Achieving calm in a crisis
Our Beloved Family:
I recently had the honor of being the keynote speaker for the 2019 graduating class of medical students at Western University of Health Sciences in Pomona, CA. I wanted to share the speech I gave with you and hope you are blessed by it.
Nearly 20 years ago, I left a seat just like the one you’re sitting on to rush to a major hospital in New York City to start my internal medicine internship. During one of my first calls as the house officer, I was so excited to evaluate the patient that, in my enthusiasm, I forgot to review the patient’s chart before I walked into the room and addressed him. Unfortunately, I was greeted by an unwelcomed gesture from the patient. As I extended my hand to him, he sank his teeth into it. After managing to free my left hand from the patient’s clenched jaw, I walked out to be informed by the rest of the team that the patient was HIV positive and that he most likely experienced an acute psychotic episode during the altercation. Apparently, they were familiar with his condition as he’d made repeated visits to the emergency room in the past.
In a flash, my life stopped. I realized everything I’d worked so hard for up to that point could have been destroyed in an instant. In the following days, the uncertainty and overwhelming stress about my health made the smallest task require twice the effort; even my breathing felt labored. My mind was constantly flooded with fears about how my life would drastically change if I contracted the virus. I was immediately started on a triple antiviral cocktail of drugs to prevent that from happening and yet, there were no guarantees. Even worse, I’d have to wait weeks before I could be tested and know for sure.
During one particularly long night of worrying, I found myself staring at a bottle of wine, and the realization that came to me helped me transcend out of the dark night of my soul. Looking at the bottle, I saw something that I’d never noticed before. While I had always noticed the bottle, the wine inside, and the cork, I had never noticed the empty space that existed below the cork and above the wine. As I discovered, the emptiness at the top of a new bottle of wine is called the headspace and is crucial in the wine production process. The amount of headspace in each bottle is determined by a formula that takes into account factors such as the volume of the bottle, amount of wine inside, and its percentage or proof of alcohol content. Calculating the correct amount of headspace is very precise. Not leaving enough could risk a buildup of pressure from fermentation that blows the cork right out of the bottle, while allowing too much would see the wine turn into vinegar.
As a young doctor, it became clear to me that although I had all the necessary ingredients for success like a great education, loving family, and loyal friends, the wine inside the bottle I called my life, whether everything exploded into a mess, soured into vinegar or fermented into the sweet wine of my dreams all depended on the headspace I created for myself throughout my life. This was especially the case in troubling times when something threatened what I was creating for myself.
Even in the worst moments of fear and doubt, I intuitively knew that if I could mind my headspace through my challenges, I could mend my life.
Fortunately, I tested negative for HIV, but going through that harrowing experience of not knowing what my future would be for at least three months forced me to create the headspace in my mind that was necessary to stay grounded in the eye of an emotional storm. Soon, I came to think of that headspace as my first office space where I counsel my most important patient—me. If I can’t secure my own sense of wellbeing, how can I be expected to do that for my patients? Doctor, heal thyself. Getting through the rigors of my internship working one-hundred hours per week while dealing with the possibility of having a terminal illness required great mental clarity and the cultivation of a psycho-spiritual internal ecosystem I now call headspace. Even in the worst moments of fear and doubt, I intuitively knew that if I could mind my headspace through my challenges, I could mend my life. Everything wouldn’t fall apart no matter what the tests revealed. To help myself through those tough times I created an acronym for the word headspace, and now to help you graduating medical students navigate the challenges of your lives, I share it with you.
H is for hold. Hold on! Don’t let go of your dream but be flexible enough to accept the possibility that it may manifest differently than you’d planned. Don’t get stuck on the details, but stay focused on the bigger picture of your vision. Pace yourself in a way that allows you to keep your life going without overwhelming yourself. Let the small things go and don’t feel like you have to control every aspect of the situation because you can’t anyway.
E is for empathy. Know that you are doing as well as you possibly can under the circumstances. We’re all making the best decisions with the knowledge available to us at the time. In spite of taking powerful antiviral drugs that caused extreme nausea and fatigue, I refused to beat myself up when those side effects impacted my performance. If I had to suddenly leave patient rounds or lecture to throw up in the nearest bathroom, then that’s what I had to do. Having empathy for myself helped me treat my patients with greater empathy and generosity of heart years later.
A is for acceptance. I learned peace amidst the storm comes largely from not arguing with what is. Acceptance doesn’t mean giving up or that things will always be a certain way forever. It simply means accepting that this is the way things are for now, not forever, but for now. Acceptance in the moment helps to regain a sense of peace while continuing to work toward a solution. Acceptance prevents the self-pity that often disempowers us. No one who kept asking, “Why me?” ever found a solution to their problem. Acceptance also neutralizes self-shaming that comes from second guessing ourselves. “If only” I had been assigned a different patient that night. I “should” have read the patient’s records or consulted a nurse on his condition before entering the room. All of those self-judgments go away when we accept that things are happening exactly as they are meant to happen and that there is meaning in it for us, even if we can’t see it at the moment. It will be revealed to us in time if we know how to surrender.
