Into the Magic Shop

by James R. Doty, MD

  • • •

  WHEN YOU LOOK at adults who grew up in an alcoholic home, you will find two common outcomes—either they grow up to become addicts or alcoholics themselves, a manifestation of their own trauma combined with genetic exposure, or they become overachievers, bent on being different from their family of origin and bent on escape. I was the second type. This was part of the reason I joined Law Enforcement Exploring. I liked the prestige of being a part of a select group with high moral character. I’m not sure if I was trying to convince the world or just myself. As was the case when my father was arrested, I couldn’t always keep my two very different worlds from occasionally colliding. Another one of my assignments for the Explorers was to help pack and distribute food baskets for the poor during the Christmas season. We packed big wicker baskets full of tinned pumpkin, white bread for stuffing, sweet potatoes, and of course, a great big turkey. A few days before Christmas, the deputies went around and delivered the baskets.

  I wasn’t part of the crew that delivered the baskets, but I liked to hear the stories everyone told about what happened when they knocked on people’s doors and surprised them with a gift basket. Sometimes people cried, and I had heard one of the officers say, “You’d think they never saw a turkey before.”

  I felt good when I helped with these baskets. It was a feeling of elation that lasted for days or even weeks. It was the same feeling I got when I practiced quieting my mind the way Ruth had taught me. Ruth’s tricks were a part of my daily life. I didn’t tell anyone about it, but every morning and every night I would relax my body, calm my mind, and visualize what I wanted in life and who I was going to be. I didn’t open my heart. That trick was difficult for me. It was hard to give love to myself because I had somehow internalized that my situation was my fault. It also made me uncomfortable to offer unconditional love and compassion to myself and to others. Especially those who I felt snubbed me or ignored me or treated me badly.

  When I saw the patrolman walking up to our front door with a big wicker basket in his arms, I hid behind the curtains and let my mother answer the knock. I was horrified. I’d had the feeling that we were on the list that year. I didn’t want to be someone who needed the basket. I watched my mother unpack one of the very baskets I had helped put together earlier that week. The basket was a reminder that we were poor. I didn’t want to have to rely on others. Yet without that basket, we would have had no turkey dinner on Christmas. Nobody in my family knew that I had helped pack this gift. It felt good, not because I had packed the basket but because seeing how happy my mother and father were reminded me how much those baskets meant to so many. It is rare to be on both sides of an act of kindness or generosity. On that particular holiday, I learned the pleasure of giving and the pleasure of receiving. It was a potent collision, and little did I know then how the knowledge of both would inform my adult life.

  • • •

  I STAYED IN THE Deputy Explorer program throughout high school, from the age of fourteen to seventeen. It gave me a sense of purpose and a place to belong, and those two things, combined with my daily practice of Ruth’s magic, produced a very subtle alchemy within me. I found that fear, anxiety, and worry were no longer useful emotions to entertain. More and more I could observe my thoughts and emotions without engaging in an emotional response to them. I wasn’t sure exactly who I was becoming, but I knew I was no longer the child I had been. My family became just my family, rather than a wound that caused me pain every day. I also had clarity that I was not my father, my mother, my brother, or my sister. I was me. Their actions were not mine. My brother and sister both had their own struggles, and their own fates to follow. My half sister, nine years older, had dropped out of high school, married young, moved away, and struggled to make ends meet. She would die in 2011 from health complications due to a chronic immune disorder and obesity. My brother, who was very bright, had struggled with being gay in a time and place that did not accept that people could love someone of the same sex. He had been bullied often for being different, even though this difference hadn’t been named or articulated. He left Lancaster while I was in high school, and for my last two years of high school I felt even more alone. But Lancaster became a place I would someday leave rather than the place I was stuck in. My future wasn’t bleak and drab but played out nightly in vivid Technicolor across my mind’s eye. I had absolute faith in what Ruth had taught me, and absolute trust that my future was rushing to meet me.

  With my senior year already under way, I realized I had to begin thinking about college but I didn’t know where to begin. My parents, while encouraging, just assumed that since I said I was going to college it would happen somehow. My guidance counselor didn’t even bring it up as an option. His meeting with me was short, informing me that he could give me information about technical schools if I wanted. I hadn’t even known there was a guidance counselor until I got a notice that an appointment had been scheduled. While I had done well in some courses, overall my grades were mediocre. I had no real understanding of the necessity of good grades. For me, school had been a place I had to attend, and while I naturally on one hand had wanted to do well, I had no examples in regard to how to study or prepare to succeed in school. I had never had anyone in my family offer to help me with my homework or even tell me I had to do it. While my mother encouraged me to do well, I had no idea exactly what that entailed. I didn’t know anyone who had gone to college. I certainly didn’t have any money to pay for college. And I had no idea how to apply. Still, I was absolutely, and naively, certain that the following year I was going away to college.

  It was shortly after my meeting with the guidance counselor that I tried to think of whom I could ask about how to apply to college. I was sitting in science class waiting for a lecture to begin on the three laws of thermodynamics when I noticed the pretty girl next to me filling out a bunch of forms.

