Tuesday, April 7, 2015

Rick's Camping Trip (1998)

Falling into the Stream: Rick’s Third-Grade Camping Trip.1998

David B. Schwartz

I saw her when she fell. She had climbed tentatively up the steep embankment to where the other children were lined up excitedly for their turn on the swing. They would tightly grasp the rope I had suspended from the pulley, then launch themselves off the edge, whizzing down the suspended rope over the streamlet below to the bank where I stood. Screaming in happy excitement, they would fly down to where I waited.

It was clear that she was going to have a more difficult time doing this than some of her other peers; no doubt that is why she had held back. But she didn’t stay away; she had the courage to come over from the campsite and get herself to the top. Her classmates crowded around her showing her how to hold the rope, how to push off, encouraging her. She kicked herself free of the edge, rode down a few feet in the air, and then she fell. She wasn’t holding onto the rope tightly enough, and she fell like a stone to the rocks below, levering face-down into the water and the rocks. I saw it as if in slow motion, fifteen feet beyond my grasp; she lay inert in the stones and frigid water.

I and Rick, her old first-grade teacher and the camp leader, sprung into the creek at the same time, lifting her and helping her to the dry ground, as she gasped air and started to cry. We checked her over carefully; her arm, her forehead; miraculously, she seemed all right, just frightened and cold and wet and shaken. As we sat her down on a dry spot of mossy earth and I put my jacket over her, Rick knelt down beside her. He didn’t merely pat her on the shoulder or the head; he enveloped her in his arms. Rick is a big man and his arms are strong. He had no doubt held her when she was little. His hug was a familiar one. She cried and shook. He was speaking to her softly. He didn’t let her go. I noticed that he was not only reassuring her, but he was praising her - she had fallen so well! She really knew how to fall without hurting herself! And this was true. She easily could have broken her arm or cracked her head falling from such a height, but she had managed to protect herself. Rick held her for a long, long, time. His daughter clambered down from the hillside and put her arms around her friend too. And then I came over and put my hands on her shoulders as well. The other children made little noises of concern while the grownups took care of her, wondering if she was all right.

Only when she had gathered herself and was all right again did Rick unwrap his arms and help her upright, commending her into the care of a friend to walk her back to the campsite. Word of her fall had reached the camp before she did, and a parent met her to make sure that she hadn’t sustained a concussion, taking her over to another parent who was a physician to carefully examine her. She was all right. Someone else got her dry clothes, got her a cup of hot chocolate, and seated her by the fire to warm up. In a little while, she was all right again. She was just a little sore.

In this simple story I caught a glimpse of something remarkable. For this is not how these stories usually go. Often, instead, they go like this: the child, already painfully aware that attempts like this usually don’t go well for her, falls the same way. But instead of the soft voices of concern of her classmates, there is the cruel judgment of one’s peers for someone weaker, or not as accomplished, or merely different. The teacher picks her up, but she is merely dusted off, settled, perhaps offered a few tissues, and enjoined not to cry. It may be very subtle, but the child does not miss that she is not in some way accomplished, desirable, or loved.

I will sit in my office this week and conduct psychotherapy with adults who are struggling with deep depression, or debilitating anxiety, or other painful problems in their lives. In the course of our careful work, I may eventually hear such a story as this; the story that didn’t go the right way. It will not be this story alone, perhaps, but will be a series of them, taking place over the years, that will cement a conviction that they are clumsy, different, not really quite loveable. When they tell me the story of how they fell, again, and how everyone laughed, once again, they will start to cry softly.

Standing there in the woods watching Rick hold that little girl and whisper to her of her success in falling correctly, I realized, somewhat awestruck, that I was seeing such a traumatic incident smoothed out, erased before my eyes at its very moment of origin.

Rick has been teaching first-grade children at Londonderry school for twenty-five years. In that time, he has taken groups of children to the same campground perhaps that many times. One of his former students, Chip, now in college, showed up with his sleeping bag to help out. He remembered the same hikes, the same games, the same way Rick was with the children as he was today. And he remembered the caring, loving, atmosphere of Londonderry with which Rick and his co-founder Rhoda inoculated every child who grew up in that school, every teacher who taught there, every parent who went along on a camping trip. It was not an accident that the children did not laugh when their classmate fell. That does not happen at Londonderry, and every new generation of pre-schoolers learns why.

Later, talking to Rick, I was asking about the caring community that he and Rhoda and the other teachers and parents and students had built over the years. Londonderry was not what the “outside world” was like, he readily agreed. This was a rare experience for many. But to experience the possibilities of being in a place where one was safe, and loved, and secure, whether a young child or a parent with their own grown-up realities, was to see that living this way together was not an impossible thing. Somewhere, in there, one might develop a taste, even a hunger, for living together in this way. And they might well carry this vision into the world in which love and caring are not held in such high importance.

For the children especially, though, like this young girl, the results would be deepest. For her, she would probably never really be aware of the fact that her teacher, with greater skill than a psychotherapist, had simply wiped away what might otherwise be a searing emotional experience that could cause her to be guarded and self-protected her whole life. She might never be aware that he had probably done this countless times during her childhood. She might not recall that other teachers and countless community members over the years had followed Rick’s example, and Rhoda’s, and those who had learned from them. It would be in what was not in memory that the greatest gifts would be recorded. She could simply be free.

Talking to Grandmother Oak (1998)

August, 1998

David B. Schwartz

She camped all the way to Florida, living on fresh roadkill. That’s the first thing I heard about Brenda when she showed up in Sarasota back in 1967. She and her companion Tom, an Arctic explorer, drove down from Canada, camping along the side of the road. They’d stopped when it got close to dinnertime at each roadkill, poking and examining the carcass until they found something fresh and appetizing. Then they’d make camp, dress out the raccoon or possum or squirrel with their razor-sharp buck knives, make a fire, and turn the meat on a spit. Crawling into their pup tent, they’d rise early in the morning, make coffee, and drive another day. Brenda sure looked like somebody out of the North woods compared to all of us in our shorts, T shirts and sandals. Tall, blond and angular, she dressed in a long-sleeved shirt, well-worn blue jeans and hiking boots. A buck knife was strapped permanently to her belt, a small sketchpad always in her hand.

Brenda, even at that young age, was an experienced Arctic naturalist. Traveling with her partner Tom on his frequent trips above Hudson’s Bay and Baffin Island, Brenda sketched and painted wildlife, getting as close as she could to see birds, seals, walruses, and polar bears. The finished watercolors in her folio were charged with the sharp, illuminating light of the Northern latitudes. Against a pale-blue sky and dark sea a Great Blue Heron would stand on a rocky shore. Each pebble, each blade of grass, each feather was drawn with the detail worthy of an Audubon. I had never seen anyone my age who could paint like that. The nature that she painted was alive. Later, when she linked up with my friend Roger and they moved in with him on an overgrown estate on the tip of Longboat Key, where I made my own home in a shack near the bay, I got to know her a lot better. We talked as she stood at her easel, which was set up in front of an orange tree in the overgrowth. Under her brush, three oranges on a branch rose off the page like glowing suns setting over the Gulf nearby.

After college, I saw Brenda only rarely for 30 years. But like most friends from that extraordinary time, we did not lose touch entirely. We would always hear news of each other, and we’d see each other upon occasion. I knew that she had become a noted Canadian wildlife artist, with her own gallery in Merrickville along the Rideau Canal, whose portraits of birds in the wild had become especially sought after. She painted for the National Geographic, and even achieved the greatest honor for a painter of birds: to have her work appear on a Canadian duck stamp. Then I learned that her companion Tom had taken seriously ill. In his farmhouse far from the Arctic wilds where they had spent so much time together, Brenda nursed him through his final illness.

I called Brenda up about a year after Tom had died to tell her that Roger had terminal
melanoma. So Rodger’s own dying served to bring us together again to care for him in his own final illness. The years had changed Brenda little. She still wore blue jeans and a buck knife. She still carried the ubiquitous sketchpad. But since Tom’s death, she had lost the ability to paint. When she picked up her brushes, she told me, old critical parental voices called so loudly to her in her head that she could only stop it by laying the brushes down. She struggled, for the first time in her vigorous life, with a chronic illness herself precipitated by Tom’s loss.

More than 30 years after I had stayed at Brenda and Tom’s farmhouse with she and Roger, I wheeled in the driveway with my young son Nate and his best friend. We were on a boys’ road trip, the summer after my own separation from my wife. I wanted to take Nate and Biniam on a "Blue Highways" trip to Maine, traveling only on secondary roads, taking ferries instead of bridges, and stopping to see old friends along the way. I wanted them to see the America that I had known as a child, before the advent of the interstates and their accompanying identical fast-food restaurants, Holiday Inns, and strip-malls. I also wanted to show Nate grownups who were pursuing in their adult lives precisely that interest in the natural world that so compelled him. I wanted to show him more friends of mine who did what they loved, rather than being trapped in offices and careers.

I had taken him to see friends who had returned to living the way that they really wanted to after some years of conventional employment. But Brenda was a person who had never wavered, even for a moment. We walked the trails on her 550 acres of Ontario woods. A bird flew overhead, squawking. Brenda looked up. "Those terns have made a nest in that tree. Now, they are talking in their teenage voices." It was clear that Brenda knew all of the birds around her house individually and could identify them at a distance and by voice. She knew the trees, too, even deep in the woods. She pointed out an immense white oak in a boggy hollow to the left of the trail. "Grandmother Oak has given me a hard time over the years. Not so much anymore, though. I would try to paint her and she would play tricks on me." With my questioning, Brenda allowed that she could feel the spirit of trees.

"What is the spirit of a tree like?" I asked.

"Very slow, very deep," she replied. "They don’t notice or change much. Wetness, dryness, fire, insects; that sort of thing." We walked on, Nate and Biniam running ahead, as boys do, towards the swamp.

Brenda and I sat on a rough bridge that she had made which crossed a muddy, water-lily choked, shallow stream. Nate and Biniam immediately stripped and jumped into the water, paddling through the mud and vegetation like some little African children. We watched them playing, happily and fearlessly, in the swamp. I asked Brenda to tell me more about her deep connection with the natural world. How did she come to it? How had she overcome pressures to get a "real job" for all of her life?

