, one on each arm. You don’t have to beat yourself up.

Don’t worry. Contrary to old beliefs, being kind to yourself won’t make you a lazy loser who never accomplishes anything. If you see yourself as a donkey who must be driven by threats and force, I have an eye-opener for you. You are also the driver of the donkey, and you can choose to stand down, lay a gentle hand upon your trusty beast of burden, and walk alongside for a while. Frolic in a meadow, drink in the stream. Weave a wreath of flowers for both your heads, and make them edible while you are at it. Relax. Laugh. Take some pressure off. It is not as dangerous as it feels. It is actually both safe and helpful. You can be kind to yourself, and the world will continue to spin along its axis. Trust me, I have tried this. The sun still rose the next day. And the world was renewed.

Our endless stream of self-criticism does a few things. It gets our hormones stuck in the fear cycle, seeing threats at every turn – feeling attacked from all sides. We get stuck on high alert, ready to run or fight. Easily startled and easily wounded. This critical voice that has lived in our heads as long as we can remember tells us over and over that we are failures, never good enough, not worthy. It tells us things are hopeless, and nothing can change for the good, and so we give up. Why should we try? We are only going to disappoint and embarrass ourselves, and let our loved ones down! Life is shit, and we are shit. Right? Well, according to our harsh inner critic, shaking a fist in our face and scolding us, yes. But just because they said it doesn’t make it true. You get to decide what you believe.

The good news is there are countless methods popping up through science-based research to combat these nasty voices that keep us in perpetual fear and distress. The easiest starting point is what we already do with toddlers. Give them something else to do that engages them. They change their focus, and so can you. You start ruminating about a sad circumstance? Ask yourself, is this helping you? Or harming you? If it is not helpful, stop that flow of thought as early as you notice it, especially the repetitive thoughts. Dance, garden, walk if you can. Read a book, cook something, make something with your hands. Call a friend, watch something, sit outside somewhere. Remember a time of pleasure and sit with it for a moment. Do arts and crafts. Knit a sock – make a simple greeting card. Organize your toothpicks. Mow the lawn. Anything to shake loose the thoughts.

Another way to still the inner critic is to take each thought and send it down the river. “I can’t do anything right!” can be written in your mind’s eye on a leaf and you can drop it into the river and watch the letters dissolve – watch as the leaf floats downstream and disappears around the bend. Not yours anymore! Goodbye! You can write the thought in your mind’s eye on paper and toss it into a mental fire. Watch the paper curl and the words go up in smoke. You can use any imagery that speaks to you, and you can of course go out into the world on the earthly plane and do these simple but powerful rituals. The point is to allow yourself to stop holding these critical and negative thoughts in such a tight fist, so you can open up and release them. And the good news is that the only permission you need is your own.


I remember when I went to my first intensive course in mindfulness, meditation, active imagination, and energy work. I was in a very stressful marriage, about to lose my hard-earned spousal health insurance, retirement savings, pension plan, life insurance, and maybe even my house. I signed up for this intensive course so that while I was facing the loss of all of these things, I could at least endeavor to not lose myself in this shedding process. I have always been a hard worker, and striving and effort were points of family honor. Pushing through, trying harder, straining to the utmost. Anything effort can bring, all the way to the trembling breaking point. It doesn’t matter how you feel, as long as you can keep going. Push yourself for the long haul. Effort. Striving. Heroism. The person on the couch was despicable. I was the one holding everything together. It was my duty.

So like many Westerners I came into this course ready to go. I am at the edge of my seat, ready to meditate! I will strain to relax! I will hurry up and become patient! Not judging, accepting what is? Tell me how! I will do my best! Non-striving? I will strive to get to non-striving. I will try so hard! Trust? Okay, sure, tell me what I can trust and I will practice trusting it. The universe? Whoa, that is a big chunk to trust. What is going on here? Letting go? I am losing enough! I just want to keep myself intact and not lose myself amidst all this loss. So I have to hold myself tightly, grip the life vest, and navigate these dangerous waters. I plan to meditate to hold myself together, and I am willing to squeeze hard to do it. So tell me how to do that. And my teachers told me.

