Emergency Medicine Fellowship success – Love & Gratitude

This journey is hard to explain,

Beyond the pleasure and the pain,

Like chasing the sunshine through the rain,

 

And then looking for the rainbow,

That has always been there,

But without guarantee,

 

For the heat is more than you can think,

Momentary defeat could arrive with a blink,

And cripple your confidence,

 

Until you become aware,

That what you seek has always been there,

….deep within,

 

So when you would want to shout,

Crippled by doubt,

Reach to your core, and pick yourself up,

 

Feeling and trusting what you know inside,

And then confide,

Making sense of the ride,

 

Beyond fiction and fact,

Providing safety with great tact,

You show that you care “beyond” the task at hand,

 

For in this approach and way,

You are sharing “more” than the words you say,

In a style and conviction that resonates,

 

So thank you to my amazing team,

And especially those who backed me in my dream,

Through a process that could just as well ended very bleak,

 

Had I not realised the simple fact,

That “trust” is strongest at its peak,

And “fallability” is an essential part of humanity,

 

So rise with every fall,

Smile again and stand tall,

No matter what comes your way,

 

And for me, kindness was the key,

Giving oneself permission to simply “be”,

Letting the wisdom of mind, body and soul run free.

 

With love and gratitude

– thank you.

 

 

1/8/18 – I’m sitting in Doha airport, having a left behind a beautiful winters morning first in Wollongong, and then in Sydney. My next destination in Stockholm, Sweden, to see my partner in life and love.

 

I have wanted to write this post for some weeks, a post of about my gratitude for passing the Fellowship exam ( the final chapter of the emergency specialist training program).

I am so increadibly grateful for all the support I have received to make it through, for it has been no easy feat. There have been so many forces at play to get through this exam, tangible and existential. Not least to thank is my partner, Sanna, who was supportive well beyond the call of duty, for she had to put up with me during the last two and a half years of fellowship study, on the back of supporting me through a PhD write up (and I’m sure I lost my mind for the latter part of this process). Not only Sanna, but my family and friends. I had been studying for the fellowship written and clinical (OSCE , or objective structured clinical exam) for just over 2 and a half years, prior to my recent completion of exams. During the last two months of study I didn’t see my brother who lives just over an hour away, or my little nephew, and I also ended up moving out of home into a solo appartment for the final 6 weeks – despite knowing the territory when going into it, I never would have forseen it being so challenging.

 

These strategies were to help me manage the intensity, and to help me focus my efforts to give it all that I had to give, physicially, psychologically and emotionally. At the same time they allowed me to spend a bit of time to “look after myself”. I never let go of that last principle. Being kind to oneself, was so important to me, and that included meditaiton and swimming in the ocean, surfing or body surfing.

 

Everyones journey is unique in the fellowship, and it is a very tough process, and also imperfect. There are some who pass straight through to “fellowship”. There are many who fail and then pass at subsquent sitting, and then there are those who don’t make it thought.

 

My heart goes out to the people who both fail and pass. I know the pain of failure in this exam because I failed the written on my first attempt and sat it one year later, and passed. Then I sat the OSCE immediately after and failed this the first time. Despite putting my heart and soul into the exam I failed, and this was devasting. I didn’t give up, although I did think about it. In my case I had search deep within to realise why I was doing this training in the first place.

 

Connecting with “the Why”

 

On the surface it looked as if this was just an exam I had to pass, but the real reason was that this was going to be something that was going to make me a better “Emergency Physician”, and provide the structure I needed to practice for the rest of my career. Also back in 2006 when I went to Sri Lanka for a 1 year expedition, both cultural and professional, I discovered something that I was passionate about, helping develop EM systems in resource limited settings. That interest lead to a PhD in knowledge translation, that covered the topics of toxicolgy, resuscitation training, simulation and health services research. Doing international work, and working in rural Sri Lanka was so inspiring to me, I became so passionate about teaching Emergency Medicine and Resuscitation in settings like rural Sri Lanka because junor doctors on the ground were so hungry for education, and it made a difference to their ability to support their patients (particularly in critical care).

