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Patch Adams: Holistic Healing

see the video here:

Male: Patch Adams.

Patch: Thank you. So many clowns. Maybe we should just go out and clown in Mexico City. Great. Buenos noches. I must use the few words of Spanish that I know, so I can say something. Thank you for coming. I see a lot of new faces from this afternoon. But before I start, I tell all my audiences that I answer all my mail. I’ve never used a computer; I don’t know how to use a computer. Never had a cell phone. But I can tell you that in order to find my address, you have to go to my website. I’m sorry. I don’t know how to get to our website, so I’ve never been there, but I know my address is there on a post office box. I write four to six hundred letters by hand every month. I’ve done it for all my adult life. I’m caught up, so if you write me and you have a nice clear return address, I answer your letter. If you like to wrestle with ideas or if you have big dreams for a better world or you want to argue, I’m there for you if you need a friend.

Tonight’s talk is called the joy of caring. It’s one of the talks I’ve given for my entire lecturing life, which is almost thirty years. When I started to go lecturing, I wondered what did I have to offer. And my profession, the healing arts, is a profession that people expect to burn out in. Burn out is an epidemic problem in the medical profession. I even heard today that a lot of the pediatric residents were depressed, and so this lecture was created as a burn out prevention lecture, because I know it is impossible for me to burn out. I will die, but I will not burn out, and I think anyone can prevent burning out if they at least hear what I say, and not necessarily follow it, but find their own journey to celebrating life and not burning out.

How I will shape the evening is I will describe two kinds of work that I do, the medical work and the clowning work, to show that I feel I have the right to speak about caring, since my whole life is about caring, and then I will be a pep talk for care and say what it is about care that makes me so happy, and then I will show some films about care, and a few more things, and then questions. So relax and enjoy yourself. Right? You’re relaxed? Some of you had dinner? Great.

So I’m going to describe our medical work. If you were here this afternoon, you will hear some repeated information, but it’s a good idea, and sometimes it’s good to hear ideas twice. My [inaudible] has been unique to the United States in that in forty years of medicine I never made any more. My entire life in medicine, I have been free. It was a political act to show that care, loving care, giving, is another way to think of yourself as being rich. That it is not just having money that makes you rich; that having meaning can make you rich.

I went to medical school as a political activist. I wanted to do my part to change our global society. I think we’re in big trouble, and so I entered medical school with the idea to study healthcare delivery. With a lot of reading and a lot of interviewing, with the idea to create a hospital that answers every problem of the way healthcare is delivered, not as the answer, but as simply an example that answers are possible. We are doing ours. What is your fantasy?

All over the world, I have been and lectured in seventy countries’ medical schools, and many of those countries, many of their medical schools, and correspond with medical people in 120 countries, and nowhere do people like their hospital. Nowhere do people love and feel that they are practicing medical in a vibrant, vital, sweet community, that they hate going home to because they love the practice of medicine.

And so when I graduated in 1971, I started the Gesundheit hospital, and we – no one gave us a hospital, and we didn’t have any money, so we used what we had: 20 adults, 3 of us medical doctors, and our children moved into a large 6 bedroom house and said we were a hospital. We were open 24 hours a day, 7 days a week for all manner of medical problems from birth to death. We ran it for 12 years. We had 500 to 1,000 people in our home each month with 5 to 50 overnight guests a night, so I’m sure you can picture 6 bedrooms with 20 adults and their children already living there, and five to 50 overnight guests a night. If you realize that many of those guests are needy and lonely and lonely and needy, anxious, troubled, you can imagine the intensity of this living environment. There was never any place to be by yourself. There was always on top of each other.

We had 15,000 people in our home in this period. 3,000 had profound mental health histories, and we chose at our beginning to never give any psychiatric medicine for anything because we wanted to explore non-pharmaceutical mental healthcare, and so our house was almost always full of, I would say, extreme craziness. We had one rule, and that was no physical violence. You could act any way you wanted to. You could take off your clothes and scream loud, dirty words, and we would fit it into theatre. It was a very fascinating experiment. Our idea was to make it all free, and it wasn’t just free for poor people. We wanted to eliminate the idea of debt in the medical interaction. We never wanted anyone to think they owed money. We wanted them to be excited they belonged to community and their community takes care of them. We also had nothing to do with medical insurance because they have a tremendous control of the way healthcare is delivered in the United States. It’s also a very expensive system, and I never heard anyone say anything nice about it.

