Appamāda

Rev. Mary Myoku Remington, a Buddhist Chaplain and Director of the Buddhist Chaplaincy Training Program at Upaya, takes us back to her very first day in clinical training. What began as a harried and judgment-laden handoff of a “difficult” patient quickly unfolded into a frightening moment. As a novice chaplain, with no script to follow, Mary chose to stay and listen and be interested. What emerges is a story about the slow unraveling of anger into grief, of distance into understanding. In bearing witness to her patient’s pain, Mary discovered an early and enduring truth of her calling: that beneath even the most volatile exteriors may lie a tender, wounded heart, and that the simple act of staying can lead to a closing of the chasm between two individuals.

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Transcript

Prelude

Mary Remington (00:00)

We talked about his life, you know. We talked about his broken heart. We talked about his mental health, his sense of abandonment with his family, his real helplessness. And so I just sat and bared witness and listened and felt with him. And in that process, you know, we weren't talking about pain meds anymore. We were talking about, you know, the real pain, the deeper pain.

Show Introduction

Nate Houchens (00:51)

Hi and welcome to Boundless Moments, the storytelling podcast that brings sacred moments to life through the voices of those who lived them. I'm Nathan Houchens. Support for Boundless Moments comes from the Sacred Moments Initiative. 

At Boundless Moments, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality.

All views expressed are those of the person speaking and not their employer.

Some stories featured on Boundless Moments may contain themes or content that could be upsetting for some listeners. We encourage you to use discretion and take care of yourself while listening.

Introduction: Mary Remington

Nate Houchens (01:35)

My guest is Reverend Mary Myoku Remington, a Buddhist chaplain and Director of the Buddhist Chaplaincy Training Program at Upaya. For seven years, she was Director of the Spiritual Care Department at Good Samaritan Hospital as the first non-theist chaplain holding that leadership role within their Catholic ministries system. She began her relationship with Zen Buddhism through the New York Zen Center for Contemplative Care in 2007, where she was General Manager of the Center for 10 years, working closely with the co-founders to develop the organization from the ground up. Mary brings a wealth of experience of contemplative practice as it relates to spiritual caregiving within healthcare. She completed her Clinical Pastoral Education in large medical centers in New York, including Memorial Sloan Kettering and Beth Israel. A significant portion of her direct chaplaincy supports those with addiction, disability, and persons approaching end of life. She also holds a private practice in spiritual care counseling and support. 

Introduction: Appamāda

Nate Houchens (02:36)

In this episode, Mary takes us back to her very first day in clinical training. What began as a harried and judgment-laden handoff of a “difficult” patient quickly unfolded into a frightening moment. As a novice chaplain with no script to follow, Mary chose to stay and listen and be interested. What emerges is a story about the slow unraveling of anger into grief, of distance into understanding. In bearing witness to her patient's pain, Mary discovered an early and enduring truth of her calling: that beneath even the most volatile exteriors may lie a tender, wounded heart, and that the simple act of staying can lead to a closing of the chasm between two individuals. 

In our conversation, Mary shares her journey into chaplaincy, her spiritual practices, and her insights on compassion and navigating systemic challenges in healthcare. Discover how her early experiences with death, community, and connection continue to shape her work and life. You may also hear some additional guests. A few chickens were just outside Mary's window enjoying the rain and occasionally contributing to the conversation.

The Story: Appamāda

Mary Remington (04:04)

Well, first, I thank you, Nathan, for having me on this podcast. It's an honor to be here and really an honor to share stories of people that I've cared for and who have taught me so much about what it means to love this world. 

I started my chaplaincy clinical training years ago, back in 2011. And I was living in Brooklyn and working in a very large healthcare system in New York City to begin my training. 

On my very first day of my very first exposure to the hospital system and with directions to check in to my assigned unit and begin to check in with patients… I had my brand new badge, it said chaplain intern on it. And I'm walking down a unit, walking down the hallway, heading towards the nurses’ station to dutifully check in and see who they would suggest me to begin with to visit. 

You know, I'm full of some nerves and kind of not really knowing what's going on. You know, there's so much orientation that I had yet to really understand or embody. I was just beginning.

So I'm walking down the hallway and as I'm walking down the hallway towards the nurses’ station, there is this nurse who's rapidly walking my direction. And I think we're just gonna pass each other and keep going, but she ends up essentially hooking her arm into mine and turning me around 180 degrees and now taking me with her. 

And so... Now she and I are walking together and she starts rapidly talking in my ear. And I could barely kind of piece together what she was saying. She was putting forward so much information in such a short period of time. But the things that I was getting had to do with… this was quote unquote a drug seeking patient who was causing a lot of trouble for the nursing team, and something about him threatening them with needles, and he's in a lot of pain but he's just drug seeking, and can you just go in and calm him down.

And so she's kind of rattling these notes, you know, into my ear as she's taking me into this patient room. And I'm now entering into my first patient room. And it's a four bed, very large room. To my immediate right is an elderly man fast asleep, you know, inside of his almost closed curtain. And then there's two other empty beds in the room. And then in the far left corner, there is this bed with this man to his back to us sitting up on the bed and looking out the window, which was just a few feet ahead of him and looking out into New York City. 

And so she takes me in and she says, here, you sit here. And she puts this chair, you know, kind of at the foot of his bed, she kind of plops me down in it and proceeds to leave the room.

So there I am, sitting in my chair, now beginning to bring into focus this being that's before me on the bed, who I immediately see is in distress. He has a heavier breathing that he's doing. He's like clammy skin, kind of sweating. His skin is puffy. He looks like he's been angry, kind of inflamed skin and coloring.

