newly released in September 2024:
The Soul's Red Thread
Memoirs of a Guide
The Soul's Red Thread
Memoirs of a Guide
An Excerpt from the Book
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Returning to the Lowlands
The hero may have to be brought back from his supernatural adventure by assistance from without. That is to say, the world may have to come and get him. For the bliss of the deep abode is not lightly abandoned in favor of the self-scattering of the wakened state. “Who having cast off the world,” we read [in the Upanishads], “would desire to return again? He would be only there.” And yet, in so far as one is alive, life will call. Society is jealous of those who remain away. Joseph Campbell, The Hero with a Thousand Faces |
“I say again: three phases of a rite of passage. Severance, threshold, incorporation. Of the three, the most difficult, by far, is the last. Incorporation.”
Jen was preparing us to leave for home the next morning. This last full day together had been hot, but not searing heat like earlier in the week. We had another hour of warmth before the sun would dip behind Telescope Peak.
“The Latin word corpus means ‘body,’ and so now your task is to bring whatever gifts you’ve received in the desert back into the Body of Life. But the return, my friends, is not always easy. Incorporation being so difficult is like an old guides’ tale. The wisdom has been repeated so many times, by so many wilderness guides, but no one knows who said it first. Most likely it was Steven or Meredith.”
I began to feel a fluttering in my chest, as if a small blackbird were trapped in my rib cage trying to escape. I knew why. It was that terrible nightmare from the night before.
The dream begins innocently enough with me sitting in my office at the county AIDS Clinic, preparing for another busy day. But then a wild man with a great mane of tangled brown hair grabs me out of my chair and pushes me down a secret staircase heading into the bowels of the clinic building. There we come to a dank and dark dungeon room, where he shackles me to a stone wall and locks the door on his way out.
“I like to think of a desert fast as time spent in the high country,” Jen continued. “Not just the high country of the physical desert, but a metaphorical high country. The High Country of the Mind and Heart. All through the ages, mystics have explored different routes into The High Country. Fasting. Extended solitude. Meditation. Going without sleep. Hypnotic chanting or dancing. Ingesting mind-altering plants. As for you all, you chose to fast alone on a desert mountain for four days and four nights. You chose to be a desert mystic.”
A desert mystic? I like that. That quieted the blackbird.
“But here’s the catch. What goes up, must come down. After two weeks here in The High Country, tomorrow you’ll be returning home. You’ll be heading back to the lowlands. The lowlands of the ordinary world.”
That sounds ominous. The blackbird inside started to flap its wings again.
“For as Ram Dass once said: ‘The down is part of the high.’”
I arrived home late the next day, a Saturday. That left one full day before I’d fall into another Monday morning vortex at the AIDS Clinic. I had a day to unpack, to tell my story to Bill, and to take Liza out for a late afternoon walk.
Now, looking back two decades later, I know how supremely difficult it can be for someone who has never fasted to hear about such an unusual experience. Some of the story will be incomprehensible to the uninitiated.
“. . . a nose-to-beak encounter with a hummingbird . . . forgiveness work in an imaginal Death Lodge . . . awake all night on a ridgetop, staring at the cosmos . . .”
“That all sure sounds weird,” someone might say.
And yet on that Sunday, Bill heard my story and mirrored it back in the most heartfelt way. I was too naïve to the ways of the desert to realize just how fortunate I was.
Humans are one of only a few species able to recognize a facial reflection in a mirror.[1] But before the advent of the looking glass, the only way early humans could see such a likeness was upon the rippling surface of a pond. Or perhaps, in the reflections offered back by other human beings.
Mirror, mirror. Where art thou, mirror?
Neuroanatomy research tells us that to hear and receive another person’s story well, we must call upon similar experiences from our past. These recollections are stored in mirror neurons: specialized brain cells that retain a multitude of memories, some of which may be like the story being told. Having the right mirror neurons are essential for the enjoyment of the arts—a novel, a movie, a play, or the lyrics of a song—just as they are important if you want to be a good listener to a storytelling partner or friend.
You mirror me. I mirror you.
On that Sunday, Bill made me feel so well-heard, so well-seen. How was that even possible? Bill had never gone exploring The High Country of the Mind and Heart—at least, not in this sort of way. For him, “fasting” was another word for starvation, “roughing it” meant going to a hotel without room service, and “baring your soul in a circle” was a waking nightmare. And yet Bill was right there when I returned home. Greeting me at the door with great expectation. Waiting patiently for the telling of the story the next morning. Taking in the tale of the hummingbird kiss, the Death Lodge ritual, and the vast night sky.
“Incredible,” he said at the end of the story. “It all sounds so incredible. It’s true: you’re a physician of the heart, a man of the heart.”
How did this happen? The beginning of an answer can be found way back in time: on the day that Bill and I first met at Fanny’s in the Castro. Right from the start, the two of us began developing a shared dialect of the soul: translating two very different spiritual paths into a common language. By the time I completed my first desert fast, we’d been doing that for over twenty years.
Tomorrow, I was headed to the AIDS Clinic where reflective waters would be unsettled and murky. At home, though, Bill was a clear forest pool.
You mirror me, Bill. I mirror you.
