Now, where in human society is there a mandate to be loving? And certainly the loudest in history has come from the religions. What is Christ’s message? Get off your butt and love people. It’s maybe not exactly that quote, but postmodern Christ. And Buddha? You know, be compassionate. The highest calling of your god, if you have one, is to be loving. It’s free. You can have nothing and be great for your god. It actually is true of all the faiths, of all the spiritual paths. The cornerstone of them is to be loving, to be a loving person, and so – now, this is really dangerous – when you are caring, if you’re a Christian – hold your seat – you are Christ.
If you study Christ, you know that’s what he wants. He wants you to be him. He never wants you to worship him. Oh, nice guy over there. He wants you off your butt and out there serving love on the front line. And so now you’re a caregiver, and you are a hero, and you’re Christ? And you’re burned out? I’m a hero. I’m Christ. It’s nervous, you know, it takes you a while to get comfortable. Is there a Christian here that would disagree? Christ wants you to be him, and so does your mother. If she was nice and loving, she wants you to be her. You know, they don’t want a big plaque on the wall, “Jesus is a nice guy.†He wants you to be the nice guy, and all you have to be to be the peak of your faith is to be loving. Piece of cake. So feel how hard it is to be burned out. You love people, you are a hero to save the world, and you are the expression of your faith. Might as well stop there. Goodnight.
But there’s more. Whoa, there’s more? Yes. Number four on my list is an Eastern concept. It’s called karma. The West has problems with understanding karma. On the surface it looks like banking, right? I drove you to the airport yesterday; you have to drive me to the airport today. That is not karma. Karma actually is what I call in English a kinda thing. It means if you’re a good person, you’re going to kinda get good back, and if you’re a stinky person, you’re going to kinda get stinky back. It doesn’t mean if you’re a great human being you can’t walk out and get run over by a car. That’s not the karma that we’re talking about.
When my mother was dying, the choice was nursing home or with me. That’s no choice. Everything I like about me she made, and so I’m going to take care of her the last part of her life. She’s going to come live with me. Both of my sons, who are 34 and 23, they work with me cheap. Now, it’s hard in the United States these days to get your children to work with you, especially cheap, and it’s karma. They love me; I love them. We like what we do. Karma is when we went to Cambodia, Angelina Jolie gave us 50 thousand dollars to start our work there, and it wasn’t because I’m a really handsome devil. I tried that; that didn’t work, and then no. When the tsunami happened in Italy, an Italian family gave us 50 thousand dollars to go there right away. They just trusted us; they knew we would do something that they liked.
I chose very early in my life to own nothing, to have no property, no safety net, and it’s karma that gives that feeling to me. I don’t have to worry. If I didn’t have a place to stay tonight, I would wager one of you would let me stay in your house, and I feel that. I don’t go, “Well, yeah, that’s a little arrogant.†No, I actually know that if you’re a loving person, you can find a place to stay. Karma is a beautiful experience. If you go through life being nice and wonderful – we were talking about this in the car – if you just go through life and just everywhere you go you spread joy and kindness, you’re going to get a huge amount of good stuff back. A huge amount.
And it’s not why you do it. That’s what so interesting about karma. You don’t do something to get something back. It’s just one of the beautiful things about it. Your relationship with yourself, if you’re good to yourself, if you’re not punishing yourself with a lot of language – I’m no good, I’m too short, I’m not smart enough, I’m not pretty enough – that’s karma to yourself, so you’re going to feel lousy because you’re setting up lousy karma. But if you run around going, “I’m beautiful. Aren’t I nice? Yes,†that’s going to affect your immune system. That’s going to affect all of your life. It’s going to affect your relationship with your partner, because if you think I’m no good, how are we going to have a good relationship? You’re always going to think there’s something going wrong.
So karma’s a beautiful thing. You have no idea the richness that comes to you. All day long I’ve been receiving karma from my hosts who have treated me so sweetly and kindly that it’s a big and meaningful thing to me that people are kind. And yet it’s never talked in the business part of the news as an asset. I promise you if you want to be rich, be loving, be kind, be playful. Do it everywhere, and it’ll be scary how rich you are.