 

In addition to gems in medical training, I also spent time exploring parallel paths of personal develomement, including poetry writing, music, mindfulness and spirituality. It was from this point that I had a dreamt of giving something back to society through bringing in some of these extra academic skills and soft skills into mainstream medicine. One dream plan was to to support a more kinder and human system of training, where junior doctors felt inspired to go through training, rather expecting loose large chunks of their life from which they may or may not recover. The project I started back then was called compassionate health education, which championed teaching behaviours where “kindness” and “respect” at basis of all topics of education.

 

I also believed that through research I could help contribute internationally to lower resource sttings I guess you could say that I had to travel to Sri Lanka and practice medicine in a rural setting that I found my “why” for completing both a PhD and EM specialist training. I had to re-visit and re-solidify that “why” on several occasions during the fellowship training when hitting difficult spots and it was helpful thave them mapped out. In returning to mainstream training, I saw EM through a triple lense, that of a trainee, and that of a researcher and through the eyes of being a human being. It sounds counter-intuitive, but in order to train in and brand of hospital medicine, it’s quite easy to forget one’s humanity through the sheer force of intensity of training, and consequent lack of life balance.

 

Wellbeing, burnout and maintaining mental health in training

 

During the middle of my training I was exposed a series of suicides, and became involved in mental health and wellbeing. I had lost two friends and colleagues to suicide of a period of years, both of whom were accomplished and inspiring medical educators. These events had a subtle but important impact on me. Today, researching wellbeing strategies in EM, and addressing “physician burnout” is my current focus of research. Through some preliminary work I have realised that perhaps there are many factors to do with work culture, and education systems that could augment burnout and mental heath issues, representing a gap between where we are and where we could be.

 

Another reason why I am so passionate about this topic is that during my training I experienced burnout myself. This occurred when I was trying to write up a PhD thesis and also do advanced training simultanously. I was training not only to be a better doctor for the individuals I was treating, but I was also simultanously training to improve systems of health care, including the systems of training. Thankfully I had a supportive work team, including ED director, and director of training at that time who helped me facilitate some time off, to address what was missing in my life-work balance. I ended having three months off, seeing my GP, and also going on a 10 day silent meditation (vipassana) retreat, which allowed some important rejuvenation, and change in perspective. When I returned to training I was better than before, and approached it with new vigor, and greater balance.

 

The Gratitude Roll

 

I feel such gratitude for all that has happened to allow me to get through this fellowship process. However, there are too many people to thank for this point, and no words can really express how I feel, especially for certain ones. Some of these people probably don’t realise what an effect they had on me. An exhaustive list will be futile as I’m bound to miss writing someone, and lists don’t make interesting reading. I will try and mention some of the area of gratitude and it is important for me to have you know that if you ever had a good thought towards me, you were part of the process that helped me get there.

 

Thoughts matter, and when you wish someone else well, you are actually wishing yourself something good at the same time (the Buddhist philosophy has a word for this sentiment, which is called “Mudita”, or sympathetic joy, the happiness in anothers success. So think you for any Mudita that came my way before the exam!)

 

I was inspired to write this post today because I am accutely aware of my inner circle of support, being my partner, and my coach Juli, as well as my parents brothers and families. I also have my teachers and mentors in EM and my friends and the community groups that I belong to like www.onewaveisallittakes.com. If there was a process that helped me immensly it was surfing in the ocea, meditating, playing guitar and exercise. It amazes me how lucky I have been to live close to the ocean and have access to this.

 

I am also proud of myself for being able to stick to regimen of self discipline, during the fellowship exam and enlist the joy of “missing out” on some of the things and activities that I loved the most.

 

The amazing Team of Liverpool ED

 

I have to make a special mention about the entire department of Liverpool ED, where I worked for the year leading up to my success in the Fellowship OSCE exam. Liverpool has been one of the most amazing hospitals to work at in my career to date , because of the complexity and diversity of patients who we look after, and the amazing team based culture that prevails in the Liverpool ED between senior staff and junior staff, and doctors, nurses and all levels of staff from cleaning staff, wardies to the consultants and senior nurses. This culture of Liverpool ED is a testimony the leadership of our director Dr Serena Ayers, who has empowered innorvation and leadership along the ranks and had a vision for this. Also the director of EM training Dr Jenni Davidson who had created a Fellowship training program that I could not have dream of, backed up by a motivated team of staff specialists and VMOs, and such a cohesive, supportive, and fun bunch of ED co-registrars. I remember, in somewhat of a hazy blur (despite this being only 3-6 months ago), working weekends where I would finish a shift past midnight, stay in hospital accomodation, get up for a coffee and less than average breakfast (I say this because I live for our home made museli and fresh fruit) and squeeze in a couple of hours OSCE practice before another heavy 10 hour shift.