“During your solo time,” Jen continued, “your primary mirror was the great desert.”
She looked left toward Badwater and the Funerals, then right toward Telescope Peak where the sun would soon be setting.
“Mother Nature can be gentle or calm, harsh or dangerous. Either way, her mirroring is clean and clear. Whatever is there inside you, she’ll reflect that back.”
Jen returned her gaze to the circle.
“Since you came back to our community, the human mirroring you’ve received has been more prone to distortion, like the uneven surface of a pond. Such is human nature. And yet here within the magic of this desert ceremony, we each have been so friendly, so supportive, that the distortions of mirroring have been small. Contrast that with what’s waiting for you back home. That’s where incorporation becomes so very difficult. Cultural messages in the modern world are like warped mirrors in a circus funhouse, offering back distorted images of who you are.”
She offered three examples of these confusing messages, each one paired with its opposite.
“Best to live life fast and furious . . . but what if your soul is begging for you to slow down, asking you to be more fully present?
“Success is defined by money and jobs, by power and position . . . but what if the very thing you most love won’t make you any money?
“Communication is best done quickly and efficiently, by texting and emails . . . but what if you have a soul story to tell and you need others to listen, really listen?”
This all sounded familiar. After so many solitary retreats, I had the memory neurons to understand what she was saying. Each time I went away and found some kind of solitary bliss—be it at the Abbey or in the natural world—I always had to return home. Back to the whirlwind of work. Back to the madness of the modern world.
Can I do it differently this time?
“Out on the mountain, you all received some kind of gift. You might call it ‘a vision’ or in the words of Joseph Campbell, ‘a boon.’ Now you’re facing a major crossroad with several pathways before you. The most radical choice is to withdraw from the world and keep that boon to yourself. A second is to go home and see if you can turn the gift into a skill or commodity, something to be sold; but then you’ll risk losing the very essence of the gift. A third way forward, if you’re willing, is to find a place, a person, or a group that can receive some part of what you were given, and then invest fully in the giveaway. That last path, I believe, is the highest calling of incorporation.”
So what gift am I bringing back? No answer came.
“In the tradition of The School of Lost Borders, your desert ceremony will continue for a full year. A year from the day you ended your fast. That underscores just how difficult the path of incorporation can be. Nurturing a gift, a vision, a boon may take a long time. Perhaps an entire year. Maybe even a lifetime.”
Jen looked around the circle with her radiant blue eyes, marking each person’s face one at a time.
“Of course, there’s always a fourth option. You can go home and try to forget you ever did this crazy shit.”
The New Year’s fast had changed me, radically and irreversibly. I was certain of that. The surest sign was my weight. After losing five pounds during the desert fast, I would lose another five during the first month at home. I wasn’t consciously dieting. I was eating only when hungry.
I had stopped trying to feed a vague emptiness inside.
Yes, I had changed, but my daily life hadn’t. I returned home to the same stressors, the same jobs, the same schedule. I was working three days a week at the AIDS Clinic and two at Hospice of Petaluma, and on that first Monday morning, I had a packed panel of clinic patients there to welcome me back. When the starting gate opened, I started sprinting down the track.
“Be cautious with the telling of your story,” Jen had warned our group. “What’s at stake is nothing less than the honoring of your desert experience. If you tell your story to someone who can hear it well, then it’ll be respected and honored. It’ll be held up as something sacred. But tell your story to the wrong person and you risk being met by a blank face or nervous tittering. Even open derision. And that’ll drain the energy from your story.”
Her warning was prescient. At the clinic, I was met mostly by blank faces.
“I’m just back from a wilderness program in Death Valley” was a typical opening line I used with co-workers. Heeding Jen’s warning, I then would pause to read a person’s response. If I saw any kind of interest, I might add another line: “In the middle of the week we each did a four-day solo.” Then another pause. Most of the time, though, the story devolved into little more than a weather report from the desert. The more that happened, especially with the other physicians, the more I bristled. Might a traditional AIDS doc mirror back a newly baptized physician of the heart? That just wasn’t happening.
Mirror, mirror. Where art thou, mirror?
The only person who showed real curiosity was the clinic’s nutritionist, Grace Harding: a quiet, unassuming person who had joined the clinic three years earlier. Grace and I had a hello-in-the-hallway relationship, nothing more, and yet she was the one person who kept asking me question after question. Again, following Jen’s advice, I suggested we meet outdoors for a fuller telling of my solo story. Our time together outside was both confirming for me and inspiring for her. She closed the meeting by declaring her own call to do a desert fast.
The welcoming reception from Grace underscored how unseen I felt by the other doctors in the clinic.
In fairness, the work of an AIDS physician had changed dramatically in recent years. The arrival of a new class of antivirals—the protease inhibitors: ritonavir, nelfinavir, and indinavir—was a game-changer of the first order. Instead of prescribing antivirals one at a time, we now offered each willing patient an antiviral cocktail: one of these potent new drugs combined with two of the older nucleoside analogues, like AZT. For many, this cocktail would fully suppress replication of the AIDS virus, and when that happened, T cell counts rebounded, immune systems became functional, and lost weight was regained. People who had been riding on Death’s Merry-Go-Round, waiting to fall off, were now able to reach for the Brass Ring of Life. Many managed to grab hold of the ring, though some did not.