"I have always known that the world is alive," Brenda said, dropping a stick into the slow current and watching it lazily flow through the water lilies. "I’ve always known that there is no real dividing line between humans and the rest of nature. But it was the gift of a book from my mom when I was seven that convinced me that it was possible to live a life of adventure. The book was Man Eaters of Kumaon, by a guy named Jim Corbett. After that, I never considered living any other way. My dad used to give me a lot of trouble about it. He didn’t like this about me. ‘You’re going to end up a street cleaner,’ he yelled at me. I didn’t reply – he could get pretty mad – but privately I would think to myself that it might be a rather nice job." She pursued what she wanted to anyway. Contrary to my impression, Brenda pointed out that in the art world, she wasn’t considered a "real" artist. No wildlife artist was. "Animal painting isn’t considered ‘real’ art unless the animals are dead," she explained. It didn’t bother her. We were sitting on the bridge on a beatingly hot August day. It was extraordinary – it just doesn’t get that hot in Ontario. We had driven hundreds of miles north, north of the Great Lakes, anticipating that it would cool down as we came north. But the heat never lessened at all. It was the hottest summer on record, and the longest drought. I asked Brenda about the global warming that was so evident around us. She looked off philosophically. "People are turning forms of nature that are beneficial to them into forms that are toxic to them. Eventually, it will be too toxic for us pink, squiggly worms to survive. But the earth, Giaa, will go on – that’s all the world is: cycles of creation and destruction. I’ve been sketching a portrait of my cleaning lady – you know, like these natural cycles, she is the one who cleans up. I call the drawing my ‘Black Madonna.’ Nature is going to clean the earth of all these humans." I looked out at my son and his friend paddling back toward me, pulling up things to examine from the muddy bottom with their feet, and I felt a pang.

When we left Brenda for the mountains of New Hampshire, she was about ready to leave on another birding trip. "A year after Tom died, I still felt pretty discouraged," Brenda had explained to me, "and I was sick. So I decided that I needed to do something new – some big undertaking – to pull myself out of it. I decided that I would identify and sketch in the wild 200 birds in the coming year." This was an extraordinary undertaking, it seemed to me: many birder’s life lists – the number of birds they had simply observed in the wild over a lifetime -- was only 200. By November of that year, Brenda had already sketched her 200. Then she kept on going. Someone had told her where a rare bird could be sighted in the swamps of Louisiana, and she was about to get on a plane to see if she could find it.

Before we left, she helped me pick some peaches from her tree for our journey. "You should pick them when they are as firm as a young girl’s breasts," she said, plucking a ripe peach deliciously from its stem and handing it to me. She sounded like Julia Child giving instructions for marketing. Then she unsheathed her buck knife and cut me a stem of ripe tomatoes from her garden. The boys and I got into my car and headed off towards the Eastern Mountains.

Hillbillies by Intention (2001)

Hillbillies by IntentionMarch, 2001

“A human community must exert a kind of centripetal force, holding local soil and local memory in place.”

Wendell Berry

Amtrack's Crescent pulled into Philadelphia's 30th Street Station right on time at 4:50 PM, and my son Nate, 9, and I boarded her bound for Greenville, South Carolina. It was the day after school let out for the summer, and we were bound for Country Dick's cabin in the Smokies for a salamander hunt. Nate loves salamanders. Before we moved to the city, his mom and I had lived for many years deep in the woods in the Finger Lakes region of New York State. We built a log cabin from trees I had cut one winter up on the high ridge between the lakes, just as my great-grandfather Philo had done nearby after the Civil War. We spent many years there, before work had called me to Harrisburg, PA. But we kept the old place, and brought Nate there for the first time the spring he was born, when he was just three weeks old.

Below the cabin is a stream, and when we go back to our homestead in the summers Nate and his best buddy Ian are down in that ravine as they have been from the time that they could walk, flipping over rocks to find the salamanders beneath. In the evenings, we go up to the farm pond and they catch frogs, just like I did when I was a kid. Now we were going to take the train to find salamanders at Country Dick's. We were going to see the mountains, and we were going to take an overnight train.

So I pulled my son away from his usual city amusements; cartoons and computer games and city parks, and we boarded a Pullman car for Greenville. A couple of family trips in Pullman cars are happy memories of my own childhood. I remember lying in the top bunk, looking out the little window at the small towns passing in the night, of the rhythmic clicking of the wheels as our long train sped down the track. I wanted him to know that too. Who knows how long there will still be such trains? Our friendly porter showed us to our room, and Nate sprung like a monkey up onto the top bunk as the train pulled out and headed south. Down below I unpacked my guitar and sang train songs; "The City of New Orleans," of course, and "Daddy What's A Train," an old Utah Phillips favorite:

"Daddy what's a train?
Is it something I can ride?
Does it carry lots of grownup folks
And little kids inside?
Is it bigger than our house?
Well how can I explain,
When my little boy he asks me
'Daddy what's a train?'"

The train sped along on its modern clickless rails. We had dinner in the dining car, and fell asleep to the lonesome whistle of the engine ahead, barreling through the night through the Virginia hills.

Country Dick

I had heard that Country Dick had moved up to the mountains, and I resolved to visit him. He and his wife Lori had finally had enough of what Mencken had called "snivilization." They sold their house in Knoxville and moved up to their little summer cabin high in a notch of the Great Smoky Mountains. They moved far, far, up: far from the nearest store, far from the nearest paved road, up where the mountain people lived as they had lived for generations. Setting their modern habits aside, Dick and Lori took up the way of living of what city folk called hillbillies. Despite the effort, they did so with a great sense of relief.

Back at New College in Sarasota in the mid-sixties, Dick had arrived at that eclectic place standing out by his southern country drawl, his apparent calm and personableness and how he set you at ease with his warm, relaxed style. He stood out there, far from his origins, and that is how he got his name. Early on in philosophy class one day he mispronounced Nietzsche, calling him "Nizke,[sp]" like the football player. Some New Yorker put his arm around his shoulder and corrected him. "Man, we're going to have to call you Country Dick from now on," he kidded him. And the name stuck.

Despite the six AM arrival of our train - Country had gotten up at three AM to make the two-hour trip down to meet us - he was there as we stepped off with his usual warm smile, and a thermos of coffee under the pickup seat. We headed up through the dawn mists through Asheville and then into the corkscrew roads of the mountains, pulling through deep green forest hollows and around grassy mountaintop "balds," turning left and right down unmarked washboard mountain roads, past tiny "patches" of fields and ramshackle houses, splashing through the trickles of innumerable springs flowing out of hillsides, until we finally arrived at that little collection of farms known as "Max Patch," after the high mountain "bald" in whose lee it nestled.

As we pulled up the dogs roused themselves from holding down the railingless cabin porch and ran over to sniff us over and greet us. Dick and Lori's log cabin sat on the edge of a steep field overlooking a steep-sided valley known as 'Boomer Den,' after the boomers (squirrels) that had once made their homes there. Sitting on the swing seat on the porch, you could see the high ridge of the Smokies off to the West, and other named peaks to the East. The almost complete silence of the surroundings was broken only by the hummingbirds that "buzz-bombed" you on the way to their syrup feeders. There was not even airplane noise overhead.

Spring Lizards, Healing Plants, and Neighborliness

Country Dick had written us that the Smokies had one of the biggest concentrations of salamanders in North America. “It’s one of the largest sections of biomass in these mountains,” he had written me. Even more tantalizingly, one of the myriad species crawling around in these mountain springs - hence the local term “spring lizards” - was the hellbender, the biggest spring lizard of them all. “They are a foot long,” Country had written. “Fifteen inches,” Nate sagely corrected. “Anyway,” Country Dick wrote, “down here they call them allegheny alligators.” Dumping our bags into the cabin and waving hi to Lori, we pulled on our boots and headed out into the lush woods, looking for springs and spring lizards.

While Nate turned over countless rocks reaching for lizards, Dick and I looked about the woods. Like all of his neighbors, the woods were his home, and he knew a large number of plants and their medicinal uses. Those that he didn’t know, his wife Lori did. They grew wild ginseng, sought-after by the Japanese for its potency, in these woods, and they gathered others that Lori had learned from her mother. There was blue cohash for female troubles, and others I had only faintly heard of. When we became tired and started to feel hunger pangs after long hiking, still far from home and our noon-time dinner, Dick paused by a serrated-leaf, waist-high plant with a distinctive purple stem. “This here is spignet,” he told us, busy exposing a lateral root with a pocketknife, “but some people call it spikenard. I never heard of it before I moved up here. Here,” he offered, scraping the dirt off a three-inch section of root he had cut. “Chew on this. It takes care of being hungry and thirsty and tired.” I chewed the slightly bitter-tasting root, swallowing the astringent juice and spitting out the fibrous pulp. We walked on, and in a little while I noticed that in fact my hunger pains had gone away, and I no longer felt fatigued at all. We walked along the trail with renewed energy, as if we had been chewing coca leaf up in the Andes. Here, so much of what people needed, I mused, was under their feet.

We pushed our way through the woods from spring to spring, eyes out for snakes, as Nate unearthed salamanders, bugs, and the occasional squirming orange mudpuppy. Nate would be on them like a cat on a mouse, diving full length along the stream-bottoms after them. “That Nate is all boy,” Dick observed approvingly, leaning against the rail of a footbridge.”

Later, a farmer hoeing his "tater patch’ observed about the same thing, watching Nate wade after frogs in his farm pond. ” I began to see the true differentness of these mountain people. Unlike most of modern America, the mountain folk really like children. They seem to enjoy them rather than to feel inconvenienced by them. Marcus leaned on his hoe and looked approvingly down at Nate splashing intently around the margins of his pond. “We can use boys like that in these mountains,” he volunteered. Nate reminded him, it was clear, of himself when he was young. Nowadays, Country told me later, everybody has nephews and nieces and grandchildren who come up to visit from the cities who want only to know about cable tv and computer games, which don’t exist here. I felt relieved and grateful to see that Nate was not among them.

I think of the children who I see in my practice who have been referred by schools pressing for ritalin and counselling. I am reminded of my child psychiatrist friend Normand up in the Canadian Maritimes, who observes that up in Newfoundland they don’t have any attention deficit disorder and hyperkinesis among children. “Up there, they just run around in the woods,” he observed. “People don’t think anything is wrong with them". In the modern world, it seems to me, there is very little tolerance of genuine manhood or womanhood, and very little tolerance for differentness. Up here, there was tolerance of everything except government.

