Viral's Health

Dear All,

It has been over five months since our last update to this warm community of well-wishers. We aren't quite sure how that happened -- perhaps the timeless quality to this period has something to do with it (that, and a talent for procrastination :)). 

In these interim months we've seen Viral's counts fluctuate, fall, and then slowly rise again. His Ayurvedic doctor likened the early part of this phase to the pruning process so familiar to gardeners, where a system is cut back, sometimes severely, in order to facilitate healthy and sustainable growth. Pruning is not a gentle undertaking. And shorn trees can be startling to the uninitiated. So it was special to witness Viral's steadiness when the climbing counts started to falter, and early symptoms returned. And special too, to see his steadiness when the counts once more began to rise, and the body resumed its rebalancing act. I learned a great deal from the checkered pattern of those weeks. And from all that stirred and settled in turns. 

And now it is summer and the season for growing.

Eleven months (!) into this journey, we are happy to report the recovery is in a very stable phase. Viral's hemoglobin has held fast over the last two months in a range that's close to normal. Platelets are still low but sustained at safe levels. His white blood cells continue to be elusive, and remain at half the norm. Though it's clear his immunity is still compromised we're encouraged by the fact that his body is not showing the signs of vulnerability that it did in the first months. He has a reduced need for sleep, more energy and increased mental and physical stamina. There's a sense of more resilience than the counts are showing at this stage.  Viral is still in the regular care of an exceptional doctor, skilled in modern as well as traditional modalities. His doctor (and we) feel quietly confident that nature is continuing its course in the direction of healing. There is no definite timeline, but things are shifting.

It's felt right at this stage to adjust the self-imposed restrictions of past months. Last month Viral's aunt and uncle brought his grandmother over for a visit. Such a blessing. A few weeks ago we made a special trip to visit Rev Heng Sure who shared profound stories from his time in Australia, where Ollie, a wild kookaburra numbers among his many furry and feathered friends. On Tuesday we visited my parents-in-love and Viral ate his first meal outside of our home-- cooked by his mother :) We've started a fledgling garden thanks to John, a beloved friend who visits as wise elder and leaves blossoming things in his wake. We've begun to have friends over, one or two at a time. While we are still careful to maintain most of the earlier precautions we are holding the boundaries more gently now.

In this time Viral has steadily increased his remote work with the San Mateo County Health System. His week is vibrant with videoconferences and 1:1s over chai here at our home with wonderful colleagues. He feels healthy, and like he's moving towards being healthier :), and that this period is teaching him not-fully-conscious learnings and unlearnings that will continue revealing themselves well into the future. On my end I feel a little bit like what I imagine a whale might feel, rising to the surface after extended time in the deep. The loveliness of breaking the surface into air and sunshine after being under water. The rigorous focus and concentration of energies in a single dimension is no longer needed (perhaps it never was). And now room has been cleared for so much more to enter. Alongside DailyGood and other ServiceSpace strands, I've had the space to read, sit and write more. Also the opportunity to work with dear friends on their remarkable labor-of-love projects, one involving film and the other, art, and both demonstrative of the healing that happens when we hold space for stories ... whether they are the stories of wild animals, troubled children, Death Row inmates, each other or ourselves. (More on these special efforts to follow soon -- they are meant to be shared widely and well).

While there are yet daily treatments and a routine to be followed, there is an overall ease to it. A fluency to these long summer days, in which we (well, mostly I :)) often rise with the sun. We hear the call of the mockingbird around the corner. We watch the mourning doves strut shyly amidst the wildflowers and the occasional hawks gliding in wide circles overhead. There is a new and more constant backdrop of stillness against which life's activity gleams -- like the bright throat of the hummingbird we saw last evening -- a ruby flash against iridescent green feathers. If normal life were a moving train, then 11 months ago we suddenly found ourselves off of it. And now, we walk by the railroad tracks tuned to the inward music afforded by this long state of 'almost solitude'. I know we'll never be passengers in quite the old way again. And that realization is a kind of gift. 'Sweet are the uses of adversity'...Shakespeare's pastoral lines have surfaced often in these days and weeks...

And this our life, exempt from public haunt,
Finds tongues in trees, books in the running brooks,
Sermons in stones, and good in everything.

So much has happened in these past months. A dear friend underwent a bone marrow transplant, another helped his father transition, other loved ones welcomed new lives into their midst. All around us the vast drama of existence has continued to play out in humbling, challenging, magnificent ways. And on our own journey we have continued to be supported by nameless forces, and the loving kindness of people too-many-to-name. You know who you are :) Please know too, that we are deeply grateful. Your friendship has lent a tone of grace to this time.

