Friday, August 26, 2011



The past few days have left me thinking about impermanence. It started with my dad having a heart attack yesterday morning, but took “flight,” after finding a dead bird outside my window, and then being at a clinic with lots of elderly all week. It’s not that I’m thinking seriously about death, more just that everything is finite. Relationships eventually end, just as my living in Hawaii will eventually end. The best part about living here is that beauty doesn’t seem to be finite; it’s everywhere all the time. I can be sitting on a smelly bus with a whole bunch of homeless people passing the most beautiful white-sand beaches, or I may be walking home from class pouting about my work load and look up to see a rainbow. In that way, this place is magical. I’ve screened close to 1,000 patients for coronary artery disease in the past few years, and I would say more half of them were at risk of developing or already had heart disease. I reminded my dad that his episode is a wake up call to begin living more fully, but also to start taking better care of himself. The Buddha talks about the laws of suffering in terms of attachment. It is not the desire for life that is the problem, it is the attachment to it. And while we only have a short time on this earth, it’s important to wake up.


Thursday, August 18, 2011


‘Ike Ao Pono

I spent the last two days in graduate orientation that left me feeling both exhausted and invigorated. I will be working with forty pretty exceptional people. My classmates range from age 23 to 50, and their educational and occupational diversities are reflective. There are many students who come from the outer islands, where rural healthcare has left their cities and towns without any primary care providers. These students have received scholarships to come to the program and they all hope they will return to their hometowns eventually and work as nurses there. I look forward to working with them as my colleagues. Our professors are highly distinguished and have degrees at the doctorate levels in nursing, which is also quite inspiring. Classes start on Monday so I am relaxing the rest of the weekend. I don’t have much opportunity to travel, given that most of this island is sidewalk free and not very bike friendly. I often feel like I am back in China, where there are NO traffic laws at all. I did have my first surfing lesson this past week, which proved both incredibly hard and fun. I almost got up, but the most fun part was paddling for the wave. Catching the wave is all about anticipation, motivation, direction and balance. I can’t help but think that getting through this first year will require all those same skills. Mahalo!

Monday, August 15, 2011

Move in day









After 6 days in a hotel and 4 nights on my friends floor, I finally moved in today! It's a humble beginning, but it feels good to have my own space. Luckily garage sale shopping is the thing to do here on weekends. People drive miles and spend hours in search of the best deals. So far I've bought an awesome superman bike helmet and a clap-on-off light I am pretty stoked on. I also found some nice things to decorate my studio with. Cooking with no kitchen is easier then I thought, and it's reminding me how lucky I was to cook in the Chez kitchen before I left.






My Desk: Note cards, a laptop and four stethoscopes. All I need to get me through this year.




Sunday, August 14, 2011

Farmers Market and Coco Head Crater

Step 1: Farmers Market MUSHROOM POUCH
Step 2: Hawaii's Natural Stairmaster
STEP 3: Molly lookin good.
Step 4: Climbin up
Step 5: Almost there


We made it

Saturday, August 13, 2011

A view from Waikiki


People get up early here to fish, jog, mediate even BBQ. It's also the coolest time of day so its the best time to snorkel, surf, hike and shop. The stores in Waikiki open as early as 6 a.m. The Japanese come back to the hotel with their hands full of shopping bags by 8 a.m. I opt out of everything but jogging and meditating.




Thursday, August 11, 2011

Hawaii Part Ekahi

Hell must feel like an entrapment of disease, signified by a feeling of permanence. The word disease, when broken down translates into dis-ease, a feeling of uneasiness and homeostatic justice. I say justice because it is everyone’s right to feel at peace. But I have felt everything but peaceful for the past 48 hours, so much that I was too caught up in my own black cloud to smile and acknowledge the fact that I’d arrived in paradise. Though I suppose I wasn’t the first to bastardize the experience here on Oahu, Hawaii. There was Pear Harbor back during World War II, and now there’s Hawaii’s infamous new war harbor, Waikiki. This time its Japanese against Prada and Gucci. For those that have never ventured to Waikiki it is a Mecca of high rise hotels and “world travelers,” who spend all day shopping in more high rise hotels and napping on their own private beaches muddled with “things to do.”

I’ve quickly realized that in reality there’s not much to do here, but not in a bad way because it leaves one a lot more to be. When I look back on my old life for which I must now think of as an old life because I am living such a very new life, I can only be. It is sort of a Buddhist approach, the type that believes we already reached enlightenment, that we are full and whole already. Hawaiian’s know this, because there is not much striving here on the island. The day is content with itself, and its habitants are content with the day itself.