The thing I noticed in countless interactions with Country Dick’s neighbors was how they had time for and interest in each other. Nobody would think of passing each other with a wave on their way to do some work; everyone always paused for a long conversation about the crops, and the weather, and, in our case, the best place to find spring lizards. It was not just children who they liked; they liked each other. Except for living in a commune in the early seventies, Dick and Lori told me, this was the only time that they had really felt part of a community in their adult lives. If you visited “Grandma” down the road, you weren’t bid “hello,” but just “get you a plate,” motioning to the wood cookstove always simmering with beans and corn and potatoes and cornbread, to be served with jars of relishes on the kitchen table. If you came by to visit someone, to stay less than an hour would be unforgivably abrupt.

The love of these hill folk for children and the time and interest they took in each other had more in common with third-world people than in their fellow Americans. I was reminded of our Eritrean neighbors in Harrisburg, whose son Binium is Nate's daily playmate. Binium's family became Nate's second family, and ours Binium's. When these hospitable Eritrean's invited you for coffee they invited you to a ritual. First they roast the beans on the stove, bringing the pan out for the guests to smell. They take it back to the kitchen and pulverize it into powder with a mortar and pestle. Then they bring out a tray with demitasse cups and a special urn, from which the coffee is poured over spoonfuls of sugar. You talk, and drink, and then another dense urn would is stirred up in the kitchen. You talk some more. To take one’s leave before the coffee is brewed a traditional three times is to be most un-Eritrean.

Stepping foot on these mountains is to feel the pace of life to drop back to a slow idle. And I recollected the current thinking of anthropologists that prehistoric peoples, like remaining primitive peoples today, had an enormous amount of time to simply be around each other. The necessitities of living simply took much less time and effort than they do today. People would sit around the fire and pull vermin out of each other’s hair, a form of elemental caring that Diane Fossey reported seeing among chimpanzees. Here in these hills, with their shacks and old pickups, their gardens and tater patches and the abundant woods, people lived a more loving and mutually caring life than in the busy flatlands below, from where I had come. I fell into bed each night and slept as if I had fallen into the bottom of a well; Nate barely made it to dinner before passing out exhausted on the couch.

Although Dick and Lori were raised near these mountains, neither of them were products of these high patches and deep glens. But it had beckoned to them more and more powerfully over they years. Dick had run far from the mountains for many years, said that he never conceived of coming back anywhere near here. He was lead singer in a rock band that traveled North America and Canada in an old bus, playing at any joint that offered another booking. He had worked construction and the usual hard jobs of the wanderer. Finally he settled down with Lori and worked a job as a writer for the government at Oak Ridge Laboratories. He sent me a sign from those days warning motorists of radioactive frogs. It was on my old state government office door for years. They gardenened and spent increasing weekends in the mountains, eventually buying a cabin for summers. But one day Lori came home from a particularly irritating engineering conference and announced “I’ve had it with people like this! Let’s move to the mountains." After a month of talking it over, they moved in the fall in time for the most severe winter in years. Since then they have never looked back.

Each year Dick and Lori fall deeper into mountain life, and cut more ties to the modern world. “We don’t like the world, much,” Country explained when I first asked him why he had moved up here. They grow their crops and hold on to some telecommuting work to supplement their limited needs. By the “world” it is clear that Dick does not mean the natural world in which they dwell, including that part of the natural world that is the society of mountain people. The “world” that he refers to is the created, perhaps even “virtual” world of human gain and ambition and rush and estrangement lying far below their hilltop. It is this world that makes the smog that has begun to replace the clean “Smoky” fogs blanketing the valleys below. It is this world, he keenly knows, that is killing off the frogs all over the world, even in the most remote mountains, because of pollution. The spring lizards will eventually follow.

Dick and Lori are keenly aware of having at least some toes of one foot remaining in this rejected world. In addition to making his potatoes and garden crops, Dick writes a national newsletter for his former employer, the Department of Energy, using a computer and a modem over the slow mountain telephone lines. Telephones are relatively new here: the first phones didn’t get put in to this area until 1968, and the technology is rudimentary. Lori spends all day working at her own computer running an environmental engineering department at the University of Tennessee, driving the hour and a half there and back once a week. She, particularly, is restive to cut this last economic link. Her hope is that herbal cultivation, and perhaps renting out a house they just bought nearby, might allow them to live within the local economy alone. The outside work has become an increasingly dissonant note in their high mountain tune.

As they settle deeper into “mountain living,” I see what Country Dick and Lori are doing as having real significance in the modern world. At a time in which local ways of living in a particular place and a particular way are perishing from the earth, they have gone back to a place to try to learn what place and people can teach them. In trying to keep the mountain ways alive, what they are doing is as important as those who maintain “heritage” seeds of once-common apples, or garden plants, plants that, unlike those from modern hybridized and perhaps even genetically manipulated stock, can provide their own seeds for following years.

When my son and I helped Dick plant, we seeded sunflowers that he had harvested from last year’s crop, just as farmers had done from the dawn of agriculture. His planting was informed by the moon and stars as the Farmer’s Almanac advised, just as those now resting in the local cemeteries had planted in their own time. And he leaned against his hoe and took time to talk about crops and weather in the same laconic drawl that all these people spoke to each other in as well, cultivating the human culture in they had root.

Country Dick and Lori came to this life not being born to it, but by rejecting prevailing ideas of how people should live, and deciding upon a different traditional of living. They were hillbillies, one might say, not by birth but by intention.

Boomer Den

"High on the ridge above his farm
Gone, Gonna rise again.
I think of my people that have gone on,
Gone, gonna rise again.
Like a tree that grows from the mountain ground
The storms of life has cut them down
But the new wood springs from the roots underground,
Gone, gonna rise again."

Si Kahn, "New Wood."

Even the many people who had left these parts continue to return to this
soil as home. Births, weddings, and deaths mark the reuniting of family clans on their soil. The cemetery nearest Dick and Lori’s has a picnic grove adjacent to the graveyard for burial dinners. Each family cemetery has a different weekend for a “decoration day,” when they all convene to rake out and trim the plots. But the greatest example of the attachment of these people to their original soil is what Country Dick showed me in Boomer Den.

The beautiful, musical and laconic language of the hill people is filled with words unique to the mountains. Sitting on Country’s porch, your gaze drops into the deep valley below called Boomer Den. He and Lori tend a small field down there, at the lower reaches of their property. To farm it, he usually walks, a trip of some twenty minutes. Driving down as we did takes forty-five.

Taking one twisting road after another winding into the depths of the den, we gained the bottom and followed along a winding stream to its origin. There, alone in the woods, stood a picnic pavilion, a developed spring, and a closed up log cabin. “Boomer Den,” Dick told me, was once a settled little hamlet. Most of what is woods now were fields, where they grew their beans and corn and squash, and grazed their cattle. They shot squirrels - “boomers” - with which the hollow was thick. Whether the term “den” signified a valley or rather a home, not only to squirrels, although the picnic grove was all that testified members once scratched their living out of this tiny place. In the depression, everyone left, hoping for better economic times in the cities. That hope turned out to be a cruel disappointment for many, but once there, they inevitably stayed. Except for once a year, when they all came back.

Each July, Dick said, the remaining elderly men and women who remembered living in Boomer Den came back with their children, their grandchildren, and great-grandchildren; those who had married in, cousins, and others of assorted relation. They opened up the cabin, and pitched tents. They drew water from the spring, and cooked together, and ate together. They told the old family stories. They cleaned up the graveyard, and spoke of those who had passed on. Once again Boomer Den rang with the sounds of children playing around the streams and stumps and fields. Then everybody went back to the cities where they lived until the next reunion.

This story was testament to me of the powerful attachment of a family to a particular place, a particular soil. This is something that is talked of in many songs and stories, but never had I seen this bond so firmly maintained after so many years of diaspora. The connection of these people and these hills was the strongest I had ever seen.

Glimpses of Reasonable Lives.

These habits, this rootedness in the soil of a place, may run deeper than even this family, Country mused. Up here, people grow the trio of corn, and squash and beans, as well as the more recently-introduced practice of “making potatoes.” Maize and squash and beans were the holy trinity of native Americans. They had raised these crops in these valleys for centuries until displaced by Scotch, Irish, and English settlers. Those settlers in turn, perhaps taught by the natives, continued these crops so suited for cultivation here. But more than that, it is possible that the very way of relating to one another, the emphasis of mutual support and relationships in a daunting climate had its roots in native American culture. “The land shaped the Native Americans, and then the land shaped us mountain people, Dick murmured, looking out over the patch. Everybody was formed by this place, not the other way around. And now this place is shaping Lori and me.”

Over some days I watched how this place, and particularly Country Dick, shaped my son as well. Going out together to his potato patch one misty morning, Dick handed Nate a bag of sunflower seeds, dug a furrow with his hoe, and showed him how to plant them an inch deep. Nate worked his slow way down the rows while I followed behind, covering them and tamping them down with my foot, as fathers and sons had done in this place for a very long time. When he did well at that, Country set him to prepare a new section with the rototiller. Nate followed the massive machine as it turned over the soil, wrenching on the handles built for a man to turn it at the end of each pass, but not giving up and asking for help. Finally, apparently determining him to be reliable, Country let Nate run his new Kabota tractor.

Country backed the tractor up to the heavy disks, and lowered the three-point hitch while I slid the arms over the pins, forced them home with a rap of the sledge, and knocked in the restraining pins. Dick got Nate to climb up into his lap, and I watched him carefully instruct him about all of the unfamiliar controls: the throttle, gears and transaxle settings, the hydraulic controls for the disks. As they pulled to the end of the row, I watched Nate familiarize himself with the power steering; much easier to turn than our old Army jeep. Shortly, under Dick's oversight, he was running everything but the clutch; his legs were too short. He addressed the end of the row, lowered his disks, steered a pretty straight course for the far end, lifted the disks, turned around, lowered them, and started again.

Later, Nate confided to me his excitement: "Country Dick said I was the first person he has ever let drive his tractor!" This was no ride at Disney World. Nate had just a glimpse of an unspoken fact of life here: at nine a boy was ready to start to learn to run a tractor, because by ten he might be needed to do it to help on the farm. Up in the hills, a boy still needs to become a man. He was needed as a man.

Dick and Lori have a dream. They have purchased a nearby house, and hope to invite people who wish to know mountain life and mountain plants to come and stay. Lori knows her plants and herbs, and Dick knows the mountains and farming and local people. In addition, and importantly, he has a gift. That gift, which he has had as long as I have known him, is simple but profound: people in Country Dick’s presence become calmer and clearer. How this occurs I do not know. But now that he is in this place, his gift has magnified. Or perhaps it has just taken root.