 

Anyway, my plane is about to take off and I will look forward to getting this post up on my blog. I usually write a post at least every 3 months. I haven’t written since december last year, which is a big deal for me. It is one of the things that I put on hold. But I’m so happy to be able to write this post. I am also happy to be going to Sweden

 

Looking forward seeing Sanna and her family, and having a holiday, including going to a Music festival in the heart of Sweden! I can’t wait 🙂

 

Take Care

Best Wishes

Bishan xxx

 

PS – Thanks again to everyone who helped me along the way – I really appreciate it!

 

PPs – I give my sincere apologies for those nice people whose lives and important events I missed out on whilst in this intense study period. Sorry for missing parties, and all the communication about important things (including births, and deaths of loved ones). I endeavour to get in touch in the months ahead – please don’t take it personally.

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Impossible is just a perpective #ACEM17

Impossible is just a perspective,

So let us be reflective,

And ponder with mild imagination,

.

Letting go of cessation,

And seeing what may fly,

Like babies and adults that cry,

.

Let’s not deny, the humanity that exists within,

But instead let our dreams open and sing,

The song of becoming,

.

For in observation we can only find,

That medicine can also be quite kind,

If we first reach the heart within,

.

Perhaps “this” is what possibility may bring.

21-11-17 Reflecting on the the first day of the ACEM 2017 ASM (that is, the Australasian College of Emergency Medicine’s 34th annual scientific sessions), held this year in Sydney, with a conference theme of “Impossible is just a perspective”, and a secondary theme of “getting the balance right”.

When I heard about the planning of this conference at the SMACC Dub conference last year, I was waiting in anticipation. The welcome speech by Sally McCarthy, an ex-president of ACEM and conference chair, confirmed the importance of the theme. It highlighted just how far the specialty of Emergency Medicine had come in recent decades, perhaps partly owing to this positive perspective where “impossibility” was only an impostor. However, Sally also highlighted how this rapid progress had also brought about new challenges which included keeping one’s career sustainable, and thereby released the secondary theme of “getting the balance right”.

This first speech was very powerful, and also relevant to me having recently attended the very first EM conference in Sri Lanka(SLEMCON 2017), and seen the rapid evolution of the specialty of EM since I was living there in 2006. Sally herself was a keynote speaker at this inaugural conference in Sri Lanka, and referred to this incredible progress in EM development as further evidence to the primary theme of this years ACEM conference.

Opening Plenaries – (day 1)

The opening plenaries where all gripping and impactful in their own ways. Maaret Castren’s, a Finnish Professor in Emergency Medicine, took us to the frontiers in resuscitation. This talk was delivered with Scandanavian precision, and factual flow, but also a tinge of nordic humour (“I only share Polar Bear photo’s that I take myself” – classic!). Maaret shared some pearls from her own research on leadership training in CPR as well as shedding light on controversies in the resuscitation literature. Included in Maarets many accolades is the fact that she has been a chair of the European Resuscitation council, is part of ILCOR, and had also trained as a nurse prior to training as a doctor, and a professor.

Then there was the Westmead trained FACEM , Rick Brennan who is the director of emergency operations for the WHO, who shared his insights, horrors, and triumphs form being tasked with dealing with the Ebola outbreak in West africa in 2014 (resulting in over 28,000 cases and 11,500 deaths), along with another FACEM Ian Lawton. This was a truly heroic effort by the entire response team, and it was inspiring to see an Australasian trained Emergency Specialist in the leadership role of this challenging global health crisis.

Next was Sue Ieraci, a senior Emergency Physician from Sydney. She took us on a reflective journey through the creation and subsequent evolution of Emergency Medicine as speciality. Having seen, and been part of, the initial changes in the creation and earlier stages of evolution, she put it to the audience, in an ever so metaphorical manner, that whilst creating a dream specialty, we have along with it also been party to the creation of a few nightmares. These included things like the backlash of 4 hour rules, EDs been driven by performance targets, and triage creep, just to name a few. She left us with some great food for thought about the potential steps for re-creating the system which put “leadership” and “wellbeing” at the helm of the ship.

