Updates on the health front (and related learnings)

June 6, 2023

Dear Leland and Everett,

I met with a cardiologist yesterday. I…didn’t enjoy the experience. I came to the meeting admittedly scared, but prepared with lots of questions; more than anything, I came wanting to establish a relationship with a doctor that can serve as a foundation stone in my healing process. This particular doctor didn’t seem to notice, or if he noticed be available for, my interests. To be fair to him, I think there were things going wrong for him that didn’t include me: he arrived ~30 minutes late to our appointment, and the nurse who checked me in apparently didn’t properly enter my measurements (weight, blood pressure, etc) into his system. So he was texting someone, and seemed mildly irked (he seemed to be taking it mostly in stride, but also didn’t seem able to let it go and move on, as he continued texting for a few minutes during our appointment). I asked him lots of questions, about nutrition, supplements, medications, and even alternative treatments like acupuncture. He asked once or twice where I had heard about these, rejected all of them, and at times even seemed annoyed that I was asking; as I think about it, he looked away from me and at his computer when answering multiple of them; these were the times I thought he was annoyed. I zoomed out and asked him my ultimate question, which is whether I can live a long, healthy life. He responded that I needed to take medication, noted that other than the calcium score I don’t have a lot of risk factors, and stated that my situation is not reversible. I asked a few clarifying questions about reversibility; he implied that nothing about my situation is reversible, and suggested more than once that I should have started on statins back in 2016 when I first learned of my high calcium score…which, even though he said it in a non-accusatory way, felt like he was blaming me for my situation more than helping me explore comprehensive solutions.

We scheduled some follow up tests (which was expected based on my primary doctor’s advice). I left the appointment feeling pretty triggered (meaning in fight-or-flight mode, and struggling to calm down). I digested the meeting a little, and talked it through with your mom to help me process my thoughts. I decided it’s possible this doctor was having a bad day, and he deserved another chance. I decided to continue with the follow-up tests, which I need anyway and he could schedule them more quickly than I could on my own. But I also decided I am looking for a doctor with more curiosity, more openness to discuss treatment options with me, and frankly a better bedside matter. If that’s not this doctor, I resolved to go find another. Until very recently I would have treated this doctor’s advice as sacrosanct, and/or assumed all other cardiologists would give me the same advice. So the progress, at least from my side, is the willingness to go find what I want, even if that means saying no to ‘experts’ who aren’t aligned.

Separately, my mom (your Gran) recommended a book to me about…reversing heart disease. I’ll admit that my first reaction was skeptical. This book is almost 30 years old. Surely the science has changed or improved in that time. But Gran suggested that this doctor promises reversal of heart disease, and I haven’t come across much literature making such promises, so I thought it was at least worth a shot.

I’m frankly floored by what’s in the book. The author (doctor Dean Ornish) talks extensively about how our mind, body, emotions, and spirit are connected (which today is uncommon: our doctors-including the cardiologist I saw yesterday-tend to treat our bodies as if they are completely separated from our minds and our emotions). He says almost exactly what I said in my health scare letter: that our physical ailments are manifestations of our emotional and spiritual struggles. He recommends yoga, meditation, honest communication (particularly around negative emotions like sadness and fear), visualizations, and spirituality as part of a comprehensive lifestyle approach to reversing heart disease. Partly what stunned me was how much the book’s ideas overlap with what I am currently doing (or learning how to do and creating the habits around doing). The book pointed out that most patients, when guided through visualizations, come to a vision of a wall around their hearts (as a way of protecting them from getting hurt). Just two days prior to reading that text, I had come to just that visualization via my own meditations. And the book repeatedly promises, supported via scientific studies published in prominent journals, that the program can clear blockages and reverse heart disease. Consider: this book delivers an almost completely different message from my cardiologist. I don’t recall ever reading a book that seemed so tailored to me. I feel like that book was written just for me, and I’ve never had that experience before.

Except for the diet. The book recommends a low-fat, vegetarian diet. After my original calcium score in 2016, my doctor at the time put me on a ketogenic diet (high fat, low carb). I wouldn’t call my current diet keto, but it’s still reasonably high fat and low carb. So the book’s diet calls for a big change. After some reflection, I realized that I am emotionally attached to eating meat. I’ve always resisted diets that recommend low meat consumption, and never seriously considered vegetarian diets. The keto diet appealed to me precisely because it allowed for meat consumption without restriction. A vegetarian diet by comparison feels very restrictive to me.

I came to realize my resistance is precisely why I need to try this diet. I’m not entirely sure what I fear, but I clearly need to face a fear of going without meat. I’m hopeful that in a year (or a few) my heart disease will reverse sufficiently that I can add meat back into my diet. But for now, I feel called (especially by the resonance of the rest of the book) to give this approach a try.