The thing that has probably been the most difficult to raise money is that we’re the only medical group in the United States to refuse to carry malpractice insurance. In the United States, you are required to carry malpractice insurance. Some doctors pay over 100,000 dollars a year in malpractice insurance, and we said we need the right to make a mistake, and so we’ve never been sued. We’ve made millions of mistakes.

One of the biggest concerns all over the world is not having enough time with patients, both from the staff’s point of view and from the patient and their family’s point of view, and so as a family doctor, my first interview with a patient is four hours long. Really intense four hours. I ask every question sensitive to life. I want to know you better at the end of those four hours than anybody knows you. I don’t shy from asking the most personal questions, and if I see anything strange, I ask more. I also insisted that I visited the home of all of my patients. I visited their homes, I invited myself to dinner. I snooped around the house. I opened every drawer, went in every closet. I was like Sherlock Holmes. Because you asked me to be your doctor, I wanted to – when I reflected on what it is you’re asking – I wanted to know you, I wanted to have some idea. I wanted to have us love each other, to have a love for each other that in that kind of context, great medicine can happen, especially at a death bed or at an intractable pain or chronic unsolved medical problems.

We also integrated all of the healing arts, the only hospital in the US to do that, so we were, even though it was against the law when we started, we had been, for forty years, involved in acupuncture and homeopathy and [inaudible] and chiropractic and many, many other things.

We also taught social change. We realized we come from a country that doesn’t have much political, economic, or social intelligence, and I think that’s obvious to anyone who takes a close look at us, and so we were a constant educational environment for understanding human community.

And no one gave us a donation in those twelve years. Not one little grubby donation. It was a very bad record. In fact, I had 1,400 foundation rejections. Another very bad record, and so not only did our staff make no money, they had to work an outside job to pay to practice medicine. This is what I’ve done for forty years. I pay to be a doctor, and I say that without any sense of sacrifice or long and hard journey or difficult task. That is a bunch of [inaudible]. The unencumbered practice of care is an ecstatic experience worth paying to do.

And we pretty much did it all the time. There were no breaks from it. It was our home. The patients were in our home. Get to work. An interesting thing is our first nine years, nobody left, even though it was incredibly intense, dangerous. My closest friend in medical school was murdered by one of our patients. Nobody left, and I think I mentioned it this afternoon that I think the main reason is that we were the first silly hospital in history. We made everything funny. It was also really tender and experimental, and so there was always theatre going on, always farming. We were farmers from the very beginning, and just very complicated exploration, and all of this made for an experiment that people wanted to stay in.

When we finished after 12 years to focus our attention to raise money to build our fantasy hospital, we realized that we couldn’t just raise money, that we had to do something that was for our soul, and so that’s when we started our mission trips. This was in 1985, and were a very poor organization, so we said let’s work for peace. We can at least go love our enemy, and at that time, very clearly, with Ronald Reagan, the enemy was Soviet Union, and so we made our first clown trip to Russia in November, and we’ve done it every November. I invite you to it. It’s a hell of a lot of fun. It’s two weeks of clowning ten to sixteen hours a day in hospitals, orphanages, prisons, nursing homes, restaurants, subways, hotels. We make everywhere dangerous. We’ve taken ages 3 to 88. We don’t require any training. You can be the dullest Mexican in the country, and we would take you, because in a clown costume, you immediately become a character, so even if you’re going, “Oh my God, I’m going to fail. Oh my God, I’m going to fail,” that’s a clown character, so somebody watching you goes, “Wow, you’re really good.”

So I invite you all to do it. It was really there that I found a very different life as a clown. It was there that I discovered that there were hospitals that didn’t have any pain medicine and that I could walk into a room with just horrible, horrible screams and pain, and that 80 plus percent of the time, the clowning would stop the pain. It made me take a lot keener interest in going to the worst of possible human suffering to see just what can happen with love and fun and humor.

This led, 20 years ago, to use creating orphanages in Moscow and St. Petersburg because we felt uncomfortable with the way children are cared for. There are horrible orphanages there, and then we said, “Hell, let’s take clowns into war,” because that certainly seemed like a place with a lot of suffering, and three times we’ve gone right into the thick of war. And then we just went crazy. We said, “Let’s go to disasters and refugee camps.” We’ve taken about 150 trips, and after the movie, as my speaking fees increased, everything I make is donated to our project. We started to build clinics and schools in poor countries, and we have a lifetime project in the Peruvian Amazon to stop child sexual slavery that we are working to create medical schools in Africa. And really I’m saying these things simply to give you the impression that my whole life has been about care, that I’m not a person that really takes break. I work and I love to care for other people.