Finally, in the opening plenary we were introducted to Karen Hitchcock, a Physician and a writer, and favourite by many in the conference for the ongoing creative “outside EM” perspective, which she so eloquently brought back to the centre of the emergency echelons at this conference. She presented so humbly, yet so powerfully. On this first day, she presented on this first day ethically challenging talk on Euthansia and a range of scenarios and attitudes that could associated with this term in modern medicne.

Prioritising Wellbeing culture in Emergency…the future?

There were so many brilliant talks in the ensuing 6 parrallel tracks run at the conference, which make it impossible to even cover with any meaning (perhaps check out the tweets at #ACEM17), however, perhaps one talk that stood out for me, and really struck a chord with my heart was that by Bethany Boulton, from Queensland, which was about creating a great working environment and specifically “why wellbeing is so important”.

One of the most memorable aspect of Bethany’s talk was the storytelling of her own challenging, yet interesting and creative personal journey in medical training that led her to taking an active role in creating cultures of wellbeing at her local Emergency Department, and collaborating internationally with this movement. She also brought to light some uncomfortable yet striking evidence about how prevalent psychological impairment, and burnout, are in modern Emergency Medicine. Bethany also highlighted key international literature outlining strategies for the promotion of wellbeing and also how this had been translated in her local hospital setting. This inspiring talk highlighted that sharing one’s vulnerability is surely a sign of strength. Well done Bethany – your talk was so good, and the model presented was very inspiring!

The Ripple Effect

Every drop of effort counts,

Don’t underestimate the power of the mind,

Love, then trust, and see what you will find?

For the world is not what it seems on the surface.

 

Those who have the courage are the ones that beam,

Using energy, inspiration and gratitude as a team,

 

With positivity, we can only but learn,

Growing like a fern,

Unfolding and understanding,

That in fact “to try our best” is to actually “to be” our best,

 

Beckoning success as our “fate”,

Accepting this journey in “flow-state”,

 

For after all,

To be fast is really to be slow,

And to question wisely, is perhaps to know.

 

26-6-17   Taking the plane home after after an inspiring journey to Melbourne indulging in the world of resuscitation and trauma management at Andy Buck’s ETM course (i.e. th Emergency Trauma Management course). I have come away with a multidisciplinary, multi background “total immersion educational experience” in trauma management. As part of this one of the highlights was meeting some wonderful and inspiring people coming from different stages of training (residents through to experienced and creative consultants educators in EM and Anaesthetics) and coming from different backgrounds of practice (eg. rural GP anaesthetists, Public Health anthropologists, experienced life-style oriented career medical officers) who are perhaps helping us lead health care into better directions.

Thanks for a great course everyone – it really hit the spot! 🙂



 

Two Poems for champions of my heart

Equality

 

We are all equal,

There is no sequel,

For we have only this one life.

 

Heaven or strife,

This is our choice,

 

So use your voice,

And your heart,

To rise above the dirt.

 

Make use of your mirth,

That heals up the scars and the pain,

 

Let it flow, let it rain,

 

For perhaps solace lies in the “insane”,

Who can feel the beauty of the life that we live,

Giving of ourselves without a seconds thought.

 

 

16-6-16

 

At the moment my world is inundated with study, work and exams.

As I am progressing through the arduous and challenging joruney of completing specialist training in Emergency medicine, most aspects of my life outside medicine have taken a back seat, to dedicate focus to wards the path of learning the matrix of what is is to be a specialist. I am doing what I feel is effective, and and have learned to possibly be helpful, such as reading widely in books, attending practice exams, studying alone and in groups. I have sometimes been sharing the highs and lows with others on the path, but mostly experiencing them alone, in a solitude that will never be known to the world at large (apart from in daring writings such at this).

Today I learned of the exam results being released for the OSCE (objective, skills and clinical examination), and it is with great joy and simultaneous sadnesss that I heard of the success and failure of friend who are dear and near to me in both my heart, but in terms of the journey that all fellowship candidates are on, past and future.

In the joy of one particular friend I breathed a breath of relief, and for others I shared in a gasp of despair. It seems unfair that some individuals who have such a heart, such skill, and such potential for this profession, have not made it through (this time) final gate of a greater than 10 year training. Whilst this exam processess is well intentioned, and designed to empower these very qualities, it can arguabley, on occasions, be seen to perhaps fall short of what it set out to achieve.

