This case study is based on a real story from Dr. Walsh’s recent shoulder surgery. It is designed to raise awareness for the practical application of mindfulness in real life, so you can also use it to help you.
An agonising moment at the gym several months before had initiated a chain of events leading to me having surgery on my left shoulder. A bench-press had gone terribly wrong, and two tendons had been ripped off the shoulder capsule. They had to be reattached. I had rather stupidly waited quite a long time between the gym incident and seeing the doctor. This meant the operation was going to be somewhat more difficult. The surgeon was not overly optimistic but encouraged me to have the operation, as otherwise I was doomed to chronic osteoarthritis in my shoulder.
The meditation session before surgery
With this in mind, I sat down to my last formal meditation session on the morning of my surgery. As I have been meditating for years, it was not difficult for my mind to find its usual focus. I must admit I gave a lot more attention than usual to my left shoulder. I thought it deserved some tender affection, given that it was about to be assaulted by scalpels and other sharp instruments. I felt my breath moving up into the area where my torn muscles were, and I paid exquisite attention to all the subtle sensations I could feel there - the niggles, the pain and the tingles. I was as ready as I could be for surgery.
I was well looked after in hospital. The staff were very warm and attentive. However, it was still very strange waking up after two hours of surgery, not feeling the passage of time like you do after a normal sleep. Amazingly, the surgeon had been able to rejoin everything. However, it was all very delicate and tenuous. I was going to have to be very careful with the use of my arm over the following months, so as not to rupture the muscles again. Amongst other things, this meant I was not going to be able to drive a car for six weeks. There were going to be some major lifestyle adaptations - not something I was looking forward to!
Meditation after surgery 1: finding it challenging
When I arrived home from surgery the next day, my brain was still befuddled by a cocktail of anaesthetic and analgesia. Nonetheless, I attempted a meditation in the afternoon. While sitting on my meditation cushion, I found myself falling forward about to go to sleep, at least a dozen times in the 45 minutes I was meditating. I noticed by mind going off into a dreamy state. I think there were times when I actually went to sleep. I certainly wasn’t able to notice any subtle sensations in my body. It was quite different to the meditation the day before.
That night I needed some rather strong opioid pain killers. Consequently the next morning I was constipated. Then when I sat down to meditate, the most predominant sensations were a pain in my shoulder and a pain in my anus. Not very dignified! These are moments when non-judgemental open-hearted curiosity is extremely difficult! I noticed that I was suffering, I observed my suffering and had a little giggle at my own indignity all at the same time. Obviously, my clarity of mind was back, even though what I was observing was not all that pleasant.
Meditation after surgery 2: finding my way back
The next day my meditation was more of the usual clear focus for a while and then wandering and then coming back. As there was nothing dramatic, I was able to pay attention to subtlety again.
Meanwhile, I have plenty of challenges with mindfulness in action. I notice the irritations I feel when I can’t do simple activities such as tying my shoelaces. I notice the tightening in my chest when I resist asking to help.
And I notice the opening in my chest when I allow the help in. I am a doctor and a helper, and it isn’t always easy for me to allow others to help me. So I have begun a practice of allowing myself to breathe in others’ good wishes and help with an attitude of gratitude. Perhaps this is the biggest gift of all that my injured shoulder can give me.