Part I: Staying with Conditions

A two-part reflection on living with chronic illness, Zen practice, and the conditions that shape our lives.

Part I sits in the body—fear, care, memory, and the slow work of practice in the middle of medical uncertainty.

Part II widens the lens, looking at how the same conditions move through systems, race, power, and the world we share.

This isn’t about resolving suffering.

It’s about learning how to stay present—without closing the heart.

Part I: Staying with Conditions

For me, the five skandhas — the five conditions — have never felt like problems to overcome.

They are what make us human.

Form, feeling, perception, mental formations, consciousness — these aren’t obstacles to awareness/awakening. They’re the terrain. What matters isn’t whether these conditions arise, but how I’m working with them. How I’m holding my mind. How that mind moves into action, into clarity, into attitude.

This week, I started a new treatment protocol.

I’ve been living with a slow kidney transplant rejection for years now, driven by antibody sensitivity. This is my third kidney transplant, and because of that history, my immune system is highly sensitized. I’ve been working with this reality since 2020. Antibody sensitivity happens when the immune system develops defenses against foreign tissue — often after previous transplants. It’s technical, clinical language, but what it really means is that my body remembers loss.

As I sit here receiving this infusion, I wonder — quietly, honestly — will this help slow the decline? Will it give this kidney more time?

My mind drifts back to my second transplant in my thirties. It lasted only a year. I remember the physical pain, but more than that, I remember how my mind spiraled. Even though I was practicing Zen. Even though I was seeing my therapist. I still fell into depression. Practice didn’t protect me from that.

What it did — what it has continued to do over the twelve years of living with this third kidney — is help me find a rhythm. A way of being in my life while also noticing what else is true. Including the parts that make me uncomfortable.

A large part of that has been my practice with my teacher, Koshin. I don’t always agree with everything he says or with his approach — and that’s not the point. The practice, as I’ve come to know it, is simple and unforgiving: show up, shut the fuck up, and receive the teachings.

Not because the teacher is always right — but because my resistance is usually louder than my listening.

The living Dharma doesn’t arrive on command. You never know when or how a teaching will land. You receive it when you’re ready — when you drop your mental shit storm long enough to let something else in. That’s why showing up matters. Listening matters. And I’m still struggling with that.

Which is fine.

I’m supposed to.

I’m human — working with the very conditions that make me human.

As I sit here now, I notice something else.

Yasmine, my nurse, is moving between patients. She’s juggling orders, checking vitals, adjusting lines. And yet she’s present. Her smile is warm. She checks in, makes sure I’m tolerating the infusion, notices that I’m cold, and brings me another blanket without being asked.

I can hold that alongside my fear.

I can hold concern about rejection and gratitude for care at the same time. Practice has taught me that these truths don’t cancel each other out.

As my teacher often says, practice gives us the opportunity to catch the mind — especially before it starts spinning stories that aren’t helpful in the moment. Otherwise, before I know it, I’m deep into season eight of my uncertainty, anger, and worry show.

Right now, I don’t need to resolve the future.

I just need to stay with what’s here.

This body.

This mind.

This infusion.

This kindness.

The Dharma isn’t asking me to escape my conditions.

It’s asking me to meet them — without abandoning myself.

What I’m learning here—in this body, in this chair, in this moment—is not separate from the larger world I return to when I leave this room.

The same conditions that shape illness and care also shape systems, power, and belonging.

The same practice that helps me stay present here is what I rely on when I step back into the world.

This is where Part II begins.

See you soon.

-DT