Karma Ripens

After a sunny day spent rock climbing, I found myself in the local ER. It was near midnight and silent technicians had just performed an echocardiogram. Their grim expressions left little doubt I was in serious trouble.

As dawn broke I lay in a private room in the ICU waiting for the doctor to make his rounds. An IV needle was taped to one arm, a self-inflating pressure cuff encircled the other. The wires of a 12-lead heart monitor looped in every direction out the neck and sleeves of the flimsy hospital gown. I was exhausted having been awake for over 24 hours.

Shortly after 7:00am St. Joe’s head cardiologist walked into the room looking like a man who’d rather be anywhere else. “I have bad news,” he said, gazing somewhere over my head unable to meet my eyes, “you’re in acute congestive heart failure. Your heart has been seriously damaged and I can offer you no hope of recovery.”

And that’s when I realized—having just finished six years of graduate school in pursuit of a PhD—that I didn’t have a clue about the one thing I truly needed to know, the single most important moment any of us ever face: death.

An eon passed in those first seconds after the doctor delivered his news, or perhaps time stopped altogether because the room around me disappeared. I was alone and looking over my right shoulder where my entire life spun out like a cinema newsreel. Bright vivid images—childhood, teen years, adulthood—flashed past one after the other picking up speed in a surreal fast forward as the present moment grew closer until with the last frame everything faded into darkness. My past was gone.

I turned to face forward where I stared into a dense white fog searching with increasing desperation for some glimpse of a future—anything to hold onto. But there was nothing to be found in that direction either. I had no future.

With that understanding I found myself suddenly back in the hospital bed, the room materializing around me. I landed into the flow of time, into the present moment bringing with me a new insight. The past and future are illusions, they don’t exist, they never have. The past is always in the past—forever gone—and the future never arrives. I hadn’t lost anything. I had this one single precious moment which is all I’d ever had. I relaxed. The doctor stood silently nearby, a nurse just behind him. My sister sat pale-faced, silent and frightened in the corner with my brother-in-law standing next to her, one hand gripping her shoulder. All were watching and waiting.

My scholar’s mind whirred as I tried to parse this new information. “Did I damage my heart on the backpack trip,” I broke the silence. Four days previously I’d finished a long hike through the Pasayten Wilderness of Western Washington. Improbable though it seemed I could think of nothing else that could have damaged my heart.

“No,” he replied. “You were already in heart failure on the hike. In fact you were lucky to have survived it. This is just the hand you were dealt.”

“You’re telling me this is just piss-poor luck,” I asked, incredulous.

“Sometimes bad things happen to good people,” he answered.

I looked at him, wondering at his assumption and the implications. For a moment I contemplated anger at the unfairness of it all: Why me? The sensation was one of trying on a heavy coat only to discover it doesn’t fit and isn’t comfortable. I quickly shrugged it off. Anger was all wrong. It implied that someone else should be lying in the hospital bed and I would never wish it for anyone. In that moment I accepted the cards handed to me.

The doctor, eager to be on his rounds, told me the various medications I would be started on and for what purpose. I had no questions and asked to speak with the hospital chaplain. He left the room.

Twenty minutes later the chaplain walked in. She introduced herself, pulled a chair close to the bed, took my left hand gently in both of hers and waited. My sister and brother-in-law quietly left to call my parents.

“Four days ago I finished hiking 72 miles. Yesterday I was rock climbing. Now they tell me I may be dying,” tears welled in my eyes. “Do you know how to die,” I asked.

“No,” she replied.

I was stunned and more than slightly disappointed. How could a hospital chaplain—surrounded by death—whose job it was to help the dying—not know how to die, I wondered. I needed help. Guidance. I felt desperate and the chaplain apparently had nothing to offer.

She looked thoughtful. Then as if divinely inspired asked, “Did you learn anything on your hike that can help you now?”

Ahh. I smiled and told her a story.

A Raven’s Warning

On the third day of my trip I awakened once again to a steady drizzle. Low clouds closed in creating a gray claustrophobic world. That night a wracking cough and chest pain had me awake after midnight, echoes of a virus from two weeks previously.