And so I'm sitting there and I'm bringing him into vision and just kind of laying my eyes upon him. And before I can say a word, he shoots up from the bed and he lunges towards the window and he grabs a needle, a sharp that the nurses had, in their haste, left behind. And he proceeds to plop himself down on the bed and he takes the needle and he lunges it towards his neck. He doesn't impale himself, but he holds the needle so it's pressing right into the base of his neck. 

And all this happened within a flash, within two seconds. And now here we are, and now we're in a situation. And there's no immediate help in my midst. Nor do I have any real clue on what to do. 

And my heart starts to beat. I can feel the gravity of this situation that he really could create, either a lot of harm to himself, to me, to the patient that's sleeping in the corner of the room. 

An eternity goes by, and I just say, “What's your name?”

He's continuing to hold this needle right at the base of his neck and kind of annoyingly says, “James.” He's annoyed by my question. He says, James. He answered me. And I said, “Hi, James. My name is Mary.” I said, “It's nice to meet you.” And he was kind of put off, but he said, “It's nice to meet you.” 

And I just kind of hung there for a minute with him. And I said, “James, what's going on right now?” His anger came out and he said, “You know, no one fucking cares about me.” He's like, “I'm just an addict from the street. Who gives a shit about me?” He's like, “And I'm in fucking pain and no one is listening to me. No one believes me.” He's like, “They should have given me my pain meds 30 minutes ago and they didn't.” He's like, “I am suffering and no one is here. Nobody. Nobody's listening.” He said, “You know, what do they care about me?” 

And so, I just let all that land. I said, “Well, I'm here.” And then I said, “What else?” 

And so he's still, you know, iron fist with this needle on his neck and, really this question of, no one knows what's next. But with that question, “what else?” his whole expression began to change. His hands started to soften, and his eyes started to fill with tears. And he said, “Kate died.”

And with that, you know, the hand began to fall. And I said, “Well, what happened?” He said, “She threw herself off the balcony last night. She was the last friend I had. You know, we took care of each other on the street. We kept each other safe.” And now he's starting to let the emotions come through and his grief come through, and his hand keeps kind of moving down towards his lap.

And as I'm listening, I find myself slowly getting out of my chair and walking toward him. And I offered my hand to him. And he put the needle in my hand as he continued to kind of open up about Kate. And I slowly went back to my chair and kind of, you know, quietly and gently put the needle next to me, kind of behind me. 

He then proceeded to begin to lie down in his bed, and we talked about his life. You know, we talked about his broken heart. We talked about his mental health, his sense of abandonment with his family, his real helplessness. And so I just sat and bared witness and listened and felt with him. And in that process, we weren't talking about pain meds anymore. We were talking about the real pain, the deeper pain. 

We concluded that meeting with a real sense of trust and that, you know, some, in my experience, real divides melted down between us. Myself too, as a middle class, very privileged person who had never had a full conversation with a man who was homeless. 

In that space, we just kind of got to be two human beings together. And I left that room changed. 

I often say in chaplaincy, you know, every bed—meaning every patient—is a world, an entire world. But he... one of my deepest teachers in chaplaincy. And it's such an honor to honor him by sharing this story and what he taught me about really being present, really staying soft and open when things feel potentially hard or scary, you know how to stay in kind of a flexing and receptive posture. And also that the outward expressions of anger, of harm, were just layers that were covering a very tender heart and someone who was very wounded.

Interview

Nate Houchens (14:54)

Wow, all I can say out of the blocks is, wow. Mary Remington, thank you for being with us. Thank you for sharing that story about the very first patient that you saw as a chaplain in training, with your brand new minted badge, your freshly pressed everything, and yet entering the room of this individual who is in such immense distress on so many levels. Thank you for sharing the story and thank you for being here.

Mary Remington (15:22)

Thank you for the opportunity, truly.

Nate Houchens (15:24)

Mary, I wonder if you could tell me a little bit more about your background and perhaps who you are and were as a person and how you chose the pathway of the chaplaincy.

Mary Remington (15:37)

I don't know that I chose it. I have always felt that this really is a path of calling. You know, I oversee the chaplaincy program at Upaya Institute and Zen Center out of Santa Fe, New Mexico, and that was founded and created by Roshi Joan Halifax. Roshi says this, and I fully agree, that chaplaincy is a calling, it's not a vocation. And that would be also affirmed by the level in which chaplains are paid. It's a vocation of calling. Yeah. 

When I was a very little girl, I had an experience that changed my view on everything and myself included. And I was about four years old. And it was just a simple moment. I was, we lived on a farm in Virginia and I was outside in the front kind of pasture with my sister and our three dogs. We were horsing around, playing around, and I plopped down on the grass. I'll never forget kind of looking down next to me, to my right, to the grass. I said, Laura, Laura, come here. Come look. And she came running over and she said, what? And I started pointing down to the grass. And I had my eye on this one piece of grass in my head. And she said, what? And I said, look, it's growing. And she didn't know what to say, turned on her heel, ran off with the dogs. And I kind of just kept my focus on this piece of grass. And then I saw the other blades of grass around it. And then I saw these blades of grass that were all around my body, sitting on the ground. And then I looked up, and it was just all these growing blades of grass. 

In that experience, I had no language for it. I was four. But there was a felt experience of non-separation, of oneness. And then I got up on my feet and started running after my sister and playing with the dogs. But that was an imprint that kind of marked the way I navigated through life. I've had a very winding life, a lot of different chapters, and what I've done with my time here on this earth. 

