Undress Your Heart

Undress Your Heart

 

Remove the bulletproof vest

that has been covering your heart.

Rather than protecting you, 

it is the cause of pain.

 

Undress your heart!

You have imprisoned Love.

No wonder it aches!

Its longing is a message.

 

Let Love's tiny stirrings

become an explosion

that shatters Separation.

Love needs no protector.

 

Its ocean is your body.

Its sun melts frozen sorrow.

It sword cuts through delusion.

Its tenderness heals wounds.

 

Undress your heart!

Let yourself fall open

in your longing

to What ends longing.

 

 

 

© Dorothy Hunt

 

Dr. Lissa Rankin, mentor and author of several books including Mind Over Medicine, introduced me to the poet Dorothy Hunt and her poem “The Invitation.” So I explored some of Dorothy Hunt’s other poems and found “Undress Your Heart,” and it resonated with me. From the age of about 28, I have dressed my heart with barriers, and bulletproof vests to make it impenetrable. To protect me from breakage or harm.  The age of 28 has significance, because it was the age at which I lost both my parents within months of each other, and started medical school. I know that after my father died, my heart shut down just a little bit, and when my mother died a little bit more. My heart shut down when I started medical school and I was told to not show my emotions. Don’t cry in front of patients. Don’t hug or touch your patients(with the exception of a physician exam). Do not take any gift from your patients or give them gifts. Keep your boundaries because it is inappropriate otherwise. So when my patients who were children would run up to me and hug me, I would literally have to peel them off of me, reluctant to allow physical contact because that is not what a doctor is suppose to do, let alone a psychiatrist. I think these rules were established to prevent any inappropriate sexual contact that many doctors have been guilty of. But touch is of many kinds, not just sexual, and much of it is lacking today. Our largest organ is our skin hungers for touch and we need physical contact and touch to open our hearts. So I was shut down at work, because it was for survival, and I was shut down at home because it was a way of being.

 

It took having a heart attack to open my heart. Sometimes things break before they can heal. I have a healing heart now, that is learning to reveal itself. I think for the first time, after my heart attack, I realized the extent of my closure, and my bullet proof composure. My heart attack was the first time I really felt my vulnerability not only to life and death, but also to my sadness and longing. I was certainly not a “heartless” person, I was just guarded and protected, and I didn’t take risks to show my fear of rejection. I had learned to feel things but not show it. Collect feelings and holding it all inside the chambers of my heart. There comes a time when things just implode if you do this. It is my feeling that heart attacks are a way the body reminds us that we are vulnerable and human. If we survive we are forever grateful and share what we have learned with others.

 

My independence has served me, but it has also hardened me. I am seeking balance.

I am learning to listen to my body, it is a way of removing some of the armor. 

I am learning to say yes to things and say no to what does not serve me. 

I am learning to extend self compassion. 

I am learning to let others give me things and and accept help.

 

 

So a couple weeks ago, I found myself in the Los Angeles area without a car. When I got to the airport in Boston on my way to California, security informed me that my drivers license had expired. The TSA officer said, “This happens all the time, I guess no rental car for you!” Then it hit me, I cant rent a car and I’m going to be in California. I didn’t panic, I just said it will work itself out and explored options. I couldn’t renew online, I needed a new photo and an eye exam so a temporary license was not an option. What I discovered was that there were many blessings along the way. 

 

For one, I was fortunate to have a hotel in town that I could walk to my daughters graduation or take an Uber or Lyft. I was one of the lucky parents who was able to secure a hotel in town as they sold out within minutes, 6 months ago. Had I not had this hotel the situation could have been much worse. 

 

So I made myself vulnerable and posted my situation on Facebook and the response was amazing. People I hadn’t seen in years reached out to me and what followed were a series of new and beautiful adventures. Adventures that I wouldn’t have had if I hadn’t reached out to others. A former colleague offered to drive an hour to pick me up and bring me to their home for Mother’s Day dinner. While I was there I met so many wonderful people and felt a community of love and acceptance.

Another couple I met last summer at a photography course in Provincetown, invited me and my daughter to stay in their home in San Francisco where they hosted us for several days. My friend drove us along the Pacific coast from San Francisco to Carmel, it was beautiful!

 

Another Facebook friend who I met in person for the first time, gave me a full tour of Oakland from top to bottom and shared stories of his life and times in California. My old friend, James from my college days met me for lunch in at a French Bistro in San Francisco. We talked about old times and shared stories of our children and caught up on life.

