Connecting with Compassion

My last two posts were about a negative view and a positive view of choice and behavior. I find that I am extraordinarily drawn to the negative view. It seems to have quite a hold over me. I find myself feeling beaten down by the idea that there is some innate badness at my core that spoils any "good" I might do and makes my every action "bad." Therefore, it is best that I find an isolated niche in this world where I can do as little harm as possible. As fear-based, as life-destroying, as nuts as this view is, I find it quite gripping.

Now, let us apply Karen Armstrong's idea about the neocortex to this. I discussed Karen Armstrong's idea about the neocortex in my previous post.

First, I would like to consider the progression of creation. We have non-animate entities: the mineral kingdom, if you will. We have the elements: earth, air, fire, water. I think of rocks, particularly - very much there, enduring, being. All four elements are beautiful, all are powerful. This speaks of something important at the heart of God - beauty, power, endurance, being - and the capacity to support and provide a home for life.

Then, we have the non-sentient life forms: one-celled organisms, plants, insects. And we have life-forms where I am not sure how sentient the creatures are: reptiles, amphibians, fish, birds. Here, I would add to the heart of God abundance, diversity, proliferation, and more beauty - a sort of divine extravagance.

Hmmmm - God is creative, extravagant, beautiful, and joyful.

Next, we arrive at the mammals, particularly the higher intelligent mammals: horses, whales, dogs, cats, chimpanzees, and others. These animals, it seems, do not have the capacity of self-reflection, but do they perhaps have the beginnings of compassion? I know that rhesus monkeys who are deprived of food and made to see that they will receive food as a reward for giving a painful electric shock to another rhesus monkey, will refuse to give the shock (especially if they have previously experienced such a shock) even though this means enduring hunger. These monkeys will refuse to cause pain to another monkey, even though this means that they won't be fed. Here we can add to the heart of God love and loyalty.

And then we arrive at human beings with our neocortex - self-reflection, reason, compassion. Karen Armstrong says that the precarious situation of today's world comes from the use of our reasoning powers (our neocortex) in the service of our selfish survival instincts (our hypothalamus). This gives us weapons of mass destruction (created with the reasoning power of our neocortex) to use in keeping ourselves on top (a survival goal of our hypothalamus). Nonetheless, we also have the capacity to align ourselves consciously with the compassionate heart of God.

God - compassionate, creative, extravagant, beautiful, joyful.

SO - here is a solution to my impulse toward the innate badness view. The solution is to acknowledge the impulse, to recognize it, to stand aside from it, and to choose something else. To choose compassion for myself. To choose to act for good in the world, knowing that I make a difference, whether that difference is immediately apparent or not. Every compassionate thought, word, or act makes a difference.

Choices and Our Brains: A Positive View

In my last post, I wrote about a view which would say that some people are innately bad so that even their "good" choices become "bad" by virtue of their innate bad nature. In this post, I will present a much more positive view as expressed by Karen Armstrong in her latest book, Twelve Steps to a Compassionate Life.

First, I would like to mention that Karen has studied the religions of the world, and has found at the core of each an understanding that the heart of God or the Transcendent or the Universe is compassion. Karen has so many wonderful and right-on things to say about compassion.

Let me begin with Karen's definition of compassion. I will quote her definition from page 9 below, with the addition of bullet points to make the elements of compassion stand out:

But "compassion" derives from the Latin patiri and the Greek pathein, meaning "to suffer, undergo, or experience." So "compassion" means

• "to endure [something] with another person,"
• to put ourselves in somebody else's shoes,
• to feel her pain as though it were our own,
• and to enter generously into his point of view.

Karen explains that compassion is natural to human beings. We feel good when we behave compassionately, and life flows more smoothly and positively when we treat each other with compassion.

Karen also explains the uneasy co-existence of two parts of our brain:

• The hypothalamus (a very ancient part of our brain located at its base and stemming from our reptilian ancestors)
• The neocortex (a more recently evolved area of the brain)

Karen says that the hypothalamus is concerned with feeding, fighting, fleeing, and reproducing - in other words, with survival. It is ruthlessly selfish. It strongly pulls us to consider ourselves and our own safety and well-being first. It also evolved to handle conditions of scarcity, so the hypothalamus will prompt us to continue hoarding even when we already have more than enough.