There is much in how we live now that I want to hold fast to as we travel the road back to 'normal'. A sense of spaciousness, that comes not from an empty schedule but a relaxation of certain old, unhelpful patterns of thinking. A sense of honoring relationships in deeper and more sincere ways than the whirl and rapid-fire of much of today's communication allows for. A sense of walking this path ultimately alone and also infinitely connected to all that surrounds us.

An awareness (if veiled at times) that in all things, and all circumstances, in all states and seasons there is room for growing. And for gratefulness.

We hope you are each doing well and that this note finds you joyful and fulfilled. Thank you for being part of the good in our journey.

Love,
Pavi and Viral

Dear Community,

We have let more weeks slip by without an update than we intended to. Thank you for being patient with our silence. Viral's recovery is continuing slowly, at its own secret pace. Things are stable overall, though there have been fluctuations with his blood counts. His hemoglobin and platelets have dropped since the last update, but have remained in the safe range. This week they are at 10.5 and 41K respectively. His WBC count continues to be acutely low. But the fact that his energy level has been great and that he is showing none of the earlier symptoms is encouraging. These are good signs, and indicative perhaps of resilience in the body at subtler levels than blood tests can measure at this stage. The overall sense from his doctors is that we should continue with the various natural treatments and wait and watch.

It has now been just over six months since we started down this path. Summer has trailed into Autumn, faded into Winter and is now burgeoning into Spring. We watched the leaves on our young plum tree brown, wither and fall, and the bare branches stand tall through the winter. We saw the spring green buds appear almost overnight, and then one magical morning found a misty white veil of plum blossoms waiting for us.

"The force that through the green fuse drives the flower / Drives my green age; that blasts the roots of trees / Is my destroyer." At nineteen, the poet Dylan Thomas penned these vivid lines. Nineteen! Such a young age to recognize the twin forces of creation and dissolution at play within, and to see them mirrored in the world without. The ancient cycle has never felt quite this fantastically beautiful or fleeting.

The days have been touched with slow wonder. On our daily walks we point out to each other the citrus trees slung heavy with oranges, and rejoice in the magnolia blossoms raised on leafless branches like hundreds of goblets toasting the sun. We notice the hummingbird who visits our window and dazzles us with his aerial antics. The robins who flutter like so many rust-and-gray handkerchiefs into our berry trees. The hilarious squirrels who go through agonies of deliberation, trying to decide which of our flowerpots to dig up. Families of deer with their shy, attentive faces, who come and go on such slender ankles. In the midst of a vast yet strangely intimate tapestry, I feel more vulnerable and more trusting than I have ever felt before. Life is fragile. Nature's design awe-inspiring. Change is in each moment.

None of this is new information. But the lived experience of it is fresh, keen and bittersweet. As I told a new friend, it has softened my gaze. Opened doors of compassion for the world, that I didn't even know were closed. How kindred you and I and all of us are in this thin wrapper of mortality! How casually I have wielded it all these years -- this double-edged sword of being human -- and all its extraordinary potentials for hurt and healing.

So much depends on perspective.

I remember the morning after our first night back home from the hospital, I woke up and felt like my whole mind and being were enveloped in a deep blanket of peace. The last two days have been a hot blur. A whirling surreality. Now it is just the two of us, here in our shaded room. The quiet air, and the strength of our long-time love between us. And a certainty blooming inside me like a flower in the desert: Everything is going to be fine. My husband opens his eyes. I lean over and repeat these words. Everything is going to be fine. He smiles, and his eyes crinkle at the corners. "Everything is going to be fine. And everything IS fine," he says in a voice fuzzy with sleep. And after the space of a heartbeat adds gently, "You have to expand the definition of fine."

Six months later I can honestly say my definition of fine has greatly expanded :) I know this because a couple of nights ago, drifting off to sleep I had a thought that danced between insight and incoherence. And it went something like this: "Life is good. Practice knowing this, Pavi. Practice when life seems good. Practice when life seems uncertain. Practice when life seems anything but." Far from being a cultivation of denial or passivity, I'm learning how much it is really about a vigorously, vigilantly engaged perception. A way of being and acting in the world that stems increasingly more from love. And less from fear.

Viral does all of this so well. So well and so wisely that I wanted him to articulate his perspective in his own words. So --- I 'interviewed' him :) Here is the transcript: The Privilege of Living Whatever Life Brings.