But from a young age, also had this comfortability with death and comfortability with elders. I loved people who were 65, 70 and above. When I learned how to ride my bike, we had moved and we were now in kind of the suburbs of Nashville. I was about eight and I had, you know, permission to ride my bike in these winding streets in our neighborhood. And as soon as I had that permission, one of the first things I did was I started to pit stop at all the homes that had people who lived in it who were about 70 and older. And I would rap on their door. And they'd open the door and see this little girl standing in the threshold. And I'd say, hi, my name is Mary. And they'd say, hi, my name is Joe or whatever. And, what are you doing, Mary? I said, I'm just riding my bike. 

And lo and behold, I started to make these visits in the houses around the neighborhood, and they would invite me in and we'd have tea and cookies and coke. I was getting to know them and delighting in who they were and the stories that they had, the time that they had for me, and the time I had for them. It was very, very precious. And I wasn't thinking about it. This is just what I enjoyed doing. 

It was only years later that I looked back on this and saw, oh my gosh, that's kind of what chaplains do. They offer their presence. They spend time. Offer love and interest and curiosity and getting to know one another, connecting, having a relationship. 

So that was a part of my childhood and also comfortability with death. Again, when we lived in Nashville, we lived in a kind of a three-level house. And the lower level was an entire home that my maternal grandparents lived in. So that was my mom's mom and her father: Big Mary and Jut. So Big Mary was like 5’2”. We called her Big Mary and I was Little Mary. Even though I'm almost 5’9”. We loved each other. She's very much a part of why I'm a chaplain. 

Jut was very sick with kidney failure and ultimately one day was deeply struggling physically at home in his bed down in their lower level home. I was on the main level of the house, at the top of the stairwell and I knew something was going on downstairs. I could hear him struggling. I could hear Big Mary with him and my sister, who's again nine years older, had run downstairs. And I knew she was involved in somehow trying to help Jut. She gave me the strict instructions to stay upstairs, and so I did. 

Eventually as I was standing there probably, I don't know, 20 minutes passed. My sister comes up the stairs and she has blood on her shirt. And she then says, again, don't go downstairs. I stood at the top of the stairs and I could see my sister leave out the front door of our house and proceed to start running in circles around the perimeter of our house as fast as she could. And I did not know what she was doing, but I knew that Jut was gone. And my mom, who had been running errands, came home immediately. She saw Laura outside. She went immediately downstairs. My sister went downstairs. And eventually I took myself downstairs. No one invited me. I went down there. 

And at this point, there had been a sheet that was pulled over Jut in this little bedroom that he was in. My mom and Big Mary and Laura were all talking in the kitchen. And the coroner had already been called, someone's going to come pick up the body. 

I'll never forget looking up at my mom, and I had to like tug on her shirt to get her attention. And I said, I want to say goodbye too. She kind of, it like dawned on her that I was here as well. She said, OK. And she took me down the hall, and she opened the door. And she stood in the threshold and I walked into his room. And I walked right up to, you know, that mound of a body beneath this white sheet. And I put my hand over his hand over the sheet and held it and I could still feel his warmth. And I told him I loved him. And I said goodbye. And I could hear my mom sniffling, you know, behind me. 

Later, a few months later, our dear dog died. It was hit by a car. And I'll never forget my mom coming to my bedroom and letting me know that Sassie had been hit and was dead. And I said, where is she? And she said, well, she's still down the street. They're going to come get her. And I just proceeded to get on my bike and go right to her body. There was already flies on her. And I just remember petting her and being with her. 

There was just this natural proclivity and natural tendency to want to be in these thresholds. 

As I grew older and grew into adulthood, I was trying to find my spiritual home. I was raised Episcopalian, very conservative upbringing… socially, politically, religiously, very conservative. And I never quite felt at home in the church. In fact, often I was complaining about having to wear a dress and I'd go and sit in the church and argue in my mind against the pastor. There was a lot that I was resisting. 

And when I turned 16, my parents stopped requiring that I go to church. And it was then that I started to just explore, what is this sense of connection for me? What does it look like? How does it feel? Where does it land? Where does it collect itself in the world and potentially with others or not? And so I spent a lot of time in nature and a lot of time with sacred music. 

It was when my grandmother died, when Big Mary died, I had always sensed that I would one day align my life professionally into becoming a caregiver and specifically a chaplain. But it was upon my grandmother's death where something happened in my ego, and I knew I was ready to commit myself to that walk. 

So my chaplaincy work is kind of an honoring of my relationship with her as well. And it was upon this kind of reorientation of the direction of my life, as I decided that I was ready to walk this walk of service and spiritual care. At the very same time, I stumbled upon Zen Buddhism. 

And so my beginnings of practice and meditation practice and contemplative practice and my practice of being at the bedside have always been completely one, completely intermingled together. And when I first entered into the Zendo, the place of meditation and liturgy for the first time, I sat down for my first sit of 30 minutes in the quiet with others. I remember sitting there, feeling that stillness, feeling that quiet, feeling this kind of sense of wonder of what am I doing here? And then looking up and seeing all these people sitting peacefully and quietly and breathing. And I shot back to when I was four, in the field with the grass. And I knew this is my spiritual home. This is my place of practice and exploration through this home of Zen Buddhism.

Nate Houchens (26:29)

The connectedness that you felt at the ripe old age of four years with something greater, as manifested through blades of grass as a microcosm of something greater… I don't remember what I was doing at four years old, but I don't think I had that amount of epiphanies or sort of wisdom. 

And then to hear your visits with elderly individuals in the neighborhood and how you offered companionship and comfort and solace to those individuals. 

