“[Well] will surely be helpful to anybody with a serious illness or, indeed, anybody affected by chronic fear.” Richard Smith, British Medical Journal “An insightful, compassionate account of living WELL in the shadow of death; a book for everyone by an inspiring woman.” Professor Liz Grant, Director, Global Health Academy, University of Edinburgh “A poignant yet heart-warming account of a journey – at times over very challenging terrain – told with honesty, humour, and wisdom … Profound, selfless, and uplifting, this book . [is] not only a must-read for doctors and health care professionals, [but] for anyone who wants to live well.” Stewart Mercer, Professor of Primary Care Research, University of Glasgow “A very personal story … [Gunn] shares her transformation from fear to connection and joy and gives insight into how each of us can do so as well. Insightful and profound.” James R. Doty, M.D., Professor of Neurosurgery, Director, Center for Compassion and Altruism Research and Education, Stanford University “Mary’s strongly positive mind has given her the ability to deal with the difficulties of ongoing sickness with calm and joy. I am quite sure that her book will give inspiration and encouragement to many.” Lama Yeshe Rinpoche Abbot of Samye Ling Tibetan Buddhist monastery, Eskdalemuir “Well is testimony to the fact that … there are other ways to live when faced with adversity, of any nature, and this book is a gentle guide, with humanity shining through.” Iona Jones, Medical student (Glasgow) Well Navigating fearful and uncertain times Mary Gunn Published by Saraband Digital World Centre 1 Lowry Plaza, The Quays Salford, M50 3UB www.saraband.net Copyright © Mary Gunn 2021 Previous edition copyright © Mary Gunn 2017 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without first obtaining the written permission of the copyright owner. ISBNe: 9781913393243 Typeset by Iolaire, Newtonmore Printed and bound in Great Britain by Clays Ltd, St Ives plc. 10 9 8 7 6 5 4 3 2 Any details of patients referred to in this book have been changed to ensure that patient anonymity is always protected. This book is dedicated to the memory of Rachel Hunt, 1966–1996. Royalties from sales of the previous editions of this book were divided between The Akong Memorial Foundation and Mary’s Meals, a global charity that provides food for children living in extreme poverty. We would be delighted if those of you who have appreciated this free ebook edition, and who have the means to do so, would consider donating to The Trussell Trust, a charity that eases hunger and food poverty in the UK. If you are elsewhere, please feel free to choose a local alternative. Contents Foreword by Renee Lyons xi Preface xv Part One 1. Before the Beginning 1 2. Diagnosis, 1997 12 3. Treatment 28 Optional Exercise 56 4. Finding a New Normal 59 5. A Wider Way of Seeing 69 6. Recurrence, 2010 75 7. A Skype Call to Mumbai 84 8. Ways of Living with Dying 101 9. Dying Into Living 123 10. 2016–2020: Life Continuing 126 11. Fear in a Time of Global Emergency 131 12. My Ongoing Journey: Autumn Diaries, 2020 144 vii Part Two 1. How Do We Look at Our Life? 169 2. You Cannot Step Twice Into the Same River 177 3. What Increases Our Suffering and Lessens Our Happiness? 189 4. What Lessens Our Suffering and Increases Our Happiness? 209 5. What Tools Do We Need to Effect These Changes? 227 A Few Brief Exercises 233 6. Many Paths, Same Destination 250 Part Three 1. Love in a Time of Fear 279 References 293 Useful Books 299 Acknowledgements 301 Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there. 1 Jalāl ad-Dīn Muhammad Rūmī, thirteenth-century Persian poet (translated by Coleman Barks) Foreword The worry/anxiety part of the brain seems to be at work constantly, even when there isn’t anything much to worry about. And this characteristic starts early in life. How can we, as family members, friends or coaches, provide guidance to young people on how to deal effectively with stress, anxiety and uncertainty? Could this save them all those hours of worry that we went through and redirect that energy usefully? If only I had had some of those ideas when I was young! How different my life might have been without the distraction of needless fear and worry. This book is about overcoming fear. It originated from Mary’s journey with cancer. Mary Gunn, a Scottish family doctor with young children, has received the news that her cancer, after treatment and recurrence, is incurable. So she bravely writes a book about coming to grips with her life and moving forward. This revised edition provides new episodes