Number five on my list – and this is a real thrilling part of life. I think as we understand neuroscience more and more, we will understand that one of the greatest forces in life is living in the force of creativity. To care is a chance to be creative. In medical school, I wasn’t really taught to be a doctor; I was taught to be a technician. It’s hard to be a doctor in seven minutes. You can do technical things, but actually knowing a human being and having them know you is very different. Know what I had no education in? No one told me that most families were dysfunctional. I’m a family doctor; I didn’t get one lecture on healthy family, and yet almost every family that I sat there and spent four hours with, I went, “Whoa. You call that family?â€
You know, in those four hour interviews, I found that less than three percent of the people I interviewed had self-esteem, so that meant that three percent of the adult population from my series has self-esteem. What does that mean, to live a live without self-esteem? I found less than five percent had a day to day vitality for life. Yay life! Yeah, baby! Come on. In fact, I found a normal adult didn’t like themselves, didn’t like their marriage, and didn’t like their job, and that wasn’t why they were coming to the doctor.
Now, what can a doctor do about those things? You want to figure out – maybe we have seven or eight minute interviews so that we don’t have to deal with the really complicated parts of people’s lives. You know, the father beats the mother twice a month. Gets drunk, beats the mother. Very normal West Virginia. Never mentioned in medical school. What kind of creativity do you need as a caring person to stop domestic violence? Is there any domestic violence in Mexico? Lots, right? So, you know, it’s not actually that creative to treat strep throat. You do the throat culture, it comes back positive, you give an antibiotic. You can almost do that as a vending machine.
But when you can see in the US, if an unhappy housewife goes to the doctor, she’s going to get an antidepressant instead of something good for her, because that antidepressant is never good for her. She needs an exploration into healthy relationships, and to work together to try to have a healthy relationship. She’s not mentally ill; she’s showing that her marriage sucks. And this chance to be creative.
Okay, there’s an abundance of food. If we took all the food we threw away today that we didn’t eat from the food we had, that might have saved some lives of Mexicans who will die today of hunger. How can we be creative enough to end hunger, to end all of the problems of the world? Since no country has ever been safe to women, what kind of creativity will it take to make a country safe to women? Whoa. What a thought. It’s going to take a lot of creativity, and we haven’t had it yet. And that’s the thrilling part of caring, because the more you care, you wonder.
Your mother’s getting Alzheimer’s. Now, the easy thing, of course, if you have money, is to put her in a nursing home, but did that mother work for you all of her life and give you love? Do you want to find a way to have her come and live with you and not have it hurt your marriage? And these are some of the really creative directions of healthcare: how to care for people.
We can’t figure out in the richest nation of the world how to have healthcare for everybody. No matter how hard we look like we’re working, we haven’t figured out even basic healthcare needs for our population. Where we’ve figured out how to have a hospital operate at ten percent of the cost, and that’s creativity. Eliminate 90 percent of the cost by making it a communal Eco village model celebrating care. And again, I think creativity is one of the greatest psycho- neuro- immunological highs you can have in your life, whether it’s creating how you are as a person, creating how you are as a cook, as an artist, as a physician. It’s a beautiful thing to be in that creative process.
And related to that, number six on my list is – whoa, it’s a chance to be enthusiastic. [Inaudible]. Crazy. You know, if I wasn’t embarrassed from my singing, I would break out in dream the impossible dream, right the unrightable wrong, bear with unbearable sorrow, run where the brave dare not go.
Some of the hardest stuff for me to do is to hold starvation in my arms. I’ve held maybe 2,000 children dying of starvation, and it is hell. I don’t have any way to get rid of the memory of it. And I think we have enough food, we just – and food is cheap. I think one ballplayer in the United States, one famous person who uses a ball makes enough money over and above what they need for their million dollar mansion to create a foundation so that no child would ever die of hunger. One ballplayer.
It’s not interesting yet. The enthusiasm – if I thought if I just did these ten things that no woman would ever be abused again, I would do those ten things. What is it, is it really ten thousand things that we have to do? I don’t know. They’ve never been safe, so we don’t know yet what a safe society for women would be. Let the enthusiasm to try to do it – if you feel that you are losing some of your energy, your enthusiasm for life, tackle something hard. The great English sculptor Henry [inaudible], when he was in his eighties, was asked, as people that are in their eighties that are famous often are, “What is the meaning of life, the purpose of life?†And he said, “The purpose of life is to have a task, something you devote your entire life to, every minute of the day for the rest of your life. And the most important thing is it must be something you cannot possibly do.â€
So creativity, enthusiasm. Now, these are great medicines. If you can find your own way to make creativity in everything that you do and to bring enthusiasm to what you do, you will see yourself infect environments. And the seventh reason why care is good for me is for the actual truth that it is good for you. It’s scientifically proven that to be loving and fun is good for you. But don’t believe the research; do your own research.