My first few days here have been tough. I trudged through shit hole apartments, looking for a place to stay. But after looking I began to think there was nothing good left in the world. That the dirty floors and fluorescent lights, hot pan kitchens and slumlord landlords were it. My scope became the size of a bee stinger. I was looking for everything bad. And it all flew back and stung me, worst of all I don’t even think there are any bees here. I was suffering. I wanted out. I didn’t want to go back to school. I didn’t want to become a nurse. I wanted to go home, where life felt easeful. That was before I came to look at the house on Ferdenand St. in the Manoa valley.

The Manoa valley is like a prehistoric park. The mountainsides must have dinosaurs and wooly mammoths crawling their hearth. Banyan trees grow roots up and down, until they are fully connected with the soil. Broad leave plants look like forest thrones and black clouds sit like umbrellas over the valley. I came to Ferdinand feeling defeated and unwanted. But I walked into the beautiful home on Ferdinand St. to meet Tom, a husband, yoga teacher, father of two and a nurse. His wife Katina, an anthropologist, and himself were renting out the studio above their lofty suburban prehistoric beautiful home. They had wood floors and Buddha statues, a bookshelf full of new-age enlightenment texts and best of all two cute kids. The studio was idyllic, with a beautiful view of both Honolulu and the valley. I immediately took the place even though it was over my budget. It felt right, like I had finally arrived home. I told Tom that I was happy to exchange childcare in exchange for the stay, in which he responded, “we don’t really leave our children, we do everything together, as a family.” It was then I knew that I would be here for the next year, living life as openly as possible, staying away from the non-existent bees and exploring my own inner and outer island. I will learn to care for sick people here in the Pacific Basin as I work through my own dis-ease, while at least enjoying a little taste of paradise.

There’s much to dispose of in paradise; expensive clothes, bad hotel infrastructure blocking views of the ocean and housing zombie shoppers. The Hawaiian people stand out here more than the foreigners. They have full eyes, which welcome and warm you. They greet each individual with the care each individual deserves; this is something I have yet to learn. On Sundays families pitch tents along Ala Moana Park and barbeque all day. They bring fishing poles, food and family. I jog past them at 7 am as most of the families have already grabbed their site for the day. Schools of fish follow rocky edges along the shoreline and weave in and out of the harbor’s boats. Old white men with round red bellies climb onto their sailboats and chat the morning away with their friends. By this point I am ready to indulge in some tourist activities, like parasailing, overpriced surfing lessons and a tan at the pool. But instead I opt for the Hawaiian lifestyle, which includes eating fresh pineapple by the beach and relaxing. It truly is the simple things in life. Having my mom here has been a blessing, she has helped me trudge through the murky waters here to settle me in. We’ve spent a lot of time getting lost in the car, trying to avoid mopeds and crazy foot traffic. We toured around the beautiful University of Hawaii, which is laden with trees, grass, a few surfers who probably rarely even make it to class. I picked up about 200 lb.’s of books, which should keep me busy over the next few months and I secretly stressed out but eventually decided to avoid the “Fall Fear,” I’ve seemed to accumulate over the years. We picked up my friend Molly, who grew up down the block from me, but we never even knew it. She’s already a good friend and outdoors buddy. We built trust in each other before even leaving the mainland, where did some Bay Area rock climbing. Now I am putting my trust in her to teach me the waves. She has promised four days of surfing lessons. Wish me luck.

The Ocean is its own beast. It is a basin of fluid salt and water that sits above a mostly unknown world. Water makes up nearly 80% of the earth. We don’t give it nearly as much respect as it deserves. I have always feared the ocean. It takes me at least a few days to build up my brevity enough to get in. But here, I got in immediately. I had to take the plunge. This morning I jogged a few miles west to a beach where the locals swim. I went before anyone was up. There was nobody in my tiny cove, which blocked the ocean from entering the pool. The waves crashed against rocks and my body crashed against the tide. We were symbiotic in movement, and without the waves push, I was immobile.