I started the day exhausted and with a steep descent followed by a long slow climb to Devil’s Peak. My breathing was labored as I made my way up the switchbacks out of Holman pass. Little light reached the forest floor turning it into a gloomy foreboding twilight. Water dripped from the trees, the trail was deep in mud, not even birds had the heart for song. I was in a foul mood, frustrated by the weather, disappointed at missing miles of spectacular views onto mountain peaks that were heavily veiled in mist—country I would never pass through again—a once-in-a-lifetime trip ruined by inclement weather.

At tree line I stepped from the dark forest, slung my pack to the ground and sat in the mud not caring about niceties, tired, breathless and consumed with irritation over the rain. As I removed a boot to massage an aching foot a raven flew up and settled on a nearby branch. The bird cocked its head, looked at me through one black eye and shattered the silence with a raucous scolding.

Great, I thought, the weather is ruining my trip and now a damn bird is destroying the only thing left—my peace and quiet. The pressure in my chest mounted; the pain intensified. Frustration quickly turned to anger which seethed and boiled. The raven continued its rebuke and as my temper flashed, turning to white hot rage, I saw myself with sudden clarity as if from a distance: a silly woman sitting in the mud behaving stupidly, making herself sick—over the weather…and a bird poking fun.

I started laughing. As I laughed the pain and pressure released like water breaching a dam and flowed swiftly away. I could breath again. Suddenly silent, the raven watched.

In that same instant insight dawned and I realized that the present moment—however it manifests—is perfect just the way it is. It is perfectly complete the way it is. Nothing is missing. There is nothing that needs improving. The weather was not ruining my trip.

The raven flew off.

I looked at the chaplain who’d listened patiently to my story and said, “This moment, lying in a hospital bed with heart failure, not knowing how long I might live, is perfect just the way it is.”

I surrendered. And in surrendering relaxed fully and completely into the moment. There was nothing else I could do. The situation was beyond what I could fix or change and I certainly couldn’t fight it.

Nearly two decades later I had the opportunity to ask my Buddhist teacher how to prepare for death. His reply was all of five words: “Death is just a moment.”

When one knows how to live the moments of life well, one knows how to die well. The question is obvious.

Recovery: Beyond hope and fear

When water gets caught in habitual whirlpools,
dig a way out through the bottom
to the ocean. There is a secret medicine
given only to those who hurt so hard
they can’t hope.

The hopers would feel slighted if they knew.

-from “My Worst Habit,” Jalāl ad-Dīn Muhammad Rūmī, as translated by Coleman Barks

“I can offer you no hope of recovery.” It might seem a needlessly cruel thing for a doctor to have said but strangely enough it freed me. In the very moment hope was lost all of my fear dissolved along with it. Because there was literally nothing I could do, there was no point in worrying.

I stepped forward, so it seemed, and leapt into the vast space of a wide open sky leaving the ground and hope behind. Falling and falling I discovered how to fly. As Rūmī wrote so many centuries ago, there is a secret medicine given to those who no longer hope and quite by accident, forced by circumstances, I found it. When there was nothing left to lose I found a freedom I’d never known and a courage I didn’t know I had. Every time worry or fear or hope arose, I let go and relaxed.

I was released from the hospital four days after being admitted and told to get on a transplant list when I returned to Albuquerque. Back in New Mexico, during the months I waited for a second echocardiogram, I didn’t know from one moment to the next if my heart might suddenly stop. The not knowing kept me vividly present. I didn’t want to miss any of the precious moments of my life. It didn’t matter what I was “doing,” the important thing was simply being present. Life really isn’t about accumulating peak experiences—or possessions or money—it’s about the quality of our awareness.

We never know the moment of our death. It can come at any time. All we ever have is this one moment in which to live life well. The present moment: it’s where life happens, where all we search for is to be found, where healing occurs. There is nothing more profound or miraculous.

In late December, a cardiologist in Albuquerque delivered very different news. “Your echocardiogram is completely normal,” Dr. Koshi said. “You’ve made a full recovery.” And then he added, even knowing I was an atheist, “We have to thank God, because it’s a miracle.”

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