PO Box 9286, Santa Fe, NM 87504


Breast Cancer: A Deepening of the Practice
by Sabine Schulze-Steele

A year and a half ago, just as spring arrived, my friend Stella died from breast cancer. It was the first death of a friend my age; she was 42. I visited with her a week before she passed on and was profoundly touched by the presence of death, that special darshan only a dying person can give, that great gift and reminder.

It seemed all my women friends were making time for their first mammogram. My appointment came two weeks after Stella's death. For weeks afterward, I didn't hear anything from the x-ray lab, and I naturally assumed my test was negative. But as I entered my office one day, the phone was ringing - my gynecologist was asking if I had gone for my second mammogram yet. Right before this call, I had a very disturbing dream: I was traveling to an unknown destination in the company of a stranger and, when I disembarked from the ship, my luggage was lost. I awoke alarmed by the danger I sensed. The second x-ray confirmed the possibility of breast cancer.

A few days later I was in one of those surreal situations- clad in a hospital gown, my right breast on the plate of the mammography machine, the radiologist inserting a guide wire leading to the suspected tumor area, and drops of blood accumulating on my gown, the plate and the floor. Trying to dissociate from my body by reciting mantra, I was deeply grateful for the kindness of the radiologist, a specialist in breast cancer detection, sensing his compassion while he performed this torturous procedure.

I had embarked on the most frightening experience of my life. As I followed my breath in and out, it was still there, and I was still there. That day I received the diagnosis: - breast cancer. I felt the suffering of all people confronted with the harshness of a life-threatening disease. I was certain there were thousands of us going through the same turmoil at this very moment.

On the same day, in Germany, my mother was diagnosed with uterine cancer. My mother had given birth to me exactly eight years after she had been hung in an attempted family suicide in war-torn Europe. I felt the suffering of my lineage as I experienced a sense of remembering every moment of my existence: the turmoil of fleeing the east and spending my first year in refugee camps in West Germany, living without sufficient food and heat in a converted fortress during the harsh winter of Bavaria. I had lived with a sense of threat to my existence for a long time; now the threat of breast cancer was very real. I felt tremendous grief for all of us.

My mother underwent a hysterectomy, but required no further cancer treatment. The operation was a frightening event without life-changing consequences. On the other hand, I was to live with a 50% chance of recurrence at any time. No one would vouch for my life until I had survived five years without new tumor growth. Life, as I had known it, was over. The old self died that day and was not going to be magically restored. Everything had changed. More precisely, I was aware of the constant flux of events and that there was nothing I could hold onto, my health or my life. The meaning of impermanence became starkly clear.

Within the next month, I underwent three surgical procedures. I joined the sangha of millions of others facing the natural event of disease. Before this time, my Vipassana practice was based on the wisdom of others. Now I recognized impermanence not only in my physical body, but also in mind states, time, emotions, and beliefs. The most dreaded medical test result - lymph node invasion - became another fact to be examined and followed by appropriate action, chemotherapy. Anticipation and imagination turned into momentary reality and soon became part of the vast storage facility of past events. I was in a state of heightened awareness that I had previously experienced only at the end of a retreat. I was experiencing all occurrences in their future, present and past aspects.

For years I had heard about the importance of meditating on death, but it had been just another piece of ancient wisdom. Now I felt the powerful impact in my entire being of Buddha's words as he approached death:

Of all footprints that of the Elephant is supreme

Of all mindfulness meditations that on death is supreme.

(Mahaparinirvana sutra)

As the medical tests continued, trying to find out how far the cancer had advanced, I watched my very rapid redefinition of self, almost like a constant parade: - winner; then, loser; then, conqueror; then, victim, and so on. I vividly recall sitting in the hallway at St. Vincent's hospital waiting for the results from a bone scan which would determine if the cancer was stage II (treatable) or stage III (beyond the scope of chemotherapy). The waiting was exhausting; the only activity that helped was to simply watch. I watched inside and outside the body, becoming a true nangpa, or insider, as spoken of by Tibetan Buddhists, tracing the different sensations, changes in posture, breathing and muscle tension that certain types of information created in the body. I followed as the information was judged by the mind, observing the illusion unfolding in every moment. I could see the whole loop: some words spoken by a doctor about my health - the body's response - the mind's interpretation - the immediate projection into the future. Only by returning to my breath, over and over again, could I distance myself and sometimes break the cycle, coming into the here and now.

