Even after I got better from my cancer and was pronounced in "complete remission" one year after the bone marrow transplant, Mama Doug and Granddaddy continued to send cards of good wishes. They never failed to buoy my spirits.
When Granddaddy was diagnosed with cancer, everyone including himself assumed he would "go first" as he put it. It therefore came as a shock to learn that Mama Doug had passed on. On one of the rare days that I got home for lunch, there were two messages on the answering machine, one from Dale and one from brother Jerry, telling me the sad news. I was instantly overcome with a familiar numbness I had learned to call "unbelief." Oh no, that can't be. I caught my breath, choked back the tears, and returned both calls. I got more of the details: Mama Doug was at the church. She had two pies in her car to deliver to the nursing home were she did volunteer work. "Too busy to be depressed" read the last entry in her journal. She sat down behind the steering wheel and slumped over with a massive stroke. She never closed the door. She never regained consciousness. Both Jerry and Dale said she asked about me every time they saw her, and Granddaddy wanted to make sure I was notified. I said of course Sue and I would come to the funeral.
The funeral was a family reunion and community gathering in the little town of Westmoreland, Tennessee, much like the town of Newport, Maine, where I had grown up. Westmoreland is closer to Bowling Green, Kentucky, than it is to Nashville, but then Johnson City is closer to Windsor, Ontario, than it is to Memphis. The land knows nothing of such boundaries. This is Tennessee. As we drove through the rolling hills on a sunny-cold autumn morning, green fields punctuated with red and yellow trees, Sue said, "Heaven couldn't be any prettier than this." The theological implications of that simple observation where too complex to grasp. What is next? Cancer taught us to cherish each day. Already the leaves were dropping from the trees, and soon the fields would turn brown. Then the cycle of life would begin again.
Sue and I were included as members of the family as we reunited with old friends we had met at other family gatherings over the years. Although Sue and I both came from close families, we did not have family close. Sue had lost both her parents. My father had died, and I never knew my grandfathers.
I agreed to say a few words at the funeral. I wanted to share something of the positive influence Mama Doug had been for me. The pain of her loss struck me most sharply when Sue and I were seated at Granddaddy's side waiting for the ceremony to begin. Sue pointed out how much it would mean to these people, who had been praying for me throughout my cancer treatment, to see that I was doing so well. Their prayers suddenly became very personal and very poignant. We had all just lost the woman whose kindness had touched so many of us and brought us together. I understood in a way that I never had before the power of a faith community. I knew then what I would need to say. The following is my best attempt at reconstructing those remarks:
October 23, 1999
I would like to share with you a lesson I learned from Mama Doug last year when I had cancer. It is a lesson about faith and hope and most importantly about love. I think it says a lot about the kind of person she was.
One day Mama Doug told me she believed in intercessory prayer. She said she and Granddaddy had prayed that Dale would return from Vietnam alive, and he did. She told me they were praying that I would get well from cancer, and I did.
Every few days there would be a card, or a call, and sometimes a visit. There were cards from Dale and Leslie and from Jerry and Linda. In Johnson City there were visits and shared meals with Paige and with Scott and Katie. These cards contained inspirational poems or sayings or prayers. There is one in particular I would like to share on this occasion.
The Warrior's prayer
I asked God for strength that I might achieve
I was made weak that I might learn humbly to obey
I asked for health that I might do great things
I was given infirmity that I might do even better things
I asked for riches that I might be happy
I was given poverty that I might be wise
I asked for power that I might have the praise of men
I was given weakness that I might feel the need of God
I asked for all things that I might enjoy life
I was given life that I might enjoy all things
I got nothing that I had asked for but everything I had hoped for
Almost despite myself my unspoken prayers were answered
And I am among all men most richly blessed.I know Mama Doug involved many of you in this community in those prayers. I want you to know that your prayers worked, that I am well, and that Sue and I are deeply grateful.
I had heard the story of Mama Doug's prayers several times from her and from Dale. Each time it was told, more details were remembered. Dale recently told it again in this e-mail:
I do believe the prayer is what sustained me and protected me in Vietnam, as so many around me went down. At times, I was so scared that I just prayed over and over and over. I prayed to return and complete my planetary mission in this realm of existence. I promised to fulfill this mission, if I was given the gift to continue my life.