Meanwhile we continue in this oddly sweet retreat-mode, with weekly visits from immediate family, and limited 1:1s with colleagues and friends. Viral has begun to increase his remote engagement on the work front. Between that and the requirements of his treatment regimen, we continue our work with various ServiceSpace projects, we carve out time for stillness, for yoga, for reading and more. Life is full. And life is good :) The flow of good-wishes and blessings from you continues to refresh and sustain us in special ways. It is no small task to pay forward all that we've received. But we intend to keep trying.

Thank you for walking with us.

With love,
Pavi and Viral

Dear Friends,

We hope this winter update finds each of you full of holiday cheer and surrounded by loved ones. As the year bows out, (and what a year it has been!) Viral and I have much to be grateful for. We are happy to share that his body continues to get stronger. At 12.3 his hemoglobin is now almost normal. His platelet count has been a little up and down, but has stayed consistently in the safe range. His white blood cells have finally begun to trend up, but will have to rise further and stabilize for a sustained period before a return to 'regular' life can be considered. Several specialists have weighed in. There is still a ways to go but they believe a critical corner has been turned. The traditional medicine practitioners we are working with are quietly confident that time, and the gentle treatments being provided will facilitate the rest. While nothing is definite, this does feel like a new phase in the journey. We're still climbing the mountain, just not quite so close to the edge :)

When Viral was summoned to the ER on August 13th, and told all three of his blood cell types were drastically down, we did not understand all the implications. We'd never heard of aplastic anemia. We hadn't the foggiest notion of what a neutrophil was. And no inkling of the prominent role platelet-boosting papaya leaves were about to play in our lives. We had much to learn. About bone marrow biopsies, transfusions and transplants. About IST treatment, Ayurvedic herbs, acupuncture, and natural healing. About trust, uncertainty, fragility and resilience. About inner reserves and invisible affinities.

Since that time almost five months ago, our home and the hospital are the only buildings Viral has entered. The same holds true for me, with the exception of weekly supply runs to the store. It is a rather tightly circumscribed life. But a small price to pay for minimizing the risk of infection. And besides -- the small circle of our days is packed thick with blessings. Viral has ever been, and continues to be my rock and star. A steady, luminous force. He does not argue with nature, and he's unstinting in his generosity of spirit. Even in the ER, he was so warm and unruffled in that silly blue hospital gown. He greeted the succession of doctors and nurses with unfeigned friendliness. On multiple occasions in the uncertain weeks that followed, his niceness put a fist-sized lump in my throat. It takes a certain kind of unselfishness to shine the spotlight of your attention on other people when life -- your life -- hangs in the balance. To smile and inquire about trivial details in their day, and to listen with genuine interest. The direness of the diagnosis never distracted him from being himself. I don't know his equal for being so steadily present, so readily full of goodwill for whoever happens to cross his path. I am glad, so many times a day, for his particular way of being in the world. And what it inspires in me, and so many others who know him.

We have such good times together :) These short winter days are happy and full. And alongside the regimen of his treatments, the rigorous cleaning, rest, reflection, and exercise, we are each starting to find time and space for our own work. The family and community continue to tend to our well-being in exquisitely thoughtful ways. Too many to name here, you know who you are. :) Please know too, that your beyond-kind gestures, your endearing messages, your loving prayers and the goodness you beam out, reach us in manifold ways.

While we've been closely cocooned by the personal demands of this time, the world has faced intensities of horror and heartbreak. From the Paris attacks, and San Bernadino shootings, to the refugee crisis, and the devastating floods that hit close to home in Chennai. There are vast tides of darkness to contend with. And there are, as there have always been, people who rise to the call of the moment. People whose radical response to fear is love. People who will always, stitch by stitch, brick by brick build up our world. People who refuse to stop reaching across boundaries, being kind to their neighbors, and caring for one another in courageous ways. And it's not just people who do this. Earlier this month I received a photograph from a dear friend in South India. A photograph of a little, lost newborn puppy. Being tenderly groomed after torrential storms. By a monkey :)

A reminder of what it is in us to do. Despite all the terrible things that happen. We still have it within us. This surprising and sweet capacity. To reach out to the other in the rain.

"For all that has been -- Thanks. For all that shall be -- Yes." In this season of giving and gratitude, in this time of endings and beginnings, we wish you peace on your path, joy in your work, and a heart lit by love. Happy New Year to all!

