WillSpirit!

Where Will meets Spirit
∞ Love, Clarity, Balance, Peace, & Bliss ∞

A science, mental health and spirituality blog written by a physician.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.


Biology, Spirit, and Transcendence

My blog’s tagline includes the word spirituality, which has devolved into a vague term that can mean almost anything. In the interest of clarity and to balance the two previous posts that emphasized material takes on human life, this essay will outline my spiritual path and beliefs. Readers may or may not be interested, but it helps me to spell out my philosophy from time to time, especially since it’s still maturing.

What follows rambles through my ideas about different metaphysical stances, to my own personal experiences with them, to a description of my current stage of development. Since my understanding of the world’s religions is superficial, at best, don’t be surprised if my statements about faith and practice sound obvious or naive.

Two posts back I stated that our animal identity constitutes “the most central and accurate description we could give of ourselves.” After all, it seems unarguable that humans are mammals with large brains. Even while writing that sentence, however, I remained aware that many resist considering themselves ‘mere’ biological organisms. Indeed, when I posted the same essay on my Psychcentral blog, the following comment came in:

Hmmmm, so we are reduced to “cycles of carbon and calcium?” I prefer that we are “fearfully and wonderfully made” by our creator. As a believer, I will be returned to Him.

This reader’s opinion probably resonates with many who consider themselves religious or faithful. Here’s an edited version of what I wrote in reply:

You bring up the other common opinion about ultimate identity: that we are best described as conscious entities (souls) inhabiting organic forms. But even if one takes that view, at death the body is still reduced to its constituent elements and recycled in the biosphere. The two viewpoints are not mutually exclusive. In fact, since our biological form is apparent, while our spiritual nature remains debatable, even believers should look for ways to interweave the two perspectives. To deny our biology is to deny material reality, just as to deny our divinity is to deny higher meaning.

Divinity, as I intend it here, is a loose term meant to suggest that we have inner measures of soulfulness that go beyond the solid, predictable qualities of organic matter.

In the opinion of Christians and Muslims, each person has an immortal soul that is born once to this world and then consigned to eternal bliss or damnation based on a lifetime’s accounting of virtue, sin, faithfulness, and redemption. The sensible person thus works toward righteous behavior in order to secure a place in Paradise.

According to many Hindus and Buddhists, a soul (or its equivalent) is reborn repeatedly through time because of karmic entanglements accrued in previous incarnations. The wise soul engages in right action to limit such attachments and thus escape the cycle of death and rebirth.

Not all religions postulate an eternal and personal soul. For instance, Western Buddhist teachers seldom mention reincarnation. They discuss the basic principles of detachment and right behavior without reference to rebirth. This obviates the need to discuss a soul-entity, and in fact the Buddha himself rejected the existence of a discrete soul, since he found no evidence for any consistent, fixed self in his deep explorations of mind. Most Buddhists in the USA seek direct, meditative insight into the nature of consciousness as the ultimate goal of practice and don’t worry about escaping the cycles of birth and death. The focus is on mental process without invocation of any divine or eternal soul.

Many contemplative traditions (including some strains of Sufism, Christianity, Buddhism, and Hinduism) also reject the personal soul-concept. However, they do so by invoking a universal consciousness that subsumes the individual. This is the non-dual stance, which sees no meaningful distinction between soul and body, or between spirit and matter, or between God and individual souls. According to this philosophy, all beings arise as creative expressions of one vast Presence that manifests in myriad forms but retains core unity, which unenlightened humans fail to grasp. Such analysis rejects boundaries as illusory, whether between individuals, between people and animals, or between people and Divine Nature. We are viewed as all of one body, in the deepest sense. This perspective is essentially ecological and fits well with what we see in the biosphere.

Those of conventional scientific persuasion bristle at mention of either soul or universal consciousness. They see any suggestion of mystical reality as unfounded, infantile, and dangerous. But there is no scientific evidence that rules out either individual souls or cosmic consciousness. Quantum mechanical principles such as entanglement and non-locality provide plausible, if completely unproven, mechanisms whereby enduring impressions of mental life could be retained in the cosmic matrix without violating established physical laws. These ‘recordings’ could possess all the qualities we expect of discrete souls or universal awareness.

Over the years I’ve explored many different metaphysical positions. Raised as an atheist and educated extensively as a biologist, I never seriously questioned the strict materialist perspective until age twenty-nine. At that time, as I entered Alcoholics Anonymous and felt encouraged to find a ‘higher power,’ fate connected me with the Religious Society of Friends (Quakers). Quakerism eschews dogma and doctrine in favor of direct, experiential discovery of ‘the light of Christ’ within each of us.