I remembered a story told by my friend, Jack Kornfield, at one of the Vipassana retreats he taught at Lama Foundation in New Mexico:

"Once, the son of a prominent man in the village had fallen ill and no doctor could help him. When a Sufi master traveled through, the father asked if he could heal his child. The Sufi touched the boy gently and spoke prayers and blessings over him, then he turned to the father and assured him that his son would soon be well again. A young man who attended the healing ceremony got very angry and shouted, "Who are you to think that you can heal with a few words," whereupon the Sufi master answered, "See, if a few words can make you this upset, why can't a few kind words heal?"

The Buddhist practice of paying attention allowed me some measure of equanimity in situations, such as being in the oncologist's waiting room, surrounded by scared and defeated-looking fellow beings in various stages of the disease. Mindful attention helped as I changed from street clothes into the light blue paper gowns, or as the gurney moved me to the surgical prep room. I was mercilessly stripped of the world I knew, and paying attention to every moment provided a walking stick along unknown terrain.

Just as importantly, my partner, Ralph, and the sangha of friends from different spiritual backgrounds lovingly carried me through this time. They could be with illness, express their fears and sadness, while maintaining their sense of humor. I felt the energy of many prayers spoken for my recovery. And the remarkable bonding with my women friends as they saw me through baldness and weakness, offering hands-on healing sessions, drumming and singing for the restoration of my health and balance. They all provided a chance for me to experience wellness in illness.

When I was two months into the chemotherapy treatments, a friend invited me to sit with a recently-formed group in Santa Fe. As I approached the house of this Tibetan teacher, Lobsang Lhalungpa, I was excited. I sensed that I had finally found a teacher to study with on a daily basis. Not only had I found a kind and knowledgeable teacher, but he too was living with cancer. He had been in remission for a few years, but understood all too well what I was going through during chemotherapy, making my remaining four months of treatment that much more manageable. Well into the chemotherapy treatments, I realized how immensely valuable the first, intense month of this journey was, how the powerful impact shook me awake and how the work of maintaining awareness really began with this wake-up call. The mind tries so desperately to create security. I watched myself feel safer after the treatment decisions were made because something powerful was being done.

But the lesson continued to be impermanence and unpredictability. In the years following treatment, I lost my job, which had been extremely stressful and probably unhealthy for me. Then a home was offered us in the country. No TV reception, just enormous pink cliffs, birds of prey, and the Rio Chama thundering behind the house- a completely tranquil hermitage. These days, I receive many calls from women who have just been diagnosed and are involved in the turmoil of initial decision-making. In town we have formed a support group for women with breast cancer, sharing experiences and information about helpful alternative adjuvant treatments.

My cancer is in remission, but I continue to treat it with healing herbs and acupuncture. On some level, it is always present. Or as Joseph Goldstein told me during this past summer's retreat at Lama: If you can maintain the keen awareness of death in everyday life, especially after your health is restored and the cancer in remission, that's your path for practice.

The threat of recurrence with metastatic breast cancer is very real. I am healed, but not cured. No one ever tells us we are cured, although the mind continues to get stuck in the illusion of well-being. Experiencing physical well-being and knowing at the same time that it is an illusion, has helped me understand the illusory nature of reality. I watch the mind move back and forth between accepting things as they are and wanting a certain outcome. I watch how duality sneaks in and disturbs attention and equanimity. As time passes, the work of paying attention gets harder, the memories of the wake-up experience fade slightly, and impermanence needs to be greeted with the same respect each day.

As my teacher Lobsang Lhalungpa says, "Be aware of the special opportunity this represents, having received a life-threatening diagnosis, and being able to work with it, with a clear mind and functioning body." I often look at a reproduction of Frieda Kahlo's painting, "The Dream." It sums it all up very well.