It’s time for the next installment of Howard’s Divine Comedy, wherein Howard continues his journey toward death with his hero companion.

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Howard: Hey Jerry, did you ever do yoga?

Jerry Garcia: Well, not really. But, you should see this cool yoga mat with me on it!

H: Far out!

J: I know, right?! It’s hilarious, because I wasn’t exactly a paragon of healthy living. I basically gave myself Type II Diabetes with my infamous Haagen Dazs Diet.

H: Yeah, but Jer, contrary to the most common modern Western varieties, yoga isn’t primarily about physical fitness. The word yoga comes from the Sanskrit root yuj, which roughly means “to unite,” like, to cultivate a union between body, mind and spirit, and between the individual self and universal consciousness.

J: Hey, well, that’s what music does for me! [sings] I ain’t often right, but I’ve never been wrong. It seldom turns out the way it does in the song. Once in a while you get shown the light, in the strangest of places if you look at it right.*

H: Exactly!

(*–Robert Hunter, from Scarlet Begonias by the Grateful Dead)

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Occupational Therapy: a definition

Interventions to develop, recover, or maintain meaningful activities, or occupations, of everyday life that have been limited or prohibited by a medical condition, injury, or disability.

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Occupational Yoga

As ALS progresses, motor neurons die, muscles in the arms, legs, hands, and feet atrophy, fine and gross motor skills decline, and maintaining “meaningful activities of everyday life” becomes gradually more difficult and then impossible. This slow erosion is brutal. The loss of independence is devastating.

And yet, on my better days I’ll experience brief moments when I can keep myself from going immediately to despair upon struggling with something due to my crippled hands and weak legs, and I owe it to having practiced yoga off and on for many years.

What I’ve now named Occupational Yoga, then, simply applies the following principles to activities such as feeding, bathing, and dressing myself, rather than to forming a variety of dynamic and static body postures:

• breathe
• concentrate on form
• proceed slowly
• breathe
• ahimsa, aka do no harm

As with other disciplines, I must be honest and say that I’m only occasionally successful at utilizing this method and staving off intense frustration and disappointment at having such difficulty with these basic self-care tasks. (NOTE: Also, the breathing component of yoga is made more difficult by The Breathing Paradox that I wrote about in February, and breathing has become considerably more difficult in the months since.)

However, I really do think this is a promising application of yoga principles, and not just for ALS patients, or persons with other limiting medical conditions or disabilities. Even fully able-bodied people can have difficulty with some kind of activity of daily living, but with practice, and perhaps with the help of an Occupational Yogi, should that ever become an actual thing, I sincerely believe that this could be an incredibly helpful approach.

To more fully illustrate Occupational Yoga — and taking inspiration from Vinyasa Yoga, which employs sequences of postures completed in succession, and which flow, one into another — here’s an ALS variation on perhaps the most famous flow yoga sequence of them all: Sun Salutation.

Coffee Salutation

• Approach the coffeemaker
• Breathe in and breathe out, enjoying the invigorating aroma from the coffee so generously prepared for you each morning by your loving wife
• Breathe in and apply your dominant hand to the handle of the coffee carafe
• Breathe out and apply your other hand to the handle, taking care to prevent a burn by keeping the knuckles from touching the carafe for too long
• Breathe in and lift the carafe, slowly moving it toward the mug that your wife so thoughtfully set out for you
• Breathe out as you pour, breathe in as you return the carafe, breathe out as you twist off the cap to the creamer carton using your index and middle fingers in that funky way you’ve figured out that works if the last person to replace the cap didn’t do so too tightly, breathe in as you grab the carton carefully in both hands, breathe out as you pour, and in as you replace the cap
• Take a deep breath in, and on the out-breath slowly and gently begin a forward bend, legs bent slightly, back straight, moving your head toward the mug on the counter
• Breathe in and sip/slurp coffee from the mug until the coffee level goes down approximately 1″ to 1-1/2″ from the rim, breathe out
• Breathe in while placing your dominant hand on the mug handle, breathe out while placing index finger and thumb of your other hand on opposite side of mug within that 1″ to 1-1/2″ from the rim where the mug is slightly cooler
• Breathe in, firmly apply pressure with fingers and hands and lift mug slowly, breathe out and gently pivot 90°
• Take alternating steps forward, left foot on the in-breath, right on the out-breath, alternating gaze between the coffee in the mug to prevent spillage and the armchair that is your destination
• Upon reaching the chair, breathe in, and on the out-breath begin another gentle forward bend, this time in order to place the mug on a coaster on the adjacent end table
• Breathe in and slowly assume a seated position, breathe out and you are ready to enjoy your morning coffee

Namaste!

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