She was a friend. The woman who had told me her voice was the most important thing in the world. I had promised her nothing would happen. I had promised everything would be fine.
It’s deadly for a surgeon to connect with a patient’s humanity during surgery. It has to be a technical exercise. You have to objectify the person. If you think of what might happen to this fellow human being, you can’t possibly do the surgery. It’s too close to home. I felt scared. It had never happened before.
My hands were shaking so hard that I had to stop for a moment and sit down. I closed my eyes, and focused on my breath—inhaling then exhaling slowly—until I could create enough space in my thoughts that the fear had nothing to hang on to. There was a time to open my heart, and there was a time to rely on my skill and ability as a surgeon. My ability as an absolute technician. This was a procedure I had performed many times. One that I was extraordinarily good at. My fear left me, and I was back to that calm state of certainty about my intention. I could see in my mind the clip being placed and the aneurysm being obliterated. I turned back to June’s open skull and focused the microscope back on the aneurysm, slowly guiding the clip into position in that tiny gap I had created, and once there, slowly closing its jaws. I then put a needle into the dome and drained the residual blood. It did not reexpand. The beast was truly dead and no longer a danger. June would sing again. I slowly closed the dura, replaced the bone flap, and closed the scalp. As I was putting the final head dressing on I realized the music was playing the same song that we had begun with. “Love is all you need, love is all you need.”
June was extubated and taken to the recovery room. I sat down exhausted and closed my eyes for several minutes before I began writing orders. I thought of June and I thought of my hand shaking. I suddenly heard June’s voice. “Where is Dr. Doty? I need to talk to him. I need to talk to him right now.”
I walked over to her and took her hand. “Hi, June. How’s it going?”
She looked deep in my eyes and saw what she needed to see. “Just fine, just fine. Thank you.” Then she reached up to hug me and began crying as she realized she was going to be OK.
Driving away from the hospital a few hours later, I put in the CD that June had given me the day before. Just as the first few musical notes began, I accelerated onto the highway toward home.
June’s voice suddenly filled the car with an aria from Carmen: Habanera—Love is a rebellious bird. I turned up the volume, rolled down my windows, and let the wind blow against my face. June had a gift. She could make people feel with her singing. She could touch people’s hearts with her voice, and even through a recording, she could connect.
We all have that gift and ability to connect. Whether through music, or art, or poetry, or just through listening to another. There are a million little ways for our hearts to speak to each other, and this was June’s way of reaching out to speak to mine.
The music made my heart ache. There was such beauty in her voice. I let my mind wander to what might have happened to June if the surgery hadn’t gone well, and I could feel the tears well up in my eyes. I was grateful she would be able to continue sharing her gift with the world, and that gratitude brought even more tears. I couldn’t sing opera, but I could still feel how much it meant to her. At that moment I wanted to be home. I wanted to hug those I loved. And I was thankful. Thankful that I was able to help June. Thankful that I was a doctor.
• • •
IT CAN HURT to go through life with your heart open but not as much as it does to go through life with your heart closed. I was still struggling with how to reconcile the part of me that had to be a detached neurosurgeon with the part of me committed to connecting with others.
I found myself thinking often of Ruth and wishing I could ask her as an adult the same thing I had asked her as a child: Why? What made Ruth reach out to me, when so many don’t reach out? Ruth wasn’t wealthy, and she wasn’t without her own life problems, but her heart was open, and she saw someone who was in need and did something about it. It made me wonder, how is it that those who have so much can do so little to help those that are struggling? And how is it that some, who have nothing by way of material things, will still offer everything they have to someone less fortunate? Why will some people, like Ruth, go out of their way to help, and why do others turn their backs on someone who is suffering?
These weren’t just idle philosophical reflections. I began devoting myself to rigorous scientific research and collaborating with others who were exploring similar areas. I had explored the mysteries of the brain, and it was time to devote as much academic rigor and hard science to exploring the secrets of the heart.
What I have learned since is that compassion is an instinct, perhaps our most innate. Recent research shows that even an animal can go through tremendous effort and cost to help out another of its species—or even of another species—who is suffering. Monkeys care for each other when they’re injured, baby owls feed their less fortunate nest mates with bits of their own food, a dolphin has even helped save a beached humpback whale. We humans are even more instinctually compassionate; our brains are wired with a desire to help each other. We see this desire to help in children as young as toddlers.
There is a part of our brain called the central or periaqueductal grey matter, and its connections to the orbitofrontal cortex are responsible in great part for nurturing behavior. When we see others in pain or suffering, this part of the brain activates, meaning we are wired to nurture and help others when they are in need. Similarly, when we give to others, it lights up the pleasure and reward centers in the brain, even more so than when someone gives to us. And when we see someone acting kindly or being helpful, this in turn causes us to act more compassionately.
