Holding Space

I’m presently on shift 8th night shift of 42 and still have a big, warm, welcoming smile on my face while working. So far, it's been effortless and I’m just in the flow, simply allowing and observing everything that is happening. After all, everything, including me, my thoughts, and my perceptions are simply “happenings” in the flow of Consciousness.

I evaluated my third cancer-related patient this week. The first patient was interesting in that I actually took care of him about three months ago. When I first evaluated him, he was obese and despite only having waited for less than one hour, was quite angry and impatient. He complained of a cough productive of yellow phlegm without any associated shortness of breath or chest pain. He was formerly a one pack per day tobacco smoker but had stopped smoking one month before. As I spoke to him, I also noted a high level of anxiety. He refused to sit down and paced back and forth in the room. I ordered a chest x-ray that demonstrated a large lung mass that was obviously cancer.

When I told him, he seemed somewhat relieved, as though he already suspected the diagnosis, and hence, his high level of anxiety. He finally sat down and burst into tears, stating in between his sobbing that after so many years of smoking and finally finding the courage to quit, he couldn’t believe that he had lung cancer but somehow knew it. I obviously would never say this out loud to a patient in those circumstances, but it is exactly because of a lifetime of smoking that he had cancer. Rather, I sat next to him on the gurney, put my arm around him and just sat with him for a long time, which seemed to facilitate even more tears. The room was filled with overwhelming silence punctuated with his sobbing.

What was there to say? I learned to approach situations like this in the same way that one would walk into a room to find a child crying. Rather than trying to convince the child that everything is okay and that there’s no need to cry, what is really required is to simply hold the child in your arms and comfort them. It’s the idea of “holding space” for someone. To allow them to go through whatever it is that they’re going through without interference or intervention, and just provide them with your loving presence to support them.

Over the years, I’ve found that a large part of my role as an emergency physician was simply to hold space for patients in the emergency department, the vast majority of whom don’t present with life-threatening emergencies. Sure, I read my lines and play my role dispensing my expertise, medications and whatever else is called for, but I also clearly perceive the energetic undercurrent that flows parallel to the exchange of words. Similar to Henry David Thoreau’s comment in “On Walden Pond”: “Men lead lives of quiet desperation,” I perceive the underlying malaise that patients are experiencing in their lives that present as a variety of illnesses. Yes, the salves, potions, and concoctions that we in the medical profession administer are beneficial and provide relief from the somatic manifestations of their quiet desperation, but often, what is often required us to hold space for them.

I am not suggesting in any way that the medical treatments we offer are not necessary or helpful, because they are. I am suggesting that there are other energetic currents going on that require attention without any other action than to show up with our arms open and to hold space for their deeper suffering. We often speak of having compassion, but even this is superfluous. We are all in the midst of our journey back to Consciousness, to our true nature, and the paths we take in order to arrive can be quite painful. It is not compassion for any individual but rather for all of humankind who are suffering under the delusion of separation from the only thing that truly exists: Consciousness. There is only Consciousness. Consequently, what does compassion mean in this regard? Yes, we should feel compassion if only for our benefit, but when we can, just hold space.

So after a long cry that could have irrigated and reforested the arid plains of the Serengeti, he asked me if he was going to die. I held his hands tight and told him yes. I told him that I didn’t know when or even if it was going to be the cancer that would kill him, but yes, he was going to die. That was the one certainty in this life. I suggested that while undergoing whatever treatment was offered, that he meditate on his life, his experiences and his loved ones, and take full advantage of every minute that he had left. Many of my colleagues have criticized me for discussing death so frankly with patients but I honestly believe that these life-altering events have the potential for transformation and hopefully transcendence, and are opportunities that should not be missed. It would obviously be better if we all could have this type of transcendent experience without being body-slammed into it with such trauma, but for many, this is their path. Hopefully, when we encounter someone else undergoing such an experience it serves as a reminder to “Memento Mori” (https://www.richardlanoix.com/post/memento-mori), remember our death, allowing us to live more fully.

Before discharging him home, I shared with him a very basic, but what I believe to be the ultimate meditation: Sit and observe your thoughts, emotions, and body, and be present with whatever arises. I discharged him home with appropriate follow-up and gave him a hug. The more I practice emergency medicine, the more freely that I give out hugs believing that perhaps this is what some patients really need. I don’t believe that “I” am offering anything, but I do believe that we all have the capacity to serve as mediums through which Consciousness can transmit whatever it is that the patient requires at that moment. It has nothing to do with “me.” I am only the middle-man through which the healing energy of Consciousness flows. I am in service.

So this encounter took place months ago. Flash forward to the present and it’s a hectic shift. I just had an operation on my foot and have been working in a wheelchair. I was rolling myself to the bathroom and I heard a patient yelling out: “Doctor, doctor!” I really needed to get to the bathroom but wheeled myself back to address this patient who may have needed to go to the bathroom more than me and perhaps had been trying to get someone’s attention for a while now. I went inside the room and the patient stated that he had been looking for me for a long time. He clearly knew who I was but I had no recollection of him so I asked where we had met. He was cachectic and emaciated, but had a broad smile and exuded happiness despite his ill appearance. He reminded me that I diagnosed his lung cancer months before and how much it meant to him that I sat with him for such a long time and was so frank about death. I then remembered him and was really shocked to see how much weight he had lost. He was undergoing chemotherapy, which he stated was not going well and knew that he would soon die. He had stopped by the emergency department a few times to look for me to thank me. He said that my words had moved him and he was in fact able to transcend his death sentence and find a peace that he had never known in his life. He had come to terms with his life and death, and again, parallel to the words, there was another energetic communication that I registered that was wholly congruent with the joy and peace that he exuded. He didn’t have any fear. He was simply doing what seemed indicated to him and despite the fact that the chemotherapy did not hold any hope, he seemed content to read his lines and fight the good fight. He opened his frail arms inviting me to hug him. There were no tears this time, but just one Being saying hello and goodbye to another; one wave crashing onto the shore while another recedes. It’s all ocean, all Consciousness.

I am so grateful in this life to have the opportunity to hold space for people in their moments of need, to be reminded to “Memento Mori”- that I too will die, and consequently should live fully and be grateful for every breath that I am given. It is a gift and every day, I say thank you, gracias, merci, muito obrigado!

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The author was born in Haiti and has lived in New York City for the past 54 years. He is a practicing emergency physician who has dedicated his life to the healing arts and the exploration of Consciousness and creativity.

He self-published his second novel "Love in the Time of Coronavirus: 20/20 in 2020" on Amazon (https://www.amazon.com/dp/B09BZLVKP4).

He & his wife are presently on a world-travel adventure that he is writing about in his blog "Travels with Ale." For exciting & thought-provoking content, & to be part of the adventure, follow him here, on Instagram (https://www.instagram.com/richardlanoix/) & Facebook (@RichardLanoixAuthor· Author). His other blog posts related to Consciousness can be found at medium.com/lanoixvisions.