  “What are you doing?” I asked. “What’s all that?” I wondered if we had some sort of science test that I had missed somehow.

  She looked up from her paperwork. “I’m filling out my college application.”

  I nodded, as if I knew exactly what that entailed. “Where are you going?” I tilted my head sideways, but couldn’t see the name of any school on her forms.

  “UC Irvine,” she said.

  “Really?” I wasn’t sure exactly where Irvine was, but knew it was south of Los Angeles somewhere.

  She laughed a little. “Well, it’s where I hope I’m going. The deadline is next Friday for all of this. I’m never going to get it done.” She waved her hands over the papers.

  I said nothing as my mind shifted into overdrive. Deadlines? I had no idea there were application deadlines. I didn’t know how any of this worked, and for a moment I felt doubt creep in. Would I even be able to apply to college in time?

  “Where are you going?” she asked.

  I thought for a second, considering how to reply. “I’m going to UC Irvine too.” I don’t know why that came out of my mouth, but in that instant that was my first-choice school. I didn’t really know anything about UC Irvine, but it was still more than I knew about any other college. I knew I needed to go to college to become a doctor, but no one had ever told me there were deadlines and stacks of forms to complete.

  She looked at me and said, “I guess you’ve already filled out your application?”

  I stared at her for a moment and then lied. “Well, no . . . I haven’t received the application. I thought it was due next month. I’ve been waiting for it.”

  Then, like a magician, she pulled out another set of forms and said, “Hey, you’re in luck—I have an extra application. Do you want it?”

  “Sure. Thanks.” I took it from her. I went home that night and tried to fill it out. I realized I needed to get my transcripts, letters of recommendation, and my parents’ tax return. For the next three days I ran around getting everything. I filled out the forms to app
ly for financial aid and hoped it would be enough to pay for school. It was during this time that I really looked at my grades and test scores and the average grades and test scores of those who were accepted. I would never get in. What had I been thinking? I realized all of Ruth’s magic wasn’t going to help. Plus, I didn’t have the money for the application fee. I mailed the application anyway. When I got home, I sat on my bed and thought about Ruth. All the stuff she taught me. Could it really work? That night and every day thereafter, I sat on my bed and visualized receiving my acceptance letter. UC Irvine was the only college I applied to, and for a few months I heard nothing. In that time we had moved twice. When the thick letter from UC Irvine finally arrived it had multiple forwarding notices on the outside. I took it up to my room and sat down on my bed. I slowly breathed in and out, in and out. I knew Ruth had been right.

  I had applied myself to my “practice” every day for years, and I had applied to college. I stared at the large white envelope, and I saw myself in a white coat someday. This was the next step in the universe’s conspiracy plot to make me a doctor, and as I ripped open the letter I had no doubt what it would say.

  Congratulations on your acceptance to the University of California at Irvine. . . .

  My future had arrived. Yes, it had to be forwarded many times through the mail, traveling from one seedy apartment to the next, but my future had chased me down and finally found me.

  “Thank you, Ruth,” I murmured. “And good-bye, Lancaster.”

  I had been accepted. Amazingly, by graduation I had significantly improved my academic performance and had received some small scholarships and enough financial assistance to pay for tuition, room, and board. I was going to college.

  I was free.

  • • •

  I STILL VISUALIZE what I want in life. I see it through a window in my mind that often isn’t quite clear and then I trust with absolute faith that when the time is right, it will be crystal clear. I have learned that this process of manifesting isn’t always linear and doesn’t always operate on a timeline that is as I desire or makes sense, but whatever I visualize usually manifests, and when it doesn’t there clearly has been a good reason it didn’t. Over the decades I have learned that having faith in the outcome is quite different from being attached to the outcome, and I learned the hard way that you have to be careful about what it is exactly that you want to manifest. I have also learned that there is immense power contained in one’s intent.

  • • •

  I HAVE NEVER BELIEVED in a powerful Supreme Being who decides who is worthy and who is not, and grants wishes and gifts accordingly. I have seen too many times the arbitrariness of a world in which an incredibly kind and wonderful person meets a sudden and painful death, and I have also seen people who are fundamentally unkind and even evil flourish. But I do believe we have the ability to transform the energy contained within each of us to have a profound impact. Each of us can change our brain, our perceptions, our responses, and even our fate. This was what I learned from Ruth’s magic. We can use the energy of our minds and the energy of our hearts to create anything we want. It still takes hard work. It still takes consistent effort and intention. I didn’t take a magic pill and suddenly become a neurosurgeon. But I learned as a teenager that I had the choice of how to use my mind and how to respond to events around me and, later in life, how to use my heart to touch those around me. I don’t think there is a law of physics that can adequately describe the power and force that’s created when you use both, but I will always remember the first law of thermodynamics that we had to memorize in science class the day I was given a college application.

  Energy can be neither created nor destroyed. However, energy can change forms, and energy can flow from one place to another. That is the gift we are each given.