Open your mind. You cannot open your mind with tightness. You cannot open your fist with anything but a very loose hand. Breathe slowly. Loosen your tight muscles. Slack your jaw, allow your eyes to fall closed. Relax and observe. What is going on inside you when you slow down and listen and watch and feel? You expand. You clear space. You make room.

Withhold judgment. Just observe. Not banishing or fighting your reactions, but watching them float down the river and around the bend like fallen leaves. No one is fool enough to step into the river and try to change its flow. So don’t push the river. Don’t flounder in your thoughts. You are more likely to drown. Just sit quietly and watch from the shore this time. Release your thoughts. Let them go. Watch them disappear around the riverbend. No one wastes time chasing dead leaves and trying to tie them back onto the tree. The tree has released them for good.

Be patient. You don’t have to figure it all out the first or second or third time. Many things take an hour to learn and a lifetime to master, as you go deeper and deeper into circles of experience. Let it be what it is, own the experience, and let it unfold. More will be revealed. You and I have a mutual friend who never lies – Time. The universe is still unfolding. Breathe into relaxation, breathe into more peace and quiet. Be kind and gentle with yourself. Let it be.

Trust. Trust that you are on your path. That you are right where you need to be at this moment. That you are intact and you are okay. That you are resilient and will find your way back to balance and joy over time. Trust yourself to navigate through your current situation with the help and support you can access from people known and unknown. So much is available to you. Trust that you will get through this and come out stronger, wiser, and even more compassionate, through this experience.

Release. One of the hardest things for strivers is to move from the clenched fist to the loose and open hand. To let go of what no longer serves us. We can be like hoarders in our own bodies and our own space. We don’t want to lose anything! But what about the tension and pain we hold in our bodies? Wouldn’t that be a sweet thing to let go of? What about the repetitive and intrusive, gut-wrenching memories of betrayal or other past wrongs? That would be nice to quit reliving. What about our harsh and demanding inner critic, who tells us that if we can bear something, we must, for the sake of others? What about releasing our false sense of duty to something that is dead and cold? Because there is no obligation to keep gathering and relighting a fire that someone else has scattered. Make your own fire, and be warmed.

As we moved through weeks of training and practice, and these concepts were revealed to me among others, it seemed too good to be true. I can make things easier on myself by letting go and being patient, rather than striving? What? I can open my mind and accept what is happening without so much judgment and disdain and fury? I don’t really need righteous indignation to keep myself intact? I can trust the universe and let go of my specific intended result, trusting that I will land where I need to?

It was hard to believe. But eventually, by holding my life and my hopes and dreams in a loose hand, and letting the rest fall away, I found that I had so much more free space for the things that truly mattered to me. So I offer you the question. What matters to you, and have you made room for it? It is a question I continue to gently ask myself, and then I do my best to stay quiet enough to listen for the answers, as the universe unfolds.


Psychologists often use the image of a three-legged stool to show us what “coming into balance” looks like. The stool can represent a number of things. Diet, exercise and sleep can be the legs of good health. Home, work, and social lives can intertwine to give life meaning. The three-legged stool I am thinking of today is made up of our three basic emotional regulation systems. One is our “get up and go”. It helps us feel incentive and seek resources. Another is our “fight, flight, or freeze”. It helps us perceive threats and move into self-protection. The third leg of the stool is our “social animal”. It gives us our ability to soothe and care for each other. Let’s take a look at these three emotional regulation systems, and then check our balance. It would be interesting to make a three-column inventory of our thoughts for a day, and get a visual of where we are putting our focus and our energy.

What does resource-seeking look like? What resources does the human brain seek after? The basic means of survival: food and shelter. In our modern world, this gives us the incentive that leads to secure work. Using our jobs to pay our bills. Or more frequently, borrowing money and paying debt. Investing and risking. Getting ahead or falling behind. When we are successful in this area, it is going to be rewarding. We feel excited when we find out we are getting a raise or a promotion. We are satisfied when we can support ourselves and our family. We are happy when we feel strong and healthy. We are filled with vitality when we have our house, our garden, our physical lives set up and working well. We feel eager.