Before, my biggest responsibility as an AIDS doc was having intimate bedside encounters with people who were sick and dying. Dear people like Phillip and Alistair. Now, instead, I was an antiviral chemist. My job was to mix and match the right medicines, preach about the importance of adherence to whichever regimen a person was taking, and then watch for the development of drug resistance. All to the good, truly. We were saving lives, nothing less.
But is this the work I want to be doing?
During these first weeks back at work, I often thought of the nightmare I’d had in the desert: being shackled in a prison deep below the AIDS Clinic. With that, I also revisited what I’d said to my boss, Helena, just after the Geneva conference. “My days at the clinic are numbered in the thousands, not the hundreds.”
That was well over a year ago. Is the number now in the hundreds?
“Be forewarned,” said Jen. “In the coming weeks and months, some of you will start to doubt that this ceremony was real.”
Question if our time here was real? I saw myself on the last night of the solo, sitting under the starry cosmos. Of course it was real.
The sun had just dropped over the mountain and Jen was wrapping up the afternoon session.
“With all the distorting mirrors of modern life, the magic of the ceremony inevitably will fade. That’s when the questioning may start. For some, the questioning may even lead to a depression. What Meredith calls ‘the predictable depression.’”
Anxiety, yes. But a depression? Hard to imagine that.
“I’ll say again: this ceremony won’t make your life easier. It’ll make it more authentic. This makes me think of the psychologist Donald Winnicott and his ideas about the true self and the false self.”
Winnicott? My ears perked up. What might he have to say about all this?
“According to Winnicott, your true self lives in the present. It’s alive, instinctual, spontaneous, creative. During your solo time, that present-tense aliveness got activated in each of you. And that aliveness was so evident in the stories you each told after your return. Contrast that with the false self: an independent-seeming façade that often conceals an emptiness inside. Bad as that may sound, Winnicott was convinced that we all need a false self to survive in the human world. That’s why I prefer to call it ‘the survival self.’ This is the protective guise we each need to function in the lowlands of the ordinary world.”
What’s my own survival self? Immediately, an answer came. The do-gooding AIDS doctor. That’s what’s waiting for me back home.
“Trouble is the false self, the survival self, doesn’t always want to make room for something real and true. Its job is to survive the modern world, and so it’s going to be more invested in keeping life easy than making it more authentic. When you get back home, the survival self and the true self may start to battle, and if the survival self wins, you may question if this desert experience was even real. That was some crazy shit, you may tell yourself. That’s how the predictable depression can start.”
Back home, I never got truly depressed, but I did develop a serious case of ennui. Ennui: how I came to love to hate this word. The very sound of it--aan·wee—is so expressive, just as the feeling of it is so unpleasant. Ennui is like a heavy morning fog that blocks out the sun, refusing to lift until late in the day, if at all.
When I first thought of this label, ennui, I went to Webster’s in search of a definition. “Weariness and dissatisfaction resulting from inactivity or lack of interest.” My problem wasn’t inactivity; it was a lack of interest. Overactivity and a lack of interest in the action. Jen’s comments about the true self and the survival self helped me make sense of this feeling. I was back to rushing around, back to forever being in service to others. Perhaps all the hard work I was doing—this seemingly noble call to serve—was just the workaholic façade of the survival self trying to hide an emptiness inside.
Well then, where’s the true self to be found? Maybe that’s what I’ve been searching for on all those solitary retreats.
When I was away alone, I did feel different. More alive. More instinctual. More creative. But going away on frequent retreats had me living a ping-pong existence, bouncing between two extremes. Either I was an overworked doctor at home, or I was a slow-moving contemplative on retreat.
Am I the survival self at home and the true self on retreat? Probably not as simple as that.
By early March, two months after returning home, the ennui of incorporation was at its worst. I wasn’t sleeping well, which often left me dragging through the day, especially when I was at the AIDS Clinic. I knew how to play the role of the good enough physician when seeing patients, and yet I often was faking the part rather than feeling it. One Friday morning, I had an especially difficult clinic: too little time for too many people, and each visit seeming to be more of the same. Revisit the med list, review the latest lab results, and lecture about drug adherence. Over and over and over.
All to the good, but . . .
By morning’s end, the four walls of the office felt like a prison, as if I’d fallen into that dark dungeon room from my dream. I desperately needed to escape. Outside, dark clouds were threatening to dump rain, but still I grabbed my jacket and went out for a lunchtime walk. I meandered aimlessly through the downtown district, in search of some kind of solace. Soon I realized it wasn’t to be found in the outside world: in shops, cafés, or restaurants. Instead, I turned inward, gazing back at memories from my time in the desert.
Sitting on that ridge, looking across Badwater to the Funerals.
The night sky on the last day of the solo.
Listening to another person’s story when sitting in circle.
But all these images, as colorful as they were, were hazy and dim, as if they were from a long-ago dream. Where’s the magic of the desert? The magic of Liza’s first world? It’s gone. It’s long gone.