Maybe Dick and Lori will be successful in dispensing with the “dissonant” economic notes which they find so foreign to this life, and be able to offer an immersion in this lost way of living to others. Guests can sleep in the clear mountain air, dream mountain dreams, eat biscuits and gravy, and walk in the herb-filled woods. Maybe they will hoe the rich loam with bare feet as I did, and look down into Boomer Den as I did, while the slow rhythmic tones of Dick and his neighbor’s speech work their way into nerve and muscle and bone. They may stoop to drink from mountain springs, scaring away a few colorful wiggling spring lizards. Like generations of people in this place, they may end each day on the porch along with the dogs, sipping a lemonade and watching the setting sun before turning to supper and playing some music and singing together, wishing that they didn’t have to go back down the mountain tomorrow to go to the cities to work:

Like a highway heading North,
Like a highway heading South,
Sometimes I feel that I’m
just like a rolling stone.
From the rolling mills of Gary
To the rolling fields and spinning mills of home.

-Si Kahn

There is a church tradition that monasteries, high on their own hills and seemingly producing little for others, are in fact “dynamos of grace,” bringing grace to earth through their ceaseless and rhythmic prayer. I wonder if it is too far afield to see Country Dick and Lori, up on their mountain, as practicing a similiar kind of devotion by the daily work of seed and soil and neighborliness, keeping a lost way of dwelling on a particular spot of earth alive with eyes clear upon the beauty that this most endangered of all species really is.

The Vein Dowser (1998)

Touch my Hands: Bessie the Vein Dowser

When you want to find a vein of water underground in Tallahassee, Florida, you call a dowser. When you want to find a vein in a person you call Bessie Smith, RN.

Dowsers wander around your property with a forked stick until the stick dips. "Here," they point. "Drill it here." And the well driller does. I saw a dowser work, once. This one didn’t use a forked stick: he used a backhoe.. My friend Bob had a broken underground water line. He’d searched for it fruitlessly for a week, digging holes all over the side yard. He called in Willie, the local backhoe operator, and showed him where he thought the break most likely was. Willie didn’t seem to listen to him. He bent over his steering wheel for a few minutes, holding lightly to the hydraulic levers. Then he suddenly dropped it into gear and headed for a place two hundred feet away from where Bob had directed him. Bob ran behind, trying to keep up. He lowered his scoop, quickly dug down four feet and hit a break in the line precisely where the water was squirting out underground. Then, while Bob stood slack-jawed by the edge of the hole, Bubba drove over to a second place seventy-five feet distant, lowered his bucket, and quickly exposed a second leak that Bob didn’t know about.

Bessie Johnson is like that. She finds veins under the surface of people’s skin. I heard about her from a friend who worked as an IV nurse in a Tallahassee hospital. All day my friend went from room to room putting IV lines in people. You do this every day for a few years and you get really good at it. My friend could get a needle into the veins of people with tiny or collapsed veins, or people who had had many previous intravenous lines, with consequent scarring. It might take her a few tries with a really complicated one, but generally she could do it.

There were certain cases, however, that she or any other nurse simply couldn’t get a line into no matter how hard they tried. These were inevitably very sick people for whom getting intravenous fluids and medications into was a matter of life and death. For these people, they would page Bessie Johnson wherever she was at the hospital.

Bessie is a large, Southern African-American woman with an easy manner and a perpetual smile. She has been putting IVs into patients at the Tallahassee General Hospital for thirty years. I got her to talk with me one day about what she did and how she did it. Initially a little guarded about her gift, she eventually warmed to my serious interest.

"Yes, it’s true that I can get an IV line into anybody," she admitted. "I’ve never not been able to do it on somebody -- not after my first year, anyway. When I go in to see a patient, I always give myself just one try. I have to get it in that one try. I always tell myself this. And I always do." "When they call me, it’s always somebody that’s been stuck a bunch of times. It’s usually an old, sick person whose veins are all collapsed or some little, newborn baby in its mama’s lap who is all dehydrated and squalling. The mama’s always real upset, and the baby’s upset, too. Lots of times when I come in, there is a whole group of nurses and doctors around that person’s bed. When I come in, that crowd just parts. I feel like Michael Jordan," she chuckled. "When I slip that needle in so easy and test it, they just about always look up and say, ‘That’s it?’ Lots of times they cry – the old person or the mama. I start the drip and pretty soon they start to pinken up and feel better. It makes me feel good."

"How do you do this?" I asked. "How do you hit the vein every time?" Bessie paused before replying.  "I lay my hand on their skin, and I know what those veins are doing," she said simply. It became clear that Bessie was describing exactly what she did. Putting her hand over the surface where veins lie, she visualized – literally saw -- the veins under the skin. She saw them even if they were in an unusual place, if they tended to roll in a certain direction when pricked by the needle, or if certain places were impenetrable because of scar tissue. She saw them like Willie the dowser saw water underground. It was then simple to insert the needle into the center of the vein that she was seeing.

"How do you suppose you got this ability?" I asked her. "From God," she replied immediately as if, perhaps, I were a little bit dense. "All gifts come fron God."

Given this, I knew what Bessie was going to tell me in response to my last question.

"Do they ever ask you to train others to do what you do?" I asked her. "Oh, Lordy, yes!" she laughed. "They send me them young nurses all the time. But you can’t really teach somebody how to do this. It’s not something you learn by teaching. I just tell them: Lord, child, just touch my hands."

The Yuri Gagarin of NIH (2002)

The Yuri Gagarin of NIH
Roger P. Peters ( 1943 - 2001)

Though you are in your shining days
Voices among the crowd
And new friends busy with your praise,
Be not unkind or proud,
But think about old friends the most:
Time's bitter flood will rise,
Your beauty perish and be lost
For all eyes but these eyes.

-WB Yeats

“The modern hero is he who triumphs in the inner struggle.”

James Hillman

I only heard from Roger in times of great crisis. Once, after years of radio silence, he called from a curbside in L.A. He had just filed for his third divorce and was fleeing crazy in pain from his home in Colorado, driving his Volvo P1800 fast and living in his car until the worst of it subsided. “I’m getting divorced again, Schwartz,” he started abruptly. “I’m across the street from the L.A. courthouse. I just filed the papers. I’m heading North.” Then all was quiet for some more years. He buried himself in teaching, tracking coyotes, skiing, and writing books on cognitive psychology, trying to grab fame somehow with this next one. This was normal for Roger. He had been just this way back at New College in Florida in the sixties, when we had sat on a log by the bay and studied the emerging field of psychobiology together. Life for Roger was all full-throttle acceleration punctuated by cataclysmic crashes. As he crawled out of the latest wreckage, my phone would ring.

“Roger!,” I exclaimed with delight when the phone rang a few years ago. “How great to hear from you! What’s up?” Roger was at home in Durango. This time he did not get to the point right away. We talked of this and that. But then he blurted it out. “I have melanoma.”

I’d heard a little about melanoma, one of the most feared of all cancers. I remembered Doc Daneeka in Catch 22 was morbidly afraid of it. Doc Daneeka was a driven hypochondriac who was always sure that the latest of his symptoms were sign of some dreaded disease that would kill him and, at least by that route, get him out of the War. He studied up on fatal diseases. His favorites, I remember were melanoma and Ewings’s tumor. He liked the fulminating kinds best.

A fulminating disease was what Roger had, but he seemed typically matter of-fact about it. Once he rebounded from the first lightning-bolt of a cataclysm, Roger always spoke as if he were delivering a lecture to a large hall of his students; outlining his points logically, enunciating clearly with precise diction. He had had the mole even thirty-some years ago at New College; old photographs of him without a shirt showed it. It had never caused him any trouble. But a couple of years ago a physical therapist giving him a routine treatment had remarked upon it and advised him to get it checked out. It looked suspiciously like a melanoma to him. The physical therapist had been terribly right.

Melanoma, a physician friend of mine told me, is “sneaky.” I thought of it as a dry dandelion ball. You blow on it and the seeds fly in all directions. At least one seed had apparently scattered in Roger’s body. He hadn’t even bothered to tell me when he had the first mole removed. He hoped for the best. Sometimes it doesn’t spread. But another mole had appeared nearby. That was bad. His doctor had removed this one, too, but had taken the serious step of starting him on a year-long course of interferon. Interferon stimulates your immune function, makes you run a fever and hopefully “burns out” the dispersed melanoma seeds. Roger had just started as we spoke. He had taken a year’s leave from the university. Taking interferon, he said, was like having a mild intermittent flu. You gave yourself a shot, then you started feeling sick. You felt bad for a few days, and when you started to feel better you gave yourself another shot. Roger rolled with it. For the first time in his life, he was not focused obsessively upon being productive. For once he didn’t have a book deadline set for himself. He didn’t because he couldn’t.

Interferon was strange stuff, Roger reported, ever the meticulous observer. It gave you technicolor dreams. It also impaired your sexual functioning. No real matter, he quickly said. His girlfriend was on an extended job in another state. But she was to come home just when his year of interferon was over. “When Sherry gets back, Roger volunteered enthusiastically, “I’m going to get a 55-gallon drum of Guinness-flavored Astroglide!” That was Roger, fighting melanoma and laying in sexual lubricants at the same time.

Although he kind of breezed past it, there was one thing that told me just how serious Roger’s situation really was. “The doctor,” he said, after outlining in detail the next stage of his medical campaign, “says that if it comes back a third time, I’ve got about six weeks.”

I hung up my telephone and called our old friend Hart. “If we want to see Roger, we should see him soon,” I said pointedly. “Despite his optimism, I don’t think he has long. “Let’s go to Durango.” Hart agreed at once.

“But let’s not just fly,” I suggested. Let’s arrive in the proper style on motorcycles, just like the old days.” Hart was enthusiastic. We bought plane tickets, and not many weeks after met in the main concourse of the Albuquerque airport. “So how bad do you really think it is?” Hart asked, now that we could talk in person. “Roger sounded pretty upbeat on the phone.” “Roger’s always upbeat,” I countered. I’ve done a little reading on melanoma. Do you know what one oncologist said?” I asked.
“Melanoma,” I paused,” “gives cancer a bad name.”