What about self-protection? These feeling are not so nice to fall into, although in the face of a real and imminent danger, they are literally life-saving. The problem is that very few of us spend our days actually running from top predators or escaping from burning buildings. Our threats are quite commonly made up in our own minds as we linger in this system, caught in a web of our own creation. This threat system motivates us to react when we fear we are in danger, conscious or unconsciously. We feel panic and a desperate need to lash out or run – or we shut down and cannot take necessary action. Yes, fear is the overwhelming emotion here. But this is also the system that awakens our feelings of disgust, and anger, and judgment as well. We see so much wrong with others here, and it helps to keep us at a safe distance as we look down upon these idiots. So judgment is part of our self-protection system, and is fear-based.

In the dominant US culture, where we live in a paradigm of right and wrong, winners and losers, the strong and the wimps, we may lose sight of the necessary third leg of our emotional regulation system: caring and soothing. This is where we harbor our pro-social feeling of affiliation with others. Belonging. We give and receive affection. We encourage others and are encouraged in our turn. We give and receive reassurance, comfort, and love. We find our people, our family, our friends, our clan. We are in overlapping groups and have shared interests. And how does this make us feel (once we conquer our competitive beast and move from “I have to win” to “we are all in this together”)? Relaxed. At ease. Content. Safe. Receptive to others. Able to listen and learn, in trust. Compassionate. And wanting to soothe and comfort others.

Unlike systems with on and off switches, these three regulatory systems are not mutually exclusive. They moderate and influence each other, but do not exclude each other. So we can run some background fear even as our bills are getting paid. We can choose to feel safe, taking it one day at a time, even when facing a grave illness. And we can easily be judgmental, even of the people we love the most, the ones who have our backs. So how does this information help us live more happy, useful lives? What researchers have found is that when we turn up our reactive and fearful emotions, including our fears about resource-seeking, we become self-focused and are less able to attend to the needs of others. And we scare ourselves. By practicing mindfulness and especially compassion, we are moving the focus off ourselves, and heightening the emotional system that regulates caring and soothing. And we soothe ourselves. So consciously spending more time in our social affiliation zone heightens our sense of community and calm safety. It actually helps us to care about others.


Those of you familiar with Tarot cards know about the fool’s card. Usually portrayed as a happy-go-lucky young person with a knapsack and a hiking stick, heading off into the unknown with full acceptance of whatever they are going to wander into. The “fool” is not stupid or gullible, so our current idea about how we must be worldly wise (and even cynical) does not come into it. The fool is simply a person who is seeing the world with new eyes and willing to head out into the unknown to have their adventures. From the traditional deck, it looks like the fool may be heading over a cliff – or maybe not. The fool is showing full trust and embracing the coming adventure, which they are already embarking upon. Like many fairy stories and myths (and not coincidentally, our human life cycles) the fool’s task is to go through a set of adventures and then gain the world – becoming wise about the world while still retaining that sense of wonder and innocence that has us waking up to a new world each morning.

Burnt out interpreters and many others can end up facing “yet another” drunk driver or self-destructive patient or whatever we have grown tired of, and feel like we know all about them. All our past experiences only add to our impatience, frustration, and judgment. We just wish we could make them behave, or that somebody could “knock some sense into them” and get them to take responsibility for themselves. Not this again! For heaven’s sake! Same old, same old. People can be so frustrating! They just do all kinds of stupid crap and we have heard it all before.

But what if we can find a way to come into each encounter, fully equipped with our vocabulary, and our ability to predict content and prepare ourselves with vocabulary and phrasing, and yet still come with what buddhists call Beginner’s Mind? And it is not only Buddha, of course. The christian tradition talks about how only those who can be childlike (fools) can get into heaven – let those who are childlike come to me, Christ says. And in a historic docudrama about the Ottoman Empire, a wealthy and educated judge starts to train under a Muslim monk, and demands important work, in accordance with his rank. But the wise old monk tells him, your task is to answer “I do not know” to every question that is asked of you. It was an adventure in itself to see how much this brilliant scholar learns by declaring aloud that he doesn’t know – by opening into childlike innocence and listening to others – letting go of what he thinks he knows. His world is made new.