The neocortex, on the other hand, says Karen, allows us to reason, to think about the world and ourselves, to stand aside from and consider the instinctive reactions of our hypothalamus, to make choices about our behavior. The neocortex allows us to align ourselves consciously with the Heart of God, of the Transcendent, of the Universe - which is a Heart of Compassion.

What this means, says Karen Armstrong, is that we have a choice: to behave at the level of our hypothalamus, that is, instinctively and selfishly with concern for our own survival, or to behave at the level of our neocortex, that is, compassionately. Karen stresses that the pull of our survival-oriented hypothalamus is strong, so we would do well not to castigate ourselves for our feelings of fear and anger and our impulses to selfish behavior, but rather to accept them with compassion for ourselves, realizing from whence they stem. We do not, however, have to choose selfish behavior. We can calmly acknowledge selfish impulses, stand aside from them, and choose compassionate behavior.

In other words, IT IS NOT A QUESTION OF BEING INNATELY BAD. It is a question of choosing instinctive and selfish behavior associated with the hypothalamus, or choosing conscious and compassionate behavior associated with the neocortex. This is very hopeful!

Hospital Experience #18: Karen Armstrong - Compassion and Pain

This is the eighteenth in a series of posts on a recent experience at Ochsner Hospital - having a cardiac catheter ablation procedure to correct a heart arrhythmia. These posts describe and reflect on various aspects of the hospital experience. This eighteenth post will reflect on my hospital experience in relation to what Karen Armstrong says about compassion and pain in her memoir The Spiral Staircase: My Climb Out of Darkness, in which she describes her adjustment to life in the world after seven years as a Catholic nun.

In her study of world religions, Karen Armstrong finds that compassion is at the heart of all. Compassionate behavior is expressed in the Golden Rule: Do not do to others what you would not want others to do to you. Karen prefers this ancient Jewish expression of the Golden Rule, asking us to refrain from what would cause others pain or discomfort.

How do we know what may cause pain or discomfort to another? Karen Armstrong says that we learn this by observing what causes pain or discomfort to us. Compassion means feeling with another, standing in another's shoes and feeling what it is like to be that person. Karen says that nothing teaches us better how another may feel than our own pain. When something happens that causes us pain, it is well to take careful note and to resolve never to cause such pain to another. This, Karen says, is how pain can be redeemed - by using it to build compassion. Otherwise, pain is wasted.

I found that, in the hospital, I wanted to be treated in a kind, caring, professional, and dignified manner. I experienced pain when Nurse Dreadful did not treat me in these ways. I experienced comfort when other nurses did. I am not a medical professional, so it is not likely that I will be called upon to treat hospital patients in kind, caring, professional, and dignified ways. However, I am a teacher - and my students would certainly appreciate being treated in kind, caring, professional, and dignified ways. They would appreciate seeing that I welcome them, that I am happy to see them, that I have the skills to teach them well, that I take their concerns and questions seriously, that I evaluate their work fairly, that I have time for them, that I am available to them, that I respect them and deeply value their contributions to the class.

I think that it is extremely helpful for professionals of all kinds to be in the position of those they serve - for medical professionals to be patients, for example, and for teachers to be students. This builds compassion. Medical professionals need to know what it feels like to be handled by strangers, and teachers need to know what it feels like to struggle with an unfamiliar subject. Language teachers need to know what it feels like to be confronted with a new language and culture, and writing teachers need to know what it feels like to be confronted with a writing assignment, a deadline, and a blank sheet of paper or computer screen.

These are important lessons from the hospital and from Karen Armstrong - use pain to build compassion, and put yourself in the shoes of those you serve.

Hospital Experience #10: Panic Throws Light on Rage

This is the tenth in a series of posts on a recent experience at Ochsner Hospital - having a cardiac catheter ablation procedure to correct a heart arrhythmia. These posts describe and reflect on various aspects of the hospital experience.