What I think I hear is the earnest desire to bear witness to what's happening and to be there for these thresholds, these transitions. That is what I'm hearing over and over again, and it sounds like that is a huge part of your practice now.

Mary Remington (27:18)

Completely. I think that perfectly describes it really. And it's interesting too, looking at our relationship in kind of a Westernized culture and how we work with death and youth and children. And often there can be this tendency to draw a line between them, you know, that the youth are children not exposed to end of life or mortality in certain ways. I mean, working in the hospitals at Chapel, and I came alongside many families who were in this question of how to let our two-year-old daughter be with their dying mother or the 16-year-old son be with his dying father, whatever it was. 

I think there's a lot of credit that we actually don't afford the youth in this way. And there's a lot that gets stripped away from youth in their potential opportunity to grow and learn and to naturalize and normalize the truth of our impermanence and the sacredness of our life and our death. We don't have traditions as much in our Westernized culture as other cultures do that know how to hold mortality in a sense of community or through a communal spirit. For me, that's been very, very powerful in helping give voice to those who are younger bodied, smaller bodied, and not to push a family in any direction, of course, honoring whatever they would like to do in relationship to this, but to open the possibilities that this could be a real gift for your daughter to be in the room with her mom right now, you know.

Nate Houchens (29:22)

I'm reflecting on why it must be and how it sort of evolved that way and why children are sequestered away from this very natural process, especially in the Western world. 

I remember my first encounter with a person who had died as a child and I was, I don't know, probably 12 years old. And I remember feeling this immense sadness. And I remember my mom saying, you know, you don't have to go to the funeral. You don't have to go to the wake. If this is too hard, it's OK to not do that. And I remember even then feeling this sense of, no, no, no, I need to be there. This is something that I need to do. 

For me, I couldn't quite figure out where that stemmed from. And frankly, I still don't know. But I think as I have thought about my career since and my earnest desire to offer what little comfort I can to those who are suffering… there was something even then that I think was speaking to me and I'm sure to people in your practice and to people that you know well that just comes from somewhere or something or some deity or something, right? Something in the universe that is a part of that calling as you described it.

Mary Remington (30:46)

Yeah, I love that. And I love that we most often don't understand it. To me, that is such a relief. You know, in this kind of culture where we are intellectualizing and conceptualizing and putting into boxes things that don't fit there, that we can allow these mysteries to exist through us, that that, I have no doubt, comes through our caring. You know, when we allow for the mystery of love to work through us or connectedness to work through us and don't have to understand it. 

I often say, you know, the older I get, the less I think. And I really mean it. I really genuinely mean that. And I don't mean to sound like a dim bat or something, but it's that I trust my gut. I trust what I sense, what I feel, much more than I trust what may be arising or not arising in my thoughts. That is also truly a quality of meditation practice in Zen Buddhism, is to practice cultivating awareness that can help us rest in our sense of wholeness and embodiedness versus trying to rest in our identity or our ego, where so much of our kind of extractive, contractive actions arise.

Nate Houchens (32:07)

I want to pull on that thread a little bit, and to just go back to that first story of the nurse that as you're walking down the corridor sort of forcibly causes you to do that 180 and fired off just this rapid intense series of pieces of information about this individual that you eventually meet. I want to ask a little bit about what your immediate responses were to that sort of deluge of information from the nurse and how they were speaking about this patient to you that kind of framed entering the patient's room. I'm just curious how you initially sort of thought about that interaction with the nurse.

Mary Remington (32:47)

Oh, it was completely disorienting for someone who didn't even have the orientation yet to begin with, in a certain way, you know, in the hospital context. So it was very disorienting to receive this amount of very intense information that also had a lot of, kind of objective and objectifying tone to it. And to then be asked to care for that person after these unconscious biases have been laid into what was communicated to me. 

You know, by the time I sat in that chair, I also had about a year and a half worth of beginning my contemplative practice. And so, there was already a capacity in me to know that I'm upregulated right now. To know that, OK, I'm sitting in a chair right now. To know that I can observe what's before me with as much openness as I can muster right now. You know, like there was enough in me to help me in a moment-to-moment kind of way be in what was a very intense situation. 

And I also have to say, this could have gone left, you know? It went right in this story. It could have just as easily gone left. And so, it's not that I had the fix or that I'm the hero in this. I am just the fortunate one who got to observe and learn what arose in this particular moment with this human being called my first patient as a chaplain. But if it had gone another direction, my learnings would be completely, you know, who knows what I'd be saying right now. So, you know, just to humbly offer that.

Nate Houchens (34:35)

There's a real humility, I think, to appreciating how a patient's response, a nurse's response, anybody in the environment's response is going to be what it is and what they're going through that day. 

And what I took away from your story is that we have the immense privilege to be able to have a little bit of an influence on that outcome and have a little bit of a change of course through being open, being receptive, being inviting rather than closing off and judging or stereotyping. 

There is so much about your story that we teach in medical school and residency training. And it gets challenged, day after day, by the system and by the immense numbers of pressures and responsibilities and critical items that health care practitioners and clinicians and others are forced to focus on. I'm just wondering if you have thoughts about that.

Mary Remington (35:37)

100%. I mean, the compassion for the nurse… You know, what amount of patient load and responsibility and stressors she had very likely gone through that happened before that moment where she swooped me 180 in the hallway. 

These very challenged systems, particularly in health care, amongst many others, where there is kind of a dehumanization process that's happening, a moral suffering and moral injury that's being created because of our time pressures, our patient loads. Also, monetization of health care, corporatization of health care, systemization of health care, where literally, know, human beings, not only the patient, but the staff are getting converted into numbers. Converted into figures. Converted into data. And that process of dehumanization from a human being to a number or a quota is full of suffering. And it's refractory. I mean, it's immeasurable kind of the ways in which that suffering then seeps through the care that we abided to give that we're not able to give. 

