By Mick Krasner
This essay was originally published in the Mindful Practice January 2021 newsletter. Dr. Krasner is the Co-Founder of Mindful Practice and Professor of Clinical Medicine at University of Rochester. The Gold Foundation is proud to work with Mindful Practice to share their transformative workshops with our community. The next workshop is April 28-May 1, 2021.
Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed, and everywher
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.
Surely some revelation is at hand;
– From The Second Coming, Wiliam Butler Yeats (1920)
Just over 100 years ago in the aftermath of the first world war and the 1918-1919 influenza pandemic, Yeats wrote these words as his pregnant wife lay close to death, suffering from the same virus that killed an estimated 20-50 million people. An almost equal number of deaths resulted from the war itself. It is unimaginable, the scale, depth and impact of those events at that time.
Yet, like the spiral described by the falcon’s gyre, we find ourselves again and now in the midst of another pandemic, with unimaginable shifts in political leadership, alliances, convictions, and yes, with much passionate intensity as well. One outcome of these dynamics that we all can relate to is uncertainty. We find ourselves uncertain about so many things. About when we can visit a loved one, or plan a vacation, or eat somewhere other than in our own home. Our professional experiences now include weighing the further social costs of confining our patients for a necessary or elective hospital stay, or even what it means to request our patients come to see us in person in the office at all.
As health professionals we often find ourselves unable to ascertain what is actually going on, as we reside deep in the weeds of our work within the illness experience, sometimes seeing the landscape around us, but more often just trying to make it through the care we are rendering, or just simply making it through the day. We attempt to provide the best quality of care as we understand it, and experience how even the standards of care shift sometimes daily, challenging our sense of self efficacy, professionalism, empathy, and even compassion. Things seem to be falling apart, anarchy appears to be loosed, innocence looks drowned, and it feels that we (and many others) cannot hold onto our center.
What does our mindful practice have to offer us in this time, in this new year which has begun with all the same currents of uncertainty still upon us? One of the most useful but often misunderstood resting place for us, which is actually not a resting place at all, is equanimity. Among the dwelling places within which to cultivate our thoughts and action so that they may take root — kindness, empathy, compassion, and equanimity — equanimity alone offers us the possibility of standing strong in the middle of all that is happening. Like ballast keeping a ship upright in strong winds, equanimity is not neutrality or aloofness. Instead, as our inner strength develops from the cultivation of mindfulness of the ordinary moments of life, equanimity follows. We realize that the awareness that has held our ever-shifting sensations and feelings and thoughts, reliably holds what is here in this moment. Even if this moment and so many others include fear and terror, our awareness can remain strong when bolstered by equanimity.
A friend of mine recently shared with me what I find an extremely useful reframing of the often used and usually annoying (to me) phrase “it is what it is” with “it’s like this now.” Embedded within “it’s like this now” is an acceptance of the reality of how things are, devoid of the nihilism of resignation. To me it is a statement of equanimity — one that doesn’t turn away from this in exchange for that, nor does it preclude the possibility of that developing at some point, through clear seeing, intention and compassionate action.
As we hold in awareness the shifting sands under our feet of what it is like to practice medicine in the time of COVID, may we be able to not stand still and unmoved by these changes but instead remain upright, fluid and supple in our capacity to respond to what is called for now, with kindness, empathy, compassion, and with, as Roshi Joan Halifax calls it, the strong back and soft front of equanimity.
Learn more about Dr. Krasner, Mindful Practice and their workshops.