Whatever traditions we blend, their common thread encourages us to open ourselves to beginner’s mind as the first step into awareness, peace of mind, and calm spirit. These traditions of renewal, starting with beginner’s mind, refresh us in our work as well. Staying in non-judgment, even when we think we have someone pegged. Having patience in our daily grind. Accepting the sometimes precarious and less-than-perfect conditions of our work. Avoiding the daily temptation to thrust ourselves into these encounters and make them come out “right”. Going into things with a calm sense of trust – presuming that nothing is wrong unless and until it really is, and then taking action as needed, without dwelling and suffering needlessly from our unwarranted presumptions. Letting go of our desires to control the outcome, which is so inimical to our neutral work as transparent interpreters.

The more we can greet each new language recipient as a new person, and accept that we don’t know “all about them,” the more we can stay neutral and suspend our common judgments. The less we judge, the more we can focus on our job and let the encounter take it course. The less tied we are to a specific idealized outcome, the more accepting we can be with how each encounter plays out. We will intervene less, and hold our interventions to when they are truly needed to set the communication to rights, once we stop feeling so urgently like we are the only ones who know what is best. As I deepen my meditation practice, I hope to become a greater fool, more open to the journey, and taking each new day as it comes. Because the less I judge, the more I am able to accept. And the less I know, the more I am able to learn.


Recent studies indicate that a typical person spends around half the time with their mind wandering from the present moment and the task at hand, and that it is a source of unhappiness and unease. I would like to know the details of the brain imaging and how they interpreted their data. I am also surprised it is not more frequent. Do we really only waste half of our waking hours lost in thought? Of course I am thinking of five things as I write this. Yes, distraction is real. One of the many purposes of mindfulness meditation is to tame the unruly mind by noticing what thoughts flow through, and gently directing our attention back to the present moment.

Certain areas of the brain light up when we are “not doing anything else”. The interesting part is to examine, through meditation, what the actual content is of our default mode. We have an endless stream of wandering thoughts – about what? For most of us, we weave many of our distracted thoughts out of the same three things: criticism of self and others; worries about the future; and regrets about the past. So it is worth examining the specifics of what engages us in our default moments. What stories are we telling ourselves? What are our personal myths? Did somebody do us wrong? Or have we let ourselves down? Do we waste time regretting how much time we have wasted? Are we stuck in a rut of repeated thoughts that serve no purpose but to nail us to the floor? Perhaps it is time to change our stories, and give ourselves some relief. One practice is to give ourselves the same kindness and encouragement and support that we give to our friends.

In addition to consciously changing the quality of our wandering thoughts, research indicates that we can also limit the time spent in default mode. Just as we cannot breathe in and out at the same time, we cannot stay in the default mode network of our brain once we engage the task positive network. They are mutually exclusive. As we focus on our breath and become fully present and aware, we can observe our thoughts and even (according to research again!) come to smile at them, rather than have them distress us. Almost all distress comes from past or future thoughts – we are usually judging something we think is wrong (someone’s past behavior) or worried about things that haven’t actually happened (future catastrophes). Right now, things are good. I am sitting comfortably in a chair writing to you. As you read it, you have taken a moment to relax.

Through practice and repetition, we can hold our attention with a gentle hand, and guide ourselves back to the present moment, over and over again. We can train our mind to be here, in the present, embodied and connected. Meditation has even been shown to develop and thicken the areas of the brain related to attention and emotional awareness. So this sense of being more connected is not just imagination. What we practice gets stronger, not only muscles, but mental habits. If we are destined by neurobiology to keep “playing back the same movie” on a loop, we may as well learn to turn it off more easily, and make it a better movie while we are at it. Letting our old superhighways of negative patterns dwindle away as we steer away from them. Creating more life-affirming and soothing thought patterns. We may need a machete to break though the first few times, but as we practice we can make ourselves some sweet little paths and forest trails to wander along, when our minds choose to wander.


I was just invited to participate in an online mindfulness course geared toward health workers. During the pandemic especially, many of us have read articles or watched programs about mindfulness, as one of a myriad of self-care suggestions to keep ourselves going, but what does mindfulness really mean? Is it about meditation? Sitting cross-legged and chanting Om? Thinking about – nothing? Realizing that pain is mere delusion and we can escape it all through our mindfulness? Rise above this human condition and have nothing bother us forevermore, a heaven on earth? Not to me, at least.

