The Anatomy of Forgiveness



First year of medical school, we learn the basics of human anatomy.  Bones, muscles, nerves, vessels…we learn the building blocks of what, for the osteopathic physician, are basic components of the masterpiece and symphony, which is the human body.

Just like any new endeavor, we first learn the basics.  What is a bone?  What is a tendon?  What is a ligament?  Which muscle is which? What is fascia?  What is the difference between an artery and a vein?  What nerve branches into what? Things that eventually become second nature to us must begin somewhere.

After memorizing the basics, we begin slowly weaving things together.  We learn to integrate the separate segments into a whole living and ever changing organism.

This integration is the key component to Osteopathic medicine; a skill that develops over time.  We take extra classes, read extra books, and most importantly use our hands to learn directly from our patients.

Lately, I’ve been watching a lecture series called, “Human Embryology” by Dr. Brian Freeman, PhD.  Twelve intense hours of in-depth and step-by-step analysis of human development, from what Dr. Freeman calls a, “biodynamic perspective”.

What does Dr. Freeman mean by “biodynamic perspective”?  Simply put, rather than memorizing dates, stages, and structures like you might in a college embryology class, he explains the developing embryo in a functional and integrated way.  For example, instead of simply stating, “the myotome develops from the somite” he explains how the development occurs and how one cannot develop without the function of the other.

Don’t worry if you have no idea what a somite or myotome is.  My point is the importance of understanding how different parts of our development are affected and influenced by the other.  The entire embryo acts as a syncytium; a group of cells clustered together constantly shifting depending on environmental stressors.  A beautiful ballet directed by forces science is unable to quantify at this point in time.

I find this information valuable because it gives me a unique perspective into my osteopathic treatments.  Who is to say our bodies ever stop operating as the embryo?  Who is to say the music has an end? Sorry Don McLean, your song is catchy but I respectfully disagree.

In addition, a lot can be learned about how we function as adults by how we develop as an embryo.  For example, nerves supply the nutrients that help form developing muscle cells.  Therefore, if I diagnose a dysfunctional muscle in an adult, does it do them any good for me to simply treat the muscle?  Or shall I first treat the nerve that innervates that muscle?

If I haven’t lost you by now, you may be thinking, “what on Earth is she talking about?” or alternatively, “wow, that makes a lot of sense”.  It all comes back to the basics- “Anatomy, anatomy, anatomy!” as A.T Still would say. Bones. Nerves. Muscles. Vessels. Fascia. Organs. Connections. First year of medical school.

The funny thing about anatomy (and embryology for that matter) is that it is always changing.

What?  Yes.  Changing.

New discoveries are made all of the time on both the gross and microscopic level.  New connections, new structures, new functions…You would think that something like anatomy wouldn’t change over the years but it does.  Anatomy is a science and science changes with new discoveries.

Last year, I went to a 4-day conference that focused only on fascia, the spider-webby stuff surrounding all of our muscles, nerves, vessels, bones, and organs.  4 days of nothing but fascia! Some people were saying that fascia is the key to existence.  Others were saying it is garbage.  Bottom line is it is there.  We can see it, touch it, analyze it…there is no manual to tell us why it is there and exactly what it does.  We have to study it to find out.  Trial.  Error. Study.  Analyze. Re-analyze.  Thus is life right?

I decided on January 1st, 2013 that this year I would learn and integrate into my life the process of forgiveness.  Wow, did I just change the topic?  Yes.  And no.  Just bare with me.

I came to this decision based on knowing that when someone hurts me, I tend to not speak to, ignore, and distrust the perpetrator for an in-definite amount of time.  Depending on the person, my relationship to them, and how badly they hurt me, the time ranges from weeks to years.  I’ve been this way for as long as I can remember.

As a woman traveling on an exponential spiritual path, I figured it is about time I tackle this trait of mine once and for all.  My growth as a woman and healer will be hindered until I figure it out.

Forgiveness.  Easy enough right? One New Year’s resolution…I can handle that.

Handel yes, easy, no.

As I started to ponder forgiveness, I realized that just like anatomy, it becomes a lot more complicated the more you study it.

I knew I had to start with the basics.

What is forgiveness?  Forgiveness is defined as, “the renunciation or cessation of resentment, indignation, or anger as a result of a perceived offense, disagreement, or mistake, or ceasing to demand punishment or restitution”.  Okay…what does that mean?

What is the difference between forgiveness and compassion? Between forgiveness and suppression? Acceptance? When do you know if you have forgiven versus forgotten?  In what circumstances is forgiveness essential?  And lastly, can you forgive someone and still not trust them?

Too many questions.  Too many worries. Not enough basics.

In comparing my thoughts and worries about forgiveness, I realized the ability to forgive comes down to a syncytium of few simple ideas.

Trust. Listening. Confidence. Strength. Acceptance.

Bones. Nerves. Muscles. Vessels. The Whole.

Lets begin with the idea of trust.

The majority of circumstances for which one needs to call upon forgiveness is when trust, the foundation, the backbone of a relationship, is breeched.  I’ve talked to a few people about this concept.

One person said that you should never trust anyone because eventually everyone will break your trust.  While this idea has some truth behind it, in my mind, a strict following of this rule would not lead to very many close relationships.  A fate I would rather not face.

Another person said that whenever she feels betrayed, she thinks of the moment when she betrayed herself first.  While this statement seems obscure, it rings with much truth.  In my experience, you always know, at some point, the truth in a situation.  Whether it is only a flash of a moment or a nagging feeling in the pit of your stomach.  “This person is not right for me”, or, “this person will steel from me”, or, “this is not the right place for me to be,” ext… the knowing is always there.  The catch is, do you listen to it?  Do you permit the nerve to fire the muscle?


Are you confident in your abilities?  Do you second-guess yourself?  Do you trust yourself?  Are you confident enough to listen to your inner truth?  Can you move your muscles the way your nerves intend?


Do you have the strength to believe in yourself?

Strength is essential to feed confidence.  A muscle cannot contract without energy.  Oxygen is essential for energy.  Vessels carry blood.  Blood carries oxygen.  Oxygen is necessary for energy production.



Most important part of forgiveness is acceptance.  Accepting yourself, accepting the other person, accepting life’s imperfections, and accepting life’s perfections.  Seeing the Whole for what it is.  Integrating all components into a working unit of function.  A syncytium. Finding the gratitude in learning from others and learning to be who you are no matter what the circumstance is.