One time, near the end of my tour of duty, we were surrounded for days near the Aushaw Valley. We had run out of water and things looked pretty bleak. We would try to slip out of our perimeter and find water, but would get hit and retreat. We were in so close in contact, plus the mountain hills and terrain, that we could not call in air support or big guns. I remember calling out to GOD to help me and us through this experience, and then I called out to Mom in deep desperation. Before then, I never wrote to Mom what was really going on around me most of the time. Years later, she said that during that time, she was in the apartment in Jacksonville and heard me call out her name. She said it was so real and that I was in the back room. It freaked her out, as she knew that I was on the edge of death and no one had to tell her. She could also feel what I was experiencing. She dropped to her knees and began to pray for her son's life. She would spend hours each day in prayer and go to her friend's house and they would go into the Light together with prayer.
She also did this each day and throughout each day for your healing. She took you into prayer in the church and in her prayer groups with her special request for You. She was a most unselfish spiritual being and spent much of her time helping others. She really loved you two and we talked of you every week when we'd sit and talk.
The stories that were told at Mama Doug's funeral were a celebration of the life she had led. For a few minutes longer, we all could continue to enjoy her presence. And she would return again and again. Her work was not done, and it was not ended with this chapter of her life. She would not see her great grandchildren, the one on the way and those not yet conceived. The cycle of life would go on. She would live on in memory and in spirit. I might even see her again in . . . Nepal. Who knows?
Sitting in that little Methodist church, united in the spirit of love, I understood in a way I never could before the strange mixture of sadness and joy that we call grief.
I could see in Mama Doug many of the qualities of my own mother, her generosity of spirit, her readiness to serve others. Even though my own struggles to achieve independence and self-reliance made it difficult for me to allow myself to continue to be in the role of being served, cancer had taught me that there is an appropriate place for that. It is not so bad to be cared for. Just as I admired Mama Doug for what she did for her community, her town, her circle of friends, I was also proud of my own mother. Diabetic crisis? Don't call 9-1-1. Call Avis. She would know what to do. Volunteers to read to school children. Of course she would be there doing for others what her own children and grandchildren no longer needed. And of course she would remember the sick and visit when a visit might be most useful.
The ethic of service to others was something I had grown up with, inspired by both my mother and my father. It was part of the Hippocratic Oath, the service ideal of the medical profession. It was certainly part of the ethic of medical educators. A little known section of the Hippocratic Oath requires teachers to treat students as members of one's own family. I recall on our first trek in Nepal, General Sam once speaking what is rarely spoken of the bond of love that develops between the officer and his soldiers. I could readily appreciate the parallel for a teacher and his or her students.
The Kellogg Fellowship extended the understanding of family and community to include an awareness of global interdependence. Brazil's economy is intertwined with the American economy. The problems of Southern Africa are our problems. Will and Cliff accompanied Sue and me on my lecture-study tours around Europe and across Asia by the time they were eight and six. Cliff once said, "Daddy, what are we going to do when the Kellogg Fellowship is over?" I explained that we would continue to be concerned with the peoples of the world. We just might have to buy our own airplane tickets.
The Kellogg Forum we had been planning through my bone marrow transplant was a call to rededication of the ideals of service. A meeting in Washington, "Leading Change in the New Millennium," brought together fellows from North America, South America, Southern Africa and Asia. It served as an important reminder of all we were working for in public service.
Cliff caught the Kellogg spirit as a small child. He was now studying world religions and accompanied me on the trip to Nepal. Glenn Douglas, ever eager like myself to understand health care in a broad social context, also went along. Glenn ran the Bermuda Marathon for the Leukemia Society's Team-in-Training, and--through the generosity of his friends and mine and our mutual colleagues on the ETSU facultyñhe had raised a significant amount of money for the Leukemia Society. It seemed a curious irony that after running with Team-in-Training I would develop a form of leukemia, but three weeks after the Bermuda Marathon, Glenn, who had ridden with my bicycle team in the MS150, was diagnosed with optic neuritis, a form of optic nerve inflamation that sometimes progresses to multiple sclerosis. Glenn was left playing the medical probabilities as I had learned to do. Would he be able to run and hike and trek and climb mountains in the years to come? His residency training director was sympathetic and said of course he could take time off to go to Nepal. Cliff's professors said the same thing.
When we arrived in Kathmandu, Chandra met us at the airport, put white silk scarfs around our necks, and took us to our hotel. Seated in the garden with a pot of tea, he introduced us to our Sherpa guide and presented the plan. After a reunion that evening with Silajit (now retired from the Gurkhas and working for an international manpower organization to find employment for ex-Gurkhas), we would trek for a week in the Langtang Valley north of Kathmandu near the Tibet border. We would leave at 0330 hours, the middle of the night, to get out of the Kathmandu Valley before a Communist demonstration made it impossible to leave. Nepal now had all the advantages of a modern democracy.