With grateful hugs,
Pavi and Viral, on behalf of the Mehta family

Dear Friends,

Thank you for holding us in your hearts through a month of silence! We're glad to share that through all of this time Viral has been getting steadily better. Most importantly, his counts are showing sustained signs of recovering bone marrow function. He has been transfusion-free for over two months. His hemoglobin is steadily rising and is approaching normality at 11.7. His platelets are at 75K, significantly above the range for immediate concern. These are very significant milestones. White blood cells continue to be acutely low, but his doctors anticipate that with more time we’ll start to see recovery in this line as well.

When Viral was diagnosed with this two-in-a-million condition we were told that there was less than a 1% chance of 'spontaneous resolution'. But now his doctors believe that we are seeing exactly that -- a natural recovery. The term "natural recovery" sounds deceptively passive :) In reality there's an intricate matrix supporting the process. From the exceptional Ayurvedic and Chinese medicine practitioners we're working with, and the many prayers and blessings and handwritten letters, medicinal foods, herbs and supplements, to the sweetest offers of support and acts of service and invisible equations and affinities...There's no tracking how it comes together but we’re indebted to all of it. Noble friendships inspire and hearten our days in more ways than we can say. To be clear, there are still risks and there’s no telling how soon we will be able to resume “ordinary life” (not that there is such a thing :)). But we are prepared to be patient, and to try and cultivate more deeply whatever the path ahead.

“Quiet minds cannot be perplexed or frightened, but go on in fortune and misfortune at their own private pace, like a clock in a thunderstorm.” A friend quoted RL Stevenson to us early on. The imagery is vivid and striking. Viral has one of the quietest minds I know. And like that clock he hasn’t missed a beat through all of this. He’s greeted the rising blood counts with the same equanimity that he met the initial diagnosis with. I see over and over again, how his cultivation goes deeper than the bone.

Rest is key, so apart from weekly blood tests, treatment prep and the rigorous housekeeping (our home has never been this sanitized and spotless!) our time is spent in fairly simple tasks and activities. We have a limited range of visitors --immediate family, the gifted alternative doctors we are working with, and Viral’s close colleagues whom he’s started to have 1:1s with as he begins to re-engage on the work front. The vast majority of our time though, is spent with each other. We read, sit, cook, clean, and take walks in the hills. We have long conversations unbounded by schedule and the demands of the usual work week. We share laughter and stories, silences and music. Here's an exquisite Kabir song that we've particularly enjoyed listening to...'A lifting up of common acts by love,' is a line from Sri Aurobindo's 'Savitri' that I think of often. We have a very limited scope of action these days :) None of it important in a worldly sense, and yet all of it, an opportunity to practice deepening.

Last week we crossed our tenth anniversary. Our tenth! “You’re such a nice couple,” sighed the nurse with the tired face and kind eyes. This was the night we spent in the hospital after the first blood tests revealed something was drastically wrong. And I knew what she was thinking -- that we were too young for this. I’d had that fleeting thought too. But I knew in my heart of hearts that it wasn’t true. Of course I want more time. Much more time. But that doesn’t mean I’m entitled to it, no more than I’ve been entitled to the last ten years. It’s all been a gift, and gifts aren’t owed. They are bestowed. I hope to stay close to the humbling truth of that, and to whole-heartedly live all the moments that are given.

We hope you are each happy and well, and we look forward to connecting in person whenever the time ripens. May your moments be filled with the gifts of peace, joy, and work that lights your heart.

With much love,
Pavi on behalf of the family

Dear All,

Hope that all of you are well. On our end, things have been good since our last writing, as the healing process and progress continue. Of the three key blood cell types generated by the bone marrow, two seem to be rising, slowly and sustainably for now: hemoglobin is up from 9.1 to 9.7 (normal is 13 - 17) and platelets are up from 45K to 65K (normal is 150K-450K). White blood cells though, which constitute immune functions, remain very low, which means we must stay cocooned at home with minimal outside interaction. Fortunately those advising us medically, from both modern and traditional perspectives, are in agreement that a natural recovery is in progress right now, and that the best treatment at this time is to continue everything we're doing, and just be patient. :)

We are resting into this prescription. In this newer phase where treatment seems well-defined and weekly test results are encouraging us to keep walking this path. Pavi and I are increasingly feeling that this space and time is a gift -- a retreat. In all of this time, for me, Pavi has been a teacher of unconditional generosity, uncompromising dedication, and unflinchingly soulful partnership. It is hard to imagine my journey without her loving and joyful presence and togetherness. And then the times with immediate family that have punctuated the bulk of this alone-time have been a blessing of love and grounded-ness (including Pavi's younger sister Deepa, who was here with us for two months from South Africa, and who just left, after supporting us in so many ways during the period of greatest uncertainty). More broadly, both of us continue to be deeply supported and sustained by all of your messages of goodness, spoken or un-articulated, and though I, in particular, have been pretty silent in response, we feel so powerfully held by the community.