And being proud of it.

This is the key component to forgiveness; and for me, the hardest part.

Perhaps it is because I don’t trust myself enough.  Perhaps it is because I don’t always listen to myself.  Perhaps it is because I am not confident all of the time.  Perhaps it is because I haven’t learned to love the things I hate about myself.

That doesn’t mean I will be this way forever.

We all started as an embryo and have grown into the perfect adult system we are today.  Most of the time, the parts work together as one, in synchrony.  Sometimes we hurt ourselves.  Sometimes we get sick.  Sometimes we need to give ourselves time to pull ourselves back together.  Sometimes we need help.

And that’s okay.

Our anatomy is always changing. We, as whole individuals, are eternally growing and adapting.

And come on… it’s only the end of February and I’ve been able to figure out at least the basics of forgiveness. I’ve got a whole ten months to shift through the details and connections.  That’s plenty of time to experiment, analyze and re-analyze.

Then I might have to start all over when the details change…

Again and again…

Life is perfect.




The first time I ever went snorkeling I was ten years old.  Fortunately for me, my my dad’s job led himself and my family to much traveling and many adventures.  Therefore, my first snorkeling experience was in the Great Barrier Reef off the coast of Australia.  Specifically off the shores of Hitchenbrook, a small island just south of Cairns, Queensland.

I remember the first time quite vividly.  The feeling of the wind in my hair, the smell of the salty ocean, and the sound of the waking waves on the nearby beach as Steve, our guide, led us in his boat around the reef.  The water was so clear you could see the sandy bottom and the massive islands of colors beneath the water’s surface.

I leaped into the ocean off of the dock of the ship; plugging my nose so it did not get filled with saltwater (a painful experience for any one who’s had it happen to them).  Slightly panicked, my breaths became shallow and quick, hyperventilating.  My brain was having a hard time comprehending the fact that while I was underwater, I could still breath.   My legs and arms flailed.  My heart raced. I was afraid to take a real breath.

Slow and deep breaths Shana,” I kept telling myself.  It wasn’t until I thought I was going to pass out that I listened to my own advice.  I stopped flailing around and forced my lungs to expand and relax slowly.  I opened my eyes and awakened to a whole new world in the deep.

Life was everywhere.  Colors were more vivid than even the most realistic television shows (before HDTV and Planet Earth DVDs).  To better date myself, I felt like I was Ariel from the Little Mermaid except I started out human and had turned into a fish.

Suddenly, right in front of my face, a small jellyfish glided by.  Quickly, I realized I was surrounded by hundreds of small jellyfish.  Panicked, I emerged to the surface and yelled for Steve.  He assured me the jellyfish were not poisonous and I could touch them if I wanted.

Naturally, being the curios child I was (and still am), I dove back under the water to observe the jellyfish.  They moved so delicately and smoothly.  Like little parachutes set sail in the wind.  I caught one of them in my hand and its tentacles stuck like fly paper to my palms.  I cupped the small creature in my hand.  It was so light and soft. It would have been impossible to tell I was holding anything at all if I wasn’t looking straight at it.  I remember thinking, “Wow, how has something so soft and delicate survived millions of years in the violent ocean waters?”

Jellyfish are some of the oldest living organisms on the planet.  They have been cruising Earth’s oceans for more than 500 million years.  They are in the phylum Cnidaria; the second phylum on the evolutionary tree, secondary to sponges.  They have survived earthquakes, the demise of the Dinosaurs, the Ice Age, the rise and fall of Rome, nuclear waste, and global warming.

There it was.  Millions of years of evolution. Sitting in my hand.

Then, it spontaneously ripped right in half.

I felt awful.  There it was, floating along, minding it’s own business, when this ten-year-old American girl decided to come along and destroy it.  I couldn’t understand.  I didn’t squeeze it.  I didn’t poke it.  It just ripped…as if the pressure of my child hands was too much for it to handle.

I probably cried every night for a week after I did that.  I felt so bad.  I replayed the scene over and over in my head.  I could not figure out what I had done to destroy that little jellyfish.  How could it be that a creature that survived a meteor smashing into the Earth imploded after a child’s touch?  Was it too old?  Was it too young?  Was it having a bad day?  Do jellyfish even have bad days?

Lately, I’ve been doing a lot of yoga classes on by this woman who uses jellyfish as an example and analogy of how to move in, through, and from different asanas.  Jellyfish initiate wave-like motions from their center that move out to their periphery.  By doing so, a continuous current is created for the jellyfish to glide around in.  The current direction they are moving had to have been initiated from their center before their current trajectory took place…Jellyfish literally begin each movement of their life from their center, which is what makes them a great analogy for yoga asana and life in general.  By moving from your center, your truth, you too could last millions of years and handle whatever storm comes your way.

As I moved through the jellyfish practice on my living room floor, it finally it became clear to me what happened to that jellyfish 17 years ago.  The jellyfish didn’t die because of how hard I was holding it.  It died because my hands blocked it from moving.  It was stuck in space and literally collapsed under it’s own pressure.

By the end of my practice that night I was crying…only partly because of the memory of ripping the jellyfish apart.  I cried because I realized that so many of us, including myself, stop moving from our center when the pressure life throws at us becomes too high.  Many of us stop moving in general.

We look outside ourselves for support.  For answers.  For help.  For the easy way out.  The path of least resistance.

But that can only take you so far before you eventually break into pieces.

We alone are the only ones who can move ourselves through life.  Our choices must come from our own truth and no one else’s. It takes determination, strength, bravery, and clarity.

This is all easy to say in theory but when you are sitting here simply trying to function after working 65 hours in 4 days, it’s a different story.  Lately I feel it takes all of my effort and strength to simply brush my teeth at night.

I cried because I don’t want to end up like that little jellyfish.  I cried because I don’t want to end up like other’s I’ve seen who have cracked under pressure.  I cried because don’t want to give up who I am as the walls feel like they are closing in.


After my pity-party on my living-room carpet I made a decision.  A choice.

I’m in the flow right now.

I just have to remember to, “take slow and deep breathes,” relax, and open my eyes.  Who knows that will be there.  It might be surprising.  Something might be floating along and appear right in front of my face.

The tide is always there to ride.  We just have to ask ourselves to find it.

To accept it…

And that’s the scariest part.