This tenth post is a follow-up to "Hospital Experience #3: Panic." Here I will reflect further on lessons to be learned from the panic I experienced in the procedure room, just before undergoing the cardiac catheter ablation. I especially want to consider the similarities between panic and rage and to see how my having experienced a state of panic may increase my understanding of what it's like to be in a state of rage. To make full sense of this present post, it will help to have read "Hospital Experience #3: Panic." It also wouldn't hurt to have read my post of March 21, 2010, titled "Philosophy Cafe: Detachment," especially the final section of the post, subtitled "My Father."

In "Hospital Experience #3: Panic," I described how I panicked in the procedure room. Before being sedated, I was hyperventilating, trembling, jerking about, struggling, and crying out. I was out of control. My behaviors seem to have an instinctual component - near-automatic responses to what was being done to me, responses that were largely beyond my control.

I remember a similar incident from when I was five years old, an incident when I panicked. In the five-year-old incident, I was more deeply gripped by panic, even though the catalyst was minor when compared to a cardiac catheter ablation. I panicked over a simple booster shot at the doctor's office.

Here's what happened. My mother picked me up after kindergarten and took me to the doctor for a booster shot. The doctor's office was not in a typical office building but in a small one-story house converted into a medical office. (This is why I was able to do what I did.) When the nurse called my name to come in for my shot, I panicked. The door of the waiting room was ajar, opening onto the porch. I saw my chance and ran for it. Out the door, across the porch, down the steps, over the path, through the gate, and up the street I ran. The grown-ups gave chase and caught me. I fought - kicking, punching, flailing. I remember knocking one nurse's glasses off her face. The grown-ups, of course, were over-powering, and soon I found myself being held face-down on a table. The shot was administered, but my adrenalin was pumping so strongly that I didn't feel a thing.

The point of this is that I was in the grip of panic. I was out of control. I did not decide to run for it or to fight. I just instinctually did. Panic had taken over at a deeper level than was the case with the cardiac catheter ablation, where I was actually thinking about my behavior and even considering if I might try to calm down and breathe deeply, but not seeing how to get there while overwhelmed with all that was happening to me in the procedure room.

At age sixty, in the procedure room, I was panicked and out of control, but I was still able to think about my behavior though not able to change it. I also had enough presence of mind not to hit anyone. At age five, in the doctor's office, I was more deeply panicked and out of control. I had no thoughts about what I was doing - I was pure action, first flight and then fight. I hit people.

I also find that I have compassion for myself at age sixty and at age five. I don't judge myself for being out of control, for panicking, for being unable to calm down in the procedure room, for running away from the shot, for hitting the shot-wielding grown-ups. I also find that I have compassion for the cardiac doctor and medical team and for my pediatrician and nurses. It is not difficult for me to have compassion for myself and for the medical professionals - and for my mother!

NOW - here is where I want to go with this. It IS hard - at least it has been - for me to have compassion for people who go into a rage and hurt or kill others. But being in the grip of rage is like being in the grip of panic. One is out of control. The rage takes over. I think that a person in the grip of rage may not have decided to bash or kill the object of the rage - the rage takes over and the rageful person just does it - the rageful person acts without having made a decision to act. It is as though the rage is acting rather than the person whose body is doing the actions. The rage possesses the person and acts through the person.

I do not mean to suggest that this is okay - that it's okay or excusable to hurt or kill others when one is in a rage. It is not. At the very least, one is responsible for recognizing when one is moving toward rage and walking away from the situation. Unfortunately, some people have not learned how to do this. They do not know how to recognize when they are moving toward rage, and they do not know how to activate the strategy of walking away. They may even see that strategy as cowardly.

All I want to say here is that having been in a state of panic gives me some understanding of what it may be like to be in a state of rage. I can begin to stand in the rageful person's shoes. I can begin to imagine pulling the trigger without having decided to do so. I can begin - but barely - to imagine what it must be like, after the rage has evaporated, to realize that one has taken the life of a fellow human being. (I do recognize that different people who kill in a rage will have different post-rage reactions, probably ranging from horror at what they've done to callous indifference.)