When raindrops started to fall, I headed back toward the clinic, though I continued to walk slowly. I wanted to breathe in the clean air, to seek out a fresh perspective. I reviewed my entire workweek in search of highlights that would contrast with the lowlight of the morning clinic. Two immediately came to mind. A Monday visit with Cristóbal Casal, one of my patients with full-blown AIDS, and the Wednesday interdisciplinary team meeting at Hospice of Petaluma.
Both involve caring for people who are dying. What’s up with that?
The hospice team meeting was the easier one to explain. This weekly meeting, more than anything else I was doing, was so reminiscent of the storytelling circles in the desert. We opened meetings holding hands in silence. We sat together in an actual circle, telling tender stories about people trying to live life fully to the very end. We closed each meeting with a candle-lighting ceremony to remember those who had died.
Where else in medicine does intimate storytelling like that happen?
The second highlight was the visit with Cristóbal, a former ballet dancer and choreographer whose career had started long ago in Spain and had ended in San Francisco. I had become his doctor a year before when he’d retired and moved permanently to a summer home outside of Petaluma. Sad to say, Cristóbal was one of the people on that fast-spinning AIDS merry-go-round who had reached for the brass ring and missed.
The split between the antiviral haves and have-nots was years in the making. In the late 1980s, long before the arrival of the protease inhibitors, people with AIDS were prescribed the first nucleoside antivirals, AZT and others, usually as monotherapy. That included Cristóbal. The virus inside him, exposed to just a single drug, was free to mutate into a drug-resistant strain. Taking one monotherapy after another then bred a super-resistant virus, which made all the available drugs worthless. By the time the protease inhibitors arrived, doctors finally understood that a person needed to take three drugs together to corner the virus and prevent it from mutating. But that understanding came too late for Cristóbal (and so many others). Any drug cocktail he took would be just another round of monotherapy—a potent new protease inhibitor plus two worthless drugs—and so resistance to the new protease was inevitable. By the time I met Cristóbal, he had no effective medications left. He was slowly wasting away and would likely die soon.
I want the drugs to work for Cristóbal, too. Of course I do. But why does his story interest me more than my other patients?
Winnicott’s true self and false self suggested an answer.
For Cristóbal, death was looming on the horizon and that had him looking at life with unbridled honesty. Here was the curious part: the stories I heard from Cristóbal, a man facing physical death, reminded me of those I’d heard in the desert from people facing a symbolic death. All these stories—from Cristóbal and from my desert compatriots—were a bald telling of personal truths: a true self revealed one person at a time. Facing death, physical or symbolic, seemed to demand nothing less.
The dark clouds overhead suddenly opened, releasing sheets of rain. I covered my head with my coat and began to run. By the time I reached the AIDS Clinic, my upper body was still dry, but my pants were soaked. As I stepped through the front door, the Geneva insight came back to me once again.
Yes, my days here are numbered.
Sitting at my desk, minutes later, a new line arose.
Is it time to quit?
“So yes, my friends, incorporation can be uber-challenging.”
Jen was leading the closing circle on our last morning together. In an hour, we all would drive away, heading north or south, east or west.
“Mirrors in the modern world are distorted and distorting, and so the desert gifts you’ve been given will be hard to remember, hard to retain. You may even experience that predictable depression. What then are you to do? My biggest recommendation is to be patient. Be patient and kind. Know that this ceremony lasts for a year. Inevitably, you’ll have your good days and your bad days. Such is life. So, what might you do to encourage the good days?”
This I needed to hear. A day later, I still felt shaken by the dungeon nightmare.
“To create this desert ceremony, we’ve brewed together a wonderful concoction of mind-altering elements. The most important of them all may be one you’ve hardly noticed. Spaciousness. For two weeks, you’ve had spacious freedom of a kind you never get back home. You’ve been able to slow way down, quiet the mind, and allow something new to emerge from within. ‘The true self,’ as I said yesterday. How do you bring that spaciousness back home? The answer is very simple to name but exceedingly hard to do. You’re going to need to set boundaries. You’ll have to learn to say ‘no.’ And often. All so you can create space in your day and slow down, and—even if just for a few moments—become still. Here’s a great quotation from Joseph Campbell, which captures this.”
She lifted a card from her lap and read the quotation. “You must have a room, or a certain hour or so a day, where you don’t know what was in the newspapers this morning, you don’t know who your friends are, you don’t know what you owe anybody, you don’t know what anybody owes to you. This is a place where you can simply experience and bring forth what you are and what you might be. This is the place of creative incubation.”
She scanned about the circle, waiting for Campbell’s message to land.
“What might be your own way of doing this? Lots of options. Meditating. Walks in nature. Yoga or tai chi. Reading poetry. Writing in a journal. Art projects. Or just sipping tea in the garden. Your soul, your true self, needs quiet time like this so it can breathe.”
Maybe it’s time I try meditating again. I’d long wanted to do this but had never managed to keep the practice going.
“Here’s another essential ingredient for our ceremony. Living outside in nature, beyond the confines of a four-walled shelter. When you’re back home, back in the lowlands, get yourself outside. For as long and as often as you can, get yourself outside. If the mirrors of daily life are distorting, then best to spend precious time outside, surrounded by the clear mirror of the natural world.”
This I can do. With Liza as my guide, I can get outdoors.