(I took the above photo in Osaka, Japan)

Operation Roadrunner




We’ve all seen it.  Some species of rodent is being chased by a predator or waterfowl.  It stops, pulls a banana out of its secret kangaroo-like pocket, consumes the banana in one bite and leaves the peel on the ground. In close pursuit, the predator slips on the peel and falls…ensuring the rodent’s escape.

Growing up watching such cartoons, the inevitable five-year old Shana’s question arose: Can someone really slip on a banana peel?

Thus began one of many science experiments I performed in the lovely house across Lollipop Lake.

I knew while designing the experiment it would need to take place in phases as I usually only ate one banana a day.  The plan was as follows: I would leave a banana peel on a variety of walking surfaces- regular carpet, linoleum, grass, concrete, and lastly, the amazing 70’s style bright green shag carpet located in my parents’ bedroom; a six-day operation if everything ran smoothly.

The placement of the peel in the experimental location would be at the exact same time every morning (I always ate my banana with Cheerios for breakfast).  My 5 years old self’s design was brilliant. The only thing left to do was complete what I decided to call, “Operation Roadrunner”.

The first two days nothing happened.  No one slipped or said anything about the random banana peel left in the middle of the kitchen floor or on the outside back door concrete stoop.  On the third day however, Operation Roadrunner quickly decompensated after planting the “carpet” banana peel…in front of my sister’s bedroom.  

I was watching Donald Duck Presents in the livingroom when my sister stomped into the room and chucked the banana peel at my head.

“Shana!  Clean up your fucking trash!”

5-year old Shana: Abort mission!  I repeat, abort mission! Operation Roadrunner has failed!

Clearly I had neglected to consider the humanitarian implications of my experiment, the sanitary aspect and any medical issues that could arise.  I didn’t want to hurt anyone.  Or make the carpet smell like bananas.  

I learned an important lesson that day.  No matter how hard you try to analyze or predict the outcome of a situation, you can never know what is really going to happen.  You can only hypothesize, try, and hope for the best.

This lesson didn’t stop me of course.  I continued multiple experiments around the house, everything from growing mold in various environments to seeing which shampoo my cat Teilah liked to be washed with the best (unfortunately for Teilah, she was allergic to one of the shampoos I used and all of her hair fell out.)

Now that I’m older, I realize these childhood actions were integral components of my neuro-cognitive development.  A key to how my mind works?  Maybe.  However, if you think about it, most living creatures base all decisions and actions on past experiences and results.  If it hurts, don’t touch it.  If it tastes good, eat it.  If it smells bad, it will probably make you sick–Sensory input resulting in distinct and individually unique biological responses.  

Most of western society is based on this idea.  Does sex feel good?  Yes it does.  Do we feel good when we think of sex?  Yes we do.  Are you going to feel good when a product is advertised in a sexual way?  Whether we realize it or not, because our bodies are programed to enjoy sex and to even become thoughtless during sex, the thought or image of sex results in the feeling of desire. Therefore, even if he wasn’t in the market to switch cellphone carriers, if a man see a sexy woman in tight pink leather riding a really fast motorcycle, he may catch himself thinking, “Maybe I should switch to T-mobile…”  Ah, the wonders of programed desire. The perfect marketing tool…and a genius one at that.

But what exactly makes us interpret our experiences the way we do?  React in a specific way?  Form unique opinions about situations? Decide what movies we enjoy?  Which flavor of ice cream is the best?  

I would say the answer to this question is based on “experiments” we have done in our lives and our interpretation of results.

But what affects our interpretation?  How about the experiments?

Buddhists say every action we perform and every thought we think is the product of “Karmic seeds” we have planted sometime in our past.  This also implies that at the same time our thoughts and actions reflect our past, they will also dictate our future perceptions, actions, and thoughts.  Thus, we really are what we think (a book I highly recommend is As a Man Thinkith, by James Allen.  You can get a free audio version at:
It is only an hour long and well worth the time!).

As a spiritual woman and a woman of science, I of course have my own physical perception of how this idea works.

Our bodies are made of physical matter; atoms vibrating at a unique frequency to us.  We do not, however, exist in a vacuum environment.  The atoms vibrating to keep our solid matter together are also in contact with the air molecules around us, the floor we are standing on, and the clothes on our backs- all which are also vibrating at their own frequencies.  

At some point, my body molecules will collide with the air molecules, the clothing molecules, and the floor molecules.  What happens when two moving objects collide?  To keep it simple, (as there are infinite possibilities as far as angle and inertia) there is some trajectory and energy transfer between the two moving, colliding objects.  Pool and Billiards players understand this concept well.

That being said, our thoughts also produce energy in the form of waves.  These waves interact with atoms in the environment, creating movement and change.  The amount of change and type of change depends on 1) the nature of the thought (Creation), 2) the intention behind the thought (Amplitude), 3) how often you think the thought (Frequency), and 4) where the thought is directed (Trajectory).  

Is this starting to make sense?  How about real life examples.

About nine or ten months ago, I heard a story on NPR about a research project done at multiple hospice facilities looking at what people remembered about their lives and how their memories affected their outlook on life and death.  They asked multiple patients to audio-record their life stories…or at least what they remembered or wanted to talk about.  They then took the recordings and had close family members and or friends listen to the transcripts and comment on how close the transcript was to their personal recollection of the various events.

As it turns out, most of the time, the dying patient recalled their stories in a more positive light than what the friend or family member did.  For example, there was an old woman who talked about a vacation she had taken with her daughter.  She described it very positively and said it was one of her favorite trips she had ever taken with her daughter.  The daughter was flabbergasted when she listened to the transcript, saying her mother seemed to have a terrible time on the trip- they fought all the time, nothing went right, and her mother ended up with the stomach flu.  She didn’t understand how it was at all possible the mother could have said anything positive at all.

The most interesting conclusion the researchers came to was the more positive the recollection and telling of the life story, the longer the patient lived.  This finding was statistically significant even after taking into account the age of the patient and severity of disease.  Some patients had, what to a “normal” person would seem very tragic life stories.  However, as the study showed, the patients who recalled their lives in a positive light lived longer than those who remained dark and bitter in their final days on Earth.

Going back to how our actions and thoughts reflect our past and influence our future, can we say, according to this study, a positive disposition causes a longer life? It depends on how you want to look at it (or, per our conversation, how you are predisposed to look at it).  It is impossible to determine exact causality on most things in life.  All each of us can do is look at our own experiences, our own Operation Roadrunners, and come to whatever conclusion we feel resonates with us the most.  What more can we do?

