The Nest in the Stream

by Michael Kearney MD

  I think of Ben as I am driving home. I notice a hollowness at the center of my chest and realize I am feeling saddened and impotent. I care deeply about him and wish I could do more to help. I feel frustrated with the Western model of medicine, which has so little to offer here, notwithstanding its great achievements and its self-confidence to the point of arrogance. Despite some temporary successes along the way, at some more fundamental level I know that we, his team of clinicians, are failing Ben. Yes, we have eased his pain, but he wants more than this. He wants his health back. He wants his youth back. He wants his life back. Although no one has said so directly, it’s looking increasingly unlikely that we are going to be able to achieve this for him.

  But there is another kind of failure and a deeper disappointment here. Even though he is surrounded by people who care about him, I sense that Ben feels utterly alone in his suffering. And while his emotional solitude is probably in part a voluntary withdrawal, compounded by the traumatic effects of treatment and the pain of his disease, I suspect that it is mostly because of the uncertainty and grief he is living with. I am acutely aware that what is needed here is not a scalpel or another pill. I long, as one human being to another, to reach out to Ben in his isolation.

  When I arrive home, our family dogs, Lenka, an English springer spaniel, and Lucy, a Chihuahua-mix, give me their usual enthusiastic welcome. I take them for their evening walk along the quiet tree-lined roads close to where we live. It’s a hot September afternoon. As the dogs sniff around, I linger in the shade and listen to the bird song. I notice a white-breasted nuthatch and watch as he walks along the underside of an oak branch, all the while hunting for insects in the fissures of the bark.

  When I get back to the house, I feed the dogs. I look at today’s text messages from my daughters and the pictures of the day’s activities of my little grandson. I send off a brief reply and begin to get my things together for the Native American sweat lodge I am planning to attend this evening.

  I have been attending these ceremonies for more than ten years now. They have become a spiritual lifeline for me and are something I look forward to each week. This way of prayer has become my “church,” not in the sense of a religious belief system, but as an Earth-based practice that feeds my spiritual hunger in ways that my root tradition of Roman Catholicism no longer does.

  I eat a quick supper and leave a note for my wife, Radhule, who is still at work. I get into my car and begin the one-hour drive south, hoping I won’t be delayed by the rush-hour traffic.

  As I arrive, I notice that the willow-frame structure of the lodge has already been dressed with canvas tarps, old blankets, and comforters. People are gathering around the fire. Wolf Wahpepah, the water pourer of the sweat lodge and its spiritual leader, is sitting on the ground to the north of the lodge, calling any newcomers to join him. His wife, Lisa, stands nearby, talking to a friend. For more than twenty years they have made these ways of prayer available to whomever comes their way.

  I approach the fireplace and look around to see who is there. There are men and women, young and old, Natives and non-Natives. Some are sitting alone, while others are standing side-by-side facing the fire as they chat. A young couple have brought their little baby and are introducing her to everyone. A group of newcomers are now sitting with Wolf in a circle on the ground. He is talking to them quietly about this way of prayer and telling them what to expect in the ceremony. My awkwardness soon fades, and I quickly feel at home in this diverse and welcoming gathering.

  To strengthen my prayers, I go to take some tobacco from the stone bowl on the ground. I hold the tobacco to my heart and close my eyes as I think about what I want to pray for this evening. I sit down and look at the sacred fire, blazing logs surrounding the “stone people,” the lava stones that are at the heart of the ceremony. I notice that I am full of my concern for Ben. For a moment, I see his gaunt young face. There’s a crack between two burning pieces of wood through which I glimpse a glowing, orange-red rock. I step forward and give my tobacco offering to the flames.

  Wolf has stood up now and is calling us together. “Relatives, the fire-keeper informs me that the stones are ready. It’s time to change into your sweat clothes, take a final drink of water if you want to, and then let’s crawl inside.”