That's been one of the more profound lessons for me in this period, just realizing how this resilient ecosystem of deep care has been in fact the most active component of response to the sudden turn within my own bodily ecosystem. In ways too many to count and too mysterious to understand, supporters of all kinds, many of whom have been previously unknown, have come to serve my recovery. In the ServiceSpace gift ecology work, we've come to know that this type of compassionate motivation is itself animated and propagated by our deepest shared, human-ness, and is itself a part of a massive pay-it-forward chain. Which all leaves me feeling inspired to sincerely keep that chain going in ways both known and yet to emerge.

One of the other realizations has been to see how much deeper in humility I can and should grow. This health development arrived out of the blue, for reasons no one seems to fully understand, and it seems to be leaving in a similarly inexplicable fashion. As a result of this ongoing process, though, I have a much more developed relationship to my body, and an ever-deepening appreciation for the crucible of the present moment, where the precious opportunity is given to each of us to forge the tools of equanimity, awareness and wisdom, that in their turn, shape the inner and outer trajectories of our lives. These laws of nature remain paradoxically both intuitively approachable, and infinitely complex. It has been humbling and confidence-inspiring at the same time. To surrender to the reality of each moment, while retaining one's deepest responsibility, or response-ability is a beautiful art. Regardless of what happens to us, that we each have the freedom to choose our response, is such an incredible gift.

In many senses this is fully a heightened period of self-discovery, growth, and solidarity, expressed beautifully in these words by John O'Donohue:

To be wholesome, we must remain truthful to our vulnerable complexity. In order to keep our balance, we need to hold the interior and exterior, visible and invisible, known and unknown, temporal and eternal, ancient and new together. No one else can undertake this task for you. You are the one and only threshold of your inner world. This wholesomeness is holiness. To be holy is natural; to befriend the worlds that come to balance in you.

Dear Community,

We know many of you have been waiting anxiously for news of Viral. The days have been full on this end, but please know that even though you haven't heard from us in awhile, we have felt your presence each day. Your multi-faceted expressions of solidarity and love have punctuated the intensity of this time and touched a challenging stretch of the road with such grace.

I'm grateful to be able to share that Viral's condition is showing some early signs of improvement. Our optimism at this time is tempered with caution. His blood counts are still severely suppressed, and he is still at high-risk of infection. But his platelets have been steadily rising over the past two weeks and are now at 45K (up from 18K). And after a second blood transfusion on the 9th, his hemoglobin level has been stable and is even showing some slight upward mobility. It is now at 9.1. These are not normal levels by any stretch, but they are vastly improved from where things were. And all without any aggressive intervention.

When we learned a few weeks ago that his brother was not a match, and therefore a sibling bone marrow transplant was off the table, we were advised to start Immunosuppressive therapy (IST) as the first-line of treatment. We had strong reservations about both the transplant and IST scenarios. But we wanted to make sure to explore and assess all our options in as unbiased a way as possible. On the modern medicine side this meant doing our own research on transplants and IST, browsing case studies, journal reports, countless bone marrow forum posts, and Aplastic Anemia Survivor blogs, compiling findings, getting second opinions and polling specialists with specific questions. We had a phenomenal "thinktank" of brilliant and loving friends who spent long hours working with us on all of this. A repository of well-organized data was created, and thanks to several of you we received valuable feedback from over a dozen specialists. On the traditional medicine side we set to work (with your help) identifying seasoned practitioners who have a successful track record with treating aplastic anemia, we tracked down their contact info, and interviewed them to learn more about their methods. Since many of these practitioners were based in India, we then had to find experienced local practitioners who could visit Viral in person, read his pulse, and use other physical signs (tongue, palms, eyes) to diagnose his condition and prescribe appropriate natural treatments.