Many misinterpret Darwin by implying that survival of the fittest means the survival of the strongest and most ruthless, when in fact it is survival of the kindest and most cooperative that ensures the survival of a species in the long-term. We evolved to cooperate, to nurture and raise our dependent young, and to thrive together and for the benefit of all.
I cried over June that day, just as I have cried over other patients since, although I have never again had a surgery interrupted by such emotion. There’s no shame in caring or feeling someone else’s pain. It is beautiful and, I think, why we are all here in this life together.
• • •
WHILE WRITING THIS BOOK, I found out that Ruth had died in 1979 from breast cancer, so while I’ll never know for sure, I do believe that Ruth would have been proud of my quest to open my own heart and the hearts of others. And I think she would have understood my desire to prove scientifically that which she knew intuitively. When our brains and our hearts are working in collaboration—we are happier, we are healthier, and we automatically express love, kindness, and care for one another. I knew this intuitively, but I needed to validate it scientifically. This was the motivation to begin researching compassion and altruism. I wanted to understand the evolution of not only why we evolved such behavior but also how it affects the brain and ultimately our health. Clearly, there was preliminary evidence that showed significant positive effects. My goal was to join a small group of researchers who had already been working in this area. On a personal level I already knew the effect, but wondered if we could create ways to improve people’s lives through this knowledge. Could I contribute?
I had already begun some preliminary investigations with colleagues in neuroscience and psychology. The results were encouraging. We had even begun meeting every few weeks to discuss the latest research as well as potential research projects. We called this informal initiative Project Compassion. Initially, I was funding this research myself. During one of our meetings the Dalai Lama’s name had come up, as one of the leading centers doing this work had been encouraged by him to research the effects of meditation and compassion on the brain. A few days later while walking through the Stanford campus, a v
ision of the Dalai Lama just popped into my head. I thought, wouldn’t it be great to have him come to Stanford, meet with me and my colleagues, and talk about compassion. It’s interesting, because I wasn’t a Buddhist, nor did I know much about the Dalai Lama other than that he had visited Stanford in 2005 and discussed addiction, craving, and suffering. Yet, I couldn’t get the idea of him visiting again out of my head. I found out that the visit in 2005 had been, in part, motivated by the dean of the medical school’s wife, who was an admirer of the Dalai Lama. She told me that one of the faculty members in the Stanford Tibetan Studies Initiative had been responsible for making the appropriate introductions. I contacted him, and he was very encouraging. He referred me to the Dalai Lama’s English translator, Thupten Jinpa, a former monk who had been working with His Holiness for almost a quarter of a century at that time. He and I spoke on the phone, and he arranged for a meeting with the Dalai Lama during his visit to Seattle in 2008.
And just like that, I had manifested the Dalai Lama.
Several Stanford representatives accompanied me on my trip to Seattle—a representative from the school of medicine, the dean for Religious Life, the director of the Stanford Neurosciences Institute, the Tibetan studies professor who had arranged the first connection, and a potential benefactor. It was quite an entourage, and one I had not quite planned on when I had the idea to have the Dalai Lama come speak.
We met in his hotel room and introductions were made, after which I explained to His Holiness my interest in compassion and my background as a physician and neurosurgeon, the preliminary research that we had recently begun on compassion, and my desire to have him speak at Stanford. He asked several insightful questions about the research and the science of compassion. After I finished answering he looked at me and smiled. He said, “Yes, of course I will come.”
It is quite extraordinary to be in the presence of the Dalai Lama. There is this absolute and unconditional love he exudes that feels just like taking a deep breath after holding your breath for a long time. You don’t have to be anyone other than who you are, and you are met with total acceptance. It’s a profound feeling, and there are no words that can adequately explain it. A monk soon brought out a large paper ledger to find space in the calendar to schedule the visit. A date was agreed upon. Suddenly the Dalai Lama began an intense and animated discussion in Tibetan with his translator. This went on for quite a while, and the Stanford entourage all sat silently. Had I done something to upset him? Had I inadvertently pissed off the Dalai Lama? What were they saying?
I began to sweat and feel anxious.
The conversation abruptly came to an end, and his translator, Jinpa, turned to me and said, “Jim, His Holiness is so impressed by your intent and this endeavor that you have begun that he wishes to make a personal contribution to your work.”