An hour later we were at Pedro’s motorcycle rental shop, cranking over two overlarge bikes for the trip up to Durango. Motorcycles had changed since Hart, Peters, and I had been riding buddies in Sarasota in the sixties. You used to have to stand on the crank in sturdy boots and kick the engines over. Now you just pressed a starter switch. But they roared just as loud as ever and went immensely faster. We flew out of town on old route 66, catching the old twisty main route up to Santa Fe. We leaned through the curves in the desert hills, stopping in Santa Fe, then climbing the mountains into Colorado, soaking our stiff motorcycle butts in the Pagosa hot springs. Pausing overnight, we rode the remainder of the route into Durango the following day, following Roger’s directions to his driveway.

Stopping at the bottom, we rode side-by-side up the sandy road to his house in a valley overlooking the overhanging mountains, rattling the windows with our straight-pipe exhausts. As we leaned the hot bikes over on their kickstands and pulled off our helmets a frail, back-braced, but broadly grinning Roger came out of his house to greet us. “Schwartz!,” he exclaimed, hugging me. “Hart!” “You came! And on these beasts!” He walked around them admiringly.

A mutual friend later told us that Roger had said that when we arrived it was like a whole part of his youth had come riding up his driveway. I was pleased. This was the effect that I was looking for.

Basic Natural Roger Peters.

Roger made his dramatic appearance on the New College scene in a memorable Basic Natural Science lecture on the mating ritual of the cricket. It was 1966. All one hundred of we first-year students were sitting on folding chairs in the teak-lined music room of the old Charles Ringling mansion in which we had heard so many intellectually challenging but academically wooden lectures. It was sometimes hard to keep one’s mind on the speaker as just yards away Sarasota Bay sparkled under the brilliant Florida sun, dolphins swimming along the breakwater in pursuit of jumping fish. And sitting just a few seats down from you was the entrancing and intelligent young woman with whom you had watched the sun come up sitting on that very breakwater. Having passed the night deep in conversation, you wondered if the pleasures of last night might lead to even more thrilling ones in the coming evening. Looking up from her notes, she gave you a warm glance. Yes, it was hard to concentrate on a monotonous academic monotone.

Then this little intense guy - he couldn’t be more than 5’2, shorter than his younger brother John a year or two ahead of me in school - took the lecture platform. I knew that he was a math tutor, although the catalog listed him as having a degree from Chicago in political science. But here he was lecturing on animal behavior. Well, at New College, the lines weren’t drawn rigidly. He was an incredibly dynamic, energetic speaker. He talked about the new emerging field of psychobiology, and the way that the study of animal behavior could tell you a great deal about the foundations of human experience itself. Sex, for instance. I glanced over at the young woman to my left. To dramatize, he laid out the invariable“hard-wired” fourteen steps of the mating dance of some kind of cricket. But instead of just delivering them from the podium, he danced them out.

‘First, the male cricket approaches the female cricket and waves one antenna,” he instructed, crouching down in a cricket-imitative stance, hands pointing out from the top of his head as antennae. Fixing a fetching woman in a sundress and sandals in the front row in a libidinous gaze, he suggestively wiggled one antenna at her. She colored, and the audience roared. “The female then signals back,” he intoned, leaping as if he were a cricket himself to the far side of the platform, spinning about and wiggling an antenna in the direction from which he had come. More giggles. Meticulously and dramatically, he laid out all fourteen ritualized exchanges of cricket foreplay.

“The purpose of the instructor, a great Michigan professor named Marian Kinget once pronounced, “is to dramatize certain insights.” The cricket lecture, remembered fondly by friends who were there with me in that room thirty-five years ago, conveyed an insight that piqued curiosities on my part that have driven a lifetime of study. Back then I couldn’t know with what power Roger would come into my life. “Who was that masked man?” I questioned a classmate after the lecture. “That class, my friend, was Basic Natural Roger Peters. And that’s the guy himself.”

Sitting on the Log.

By a year later Roger and I had become fast friends. We both loved motorcycles, we both loved adventure, and we both had become completely absorbed in the emerging field of psychobiology that I had first heard of via the crickets. Back when the field was small, we could do the heady thing that is so rare in modern scientific fields - we could read every article that came out. Then we’d talk about them.

One spring, Roger signed up to teach only one tutorial, and I signed up to take it. That administratively took care of his teaching and my course requirements for the trimester. We developed a rhythm. Starting early in the mornings, we would read the literature. Then, after lunch, we would meet on our tutorial log in a little clearing by the bay. Roger would fish under the log and fish out our mason jar, we’d roll a joint, and talk. “What about this new holographic theory of memory in Pribram’s Scientific American article?” I’d ask. “Is this incredible, or what?” And we’d talk animatedly about Pribram’s experiments and his new theory, which promised to replace the old localized idea about memory storage. We’d connect it with other things that we had read and thought about, about the behavior of people around us, and even society, in the midst of sixties turmoil. Everything was fodder for our conversation. This conversation continued between us, despite long interludes, for the rest of his life. These are things I speak of to no-one, anymore.

In doing psychoanalytic psychotherapy, which has become my profession in later life, I have learned the truth of the dynamic formulation of intrapsychic conflict. You conceive a wish, and against this experience a fear. The wish draws one forward, and the fear pulls back. In describing this, Freud captured a basic quality of the experience of living. I have come to see that the nature of the conflictual struggle in a life is determined in part by the intensity and energy of what analysts term libido, and which I think of as soul-force. In some people the energy of the soul seems very weak; in such people the intensity of the struggle is weak also. Desire is weak, and fear strong. When resistance to moving forward arises, it is not so hard to distract and subdue the resulting anxiety: some television, a few beers, maybe a little shopping makes it possible to continue what one is doing without too much discomfort. With others, however, the soul-force is massive, and the fear also. Here one sees a great and even illuminating struggle, with massive suffering. One may see a life-course characterized by stratospheric flying interspersed by cataclysmic crashes.

I remember hearing a story about the great composer Stravinsky. He had written a piece for violin which a great violinist in an orchestra had struggled with hopelessly. Finally throwing down his violin in disgust, the violinist shouted to Stravinsky, at the podium, that the piece “unplayable.” “Yes,”Stravinsky replied. “What I am looking for is the sound of someone attempting to play it.”

This was like Roger’s life - riveting music punctuated by broken strings, jumping up and down on the violin like a frustrated Daffy Duck, followed by great heights of musicianship. As often as Roger proclaimed another “peak experience,” he was alternatively dusting himself off of broken glass, broken telephones (he once put one that had brought news that displeased him through a small hole in his kitchen wall, followed by the kitchen chairs.) When he married his second wife, a very nice woman who struggled with depression as much as Roger struggled with more animated crashes, we referred to them as a couple as “R & B:” not for Roger and Bonnie, as they thought, but for “Rhythm and Blues.” Roger was all Rhythm.

This was the story of Roger’s life. Back in college, one of those sudden torrential downpours started when Roger realized that he had left his car windows open. Rocketing out of the door of the science lab without looking to the left or right he stepped right in front of one of the maintenance crew’s pickups, which caught him square on the bumper like the sweet spot on a baseball bat, whacking him in a low, sickening arc into the sandspurs alongside the road. When I dashed over to pick him up, he groggily pulled himself up on my arm, waved off any offers of medical attention, and insisted that I drive him not to the hospital but to a friend’s house, where he staggered in and collapsed on the couch, regaining consciousness later that evening to go stiffly about his remaining business.

On another occasion, running in late to teach a class he neglected to see that the glass door to the room was closed until he was on the other side of it, covered with glass and dripping blood on the carpet. Girls screamed as he started to ready his lecture notes regardless, and he was forced to retreat, staggering into my girlfriend’s room to be cleaned up and bandaged. As his motorcycle riding buddy, it seemed to me that he was saved from vehicular disaster only by his lightning-sharp reflexes.

Roger’s appetite for walking the razor’s edge reached its highest form in relationships with women. The complexities of a relationship with one woman seemingly not enough, Roger often arranged relationships with two women at a time, constantly calculating their respective travel paths so as to avoid encountering one when he was with the other. Once, walking down Main Street in Sarasota with his girlfriend Marci, he suddenly spotted his wife walking toward them, who had suffered a breakdown and was presumedly in the psychiatric ward. Marci felt a sudden push in her back and found herself propelled through the open door of a shop, as Roger ran forward to see his wife and redirect her away from the scene. Marci had to find her own way home. Later, of course, he was deeply and sincerely apologetic to her - as he always was after such near-misses and disasters. Supplicating angry women was a regular necessity of Roger’s early romantic life.

This diminished as Roger grew older, but never disappeared. In his early fifties, he wrote a letter to a sometime girlfriend when he realized that he owed a letter to another. Hitting the “find/change” command on his MacIntosh, he printed personalized but identical versions to both: every “Kristy” became a “Jordan.” He sent both out. A few weeks later he received replies from each of them, who were friends. Both Kristy and Jordan sent him copies of the same reply, word-for word. They had just had lunch together.

Despite the many “crashes” he experienced, Roger was like the legendary motorcycle-jumper Evel Kenevil: always rolling out of some flaming crash to jump to his feet, arms held up to show the crowd he was OK. A few ribs taped, and he’d be back off the ramp, whether that was tracking wolves by light plane and snowshoe in Northern Minnesota, working out a new theory of how human intelligence evolved from the cognitive mapping necessary to track prey, passing Robert Redford’s sport’s car on his bicycle down a precipitous mountain road, high and outside, teaching his classes, writing another book, getting married again. “Our relationship has deteriorated to the point,” he wrote me in the midst of one marriage, “that we communicate exclusively through slammed doors.” Yet he would always try again. How can you not love someone like that?

The melanoma had reappeared, despite the year on interferon. It was a reversal surely signifying his imminent death. I spoke with him by phone. “Yeah, I was really bummed out for a day,” Roger admitted. “But now I’m seeing if I can qualify for a Phase I trial at NIH.” As a researcher, Roger knew better than I that a phase I trial is the stage of experimentation in which they try to find out merely if last-resort patients can survive the treatment. No matter: Roger didn’t dwell; he was always ready to try the next thing.

I woke up last night from a dream in which my doctor had biopsied my intestines and told me that I had a fatal malignancy, from which I would soon die. My doctor did, in fact, recently tell me that he has detected some abnormality with my liver. It is probably not a cause of significant alarm, but I am scheduled to see a liver specialist in Philadelphia. Maybe she will do a biopsy with a long hollow needle through the abdomen - that is how they do it, I know. So the dream may tell me that I am more worried about this than I realize. Or it is even possible that the dream tells me that I am in fact fatally ill - dreams do tell such things sometimes. What the dream makes me think most of is Roger - how for four years he must have had such dreams, only to wake up always to find that it was true.