As a researcher in education systems, and someone who has been observing their own progression through various stages of a very diverse journey of education in the arts, sciences, surgery, research and now emergency medicine, I am acutely aware that “assement” and “qualification” are but a prediction tools of relative certaintainty, but are simultanously not gold standards in this objective. In my own endeavours to help improve education and assesment systems, I’ve realised that training, sitting exams, and passing are but steps on a much greater journey, in which the destination can perhaps never fully be realised, for it is ever-evolving.

So then how do we evaluate the concepts of failure, or success?

Is it not an imaginary line (albeit, calculated through a process and mechanism), on a continuum of life-long learning?

Perhaps in specialist training, and many other forms of education for that matter, this line forms a both an psychological, and actual barrier to progression. I wonder how well the impact of examinations correlate to the end product of achieving skilled, well rounded individuals?

These may seem like esoteric questions, but to an educational researcher they questions that could potentially form a life’s work.

 

Coping with Success and Failure – through the relationships we make along the way

As a friend who was studying for his own specialist exam in another field, Anaesthetics, once reminded me “failure is an event, not a person” (taken from a line provided by personal development legend Zig Ziglar). This advice came in incredibly handy when I sat, and failed, my own big exam, the fellowship “written” exam. I have now been studying for a whole year since then, whilst working, getting over the loss of esteem, and building an entirley new strategy. If I pass this time around in August, I have the opportunity and privelidge to sit the same exam, the OSCE, that I am celebrating and mourning the results of with my friends, who are at this next stage.

It seems like a very long and uncertain journey, and perhaps this is why the final result will be so very special.

However, in the meantime there is so much pain, and equivalent joy. The joy partly lies in the hope of achieving what I set out to do, partly in feeling the success of others, but perahps the most guaranteed joy of all, is the wonderful relationships that are forged along the way – irrespective of outcome.

When studying for this exam we are in positions of vulnerability and humilty that most would not actively choose to occupy. Some, perhaps, will quickly forget how uncomfortable it feels to not definitely know if one can make it “there”, whilst others will never forget, no matter how well they perform, for it is in their nature to help others on the path.

Two of these such people, who are always there to help others, ironically did not pass the the OSCE this time around (and I’m sure there will be more good candidates to come, who also didn’t pass, for the OSCE has a pass rate often hovers around the 50%, or less, mark).

Perhaps you also know someone like this, someone who is clearly capable and desrving of such a pass? Perhaps it is even you, the reader.

Whatever the case, the following poem wholeheartedly dedicated to all of you, and all of “us”, life-long learners, who courageously endeavour to live, learn and love.

 

Wisdom, compassion and humility

 

Champions of wisdom, compassion and humility,

Using a pathway to divinity,

That has guided us thus far,

 

Whether we drive a sailboat or in a car,

The vehicle is of no consequence,

If we are not guided by light.

 

Use your sight to look within,

And feel the unity of “Humanity”,

As we once knew and later forgot,

 

We only have this shot,

To get it right,

To live without fright,

For there is really no fight,

 

When we use our energies together at large,

Voyaging in natures communal barge,

That can only be experienced as “Love”.

The rising tide of burnout – a major threat to our healthcare system?

Physician burnout 2

http://catalyst.nejm.org/videos/physician-burnout-stop-blaming-the-individual/

The above is a link to a brilliant talk by the program director for Physician Wellbeing from the Mayo Clinic, Tait Shanafelt, illustrating how physician burnout is a “system issue”.

“We tell physicians to get more sleep, eat more granola, do yoga, and take better care of yourself. These efforts are well intentioned,” says Shanafelt. “The message to physicians, however, is that you are the problem, and you need to toughen up.”

Shanafelt goes on to describe how the six drivers of burnout amongst physicians are largely derived from the characteristics in the work environment.

These drivers are stated as;-

1) Excessive workload

2) Inefficiency and undue clerical burden

3) Loss of flexibility and control over work

4) Problems with work-life integration

5) Loss of meaning in work

6) Organisational objectives that conflict with the altruistic values of the profession

He also states that promoting professional wellbeing is the shared responsibility of individual physicians and healthcare organisations.