  As I approach the lodge, the firekeeper is by the door holding some burning white sage. The sage smoke purifies the individual and the area around them. I fan the smoke towards my face and chest, get down on the ground on my hands and knees, and crawl to the opening of the lodge where I touch my forehead to the earth. As I do so, I say the greeting, “For all my relations!” Wolf replies, “Welcome, relative!” I crawl inside and move, clockwise, “sun-wise,” into the dark.

  “Bring us the stones!” Wolf says as Lisa leads us in a song to welcome the lava stones, “the grandfathers,” who arrive one at a time, glowing red. The doorman uses deer antlers to catch each stone and carefully place it in the fire pit at the center of the lodge. All the while, we are singing a song that welcomes the stone people as friends. One at a time, Lisa drops sacred herbs on the stones. As the fragrant smoke rises, someone close to the stone pit reaches for a handful of smoke and rubs it into his hair.

  Wolf calls for the water and the firekeeper passes in a bucket, full to the brim. Wolf touches the base of the bucket to the stones and says, “Water is life,” then he rests it on the ground, takes the ladle in his hand, and turns toward the stones. He gives thanks to the Creator for these ways of prayer and for our very lives this day. He sings and prays as he pours water on the stones and the lodge begins to fill with “the breath of the stone people.” He talks to us about these grandfathers, “the oldest living beings on the planet.” He says that the natural state of the stones is gray, which is how they were when they were found on the desert floor, but that this is not their “original state.” Their original state is glowing red, which is how they are when they are born. In the fire they once again burn red and bright. Wolf says that our spirits also have that same quality of brightness when we come into the world but that living in the world and being subject to negativity, over time, can dim our spirit.

  “This negativity is not ours,” he tells us. “Ours is that original bright spirit. By building the fire, we help the grandfathers to return to their original state. Then, when they come into the lodge, they remember what we did for them and they return the favor. They bring us back to our original state. This is why the sweat lodge is called a ‘purification ceremony,’ because it washes off that negativity.”

  As we sit in the break between the first and second of the four parts or rounds of the ceremony, sounds of hissing and bubbling come up from the stone pit. Wolf talks about how the first people prayed in this way before they had conversational language or song. “The original songs in the lodge were the natural sounds of the ceremony that the medicines make, a language that our minds don’t understand but our hearts and spirits do. Being in here is not primarily about what words we use. It’s about allowing our spirits to mingle with all the helping spirits of the lodge. It’s about remembering how to pray.” After a pause, he adds, “Prayer is not about what we say or do. Prayer is a state of being. Whenever we’re in the state of being that is prayer, everything we say or do is prayer.”

  Wolf calls for more stones and, as they are brought in, he invites people to offer a prayer, if they would like to do so. A young woman talks about how she is having a hard time with panic attacks and prays for help. She signals that she is finished with her prayer by saying the word, “Aho!” Others quietly echo, “Aho!” in understanding and support.

  I think of Ben. I see that he is dying, even though I hope he is not. Ben doesn’t want to die, yet I sense, at some level, he realizes what is happening, and this is fueling a deeper pain: the pain that I have not been able to reach. I feel so powerless. I wish I could do more.

  The sweat is pouring down my body now and dripping from
my hands. I let it carry all that I am feeling for Ben in its flow. As if he heard me, Wolf says, “We can bring our pain to the stone people and offer it to them. Like the water we pour, we can let our pain go to the stones. Just as the sweat flows from our bodies, we allow our pain to fall on the Earth. The Earth doesn’t judge our offering as positive or negative, good or bad; it doesn’t put a value on it. Mother Earth just receives whatever we offer her as energy. She takes that energy back into her body and transforms it into pure life force…” As I listen to Wolf’s words, something in me quiets, listens, remembers. I sense that I am receiving a teaching I already know, yet am searching for. I make a silent prayer for Ben, for his deepest healing, whatever happens, and I pray for his family.