I’m learning one additional benefit will be that the diet will force me to engage more honestly with the people I love. One persona I haven’t introduced yet (because he emerged later) is It’s Fine. It’s Fine is afraid to ask for what he wants, and is afraid of being judged for being fussy or difficult. It’s Fine constantly sacrifices what I want for what I perceive others want. It’s Fine has been one of the primary decision-makers in my life for 30 years, and is frankly partly why I have heart blockages in the first place. Thus, I need to practice asking for what I really want, and being who I really am. Eating a vegetarian diet will inconvenience lots of people around me. While I certainly don’t celebrate inconveniencing the people I love, I realize that I have not asked any of them to be inconvenienced enough on my behalf of late, so this diet serves as a good opportunity to practice.

Finally, I met with the minister of the church I’ve been attending. He offers what he calls ‘spiritual direction’. My impression after one session a couple weeks ago: it feels like a natural continuation of the work I was doing with my coach, but with a more explicitly spiritual focus. Much of the work overlaps: focusing on body awareness, acknowledging and accepting the struggles the world presents us, and going inward via meditation for the answers we need.

During the session I outlined a few things on my mind. I brought notes that seemed disparate in nature, but as I talked I recognized that I seemed to be struggling with something specific and related in all of the different topics. As best I can explain it, I was struggling with how to re-engage with the world. My sense is that I’ve learned how to go inward over these last few months for answers, and that I’m developing confidence in my ability to manage myself and my emotions. And I’m sensing that it’s time to engage with the world again, for myriad reasons (not least of which being that sitting at home all day gets lonely!). But engaging with others means engaging with their fear and sadness, and right now I feel a little fragile from processing my own fear and sadness. And people seem much more gripped in fear and sadness than at any time I can remember, so it can be hard to engage without feeling overwhelmed by others’…stuff.

The minister said three interesting things in our session. First, he opined that I had only experience a ‘teaspoon’ of God’s love, and that I hadn’t yet opened myself up to the ocean available to me. Second, he suggested that I had dug through my layers of fear, but sensed that I hadn’t yet dug down to identify whatever was beneath it. As soon as he said it, I said without thinking, “sadness”. I didn’t realize that I had sadness to process, but since then I have realized I do. The third came in response to my request for advice on what to do next; he suggested I look in the mirror and say “God loves you” until I believe it. Then he looked at me and said “God love you. What are you gonna do with that?” Sensing that the magnitude of the message hadn’t landed, he leaned in, “GOD LOVES you. What are you gonna do with that? How are you going to let that crack your heart open?”. That did it: I was overwhelmed. We prayed and he went on to another meeting. I walked to the sanctuary and cried. Huge, heaving sobs. I realized that as I grew out of boyhood and into adolescence, I internalized that love became conditional. I realized that, for the past 30 years, I have lived my life in an effort to earn love from others. In that moment, I came to realize that I am loved, by God, and God’s love is unconditional. And that God’s love allows me to Be me, and not worry so much about how others react. The magnitude of the gap between the love I’ve been willing and able to feel, and the love that’s been available to me, overwhelmed me.

I’ve continued to practice like the minister suggested, first looking myself in the mirror and repeating “God loves you”, and then laying down to meditate. I’ve processed a lot of sadness, but sense that I have a long way to go. In one of those sessions, I realized that I truly loved being Gran’s (my mom’s) little boy. I felt so safe, secure, and loved. Adolescence and adulthood by comparison felt cold, distant, and remote. I accepted that I needed to grieve that I wasn’t a little boy anymore, because grieving honors the love and joy of something lost. Then I realized that you two are precisely the age I so enjoyed being, and I was reminded of how precious this window is. I said to the two of you recently that I wish I could freeze time and enjoy you just the way you are, because you are growing up too fast. Of course I don’t mean it: I love watching you grow up, and I would never want to impede you on your path. But I did realize that I am soon going to need to grieve the two of you moving from boyhood into adolescence, the same way I just grieved my own transition. But first I hope to enjoy these moments as fully as I can.

Through this process I have noticed some changes. I carry less tension than I have in years. My relationship with your mom has improved, as if by letting go of some sadness, I’ve made space in my heart to send and receive love again. I’m feeling better, and seem to be losing weight.

Subconsciously, I used to think that my health, my day-to-day life, and my spiritual journey were all separate, parallel paths. What I am starting to realize is that they are all deeply connected. There is only one path, and that is to Be. In order to Be, I need to live my life, I need to feed my spirit, and I need to ensure my physical wellbeing. But these are merely different aspects of Being. I just need to Be.

No grand conclusion today. I’ve decided that I will give you updates on my personal journey, so that you can see how I dealt with struggle, and take what is useful for you. Not that I expect all future letters to detail my struggle, but I do intend to write about my journey as baldly as I can bring myself to do so.

I love you,

Dad