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Balanced Caregiving

How embracing paradox helps you help others


It was my first day as a volunteer hospital chaplain. The nursing supervisor cast a sideways glance at my Zen robes and said, ‘You must be the new chaplain. They need you in there. Now.’ 

She pointed to Room 9. 

Until that moment, I believed that decades of contemplative practice had prepared me to face the unknown. After all, my demons had visited again and again, and I’d learned to offer a balanced, caring response. 

But as I opened the door to Room 9, I fell out of balance and stumbled into a world in which I had nowhere to stand and no idea what to do. 

A woman in her 30’s lay in the bed, her face half-consumed by a red, weeping tumor. Two school-aged children played on the floor. Seated opposite the patient’s bed was a woman in her 60’s. She was slumped forward, sobbing into her hands.  What was I to do? The woman with the tumor stared blankly at the ceiling; the children didn’t look up. But, ah, the sobbing lady — she was the one whose pain ached in my heart. So I walked to her chair, planted both of my knees on the white linoleum floor and said, ‘Hello.’


People who need our care have lost their balance. Their lives have been upended by illness, oppression, grief, injustice or any of the myriad sufferings our lives are made of. The skills they’ve used to maintain balance, both healthy and harmful, now escape them. They are teetering on the edge and grasping for our support.

But if we, as caregivers, aren’t standing in our own balance, it’s hard to help. 

Opening the door to Room 9 was my first consciously out-of-balance experience. But it wasn’t the last. Over a long career as a hospital, cancer-care, and hospice Chaplain I slipped on more banana peels and slid down more slippery slopes than I can remember (mercifully) but every pratfall taught me a little more about how to live in balance so that I could be authentically helpful.

I learned that true balance requires a broad foundation; we can’t remain balanced for long if we’re trying to stand on a single point. Single-pointed balance usually teeters on viewpoints and ideologies: We believe that good and bad, right and wrong are separate and that balance means being ‘here’ with no part of me ‘there.’ 

Yet contemplative practice shows us that everything is intimately connected. As my teacher, Thich Nhat Hanh, liked to say, we are the mud and the lotus, we are the compost and the rose. Any attempt to separate them leaves us balanced unrealistically on a single point made of misunderstanding. 

Looking even more deeply, we see that true balance embraces paradox: We can only embody our Bodhisattva nature if we learn to stand with our two feet firmly planted on opposite shores of self and other, giving and receiving, results and futility, and birth and death. Balancing with a foot on each shore leaves us hovering vulnerably over turbulent waters, but also allows our heart to respond wisely to the suffering we encounter. We’re freed from shaky ideologies so that we can respond with don’t-know mind.


Building on the wisdom of many teachers (including patients and peers, Roshis and rogues) I developed a set of eight aspirations to direct my heartmind back toward the Noble Way. These vows help me create less suffering and respond with greater compassion. Here’s one example:

Living in the balance between well and unwell, I turn compassionately towards my own changing nature. I embrace decline in order to learn compassion. Aware of life’s ever-changing nature, I will bear witness to the fires of loss within and around me, knowing that I am well even when I am not.

Turning again and again to these eight aspirations helps me discover ever more subtle ways of living in the balance that grows out of paradox. For example, when the foreground is dominated by the unwell, as often happens in hospice work, the aspirations remind me to bring the background of wellness into focus, showing me that endings and beginnings are part of life’s dynamic balance. I sometimes take care of my ‘unwellness overload’ by heading to the maternity ward and drinking in the sights and smells and sounds of newborn babies. As beautiful babies are born into this unwell world, a smile is born in me. Balance is restored.


I offer care to Buddhist students and the dying, but you may care for the environment and the oppressed, the hungry and the lonely, or for suffering that burdens your own heart. We are all caregivers. 

In its deepest sense, caregiving is more than one separate being caring for another separate being; true caregiving takes place whenever we bridge the gap between self and other and meet as an interbeing.

I no longer visit Room 9, but when I see the world’s suffering, offer a Dharma talk, sit with a dying person, or call my aging mother, I allow that memory of being out of balance to bring me back to don’t-know-mind. If I don’t pretend to know, if I don’t hide behind ideology, if I don’t get lost protecting my separate self, then maybe, maybe, I can embrace the paradox of offering balanced, effective care. 

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