In 2000, after a series of profound (even shattering) spiritual experiences, I converted to Catholicism. For many years I went to mass several times a week and tried hard to buy into the Roman Catholic worldview. But although I appreciated the call to mysticism and the sacred rituals, the Church’s dogmatism, reactionary sociopolitical views, and rejection of female priesthood alienated me.

As an alternative, I explored Buddhist meditation. For two years I went to local meditation centers for weekly sittings and occasional longer retreats. At the same time, I undertook an intensive program of reading about Buddhism. The emphasis on silence and detached observation of thought felt quite helpful and fit with the clinically oriented mindfulness meditation I’d learned ten years earlier in classes at a local medical center. But in the end, I had trouble with Buddhist emphasis on emptiness and detachment. Although I see the value of exploring these qualities, they offer little in the way of felt love or sweetness. Meditative consciousness is vast and reverberant, but not inherently warm.

Next, I explored a Hindu offshoot at a retreat center that opened a couple of miles from my home. The monastics taught me to visualize my soul as residing in the area of the third eye in the middle of my forehead. I learned to concentrate on my soulful qualities rather than my bodily identity. This approach challenged me at first, because so much noise and confusion seems to arise in my head, and focusing my attention there failed to quiet the uproar. At the suggestion of a skilled meditator, I adjusted the technique by moving my conscious centerpoint to my heart, where there is more peace and warmth. Before long, I awoke to the powerful illumination of an ancient inner awareness that has little use for my day-to-day worries, ambitions, and desires. This inner light feels like a combination of personal soul and universal Presence arising from the cosmos itself.

Oddly, and beautifully, I now find myself having gone full circle. After all my explorations I am back at the Quaker starting point, only with a much more palpable sense of that divine light within each of us. This is experience and not belief. I cannot justify it in rational terms and see no reason to try. All I can do is describe what happens when my meditations go well. It matters little to me whether my direct apprehension of love, unity, and rightness resides only in my brain or truly connects, as it seems to, with a cosmic consciousness. Because it is experiential and not referential, it feels quite solid and unshakable. Some days I interpret my soulfulness in mystical terms, and other days I think about it in purely neurological ones. But no matter what I believe about this state of mind, it brings me peace.

Every person must choose her or his own path, and I have learned to judge no one’s, not even my own. Those who prefer material atheism have adopted a belief system that requires no leap of faith and has a logically satisfying internal consistency. Those who believe in heaven or reincarnation, and who view souls as eternal and individual, have found a comforting formula that gives meaning to what happens here on earth. Those who meditate mindfully to enter spacious states of consciousness experience inexpressible mental stillness. Non-dualists, in turn, use their practice to find (what seems like) experiential confirmation of an ageless and infinite cosmic unity.

For my part, I know only that there is something that feels divine and non-egoic in the center of my chest. It beats like a spiritual heart throbbing in unison with the biological pump that moves my blood. My metaphysical position is neither more nor less valid than any other. It has features in common with the tenets of materialism, since my bliss seems deeply rooted in my biology. It shares some aspects of the soul-religions, because the brightness within acts like an eternal spark that illuminates my better nature. Consciousness also feels enhanced, as I tune into the infinite harmony that comes with silent meditation. My practice has non-dual aspects too, since in its highest expression I feel merged with all beings and all Nature.

This is my spiritual trail, which has been blazed through two-and-a-half decades of searching and introspection. I believe each of us must choose whatever path feels right. We should seek the tradition(s) that can heal both our own wounds and the troubles of the larger world.

So although I spent two posts honoring humans as living, breathing organisms, it feels vital to round out the discussion with my conviction that we also embody a loving, timeless Presence that permeates and transcends our material forms. This may be a personal soul, or a universal one. It may be pure consciousness or an artifact of brain physiology. No matter. It dwells within each of us, waiting for the day we abandon our desperate scheming and open to Life in all its terror, splendor, and Grace.

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Sinful Desire?

This will be my last word, for now, on desire. So far I’ve summarized the Eastern view on it and dealt with two of the questions that inevitably arise: How do we motivate ourselves if not by desire? and Are there not healthy forms of yearning?

To round out the discussion, let me point out that although one post was titled “The Road to Hell Is Paved with Desire,” I did not mean to imply that desire is sinful in the usual sense of the word.