I would say that one important lesson for me to learn from panic is a tiny infant step toward compassion for those who hurt or kill others in rage. This is not to excuse or justify the hurting or the killing but simply to gain some understanding of the perpetrator and to move a tiny tenth of an inch toward compassion for that person.

Hospital Experience #4: Nurse Dreadful

This is my fourth post about my recent hospital experience - having a cardiac catheter ablation at Ochsner Hospital to correct a heart arrhythmia. My previous three posts are (1) an explanation of the background leading to my hospital experience, (2) a description of the hospital experience itself, and (3) my reflections on my panic in the procedure room.

In my previous post, I mentioned that I could see some very small steps of growth in compassion within myself, particularly toward my doctor and the medical team during the cardiac catheter ablation procedure. This post will show that I still have a long way to go compassion-wise. I am certainly not there with Nurse Dreadful. Nurse Dreadful is the name I will give to the first nurse I encountered at Ochsner Hospital on the morning of the cardiac catheter ablation. I will begin with what happened, and then reflect on the experience.

POST-SCRIPT: I am writing this Post-Script after completing this post. Having just finished writing the post, I am struck by the power of writing to call forth deeper insights. I started this post with no compassion in my heart for Nurse Dreadful. The very process of writing took me from a place of no compassion for her to the beginnings of compassion, as you will see.

WHAT HAPPENED - FROM MY PERSPECTIVE

When I arrived at the Short Stay Cardiac Unit of Ochsner Hospital for the cardiac catheter ablation, I was shown to my hospital room, where I would undergo initial preparation for the procedure. I was instructed to remove all my clothing and put on a hospital gown. I decided to remove my upper clothing, put on the hospital gown, and keep my slacks and underpants on until the nurse actually came in to start doing things, at which point I could quickly slip them off.

After about twenty minutes, Nurse Dreadful appeared. As soon as she spoke, I could tell that I didn't like her. She was very matter-of-fact and stand-offish, and she lacked a kind and caring manner. (Every other nurse I dealt with that day had a kind and caring manner.)

Here's what Nurse Dreadful said: "You'll need to take off everything. You have to be naked as a jaybird."

Here is what I heard: "I don't have to respect you. I can use expressions that remind you of your nakedness in our hospital - such as 'naked as a jaybird.' I don't have to use polite expressions with you, such as 'We're going to start getting you ready for your procedure now. Would you remove the rest of your clothing, please.' "

Later I asked about getting two extra pillows. (It really helps me sleep at night if I have a pillow on either side of me as well as at my head, and at this point, I believed that I would be spending the night. My previous post "Hospital Experience #2: The Experience Itself" explains why I was able to go home on the same day.)

Here's what Nurse Dreadful said: "We have eighteen patients to take care of today. We don't have any extra pillows right now. I might be able to find some later, but I don't know." Merry, a wonderful friend who was accompanying me throughout hospital day, jumped in at this point to explain that my request for pillows wasn't just a whim or preference. Merry said: "She needs the pillows because she has sleep apnea and uses a C-PAP machine at night. The pillows help to keep her in a good position for using the machine. That's why she needs them." [This is indeed the case.] Nurse Dreadful said: "Well, I'll see."

Here is what I heard: "You certainly are a bother to us. It's a burden to have to take care of you on a day when we have seventeen other patients, who are more important than you. And now you make even more work for us with your demand for extra pillows. Well, I'll try to satisfy your demand, you inconsiderate and unimportant person."

Boy, I didn't like Nurse Dreadful! She proceeded to ask me the usual array of hospital questions - very matter-of-fact the whole time. Then she got ready to draw blood from a vein in my arm and to put in an IV port through which sedatives would be administered to me in the procedure room. Another nurse, whom I'll call Nurse Kindness, also came into the room at this point.