Whilst this talk comes from the US setting, I believe the themes that are discussed are becoming increasingly relevant to the Australasian healthcare. My own observations from working in a number of busy tertiary and secondary hospitals across Australia and New Zealand is that we have developed highly efficient systems of delivering essential medical “management”, however, heartfelt “care” appears to have become optional extra.

Hearts in Healthcare

An increasing number of doctors, and doctors in training, have experienced disillusionment the conditions of medical training, and practice, and at the consequential neglected dimension of “care”. I have had countless conversations with caring physicians over the past 5-10 years, at all levels, which has led me to believe that there is a deeply “broken” element to the current healthcare system. Some have felt strongly about the issue of restoring humanity, and the heart, back into medicine that they have also made it their life’s work.

For example, Dr Robin Youngsen, who is a NZ Anaesthetist, has highlighted the importance of creating “time to care” in his first book, which takes on this very title. He also furthered this message his recent TED talk “perfectly broken and ready to heal”, and has set up an organisation dedicating to rehumanising healthcare, called “hearts in healthcare”.

The power of humanity in health care

Looking both forward and backwards in time, isn’t it “humanity” that is at the what is special and important in healthcare?

It seems to me that through a greater understanding, and appreciation, of the benefits of the “human side” of medicine, it is still possible to steer the evolving culture of healthcare in a better direction.

The opening story in Tait Shanfelt’s talk perhaps conveys this better than any, where he recalls how one particular doctor took a deeper interest in his son on a personal level, when he was a patient in hospital. Despite the all round exceptional treatment his son received in hospital, it was this one persons humane interactions that stood out, and also meant so much to him.

Which future shall we steer towards : physician burnout, or, physician wellbeing?

I am a big believer of the notion that often the question is more important than the specific answers.

We now know that burnout exists in high proportions than ever before , but the question remains, how do we respond to this rising tide? Perhaps one strategy can be rather than reacting to the negative effects of burnout, we can proactively create more wellbeing?

But how do we apply this vision in local physician settings settings? Perhaps a start is by asking the question “what can we be doing to improve physcian wellbeing?”.

What am I doing to improve my wellbeing?

What is happening within my hospital or training organisation?

…and

How can I help this ever-growing movement?

What are your reflections on preventing physcian burnout, and promoting a culture of physician wellbeing? I would love to know your views.

I’m just putting this out to further the coversation, between the ever-growing, increasingly diverse network of caring physicians who have a vision of healthcare that values the wellbeing of all, starting with the one who cares.

Physician burnout editorial

Ref: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)30940-6.pdf

Loving Kindness for 2017?

A highlight of my recent trip to Sri Lanka to attend the Developing EM conference in Colombo included a visit to the Ayya Khema meditation centre to visiting Bhikkuni Kusuma a spiritual teacher of wisdom and kindness.

Bhikkuni Kusuma is an amazing lady. She grandmotherly figure in her late 80’s who has lead an increadibly rich lay life as a scientist, wife and mother of 6. She later took to the robes to become a leading figure in reviving the female Buddhist order in Sri Lanka.

One of the many intriguing stories she talks about life includes her experience as a university science teacher, when she undertook a masters degree in molecular biology many years ago in USA. She is said to have earnestly enquiries from her then supervisors “what I am leaning about is quite amazing, but I am really searching for the answers to the deeper questions in life like ‘why are we born?’, ‘why do we die?'”. To this her supervisors replied “i’m sorry, but science has yet to discover all that”. It was from here that she changed tack in here career and focus her efforts in a field that was dedicated to the complentation of all such entities. Upon returning to Sri Lanka she embarked upon her first PhD in Buddhist philosophy at the Sri Jayawardenapura university in Colombo.

She initially completed a masters thesis investigating aspects of Vipassana (insight meditation), and later completed a PhD on the Dasasil Mattha (Ten Precepts Buddhist nun movement) in Sri Lanka. However, due to the civil instability in Sri Lanka at the time  she submitted her first thesis there were problems with first PhD being awarded, so she embarked on a second PhD (tho only person I know who has done such a thing, perhaps a testimony to her patience and determination as middle aged woman who also had a family of her own). Here she went on to study the female Buddhist order in Sri Lanka, and she investigate why the order seemed to have dissipated, eventually fuelling the difficult journey leading to its resurgence.