And now for a personal example…another Operation Roadrunner if you will.

In the last two weeks my life has completely changed.  I started residency at a new hospital, moved to a small town where I know no one, in a state I’ve never been, located in a part of a country I know absolutely nothing about.  Everything that could possibly go wrong went wrong the moment I got here and I felt hopelessly depressed. Then, in the last three days, six different people who live here have vented to me about how depressed they are and how everything in their life is going horribly wrong.  And you know what? I started to feel better.  Not because misery loves company but because I realized that maybe the things that were happening to me and the thoughts I was having were a reflection of everyone else around me and I was reacting in the same manner they were.  I then decided my own thoughts and karmic seeds might have lead me to this place but I have total control of how I react and of the seeds I plant from here on out.  

I’ll do my best to stay positive.  I’ll be a good listener.  I’ll be a good friend.  I’ll be a good doctor.  And we will see what happens.  After all, in all the experiments I’ve done in the past, these things have always worked for me.  Why would it be any different now?

But like I said before, I can’t predict the future.  I can’t predict the outcome.  I can only stay positive, work hard, be genuine, plant good seeds, hope for the best…

and watch out for banana peels.

Sperm Karma


Okay Shana…just stay for an hour…make your appearance…say hello to people…then go home…it’s no big deal…

I rolled up to the front porch on my bike the Red Barron.  It was a typical Oregon March evening… cold, dark, and rainy.

I stepped off the Barron, carried it up the steps, and parked it behind a large bush.

I was going to a party celebrating the completion of my ex-boyfriend’s senior project: a movie shot completely in black and white film.  Because I had played a small role, I was invited to partake in the festivities.  I knew I wouldn’t know very many people but I figured it would be nice to come even if I just sat awkwardly in the corner.

I made my rounds of “hellos” and “who are yous” then parked myself on the living room couch.  Conveniently beside me on the end table was an Anatomy Jane doll. Perfect for a dorky science major to play with while the art and film majors got drunk and stoned in the back yard.

As I was struggling to fit Jane’s pancreas and liver back into her abdomen, the front door opened.  I looked up.

Time stopped.

Or at least if felt like it did.  Someone hit the pause button on my film projector.

There was no sound.  No movement. The second stretched out for what seemed to be an eternity.  It was like the scene in the movie, Big Fish with Ewan McGregor, when he is at a fair and he sees his “one true love” for the first time… popcorn suspended in mid-air as he moves it aside, one kernel at a time, until he reaches her…and speaks…

All of a sudden, I am standing and staring into the blue eyes of a stranger.

“What are you doing?  Is that Anatomy Jane? ”

“I can’t get her liver back in…” Blank… mind…blank…what the hell did you just say Shana?  Am I on drugs?  No…I hadn’t had as much as a sip of water since arriving…

“I’m David…who are you?” <not his real name>

My fingers fumbled around with Jane’s liver and colon.  I looked up and paused again…magnetized.

“Um…uhhh…sorry, what did you say?”

“Your name? Who are you?”

“Shana.  My name is Shana.”

“Shana? Like Shaina Medela? Beautiful girl. What a perfect name. Where is everyone Shana?  You are the only one here.”

I couldn’t move…yet somehow, we ended up in the backyard by the fire pit then at another party a few blocks away. I was having an out-of-body experience.  I felt like I was floating around in a giant bubble…bizarre.

It turned out David lived in a city about 5 hours away and was just visiting for the weekend.  Nevertheless, by the end of the night, we exchanged information and were together again by the following week.

My relationship with David was truly out of this world.  After only knowing each other for two weeks, we disappeared for a week together, traveling up the West Coast, biking, hiking, and camping on the beach.  It was the most intense relationship I have ever experienced.  Whenever we were together I felt like I was in a whirlwind.  I couldn’t figure out what direction was up, down, north, or south.

Things ended after five months when I refused to move in with him.  I was too much into my studies, research, and running to give everything up for a boy…I was only twenty for goodness sakes.

We saw each other three times after we broke up…each time a year apart. All three times I felt like the floor had dropped beneath my feet.  Although time had passed, the sensation never changed.

David is married to a beautiful woman now but we talk from time to time.  I still wonder what exactly those feelings I had were… were they real? Lust? Or just a strange Karma connection?

The only time I have felt similar feelings, though not in a romantic context, is when I am with my best friend Anna- my kindred spirit, my bosom friend. When Anna and I are together we lose all sense of time, place, and direction.  We spend hours walking together and making up stories; always ending up in spontaneous yet amazing situations and places.  We have been friends for twenty-one years and it is creepy sometimes how connected we are despite months of non-verbal communication and thousands of miles of distance.

I have heard many stories about how people recognize their soul mates or best friend.  Here, famous basketball player depicts the moment he saw his wife for the first time:

I walked into the bar after a game and all these guys were congratulating me…then one of my friends made some comment like, ‘I bet you could get any girl in this joint’.  I took the bet.  I looked around and my eyes immediately met this beautiful blonde woman in a red dress.  A few months later we were married.  My friends tease me because it turns out when you look at the security camera, she was the only woman looking at me in the whole place!

There must be something to this; this “time stopping” and “knowing” phenomena…yet others will say the father or mother of their child was simply a freak encounter or mistake.  Either way, in my opinion, there is Karma or something predestined about our relationships.

Last month I read an article in an embryology journal talking about how the egg (oocyte) actually CHOOSES which sperm will fertilize it.  To make a very complicated story “short” for non-science readers, here is how it works:

After the male orgasm, thousands of sperm will swim their way through the cervix, up the uterus, and into the fallopian tube to meet the egg.  The egg then sends out chemical signals to ONE SPERM telling the sperm: “come to me!” Once the sperm is close enough to the egg (in a zone called the zona pellucida), the egg makes a force field around itself, impenetrable to any other sperm.  Lots of other fun things happen and nine months later, presto!

The really interesting part of this story is the fact that oocytes are some of the only cells in the human body that are NEVER replaced.  Most cells like skin cells, intestinal cells, and even muscle cells will die and be replaced at one point or another.  Some say you are literally a whole new person after seven years.  However, a woman’s oocyes are fully formed within 100 days of fertilization!  Granted, a significant amount of these oocytes die.  A woman is born with one to two MILLION oocytes but during her reproductive years, a woman loses up to 1,000 oocyes per month, with only one actually being released at ovulation (sorry guys, but the cycle of sperm demolition and regrowth is only about ninety days).