One of my favorite Buddhist folk tales explains a key practicality of enlightenment in the simplest terms. A young monk approaches the master with a question he has been asking himself since arriving at the monastery. What is enlightenment? What is it really, on the ground? How will it change things? He gathers courage and in one of his mindfulness training sessions, he asks. Master, what will I do once I am enlightened? The master answers with a question. What do you do now, child? Master, I chop wood and carry water. But Master, what will I do once I am enlightened? The master smiles at the young innocent, and says, “You will chop wood and carry water.”

Moral of the story: We will still live in the world. No matter how mindful we become.

A dear friend of mine heard a lecture years ago by a renowned Eastern philosopher, who was on his first tour of the US. He observed that while people in his home country meditate to reach enlightenment, to become one with all that is, to attain nirvana, he was very surprised to find that these were not the typical goals of the Western meditator. The Westerns, he observed, had converted meditation into one of their many forms of strenuous self-improvement, like diet and exercise. They reportedly pushed themselves to do it so they could sleep better, lower their anxiety, be healthier, become happier, have better focus, and be more productive at their jobs. So these ancient traditions were transformed into one more task, rather than a path we can take to ease our minds, connect us with spirit and allow for more joy and compassion in our daily lives. I think this has been changing in many communities, and I am glad for it.

I once knew a man who was so disconnected from his feelings that I had to tell him what he was feeling. And ironically enough, when I noticed he was mad, and told him he was mad, he would claim he was not mad, but only became mad because I said he was mad. He really believed that I made him mad by noticing that he was mad. An astute young observer told me in confidence that “the reason he gets mad when you say he’s mad is because he’s embarrassed that you can tell when he’s mad before he can tell that he’s mad.” There is the extreme distance from mindfulness: dissociation. Disconnect. Lack of awareness. How can we have any hope of emotional regulation, of balance, let alone inner peace, if we don’t notice how we are feeling, if we never check in with ourselves? This is where mindfulness comes in.

A simple definition of mindfulness is cultivating the ability to know what is happening in your head at any given moment, without being carried away by it. Imagine noticing that you are getting mad before you get mad and act out. Noticing when you need a break. Noticing what thoughts are repeating themselves, and releasing them. Just being aware. Being here and now. Reflecting calmly and even with compassion – for ourselves as well as for others. And reminding ourselves that calm is just as contagious as fear and anxiety. Calm is just as contagious as impatience and frustration. We can spread calm. Within ourselves and without. And we can do so while continuing to chop wood and carry water, through our work in the world as well.


The United States is a culture of striving and trying. Trying to change things. Trying to control things. Worrying that we are falling behind in an invisible race. Striving to improve our circumstances. Not always seeing that we risk losing in wisdom what we gain in knowledge. Too hurried in the invisible competition to notice that whatever we gain in money, we lose in time. Feeling like we are failing if we cannot make everything “perfect”, and of course we never can. Those of us who were raised in the dominant US culture have so much to learn from others. Especially about acceptance.

Several monolingual people have asked me over the years if it is hard for me to work with a population that is “so uneducated”. I first surprise them by asking if they mean the patients or the doctors. Once they admit they think it is the patients who are ignorant, my answer is always the same: For every thing that I know that the patient does not, there is a corresponding thing that the patient knows and can teach me. Things great and small, some very conceptual or philosophical, and many that I believe are ancient ways of living that some sectors of our splintered society have lost along the way as they move away their multi-generational households, original languages, and old traditions.

A case in point. Babies. Many people from the dominant culture are convinced by the new healthcare “business model” that a perfectly healthy, well-formed baby is the natural result of “informed consumers” working with a team of scientific experts (culminating in a nicely appointed birthing room complete with jacuzzi and surround sound). From pre-pregnancy counseling to preventive vitamins and more, couples are led to believe that as they have “done everything” and “prepared so well” they can take for granted a perfectly healthy baby and even a pleasant delivery with all the perks that cutting edge technology can provide. Satisfaction guaranteed!