Nurse Dreadful wasn't able to find a suitable vein for drawing blood or installing the IV port. She kept sticking different veins, which I didn't like at all. Merry came over to hold my hand while Nurse Dreadful kept sticking me, and Nurse Kindness said encouraging things. Blood just would not come out of my veins. Of course, I was getting more and more tense, which wasn't helping, either. Blood can be drawn more easily from a relaxed arm.

Finally, Nurse Dreadful and I had this interchange, with me being quite irritated.

ME: Haven't you found a vein yet?

NURSE DREADFUL: No. Your veins are jumping.

ME: I am NOT jumping. This has never happened before.

NURSE DREADFUL: Ma'am, I have been doing this for many years.

ME [feeling that I might need to rely on her care later and probably shouldn't get her too irritated]: I'm sorry. I didn't mean to suggest that this is your fault. In fact, I know that it's my fault for not relaxing. I just meant that this hasn't happened to me before. [I figured I had better say something placating so that she wouldn't try to take revenge on me later. Someone like Nurse Dreadful probably has all kinds of ways of making a patient endure discomfort.]

At this, Nurse Dreadful left the room, and Nurse Kindness took over. Well, guess what. Nurse Kindness was able to find a vein for the IV port and to draw blood on her first try.

MY THOUGHTS ABOUT WHAT HAPPENED

I find it very difficult to feel compassion for Nurse Dreadful. Actually, I don't feel compassion for her at all. In fact, I even find myself enjoying a revenge fantasy - what I might have said to her instead of my final placating words. I imagine the conversation with a vengeful final line from me, like this:

ME: Haven't you found a vein yet?

NURSE DREADFUL: No. Your veins are jumping.

ME: I am NOT jumping. This has never happened before.

NURSE DREADFUL: Ma'am, I have been doing this for many years.

ME: And after all those years, you STILL haven't learned how to do this right???!!!

So, you can see a lack of compassion and a depth of hostility on my part toward Nurse Dreadful. I realize that she may normally be a much more pleasant person who was temporarily thrown off-kilter by a bad day. I realize that she may have been dealing with pain or stress or loss in her life that might do me in if it happened to me. I realize that she may be unaware of how negatively her words, spoken with good intentions, are coming across to patients (or at least to me) - like "naked as a jaybird." I realize that she may be unaware of how brusque and uncaring her matter-of-fact manner can seem.

I also realize that Merry saw Nurse Dreadful differently. When I complained to Merry about Nurse Dreadful, which I certainly did as soon as Merry and I were alone in the room again, Merry said, "She certainly wasn't a good match for you," and "She does take a matter-of-fact approach." But Nurse Dreadful didn't strike Merry as quite so "dreadful." I realize that my perspective was colored by my anxiety.

I do think, however, that there is some truth to the way I perceived Nurse Dreadful and that Nurse Dreadful should be made aware of what at least some patients will hear through her choice of words and her manner. When Nurse Dreadful says, "You have to be naked as a jaybird," at least some patients will hear, "I don't have to respect you." When Nurse Dreadful says, "We have eighteen patients to take care of today," at least some patients will hear, "You are a bother." When Nurse Dreadful speaks in a strictly matter-of-fact manner, at least some patients will interpret this as uncaring.

Nurse Dreadful may be a skilled and competent nurse who would be great if she would improve her bedside manner. Or she may be a skilled and competent nurse who does usually communicate kindness and caring - but I just caught her on a bad day.

I wonder - what is Nurse Dreadful like as a person outside of her role as nurse? Who are the important people in her life? Which books and movies does she like? Which activities does she enjoy? Does she go to a church or synagogue or mosque or temple - perhaps sing in the choir, have a meditation practice, volunteer in a soup kitchen? What is she like if you sit down and talk with her over a cup of tea?

How did Nurse Dreadful perceive me? I complained to Merry about her. Did she later complain to someone about the hostile patient (me) that she had to deal with?

Nurse Dreadful and I clashed in the hospital. What was going on at a soul level? What can my encounter with Nurse Dreadful teach me?

I have a feeling that I will explore those final questions in a future post.