in Mary’s journey, up to and including December 2020, and expands on her approach to living well despite cancer. It also shows how these personal tools will be of value to all of us in managing the societal and global chal- lenges we face. This book is not a sad tale of coping with difficulty, nor is xi Well it another traditional self-help book. At its heart, it is about how simple shifts in perspective can free us from unproduc- tive thinking and acting, whether it’s a health issue, a fear about money, a regressive leader, a virus or tackling climate change. Many of the ideas come from Tibetan Buddhism and some of its amazing leaders who seem to know exactly how to support Mary through her challenging times. Lama Yeshe Rinpoche at the Samye Ling Tibetan Buddhist monastery in Scotland plays an important role in Mary’s journey. Mary’s captivating, calm writing style makes this book exceptionally impactful. Well is a BALM for the soul. Wise, profound phrases, sometimes stated in a direct yet often humorous way, or sometimes through a poem, jolt the mind away from defeatist thinking to something much better. Three interconnected themes are present in her writing: how we handle stress, anxiety and worry; the legacy we provide family, and especially, young people; and how these two things will be central to how we tackle major global challenges such as living in harmony with planet Earth. Mary writes about the need to “unmask” the erroneous belief that all life’s misfortune can be controlled. We humans spend a lot of time acquiring personal wealth and power to protect us from bad things. Yet we are simply powerless in many cases to avoid them. Difficulties are a normal part of life’s journey. The mind can be trained to appraise and act appropriately in response to stress, rather than over-reacting. Kindness and compassion are central: so are humility and humour. Drop the victim mentality. Start trusting yourself. Listen to your “inner doctor”. (If we) turn in and face our own inner fear, our gaze widens… We calm down. xii Foreword Mary’s worry about how much suffering she may be causing her family leads to a most profound statement by Buddhist nun Lama Rinchen: The gift you give to your family is the gift of your mind. The sharing of such remarkable, profound thinking in Well: Navigating Fearful and Uncertain Times with others, including young people, will provide a valuable contribu- tion to their lives. In her new Chapter 11, ‘Fear in a Time of Global Emergency’, Mary writes that we need to stop denying difficulties and open our eyes to the shared duty to respect and protect all life and the planet. In order to focus on and correct our alteration of the Earth’s climate, for instance, we will need informed, well intentioned humans as citizens and as leaders. We will need to optimise our social resources, both individual and communal, to make the necessary adaptations. The scientist in me says that we need to further develop and test some new theories that speak to the effectiveness of the ideas Mary mentions. There is evidence that mindful- ness, meditation, positive thinking and similar techniques are helpful, but at the heart of Mary’s use of these methods, there is an ideology about values and how we should conduct our lives with kindness and compassion. Mary explicates ‘tools and methods’ from that base. Speaking as a counsellor and researcher who has seen all forms of human distress, wouldn’t it be fantastic to have guidance like Mary’s available to us all? I see the possibili- ties of embedding these powerful ideas in the training of mentors and people of all ages to be more supportive of others around them. xiii Well Of course, these insights originated from dealing with serious health issues, and there is a huge need, even from my own research, for supporting mental wellness and coping. About eight years ago, my research team conducted an in-depth study of 160 adults with serious physical health issues and found very high levels of depression and anxiety and a lack of services beyond physical healthcare. More than 99 per cent of healthcare workers surveyed felt inadequate in supporting their patients with these issues. We need to change this situation with all hands on deck. That includes the hands of family members. The role of Mary’s family, and especially her husband, John, in her journey cannot be underplayed. Thank you Mary, for your valuable contribution to improving the quality of our lives through this book! This new ebook edition is being distributed free of charge to ensure that anyone who needs it can benefit from reading it.