Other populations do not come into pregnancy with these notions. And when something is not the desired outcome, these parents are deeply equipped, at a root level, to handle the unexpected. A couple I will never forget, when they were gently offered information about their gravely ill unborn child, gave this reply: “We have talked it over, and we understand that our child will be flawed. But we have thought and prayed, and firmly decided to embrace this child as he is. Because really, who are we to demand of God a perfect child? We are not perfect. So we bow our heads to this and we take what God sends us. Our only job is to love this baby. And this we will do whole-heartedly.”

I have been interpreting for a family whose newborn baby has bones that did not grow in the usual way. This has resulted in short, stubby limbs and fingers. Most dangerously, this baby has a tiny, constricted chest. The official title of this syndrome includes the word “asphyxiating”, and they do not always survive the birth process once they have to draw their own breath. Whenever this little darling tries to move, cry, or feed, he cannot expand his lungs enough to breathe in fully – there simply isn’t room in his tiny rib cage. And his oxygen drops to dangerous levels, and his tiny heart races in response. He isn’t expected to live long.

Who knows what this tiny person is experiencing? I hope and pray for his sake that he is still in that state of primal “oneness with all living things” that so many people have tried to describe in words, and I like to believe that while he struggles to breathe, he also enjoys being held and caressed by his loving parents. In any case, I am fully convinced that he has none of the harrowing “why is this happening to me?” questioning that adds volumes to our suffering beyond babyhood, especially in the dominant US culture.

The doctors and specialists keep coming in to talk to this couple the way they are trained to do. Lots of talk about how the next study should give us more information, and we would like to run some genetic tests to narrow down the diagnosis, and the CT, and the MRI, and the X-rays, and the blood work, and the oxygen desaturations and the heart accelerations, and the calorie supplements for the pumped breast milk should be 22 grams per feeding. Each new young doctor has come in with thinly veiled discomfort and has interlaced multiple apologies into their updates, using words like “unfortunately” and “sadly” and “we just don’t have a cure yet!” No, we don’t, doctor. We don’t have a cure for the human condition.

As happens so many times, it was this young couple, embracing their extremely disabled baby, who could educate and enlighten any doctor who would take a moment to move beyond their repeated apologies for giving “disappointing” news about this “imperfect” baby that they found so personally painful and uncomfortable to relay. If only they could take a deep breath and pull back and truly listen to what these parents are saying:

“We love our baby as he is, right now. So you can stop apologizing. We are grateful for any time we have with him. We rely on your expertise and our love to give him the best experience possible. We want to give him a safe and loving home for as long as he needs it. We don’t expect or demand anything else.”

As usual, this young pair of agricultural workers, who travel three hours each way to come to our “specialty care” hospital, bring wisdom beyond technicalities. And what they say resonates so deeply.

In the end, our only job as parents is to love our children. Not to try and improve them, or wish they were different and better. Having a healthy baby is just icing on the cake. And the sooner we can recognize how very flawed and imperfect we ourselves are, the more reverently and unconditionally we can love our very human offspring.

This couple reminds us once again that children to do not come to us to be perfect or make us feel complete, but to be accepted and protected. To be cared for. This baby may be considered “disabled” by modern medicine, but he is perfectly and absolutely capable of being fully human. Of being loved, and of providing love and comfort to his parents. And they have already shown that they can and will love their child under any and all circumstances that life brings. Can we all say the same? Or do we only want to parent the child we envisioned? To approach parenting like this couple, with humility and an open heart, is a lesson for us all.


One of the hardest parts of facing our job, like others who work around a lot of trauma, is that we cannot go back to a time of not knowing. Whether it is seeing people sit in jail because they cannot afford a low bail, or developing cancer or birth defects in higher numbers, we see what is happening in our society on a visceral level, and face to face. Domestic violence, the ravages of drug addiction, COVID and other diseases that strike so unevenly across our populations. We are now aware, and we cannot forget or discount what we have witnessed. Where interpreters are so intimately involved, this can make us feel isolated from those who have developed their respective views by reading the opinions of others, rather than forming them from being “in the trenches” and seeing actual people in their real struggles.