He told me the amount, and I was dumbfounded. This was extraordinary and unprecedented. The Dalai Lama does have discretionary funds from the sale of his books that typically he gives to Tibetan causes or initiatives. He had given smaller amounts in the past to various causes, but this donation turned out to be the largest sum he had ever given to a non-Tibetan cause. The meeting ended with all of us feeling as if we were floating on a cloud. Not only had His Holiness agreed to come speak at Stanford, but he was now our benefactor. Amazing. Afterward one of the individuals at the meeting told me that based on how His Holiness had responded to me that he felt compelled to make a donation to my work. A week later an engineer from Google whom I had met and was interested in my work called to say he had heard about the meeting and was so impressed with the donation by His Holiness that he also wanted to contribute. Ultimately, all three made incredible monetary contributions. What had begun as an informal project now became formalized by the dean of the medical school, with support from the director of the Neurosciences Institute and the chairman of my department, as the Center for Compassion and Altruism Research and Education (CCARE). And just as extraordinarily, Jinpa, who in addition to being a former monk had a PhD from Cambridge, ended up becoming a close friend and spending a week every month for the next three years helping me create what is today CCARE. At the same time, with colleagues from psychology, he helped develop a training program for cultivating compassion, which has now been taught to thousands and which we continue to research in regard to its effect. We have also trained instructors who have brought the power of this training to many parts of the world and who no doubt will bring it to many more over the years.
Since its founding, CCARE has been recognized as a pioneer and leader in the field of compassion and altruism research and has promoted the profound effect such behaviors can have on the lives of individuals, in education, in business, in healthcare, in social justice, and in civic government. We hope it will serve as a beacon of light, demonstrating the power of an individual to affect the lives of others and further showing empirically the value of these behaviors in terms of health, wellness, and longevity.
I had a personal experience with the power of an individual to affect the life of another. It is my hope that CCARE will inspire others to know the same kind of power. CCARE is one way of doing what Ruth asked me to do—teach her magic to others. Guiding other physicians is another.
THIRTEEN
The Face of God
More than twenty-five thousand years ago, Hippocrates, considered in Western culture to be the “Father of Medicine,” required each of his students to take an oath swearing to abide by the highest ethical standards as they practiced the profession of medicine. Many people remember the Latin phrase Primum non nocere, “First do no harm,” as a core tenet of medicine, believing that Hippocrates was the first to have uttered the words—but they would be wrong. The phrase is believed to have originated with Thomas Sydenham, a seventeenth-century English physician, who wrote a textbook of medicine used for two hundred years that resulted in his being called the “English Hippocrates.”
Over the last two decades in the United States and in many parts of the world, the tradition of medical students taking the oath of Hippocrates immediately before the start of classes has been formalized into what is known as the “White Coat Ceremony,” when the students are given white coats and recite the oath, after which an individual who epitomizes the highest ideals of medicine gives an inspirational speech welcoming the students to the profession.
Thirty years after I graduated from Tulane Medical School in New Orleans, the dean of the school that accepted me without a degree and with the lowest GPA of anyone attending, called to ask me to be that speaker. I cannot tell you the emotions that went through me as I heard the words. Me, Jim Doty, the failing undergraduate who had been told that applying to medical school was “a waste of everyone’s time,” asked to be the speaker at the White Coat Ceremony at my alma mater and being held up as a role model to a whole class of aspiring student physicians?
I am frequently amazed at where life has taken me.
It’s easy to connect the dots of a life in retrospect, but much harder to trust the dots will connect together and form a beautiful picture when you’re in the messiness of living a life. I could never have predicted either the successes or the failures in my life, but all of them have made me a better husband, a better father, a better doctor, and a better person.
I have taken my role as a healer with great seriousness. The lessons that Ruth taught me allowed me to open my heart and temper that seriousness with kindness and compassion. Not only did her magic allow me to believe that I could attend college and medical school but it gave me the tools to complete neurosurgical training, one of the most difficult and arduous residencies in medicine, and to become a professor at one of the most prestigious medical schools in the country.
The magic also gave me the courage to take risks and feel secure that, regardless of the outcome, I would be OK. The risk of taking over a failing medical device company and putting everything on the line because of a belief in
the importance of the technology in saving lives. The risk of giving away what it was that I thought I wanted most—money—the very thing I thought would make me happy and give me control in life. Her magic made me realize that it was OK to be me, money or not, and that in reality none of us has control. I had been chasing a chimera, and letting that go gave me the most valuable gifts of all: clarity, purpose, and freedom.
Like the Dalai Lama, my religion is kindness. It is a religion that doesn’t require a god who sits in judgment or lengthy dogmatic texts. It is also a religion that doesn’t allow for anyone to feel superior to another and requires us to accept that we are all equal. This religion inspired me to research how compassion and kindness are critical to one’s mental and physical health and longevity.
Into the Magic Shop Page 19