Then after our return to Kathmandu, we would take an airplane flight for some close up views of Mt. Everest (a real excursion to this fascinating peak, which I had climbed vicariously many times already). We would then fly to Pokhara for the 50th reunion of the Queen's Gurkha Signals regiment of which I was an honorary member. After our 1993 trek, Chandra gave me his regimental tie emblazened with rows of regimental crests, The Crown over crossed kukhari knives, and General Sam authorized me to wear it. I was official. The Gurkhas were honored that I had come so far for their reunion, and I was honored to be included in the festivities.
I saw this trek as a particular challenge one year after my Bone Marrow Transplant. Twelve months earlier I could barely walk a mile. Now I was determined to get face to face with the largest mountains in the world. I was ready.
As we trekked first through dense forests, then up, up, up through the gorge of the Langtang Khola and onto the glacial plane, everything which had seemed so foreign on the earlier trek in ë93 seemed familiar and natural. Most familiar were the lyrical Nepali sounds of Chandra's cheerful basso, offering words of encouragement to old women carrying heavy baskets of yak dung for the winter fires, instructing little children how to behave with foreign guests, inquiring of others on the trail where they had been and where they were going. Nearly every sentence was punctuated with a laugh. Those laughs had to be good for the immune system, his and mine. It also seemed familiar and natural in this setting to hear myself referred to as "Doctor Sahib". It seemed more of a nickname than a form of address.
We met a lama and a jhakri. The lama was a young man, twenty-one, Cliff's age, eager to share his knowledge, eager to show us his gompa, or temple. It was newly constructed of wood and stone with a metal roof. The statue of the Buddha inside was hundreds of years old, freshly repainted in bright colors. The lama quickly befriended Cliff. He wanted photographs made of them together. As I focused the camera, he straightened his collar and put his arm around Cliff . We met a jhakri on the trail. One morning we were warming ourselves with lemon tea inside one of the tea houses that had sprung up to cater to trekkers. Chandra came bounding in and said, "We have a jharkri here!" I dashed out to find a ruggedly handsome, young Tibetan man wearing American-style combat fatigues and a Russian-style fur hat. He could have been a Marine. Or a Gurkha. He was good natured and outgoing and immediately inspired confidence. Like the lama, he was generous in sharing what he knew. Both the lama and the jhakri served to remind us that we were in a world where spirits were active and close at hand.
With Chandra acting as interpreter, they discussed how rituals, drums, prayers, and incantations could be used to set things right in the spirit world. Shamanism and Lamaism are a kind of ritual spiritual psychotherapy that is not limited to the consciousness of this lifetime. If something is causing distress (soul loss) that stems from unresolved issues with the spirits of deceased ancestors, it must be set right ritually. The jhakri cautiously showed us his tools: a drum, an antelope horn, a neckless made of snake vertebrae, carved figures to be driven into the ground to stake out the territory and protect him from any powerful evil spirits that might also be summoned. He showed us a white robe which he did not remove from its basket (presumably because of the power it held to induce a trance) and a white headdress with red, green, and yellow bands, which he did place on his head for effect. It was clear that grieving was hard work. The Nepalis made it a central part of their culture and gave it the attention it deserved.
Chandra told a story about grieving his brother's death. After thirteen days of mourning prayers, he looked in a pot at the rice dust covering the bottom for a sign that the spirits had been contacted. (I later learned that this ritual is called "rice divination".) He saw nothing. He was not happy, he told us, and ordered another day of prayers. This was a big effort for everyone. The next night he looked in the pot and saw a large print of a bird's foot. He said, "I was happy, and I cried, and everyone cried."
Contacting the sprit world involves danger and courage. The route to spiritual leadership, Chandra explained, involves putting oneself in a dangerous place where one might be attacked by ghosts or wild animals. Surviving this experience qualifies the survivor to help others. Our jhakri had been lost in the jungle when he was thirteen. He went crazy in the head we were told. I understood that this kind of craziness was more like "excitement" than "psychosis." Tourists went crazy over the mountain flight to Everest. We certainly did.
Finally the other jhakris found the lost thirteen-year-old. After they found him, they instructed him how to do jhakri things, how to contact the spirit world with drums and incantations, how to repeat the liturgical phrases and dance the liturgical steps that create the trances that let the spirits enter or fall into the body, how to make things right, how to protect oneself and others against powerful evil demons.