  Wolf hands Lisa the drum and asks her to lead us in song. He continues to pour the water as the drumbeat begins. The heat intensifies to a point where my face is stinging. My feet are now a puddle of mud. I feel cramped and uncomfortable and my neck is strained from bending beneath the willow beam that’s pressing against the back of my head. I try to wriggle into a more comfortable position in the tiny space without bothering my neighbors. Then Lisa begins to sing. I recognize the song and I join in. I give myself completely to the singing. As I do, I notice that a quality of spaciousness and stillness has come into my awareness. I am singing with all my heart and I am silently watching myself singing with all my heart. The song ends and Wolf says, “All together!” With one voice we call out, “For all my relations!” The firekeeper, hearing this as a signal, raises the flap and allows cool air inside.

  The fourth and final round begins with Lisa singing a song of gratitude. As I join in, I suddenly understand something I once heard her say about the transformative power of the sweat lodge ceremony. She had talked about the “energy transfer” that happens between “the sacreds” in the ceremony—the stones, the water, the songs, the prayers—and us human “two-leggeds.” I flash back to how I had been feeling when I got here this evening. I had arrived full of the stresses of my day at work and worries about Ben, feeling tense and shut down.

  Now we are approaching the end of the ceremony. The stones that were red at the start of this round have turned gray, having been cooled by the water poured on them. As I watch this, I am aware of what feels like a glow at the center of my chest. Where there had been heaviness, there is now lightness and warmth, and a sense of being in the right place.

  As the final song finishes, Wolf talks to us about what will happen next. He says, “In a few moments we’ll crawl outside. I encourage you to stay in silence for a little while as you offer each other a drink of water. Act as you would after waking up from a powerful medicine dream.” He finishes by saying, “In crawling in here tonight, we crawled into the womb of Mother Earth. Now, as we crawl out, we do so as brothers and sisters.”

  Together we cry out, “For all my relations!”

  A SEARCH FOR HEALING

  Looking back on my journey as a healer, I see that the tracks leading to where I am in the later stages of my career are not in a straight line. I can relate well to poet Rainer Maria Rilke’s words, “I live my life in widening circles.”1

  What came before what I learned along the way about the nature of pain and suffering and healing is still there, but now there is more. There have been mistakes and dead ends along the way. There was excitement at something new discovered, followed by disappointment as I came to the edge of that way of understanding and realized that it did not go far enough, that I needed to go on searching.

  For more than thirty-five years I have been working as a physician in palliative care. The emphasis in palliative care is on improving the quality of life of individuals living with serious illness through pain and symptom control and social, psychological, and spiritual support. Every day, I meet with people such as Ben and try to ease their pain and suffering so they can get on with living the fullest life possible. It gives me great joy when someone I am caring for finds healing, by which I mean freedom from suffering, a sense of aliveness, and peace of heart, even though she or he may be incurably ill or dying.

  I am very grateful to be working as a doctor.

  However, I have not always felt this way. My professional journey began with a lot of ambivalence. Despite coming from a family steeped in the profession of medicine (my father, all four of my uncles, and both my grandfathers were doctors), I was not passionate about studying medicine, and there was never any pressure from my parents for me to become a doctor. One day, halfway through my studies, I was given a questionnaire to complete as part of a sociology research project aimed at determining why we students had chosen to study medicine. None of the suggested options rang true for me. The question that came closest was, “Are you studying medicine because you want to help people?” While I could check the “yes” box here, I knew that there was more to it than that. The science and technology of medicine did not excite me as it did many of my classmates. In addition, I felt dismayed by some of the care, or more accurately, the lack of care, that I saw being offered patients in the wards of our teaching hospital, especially to those with a terminal diagnosis.

  I remember meeting Jack, a seventy-year-old man, during my first weeks on the wards. He was blind and had just been diagnosed with inoperable gastric cancer. His surgeon had “opened him up” a few days before but had not been able to do anything, and so he had just sewn his belly up again.

  Jack was waiting to get news from the surgeon on his morning rounds about how the operation had gone. I had seen Jack on the day of his admission and got to know him on my daily visits since then. He was a wise, kind, and gentle soul.