This means half of you existed in some form while your grandmother was pregnant with your mother.  Your mother was born, went through childhood, puberty, learned how to drive, and had her first kiss while half of you was hanging out in her ovary, just waiting for the right moment to be released and meet your perfect sperm.

Now you might be thinking, “If this is true and the egg chooses the sperm and half of me is the egg, did I pick to be who I am? Why me out of the millions of other eggs?  Why that specific sperm?”

(Oh, did I mention your sex is determined by the sperm?  Yes.  Sperm have either an X or Y chromosome while oocytes only have an X chromosome.  If your oocyte chose the Y sperm you are a boy and  if it chose the X sperm you are a girl.)

This question can hold true for however you were conceived.  A test tube. A twin.  A one night stand…how did you create your sperm Karma? Or, if you have kids, how did your children create theirs?

Something tells me sperm Karma is a part of a much larger picture, perhaps too complex for us to delve into right now.  The bottom line is you are a mixture of your own Karma and the Karma of your biological parents.

As for my David Karma, I’m certainly happy it wasn’t sperm Karma.  Was the magnetic pull we had towards each other the night we met the same tractor beam the oocyte sends out to its perfect sperm?  Maybe it is.  But I think it starts before that…perhaps long before we are born into this life.

Regardless, my and David’s powerful attraction, hearing the story about the basketball player, thinking of my friend Anna, and reading the embryology article all lead me to this moment right now- typing this story.

And you are currently reading my typed words.  It doesn’t matter why you clicked on the link to my blog.  Whether you are an avid ShanaShow reader or you just thought the title, “Sperm Karma” was funny.  The point is my sperm Karma, your sperm Karma, our parent’s sperm Karma, and our individual past Karmas have led us here to this moment…thinking thoughts which will affect our future Karma, and maybe our children’s children’s Karma.

Kinda crazy right?

Six Hundred Variables


There are at least six hundred variables in the physical body acting to maintain homeostasis at any given moment.  Proteins combine and combust.  Hormone signals attach to intra and extracellular receptors to set off multiple chain reactions. DNA is created, altered, and destroyed. Glucose is stored and glycogen is broken down.  Six hundred different processes are going on simultaneously at this very moment so you can wake up every day, make decisions, think your thoughts, and live your life.

It is amazing to think about how if just one of these six hundred variables is changed, all hell can brake loose.  One amino acid in a sequence can make the difference between having normal blood cells or oddly shaped blood cells.  One toxin can affect a single enzyme, halting the body’s ability to create energy or carry oxygen to tissues.

Environmentalists would say this idea is akin to our planet’s various ecosystems; the “web of life,” or, “the food chain.” If one species is destroyed, no matter how small or insignificant it may seem, its absence affects how the entire world functions.  Flora and fauna die or adapt to survive.  As the climate changes, as humans pollute the air and oceans, as wilderness is groomed into city, the web shifts.  Plants, animals, and humans alike suffer.  If a butterfly flaps its wings in North America, it really is possible for a tsunami to happen in China.

Yet life always finds a way.

In the hospital, doctors can manage about twenty of the six hundred variables that make up our body’s microcosm.  With the aid of machines and various drugs, doctors can control everything from blood pH, the rate and contractility of the heart, how fast and deep the breath is, serum electrolytes, how much fluid the kidneys filter, what nutrients go into the body, and which are expelled.  By controlling twenty out of six hundred variables, people who would otherwise be dead are kept alive.

I do not consider pharmaceuticals a physiological adaptation but rather a representation of how we as humans view and manipulate our world.  If we don’t like the hot weather outside, we build a house with air-conditioning.  If we want to get from one country to another, we fly across the world in an airplane we created.  If we want to produce more food at a low cost, we genetically engineer plants and animals to fit our growing consumerism desires.  There is little consideration of how these actions affect the world around us and ultimately ourselves.

Who cares if thousands of children have developed allergies to foods they would otherwise not have due to genetic engineering as long as large companies are making a profit?  Who cares if I am destroying the ozone layer as long as I can live in the desert at a comfortable 70 degrees Fahrenheit?  Who cares why someone has high blood pressure if they can just take a pill to fix it?

I’m not saying that we should all go back to our hunting and gathering days of living in grass huts, foraging for fruits, and killing wild animals with our bare hands.  Innovation and changing our environment to suit our needs is part of what makes us human. Higher order thinking and problem solving skills have allowed our physically weak species to rise to the top of the food chain.  Often overlooked however, is human self-awareness.

Seeing sick people all day can really change your perspective on disease.  You begin to notice similar personality traits in people with similar problems.  For example, those with fibromyalgia are generally fifty-year-old women with kids that have left the home and a husband who is still working.  They tend to be very needy, complaining a lot about various aspects of their life.  I am not saying these things to be judgmental, nor am I saying this type of person represents 100% of the fibromyalgia population.  This is simply my observation.

The question then becomes, how do you treat this person with fibromyalgia?  Do you simply give them an SSRI or whatever else is in the fibromyalgia protocol and call it a day (SSRI=selective serotonin reuptake inhibitor=antidepressant)? If you are a doctor practicing “standard of care” the answer to this question is yes.  You write her a prescription and send her on her way.  She is still going to be needy.  She is still going to complain.  She is still going to have all of the personality traits that led her to this disease in the first place.  But this treatment follows our species-prone way of decision-making.  If we can manipulate our environment to make ourselves comfortable in a simple fashion with as little effort as possible, then we do it.  It doesn’t matter which of our six hundred variables we affect in the process.  Is this woman going to care if her sex-drive tanks, affecting her already strained relationship with her husband as a result of taking an SSRI?  I don’t know.  It depends on the person.

Now, in typical ShanaShow fashion, I am ready to talk about some articles I read and then throw in my “spiritual” or “cosmic woo-woo” plug to wrap all of this together.

A few months ago, I read an article (I think it was in the Huffington Post) about a woman who actually cured her spinal stenosis through yoga.  Those of you in the medical community might be thinking, “that sounds like a load of B.S”.  For those of you not in the medical community, let me explain why the medical mind might be thinking this.

