Duality of Life

Duality of Life by Sona H. Mahal USCF RN

The photo above shows my “spiritual” path with entwined circles at the Parnassus campus of University of California, San Francisco. It connects the multilevel Parnassus parking garage to the medical center across the street. Each day, this path takes many patients and family members to their destination in our multi story hospital surrounded by several smaller buildings spread across the hill. The hospital is a century and half old structure with great architecture that is interconnected with its adjacent buildings, the inside is often called a “maze”. Same path is crossed by healthcare professionals, medical students, researchers, care partners, and many more.

As for myself, this path has been my anchoring ground for close to two decades, a healing place for my tireless feet working many long night shifts at different jobs. After exiting the often crowded elevators, most people headed to their destinations while some wheelchair bound or slow walking folks stayed behind, and so did I. The cold breeze from this foggy part of the city (yes, even during summer!) often had a spiritual reminder to take a journey into the heart. On that journey inward, I reflected on the many witnessed dualities of life. 

Over the years, I believe my maturity as a middle-aged woman and longevity in Nursing has deepened my insight on the Duality of Life, which I found in these entwined circles on my beloved path. I thought of each circle as life unfolding in two ways for patients and their loved ones…and all those who crossed this path with me at their own pace.

Some patients who came to our hospital were healed while others transitioned from life to eternal rest. Some family and friends crossed this path to take their beloved one home, others came here to say last goodbyes. Maternity ward was often cheered by the overhead chime to welcome each newborn to life; simultaneously, a falling leaf was placed on the door of parents mourning the loss of their baby whom they never heard crying. One patient arrived at the hospital to receive a long-awaited organ transplant to have another chance to live while their donor’s body was prepared for organ donation after losing its rhythm to life. 

On the north side of my L shaped nursing unit, a patient was getting multiple heart compressions to restore the blood flow back to life while on the east side a patient miraculously woke up from the medically diagnosed coma. Each evening, the brain tumor neurosurgeons came to visit their patients for a post-operative check. Some patients heard the pleasant news that most of the tumor was resected and the rest would be eradicated with non-surgical modalities; however, others received the referral for Palliative Care services. In other words, there was no hope so only supportive care was recommended to alleviate the suffering from tumor related symptoms. In those moments, I learned the skills to be dual with my tone of voice and body posture to remain present for each patient in their given situation. Yes, some shifts left me feeling like an actress switching emotions to suit the situation in each patient’s room.

One of the most surreal but unforgettable moments… When I congratulated one of the female nurse colleagues on her first pregnancy, I turned around and there was the other nurse who had just returned from her bereavement leave after the loss of her first baby girl “Molly”. It was that moment when I was caught off guard and had no time to even switch my emotions to acknowledge the duality of her life, all I felt was the shooting pain from the heart settling into my gut leaving me speechless.

            Regardless of the difference between my journey and others who crossed this path with me, I learned to hold space for joy and sorrow, gratitude and despair, success and failure, birth and transition from life, forgiveness and resentment, and for the sacredness of human tears including my own. I held space for myself with my wins and losses as a single parent, duties as a caring daughter of elderly parents, and the woman inside of me who has managed to hold on to her passion for life, and the nurse who has not given up on improving patient safety.  Most living things dissolve to evolve over time…just the mysterious nature of duality. Now thinking of my life in the early 90s…I was a non-English speaking, young immigrant, single mother from an abusive arranged marriage. All it took was one winter night for my then life to start dissolving, and I started to evolve into becoming a caring human with all the freedom one can imagine.

Some days, the end of the path (right before crossing the street) with a soft yellow street light bulb was the perfect selfie spot for extra mood lift and sense of pride with the hospital sign behind me. It made up for the exhaustion from working night shifts. Stepping into each colorful circle felt like an invitation to walk on the “red carpet” of my night shift nursing life and to reconnect with my purpose while allowing the surface underneath to ground my feet in the present moment. In each circle, I recited a loving kindness meditation from the depth of my heart –

“May all patients find comfort and healing sleep tonight.

May all doctors, nurses and caregivers have the courage to reconnect with their caring spirit when feeling the bursts of Compassion Fatigue.

May the Code Blue Team find strength and wisdom to rescue those in need.

May all patients be safe in our care and their loved ones feel supported.

And then I held space for those patients whom I can never forget, especially the ones with glimmers of hope in their eyes despite baldness and fatigue from chasing cancer cells with endless and brutal chemo rounds.

Lastly sent compassionate awareness to myself…may this heart continue to warm up to patients and their loved ones, may the hands open up to provide comfort and healing, may I be surrounded by the loving-awareness to treat all patients with respect and equality, may the right foot continue to hold space for its vulnerable buddy on the left, may the third eye of wisdom continue to become the guiding light for providing safe nursing care.”

By the time I reached my home unit Neurosurgical Intensive Care on the 11th floor of the Moffitt hospital, I felt surrounded by a special spiritual energy that kept me grounded throughout the shift and I stayed mindfully present for patients and coworkers. As a nurse with a relentless passion for patient safety and wellbeing, I considered myself at risk for having compassion fatigue. Though, I felt fortunate to have had the opportunity to learn a few effective ways to combat that by staying emotionally present for others and mindfully tuning into my own emotional wellbeing at work. A special thanks to my nurse colleagues Yelena and Louise for showing us ways to combat compassion fatigue at work.

Today, I hold space for all caregivers and healthcare professionals wherever they are in their journey as we continue to evolve in the post-pandemic healthcare. In gratitude for finding a path that allowed me to embrace the ordinary human in myself and recall my purpose for being in healthcare.

A proud UCSF RN and Patient Safety Lead Coach ~ Sona Mahal.

Sona H. Mahal is a proud UCSF RN and Patient Safety Lead Coach. She has been an RN for 20+ years with experience in oncology, bariatric surgery, medical-surgical, neuro intensive care nursing, and patient safety and quality improvement. Improving patient safety is her purpose for being in healthcare. She likes to hike, meditate and create healthy cooking/baking recipes.

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