At the end of this period of study she herself ordained as a female Buddhist clergy-woman, otherwise know as Nun or “Bhikkuni”. When I asked her why she became a monk she emphatically, and affectionately exclaims, “I had to! They told me I must”, referring to the moral obligation of knowing all the trouble that Bhikkuni’s had faced in establishing equal footing of an order for females.

Apparently she had discussed this with her family at the time who she is still in touch with and taken to the robes in her 60’s, over 20 years ago. Since then she has become a humble leader in gently promoting the sharing of whatever wisdom she can disseminate through years of contempative meditation, and the writing of several books about the application of Buddhist philosophy and wisdom in everyday life.
http://www.bhikkhunikusuma.info/

An autobiography that was written at the request of her daughter and chief disciple, outlining her insightful path from scientist and family woman to religious clergy and leader. The book is called “Braving the unknown summit”, and this details the incredible journey further, explaining the great challenges that were faced in re-establishing the female Buddhist order in Sri Lanka. It also covers on a more personal not the impact of several tradgeies she faced whilst working, doing research and having responsibilities as a family woman, which included illness and death of her mother and the premature deaths of one of her daughters in her 20’s and her eldest son in his 40’s, who both died from cancer.

Meeting Bhikkuni Kusuma (2006-10)
I was very fortunate to have met Bhikkuni Kusuma during my 4 years of living in Sri Lanka, as she is actually a relation (my fathers first cousin). This was a very special situation for me because one of my aspirations in returning to Sri Lanka after a life of growing up abroad, was reconnecting with my extended family, and also learning more about meditation and spirituality. Meeting Bhikkuni Kusuma seemed to incredible offer both.

I remember when I fist met her she fondly recounts looking after my father and his older brother, her small younger cousins, proudly taking them by the hand in order to sit some school entrance examination many years ago. I wanted to learn from her about Buddhism, and had some trepidation about following the correct respectful rituals in order to engage with a senior clergy woman. However, upon Meeting Bhikkuni Kusuma I realized that beyond the surface  appearance of a woman in saffron robes, whatever distinction this may have had at the time, lay a kind hearted human being who was as easy going as ever.

It was like meeting a kind wise old aunt, or grandmother, who readily shared insight and wisdom, as well as the occasional mischievous smile that made me feel quite at ease, and lucky at the same time.
Those days I learned many points of wisdom through candid discussions with Bhikkuni (some of which I have audio recorded and video recorded) that helped me through challenging times in my life when I returned to Australasia and had to face writing up a PhD thesis whilst undergoing specials training in emergency medicine (which I am still completing). I am forever grateful for the the kindness and enthusiasm that Bhikkuni Kusuma displayed whilst teaching so much about the insights that meditation offered, including principles outlined in the Dhamma (the experiential teaching of the Buddha).

The Ayya Khema Mediation Centre 2017

During my current visit to Sri Lanka, it was a high priority to visit the Ayya Khema Meditation Centre where Bhikkuni Kusuma now resides and teachers meditation and Buddhism to people who both live locally and around the world. I came there with my fiancé who isn’t a Buddhist and didn’t grown up with a background of eastern religions, and my little brother who lives quite a modern New Zealand lifestyle, including working and playing, and enjoying life when we can- much like myself and my older brother.

Both of them had not really stayed in a Sri Lankan meditation centre like this, but I believe our short but impactful overnight stay was also a highlight for them too.


We were also fortunate to meet other people who were interested in learning wisdom from Bhikkuni, including a lovely couple from Hungary who had been living in London for many years, one of whom plans to release some of the recorded discussions on an internet website (a link to which I endeavour to share! Thanks Ferenc).

Coming here after attending an amazing medical conference in Colombo was a fitting follow on to a finely pitched conference that explored the science of Emergency medicine, but also delved into many broader topics that address the philosophical issues of humanity in health care. For me this visit to the meditation picked up where the medical conference discussion left off. We addressed many philosophical topics through discussions with Bhikkuni Kusuma over those two days at Ayya Khema, following the week-long medical conference, about the “awareness of the true nature of life”, and the journey onwards in order to understand both the source of human conflict and suffering and the alleviation of suffering.

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Loving Kindness for 2017
Finally, I will share one of the rough edits of a video clip I recorded at the end of our stay at the Ayya Khema meditation centre where Bhikkuni Kusuma wanted to teach me a useful meditative practice of extending a wish for loving Kindness to encompass all living beings. This is my New Years wish for 2017, and would like to share it with anyone who feels the benefit from knowing such practices exist and are improving the lives of many around the world. I certainly have felt the bendit of this Metta (loving kindness) meditation in the past and hope to bring the practice back into my life this year.