Okay. I want you to do two months of research with me. And I don’t have any electronic equipment, and I know you can do this on your own little iPhone or whatever you have, or you can write it down, which would be my style. I want you to keep a journal for two months. The first month, don’t care about anything, okay? You wake up with your partner and you go, “Oh, no. Maybe if I have some coffee.†You go into the bathroom, you look into the mirror. “Oh, you again?†And just all through your day, don’t care. Butt in line, push people out of the way. Don’t care about anything strictly scientifically. You know, write down how did it do waking up that way. You know, just don’t care and keep notes as to its effect on you, your not caring. You know, don’t care at work. Just really get good at not caring universally so you can do a scientific study; that’s the purpose. And write down how do you feel about it all, how was it for you, not caring.
And then the next month, care like crazy, okay? You wake up with your partner, and you call in sick, and take the rest of the day off, ‘cause you can’t believe you’re so lucky to have this person next to you. You walk into the bathroom, you look in the mirror. And all through the month, you are opening the door, and you have a problem getting into the building you’re holding the door so long. And just everywhere that you see a glimmer of possibility, you’re caring. And write it down. How did I feel? How did I do? How’s my relationship? How are my children? How am I with myself? I mean, you can look at the immune system. You can look at the studies.
One of the most important books I think I’ve read in my last ten years was by a professor at the University of Chicago, John [inaudible], a book on loneliness. It is the research using MRIs, CAT scans of what it actually is to be lonely, and I really recommend anyone in the healthcare profession to really look at the research of the hell that loneliness is. The research is overwhelming, and it is crushing. We have to make friends.
And you know, if you start observing where ever you go, look for care. Look for something you just notice in a store, the way a parent and a child are stopping shopping and playing with a box that’s on the floor or watching two old, disabled people walking and taking turns helping the other one just get down the street. Keep an eye on where you see care. A person choosing to throw the trash in the trashcan rather than on the ground. Little gestures. Notice how you feel when you see those things, and notice languages of care as you start having that be something you notice. Notice nursing stations. Notice teams in where ever you work in your medical work. How are they working? Where is care influencing the team? It’s good stuff, care.
I want to show you some films. Is my film person back there? Hold up a thumb. I want to introduce – I’m going to show you a few scenes. Oh, great. The first scene is from [inaudible], Peru. It’s in a park in [inaudible]. We’ve done many trips to Peru, and as much as I love to clown in institutions, I love to clown in public. Just go out, go to a park, cause trouble. And because I’m so interested in care, when I’m clowning, I’m clowning, but I’m also looking for suffering. Suffering has faces. You can see and learn to read the faces of suffering, and so I’m looking.
I’m clowning, and I’m looking around to see what I can see, and in this day in [inaudible], I was clowning, and I noticed a young woman in a wheelchair. Can we hold it for a second, stop? Great. Thank you. I noticed the woman in a wheelchair whose face was on her knees, and I watched this for about fifteen, twenty minutes. And it’s a beautiful sunny day, there was music in the park, there’s every reason for her to be alert and enjoying, but she wasn’t. Her face was on her knees, and so I was wondering why was that? Maybe she was tired. Maybe she was sleeping. She partied last night. Unlikely. Maybe she was orthopedically frozen in this position. If you’ve been in chronic institutions of disabled people, I am amazed at the shapes we can end up being in permanently. But I think it was that third reason that concerns me a lot in our society, and it has to do with our very narrow definition of what beauty is.
What is beautiful? This foolish little definition of beauty has become a multi multi-million dollar a year industry, in cosmetics, in Botox injections and facelifts, the issues around anorexia and bulimia. All of the pain we have in a very narrow definition of beauty. Old people can’t be beautiful in this definition. But there’s a very narrow definition, and in this kind of situation, you have to ask yourself, what is it like to be hideously ugly? I’m not talking a pimple or a scar; I’m talking your face burned off. I’m talking profound acne, acne vulgaris. I’m talking birth defects, accidents. And I told you that when I’m with a patient, I ask them very sensitive questions, so when I’ve had a patient who was hideously ugly, I asked them what it was like to be hideously ugly.