A trek such as this is not just an excursion from one place to another. Although there is an itinerary, the real destination is not a physical place, but that psycho-spiritual realm where generosity is met with gratitude. A trek is a spiritual quest. It requires cooperation and even interdependence. I carried with me the question that so many people who have trekked in Nepal have asked. What is it about Nepal that so changes people's lives? I realized it was not just the scenery, not the spectacular mountains, but the people. I knew that no simple formulation could do justice to the depth of the experience. I sensed a harmony, a tranquility and a serenity that seemed very special. Helping each other. Sharing. Caring. Our party (Cliff, Glenn, Chandra and I, Angelbu Sherpa, our guide, and Bim and Pala, our porters) was small compared to the ë93 trek when we had a team of over a dozen porters carrying tents, food, cooking supplies, kerosene fuel, as well as our personal gear. The eagerness of everyone to be helpful, especially the porters carrying heavy loads, was humbling. Perhaps I could yet learn to enjoy the regressions. Perhaps I could accept being cared for. Perhaps this was the most important lesson I had learned from being a cancer patient. One of life's greatest blessings, the willingness of others to be helpful, was right at hand for anyone able to accept it.
By the third day we had reached an altitude of 3049m (10,000 ft, up and down and up again from 1417m, 4650 ft). We were now positioned to climb a real mountain, not one of the high Himalayan peaks, but a mountain nonetheless. I had not realized that we would get to climb a mountain, and I was delighted. In Nepal the peak Angelbu chose for us did not actually have a name. It was merely identified on the map by its altitude, 5002m (16,407ft). The nearby mountains were called ri, Nepali for "hill". "5002" would have to do.
We climbed so easily to the first pinnacle we might have been levitated. From there we enjoyed specular views of the nearby Himalayas. That first pinnacle was 4773m (15,655 ft.) I made a mental note that this was higher than the Matterhorn (4478m, 14,688 ft.), the highest mountain I had ever climbed before. We did not experience the heavy steps, lighted-headedness or labored breathing we might expect at such altitudes. We had gotten here easily. It seemed more effort was in order There was another peak beckoning beyond: 5002. I glanced up at it without speaking. Then I looked at Cliff.
He said, "Okay, Dad, Let's do it." On we went.
At each of the pinnacles there was a Buddhist chorten , a square monument with a conical top constructed as an act of devotion to commemorate the dead. Rows of red, green, blue, yellow and white prayer flags (representing earth, air, wind, fire and water), fluttered in the breeze, sending off mantras chosen by the lamas. They seemed particularly colorful against the pristine white wall of Langtang Lirung (7245m, 23,763ft). We were surrounded by dazzling, towering, 7000 meter Himalayan peaks. They were so white in the intense sun that the sky appeared black. Gentle winds whistled about. The direct rays of the sun warmed our bodies in the chill of the morning. In the village below the brooks were still frozen solid. We were about a mile from Tibet. There could be no question we were in a sacred place.
When we reached the second pinnacle, Chandra assembled a mani, a stone pyramid, in remembrance of his brother. He, Angelbu, and Cliff helped me erect a similar monument for Mama Doug. Ritual Buddhist prayers were said.
OM MANI PADME HUM
OM MANI PADME HUM
OM MANI PADME HUM
It is a loving prayer of positive, glowing energy: May all be right with the universe.
The gentle smile of a single violet blossom high above the November snow fields assured me that we would not have to worry that Mama Doug's soul would find a happy resting place. I prayed instead that those of us left behind would find her generosity of spirit in our own lives. I also offered a prayer of Thanksgiving. A year earlier I had been flat on my back. Now with my born-again bone marrow and my renewed faith in the powers that make us whole, I was able to climb higher than I had ever been before. Here I was unexpectedly higher than Mt. Blanc, the highest point in Western Europe, higher than Mt. Rainier or Mt. Whitney, the highest point in the continental United States. Here I was cradled in a sacred space, held in the company of wonderful people sharing a very special moment. I could only count myself as blessed. I was in no hurry to return to the world below. This was a time I would never forget. It would always be part of me.
I found in Nepal the words I had been looking for to explain what we were experiencing on our trek, the commitments of the Kellogg Fellowship, and what I had learned from cancer. They were in the form of a Nepali greeting, seen on one the teahouse lodges.
(maayaa namaarnu holaa). Underneath was painted an English translation: "Please come back." It is a familiar sentiment, which can rendered many ways, "Come again soon", or in Southern US hospitality, "Y'all come back". But the literal Nepali captures it best:
"Don't let the love die."