Modern medicine opinions were fairly unanimous that IST was the best option, and if there were no signs of appreciable improvement that it should be started without excessive delay. Definitions of "excessive" were varied. But most specialists conceded that if we wanted to continue with a natural approach until mid-October, the increased risk incurred would be marginal. Given the aggressiveness of IST, the uncertain outcomes and potential long-term complications, and given the encouragement we'd found on the traditional side of the spectrum, as well as Viral's own intuition that things were shifting for the better, we decided to use these weeks to give natural approaches our best shot. IST is still a very real possibility and if we do end up needing to go that route, we know we will be in good hands. He is still being monitored closely by his hematologist/oncologist via regular blood tests, is in no pain and continues to be his irrepressible sunny self :)

We've been blessed to have a team of skilled practitioners (remote and local) working closely with Viral on a weekly basis, using an array of natural approaches ranging from sunlight, to food, to herbal formulas, and simple exercises, to facilitate his body's healing. Their profound respect for the natural capacities of the body to restore balance, their combination of scientific and intuitive approaches and deep experience working within fields like Ayurveda and Naturopathy -- which acknowledge the complex and lawful interplay of elements as well as cause and effect within the macrocosm of the world and the microcosm of the body -- have taught us a new appreciation for so many taken-for-granted aspects of this thing called life.

The night before the ER visit that began this recent roller-coaster ride, was the peak of the Perseid meteor showers. I remember Viral, my sister and I sitting at our window together watching for shooting stars. I saw half a dozen that night. And the child in me wished on each of them :) Each time the wish that surfaced, was to live in deeper alignment with life. I didn't realize just how soon I was going to be given the opportunity to practice that aspiration :) Viral continues to embody for me what it means to live a life of alignment. Not once has he talked about this turn of events as a misfortune or even an inconvenience. He truly sees it as a privilege and an opportunity. He does not use these words lightly, and I see him living the spirit of this perspective each day. With such smiling conviction that I have no choice but to believe it too :)

Externally there is a rigor and relentlessness to the routine. Because of the acute low immunity everything Viral comes in contact with must be disinfected and dust-free. Floors, door-handles, countertops, devices etc. Food must be vigilantly prepared. Herbal formulas and supplements taken at the appropriate intervals. Sleep, rest and all bodily symptoms and changes monitored, and outside contact ultra-minimized for all of us in the house. In many ways this time feels like a bootcamp for body and spirit. And there's a jagged beauty to that. It is not unlike being in a meditation retreat. Everything is heightened. I can see my mind's frailties are being tested. Small things trigger deep vulnerabilities. And by that same token -- the tiniest moments have opened vast reservoirs of strength, slivers of insight have risen unbidden, and small kindnesses and blessings have turned the tide inside. There is a dimensional richness to this time, a kind of genius in the design of it all, that I would not have chosen, but that fills me with wonder in certain moments.


Early on in this fierce adventure, Viral sent the family a passage from a book written by Paul Fleischman, a friend, brilliant author and meditation teacher. Here's an excerpt from it, that rings so true to me in this time that is so rich with 'the potentials of dark and light.'

"...the past is being sieved through a fine mesh screen to make the material of the future, and we are that screen. Meditation brings our attention to the micromoment, which becomes drenched in hyperreality, the way that tropical sunlight suddenly reveals the iridescence on the dove's neck. A play of pastel light brings every milimeter alive. The universe has no blind corners, no secret spaces. Every place, every moment, has the potentials of dark and light."

This would be an incomplete update without mention of the myriad ways in which we've been supported in this time. Papaya leaves are a key part of Viral's current treatment, and they are hard to come by in this part of the world. Literally dozens of people from around the country have kept a steady supply of these large, green leaves coming to our door. Other valuable ingredients and herbal preparations only available in India were mobilized and shipped over through extraordinary efforts that we are only partially aware of. We've received exquisite handwritten mandalas of literally thousands of prayers from our extended family in Japan, communities from different traditions have dedicated merit from their spiritual practices to Viral's well-being, and our family has received so many inspiring messages from the elders in our community, who look into the heart of this circumstance and remind us of the wise gifts it contains. We've received humbling messages from so many of you who continue to hold us with such love. All this is just the tip of the iceberg...It's been especially moving to see the quiet and instinctive ways in which so many of you have stepped up to support not just Viral and I, but our immediate family -- our parents, and brother and sisters-in-love. You inspire all of us, whether it's showing up with your presence at an Awakin Circle on Wednesday where the family continues to host 60 people each week, or filling gaps that allow for ServiceSpace's multi-pronged work to continue seamlessly and stronger than ever -- including Nipun's (Viral's brother's) hot-off-the-press appointment to President Obama's advisory council :)

The blurry border where individual strength leaves off, and the ecosystem's muscle kicks in has bowed my head in so many moments. Yesterday I came across this line from William James that expresses the truth of this junction so beautifully, "We are like islands in the sea, separate on the surface but connected in the deep."