  I was anxious about how the meeting would go as the surgeon swept into the double room where Jack was, followed by a group of us junior medical students. The entourage stopped at the end of the other patient’s bed while the surgeon spoke to him. As the surgeon talked, I was looking across at Jack and could see that he was sitting up alertly in bed, his dark glasses on, listening intently to the conversation with his roommate.

  The surgeon finished talking to Jack’s neighbor. But then, with the briefest of glances in Jack’s direction, he turned around and left the room. The other students scuttled out of the room in the surgeon’s wake. I just stood there looking at Jack, who seemed to be staring straight at me with an expression of incomprehension on his face. I felt a mixture of outrage at Jack’s dismissive treatment and shame that I had not spoken up on his behalf. If this was what clinical medicine looked like, I did not want to be part of it.

  During my years at medical school I lived with my parents in a house called Templehill on the banks of the River Lee, which neighbored a small cattle farm on the outskirts of Cork City in Ireland. I remember how happy I felt each day when my studies ended. Something in me seemed to open up when it was time to leave the alienation of the hospital and the city behind, and head for home.

  As soon as I got there, I would collect my dog Bilbo, a small liver-brown and white English springer spaniel, and together we would head down to the river or up into the hills behind our house. I used to fish for salmon in the river. At weekends I hunted for pheasant, woodcock, and snipe with my Uncle Dick. I realized later that what I loved most about these hunting trips was having this time with my uncle and his dogs, and the long hours of walking in wild country and sitting silently at lakesides—watching and waiting. One day, Bilbo retrieved a wood pigeon I had shot, which was still alive but badly wounded and bleeding. As I took it from his mouth, it was still breathing. I felt its warm blood on my hand. I broke its neck to put it out of its misery and never hunted again.

  I have always loved to be in nature. I find that in nature I can be undefended, I can be myself, and know a kind of peace and joy on which I can rely. When, on a Native American vision quest ceremony a couple of years ago, I was left alone on a mountainside in the wilderness to begin four days of fasting and praying, my strongest feelings were not of trepidation bu
t of relief. As I lay down on the Earth, memories came flooding back of lying among the rushes at the side of the River Lee; the air full of the warming sun and the sounds of water flowing in the shallows. Then, as now, I felt happy and at peace.

  As a child, I played outside a lot, either alone or with my brothers and friends. Every summer when I was young, I used to vacation with my family for three long months in Youghal, on the coast south of Cork. I spent each day outdoors with a gang of friends. We went to the beach to explore rock pools, catch shrimp and little fish called “cobblers,” or just laze about with the stray dogs in the sunny grass by the railway tracks behind my grandparents’ house. As a teenager, I liked to make Super 8 movies. I remember one I made about our wild and magnificent garden on the banks of the river at Templehill with images of swans, and sunsets, and the light reflecting on the river.

  Then something happened that changed my relationship with nature. Two young women, friends of our family, drowned when a canoe they were in flipped over in the swimming hole right in front of our house, despite the valiant efforts of my then ten-year-old brother who had dived in to try to save them. In the weeks and months afterward, I began to realize that some sort of naiveté had died in me that day in the dark waters of the river. I could no longer simply look at nature as a beautiful refuge that was there for me when I needed her. Nature existed in her own right and on her own terms. Nature was also awful, ruthless, and mysterious. Yes, there was beauty in nature, great beauty, but there was also pain, separation, and death. Nature had a life of her own.

  This marked the end of my idealized relationship with nature. Up until then what I loved about the natural world was its innocence. My favorite poets at school had been the English romantics. I remember turning to William Wordsworth again around this time, hoping to find words that would restore my primal garden. Instead, I found him talking about “something that is gone,” in his relationship with the natural world, and asking, “Where is it now, the glory and the dream?”2 Having my feelings and questions mirrored back to me like this brought me unexpected consolation. I realized that I was not alone in what I was feeling. It was as though I were standing barefoot on the earth.