 

All of this would not have happened if I hadn’t shared my dilemma with others and exposed my vulnerability. Instead of feeling sorry for myself and feeling a victim, I found strength in the love and caring of others who reached out to me. I actually felt happy. I felt liked. I felt loved. My loneliness seemed to disappear, and I realized that there were people out there who wanted to help, who wanted to touch me with kindness and I realized that it is so much better on the other side of the bullet proof vest. It’s good to let your guard down and take a chance. New adventures await an open heart. So undress your heart. Make yourself vulnerable and see what happens.

 

 

Reflections on a Geriatric Psychiatry Unit

I have been working long hours on a Geriatric psychiatry unit at a local hospital where ninety percent of my patients are suffering from dementia. Lost in a world that they are sometimes in and sometimes out of. The decision makers in their families are put in difficult positions. Suddenly the children are taking care of their elderly adult parents who cannot speak for themselves. Be kind to your children because they may be taking care of you when you are old.

Like Bruce's son. Bruce who is a widower was forgetting where he was all the time. He lived alone in Maine all of his life, but he would arrive at a destination, still driving at 90, and not know how he ended up there.  He would call his son Eddy in Massachusetts and cry profusely, expressing how he hated his life in Maine.  Bruce, a pleasant old man who reminds me of Jimmy Durante, tells me a different story, a very romantic version of how he would walk along the boardwalk daily and stroll with his friends. Bruce tells me he had many friends, some of whom have died. That is how he remembers it. A beautiful scene, walking in the sand and talking to his friend.

He says, "I just want to go back to Maine, I don't understand why I am here, in this place. I feel like a prisoner." Bruce is right, he is locked on an inpatient unit where there is little light and little outdoor space.

 His 45 year old son remembers it this way. "He would call me, almost everyday...crying that he had no friends, that he was very lonely and afraid...So I brought him here and now he still cries every day and asks me to take him back home."

The son is distraught and at a loss. He has just sold the only house his father ever knew. Bruce keeps asking to go home back to Maine, to his house on the beach.

'Did you tell him you sold the house?' I ask.

"No, I don't want him to know. He will forget about it anyway. "

"But you must tell him the truth, I insist."

His son responds "What's the point, he will forget anyway..." I tell him there is a part of Bruce that remembers and you must tell him the truth, in some sense he will know. Somehow it seemed to me that was the right thing to do.

Dementia is a funny thing, there are moments when lucidity exists and moments when it doesn't. I tell his son, medications will not take away the crying and the grief that your father feels. He is very much aware he is losing his memory and his brain is not functioning the way it was. Bruce tells me this everyday. That must be a painful reality for Bruce, to me it must feel like being swallowed up in quicksand and not knowing how to escape. The medications will only numb him for awhile and I prefer not to do that. The son replies, "a little numbing won't hurt him, it may help." I remain conflicted.

It is my feeling that the medications that we give, sometimes do more harm than good. In the case of dementia, antidepressants and antipsychotics do nothing more than numb the brain that is already vulnerable. As a matter of fact, we know that the antipsychotics that we prescribe for agitation in the elderly actually hasten morbidity and mortality. But they are often used. We know that the antidepressants may cause activation in some elderly people as well. The activation that got Bruce admitted to the inpatient psychiatric unit began when he had been on an antidepressant for 15 days. He became disoriented and started rummaging through other people's possessions and not sleeping at night, he became agitated and violent. He was actually admitted due to adverse effects of a medication. So the family sees Bruce as depressed because he is crying and I say he is crying knowing that he is losing the person he once knew. He is watching his memory being swallowed up in a vacuous hole to nowhere. A little numbing may help? I don't think so.

*The names and the identity of the patients are protected. This story is based on a merging of a few cases and does not represent a particular individual or case.

10 Things I Wish I Knew Before My Heart Attack

10 Things I Wish I Knew Before My Heart Attack

It was an ordinary day, we were in a Jewish Deli named Hymies in a Philly suburb. Rich and I had our usual bacon, scrambled eggs and wheat toast with a cup of coffee that morning. His dad had bagels and lox. I didn’t finish my meal, I remember leaving some bacon and toast on my plate. I was anxious in anticipation of the drive to Washington DC. We had planned to spend the fourth of July weekend in DC with Rich’s sister.