Hospital Experience #3: Panic

In my two previous posts, I described (1) the background leading to a recent hospital experience and (2) the hospital experience itself. This post will explore the panic I experienced in the room where my procedure (cardiac catheter ablation to correct a heart arrhythmia) was performed.

First, I will mention that I was amazingly calm (for me) in the weeks and days leading up to hospital day. In fact, I did fairly well until I was taken to the room where the cardiac catheter ablation was to be performed and the medical team began to hook me up to the various monitors.

Before I go any further, I want to mention that my doctor and the members of the medical team were competent, professional, and kind. I sensed that they truly wanted to help me. The problem did not lie in the way I was treated - I was treated in a caring way.

THE FACTS OF WHAT HAPPENED

These are the facts of what happened, as I understand them.

Once in the procedure room, I was initially asked to sit up while patches (to which wires were attached at one end, with the other end attached to the monitors) were applied to my back. At this point, I was fine.

Then I was asked to lie down, and as the doctor or a member of the medical team explained to me what they were doing at each step, the following things were done. These steps are not necessarily in order, and some were being done simultaneously.

• More patches were applied to my abdomen and chest.
• My groin area was shaved.
• My arms were secured at my sides.
• A clear plastic triangle was placed over my nose to administer oxygen and air under pressure. The pressure was to keep my airway open throughout the procedure, as I have sleep apnea and use a C-PAP (Continuous Positive Airway Pressure) machine when I sleep.
• Potassium was administered through my IV, as blood drawn that morning had indicated that my potassium level was a little low. (This was probably because I had fasted the previous day.) The doctor explained that the potassium would cause a burning sensation temporarily and asked if I was ready to receive it, to which I said okay. Indeed, it did produce quite an unpleasant burning sensation.

As these things were being done, I was moving more and more into panic. Perhaps it wasn't technically panic (I can imagine several levels beyond what I experienced), but it was at least extremely high anxiety bordering on panic - or maybe it was technically panic. It began when I had to lie flat, and it was considerably exacerbated when my arms were secured and when the potassium was administered. It was manifested in these ways.

• Jerking whenever someone touched me
• Hyper-ventilating
• Trembling
• Crying out
• Struggling against the arm restraints (which were simply sheets that were wrapped comfortably around my arms and then secured to the bedside and that did allow some movement - please don't imagine tight leather straps or chains!)
• Eventually reaching a state where I felt that I was going to faint, even though I was lying completely flat

This panic did not go on very long. The doctor stopped the administration of potassium through the IV (at least I heard her say, "Okay, stop the potassium"), since I was crying out that it was burning my arm, I was hyperventilating and trembling and jerking, and I said that I felt I was going to faint. It seems to me that the sedative was then administered through the IV. This worked. I could feel myself calming way down and relaxing. This was a nice feeling! I imagine that a calmed patient was nice for the doctor and the medical team as well! For the rest of the time in the procedure room, I was sometimes lightly unconscious and sometimes comfortably and drowsily aware.

MY THOUGHTS ABOUT WHAT HAPPENED

First, I was out of control. It is hard for me to imagine how I could have maintained control of my behavior - stayed calm, breathed deeply, held still. I think I can say that I wasn't capable of such control under the circumstances. It does occur to me that I could have said emphatically, "Stop. Everyone stop touching me. I want to stop." Then I could have explained that I was panicking, that this way of proceeding wasn't working for me, and that we had to proceed differently or give me a sedative first. However, I didn't do that - I really don't think I had the presence of mind at that moment to issue a stop order.

Second, I wasn't completely out of control. It's very clear to me that there are deeper levels of panic that I did not reach. One such level might include hitting the medical personnel, and I don't mean accidentally as I was jerking around but actually hitting them, becoming combative. I absolutely was not at that level of panic. Another such level would include being so lost in panic that panic is all there is - my whole world for those moments would consist solely of panic. I was not there, either - I did have some sense of how I was behaving.

