interaction with their patients, a number of features have been articulated, in addition to the model.
These aspects are outlined by educator Mark Greenberg in relation to teachers in engendering
mindfulness and compassion in the classroom. They translate well for clinicians in fostering CMC
(contemplative mindful compassion-based) care. In the following part, I am going to introduce
different features by telling personal stories to exemplify the practical meaning of these aspects:
Listening with Full Attention:
• Correctly discerning patient’s behavioral cues
• Accurately perceiving patient’s verbal communication
• Reduced use and influence of cognitive constructions and expectations
Story: I attended an elderly student, who had suffered a massive heart attack and was taken to the
emergency room near our Zen center. Hooked up to IVs, in the hush of a
private space in the ER,
she began to realize that she might be near death. As technicians stirred around her, she settled
down into a quiet, open, and fearless state. She had been a child in Berlin during World War II and
had vowed then to face death openly and with dignity. Those of us who sat with her in the ER,
listened in a respectful way to her concerns and also her courage. We could see the effect of her
practice and her training. We also felt the ballast of our training in care of the dying, as we sat with
her through this crisis and gave our full and calm attention to her and to those who were attending
her.
A few years later, my student was diagnosed with a fast-growing cancer. She died six days after
receiving the final diagnosis, and again her quiet presence and acceptance astounded those of us
who cared for her. We sat with her, listened, sat in attentive and compassionate silence when she
lost her words. When she was told that nothing more could be done to help her, she simply dipped
below the horizon and let go into the deep trough of peace. She went quickly, gracefully, her
equanimity standing her in good stead. All of us who attended her had been through the BWD
training. We were able to accept the truth of her situation, and at the same time, have a kind of
compassionate optimism that that was not about her survival but the quality of life that we
observed in our dying patient. We had the training to listen and to support her in silence. Her death
was characterized by profound peace.
Nonjudgmental Acceptance of Self and Patient:
• Healthy balance between patient-oriented, clinician-oriented, and relationship-oriented goals
• Sense of care-giving efficacy
• Appreciation of patient’s traits
• Reduction in self-directed concerns
• Fewer unrealistic expectations of patient
Story: Issan founded the Hartford Street Zen Center and the Maitri AIDS Hospice in the gay district
of San Francisco. He had not been diagnosed as HIV-positive himself, but believed it was crucial
to offer help to his brothers dying all around him. Issan was a Buddhist who was deeply intimate
with compassion. Through Issan’s work with dying people, I saw how Buddhism could function in a
practical way for a community in crisis, a community that flourishes with compassion. At the
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