The word surrender includes the prefix “sur”, which means extra or above, as well as “render” which refers to a particular kind of translation of something. So to surrender means to adopt a new translation or meaning of the problem that’s above or beyond just the physical aspects that we can see. We must put our challenges into a new context that benefits and empowers us. For example, losing a job is never fun but instead of focusing on the workplace politics that brought it to be, we have the choice of seeing the separation as the universe’s way of moving us out of our comfort zone and into a new position that pays better, where we’ll be challenged more and finally get the respect we deserve. A change in perspective like that requires acceptance and trust. The gift of acceptance taught me to let go and let God. I knew that no matter what my medical tests ultimately showed, I had all the resources I needed to move forward into a fulfilling life even if it didn’t look exactly like the one I’d planned. It was dropout medical student turned renowned poet, John Keats, who really helped me understand acceptance with his concept of negative capability or the ability to sit in the mystery of uncertainty—the ability to be okay with things not being okay. That’s where headspace is.
D is for daring. Stare your challenge in the face and don’t back down. Dare to live a full life with joy and laughter in spite of it. Answers often come to us when we feed our souls in this way, spending time with loved ones and doing what we love.
We all have this ability to appreciate ourselves in this way where you’ll counsel in that private mental office space with your first patient—you.
S is for standing tall, learning to rise above our physical circumstances in the natural world and living in a supernatural way. Life becomes a sacred practice, a living meditation when we understand that we are far more than our material selves in a physical world. It gives us the confidence of knowing that nothing and no one can truly destroy us. That is great power in the face of any challenge.
P is for the power of words. Thinking and especially speaking in positive terms is essential when going through a crisis. We may not know exactly how a problem will turn out, but we can certainly remain hopeful in our discussions about it. Hearing ourselves repeatedly use positive statements about how things might resolve not only keeps stress levels low but over time entrains our minds to actually believe what we’re saying.
To maintain compassion for myself during difficult times, I use the power of words to recite a poem to myself to let that scared inner child that I call my little Habibi who doesn’t know what to do, that everything is going to be okay. The poem is I Carry Your Heart with Me by e.e. cummings.
I carry your heart with me.
I carry it in my heart.
I am never without it.
Anywhere I go, you go, my dear,
and whatever is done by only me is your doing.
I fear no fate for you are my fate, my sweet.
I want no world for beautiful- you are my world- my true and it’s you are whatever a moon has always meant and whatever a sun will always sing- is you.
Here is the deepest secret nobody knows. Here is the root of the root and the bud of the bud and the sky of the sky of a tree called life which grows higher than soul can hope or mind can hide and, this is the wonder that’s keeping the stars apart.
I carry your heart.
I carry it here in my heart.
A is for acknowledgment of everything you’re doing to overcome a particular challenge. Give yourself the credit of what you’ve already done, and don’t expect yourself to have all the answers. This is about creating a culture of prizing, appreciating, and honoring yourself, your most essential loving essence, when you need it the most. We all have this ability to appreciate ourselves in this way where you’ll counsel in that private mental office space with your first patient—you. Of course, in order for acknowledgment and prizing to take place, this office must be a judgment-free space held sacred in the words of the Persian poet, Rumi:
Out beyond ideas of wrong-doing and right-doing there is a field. I’ll meet you there.
That’s where headspace exists.
C is for compassion. The prefix “com” means together, while passion can be defined as suffering. Facing our own challenges helps us cultivate compassion for others in their struggles and thus we understand them better. Compassion through shared experience is what unites us, all 7.85 billion human beings. In their recent book, Compassionomics, Drs. Trzeciak and Mazzarelli provide scientific and empirical evidence of the healing power of compassion. Diabetic patients who perceived their doctor to be more compassionate experienced better control of their HgAIC, while surgical patients experienced fewer complications, less pain, and healed faster which resulted in a quicker discharge from the hospital. Compassion brings us closer to Keruv, a beautiful Jewish value that means to draw near or bring close in a welcoming way. When we have the spaciousness inside to offer ourselves the compassion we deserve, then we will have the proper headspace to provide it to others, particularly those loved ones disguised as our patients. Headspace is the headquarters for the Compassionomics that will revolutionize patient-centered care in the future.
Every experience we have, regardless of whether we see it as good or bad, is working toward our learning, growth and evolution of consciousness.
E is for the evolution of consciousness. If life isn’t for learning and expanding our consciousness about ourselves and the world around us, then what is it about? I believe we are spiritual beings having a temporary human experience in order to learn and grow in specific ways that are important for each of us. In this context, nothing happens to us but for us. Every experience we have, regardless of whether we see it as good or bad, is working toward our learning, growth and evolution of consciousness. From this perspective, nothing is really bad when we know there is good in the form of growth in every challenge we face. Understanding this provides a purpose for our struggles and increases our sense of peace because we don’t see our situation as meaningless suffering anymore. The best part is that on the other side of our problems we’re different people because of what we’ve learned, and when we know better we do better.
Ladies and gentleman of the graduating class of 2019, by the power of all resources invested in me, along with your beloved friends, families, and members of faculty, we prize, appreciate, acknowledge, and honor your superb accomplishments and most importantly who you already are as a loving essence. We all send you the blessing of an unseen prayer; that may each of you mind your kingdom of headspace inside and in so doing mend your glorious lives forward.
God Bless you.
Love, Light, & Clarity in the Month Ahead,
Dr. Habib Sadeghi