“Look,” Roger said in Durango when I asked him about what was thinking about death, while he pumped his daily massive dose of antibiotics into an IV line taped to his arm, “either I live or I don’t. If I live another month, I get to go deliver a paper at the APA conference in Hawaii and visit Richard Waller up in his rainforest. If I live until fall, I get to go back to teaching my favorite course and go hunting. If I die, I don’t think I’ll have any experience at all, so it won’t be unpleasant.” When he got finished with the IV, we went out to walk and look up at the mountains he loved, in the bright Durango sky he had warmed to years ago when he had moved there. He was, as always, ecstatic at the view. “Up there is where I hunt elk,” he indicated, pointing his finger along the high ridgeline. “Maybe again.”

Yuri Gagarin

Roger and I had both been in elementary school at the birth of the space age, when Soviet cosmonaut Yuri Gagarin had ridden the first rocket into space carrying a man - at least, the first one we know of. Gagarin, a prime physical specimen, had walked into his capsule. After he hit earth at the end of the experience he was too weak to walk alone. Roger checking into the National Institutes of Health was like Yuri Gagarin climbing into his space capsule.. Checking in, he seemed a man in perfect health: we took energetic walks about the grounds and talked animatedly. I drove regularly down to Bethesda from my home in Harrisburg, this was the longest that Roger and I had been able to spend together since college, and we made the most of every minute. Roger was happy about feeling good again after recovering from almost dying last year. He was his old self again. It was only the results of medical tests that revealed him a sick man; a candidate for the last-resort of all last resort treatments, an experimental stem-cell transplant.

Always the observant scientist, Roger immediately grasped the theoretical problem. Cancer cells are always floating in the body, he reminded me. Why, then, do some cancer cells take hold? Obviously it must be some failure of the immune system. So the idea was to transplant his brother’s functioning immune system into him, replacing his compromised one. To get the transplant material, his younger brother John came to Bethesda and donated blood. Taking it into the advanced labs at NIH, technicians centrifuged out all of the new, embryonic stem cells from which new white cells, macrophages, could grow, and put them aside. Then they set out to kill Roger’s existing immune system to get it out of the way.

So-called immune systems are hardy. That’s why you remain alive. Killing one involves injecting toxic agents so powerful that they destroy the bone marrow itself. With no immunity, ordinarily you would die. You would die, that is, unless you were in the world’s most advanced research hospital, with skilled nurses working constantly to keep you alive. From a seemingly healthy man, Roger retreated into a man curled up in his hospital bed, burning up with raging fevers over 105 degrees, retching constantly, lost in agony. Agony, I recall, was the term technically denoting the last stages of dying, when one was literally “in one’s agony.” But this agony was one that wasn’t allowed to proceed to death. In a brief period of lucidity, Roger quipped that his IV pole was so hung with antibiotic bags that “it looks like a Christmas tree.” Nurses, doctors and lab technicians worked to identify the specific bacteria that were trying to wipe him out. He ended brief phone calls by a hurried need to hang up as he was overcome with wrenching dry heaves.

Looking back on that terrible period, once he was able to speak once again, Roger told me that the suffering had become so all-consuming that at a certain point he lost the sense of “I” from which one experiences suffering from. He was just all pain, spinning lost in a dark void. I have read that this is the ultimate state that torturers aim to create in their victims. The phrase of my old friend Ivan Illich came to mind: medicalized torture.

When he came out of this, and stopped shaking, there finally came the signal day: they wheeled Roger up to the lab to have brother John’s stem cells dripped into his veins. I downloaded a microphotograph of a microphage engulfing a cancer cell for him to past on he wall by his bed and use as a focus for visualization exercises. Roger was going to leave no effort undone in the quest to survive where no-one had survived before. “You, Roger,” I proclaimed one day, are the Yuri Gagarin of NIH. You volunteered to be shot off into a place where nobody has been, to advance human knowledge. One day there is going to be a bust of you downstairs in the lobby.” Three months later, another college friend and I held him under each shoulder to help him to climb the three steps to her house, where we tucked him into her bed. It reminded me of that old joke: “The operation was a success, but the patient died.” Roger himself never thought of regret; he only set himself to the next goal, whether it was taking the correct complex schedule of medications, walking a few more feet the next day, or working a few hours on his latest book manuscript.

Road Trip

Roger was subsequently hospitalized for short periods for fevers, and, six months after he had arrived in Bethesda, was ready to be discharged from this last hospitalization to go home to Durango. He had tickets on a 6:10 AM flight. We arranged for me to show up at his room at 4:00 AM the morning of his departure. He was going to take a cab to save me the trouble, but this was hardly the way to celebrate such an event, I told him. “It’s just another road trip!” I admonished him. “I’ll be here.”

When I appeared at 4:00 AM, having caught a few hours rest on a friend’s couch on Capitol Hill, Roger had his duffel packed and was ready to go. I pulled the car up to the silent entrance, and we set off. Before us, the lights of the sleeping city arrayed themselves: the lights of the Capitol dome, of the Washington Monument, the highways along the Potomac. Early flights lowered themselves on the flight path toward National Airport above us, following the river to the runways. Roger was excited.

As we drove, we remembered road trips together of so long ago: driving in my Corvair Spider convertible across the middle of Florida, taking turns shuttling a friend’s Bultaco Metralla to West Palm Beach, where we all spent a memorable week aboard a sailboat called the Volante that Waller and Hazelhoff were crewing. We recalled road trips before daybreak on our motorcycles down the old Tamiami Trail from Sarasota to Sanibel Island, arriving over the causeway as the sun came up over the mainland behind us.

As we spoke of his medical “space shot.” Roger was characteristically optimistic. The previous afternoon, as we went down for his final blood tests before discharge, Roger pulled the Nurse aside. “Can you do a HIV test while you are at it?” he asked her. “Having an AIDS-free test printout is a good thing to have in your pocket on a date,” he offered me, by way of explanation. Was this the very definition of optimism, I wondered to myself, or of denial? Perhaps it is not so simple to say.

As we drove to the airport, we spoke also about deep changes that Roger had experienced within himself during this humbling experience of serious illness. Roger had not been especially given to such deep conversations about feeling, but during his illness this had changed. We had had many deep conversations about both of our struggles during his last year - conversations that were as much solace to me as they were to him. Isn’t this what friendship is, after all? We had our troubles - him especially - but we were not all alone.

In our conversations, Roger told me something that he had never expressed clearly. During most of his life, he confessed, he had felt driven mercilessly to produce. Friends always came second to this compulsion. This, of course, I knew. But I didn’t realize how deep it had gone. I knew that Roger always was writing a book against some deadline, preparing a class, organizing a new program - and before that getting his PhD, getting into graduate school - the series of stiles along his personal track had been endless. I had written a song about him - and me too, I guess - a long time ago. It was called the “PhD Blues,” and started:

When I was a little boy
In the wheatfields green
I asked my mother
What would become of me?
She said “Hey - listen up, my son,
You know full well,
You must get your PhD
Or roast eternally in hell.”

There was always that feeling about Roger, as if he were trying to produce enough, somehow, to be loved. Roger confessed that for all his years on the faculty in Durango he would come home each night and have a stiff drink to calm the desperate feelings of not having accomplished enough that day. Yet, as is so often paradoxically true, love was all around him. It was his illness, he told me, that finally caused him to see this. It was only when he could not produce in any way, but could only be cared for, that he came to see that he didn’t have to produce anything in order to be loved by his friends. His friends surrounded him - at home, in Durango, they took turns sitting with him, bringing him food, taking him to doctors, taking simple pleasure in his company. When he came East, his Colorado friends handed him off to the group of which I was a part. For this, Roger had to produce nothing - no books, no articles, no lectures.

Back in the spring on Hart’s and my motorcycle trip, Roger had taken us over to see his ex-wife Rita, who he had not seen himself for some time. Like most exes, they usually confined their talk to their now-grown daughter. But today Roger mentioned how he had been in the hospital there last spring, in intensive care. He was in terrible pain and it was expected that he might die. For a long time he was heavily medicated and unconscious. “I know,” Bonnie replied quietly. “I was there.” “You were?” Roger asked, turning to her in astonishment. “Every day, Roger,” she said softly, touching him softly. Sitting on the front steps, Roger started to cry.

When the final recurrence of the melanoma came, there were no other hospitals to go to, even in Bethesda. His brother John flew in from California with Roger’s daughter Eden. His close friends came to be with him. I talked with Roger by phone. He was characteristically doing “real good.” John was more sober. It would not be long now.

In the end and in this place Roger, who had struggled and worked all of his life unsuccessfully to find love and caring, found himself in the center of a warm and loving family. It was nothing he had to work for. There, dying in his home in Rockies, surrounded by those who loved him, he was curiously but obviously happy. At the end, when the cancer spread to his brain, the magnificent mind that had shone so brilliantly all his life began to misfire on a few cylinders, as he would have put it could he still describe such things. Finally, John told me, he lost his ability to speak. “How are you, Roger?” John asked him. Roger flashed him a grin and raised his hands from the bedsheets: Two Thumbs Up. Then he died.

ICU Psychosis (1999)

Intensive Care Psychosis
David B. Schwartz
December 19, 1999

Driving a person into a psychosis usually takes years. Also, you usually have to start young. I am a psychotherapist; I treat people with psychoses. So I was astonished to see my mother, before me in the bed in an intensive care unit of the Cleveland Clinic recovering from abdominal surgery, in the midst of a full-fledged psychotic reaction. She hallucinated floridly, seeing people who neither I or the nurse could see; she stared fixedly at my face, describing how she could see right through my transparent jaw to my spine. She was preoccupied with something that I couldn’t make out about a hurricane. “Help! Call 911! “She yelled at me as I was outside her door speaking with the resident doctor. “These people (she meant the nurses changing her intravenous lines) are killing me!” She was delusional and sometimes panicked, but was too weak and groggy to be able to get up.

Around her, dozens of electronic instruments blinked and beeped. Monitors called out when her pulse rate went high, or low, or her breathing rate changed significantly. Four or five IV drip regulators signalled insistently when something stopped up or went wrong; these were a lower-order sort of alarm that the nurses could attend to when they had a moment to turn to something less pressing, so they often continued, ignored, for a long time. The nurses, one to each two patients, moved constantly, adjusting their charge’s physical parameters and needs. I sat by the bed, talking to my mother in a soothing, hypnotic voice, suggesting that everything was all right, that there was no hurricane here, only in her dream, and that she could rest and get better. Then she would go to sleep again, and into troubled dreams, eyelids flickering like some dog by the fireplace chasing rabbits, or maybe being chased.