“So that’s a few ways to encourage a good day. What to do if you’re having a bad one?”
This I really needed to hear.
“Call on an ally and ask for help. Preferably it’ll be someone who knows this ceremony well. Nature as a mirror is so important, but so too is finding a quality human mirror. This might be someone sitting in this very circle, or it might be a friend back home. Whomever it is, call and ask for help.”
Jen was preparing us to leave for home the next morning. This last full day together had been hot, but not searing heat like earlier in the week. We had another hour of warmth before the sun would dip behind Telescope Peak.
“The Latin word corpus means ‘body,’ and so now your task is to bring whatever gifts you’ve received in the desert back into the Body of Life. But the return, my friends, is not always easy. Incorporation being so difficult is like an old guides’ tale. The wisdom has been repeated so many times, by so many wilderness guides, but no one knows who said it first. Most likely it was Steven or Meredith.”
I began to feel a fluttering in my chest, as if a small blackbird were trapped in my rib cage trying to escape. I knew why. It was that terrible nightmare from the night before.
The dream begins innocently enough with me sitting in my office at the county AIDS Clinic, preparing for another busy day. But then a wild man with a great mane of tangled brown hair grabs me out of my chair and pushes me down a secret staircase heading into the bowels of the clinic building. There we come to a dank and dark dungeon room, where he shackles me to a stone wall and locks the door on his way out.
“I like to think of a desert fast as time spent in the high country,” Jen continued. “Not just the high country of the physical desert, but a metaphorical high country. The High Country of the Mind and Heart. All through the ages, mystics have explored different routes into The High Country. Fasting. Extended solitude. Meditation. Going without sleep. Hypnotic chanting or dancing. Ingesting mind-altering plants. As for you all, you chose to fast alone on a desert mountain for four days and four nights. You chose to be a desert mystic.”
A desert mystic? I like that. That quieted the blackbird.
“But here’s the catch. What goes up, must come down. After two weeks here in The High Country, tomorrow you’ll be returning home. You’ll be heading back to the lowlands. The lowlands of the ordinary world.”
That sounds ominous. The blackbird inside started to flap its wings again.
“For as Ram Dass once said: ‘The down is part of the high.’”
I arrived home late the next day, a Saturday. That left one full day before I’d fall into another Monday morning vortex at the AIDS Clinic. I had a day to unpack, to tell my story to Bill, and to take Liza out for a late afternoon walk.
Now, looking back two decades later, I know how supremely difficult it can be for someone who has never fasted to hear about such an unusual experience. Some of the story will be incomprehensible to the uninitiated.
“. . . a nose-to-beak encounter with a hummingbird . . . forgiveness work in an imaginal Death Lodge . . . awake all night on a ridgetop, staring at the cosmos . . .”
“That all sure sounds weird,” someone might say.
And yet on that Sunday, Bill heard my story and mirrored it back in the most heartfelt way. I was too naïve to the ways of the desert to realize just how fortunate I was.
Humans are one of only a few species able to recognize a facial reflection in a mirror.[1] But before the advent of the looking glass, the only way early humans could see such a likeness was upon the rippling surface of a pond. Or perhaps, in the reflections offered back by other human beings.
Mirror, mirror. Where art thou, mirror?
Neuroanatomy research tells us that to hear and receive another person’s story well, we must call upon similar experiences from our past. These recollections are stored in mirror neurons: specialized brain cells that retain a multitude of memories, some of which may be like the story being told. Having the right mirror neurons are essential for the enjoyment of the arts—a novel, a movie, a play, or the lyrics of a song—just as they are important if you want to be a good listener to a storytelling partner or friend.
You mirror me. I mirror you.
On that Sunday, Bill made me feel so well-heard, so well-seen. How was that even possible? Bill had never gone exploring The High Country of the Mind and Heart—at least, not in this sort of way. For him, “fasting” was another word for starvation, “roughing it” meant going to a hotel without room service, and “baring your soul in a circle” was a waking nightmare. And yet Bill was right there when I returned home. Greeting me at the door with great expectation. Waiting patiently for the telling of the story the next morning. Taking in the tale of the hummingbird kiss, the Death Lodge ritual, and the vast night sky.
“Incredible,” he said at the end of the story. “It all sounds so incredible. It’s true: you’re a physician of the heart, a man of the heart.”
How did this happen? The beginning of an answer can be found way back in time: on the day that Bill and I first met at Fanny’s in the Castro. Right from the start, the two of us began developing a shared dialect of the soul: translating two very different spiritual paths into a common language. By the time I completed my first desert fast, we’d been doing that for over twenty years.
Tomorrow, I was headed to the AIDS Clinic where reflective waters would be unsettled and murky. At home, though, Bill was a clear forest pool.
You mirror me, Bill. I mirror you.
“During your solo time,” Jen continued, “your primary mirror was the great desert.”
She looked left toward Badwater and the Funerals, then right toward Telescope Peak where the sun would soon be setting.
“Mother Nature can be gentle or calm, harsh or dangerous. Either way, her mirroring is clean and clear. Whatever is there inside you, she’ll reflect that back.”
Jen returned her gaze to the circle.