We in the West are conditioned by Judeo-Christian theology. Within these religions, there is a presumption that God judges our actions and condemns our sins. Lust, greed, sloth, wrath, pride, gluttony, and envy are all related to desire in one way or another. When we yield to these “seven deadly sins,” and hence to our base hungers, God rebukes us. Or so we are told by the Abrahamic lineage.

This kind of thinking is at odds with the views of Eastern traditions. The Hindu God is a complex entity with many facets and manifestations. But if God appears in personal form at all, he (or she) is more a companion and neutral witness than a punitive judge. The Hindu and Buddhist concept of karma implies that we are free to choose and suffer the natural consequences of our choices. If we elect to cause harm, we will reap darkness in this or future lifetimes. If we choose compassion, we will receive mercy in kind, eventually. The emphasis is on inevitable cause and effect, not just desserts.

In spelling this out, I am not claiming that one view is necessarily right and the other wrong. Rather, my point is that both Divine punishment and Karmic consequence deal with ultimate effects, not immediate results. In contrast, these essays were not written to suggest that desire leads to a hellish afterlife or unhappy future birth, but to misery in the here and now. Craving creates hell on earth.

Desire causes suffering automatically. It is not sinful in the sense of leading to eternal damnation. Nor do we necessarily accrue bad karma if we choose to live by desire. But if we bank our happiness on satisfying wishes, on constantly adjusting our circumstances to meet our expectations, we are doomed to suffer disappointment. This is a utilitarian judgment, not an ethical one.

The many questions that arise when one proposes rejection of desire become less important when we see things this way. Those who prefer to live passionately, or who feel strong hungers and enjoy pursuing them, are perfectly free to do so. Such people are neither unworthy nor unspiritual. They are free to ride the stormy waves of yearning, satiation, and more yearning. No doubt they can, as much as anyone, find realization if they want it badly enough. They can choose ethically supportable desires and reject destructive ones; they can hunger for social justice and world peace; they can elevate their passion to mystical ecstasy and so counterbalance the grinding frustration of appetites.

But those of us who tire of the roller coaster, who seek equanimity, can find it by rejecting the promise of desire. We can see how pursuit of hungers leads to nagging dissatisfaction. We can transcend the yearnings of body and ego, and move to a deeper and quieter space within.

Yes, there will be a price to pay. Life will lose its power to stimulate and arouse. But we will gain steadiness and profound insight in exchange.

The choice is ours and ours alone. The universe will love us either way.

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To forgive, divine

800px-Eye_iris

Eye surgery paid well, interested me, challenged me, and rewarded me. But it did not ‘fit’ me. My selection of oculoplastics came as close to perfection as was possible within the choices available. It suited me much more than any other subspecialty of ophthalmology, or a general eye surgery practice. The field offered more room for creativity, more incorporation of esthetics, and (frankly) more room for error. If you operate inside an eyeball, precision counts above all else. A fraction of a millimeter can make the difference, in some cases, between success and functional blindness. The preoperative examination and postoperative care require equal attention to detail. With surgery around the eye, rather than inside it, you do not need to be so compulsive. There is more need for judgment and innovation, and less need for machine-like accuracy. That matched my skill set better.

The problem for me did not come down to dexterity. It had more to do with diligent attention to detail. That is just not my strong suit. At one point, after I left my surgical practice and was looking for answers, doctors considered a diagnosis of ADD (attention deficit disorder). Even without that label, however, I knew there were problems with forgetfulness and inattention. They say that ADD might be more appropriately named ‘selective attention deficit disorder’. I explained to one psychologist that I never had trouble focusing during surgery, but that pre-operative preparation and post-operative follow-up involved a lot of details that caused me problems. She told me that my experience fit the classic ADD model. When the adrenaline surges through my system, I am capable of intense concentration. But when the pressure lessens, my mind wanders.

So working as a Western, tradition doctor (which requires keeping track of myriad facts and countless essential tasks) often stressed me out. I struggled constantly to make sure I did not overlook some crucial clinical finding, forget to order a vital medication, omit filling out the form for a key lab test, or fail to direct the patient to return for the proper follow-up. Relating this now embarrasses me. It is only in hindsight that the problem looks so clear. While in the field, I did not allow myself the luxury of admitting my weakness. I just powered onward, and did the best I could. Sedulous care was most exhausting and difficult while in training, because I was inexperienced, and few of my professors bothered to check up on us (surprising, isn’t it, that trainees were not watched more closely?). Once out in practice, I could do a lot by rote, and the staff I worked with quickly picked up on my need for others to help manage the details and paperwork. I did a fantastic job with diagnosis, planning, and surgery. But remembering all the countless peripheral components that go into taking care of patients never came easily. And relying on your helpers to catch your mistakes is destined to fail sooner or later.