It will feel strange once my mom leaves, I will be autonomous and independent again, but will have the lost the control I felt at home. There is no use in hanging onto it, because it was gone as soon as I sold my car, left my family, friends, my dog, jobs and my whole community. I pulled out my stethoscope to remind myself of the last time I did this. I remembered the Chinese people in the Yunnan province who were so grateful to get the medical care they needed, and my own gratitude for their warmth. I can already see the need for care here on the island. There are many homeless people here, ex-pats, mentally unstable peddlers, obese families, smokers and alcoholics. It reminds me of China. I wonder about what steps the government has taken toward prevention, the community attitude toward individual health and public healthcare. But it seems like the Hawaiian’s don’t stress about much, which may be the healthiest way of life anyway. It is sad to see the island covered with McDonalds, Subway, and Dairy Queens. The food that actually comes from here is so healthy and delicious. The Dole plantation is only a few miles away from here, bearing the sweetest pineapple. The island grows avocados, mangoes, sprouts, peppers, cucumbers, kiwis, and seven different kinds of melons, cilantro and lettuces. The fish are so fresh and the mussels and shrimp are some of the tastiest I’ve ever had. Mahi Mahi, Tuna, Salmon, Tombo shark, clams, crab, lobster, the list goes on. They don’t have much wheat here, and I have been on the look out for Poi, since I am one of the only foreigners and locals who actually enjoy its texture and taste. As the young boy at the supermarket exclaimed, “you really like it? It tastes like wall paste.” But I do, I like the oddities. They also have lots of pigs and wild chickens, I have yet to go foraging for eggs but it is on my to-do list. I talk about the food in relation to health, because I truly feel it is the greatest predictor of our lives. If we take the care to prepare meals that come from this island it brings not only physical health, but also a satiety and fulfillment in the moment, the day, the year, and the lifetime. Roasted shrimp with sweet corn, an avocado and cilantro salad, pineapple sorbet for dessert; there is no better way to eat here than by what grows here. This is an ideal and philosophy I learned at home in Berkeley, but practiced all over the world, in Costa Rica, Thailand, Indonesia, China, Europe, New York and now in Hawaii. It is our duty as citizens to take care of the earth. I feel for the Hawaiian people whose island is trashed by foreigners that eventually leave with more than they’ve given. I will do my best to give back.

Just lying on the beach, it feels like Oahu is giving back. This island is Kapha, which in Ayurveda symbolizes the weighted element of water. Here the people reflect Kapha with large bodies, laidback attitudes and personal warmth. This is such a nice change of pace for me coming from a Vata city, which in Ayurveda symbolizes the hurriedness of wind. When these two elements are balanced then Pita is created, symbolizing earth and fire. Kapha, Pita and Vata doshas are best when all three are balanced in the individual or place. I am slowly finding my balance here through the moisture and heaviness of the island.

The more remote areas out of Waikiki, toward Kailua up north, or toward Diamondhead, which is East, hold vast landscapes and ocean views. The drive east is reminiscent of Highway 1 in California, and the road into Stinson beach. The coves on Oahu look Neolithic and full of treasure. I still have yet to see a rainbow, but I hear there is treasure at the end of those too. My yoga teacher this morning enlightened the class about how to create a feeling of treasure and brightness in our own lives. Every morning my teacher peers at the crystal hanging in her kitchen. The crystal absorbs light rays from the sun in one highly concentrated spot and from there shines light in all directions. This foundation is the potential of the human body. When we become humble and warm, when we hug in our value, we can then extend them out creating light for everyone and everything around us. But we have to cultivate a practice of hugging into various places in our body, mainly our heart.

Studying heart disease both in China and here in Oakland were such eye opening jobs for me. When I look back on the hundreds of blood pressures I took, sometimes in one day (in China), seeing hypertensive patients became the norm. This is scary. Heart disease is often congenital, leaving the patient little option but surgery to fix it. However secondary heart disease is often caused by lifestyle. Diet, physical activity, stress, drugs and alcohol; these are the things that cause heart disease all around the world, with China leading. Heart related problems and disease is the number one cause of death in the world. The heart itself is vas network of veins, arteries and tissues that pump blood to and from the body back to the heart, without this network we are dead. But there is the bio-spiritual heart too. The one we grasp when we feel pain or sorrow and the one we think of when in love. The spirit of the heart is just as important as the heart itself. How then can public health change attitudes toward preventative disease? This is the question I hope to answer and why I am here in nursing school at University of Hawaii. There has to be a paradigm shift in values in both the culturally isolated and non-isolated mainland areas. The change needs to be large-scale, like when the ocean floor or plate tectonics shift to create mountains, volcanoes, or even earthquakes and tsunamis.