“Since you came back to our community, the human mirroring you’ve received has been more prone to distortion, like the uneven surface of a pond. Such is human nature. And yet here within the magic of this desert ceremony, we each have been so friendly, so supportive, that the distortions of mirroring have been small. Contrast that with what’s waiting for you back home. That’s where incorporation becomes so very difficult. Cultural messages in the modern world are like warped mirrors in a circus funhouse, offering back distorted images of who you are.”
She offered three examples of these confusing messages, each one paired with its opposite.
“Best to live life fast and furious . . . but what if your soul is begging for you to slow down, asking you to be more fully present?
“Success is defined by money and jobs, by power and position . . . but what if the very thing you most love won’t make you any money?
“Communication is best done quickly and efficiently, by texting and emails . . . but what if you have a soul story to tell and you need others to listen, really listen?”
This all sounded familiar. After so many solitary retreats, I had the memory neurons to understand what she was saying. Each time I went away and found some kind of solitary bliss—be it at the Abbey or in the natural world—I always had to return home. Back to the whirlwind of work. Back to the madness of the modern world.
Can I do it differently this time?
“Out on the mountain, you all received some kind of gift. You might call it ‘a vision’ or in the words of Joseph Campbell, ‘a boon.’ Now you’re facing a major crossroad with several pathways before you. The most radical choice is to withdraw from the world and keep that boon to yourself. A second is to go home and see if you can turn the gift into a skill or commodity, something to be sold; but then you’ll risk losing the very essence of the gift. A third way forward, if you’re willing, is to find a place, a person, or a group that can receive some part of what you were given, and then invest fully in the giveaway. That last path, I believe, is the highest calling of incorporation.”
So what gift am I bringing back? No answer came.
“In the tradition of The School of Lost Borders, your desert ceremony will continue for a full year. A year from the day you ended your fast. That underscores just how difficult the path of incorporation can be. Nurturing a gift, a vision, a boon may take a long time. Perhaps an entire year. Maybe even a lifetime.”
Jen looked around the circle with her radiant blue eyes, marking each person’s face one at a time.
“Of course, there’s always a fourth option. You can go home and try to forget you ever did this crazy shit.”
The New Year’s fast had changed me, radically and irreversibly. I was certain of that. The surest sign was my weight. After losing five pounds during the desert fast, I would lose another five during the first month at home. I wasn’t consciously dieting. I was eating only when hungry.
I had stopped trying to feed a vague emptiness inside.
Yes, I had changed, but my daily life hadn’t. I returned home to the same stressors, the same jobs, the same schedule. I was working three days a week at the AIDS Clinic and two at Hospice of Petaluma, and on that first Monday morning, I had a packed panel of clinic patients there to welcome me back. When the starting gate opened, I started sprinting down the track.
“Be cautious with the telling of your story,” Jen had warned our group. “What’s at stake is nothing less than the honoring of your desert experience. If you tell your story to someone who can hear it well, then it’ll be respected and honored. It’ll be held up as something sacred. But tell your story to the wrong person and you risk being met by a blank face or nervous tittering. Even open derision. And that’ll drain the energy from your story.”
Her warning was prescient. At the clinic, I was met mostly by blank faces.
“I’m just back from a wilderness program in Death Valley” was a typical opening line I used with co-workers. Heeding Jen’s warning, I then would pause to read a person’s response. If I saw any kind of interest, I might add another line: “In the middle of the week we each did a four-day solo.” Then another pause. Most of the time, though, the story devolved into little more than a weather report from the desert. The more that happened, especially with the other physicians, the more I bristled. Might a traditional AIDS doc mirror back a newly baptized physician of the heart? That just wasn’t happening.
Mirror, mirror. Where art thou, mirror?
The only person who showed real curiosity was the clinic’s nutritionist, Grace Harding: a quiet, unassuming person who had joined the clinic three years earlier. Grace and I had a hello-in-the-hallway relationship, nothing more, and yet she was the one person who kept asking me question after question. Again, following Jen’s advice, I suggested we meet outdoors for a fuller telling of my solo story. Our time together outside was both confirming for me and inspiring for her. She closed the meeting by declaring her own call to do a desert fast.
The welcoming reception from Grace underscored how unseen I felt by the other doctors in the clinic.
In fairness, the work of an AIDS physician had changed dramatically in recent years. The arrival of a new class of antivirals—the protease inhibitors: ritonavir, nelfinavir, and indinavir—was a game-changer of the first order. Instead of prescribing antivirals one at a time, we now offered each willing patient an antiviral cocktail: one of these potent new drugs combined with two of the older nucleoside analogues, like AZT. For many, this cocktail would fully suppress replication of the AIDS virus, and when that happened, T cell counts rebounded, immune systems became functional, and lost weight was regained. People who had been riding on Death’s Merry-Go-Round, waiting to fall off, were now able to reach for the Brass Ring of Life. Many managed to grab hold of the ring, though some did not.
Before, my biggest responsibility as an AIDS doc was having intimate bedside encounters with people who were sick and dying. Dear people like Phillip and Alistair. Now, instead, I was an antiviral chemist. My job was to mix and match the right medicines, preach about the importance of adherence to whichever regimen a person was taking, and then watch for the development of drug resistance. All to the good, truly. We were saving lives, nothing less.