Or we feel very challenged to give because of the system in which we work. This is called systemic violence. We look at this very deeply in the Upaya chaplaincy program too. And Roshi Joan Halifax wrote a beautiful book called “Standing at the Edge,” which also takes a deeper look at these systems and the moral injury and the moral suffering and the moral residues also that we carry with us from these kinds of environments in which we are working and serving and living and spending more time in than our own families. 

But also the kind of brighter lights in this too, for example, with moral residue that, you know, through the things that we carry in our own hearts that linger, they remain as kind of teachers for us and kind of sensitizers in us. It keeps us, can keep us open and vulnerable and less hard, if you will, when we are continuing to feel into things that we're still learning from or things that were painful, things where we felt we failed. How do we hold that tenderly, not in a way that's self-flagellating, but in a way that keeps us in a state of practice and atoning and aspiring to get up again and love again? Do you know what I mean?

Nate Houchens (38:26)

I do. do. What do the teachings say? What do your colleagues and you say to those individuals like myself who struggle with holding those concepts and feelings in our hearts, but having them feel overshadowed by the immense pressures of the organization, of the system, of regulatory agencies and so on? Like, how do we ask what else when we feel like there isn't time to do that?

Mary Remington (39:00)

Yeah, that's such a, that's a very rich question. When I hear it, I think of multiple layers. I mean, one, I think is the personal layer of this, of what do we do in our own hearts to work with the moral suffering that we experience in our living and our being here on this earth, you know, that we're here and people are starving all around the world. How do we sit with that? You know, so like how do we atone and reconcile what it means to be here in our suffering? And that is its own world. And that's where I think our spiritual life is so important, because that is a space in which we can intimately explore what it means to be a whole person, whatever that is for us. 

And then there's the more interpersonal realm where, you know, I have dear spiritual friends, advisors, teachers, mentors, people that I trust, that I take my questions to and my suffering and my blockages to, so that there's this constant kind of diffusing and non-internalizing. Because we exist in enough internalized, you know, concretized systems. Enough of that. So the more we can kind of diffuse, practice communication, transparency, allowing flow, I think is very healing and important. And to know that we have trusted friends who also will call me out, call you out. You know, you're stuck in a rut here. This is another way to potentially look at this, for example. What are you resisting here? People ask really good questions. It's very important and actually kind of rare, I think.

And then, you take that into a larger circle. Where do we have a sense of community? Where do we have a sense of village? What is our access points to even the people that live around us in our neighborhood? These are kind of building blocks of what Cynda Rushton from Johns Hopkins calls self-stewardship. These aspects of creating a sense of wholeness in ourselves. And that these are incredibly dynamic and powerful, and our ability to attune to our morals, our values, and the ethics that we are signing up to and with in the systems in that we are working. 

Then moving into those systems. John Paul Lederach always teaches, you know, systems are made of people. They're systems, but they are comprised of us. And sometimes we can objectify them into this other entity that is bigger than we are. And John Paul again teaches on this beautiful piece that we are each a leverage point in the system in which we exist. 

And so how to drop into that sense of self, wholeness, and autonomy… how to carry ourselves forward into these environments, into these hallways, and remember that our voice matters and how we are deeply matters.

So I find that there can be a lot of power posturing. People get around a table and they start acting differently. I mean this is, I don't mean to demonize any of this. This is kind of natural, normal stuff. You know, anxieties make us do strange things. But how to take on a practice of really trying to breathe and be in one's body when around a table with others, where we're making decisions and making new policies. How to be relaxed, how to invite relationality in life, in all of our moments, you know, at home, brushing our teeth, the way we put our head down on our pillow, how we sit at the board meeting, you know, this practice of just being a whole person.

Nate Houchens (43:25)

I'm so enriched when I hear that. And I would count myself amongst the individuals who are not terribly aligned or as sort of in the whole space. Like famously in residency, and now, there are times when I'm on service taking care of patients and the first meal of the day will be dinner. And at one point, that was a source of pride. Oddly, right? And perversely.

And I hear what you're saying about creating the “us versus them” mentality of well-meaning individuals who are just working in this them system that is standing in the way of allowing us to do our natural talents of connection with others and spending the time at the bedside and connecting in the ways that you did with James. 

I find myself falling into that headspace so often and so easily. Part of it, I think, is that I still am entirely a novice in terms of finding that wholeness and being OK with the fact that others around the table, to use your analogy, others around the table, the people that I work with, the systems that I work in, may not also share that alignment and may not also share that kind of set of values and principles. 

And then I think what I'm hearing you say is I can work, and others perhaps, can work on the letting go aspect of it as well, and that they may not necessarily feel the same way or see the situation as I do, and that's okay. 

This is my impression. This is how I've been feeling. This is very in stark focus for me because I have spent the last, and we've talked about this a little bit before the recording started, I have spent the last few weeks navigating a change in the electronic health record. And what I can tell you about that is that it is a series of... How do I even begin to describe it? It's a series of just important, but at the same time, not at all meaningful work, right? A series of tasks that are important for patient safety, patient care, all the things that we care about, of course, yes. And it just feels like at the end of the day, you've done all of that. And what meaningful thing have I put forth? And so often, I think, to speak to that moral distress, I think I go home and say, wow, I did a lot of tasks and checkboxing. And what can I take away from it? What are those moments that I'm going to look back on and say, that is when I felt most whole and most aligned. And I can't think of many. 

