May 3rd, 2020 started as usual day. I woke up, had my coffee, showered and dressed up, ready for work. I was about to step out of the house when I sprayed my perfume and realized I could not smell it. Sprayed some more, generous amount this time, still nothing. Grabbed the air freshener nearby and sprayed it over my face, it was as if something had turned the knob off, I could not smell a thing! In that moment, I knew I had to get tested for COVID-19.
Being a physician at Yale University hospital, 6 weeks before, I was selected as one of the first doctors to take care of the rapidly growing population of COVID-19 patients. I was anxious and nervous, but determined to do my part I decided to give it my all.
I still remember my first patient Miss H. an otherwise healthy 40 some-year-old female, who contracted the virus through community spread. I entered the room all clad up in my gown and gloves, mask and eye shield. At that time head covers were not available. I smiled my customary smile, only this time not seen by the patient. As I tried to shake her hand, she coughed up a storm. I could see the cough droplets in the air settling on the surfaces nearby and perhaps on my uncovered hair. With her teary and swollen eyes, her attention still half fixated on the television screen; a news channel flashing the latest number of coronavirus deaths in the area, with fear and great apprehension, she turned to me, “Doctor, am I going to die?”. The truth was, I did not know.
As I walked around the hospital that day, trying not to touch my hair, and knowing I wasn’t able to provide Miss. H. with any satisfactory answer, not even a smile or a warm touch, I realized the absurdity of this new reality we were all thrown into. For physicians to treat their patients, information about how disease spreads in the body, or which organ systems it might involve, and more importantly how the clinical course can be shortened or even ameliorated is crucial. For COVID-19 patients all of this was an unknown entity. All treatments were experimental and all answers were based on unproven probabilities.
I also realized that it is not just the disease that was hurting the patients, they were suffering emotionally as well. In this atmosphere of pervasive uncertainty, they desperately tried to find answers. Pointed and fearful questions were nagging their souls, questions like, “what will happen next?”; “what if I get worse and die?”. It’s natural to want to fight back against illness and pain. However, paradoxically this struggle can actually make any disease worse. For example, the damage done by COVID-19 is worse when our inflammatory response is abnormally exaggerated in the later phase of the disease. When we are psychologically stressed, our bodies trigger the release of stress hormones, causing further inflammation and increasing pain to an already irritated and inflamed body.
Over the course of next few weeks I had hundreds of encounters with COVID-19 patients. Every night I will leave the hospital knowing that at least one of my 15 to 20 patients that day will not be there in the morning. They will either die or end up in ICU. As a physician this indeed was a difficult time for me, one of those times when everyday seems to bring an unforeseen disaster.
Getting sick myself however, was not a part of the agenda. Days before my loss of smell, I was woken up at 3 AM with severe muscular pain all over my body. The intense pain with headaches, was at times unbearable. And that day when I lost my smell I got tested and was found positive for COVID-19.
Waking up early in the mornings with pain, and now not being able to physically go into the hospital, I decided to invest more time into my meditation practice. This practice was taught to me less than two years ago by my beloved teacher Sri M. At that time I was suffering from intense emotional pain. I wanted a quick fix, he promised me no such thing. Instead, he instructed me to perform my practice regularly; practice moderation in all fields of life, not to hurt anyone, not to lie and to be patient. I was born and raised a Muslim, and later in life I experimented with some ideas of atheism and agnosticism. Regular meditation was not my style. I had tried everything else and failed, so I decided to give his teachings a sincere chance.
So despite pain, I dragged myself out of bed and onto my meditation mat. My practice usually starts with focusing on my heart, practicing sincere gratitude and with much humility bowing down to my teacher and the divinity inside me. After which some deep breathing and ‘energy work’, followed by humming like a bee and then my regular attempt at single pointed attention. On this particular day, I expected my attempts to be likely unfruitful due to pain. As l focused my attention to a point between my eyebrows, slightly above, my attention kept shifting to my aching back and limbs. Months of this practice had taught me not give up, so I persevered. After a few minutes I realized that the tense and cramping muscles were easing up, the pain almost resolved, then a wave of bliss and deep relaxation. I could focus better, and then— ecstasy. Tears started rolling down my face in extreme gratitude and wonder. Not only the pain was gone but my entire body was in a blissful state.
Over the course of the next few days whenever I would find myself in pain, I would run and find a little quiet corner and then apply this technique. Focus on heart with gratitude and humility, deep breathing, humming, and then single pointed attention. I would always get the results of relaxation and easing of the muscle pain, most of the times bliss and if I’m lucky and the stars are aligned maybe ecstasy. With symptoms controlled I continued to work remotely from home, helping my colleagues and my patients. Despite being sick I did not take a single day off from work. I had the disease but I was not suffering.
I had a newfound perspective for the suffering of my patients and a lot more compassion. And maybe something new I can offer them now? Each time I was able to relieve my pain and change it to bliss and ecstasy I wanted to share it with my patients so that they can be pain-free as well.
This was fascinating to me, and led me to the question of what actually is happening in my body leading to all these changes. I read several research articles and theories on meditation and its effects on human brain. I found that only after three days of meditation prefrontal regions which are the most evolved part of the brain and make us uniquely human, exert more top down control on the posterior cingulate cortex or PCC. PCC is the key part of default mode network which is active when we are lost in thought or are caught up in self-referential processing, for example questions like “why this happened to me?” stems from PCC, which in turn enhances our suffering. Greater control over PCC results in less habitual mind wandering and less preoccupation with oneself. People with a little longer training of only a couple of months show more top down control over the amygdala. This almond shaped structure close to the center of our brain is continually monitoring our experiences for the relevance to us. The amygdala acts like an alarm bell to anything that is threatening to us, from an angry face to a bad medical diagnosis. More control over amygdala results in less stressful or tearful reaction to a bad news.
People in meditative practices also grow more tissue in the hippocampus, a nearby part of the brain shaped like a seahorse. It helps us learn from our experiences, activity in hippocampus calms down amygdala. So it’s not surprising that people after meditative practices produce less cortisol when challenged. They become more resilient and thus possibly produce less inflammation and pain in the body. There is a growing body of research on the benefits of meditative practices and it will continue to improve over time.
While the modern science is still trying to figure out the ‘hows’ and ‘whys’ of the beneficial effects of meditation, I will continue to follow the time tested advice of my wise and beloved teacher from India. With the help of his own teacher, Sri M studied the works of ancient scientists called the Rishis and distilled their teachings in to a simple daily technique. This technique not only helped me relieve my intense emotional suffering but has also made me a much calmer, happier, and more efficient human being. The added benefit of transmuting COVID-19 related extreme muscle pain into bliss and maybe “drug-free ecstasy” is still mind boggling to me.
As Sri M would say, “The proof of the pudding is in the eating”. I invite the readers to try it for themselves, adopt a meditative practice, any practice, maybe involving mindfulness or deep breathing or an attempt at single appointed attention. Start with five minutes a day but do it regularly. Avoid conflicts by trying not to lie or hurt other people. Be patient and persistent and see the results for yourself. If somebody like me can do it, then anyone can.
In this day and age of pandemics, riots, and natural disasters, anyone of us can get a disease or experience a tragedy, but none of us has to suffer.