But is this the work I want to be doing?
During these first weeks back at work, I often thought of the nightmare I’d had in the desert: being shackled in a prison deep below the AIDS Clinic. With that, I also revisited what I’d said to my boss, Helena, just after the Geneva conference. “My days at the clinic are numbered in the thousands, not the hundreds.”
That was well over a year ago. Is the number now in the hundreds?
“Be forewarned,” said Jen. “In the coming weeks and months, some of you will start to doubt that this ceremony was real.”
Question if our time here was real? I saw myself on the last night of the solo, sitting under the starry cosmos. Of course it was real.
The sun had just dropped over the mountain and Jen was wrapping up the afternoon session.
“With all the distorting mirrors of modern life, the magic of the ceremony inevitably will fade. That’s when the questioning may start. For some, the questioning may even lead to a depression. What Meredith calls ‘the predictable depression.’”
Anxiety, yes. But a depression? Hard to imagine that.
“I’ll say again: this ceremony won’t make your life easier. It’ll make it more authentic. This makes me think of the psychologist Donald Winnicott and his ideas about the true self and the false self.”
Winnicott? My ears perked up. What might he have to say about all this?
“According to Winnicott, your true self lives in the present. It’s alive, instinctual, spontaneous, creative. During your solo time, that present-tense aliveness got activated in each of you. And that aliveness was so evident in the stories you each told after your return. Contrast that with the false self: an independent-seeming façade that often conceals an emptiness inside. Bad as that may sound, Winnicott was convinced that we all need a false self to survive in the human world. That’s why I prefer to call it ‘the survival self.’ This is the protective guise we each need to function in the lowlands of the ordinary world.”
What’s my own survival self? Immediately, an answer came. The do-gooding AIDS doctor. That’s what’s waiting for me back home.
“Trouble is the false self, the survival self, doesn’t always want to make room for something real and true. Its job is to survive the modern world, and so it’s going to be more invested in keeping life easy than making it more authentic. When you get back home, the survival self and the true self may start to battle, and if the survival self wins, you may question if this desert experience was even real. That was some crazy shit, you may tell yourself. That’s how the predictable depression can start.”
Back home, I never got truly depressed, but I did develop a serious case of ennui. Ennui: how I came to love to hate this word. The very sound of it--aan·wee—is so expressive, just as the feeling of it is so unpleasant. Ennui is like a heavy morning fog that blocks out the sun, refusing to lift until late in the day, if at all.
When I first thought of this label, ennui, I went to Webster’s in search of a definition. “Weariness and dissatisfaction resulting from inactivity or lack of interest.” My problem wasn’t inactivity; it was a lack of interest. Overactivity and a lack of interest in the action. Jen’s comments about the true self and the survival self helped me make sense of this feeling. I was back to rushing around, back to forever being in service to others. Perhaps all the hard work I was doing—this seemingly noble call to serve—was just the workaholic façade of the survival self trying to hide an emptiness inside.
Well then, where’s the true self to be found? Maybe that’s what I’ve been searching for on all those solitary retreats.
When I was away alone, I did feel different. More alive. More instinctual. More creative. But going away on frequent retreats had me living a ping-pong existence, bouncing between two extremes. Either I was an overworked doctor at home, or I was a slow-moving contemplative on retreat.
Am I the survival self at home and the true self on retreat? Probably not as simple as that.
By early March, two months after returning home, the ennui of incorporation was at its worst. I wasn’t sleeping well, which often left me dragging through the day, especially when I was at the AIDS Clinic. I knew how to play the role of the good enough physician when seeing patients, and yet I often was faking the part rather than feeling it. One Friday morning, I had an especially difficult clinic: too little time for too many people, and each visit seeming to be more of the same. Revisit the med list, review the latest lab results, and lecture about drug adherence. Over and over and over.
All to the good, but . . .
By morning’s end, the four walls of the office felt like a prison, as if I’d fallen into that dark dungeon room from my dream. I desperately needed to escape. Outside, dark clouds were threatening to dump rain, but still I grabbed my jacket and went out for a lunchtime walk. I meandered aimlessly through the downtown district, in search of some kind of solace. Soon I realized it wasn’t to be found in the outside world: in shops, cafés, or restaurants. Instead, I turned inward, gazing back at memories from my time in the desert.
Sitting on that ridge, looking across Badwater to the Funerals.
The night sky on the last day of the solo.
Listening to another person’s story when sitting in circle.
But all these images, as colorful as they were, were hazy and dim, as if they were from a long-ago dream. Where’s the magic of the desert? The magic of Liza’s first world? It’s gone. It’s long gone.
When raindrops started to fall, I headed back toward the clinic, though I continued to walk slowly. I wanted to breathe in the clean air, to seek out a fresh perspective. I reviewed my entire workweek in search of highlights that would contrast with the lowlight of the morning clinic. Two immediately came to mind. A Monday visit with Cristóbal Casal, one of my patients with full-blown AIDS, and the Wednesday interdisciplinary team meeting at Hospice of Petaluma.
Both involve caring for people who are dying. What’s up with that?
