Blog | Tuesday, March 5, 2013

Practicing Zen meditation and being a doctor

I just got back from a seven-day Zen meditation retreat in Northern California. I have done three of these in the last 10 years, about as frequently as I get my teeth cleaned, and similar in some ways. They are time consuming, not particularly cheap or comfortable and I feel much better afterwards. Zen, however, unlike preventive dentistry, is really interesting.

I started meditating about 15 years ago when the stresses of being a mother of small, often irritating children, as well as a small-town physician, had made me into a person I didn't particularly enjoy being around. My sister had started meditating and recommended that I just count my breaths up to 10 and then start over again while sitting on the floor for 20 minutes. It sounded simple, and I figured I would do an experiment, counting breaths every morning for a month and I would see if I was a better person.

It was difficult. I kept falling asleep and could rarely actually count my breaths up to 10 without becoming distracted. At the end of a month I was converted and would no more have given up sitting than brushing my teeth. It turned out that I didn't have to be good at meditating in order to be calmer and happier; I just had to do it. I also had more interesting thoughts, even though I was kind of trying not to think while I was meditating, and I could sit still better when that was called for. I got better at listening to my patients. Things that should have been funny, were funny.

A few years later I attended a meditation retreat with the Zen group my sister had joined (Pacific Zen Institute) and was much better afterwards. I didn't like the fact that I never got enough sleep at the retreat (that is part of the routine, getting up at 4:30 a.m.) and my knees and butt protested the sitting in one position for hours every day. But that actually didn't matter. I started to realize all sorts of really obvious things that made me happier. Life was more interesting when I got back home. I started writing, mostly poetry, which was kind of an extension of meditation.

During this first retreat I first made the acquaintance of a koan. Koans are brief stories or conundrums that make a person think, and then make the person realize that thinking will not work. They invite mental gymnastics and frustration and then unfold into something unexpected at some random time days, weeks, months or years after taking them up. Many students of Zen will go through a curriculum of koans with a teacher, with feedback from the teacher about whether the student really got the message that the koan was meant to give.

Over generations and across continents, the messages that each koan gives are remarkably similar. I had no easy access to a teacher, in the wilds of rural Idaho, so I did my own koan curriculum, finding the most irksome koan, or one that seemed to specially talk to me, and chewing on it until all of the realizations that it seemed to have within it became clear to me. There is precedent for this, though teachers think it works better if you have a teacher.

During my second retreat I continued to work on koans, continued to sit and be sleep deprived, and had various transformative experiences which are better experienced than described. This recent retreat a couple of weeks ago helped me unwind a few delusions which now seem obvious but didn't before it started.

One of the other people there was a physics professor at one of California's state universities, and we were dinner cooks together. Like me, he came from a place of pragmatism and skepticism, and practiced meditation because it was one of those things in life that turns out to need doing. We tried to figure out, from personal experience, what it is in sitting and not thinking about a baffling ancient story makes our minds richer and calmer. Of course we didn't figure it out, but agreed that there was something about stillness that the brain needs. I also think that my mind appreciates having something to play with, and a koan is a good toy. Wiser folk than I have and still are thinking about what is important about meditation and why it does all these good things, so it is probably perfectly OK for me not to trouble myself with this question.

Apparently all Zen groups and all meditation retreats are not created equal, and I was probably lucky to have happened upon Pacific Zen Institute. I am violently allergic to that which seems unkind or insincere, and some Zen groups have these elements. The U.S. has a rich and diverse Zen tradition, with subtleties of practice of which I am, and will remain, mostly ignorant.

Buddhist meditation is even more diverse, much bigger than just Zen, and includes a myriad of Asian teachings as well as very westernized forms like Jon Kabat-Zinn's mindfullness based stress reduction. These all have passionate proponents and do the peace and happiness thing for those who practice them. Doctors such as Herb Benson at the Harvard Medical School have tried to figure out how to bottle what is good about meditation for easy consumption by patients, some of them who have been failed miserably by standard health care. Although such medicalized meditation doesn't appeal to me personally, it is wonderful that it exists to help folks who need it.

Janice Boughton, MD, ACP Member, practiced in the Seattle area for four years and in rural Idaho for 17 years before deciding to take a few years off to see more places, learn more about medicine and increase her knowledge base and perspective by practicing hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling. Disturbed by various aspects of the practice of medicine that make no sense and concerned about the cost of providing health care to every American, she blogs at Why is American Health care so expensive?, where this post originally appeared.