It is one thing to read that agricultural workers appear to have higher incidences of certain illnesses. It is another to see several babies born with their stomachs outside of their skin, and have the pediatricians immediately and correctly guess the specific county where the mother lives, because it is so prevalent in that area. To have a mother in her 20’s with bone cancer, who had been going to the farmworker’s clinic complaining of intense pain for a year before they sent her for an x-ray and found a now incurable tumor. It is one thing to read about an immigration policy, such as Secure Communities. It is another to have a judge drop the charges against a young man who got drunk and raised his voice outside his shared apartment, at which his sister-in-law panicked and called the police in fear they could get evicted. To see the joy and relief on the young couple’s face at the hearing, only to go out with the defense attorney and tell them that immigration put a hold on the brother, and he will be deported.

We cannot go back to not knowing. We cannot unconnect the dots. But we can take opportunities, when they arise, to share our first-hand experiences while maintaining our duty of confidentiality. We can talk and listen to friends and acquaintances who due to their work and their own life experience have other pieces of the puzzle that will inform, enlighten, and ultimately unite us. I try to keep this in mind at the times where I feel most disconnected and hopeless. We have common ground, and there is much progress to be made when we work together. We need to keep having these conversations, and weave our threads together to make the cloth whole.


I was once being led through an unknown forest by my baby brother, and when I accused him of not knowing where we were, he assured me that he certainly was NOT lost. He further elucidated that he knew exactly where he was, as he was “right here.” He simply was not completely sure as to where he was in relationship to the things around him, like, say, the path we had wandered away from, or the car, to name two items. He, himself, though, was not “lost”. He held up his hands and showed them to me, to prove that he knew where he was. And he tried to reassure me by adding, “Come on! You know where you are! You’re right here! We’re not lost!”

In certain disease processes, we lose some of our ability to find ourselves in space. I am not talking about getting lost in the forest, or forgetting where we are. But literally not having that natural awareness we take so for granted, of knowing where our hands and feet are, what position we are in, whether our arms are crossed, and such. There are a multitude of feedback loops processed through muscle, joints and tendons that constantly let our brains know where we are and how we are positioned at any given moment. These mechanosensory neurons are known as propioceptors, and give us what some doctors now call our “sixth sense” of body awareness in space: propioception.

I was with a patient whose disease was not named to me, who was undergoing an evaluation of his impaired propioception. They did things like moving his hands or arms into specific positions with his eyes closed, releasing them to neutral, and seeing how closely he could recreate the pose. They also posed one arm to see if he could mirror it with the other arm, eyes closed. But his brain could not receive all the signals we take for granted. He was unable to mirror his arm positions or bend his elbows or hands to match. And like an alcohol-impaired driver at a field sobriety test, he had difficulty in touching the tip of his nose with a finger after stretching out his arm.

Many diseases can impact our ability to locate ourselves in space and get appropriate feedback about how we are positioned and the movements we make. Parkinsons, Huntingtons, ALS, even strokes and arthritis can impact it. I can only imagine what it must be like to lose some of this basic function. To not know where my own arm is in space. To not feel whether it is bent or straight. Imagine how you would walk, stand, or balance, or even pick up a plate, without the myriad of constant and consistent feedback loops that we all take for granted, unless and until they quit working.

Luckily, for this patient, there will be a series of exercises that he can learn in order to stimulate and strengthen these connections and feedback loops. He is also being trained to use his sight more in order to have the additional information about where his limbs are in space. Some balance exercises may help as well. He is strong in limb, and otherwise healthy, and I hope for him that whatever his disease is will progress slowly and allow him many years of active life. Just one more of the countless precious things most of us have and don’t ever have to name or even consider.

There is so much for us to be grateful for at the most basic level. To walk through space on an uneven surface without falling. To dance. To have a sense of where my whole body is at, and to know constantly what I am doing with my hands, how tightly I am grasping something, whether I might burn a finger or drop a glass. To sit here and run my fingers rapidly along the keyboard with such facility. To be fully embodied and in touch with every limb, the tip of each finger and toe, to feel all my skin, and to know where I am in the space that surrounds me. I am right here, right now, and so are you all. Isn’t it a pleasure, isn’t it a huge gift, to feel it?