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Lions Roar : November 2016
IN THE EARLY MORNING, a weary man dressed in tattered clothes walked into a rural Himalayan mountain hospital with a grimy, reeking bundle in his arms. I was in Nepal serving in one of Upaya Zen Center’s Nomads Clinics. The doctor who was heading up our team approached the man, who wordlessly began to unwrap this large knot of rancid rags to reveal inside a young child who was severely burned on her head, arms, back, and chest. When we examined the little girl, we saw that some of her burns were filled with writhing white maggots and other HEART & MIND Help When Your Heart Breaks Caring for people who are suffering is a loving, even heroic calling, but it takes a toll. ROSHI JOAN HALIFAX teaches this five-step program to care for yourself while caring for others. Zen teacher and pioneer in end-of-life care ROSHI JOAN HALIFAX is the author of Being with Dying. MATTHEWPALEVSKY The young burn victim with her father and Roshi Joan Halifax after the little girl was treated successfully at Upaya Zen Center’s Nomad Clinic in Nepal. burn sites were badly infected. The man was a mute, but his eyes conveyed ter- rible sadness and deep resignation. Our intercultural medical team immediately mobilized, and the child was taken into a small wooden room, where local nurses and our Western team began to tend to her terrible wounds. From the beginning, I was not only observing the clinicians and child but also my own mental and physical state. I had worked as a consultant in the burn unit at the University of Miami School of Medi- cine in the 1970s, and I was aware from my past experience of how painful debride- ment is. This is a process that entails the removal of infected or dead tissue from a wound site, and the clinicians were doing a massive and masterful job on this child. My heart went out to the little girl as her burns were being cleaned. Her cry- ing was reflected in her father’s distressed eyes. In the midst of the procedure, the child seemed to have slipped into my skin. I realized that I was overwhelmed by my perception of her pain—my heart rate had increased, my skin had grown cold and clammy, and my breath had quick- ened. I realized that my identification with the child’s experience had gone out of control, and if I were to stay in the room, I needed to shift from hyper-attunement to care, from empathy to compassion. This was an example of the kind of empathic distress, secondary trauma, and moral suffering that caregivers often LION’S ROAR | NOVEMBER 2016 21 CULTURE • LIFE • PRACTICE