I had talent as an oculoplastic surgeon. Patients were referred to me from wide areas, repeatedly by the same doctors. Some even told me my reputation was stellar. The errors I made were no more common, I don’t believe, than those of most other eye doctors I knew. But if you overlook a crucial detail, it looks really bad. If you perform an unnecessary operation, or decide not to operate when surgery would have been better for the patient, people may disagree. Nevertheless, they won’t look at you the same way as if (for instance) you operate on the wrong eyelid. (There: I revealed it—my most public and shameful mistake.)

So in a sense, losing my ability to perform surgery may have been a good thing in the long run. It certainly reduced my burden of stress. It saved more patients from being harmed by my ADD. Even though there were only a few times that my tendency to lose focus caused significant harm to those in my care, every one of those mistake haunts me to this day. Yes, it is easy to come up with justifications. For instance, I remind myself that all physicians make errors. My view has always been that the type of blunder reflects the individual doctor’s personality. Some people make mistakes because they refuse to recognize their limits, and take on cases for which they lack adequate talent or preparation. Conversely, some surgeons are too timid, and hesitate rather than accepting necessary challenges. Some rush, and make mistakes by going too fast. Some are terribly slow, and needlessly prolong cases, increasing the chances of infection or other complications. Not a few just have poor clinical judgment. And so on. My mistakes came from a genetic inability to keep track of details. Frankly, I don’t think my missteps were any more frequent or severe than those of most surgeons in my field, but errors of forgetfulness are glaring and impossible to explain away. And even though I have run all these tapes about how ‘everyone makes mistakes’ countless times in order to feel better about my errors, in the end there is no valid excuse for injuring patients.

In my day, and probably still, no one ran aptitude tests to help medical students choose the right specialty. I knew of doctors who made it all the way into a field like ophthalmology, where you simply have to have good depth perception, only to find out they had none. We were never assessed for manual dexterity. If you were a good student you could do whatever you wanted.

I liked the eye. The first time I looked at a human eyeball through a ‘slit lamp’ (the clinical microscope used by eye doctors; you know the type: you put your chin in a little cup while a bright light flashes in your eye), it literally took my breath away. I thought the eye was one of the most beautiful sights I had ever seen, like a faceted jewel or the most intricate flower. I once wrote a description of that first view; and I have made it available on the ‘MemoirShards‘ page of this site. That piece came out of the fact that looking at that first living human eye through a microscope stands as a landmark day in my life. The way the eye’s beauty thrilled me led me to be an eye surgeon. But it may not have been the best way to select a specialty.

My instinct told me to become a psychiatrist. When the time for choosing a direction arrived, I had yet to develop the mental health history I now have. There was depression in my background, but I had never been hospitalized, and never given medications. But both my mother and my sister had been through the ‘mill’, and the subject fascinated me. The brain held more intellectual interest for me than any other organ. (The retina, by the way, develops as an outgrowth of the brain. Studying its circuitry in graduate school laid the groundwork for my later connections within ophthalmology. It is not an exaggeration to say that the retina is actually a subunit of the brain.) I also had a natural facility working with psychiatric patients. They did not scare or repulse me, as they did some other students. I found them interesting, and their plights deeply touched me. I connected well with those on the psychiatric unit, and seemed to be able to bring them comfort.

But ‘eye surgery’ had more cachet. It paid better, seemed more technically sophisticated, and attracted more driven and competitive students. Always one to look for a chance to enter a contest and win, I couldn’t resist. Plus, the research in ocular cancer that I did as a medical student went quite well, and the eye surgeon/professor who guided me had an international reputation. He mentored me, complimented me, and persuaded me to enter ophthalmology. I ignored my ‘heart’, and my natural talents, and did the more impressive, ‘ambitious’, and expected thing.

What can I say? When young, we make poor choices. By the time I figured out my mistake, so much work and time had been devoted to becoming an ophthalmologist that it seemed like it would be stupid to switch. So I motored on, and chose the field within ocular medicine that suited me the best. I did well, got a lot of recognition, and actually enjoyed the work. But it never ‘fit’.

Worse, I knew going in that my family has a strong history of severe arthritis. The emotional stress of working so hard to avoid forgetting things, and the physical stress of operating as much as I did, led to a liability for my neck that it could not sustain. My spine failed me, and I had to abandon the career. That led to my psychiatric collapse, from which I have been recovering for a decade. I am now better, but permanently marked as a ‘mental patient’. And my body has been irreversibly scarred by the medications.