We got up to pay the bill and as I walked over to the counter, I was struck with a sudden jolt.  Like lightening hitting me, a sudden debilitating pain and weakness came over and slammed me in my chest and left arm, elbow to be exact. It was like a heavy lead weighted blanket of pain. I knew this was something serious and I could only struggle and wish it away.

I began to pray silently to myself and think of my daughter who was in NYC, so far away from me. Faced with my own mortality, unable to move I felt like I was 90 years old. The possibility of death hung over me like a chandelier about to fall.  I continued to pray and beg God to save me at that moment. I could only hope he heard me as I traveled to the hospital silently in the back seat of our car.

To make a long story short,  I was spared and they say hindsight is 20/20, so here are some things I wish I knew before my heart attack.

 

1.  I remember how often I would casually say. “I almost had a heart attack,” to something that was scary or surprising. If I knew how powerful those words were, they would be struck from my vocabulary. Those words take on a new meaning and those casual utterances now startle me. Knowing what I know now, I would watch my words, so they don’t take my mortality or heart for granted. I no longer say, “I have a broken heart,” I say “I have a healing heart.” Words matter. 

 

2.  I would walk slowly, not like I was running a race that I never seem to finish. I would slow down and smell the roses. Clichés are there to remind us, to be grateful for the little things in life.

 

3.  I would meditate rather than dismissing it and saying “Nah I could never do that.” I would breathe deeply instead of the shallow breaths I took in my stressed out existence. I would breathe deep into my pelvis and out through my mouth. I would have oxygenated my heart and given it the oxygen rich love that it needed. Meditation got me through the hardest part of my cardiac recovery period. It sustains me now.

 

4.  I would have worked less and lived below my means, allowing me to travel and spend more time with my family. 

 

5.  I would focus more on the present moment and appreciate the smaller things in life, like the way the sun hits the trees, the way the birds gather on the telephone lines in the morning sun outside of my bedroom window. I would have noticed the way my food smells, the way it looks and tastes without gobbling it down, blindly in the car on my way to work. I would be more mindful, and more observant.

 

6. I would have preserved my body and given it more time to rest and recover from the grueling workouts, I did over and over, for the imaginary race to the never ending finish line. 

 

7.  I would have focused on what I love to do and focus less on what I should do. I would not care as much what people thought about me. I would have listened to my gut more and listen to what my heart was telling me. When my body said “I’m tired and worn out, don’t travel to Philly,” that day I had my heart attack, I would have listened. 

 

8. I would have made sure I found a way to laugh more and bring joy to my life each day with gratitude, grace and love. I would have watched more Saturday Night Live, Trevor Noah or watched cat videos that make me laugh. Laughter, I now know is the best medicine.  

 

9. I would have allowed my self to grieve, for losing my two siblings within months of each other. I would have cried more and given myself comfort and pampering, like a warm bath full of lavender and bubbles. I would have talked to someone about my grieving instead of burying the loss in my body and soul, as I continued to work, afraid to ask for time off to attend the out of country funeral.

I would have put my needs first. 

 

10. If I knew then, what I know now, I would have done the things I had been thinking about doing for the last 20 years and not put my life on hold. Life is to be lived not put aside for later. Never put things aside! The time is now and we have this wonderful body, heart, soul and mind that needs to be nourished and fed with a diet of gratitude, adventure, learning, openness and love. Live each day as if it were a gift, because it is. 

 

“Tell me, what is it you plan to do with your one wild and precious life?”  Mary Oliver 

 

About Hisla Bates, MD

I'm a board certified, Harvard trained psychiatrist with 20 years of experience treating and diagnosing patients in the Boston area. I have also trained at Yale University in Primary Care Internal Medicine and Mount Sinai School of Medicine in N.Y. for my General psychiatry residency training, before going onto complete my Fellowship in Child and Adolescent psychiatry at Harvard Medical School, Massachusetts General Hospital Department of Psychiatry. 

In 2016, I was certified in Positive Psychology by the WholeBeing Institute. At this time I am focusing my practice on coaching using mindfulness, positive psychology and the creative arts. I am a former fashion designer, artist and printmaker who dabbles in photography and filmmaking as well. Today, I bring all of these skills into my work as a psychiatrist and positive psychology coach. After having a heart attack, I am now dedicating a portion of my practice to coaching individuals in transition after a serious cardiac event.

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