So I don't know where I was going with that, except to say that I think that's a microcosm of the larger challenge that I personally face in finding my whole self and being in a mindset, being in a way of being that feels aligned with who I am at my core.

Mary Remington (46:31)

Yeah. I mean, to me, that is just our life practice, actually. That is the trip we are all taking in our own ways, you know, and at different levels of awareness and consciousness. And boy, you know, I've lived also through an EMR shift in a hospital system, and it's not easy. I mean, that's some charnal ground work, as a chaplain might call it. That's your version of it. Getting through that level and depth of systems work and detail and attention, that is such a practice. 

And maybe that is a doorway, that this is a practice, of my attention, of my staying in my body right now, of my adding a little humor and a coffee break with friends so that we can stay sane, you know, to stay real in the pressure cooker of it. It's a… Yeah, anyway, I really feel for you. It's a very significant process. And, you know, we do our best. 

But there are ways, you know, when you're talking about looking through the day and that you did a lot of things that felt like checking these boxes, as we were talking about systems are made of people, to remember that every box that you checked represents life. It represents a human life that is impacted by your attention, by this conversation about this very boring, you know, systemic thing with the technology on the, like, you know, but it does impact a life and it's not at the bedside in that warm hand to warm hand kind of way, but it's still an offering. So I thank you for doing that work because it's not everyone's cup of tea and you're still showing up and you're doing it. So thank you.

Nate Houchens (48:23)

Thank you. And that's very kind of you to say. I think it speaks to my proclivity and what fills my cup. The thing that really, I try to anchor onto is that perhaps if I advocate for these changes, for the click boxes to be fewer, for the process to be a little bit easier, I tell myself that the clinicians who are seeing the patients more than me will have a more meaningful experience as a result. And that is what keeps me going. Because otherwise it becomes a slog.

Mary Remington (48:59)

That's it. You just described it perfectly. I mean, I feel like that, you know, for me in my small little part as Director of the Spiritual Care Department in the hospital that I worked in, that's what I was doing too. I did not want to be in those meetings about technology and, you know, the checkbox. I didn't. 

But I too, like you, understood, well, there's actually impact in this very minute shift that we're talking about. There actually is a great ripple effect that, you know, in Buddhism, we have this beautiful Sanskrit word, it's called appamāda, and it means diligence, conscientious caring, as Stephen Batchelor describes it, conscientious caring. But it's kind of grounded in this understanding that every action we take matters. Every single one. And so if we can, you know, practice dropping that into our mundanity, that's a shift of perspective. A shift of life, period. That shifts how we get in our car. That shifts how we order our coffee. That shifts everything. Everything.

Nate Houchens (50:05)

Appamāda. I'm going to keep that in my forefront of my mind.

Much of your work, I remember hearing about your professional sort of roles, now and in the past, and much of your work has focused on supporting people facing disability or being unhoused or addiction or substance use or end of life transitions. These are challenging moments for people's lives. What has your work with these communities, these individuals facing such challenges, taught you about resilience and dignity and that connectedness that you described that started for you as a four-year-old.

Mary Remington (50:46)

Yeah, God, where to begin? I mean, on one level it’s to never take anything for face value. To, you know, invite myself to always look upon life with curiosity and wonder. Truly, not like this practice in Buddhism we have of a beginner's mind, a not knowing mind. 

And I can't help but to lift up Sandy Sewell, who I have full permission to talk about. She's a patient that I met at Good Sam, Good Samaritan Hospital where I used to work. And I continue to come alongside her as a chaplain over time. I'm no longer at the hospital anymore. She, to me, is one of the most powerful people I've ever met. She is 85 years old. She was born with cerebral palsy from forceps that were too tight around her neck in the birth canal. And so she came into this world only able to barely move her head and her hands to a very small degree, which made her be in a wheelchair for her whole life. 

And I met her as a patient. And as soon as I started to get to know her, I realized or started to understand how much I don't understand. 

She was married for a couple of decades to a man who also had cerebral palsy who died of cancer. When he died, she then had a relationship with Scott, who also had cerebral palsy, who was her lover and boyfriend for decades until he died almost two years ago. She started her own nonprofit where she helped people with diffabilities have social events. That was kind of the heart of her work. She also taught occupational therapy for a community college here in the New York area. And she still to this day works at Target about once a week, you know, directing people down the aisle. 

She's unstoppable. I would say, you know, Sandy has flames that are literally coming out from behind her wheels as she goes through life. She is a force. And part of her force that she has is that she was deeply loved when she was born. Her parents loved her. They supported her joy. They supported her character and her being fully accepted. There was like gates that were open for her. And so her whole life has been a process of opening gates for others and helping them understand and see through the lens of physicality into what is the magic of who we are within. 

I feel like that has been also the teaching in working with those struggling with alcohol and drugs. There's such heavy bias, such cultural bias, negative bias with that part of our population. And as I started to work with them, I fell in love with a part of our humanity that's so misunderstood and rejected and dejected and is actually… they're some of my greatest teachers has been in that community. Yeah, I mean, really people who've just changed my view and helped me in my practice of what it means to be aware of my judgments. Of course, I'm a human being. I have them. I have bias that arises. I have all the things. But I, they've given me the gift of becoming more aware of that and becoming less imprisoned.

And so through that, I feel so much more connected. And that harkens back to this very basic raw sense of connection with life itself. This kind of non-separation when one starts peeling the layers away.

Nate Houchens (54:53)

The nurturing and love that I heard you talk about with Sandy must have this amplifying effect. This connectedness that arises, I think, then is just multiplied by Sandy's actions and by everyone that she gets to meet. 