Third, I can see from this experience that I react almost instinctually to certain behaviors of others toward me. I instinctually move to protect myself from people doing things to my abdomen (placing patches, for instance) and from having my arms restrained. I do think that those two things can trigger a self-preservation response in people, whether happening singly or together.

Fourth, I think that the combination of things happening to me was overwhelming.

• I was lying on my back (a vulnerable position) with people hovering over me.
• People were doing things to my abdomen.
• People were doing other things to and around me as well.
• The potassium going into my arm through the IV was burning.
• I couldn't use my arms because they were restrained.
• I began to feel that I would faint, even though I was lying down.
  

Result - panic. People doing things to my abdomen was triggering a self-preservation response, having my arms restrained was triggering a self-preservation response, feeling a burning pain in my arm while unable to move was triggering fear, and feeling that I was going to faint was triggering more fear. When I look at all those individual fear-inducing elements happening at once, I can understand why I would panic.

Fifth, as I think about this, I wonder why on earth I wasn't simply given the sedative before anything was done to me. I do think that this was a judgment error on the part of the doctor, which she did correct as quickly as she could. It does seem to make far more sense to spare any patient the discomfort of these preparatory procedures by administering some sedation - even if the patient isn't panicking. The answer may lie in the real difference between the perspective of the medical personnel and the perspective of the patient.

For medical personnel, this is a routine procedure. Medical personnel routinely apply patches to patients' abdomens, routinely shave patients' pubic hair, and routinely restrain patients' arms during certain medical procedures. For the patient, however, none of this is routine. Patients are not accustomed to having people put things all over their abdomens, may feel embarrassed about being shaved (for me, this was not a problem, especially given everything else that was going on!), and may experience arm restraints as a frightening loss of control. Where medical personnel are having a routine and normal experience, patients are often having a bizarre and alienating experience. I think that doctors and other medical professionals know this intellectually but may not fully grasp it emotionally.

Sixth, I did not effectively communicate the depth of my fear to the medical team. Before the procedure, I described my feelings as "very nervous." I now see that the words "very nervous" were far from strong enough. For any future medical events of this type (and I hope there won't be any!), I plan to say, "I am moving toward a state of panic. I do seriously panic when faced with a medical procedure. I panic as soon as I lie on the table and people begin preparing me by touching me in any way. This means hyperventilating, trembling, jerking, struggling, and crying out. I WILL NEED SEDATION FIRST."

Seventh, I seem to be growing with very small steps in compassion. Rather than judging myself for out-of-control behavior, I can manage to feel compassion for that panic-stricken patient who is me lying on that table in the procedure room. Rather than judging the doctor and the medical team, I can manage to feel compassion for those trying unsuccessfully to help a panicking patient. I don't think that the doctor used the best judgment at first about when to administer the sedative, but I also don't find myself holding anger or resentment toward her or toward the medical team. I find myself able to recognize that they had kindly intentions toward me.

Finally, I thank those who have engaged in deep conversation with me and contributed thoughts that have helped me to see what I have expressed in this post. These include my friends David, Donna Glee, Merry, and Yvonne, and my sister Janet.

Compassion at the Heart of Faith - Karen Armstrong

Karen Armstrong's study of world religions has shown her that compassion lies at the heart of each one. Thus, we can say that at the heart of Being is compassion. Karen says that compassion is feeling with another. It is putting ourselves in another's shoes, standing where another stands, seeing through another's eyes--and acting accordingly.

Karen connects compassion with ecstasy. Ecstasy occurs when we empty ourselves of the self, when we step outside of ourselves, when we leave behind our local individualized self--and step into something larger. By being compassionate, by feeling with another, we step out of our own self-focused experience and into the experience of another.

How do we enter into the mind and feelings of another? Karen Armstrong says that one way to do this is to use our own pain. In other words, when we are treated in a way that causes us pain or discomfort, we can take careful note and resolve never to do that to someone else.