Bhikkuni Kusum was adamant that I share her teachings with as many people who are interested as possible, and was very happy to use whatever mediums (eg, video, blog, audio) as I saw fit. I am very grateful for this and thus will share the following You Tube recording. I hope you find it of interest. Feel free to leave comments as you so desire.

I have detailed the Pali words from this version of the Metta Sutta below, along with their  translated meanings (which the video also outlines).

Metta Sutta: Radiating kindness without limit:-



uddham – above

adho ca – below

tiriyañca – across

asambhādam – without pain and suffering

averam – no anger/hatred

asapattam – no enmity (no enemies)

sabbe sattā – may all living beings

bhavantu – be

sukhitattām – well and happy

Dear Venerable Bhikkuni Kusuma – Thank you for your patient effort in teaching me a small about of wisdom in your kind and compassionate ways.

I will cherish he words and the sentiment of this verse, and hopefully share the inspiration I have gained from you and the Bhuddist teachings I have learned through you.

A wish for 2017! 

May all beings be well

May all being be happy

Best wishes for 2017!!!

1-1-2017

Leadership is Key: we have time 

I just watched this incredible interview by Simon Sinek on London Real. 

The points he conveyed we so on the mark about the shift in society. 

Some key point were about;

  • The addiction to social media in modern society 
  • The lack of correlation between shiny social media profiles and how people feel inside
  • Confidence is often surrupticiously low in the younger generation (despite higher achievements than ever before)
  • A practice of Patience is what is needed
  • Companies and organizations need to prioritize looking after their people rather than their number if we want to see a shift (and perhaps avoid an epidemic of mental health decline) 

And… leadership is Key

To take it one step further I would like to say that everything in Simon’s argument could perhaps be consumed in a different flavour if one replaces the word “they” with “we”. 

This came to me as a reflection after watching this brilliant interview, because as a 41 year old human, I can relate to many of the traits that were ascribed to the millennials. I’ve always related to the younger generations, maybe because I grew up with a kid brother who was 12 years younger than me, or maybe it’s due to my free spirited nature, or perhaps it’s owing to a number of factors including taking on PhD during my 30’s (which lead to an extended period of an international student lifestyle)- who knows? Whatever the reason, I can relate on many counts to many perspectives ascribed to the newer generations (gen Y & Z). However, there is  also a salient difference in that I also well relate to my own generation stereotype and with that can clearly remember life during a time before the age of smart phones and social  media- this was a time when we talked in person a lot more, and we were less socially shielded from interpersonal encounters.

Mediation Retreats: ground zero for social media

When I did a 10 day silent mediation retreat in the Blue mountains, near Sydney, last year, one of the conditions of the retreat centre was to hand in our mobile phones to be locked away for the duration of the retreat.

The retreat itself had a profound effect on my mental health and state of wellbeing,  but perhaps an important confounding variable in the personal study of the effects of 10 days of mediation had to be the simultaneous disconnection from mobile/social media/emails (i.e. I often wonder how I would have felt if I just locked away my phone for 1 week, and didn’t check emails, and did no meditation). 

On thing I learned by doing a retreat where you cut back your regular routines to a minimum is that habits (and in some instances addictive tendencies – or addiction itself, quickly surfaces). It is my hypothesis that it’s not just the millennial that are addicted to these light emitting plastic communication devices. Social media and smart phones have become so embedded in modern society (affecting many age brackets), that it is difficult to appreciate how much so unless one completely removes themselves from it. 

The new face(book) of society?

Perhaps the first step to changing the direction in which society is moving is to appreciate this very uncomfortable proposition, that many who are not outright addicted are probably  habitually constrained, to varying degrees. After all a therapy or way of being to address the deficits for the millennial is most likely a therapy that we could all benefit from to varying degrees. Now wouldn’t that be an interesting shift – from “us” and “them” to simply “all of us who are interested”.

Thank you Simon for picking up this hot potatoe that so few want to catch!

These are just some instantaneous reflections from someone who intentionally caught that potatoe, whilst himself caught under the spell of a habit that is being regularly actively monitored and held at bay.