The hospice team meeting was the easier one to explain. This weekly meeting, more than anything else I was doing, was so reminiscent of the storytelling circles in the desert. We opened meetings holding hands in silence. We sat together in an actual circle, telling tender stories about people trying to live life fully to the very end. We closed each meeting with a candle-lighting ceremony to remember those who had died.
Where else in medicine does intimate storytelling like that happen?
The second highlight was the visit with Cristóbal, a former ballet dancer and choreographer whose career had started long ago in Spain and had ended in San Francisco. I had become his doctor a year before when he’d retired and moved permanently to a summer home outside of Petaluma. Sad to say, Cristóbal was one of the people on that fast-spinning AIDS merry-go-round who had reached for the brass ring and missed.
The split between the antiviral haves and have-nots was years in the making. In the late 1980s, long before the arrival of the protease inhibitors, people with AIDS were prescribed the first nucleoside antivirals, AZT and others, usually as monotherapy. That included Cristóbal. The virus inside him, exposed to just a single drug, was free to mutate into a drug-resistant strain. Taking one monotherapy after another then bred a super-resistant virus, which made all the available drugs worthless. By the time the protease inhibitors arrived, doctors finally understood that a person needed to take three drugs together to corner the virus and prevent it from mutating. But that understanding came too late for Cristóbal (and so many others). Any drug cocktail he took would be just another round of monotherapy—a potent new protease inhibitor plus two worthless drugs—and so resistance to the new protease was inevitable. By the time I met Cristóbal, he had no effective medications left. He was slowly wasting away and would likely die soon.
I want the drugs to work for Cristóbal, too. Of course I do. But why does his story interest me more than my other patients?
Winnicott’s true self and false self suggested an answer.
For Cristóbal, death was looming on the horizon and that had him looking at life with unbridled honesty. Here was the curious part: the stories I heard from Cristóbal, a man facing physical death, reminded me of those I’d heard in the desert from people facing a symbolic death. All these stories—from Cristóbal and from my desert compatriots—were a bald telling of personal truths: a true self revealed one person at a time. Facing death, physical or symbolic, seemed to demand nothing less.
The dark clouds overhead suddenly opened, releasing sheets of rain. I covered my head with my coat and began to run. By the time I reached the AIDS Clinic, my upper body was still dry, but my pants were soaked. As I stepped through the front door, the Geneva insight came back to me once again.
Yes, my days here are numbered.
Sitting at my desk, minutes later, a new line arose.
Is it time to quit?
“So yes, my friends, incorporation can be uber-challenging.”
Jen was leading the closing circle on our last morning together. In an hour, we all would drive away, heading north or south, east or west.
“Mirrors in the modern world are distorted and distorting, and so the desert gifts you’ve been given will be hard to remember, hard to retain. You may even experience that predictable depression. What then are you to do? My biggest recommendation is to be patient. Be patient and kind. Know that this ceremony lasts for a year. Inevitably, you’ll have your good days and your bad days. Such is life. So, what might you do to encourage the good days?”
This I needed to hear. A day later, I still felt shaken by the dungeon nightmare.
“To create this desert ceremony, we’ve brewed together a wonderful concoction of mind-altering elements. The most important of them all may be one you’ve hardly noticed. Spaciousness. For two weeks, you’ve had spacious freedom of a kind you never get back home. You’ve been able to slow way down, quiet the mind, and allow something new to emerge from within. ‘The true self,’ as I said yesterday. How do you bring that spaciousness back home? The answer is very simple to name but exceedingly hard to do. You’re going to need to set boundaries. You’ll have to learn to say ‘no.’ And often. All so you can create space in your day and slow down, and—even if just for a few moments—become still. Here’s a great quotation from Joseph Campbell, which captures this.”
She lifted a card from her lap and read the quotation. “You must have a room, or a certain hour or so a day, where you don’t know what was in the newspapers this morning, you don’t know who your friends are, you don’t know what you owe anybody, you don’t know what anybody owes to you. This is a place where you can simply experience and bring forth what you are and what you might be. This is the place of creative incubation.”
She scanned about the circle, waiting for Campbell’s message to land.
“What might be your own way of doing this? Lots of options. Meditating. Walks in nature. Yoga or tai chi. Reading poetry. Writing in a journal. Art projects. Or just sipping tea in the garden. Your soul, your true self, needs quiet time like this so it can breathe.”
Maybe it’s time I try meditating again. I’d long wanted to do this but had never managed to keep the practice going.
“Here’s another essential ingredient for our ceremony. Living outside in nature, beyond the confines of a four-walled shelter. When you’re back home, back in the lowlands, get yourself outside. For as long and as often as you can, get yourself outside. If the mirrors of daily life are distorting, then best to spend precious time outside, surrounded by the clear mirror of the natural world.”
This I can do. With Liza as my guide, I can get outdoors.
“So that’s a few ways to encourage a good day. What to do if you’re having a bad one?”
This I really needed to hear.
“Call on an ally and ask for help. Preferably it’ll be someone who knows this ceremony well. Nature as a mirror is so important, but so too is finding a quality human mirror. This might be someone sitting in this very circle, or it might be a friend back home. Whomever it is, call and ask for help.”