Spinal stenosis is a physical problem you can see on an MRI.  The holes where spinal nerves travel through each vertebra in the spinal column calcify and narrow, impinging the spinal nerves causing intense neurological pain.  Usually stenosis is progressive, getting worse over time.  The woman in the article had gone to a neurosurgeon who told her that if she did not have surgery, she would not be able to walk within a few months.  Having seen many of these procedures myself, the surgery involves physically sawing the spinal foramen on the vertebra open to decompress the nerve, permanently destroying the bone.  This procedure relieves pain affectively in 45-90% of patients (yes, that is a rather large window if I do say so myself…).

In our humanistic and mostly physically based minds, why not just have the surgery?  Who cares if you permanently change your skeleton if the pain is relieved?  Never mind the well-documented viscerosomatic/somatiovisceral reflexes between internal organs and the spine…a system Chiropractors and many Osteopaths have based their entire belief system on.  So, you might get some intestinal problems after the surgery…what does it matter?  And does it matter WHY you got the spinal stenosis in the first place if you can fix the result via surgery?

Not wanting to go through such an invasive procedure, the woman told the neurosurgeon, “thanks but no thanks” and decided to try yoga.  Here is another thing that might make anyone who has had neurological pain cringe.  How on Earth does one do yoga with incredible neurological backpain?

First off, not all yoga is standing on your head and downward dog.  Yoga is about connecting your physical body with your mind, a sort of physical meditation if you will.  Just like anything spiritual and physical, it takes time to develop awareness and strength.  You can’t expect to be able to do everything your first try…or even your 100th try. It takes time and dedication.  But wait…that sounds much more time consuming and takes far more effort than going through a day surgery, right?

A few months after starting yoga, the woman in the article could still walk.  Not only could she still walk but also her pain had decreased.  A repeat MRI six months later showed a reversal of the spinal stenosis.  She her physical condition was getting better. She also noticed other changes in herself.  More awareness, more calmness, and clarity of thought…her whole being as it seemed had changed.  And she was happy.

I am not suggesting that everyone start doing yoga to treat physical ailments.  I am using this as an example to prove a point.  This point being that there are thousands of factors we humans do not necessarily have the mental capacity to acknowledge which affect the six hundred variables governing our physical body.

Our tendency is to manipulate physical factors we can see and touch in order to achieve a desired result, no matter the consequence.  Each tiny change we make can affect our entire life in a chain reaction, for better or for worse.  We often look for the quick fix because it is easy, effortless, and results in immediate gratification. Don’t kid yourself, that woman with spinal stenosis probably suffered in pain for months and worked her little mind off before she even began reaping the benefits of her effort.  But in the end it was worth it because she was truly cured of her disease and became a better person in the process.

There are many spiritual healing modalities and ways of life that work this way: homeopathy, osteopathy, yoga, acupuncture, massage therapy, religious studies, meditation…these modalities help you become more aware of the world around you, the world inside of you, and how these worlds are connected.  People shy away because most people cannot physically see instant changes or benefits.  And lets face it; it’s a lot of hard work!

It has been scientifically proven you can actually change how your brain is wired over time by changing the way you think.  This is the basis of psychotherapy.  A depressed person with the tendency to think negative thoughts works on becoming more positive and over the course of a few years (yes, years), thinking positively becomes second nature and the depression becomes a thing of the past.  Our thoughts emit alpha and beta waves, thus physically affecting the world around us (if you remember your physics).

Imagine how much things would change if everyone realized the power we each have inside of us.  Maybe we would stop throwing grasshopper genes into our tomatoes and cancer rates in this country would decrease.  Maybe instead of drugging our children to force them to pay attention in school we would focus on the real issue: how little attention is given to the educational system.  But then pharmaceutical companies wouldn’t be making as much money…it’s all connected.

How we treat ourselves, how we think, and the way we live our lives is reflected in our world around us.  The American obesity epidemic, our nation’s deficit, the polluted environment, our drugged children, and our shitty healthcare system are all symptoms of over-consumption, instant gratification, and greed.

Yet here we are, each and every one of us, with our six hundred chemical processes going on simultaneously in attempt to keep us balanced to ensure survival in this crazy world we live in.

The only thing we can do individually is be the best person we can at this very moment with our own actions and thoughts.  Whether it is having an intense spiritual study/practice, or saying no to that extra piece of chocolate cake.

Life is what you make of it.

All I’m saying is we might have a lot more control over it than we think.

Paying it Forward


Its 4:40am.  I slink around my sister and brother-in-law’s kitchen, using my cell-phone as a flashlight.  Do I have everything? Lunch? Check. Money? Check. Directions? Check.  3.5’’ heels? Check.  Cell phone? Check.

I zip up my wind proof jacket over my Banana Republic suit and slip on my Ugg-style sheepskin Costco boots.  It’s a little over a mile to the bus stop.  I better get moving to catch the 5:05am bus from New Jersey to Port Authority station in Manhattan.

It’s freezing outside, much colder than the 50 degree winter mornings I am used to in Phoenix.

I make it to the bus station by 4:50am, briefly considering taking up speed walking as my next sport to excel in.

There are a lot of people at the bus stop.  I always wondered what kind of people besides medical professionals are awake this early to go to work.

It is 4:53am.  A bus pulls up.

Shana #1: Is this my bus?

Shana #2: No…it can’t be.  It’s 12 minutes early!

People begin filing onto the bus.

Shana #1: Dude.  Shana.  That’s totally your bus. Get on that bus or you are going to be late!

Shana #2: It cannot be.  12 minutes early is crazy talk.

Man behind me: “Are you going to get on the bus young lady or what?”

Me <stupefied>: “Uhhh…”

The man behind me gets on the bus.

Shana #1: Shana.  Seriously.  What is your problem? Move your ass and get on that bus!

I look at the bus driver.  “Excuse me sir, what is the last stop for this bus?”

The driver closes the door and drives away.

Shana #1 and Shana #2: SHIT!

Half of the people are still waiting at the bus stop.  I’m internally freaking out.  How the hell am I going to make it to Brooklyn by 7am?  So much for this residency…

“Where are you trying to get to young lady?” One of the men at the bus stop asks me.

I look at him with tears welling up in my eyes.  “I have to be in Brooklyn for an interview by 7am”.

“Oh, and you wanted to go to Port Authority station?  Where in Brooklyn do you need to go?”

I tell him which hospital and the subway stop I need to get off at.

“Oh, just follow me young lady.  I’m headed that way.  The next bus comes in about 3 minutes.  We will get off at the George Washington Bridge, then we have to RUN to catch the A train…” he paused and looked at me in my suit and boots with one raised eyebrow. “We really have to run fast or we will miss the train.”