And what I'm hearing you say also is that the individuals that you have come across in your work… your gift to them, I think, is offering that openness. And just like in the case of James, having that open heart, having that clarity with the ability to see that he and you and the rest are connected in meaningful ways is an invitation. And for those who choose to accept that invitation, I think that could be amplified as well, right? And then whatever actions occur on their side, whatever kindnesses they offer in the future.. it is a ripple effect.

Mary Remington (55:53)

It's a ripple effect, and I think it's also a co-created field we make. They offered their openness to me. And so, that's when we can start to experience this shifting and letting go of the boundaried self. Not that I forget that I am Mary, that I am in a body, that I have my feet on the ground, that I have my own particularity, that I am here as this person. But that the being part of the human being has space to live and only actually in relationship to another. None of, we don't do this as islands. 

And this piece you're talking about in terms of the ripple effect… Yes, and as soon as you said that, I was like, yes, and look at the work that you're doing. Look at the way that you're passing on the ripple effect through this medium and the intention that's driving you, motivation that's driving you to do good, to do good for others. These are parts of language and Buddhist precepts, you know, that our life becomes this kind of relational celebration.

Nate Houchens (57:05)

Yeah. Yeah. And, you know, as you talk, thank you for those kind words. That is the goal, of course. I think we are poised to be able to contribute to that ripple effect.

Nate Houchens (57:31)

And what you said before, I think, just resonates so intensely. How astonishing for James, who has been treated in such a way for so long by so many to have the strength to then accept that invitation. I mean, that is unbelievable. And yet…

Mary Remington (57:54)

No, please go ahead. I don't mean to interrupt.

Nate Houchens (57:56)

I am very privileged as well, in all the ways that you described and many more. And I can't even begin to fathom what it must feel like to let the guard down even for a hot second when you have been treated this way for so long by so many and by so many different types of biases and systems.

Mary Remington (58:18)

That's right. It is a true act of courage. And you know, another element of this too, I was just saying this a couple days ago… you know, we're animals. We are full of instincts. And to remember that we're feeling and sensing each other. There's so much to that. 

And in chaplaincy, a lot of what I'm interested in and focus in and practice on also is the somatic presence. And what can be offered just through the body alone, just through… Frank Ostaseski often says, the regulated presence is in and of itself an instrument of healing or an offering to another. 

And as instinctual beings, we can sense when another person is entering into our space grounded, regulated, openhearted, vulnerable, human, you know. Not coming in as their role, not coming in with a bunch of tools and pathologies or whatever it's going to be, but just coming in as a person, a genuine person. And we can do that. I don't care what your role is. I don't care if you're a doctor. We can come in as people and still maintain the duties at hand and humanize them action by action by action, you know, with this appamāda heartmind, if you will.

Nate Houchens (59:46)

I'm with you and it's so hard and nebulous for me to put into words when I can sense the other person that is grounded and that is there to connect and not just do whatever, right? Poke, prod, ask questions. There's a whole feeling. There's a whole sensation. There's a whole aura that is different. 

And I really struggle with words. I know it's ironic. This is a podcast. All we have are words. But I really do struggle with words when it comes to some of these sensations that you're describing.

Mary Remington (1:00:21)

Oh yeah, I'm with you. I weep. I have wept over words. I have wept over the inadequacy, my frustration, the wrestle, that there is this kind of boundlessness in the experience of being alive and then this, you know, sometimes can feel confining experience of trying to put language to things which are ineffable, not containable.

And also, of course, that very grist is where art comes in and music comes in and all sorts of ways to play with this kind of threshold of the ineffable and describing it. 

But I also think, again, you mentioned this earlier, there's some kind of relief in not being able to describe these things, but just to rest in our… as Marie Boddy, Marie… no, Mary Oliver. In one of her poems, she calls it our animal body. You know, that we have an animal body. What a relief to rest in that.

Nate Houchens (1:01:29)

I think about dualities all the time and I find this particular duality fascinating because, on the one hand, I want to be able to put words to these sensations, these feelings. I appreciate that sometimes it's music and art and nature that can speak in ways that I never will be able to. 

And then the duality of simply saying, I accept and I appreciate that I'm not going to be able to come up with the right word to describe. 

And it's such a storm, right? It's like this perfect front in my brain, my heart, my soul. I just think about that on a regular basis in conversations like these and with colleagues and loved ones. It's fascinating to me.

Mary Remington (1:02:18)

It's fascinating. It can be really joyful to play with. I mean, look what you're doing. You're kind of playing with that very edge that you ride. So what's that saying? We always teach what we're going into. 

And there was one other thing I wanted to touch in on about the energetic qualities of the regulated presence and that our presence alone can be an offering of healing. Or maybe possibly helping conditions where healing can occur, that there's this element of transmission, you know, that we can hand things between each other through presence, through nonverbal expression, through shared silence… that we can connect on profoundly deep ways and experience healing moments or awakenings or realizations through this alone. It's a profound space. 

In Zen Buddhism, there is something that is literally called transmission, which is the transmission of wisdom and understanding and knowledge from one teacher to another. And it's not a contract you sign. It is done in ritual and acknowledgement and embodiment and warm hand to warm hand.

So just to really bring that in, and it's also something that often gets forgotten or not given much light to in our Westernized modern day life. We don't really talk about this too much. But how we are each shifted alone by someone's presence. I mean, I think we all likely have stories like this where we're changed just by someone's presence alone.

Nate Houchens (1:04:09)

Yeah, I love that. Put another way, I think we all have the capacity to be able to enrich another person's day or life, if we so choose.