With love and gratitude for the depths that connect us all,
Pavi, on behalf of the family

Dear Community,

The waiting period for figuring out what's happening with Viral's condition is mostly coming to an end. As we enter into the next phase of his healing process, what remains constant is the way in which we are so deeply held and supported by so many heads, hands, and hearts.

Last Thursday was Viral's appointment with the specialist at Stanford's Bone Marrow Center. We were able to get in three weeks earlier than the original appointment we were given -- thanks to friends who quietly, and unasked, reached out on in extraordinary ways on our behalf.

The specialist there confirmed the diagnosis of severe aplastic anemia, a condition that 2 in a million people develop. The root reason for this remains unknown in his case, but the Stanford specialist walked us through two main treatment scenarios, a bone marrow transplant with a matched sibling (should Nipun be a match), or immuno-suppressive therapy. Each pathway comes with a set of very high risks and potential complications. Neither is a benign option. But at least they are options. And we're grateful for that.

We will know by the end of this week whether Nipun is a match or not. If he is not a match then immuno-suppressive therapy will be the default treatment prescribed. In the interim we are doing all that we can to stabilize Viral's condition through alternative methods, and try to support his body at a more root level, though that is really a long-term view. Highly skilled Naturopathic and Ayurvedic doctors have been offering their guidance at each step, and the community has stepped forward in remarkable ways to bring even the most obscure things we might need, right to our doorstep. Fresh papaya leaves, tender coconut water, a massage table, special herb preparations from India ... anything that we've required has found its way to us almost instantly. Viral's immunity is still low, so no one is entering the house except doctors and immediate family. Even so, we've had so many of you willing to drive hours just to do a drop-off at the bottom of our staircase. The love that is holding us through this time continues to astound and touch us.

I can't put into words how incredible it has been to be by Viral's side in this time. His practice is vivid and present. He inhabits each day, each moment really with such unassuming poise, lived insight and contented joy that it takes my breath away. He is courageous in the original sense of the word. As many of you have heard him share before, the word courage comes from the word coeur -- heart. He is living the moments with such a big heart.

All your notes, and emails and prayers and touching gifts and stories have brought big smiles to his face and mine. Please know that we are wonderfully well taken care of. Mummy and Papa have been pillars of strength as have Nipun and Guri. And my sister is here with us too, working tirelessly to fill gaps. And you, our extended community of family and friends have not let us want for anything.

As Viral so often has said to me in the past, and continues to remind me now --

It's a Good Life.

Grateful to each of you for being a part of it.

With love,
Pavi, on behalf of the family

Dear Community,

So many of you have emailed, called, and texted asking for updates on how Viral is doing over the past few days. And you've continued to offer up all kinds of things from grocery runs and medical contacts, to your homes, and your cars, and your marrow should we need it. Your love for Viral and your generosity of spirit humbles me. And I do want to respond to each of your heartfelt messages individually but there hasn't been time yet, so this joint one is for now.

We still have not heard anything definitive yet from the hematologist's office. Viral's blood tests from yesterday show continued evidence of bone marrow suppression.The biopsy results that have come in so far have helped rule out certain things, but haven't pointed to a clear diagnosis yet. In the meantime we've been in touch with several other oncologists (gratitude to those of you on this list who helped with this!). Some of these doctors think it may be a temporary condition triggered by a virus, while others sense that it's aplastic anemia (the medical term for bone marrow failure) -- a rare and serious condition with a variety of potential underlying causes. Often times the trigger is never identified, and in most instances requires intervention that can range from various kinds of medications, and immunosuppressive therapies to bone marrow transplants. Kaiser is transferring us over to Stanford's Bone Marrow Center this week. So we will soon learn more about what the best treatment options might be for us. From everything we've heard, it is one of the best and most experienced centers for these kinds of cases. We're fortunate to have access to it.

As you can imagine it's been a lot to take in. Yet, it's been incredible to see not just Viral's strength (he hasn't faltered once through this whole experience), but also the strength of the core and extended family in this time. They have risen with such love and grace to this unexpected challenge. It has been almost two weeks of facing the unknown, and even in the midst of the uncertainty there has been joy and laughter, and many beautiful, extra-ordinary moments. We're still restricting house visits to immediate family to minimize the risk of infection, so Viral has been treating this time as a special retreat. In between lab draws, hospital visits and family time, he is able take walks, sit outdoors, meditate, catch up on ServiceSpace mails, and continue with some of his work from home. And as I finish typing this he has just gently escorted a little black spider out of our home. (He's always been the Spider-Putter-Outter in this household :)).