The next day, when my mother was physically well enough to be transferred to the regular floor, her psychosis was still florid. But now she was stronger. She demanded her coat so she could go out for dinner. She wanted the bars on the side of her bed down; when the nurses and I said that she really had to stay in bed, she ordered me to get my toolbox and take the bars off. My ability to calm her waned. When I went out of the room for a minute she tried to crawl out between the side rails and the footboard, pulling her IV lines out in the process.

Unable to control her now myself I demanded the resident doctor on call who, with admirable patience instead of drugs, which he explained would depress her already diminished breathing ability, managed to talk her fully back into bed and reluctantly ordered body and wrist restraints until the psychosis passed. “It’s ICU psychosis, certainly, he confirmed. We see it all of the time, especially in older people.” “How long does it last?” I asked. “They have to experience a day and a night,” the nurse interjected. They have to see the sun come up and go down and come up again. Up on the ICU there is no day and no night. And it’s noisy and busy; they can’t sleep.” True to their predictions, a tumultuous day later my mother’s psychosis started to break up, leaving much residual confusion and alarm.

What Causes ICU Psychosis?

Everyone that I talked to, both doctors and nurses, instantly identified my mother’s psychotic break as an ICU psychosis. It was, in fact, apparently unremarkable to them. They see it constantly. But what was unremarkable to these clinicians was remarkable to me. What immense pressures must be operating to jar someone into a psychosis so quickly! This is almost unheard of elsewhere. At first, I assumed that this must be a toxic reaction of some kind, or a neurological event. Such things will produce a psychosis this quickly. But I was reassured by those who saw it daily that, despite the alarming symptoms, it was not toxic or neurological, and usually dissipated after a little while. Although when I first put the question to the resident doctor about its usual duration, he admitted that he did not know. It only dissipated after patients had left the ICU, he pointed out. He, himself, was always in the ICU. So he really didn’t know.

Everyone agreed, however, on the various factors that seemed to go into the potent mix which produced ICU psychosis. First, there was usually age and some fragility, together with the patient’s own pre-operative anxiety. Then there was anesthesia, which took a while to completely wear off and get out of the bloodstream, and the trauma of the surgery itself combined with post-operative pain medication. In addition to these primarily physical factors, there were others inherent to the ICU environment itself. The ICU was a self-contained, brightly-lit world in which the normal rhythm of days was suspended. Things hummed on endlessly, day or night, weekdays or Christmas. There was the busyness of the staff working tirelessly in shifts to keep the person alive, attended by the constant beeping of clusters of machines around the bed. There were dozens of unrecognizable people constantly disturbing and touching you . There were staff conversations at all hours and the checking and administration of medications 24 hours a day, making it almost impossible to sleep.

Research on ICU psychosis has attempted to weigh the various factors in the ICU experience to determine which is most influential. Perhaps it is the loss of a 24-hour circadian rhythm, some speculate, or the constant bright lights. Others have shown the importance of the sheer level of noise in an ICU, which approaches the din of a subway. Staff conversations are the most disturbing of noises, they found, and one hospital implemented programs to reduce noise in such units, with successful effects. Sheer sleep deprivation due to noise, apparently, may be the biggest factor in inducing a psychosis; in one study one-third of people who were sleep-deprived developed psychosis.

The possibility exists, however, is that it is none of these individual factors that precipitates ICU psychosis. Instead, I wonder if perhaps it is the cumulative effect of all of these disturbing factors, these necessary side effects of life-saving treatments, that together knock an old person loose from their moorings. Taken individually, all of these treatments have side effects which are manageable. When they are applied together, however, it is possible that a strange thing happens: beyond certain level, these individually healing factors combine to produce an environment of a fundamentally different nature: one that has a decent chance of saving the person’s life while driving them briefly out of their minds.

Perhaps it is in the ICU, I realized, standing there caring for my delusional and hallucinated mother, that the ultimate effect of an intensive caring environment may be seen. How paradoxical, I thought: out of such incredible, lifesaving care should come an environment that the human mind can simply not bear.

Effects on Staff.

One thing that struck me immediately about the intensive care unit was the astonishing compassion and dedication of almost everybody I met. There are many complaints these days about a lack of compassion in medical and other service environments , but this was undetectable to me here. The nursing staff and the doctors, charged to maintain life in people who were at a high risk of dying any minute - and who did die, every day, despite the most heroic of efforts, showed the seriousness and commitment one sees only in MASH units on TV - and without the lulls in the action. Residents virtually lived in the hospital. Nurses came in even if they were sick. There are few places in society in which people work with such undying commitment, with such unslacking effort, without a break. It was simply inspiring.

I tried to imagine going to work every day to take responsibility for people who were, by definition, at the very edge of death. One error, perhaps one personal trip to the bathroom, and they might die. Many of them would die anyway. In this ICU, virtually everyone was elderly, very sick, with many things wrong with them, who had just endured yet another major surgery. After one of these surgeries, they would probably die here. If there was a complication, they might be rushed back to surgery. “Here, If it can be done, it will be done,” admitted a young nurse, who talked with me during a rare pause late one night. The atmosphere of sedated agony must be intense, despite being punctuated with the relief of people who recover to go home like my mother. “I just try,” the nurse admitted startlingly to me, “not to get too attached to them.” This, I realized, was not the statement of a grizzled and uncaring old veteran; this was the confession of a dedicated nurse on her first job who was trying to avoid a nervous breakdown of her own.

ICUs are, in fact, notorious boiler-rooms for staff burnout. Nurses are so much on the edge of coping, she said, that they tend to request transfers out in waves. Everything will seem to be going along all right, and one nurse will put in for a transfer. Then transfer fever will spread through the tightly knit group of women, like a rash of suicidal attempts rippling through a college girl’s dorm. Before you know it, seven nurses are gone, the place is impossibly understaffed, and you have to start all over again to staff the place.

As with ICU psychosis, there apparently are a variety of theories to explain the high turnover. Certainly, it is “stressful,” to use the contemporary term. But I wonder if the same factors that make the ICU so difficult to bear for patients may have a similarly powerful effect upon the staff. They don’t go psychotic, of course, but apparently many people find the environment similarly impossible to bear over the long-term. There were no nurses over the age of 35 there, I noticed. The longest-tenured “veteran” nurse I met was a twenty-something woman who had been there six years.

The Loss of Proportion

The problem of ICU psychosis arising in intensive care units, it seems to me, captures the dilemma of what happens when you make care settings steadily more intensive in response to “need.” John McKnight pointed this out in relation to social services in a community; if you keep intensifying services around a person, eventually you pass a threshold in which people are no longer connected to the world, because all of the services surrounding them have combined to create a new and artificial environment. Sitting in the intensive care unit in Cleveland I realized that this process of intensification reaches its apogee in ICUs. It is here that one can observe the logical endpoint of increasing professional services around a person to help them. It is here that you can observe both the blessings and the costs of combining helpful services past a certain threshold.

ICUs are a kind of “miracle pill” with one whopping side effect. “Caution,” ICU’s would say in bold print if they were pills listed in the Physician’s Desk Reference; “may cause psychosis.” This doesn’t change for a moment the fact that ICUs are literally life-saving pills. But if one looks at their application with a little common-sense, certain incongruities arise. Is the accepted level of side-effects inevitable? Or could it be reduced by the application of a little proportion in prescription-writing?

While other ICUs in the Cleveland Clinic held people who were recovering from injuries and/or surgeries for neurological or cardiac conditions, or who were in acute medical crises, the people in my mother’s ward were almost all both old and sick. Does that mean that they should be denied treatment? Of course not. But many of these people, according to the nurses, came back again and again, following one surgery after another at the end of life. This is what used to be called drawing near death, or, eventually, dying. There were a lot of people there, it seemed to me, who were passing out of this life in stages via the surgery and ICU. Were at least some of these people prolonging the agony of dying by extensive medical intervention, adding a psychosis to the process as well? It seemed to me entirely possible.

If you accept the idea that there are some people passing through ICUs and experiencing a psychosis who intensive care really can’t help much, then perhaps they could be spared this high-tech tool and the side-effects that come with it. Perhaps they could approach death with the palliative help of less injurious care, and die in their own, rather than hospital, beds.

For those for whom the ICU has real life-saving blessings to offer, on the other hand, could the environment be “de-intensified,” keeping at least some connection with the rhythms of the natural world? Others have suggested that ICUs don’t necessarily have to have unvarying white lights, no windows, and a screeching-subway noise level in which it is impossible to sleep. A sharp nurse on the regular hospital floor to which my mother had been transferred after the ICU did not re-connect a cardiac monitor. She noted that in their unit the staff had reached the decision that reasonable attention to one’s patients was really just as good. “Those machines tend to make you lazy,” she observed. “You don’t have to look at the patient.”

In fact, the general nursing text used in that same hospital in 1922 retained the idea of some judgement and balance in using the technology of the humble thermometer in attending to an unstable patient whose temperature needed to be closely monitored, the more so when it was one of the few technological monitoring measures available. In that handbook the authors advised nurses this way:

“The pulse and respiration in critical conditions are watched constantly, and even though the temperature is not actually taken because it might disturb the patient, a nurse is on the alert to note any increase shown by the face - flushing of the face; hot, dry skin; hot and tremulous lips; and rapid breathing.” [italics mine]

If a nurse from the wards of 1922 were to come onto an intensive care unit, along with marvelling at the wonderful new technology, might they also not see what contemporary nurses become inured to; that the beeping of a temperature monitor might disturb a patient’s life-restoring sleep as much as rolling them over to insert a thermometer might? It might take people from another time to notice that proportion had been lost. I suspect that one reason that ICUs are quite as bright and noisy as they are is simply this loss of a sense of proportion, or said more simply, the loss of common-sense about what a sick or injured person needs to recover. The technology is there, and so it gets used. The fact that all of this together precipitates a major psychotic break is simply something that one gets used to, like the fact that taking an antibiotic may give you a stomach-ache. A psychosis, however, is no stomach-ache.

Curious about what I was seeing of the culture of ICUs, I asked my cousin, Dr. Robert Schwartz, a hematologist of wide experience. He explained it to me this way:

“ICU-ers are a lot like fireman. There may be a very small self-contained fire in your house, but the firemen in their zeal to prevent further flare-ups, will usually take their axes and water hoses and systematically destroy whatever is left of your home and possessions, doing far more damage than the fire ever would have done. In a like way, in their zeal to treat, ICU-ers may forget what they’re trying to accomplish and endlessly assault a patient with procedures and drugs, even though the suffering becomes unbearable and the outlook futile.”