“Not a problem!  Thank you so much for helping me!”  I decided not to assure him of my athletic capabilities.

We sprinted across the George Washington station and leaped into the A train just moments before the doors shut.

As I sat down on the subway, I released a huge sigh of relief.  I felt so fortunate and grateful to have run into this nice man.  He didn’t have to help me.  He just did.  I love moments like these because I am reminded that there actually are nice people in the world.

We start talking and it turns out his daughter has a medical issue.  He is upset because he does not have the money to take her to see a doctor to find out if the problem is serious.  Fortunately, when he describes her history and symptoms, I am able to get a clear picture of her situation.  Feeling quite confident in my diagnosis, I give him an explanation of what I thought it was, what causes it, and what to do for it.

While it was not a big deal for me to help out (I just regurgitated things I had learned in school), the look of relief on his face I’m sure surpassed the look of relief on mine.  At that moment, it became clear to me why I had missed the first bus.  My faith in humanity had been restored (for a short time anyway), I was now going to be ½ hr early to my interview, and I was able to use my medical education to help someone.

As I maneuvered through the rest of my day and week, I became more aware of this, “doing good” equilibrium I have unconsciously created in my life.  Such as asking a homeless man to help me navigate the subway/bus station then giving him enough money for dinner, or giving a random person I met at the Phoenix airport a ride to their hotel located only a few miles from my apartment.  Paying it forward.

I used to wonder how it is I am so lucky.  Not to say I haven’t had my fair share of trials and tribulations, but usually, whenever I am in a pickle, help is not hard to find…in fact, help always seems to find me.

I never felt like I had much to offer anyone.  I don’t have a lot of money or nice things.  I am always the one to ask to crash on a couch, borrow something, or bum a ride.  The only things I feel I can offer to anyone are my brainpower, listening skills, and friendship.  Of course, I try to make it known my couch and kitchen is always available (if you enjoy my five major food groups of veggies, fruit, cheese, almond butter, and 88% dark chocolate).  What more can a girl living on student loans do?

I recently read this Yoga Journal article about the art of receiving.  It was a relatively short article talking about how the ability to receive a gift without question is actually very hard for some people.  You can easily get into the habit of refusing gifts without even knowing it.

Say someone gives you a compliment like, “wow, that speech you gave was really wonderful!” and your response is, “Ahh, it was nothing.”  By saying that, you are refuting the kind words someone was trying to give you, as if by saying, “you are full of shit.”  Instead, it is better to accept the compliment and let the compliment make you feel good in the present time, not worrying about reciprocating right away.  Their time will come, as will yours to return the favor. Paying it forward.

I realized after reading this article I am guilty of being a bad receiver. My tendency is to worry about how to pay them back right away, over think the person’s motives, or sickly believe I don’t deserve the gift.

I then decided to make one of my new personal growth goals to be a good receiver.  So far, it has been going fantastically!  Not only have I been receiving more gifts than ever before (and by gifts I mean everything from compliments to physical support), but I have also been giving more gifts than before, which is actually an even bigger gift to me because my favorite thing in the whole world is making people feel good (which is why I chose to be a doctor).

I have always felt an appreciation for complements and support; however, I would feel awkward and uncomfortable.  I enjoy these gifts more now that I simply let myself receive in the present moment without worrying about the future.

I am also much more aware of the appropriate times to pay it forward.  I smile at someone who looks like they are having a bad day.  I hold someone’s hand as they awaken to find themselves hooked up to a respirator in the ICU.  I reassure my friend that everything will be okay when the world seems like it’s crashing down.

I have always done these things…I am just more aware of it now. I now watch myself as I paint each brush stroke in the intricate masterpiece of give and take.

In the end, we all win by receiving and paying it forward because in my opinion, you need one to really appreciate the beauty of the other.

(This painting is from Aesop’s Fable, the Mouse and the Lion)

Behold, the Power of Cheese


I’ve always been the kind of gal who wears her heart on her sleeves.  Growing up, I never left my emotions a secret.  If my feelings were hurt, I would cry.  If I was happy, I laughed…loudly. In the third grade there was a 5th grade boy who always called me fat and ugly…until the day punched him in the face.  I was never afraid to tell anyone what I thought or how I felt.

As I matured through high school and college, my emotions continued running the show.  I have never been one to get violent or yell (except that time in the third grade), but laughing, crying, and showing my emotions is just what I did.  It is who I was.

I always wondered if people felt emotions as strongly as I did.  No one else seemed to be as excitable.  Often, I felt that even though I let my emotions show, what I showed was only about 10% of what I actually felt inside.  I thought if I really let out how I felt, I might explode.

I used to tell my ex boyfriend, the last guy I dated (and most serious relationship I’ve ever been in), “I love you!” every time we parted.  I could feel my eyes get wide as I said it, and as the words left my lips, I felt my heart nearly jump out of my chest.

One day he said, “Shana, why do you always say ‘goodbye, I love you’ like you are never going to see me again?  I’m going to see you again in like five hours.”

He looked at me with the, “you silly girl” look on his face he often gave me whenever I got excited about something.  I didn’t know what to say.  In my head I thought it was normal to tell someone every day how much you love them. So I did. Plus, how could we be sure we would see each other again in five hours?  Maybe I watch too many romance movies.

“Oh, I didn’t realize I did that,” I giggled, smiling back.  But it was a lie.  I had thought about it.  And through my smile, I felt his question and the look he gave stab me in the pit of my stomach.

4 years of medical school later, I feel like a changed woman.  It isn’t that I am no longer an emotional person.  I still am.  I am just a lot better at hiding it.  Too much better sometimes.

Thus is the topic of this ShanaShow.

When starting medical school, we are lectured about how much our lives are going to change.  They told us a lot of things but really stressed the importance of not loosing ourselves or ignoring friends and family.  Rumors of students getting divorced and loosing important, close relationships turned out not to be rumors.  There are no words I can say to describe the overall life changing stress of medical school and becoming a doctor. However, I can explain one thing now; a common issue (I’m sure) for many people in medicine.  The issue of emotions.

I remember the first terminal cancer patient I saw.  It was the fall of my 2nd year at the family practice clinic I was “rotating” at for the year.  Dr. Smith (I will not use his real name, although he is a really great doctor) asked me to do a history and physical on a patient he had.  I did not know anything about the patient before opening the door to the room.  Behind the door sat a young, good-looking guy around 34 years old in a wheelchair.  It turned out he had just had multiple surgeries for metastatic stage 4 osteosarcoma (bone cancer).  I felt so weird, talking and joking with him while I was doing his history and physical.  All I could think in my head was, wow, this guy, who is only 10 years older than me is going to be dead in 6 months.  What do I say to himHow am I supposed to act?