We both continue to be deeply grateful to be a part of this precious web of life, and to be connected to each of you in the ways that we are.

With much love,
Pavi

Dear Community,

So much gratitude for the constant metta, good wishes and prayers that have been holding us at each step.

This afternoon we met with a hematologist/oncologist to review the initial results from Viral's bone marrow biopsy. Bottom line: They still don't know what the underlying problem is. The tests for acute leukemia and lymphoma have come back negative, which is good news. They have ordered a second round of tests to try and rule out various other things. We will have the next set of results by Monday. Identifying the root issue in cases like this is not always a straightforward or quick process. At this point a referral to Stanford is a strong possibility and it will likely be a little while before we have a clear path forward. But we feel like we are in good hands, and are taking it one step at a time.

Meanwhile Viral's white blood cell count is still very low which means he is at high risk for infection. So he will continue to stay at home for now, with visits restricted to immediate family. He will be monitored through regular blood tests. The transfusions he had last week are temporarily helping stabilize his overall condition, and he is fortunately not in any pain. It has been so humbling to witness his demeanor through all of this. He continues to be joyful, strong and ever-ready to face whatever life brings to his doorstep. He reminds me gently in so many ways to try and grow through this time.

I/we continue to draw strength from the immense cradle of love and support that you have surrounded us with. The acts of kindness and notes of deep caring that we've received are too many to list, but please know that you have filled our hearts many times over. It means so much to have you by our side. We will continue to send updates as we have them.

With much love,
Pavi on behalf of the Mehta family

Dear Community,

So much gratitude for the flood of metta, blessings, prayers, and healing wishes that all of you have directed towards Viral and the family. As we waited in the hospital it was truly incredible to feel the "inner net" coming alive with a profound sense of connection as people wrote in with generous offerings of everything from food, rides, blood, marrow, healing readings, medical connections, meditation sits, pilgrimages and prayer circles. Reading your notes out loud to Viral in the hospital room I teared up often, moved beyond words by the outpouring of love and the deep regard, care and concern that was being showered on this beloved being. Thank you is an inadequate word for what we received. But it is all we have right now. So Thank You.

After a blood transfusion day before and a platelet transfusion yesterday, the doctors felt they had stabilized Viral's condition enough for him to be discharged from the hospital, so that we could wait for the results of the bone marrow biopsy in the comfort of home. They have ordered extensive testing to identify the root cause of what's happening. The spectrum of possibilities is wide, and sobering, but we are optimistic. Fortunately Viral has not been in any pain. His unflagging equanimity and joyful presence is an incredible moment-to-moment reminder to welcome whatever shows up on our doorstep. Through this whole time he has been chatting with the nurses and doctors about everything from meditation to the Aravind model, he's been smiling big at all your notes, and reminding me at every turn to use this experience as a stepping stone to inner transformation.

Left to his own devices he would invite all of you to our home for an impromptu circle :) Much as we would love your presence, at this time his immunity is very low, so we have been advised to restrict visitors to just the immediate family. We will continue to send updates as we have them, but have been told that it could take until the middle of next week to hear back on test results.

So grateful for the invisible web that continues to support us. Thank you each for being a shining strand in that web.

With much love and gratefulness,

Pavi on behalf of the Mehta family

Dear Ones,

Yesterday, one of Viral's doctors called him up -- and in mid meeting, he was asked to immediately head into ER. Two weeks back, he had gone for a check-up since he was getting dizzy just climbing up a flight of stairs; and now, his blood results had shown some abnormal tendencies of a malfunctioning bone marrow. So he went in yesterday, was kept at the hospital, given a blood transfusion last night, and a few more tests are in progress right now. It will take a few days to have a conclusive idea of what is going on.

Of course, Viral is full of equanimous smiles and his usual self! :) All of us are by his side, my parents have been meditating solidly, reports are being relayed live to entire posse of doctors in Madurai, and he's got great logistical support at the hospital. Last night, Sri (who was also by his side all evening) was joking that he hasn't seen a jolly patient like Viral. :)

Although there isn't any conclusive news to share, we thought we'd still let a handful of folks (whoever came to mind just now :)) know about this -- and if time permits, perhaps you can also meditate and connect with Viral in the field of metta.

I will keep you posted with more as it develops.

With gratitude, :)

Nipun