After 48 hours with the ICU, Bob made it a rule to go back to basics and decide whether it made good sense to go on. I had the feeling that if he were the staff physician of the patients in my mother’s particular ICU that it would not have been quite so full.

As I write this my mother is back in the Schuyler County Hospital near her home, recuperating until she is strong enough to go back to her apartment. It is a tiny hospital, perched on the hillside above her village of Watkins Glen, N.Y. Looking out her windows she can see Seneca Lake stretching off to the north, the same visa that she has seen and lived in for much of her life. She knows many of the nurses and doctors at this hospital; Watkins Glen is a small village, and you don’t meet a lot of complete strangers if you’ve lived there a long time. The food is enticing and good. Her neighbors come and visit her. Not coincidentally, the confusion consequent to her psychosis has faded completely. Last night she went to the Christmas dinner at her apartment complex, returning to the hospital to sleep.

Would my mother have experienced an ICU psychosis at Schuyler County Hospital? It’s not a fair comparison, really; they don’t do major surgery at such a little hospital. She had to travel five hours to Cleveland, to the big teaching hospital, to get that done. But I wonder; if her ICU in Cleveland had a view out of the window through which she could see hawks soar, would it have made a difference? If the dawn had broken each morning on a valley outside, the sun making its transit across the sky to cast the long shadows of sunset upon the far hills, would even an unconscious person know it somehow? If the lights had been turned down softly at night, the nurse padding silently in to look at her breathing, the alarms turned down or placed outside, might she have retained a thread to the rhythms of the world that had been already so disrupted by anxiety, anesthesia, major surgery, and medication?

I think that if you tried these things and conducted a study - modern medicine is guided by studies - that you would find that the incidence of ICU psychosis would decrease dramatically. In other words, people might be able to receive the good of hospital care without incurring so many of the injuries that such care now brings. This would surely be a good thing.

I think that the lesson of ICU psychosis is that professional care, concentrated beyond a certain point, becomes something that is not so good for you. Like a powerful medication diluted to the correct proportions, care can pull someone back from the shadows of death. But beyond a certain point, paradoxically, it begins to turn into something different, harmful, even toxic. Beyond a certain point it is not the world, even in small measure, but an environment. Beyond a certain point you may preserve your existence, but lose your mind. This phase-change that occurs with the concentration of care can be observed not only in hospitals, but in all settings where people are cared for, whether these be hospitals or human service agencies, mental retardation programs or schools. ICU Psychosis dramatizes the fact that sometimes too much of a good thing is not so good at all.

The Cafe Cure (1990)

The Cafe Cure: or, Take Two Cappuccinos and Call Me in the Morning

David B. Schwartz

Coffee is a powerful drug. I am not talking here of its well-known ability to increase alertness, keep one from nodding on one’s desk in the afternoon, drive that extra hour at night. Rather I am speaking of its less-acknowledged but no less powerful stimulant qualities: the ability to stimulate conviviality, assuage feelings of isolation and loneliness, even perhaps arm one for the personal irritations of the workday. These effects are not captured in formulaic descriptions for the chemical caffeine: C8H10N4O2. For this, chemical analysis will not suffice. To get these effects, coffee must be taken in the company of others.

Each morning in Harrisburg, the daily ritual of people part of this “drug culture,” (as the anthropologists might put it) is repeated. Tables fill up at the Alva Restaurant across from the train station, at the State and the Colonnade on Second Street, and scores of other places “where everybody knows your name.” In recent years, this ritual has blossomed in the emergence of a phenomenon which residents of Seattle or Paris or Vienna could possibly do without: the neighborhood cafe. At places like Sweet Passions on Third Street or The North Street Cafe, coffee is drunk and banter exchanged. Yet there is more going on than meets the eye. For in this casual “wasting of time” may lie a potent inoculation against some of the more pernicious diseases of modern living.

You don’t have to be a particularly astute observer to recognize that the modern world is obsessed with the feeling of stress. In fact, such stress, as well as feelings of isolation, disconnectedness, and loneliness, are virtually epidemic. An ever-escalating offering of stress-reduction programs, therapies, legal and illegal drugs, and wide-screen TVs attempt to assuage such feelings. The bottom line, however, is that they often don’t work. This is because of the simple reality that people were born and bred to be part of community, to feel they are members of a tribe, to eat and drink and celebrate and suffer together. Alone, they are as bereft as the last of the passenger pigeons, or one bee in a hive. Alone, they grow so isolated that they sicken. Many prescriptions can be offered for this sickness. Yet almost free - if not free - treatments exist for the price of a cup of coffee.

Available Without Prescription

People are suffering severely from the loss of a sense of connectedness and community. This is increasingly shown by research. While it may be surprising, for instance, to read medical studies showing that participation in a support group improves outcomes for women with breast cancer, this can only be news to a medical system that has believed the historically recent idea that disease is a phenomenon solely of cells, heredity, and chemicals. By reversing the interpretation of support groups, one might claim that the “tribal healing effect” is so powerful that it can even be observed in a hospital. Can it be that a short time in a cafe in the morning increases your resistance to disease? In fact, there is some medical evidence to indicate that this may be so, and research on this very phenomenon may verify what common-sense knows to be true.

Here in Pennsylvania, for instance, there is the well-studied “Roseto Effect.” Starting in 1961, medical researchers became transfixed by this small, Italian-immigrant town in the Poconos. In Roseto, unlike in neighboring towns, the state, and the nation, residents seemed nearly immune to one of the most common causes of death: heart attacks. People died of heart attacks at a rate half of the rest of the country. In Roseto, unlike elsewhere, there were more widowers than widows.

What could be causing this dramatically higher level of health? Researchers swarmed over the town, giving physicals, measuring cholesterol, following women into their kitchens to watch them cook. People who lived in Roseto, it turned out, smoked and drank wine freely. Well, the researchers thought, maybe it’s the olive oil - based “Mediterranean diet.” Then they found that the groaning tables of Roseto weren’t the product of olive oil - that was too expensive. In Roseto, meatballs and sausages were fried in lard. It didn’t matter. So it wasn’t about serum cholesterol, apparently. What was it about? Roseto, it turns out, was an outstandingly tight-knit community. Everybody knew everybody else. Family homes held three generations. Meals took hours. Nobody applied for welfare. Concluded long-time researchers Drs. Stewart Wolf and John G. Bruhn (the latter now Provost of Penn State’s Capitol Campus): “People are nourished by other people.”

The application of this once universally-known truth was summarized by sociologist Dr. Ray Oldenburg in his aptly-named The Great Good Place - Cafe’s, Coffee Shops, Community Centers, Beauty Parlors, General Stores, Bars, Hangouts, and How They Get You Through the Day (Paragon House, 1989.) If home is your first place, and work is your second, Oldenburg claimed, then cafes and corner taverns were a “third place.” A healthy society depends upon a balance between these three kinds of places. In Britain, everyone has their pub. In France there is still one cafe for every thirty-two adult citizens. But in America, inhabitants have increasingly tried to survive with only two: home and work. It is unlikely, Oldenburg cautions, for either a free society or an individual to survive on such a lean diet of meaningful community contact. It’s almost enough to make a person depressed.

Homespun and Professional Treatments

Depression - in fact all so-called “psychiatric” phenomena - are extraordinarily individualistic and complex. As an analytic psychotherapist, I treat people’s serious depressions, depressions which are significant, painful, and sometimes even life-threatening. For such depressions people are ill-advised to “buck up,” “slow down,” or even drink coffee. In serious depression, among other painful symptoms, all the color, verve and energy of the world can simply fade away. But a depression always tells us something about the struggle the person is in, as well as the society in which he or she lives. It is often an attempted solution to an essential problem. And it is undeniable that simply living in the modern world presents essential problems.

It is far from uncommon, for instance, for a person with far too much to do, who is plagued by feelings of isolation, and who is suffering in other ways, to walk past one or two convivial cafes on the way to fill a prescription for an antidepressant. Antidepressants are marvelous things, particularly for serious depressions, but one of their characteristics is that they often work even if taken alone in one’s lonely apartment. This is not true for coffee.

This is not to simplify the problem of depression and other afflictions. But, even in the many instances in which a convivial half-hour with the regulars in a cafe might produce miracles as great as Prozac, it simply seems impossible for many people to take that half-hour for themselves. Being driven has become unremarkable. Getting to the office a half-hour early to beat the rush has become quite common, even if it results in insomnia or an ulcer; coming in a half-hour late by way of the cafe is much less so. Yet despite fortitude and determination, there are many sensitive people who are unable to live in this incessantly busy, lonely, way.

The fatalities of the pressure which characterizes today’s American society reminds me of people with anexoria nervosa, “fasting girls.” Women with this extremely serious condition diet to the point that they can die. It is a peculiar form of death by malnutrition, for it is starving in the midst of plenty. Clinical work with such women reveals that they maintain a fixed idea that they are overweight, despite the evident fact that they are thin as rails, to the point that they weaken, to the point that their menses stop. It is the frightening consequence of a false idea. It is, as many observers have pointed out, a disease which only could emerge in a society obsessed by thinness, especially for women. No Eskimos ever had anexoria.

Likewise, overwork and incessant business have become so normal and accepted that people can starve themselves of the company of others. They rush past the cafe with the firm idea that they have too much work to do, that they have no time, that they must eat lunch at their desks. After a time, these people may go to their doctors for ulcers or depression or panic attacks or some other symptom that, insistent as an oil light in a car, is telling them that their bodies, minds, even souls, can simply not keep up the pace that they have set.

So, wake up. Disregard the incessant internal and social voices. Start leaving work early one night a week and go to the model train club, or the bowling alley, or take all the kids to see the Senators play baseball on City Island. Resolve that, barring emergencies, you are going to stop at the neighborhood cafe or diner at least three mornings a week to catch up on the local gossip. You may start to feel a lot better.

If you still feel driven by pressures, good professional care may be helpful. When it works, you may find yourself walking down the street, looking at the birds circling overhead, stopping in for some coffee and a glance at the morning paper with a new spring in your step, a new ease in encountering each day. But if you are not sure that you need this, try something close at hand and see if it works for you. Take two caupiccinos and call me in the morning. It might just work.