Sometimes I think this is my retribution for the mistakes I made as a doctor. If so, then I have paid my dues. The distress I experienced from the shabby way several mental health clinicians treated me, and the horror I felt watching my body get wrecked by psychotropic drugs, have been so great that I don’t think I need to undergo any more ignominy or torment to balance the scales. This feels liberating.

So I have a clean slate. The old me has been burned. The silly arrogance, stupid misdirections, careless errors, and exaggerated drive to win have all been incinerated. I am free. Crossing that wobbly bridge from a high powered surgical career to long-lasting (though thankfully not permanent) disability took a long time, and nearly drowned me in regret, humiliation, and grief. But I am still here. Crucially, I have forgiven myself. I am still marching forward into the mists of fate, and have not jumped over the edge to avoid them.

ericgillchrist

This essay, this baring of my defects as a surgeon, would not have been possible ten years ago. Now that I have been so long out of the field, and can look back with objectivity, I see things far more clearly than I did at the time. And I no longer have a surgeon’s reputation to uphold. I can be honest. I did much good as a oculoplastic specialist: most of my post-cancer reconstructions, for instance, came out exceptionally well. But the whole time I spent in practice, I lived in fear of that critical mistake. Now it is all in the past. As devastated as I was on that day I described in my last post, the day I knew that a decision during surgery had been dictated by pain rather than clinical judgment, the day I knew the only ethical choice was to stop operating, as frightened as I then was, I now realize that everything I went through had to happen for me to be released from bondage. Losing my career was inevitable for many reasons. For my sanity, for the benefit of those patients who might have suffered harm, for my neck, and for my enlightenment.

I hated the bottomless despair of a difficult ten years. It felt like hell to spend my nights awake in anxious terror, feeling the disgrace of my weaknesses and failures becoming public knowledge, knowing I had lost every shred of status and all sense of financial security, and eventually watching critical parts of my body get destroyed. But now I understand. I get the point of suffering. I know that life is not all about having things go well, about ‘winning’, about getting what you want. We are here to learn. Some of us are destined to suffer more than the average amount of anguish. In the end, if we survive, we have more empathy for others, and for ourselves, than we could have found any other way. My emotional privations and my public defeats brought me to what I consider a ‘wisdom’ that always eluded me before. They cleansed me and brought me peace.

This relief sculpture by Eric Gill reminds me of the best of Christianity. The purification by suffering, admission of sinfulness, and acceptance of divine forgiveness, are what I have needed to get to this point. Even so, I do not know if I consider myself Christian, although for a time after my ‘visions’, I most certainly did. Christ came to me in a concrete form, and rescued me from my torments. If I had been able to maintain my faith, I might have been spared the descent into hell that followed. Looking back, I suspect my soul needed a period of intense suffering to allow myself to accept absolution. I needed to pay for my mistakes as a physician, and atone for wasting my God-given talent by choosing a career based on ambition rather than a mission of helping others. Perhaps I needed to feel the sting of punishment before I could accept the tenderness of forgiveness. However it came about, on my best days I am serene, accepting, and grateful for the trials I’ve survived. What greater blessings can we ask from life?

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Working It Out

I’m learning HTML right now, in order to build a better template for my blog, and pages for my site. I’m also thinking about what the next step might be in developing my blog concept. I would welcome any ideas, if anyone were to read this. But for now I’m on my own, obviously. I have been working on the concept of multiple views on religion in one person’s psyche. I think it is the easiest way to deal with doubt. One part of me does not believe, another does. Since I’m not strongly attached to a concept of unitary truth, this approach is fine for me. When I’m in my doubt phase I accept the stance that any supernatural being is unlikely. When I’m in my faith phase, I buy into the God concept, at least in a general sense (not in a Judeo-Christian sense, however). Which side is right does not concern me very much. We’ll never know. Science does not support the existence of anything supernatural, but it does not rule it out, either. There is plenty of room in what we don’t understand about matter, light, and energy on their most fundamental levels for some kind of extra-sensory phenomenon to arise. Maybe science will someday pin such a thing down, or maybe not. Either way, there is room for such things. “Absence of proof is not proof of absence.” So I can sit on the fence easily, by just compartmentalizing the two ways of seeing things. Ultimately, I think it comes back to the Will and Spirit dichotomy. (See earlier)

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