Of course, I acted natural and cheerful the entire encounter, as did Dr. Smith when he entered the room.  I couldn’t believe myself as I said, holding the door open upon his departure, “Well, it was really nice meeting you.  See you later!” See you later Shana?  There is no later for his guy! 

He looked up at me, smiled, and said, “The pleasure was all mine young lady. You are going to be an excellent doctor.”

At the end of the day, Dr. Smith always asked me, “So, tell me one thing you learned today.”  Usually I came up with some medical jargon or treatment plan.  But that day was different.

“Today I learned how hard it is to talk to someone you know is going to die… Especially when there is nothing you can do to help them.”  I looked up at Dr. Smith.  I could feel my eyes starting to well up.  Don’t cry Shana.  Don’t cry.  He sees this every day.  Don’t cry.  I didn’t cry.

“What are you taking about Shana?  You did great.  Don’t worry about it.  You smiled and laughed with him.  You treated him like a normal person.  Studies show that what terminal patients have the hardest time dealing with is not the fact that they are going to die.  It’s that no one talks to them.  No one talks to them because they don’t know what to say.  You did the best thing you could have done for him.  You can’t think about the fact that he is going to die.  Right now he is alive and I’m sure he appreciated seeing your beautiful smile and hearing your funny laugh.  You can’t let these things get to you or you will never last as a doctor.”

I will never forget what Dr. Smith said to me that day.  Nor will I forget the first terminal patient I saw.

Over the course of my second year, as I saw more and more dying, hopeless, and traumatized patients, I had to figure out ways to not get emotionally affected.  When I was younger and I did not want to cry, I always thought of a commercial on TV that really irritated me.  My oldies but goodies are those, “Behold, the Power of Cheese” commercials they used to make.  Yes.  It’s true.  What do I think about when I have to tell a mom we can’t see her baby’s heart beating?  The power of cheese.

Overtime, I have resorted to the power of cheese less and less (it is reserved for only really tough situations).  I don’t think I have become cold, just more protected.  Over my second year and beginning of third year I have built, brick by brick, a protective wall to hide behind.  My problem is I have always been an emotionally sensitive person.  Naturally, I began hiding behind my brick wall not just at the hospital but also in my personal life.

By the beginning of my 4th year, I had built an entire brick house.  In that house, lives the little girl I used to be.  A girl who only comes outside to play when the external environment is a perfect, sunny, 70 degree day; when she is either alone or around people she deeply trusts.  And sometimes not even then.  I’ve changed from the girl who never looked before leaping into the girl who measures everything from the barometric pressure to the phase of the moon before taking a single step.

I still feel everything the same with the same intensity.  The sadness, the sympathy, the happiness…but the feelings are stuffed in the house all day.  I open the windows to relieve the pressure when I run or do yoga.  If I don’t do that every day, the pressure builds up inside and I become pretty dysfunctional.

It’s interesting to see how doctors deal with the emotional side of the job.  Or don’t deal with it.  Some attendings become cold and callous.  Some make jokes and laugh about the horrific things we see every day.  Some don’t try to hide their feelings at all, while others are pure evil to medical students and residents.  I have worked with all of the above.  There have only been a few who act like normal people around the patients.  However, in our solitary interactions, they confide that they never get used to tragedy…but it is part of the job.  I think there was a scrubs episode about that.

As a student and soon-to-be young doctor, I am still trying to figure out how to balance everything.  I am often thankful I am not in a relationship or have kids because I’m not sure how I would handle it.  Would I be distant?  Or air out the house when it is not appropriate?  Would I say every single, “I love you” like it was going to be my last?  Or would I not say it at all?

Sometimes I listen to people’s conversations about things that are bothering them and I can’t believe the thoughts that go through my head.  You are bummed out because you farted at a meeting?  Quit your complaining.  There is a guy in the ICU who has scrotal edema so bad we can’t find the tip of his penis and he can’t pee. Or, you can’t run because of some tendonitis?  Well there was a guy in the ER last night who was impaled in the head with a lead pipe and how he is literally missing half of his face.

True stories.

What stops me from turning my head and talking some sense into these people is the thought that, although it may not seem like a big deal to me, for some people, farting in a meeting can be just has horrifying to them as I felt assisting in an autopsy of a dead, at-term pregnant woman, or telling someone the cancer we thought was localized to her left ovary had actually spread to her peritoneum and stomach.  Maybe having tendonitis is the most horrible thing that has ever happened to them.  Who am I to judge?  All I can do is be there, listen to their story, offer advice, and treat their drama like it is the most important thing in the world. Because to them it is.  Then again, this is coming from a girl who has soiled herself in front of a stadium full of people just to win a 10K…but that’s another story.

I often find myself switching into “doctor mode” when talking with friends and acquaintances.  I know I look normal on the outside.  I smile, give advise, make some jokes…but inside I feel the little girl run into my house, slamming the door shut; a move I must have made many times in my last relationship without realizing it (when I wasn’t thinking about the power of cheese…).

What I hate the most is when I do this with people I really care about.  But honestly, that’s when I need to do it the most.  Why do you think there are laws against doctors treating/operating on family members?  Because it is too hard to separate your emotions from a medical situation and a person you deeply care about.  I’m willing to bet that most surgeons would quit if we did not drape the patients in blue and cover their faces in surgery.  It isn’t just for sterility we do this.  It is also to separate what we are trying to do to save their life from the real person underneath.

I know I am not alone in this dilemma, although I have never actually talked to any other young doctors or students about it.  I can, however, see what happens to doctors when they don’t deal with it well.  Their health deteriorates.  They drink.  They eat bad food. They become cold and mean.  What I have been doing is probably not the healthiest, I admit, but it at least I am able to show compassion and understanding while I stuff my real emotions into a box.  I don’t know what I would do if it weren’t for running and yoga.  I’d probably go crazy.

I wonder if I will ever figure out a better way.  Or if this is my best way. Or if it ever gets any easier.  Or if I am, indeed, alone with this dilemma.

All I can say for now is thank goodness for running, yoga, and the power of cheese.   It’s helped stop me from bursting into tears a lot.  One commercial at a time.