I am not a naturally compassionate person, but I can think of at least one very small way that I practice compassion. (Recognizing this very small way helps me to grasp what compassion is and how it feels to practice it, and then hopefully to expand upon it.) Here is my very small baby step in compassion. First, I have noticed a particular type of situation that causes me discomfort. Sometimes when I am telling a story or sharing a thought with one or more other people, an interruption will arise. For instance, if we are at a cafe, the server may come to take our order or another person may arrive and join our group. After the interruption, the conversation may veer elsewhere, and I don't get a chance to finish what I was saying. When this happens, I feel disappointed.

Knowing how I feel when this happens to me, I try not to let this happen to others. When someone is telling a story or sharing a thought and an interruption occurs, I try not to let the conversation veer away before the person has the chance to finish. I do this by saying, for example, "Jane, I want to hear the rest of what you were saying about Edgar Allan Poe." This allows Jane to finish what she was saying without seeming to put herself forward, in case she feels uncomfortable being the one to reintroduce her story. (I've even started extending this compassion to myself. Since I've been doing this for others, I find that, after an interruption, I can more easily say on my own behalf, "I'd like to continue what I was saying about Alice Walker.")

I find that I experience a nice warm feeling when I can do this for others and when I can do this for myself. I also think that this is what it means, in a very small way, to love one's neighbor as one loves oneself. In this conversational type of situation, I show the same consideration both for my neighbor and for myself.

I would say, too, that to be compassionate in one's work, one needs to feel what it is like to be on the other side. A doctor or a nurse who has been hospitalized with illness or injury can more readily feel with his or her patients. Psycho-therapists are required to undergo psycho-therapy themselves in order to feel what the process is like for their clients. A teacher of English to speakers of other languages would do well to take a course in Vietnamese or Arabic or Hungarian to understand what it feels like to be confronted with learning a very different language and culture.

Self-emptying, compassion, and ecstasy also occur when we lose ourselves in contemplation of something greater--as a scientist does in her lab, an architect in his building, a lawyer in her client's case, a painter in his studio, a musician in her composition, a dancer in his movement, a reader in her story, a writer in his characters, a chef in her cuisine, a teacher in his subject. This loss of self in something greater can occur both as a creator and as an admirer: it can occur for the artist who sculpts a statue and for the art lover who admires it, for the chef who prepares a beautiful meal and for the gourmet who savors it, for the poet who composes a poem and for the reader who enters into it, for the gardener who creates a garden and for the flower lover who basks in it.

Karen Armstrong has found that she experiences self-emptying, compassion, and ecstasy through her study of and writing about world religions. She has learned to have compassion, to feel with, people of other faiths. On page 290 of The Spiral Staircase, Karen says, "It was not enough to understand other people's beliefs, rituals, and ethical practices intellectually. You had to feel them too and make an imaginative, though disciplined, identification." Karen explains how she did this when writing about the Prophet Muhammad. On page 278 of The Spiral Staircase, Karen says, "I had to make a daily, hourly effort to enter into the ghastly conditions of seventh-century Arabia, and that meant that I had to leave my twentieth-century assumptions and predilections behind. I had to penetrate another culture and develop a wholly different way of looking at the world. It required a constant concentration of mind and heart that was in fact a type of meditation. . . . I was learning the disciplines of ecstasy." In fact, on page 287 of The Spiral Staircase, Karen says, "I was finding in study the ecstasy [and, I would add, the compassion] that I had hoped to find in those long hours of prayer as a young nun."

On page 63 of The Case For God, Karen Armstrong speaks of Socratic dialogue as a means to self-emptying, compassion, and ecstasy. Karen says, "In a Socratic dialogue, therefore, the 'winner' did not try to force an unwilling opponent to accept his point of view. It was a joint effort. You expressed yourself clearly as a gift to your partner, whose beautifully expressed argument would, in turn, touch you at a profound level." On the same page, Karen says, "Like any good initiation, a successful dialogue should lead to ekstasis: by learning to inhabit each other's point of view, the conversationalists were taken beyond themselves." I love that: "learning to inhabit each other's point of view."

Compassion, then, is the heart of religious faith. A very legitimate question to ask about any religion is this: Does this religion lead to a compassionate life? That is the gold test.