  The energy of the universe is within us. It is in that stardust that makes up each of us. All that power of creation. All that power of expansion. All that beautiful, simple, synchronized power. Energy can flow from one place to another. And it can flow from one person to another. Ruth taught me my first lessons, and life has taught me the subsequent lessons. I have spent many years proving the reality of what I learned in the magic shop, but ultimately it comes down to one simple, mysterious fact. We can study every single mystery of the brain, but its greatest mystery is its ability to transform and change.

  There are times when I wish I had a scan of my brain at twelve, and then again at eighteen, and yet again after every hard truth that my brain has had to grasp over a lifetime. I was off to college with a changed brain, and studies have proven that focused meditation like Ruth taught me increases the ability to concentrate, to memorize, to study complex ideas. Would I have gone to college and medical school if I had never met Ruth? Probably not. Would I have succeeded in both if I hadn’t unknowingly prepared my brain for the academic rigors that the next twelve years would bring? Most definitely not.

  When our brain changes, we change. That is a truth proven by science. But an even greater truth is that when our heart changes, everything changes. And that change is not only in how we see the world but in how the world sees us. And in how the world responds to us.

  SEVEN

  Unacceptable

  Just under the cerebrum, and in front of the cerebellum, sits the brainstem. If you imagine the cerebrum as a world-famous rock star on a concert tour, the cerebellum would be the choreographer, determining the moves the cerebrum makes, and the brainstem would be the road manager—responsible for coordinating all the information needed to make sure the tour runs smoothly and the rock star has everything he or she needs to be a rock star. The brainstem is much smaller than the cerebrum, but it is in charge of all the functions that keep the body alive, and it is the highway that is responsible for millions of messages that need to pass back and forth between the brain and the body.

  The brain begins forming approximately three weeks after conception when the neural tube fuses shut and the first synapses of the central nervous system allow for fetal movement. The brainstem then develops and coordinates the necessary vital functions such as heart rate, breathing, and blood pressure—creating the potential for life outside the womb. The higher regions of the brain—the limbic system and cerebral cortex—are primitive at birth, allowing time for experience and the environment to shape them completely. This shaping and development of the higher regions of the brain through experience never ends—there is no retirement for the brain—every experience matters.

  Noel came into the emergency room complaining of headaches, nausea, and vomiting. She had her husband and two children, a four-year-old girl and a six-year-old boy, in tow. The couple were in their early thirties, and Noel was eight months pregnant. Headaches and nausea can be normal symptoms of pregnancy, but in the third trimester, their sudden onset along with high blood pressure can be an indicator of preeclampsia, a dangerous condition for both mother and baby. I happened to be on call that morning, making rounds in the hospital, when the family came in. The obstetrician had been called but had yet to arrive at the hospital when Noel suddenly collapsed in the emergency room and became unresponsive.

  By the time I got to her, she’d been intubated and was undergoing a CT scan of her brain. During the scan her vital signs started going crazy, and her blood pressure became incredibly unstable. Looking at the scan, I could see that what was once her brainstem had now been almost completely replaced with blood. Noel had sustained a massive brainstem hemorrhage—an intraparenchymal bleed—the kind people don’t recover from. We began resuscitation efforts right there in the CT scan suite, but I held out little hope. I saw no sign of brainstem reflexes—those involuntary movements that occur when the brainstem is functioning properly. Her pupils were fixed and dilated. She was completely unresponsive.

  Noel’s body was still alive, but her brain was dead.

  I ordered medications to sustain her blood pressure, and called th
e operating room to tell them to get ready.

  “Page an OB immediately,” I yelled at the nurses. “This baby needs to be delivered now, or it will die.”

  I ran alongside the gurney, heading to the operating room, praying that an obstetrician would show up. The OR team had rapidly set up for an emergency C-section. We wheeled her into the OR. The pediatrician was there, but no obstetrician. Noel’s blood pressure began dropping rapidly, and her heartbeat was becoming more erratic. And suddenly everyone was looking at me. Time was running out. It had been twenty years since I had rotated on obstetrics as an intern, but there was no other surgeon in the operating room. Unless I did something, this baby was going to die. I was going to have to perform an emergency cesarean section and deliver the baby.

  There was no time for preliminaries or any more hesitation. Noel was brain-dead. I knew we wouldn’t be able to sustain her blood pressure much longer.

  We placed her on the OR table. The anesthesiologist quickly anesthetized her, and I rapidly prepped and draped her for surgery. I looked around again praying for the obstetrician to walk in. Her heart suddenly began skipping beats with the blips from the electrocardiogram (EKG) machine. The anesthesiologist looked at me and said, “Her pressure is dropping. We’ve maxed out on the drugs. You need to move.” I could feel the sweat on my forehead and realized I was breathing fast. I was scared. And then I closed my eyes and began breathing slowly. In and out, in and out. I was back at the magic shop. I took a scalpel and sliced open her abdomen and then her uterus. I placed my hands into her body and pulled out the baby. There was a small thin cut across the baby’s forehead from the knife I had used to open up Noel, but apart from that, he was alive and healthy. I handed him to the pediatrician, cut and clamped the umbilical cord, and sewed Noel back up.