Mary Remington (1:04:21)

Yes, and that we are that. It's not even that we have the capacity, that we are that. You know, we are that transmission. We are that love. We are that regulation. It doesn't exist outside of us. It is us. That's the practice, I would say.

Nate Houchens (1:04:40)

Yeah. I grew up in central, rural Illinois, and it probably comes as no surprise that there were not too many Zen Buddhism sort of teaching centers in my neighborhood. I'm interested in how you sort of came to this practice, and also, I'd love to know your thoughts about, for those listeners who are facing fear or grief or uncertainty right now, any particular practices or perspectives that help you to return to that steadiness and that compassion when things are difficult. 

So I know it's a two-parter, so apologies for that, but I'd love to hear how others might get interested or involved in some of your teachings and then what sort of additional points of wisdom you have for them in tough moments.

Mary Remington (1:05:32)

I think it's such a great question about how to be here in the tough moments. I feel like every day is, for me, it's almost like I have to put on a seatbelt before I read the news, kind of feeling, you know, just it's a deep practice to be with the levels of input and dysregulation and amounts of suffering that are happening in this country, around the world. 

And I find that there's no one way to meet it, really. But there's the way that we can discover within ourselves. And so for some, that might mean stepping out into the village a little bit more. Maybe having a, once a month, a little Sunday lunch with the neighbors and getting a sense of community and building of relationships with those who are around us. It might mean maybe one wants to go to church more often on Sundays. Maybe one needs to turn off the news a little bit more. Maybe one needs to attend that march that's coming up this Saturday finally. There's so many avenues and ways in which we can nourish ourselves and ground ourselves right now. What's most important is that it's true to who we are and that we discover our own medicine. To me, that's vital. Otherwise, we're just kind of going through the actions in the name of healing or staying sane or whatever it may be, but it's not really going to a certain depth. So it has to be meaningful to each of us.

Nate Houchens (1:07:03)

Yeah, pre-prescribed sort of methods to navigate the world as it is are never going to work if it's not authentic to the person.

Mary Remington (1:07:12)

It's really true, but this is the thing as well, is that there's so much of that that's in our matrix. There's so much that's being handed to us in this way. Take this pill, do this diet, you got to do this kind of walk in nature. We're in such a prescriptive kind of culture. 

And so how to disengage and tune into oneself and really listen, deeply listen, I think is really important.

And I also have some amount of bias. I have a 13-year-old daughter who, you know, we're navigating what is technology, what is use of devices, how much exposure am I sensitized to now by having a child who's 13 who's entering into this technological world. So I'm incorporating more conscious practices around screen time, how much time am I on my devices and creating regulation that way. And that's helping me ground continually. 

And I also want to say, I just, think that in a time where we are experiencing, many of us, kind of this sense of social bifurcation, polarization, isolation and on, that if we are experiencing that and if it is creating emotional, spiritual, psychological, existential suffering for ourselves, to really discern what is kind of a social medicine that I can incorporate into my life right now. Could be very similar, or very simple, like the once-a-month lunch at my place on Sundays with friends or with the neighborhood. But to really attune to that piece, that seems to be incredibly pervasive for us right now.

Nate Houchens (1:08:59)

I think offering those spaces for people to share community and fellowship can't be overstated. And I can take that forward for sure. I think so much of challenge is social isolation and sort of getting into the algorithms, to use it plainly, about social media, about screen time, about what you see and how many times you see it on the news. I think shedding that in some ways can be really beneficial for some to reclaim some of the wonder of the world and not be bogged down by what the media sort of chooses to show.

Mary Remington (1:09:41)

Exactly. Yes. Yes, yes.

Nate Houchens (1:09:44)

I am energized. I'm refreshed. I have a newfound appreciation for the ways that chickens and roosters sound when they're enjoying a little bit of rain in New York. 

Thank you so much, Mary, for sharing this wisdom, sharing your perspectives, and sharing a little bit about yourself and your journey through and becoming your calling of a chaplain. Thank you for sharing that story.

Mary Remington (1:10:11)

Well, thanks so much for the invitation, Nathan, and for your curiosity and your thought-provoking and heart-provoking questions and comments. I just love the conversation. So, a deep bow to you.

Nate Houchens (1:10:23)

It goes for both of us. I am still learning and I would very much love to talk with you again because I imagine that I, that was the tip of the iceberg. I have so many more questions and ways to learn from you. Thank you so much.

Mary Remington (1:10:38)

Thank you. Bless you.

Postlude

Nate Houchens (1:10:57)

We would love for you to be a part of this movement, and we would be honored to hear your story. If you have experienced a moment of grace, connection, or empathy that changed you, we invite you to submit it for consideration to be shared on Boundless Moments by sharing, you not only contribute to a collective celebration of human connection, you may also inspire others to recognize and cherish the sacred moments in their own lives. To discover more about sacred moments and to share your own story, please visit sacredmomentsinitiative.org.

This episode of boundless moments was produced, edited, and mixed by Nathan Houchens. Our program manager is Jessica Ameling, and our publishing and social media manager is Rachel Ehrlinger. Our podcast is made possible by the Sacred Moments Initiative, a humanistic project whose aim is to study, catalog, and share sacred moments. Learn more at sacredmomentsinitiative.org. Boundless Moments is also made possible by donations from listeners like you. Thank you so much for supporting our work in sharing sacred moment stories. If you enjoyed this episode, please subscribe to the show wherever you get your podcasts and drop us a rating or review to help others connect with us. I'm your host, Nathan Houchens. Thank you for joining and until next time, be well.