It sounds like a horrible question, but the truth is no one had ever asked them. It’s the elephant in the room. Everybody knows it’s an issue, but nobody ever wants to talk about it, ever. And so they were thrilled finally to talk to somebody about themselves being hideously ugly, and I heard the saddest stories I’ve ever heard. The saddest stories are the life they live where everywhere they go in public, they are a nightmare. They actually see the nightmare. They look in somebody’s eyes, and before that person has a chance to respond compassionately, their face shows their ugliness. They can stare at them. They can have a face of repugnance, and they live in great fear that some child will point and go, “Mommy, what’s wrong with that person?â€
And there isn’t anything wrong with that person. We have a narrow definition of beauty. You know, beauty is a much bigger word than what you look like in a photograph in a magazine, a much bigger word. And I think that was – her name is Cathy. My style in clowning is I never ask permission; I invade, you’ll see, pretty aggressively, their space. I’m never in a hurry. This was about a forty-five minute exchange. And Cathy has cerebral palsy. It is not usual in cerebral palsy that you don’t speak, but there are a certain number of children who don’t, and she’s one of the people with cerebral palsy who doesn’t have the use of language.
Okay, let’s show it. Can we get the lights for detail? Turned on the lights. I want to give you an idea in case you decide to do this. Notice I’m paying absolute attention. Nothing else exists but Cathy. I am touching her throughout. I am caressing her. I have no concern if she ever smiles or laughs. It’s not important to me at all. It is important that I engage. For example, here I am doing a clown neurological exam. It might interest you that have no idea what I’m doing. I’m just not afraid to be up close and personal. Again, nothing exists but Cathy. I’m also saying I love you, te quiero. Te quiero, amiga.
Can we have some sound on this? Finally, after all that time, you see that she did smile after pulling the nose away. But it really doesn’t matter. Another very difficult thing for people who are disabled, in this case especially neurologically, you will see Cathy drool, and drooling is socially unacceptable, and so you will see that she’s embarrassed for drooling. She interrupts her fun, she’s drooling here. She’s very slow to respond, but she is embarrassed, and I, of course, don’t care, so I say don’t worry about it, but still, even with her left hand, she tries to stop it. And I show her drool on me, I love drool. I love drool. And I’m constantly telling her I love you, and caressing her. So you actually see Cathy’s a beautiful woman. She’s just looking for somebody to pay attention to her. It’s devastating for people who people don’t pay attention to.
Okay, I think that’s enough for this one. Let’s go to number ten. But let me introduce it. Next I’m going to show you this situation I had of relieving pain in a hospital that had no pain medicine was very strong for me. Don’t start it yet. When I saw the power that what we were doing to relieve suffering, I started, especially in poor hospitals, to say when I went to the hospital, “Please give me the patients who are suffering the most. Please tell me who is hurting the most,†that I want to go there to them. And this young boy, Sasha, happened to be this visit of that question.
The situation of Sasha is that right before we entered the room, the mother was told after a third brain operation for a tumor that the son would die very soon. It’s the worst experience in the world for a mother. There is nothing that is a close second. And this was her only child. I walked in the room. I saw her standing at the window. She was standing and being in a way that I’ve seen all over the world, that moment of facing the loss of your child and what that means, and she gestured that she did not want clowning, and of course we respected it, but she didn’t say to not clown for her son, and so we went over there and clowned.
And his story was he had come back from his third surgery, and like a lot of children, adults do this also, when their death is near, especially from something like cancer, they move away from society, and so it’s not uncommon as he did, he didn’t eat, he didn’t drink, he didn’t take his medicine, and he didn’t really interact with people. He had checked out, and maybe his mother let us play with him because she thought he wouldn’t do anything.
We stayed an hour and a half. The first fifty minutes, the mother did not join us. She did see him eat and drink and take his medicine. She also saw him play a game of football and a very strange game of baseball, and so she joined us for the last forty minutes. And you’re going to see just a little segment. I don’t know if the interpreter can hear the sound on the screen. You’ll see that basically, it’s really stupid things. It doesn’t take a training; it just takes a doing.