What is care? For me, care is an action verb. It means to project both the action in countenance of compassion, empathy, and generosity over time without regard for a reward. You do it for its pleasure. Victor [inaudible], a Jewish psychotherapist who survived three years in the Nazi concentration camps, said “We who lived in the camps remember the people who walked through the huts, comforting others, giving away their last crust of bread. Though they were few in number, they offered sufficient proof that everything can be taken away from a man but one thing, the last of the great human freedoms: the ability to choose one’s own way.” And probably everything I talk about is about choosing who you are, who you want to be and then decide to be.

So I think of care as a choice. I don’t agree with advertisements for hotels or hospitals that say, “We care.” “We” never cared. An individual decides in a given moment to care. For some people, it can be who they are. They’re caring all the time. For another person, they might care for a particular kind of group of people. Some, like me, who had a great mother, were simply trying to be our mother. I never, ever have thought about myself as being more caring than my mom. I saw a great example of care, and I wanted to be like that. So did my brother, who’s older than I am, and through all of these years, we have worked together. He and his wife manage our building site where we’re now building our hospital.

Others that don’t have this kind of inspiration through a parent might find it from a teacher. They might see a TV show. Since I’ve traveled all over the world and been in so many orphanages and so many situations, it’s amazing. Sometimes somebody goes backpacking, they decide to go visit a country, they bump into a problem, and then they stay the rest of their life. That can also happen. Or you can have a bad experience in your life and decide to care. You can feel moved by your religious background to care. And the way, I think, whatever it is that’s stimulates you, the experience of care is going to be very similar: the thrill of giving your time and your love to another human being. It’s, at least in my experience, it’s energizing beyond anything else that I know in life.

Another quote that I want to give before I give you my little list of things that make me [inaudible] to care is from George Burnett Shaw, great Irish playwright, who said “This is the true joy of life: being used for a purpose, recognized by yourself as a mighty one, being thoroughly worn out before being thrown on the scrap heap, the being a force of nature instead of a feverish, selfish little clod of ailments complaining that the world will not devote itself to making you happy.”

Why do I do it? What makes me so happy about it? I’m going to tell you seven things. All lists are incomplete. I’m going to tell you the truth; the first thing on the list is the foundational reason, probably for everything that I do, and that is that I love people. I can think of that in the abstract. I love all people. When I tell you that I answer all my mail, I do it for me. Tomorrow I will go home. I’ll have a stack of mail that has arrived. I will read a letter twice and answer it. I’ve corresponded with some people for twenty years and never met them. I love it. Each person, a unique creature. When I tell you I did four hour interviews with patients, I did it for me. What a sneaky trick it is to be a doctor. Well, I guess I’ll just have to sit here and have you talk to me for four hours. Not to [inaudible], that’s seven, right? The opportunity.

Here’s a little trick about a doctor. If you project that you care and love the person, they will tell you everything on the first date. You can try and experiment to ask them questions, and they will tell you. People will tell you, and I love that. I love finding out a lot of deep things about people. Since I never had any religion, I never had any relationship to God, I feel that what people get from God, I get from friend. I can even safe to say that friend is God for me, that I could call my experience with friendship my own worship. That this is really the, I think the major force in my life, just pushing me to work all the time, is the thrill it is to help other people.

I have this fantasy. You know, a magic wand – ding, world peace. Ding – no more hunger. Those are nice magic wands, and if I had one, I would have peace and justice everywhere, but let’s say you had to have a magic wand just for your own little selfish indulgence. This is one of my fantasies, and it shows you how much I love people. I would love to be caught between floors on an elevator for hours full of people that don’t like each other. Oh, give it to me. Five or six hours of human bliss. I mean, there you are. You’re stuck. You can’t go anywhere. There’s height differential. There’s smokers and nonsmokers, emerging claustrophobia. Oh, boy. And you’re there, you know? You’re there. Maybe you’re not taking notes or anything, but maybe you are. Farting? What about farting? I mean, all of it’s there for people, that you get to see these people that don’t like each other that are forced to be close, maybe even collaborate. Oh, boy. I hope you have dreams that big.

Yes. You know, I do love people. There’s so many times in my life that I’ve spent exploring people. Whenever I’m by myself and I’m not with friends, I’m out there doing very strange laboratory experiments with people. I just never tire of it. A lot of them I learned after – I had three mental hospitalizations when I was 18. I didn’t want to live in a world of violence and injustice, but once I finished that and decided to be revolution, I had all this time to explore experiments in being a human being. And in doing them with so many people, I really fell in love with us, how we can be and comfort with each other. So that’s a really big reason for my care.

Number two on the list. Number two. Now, I’m going to pull the audience. I did this afternoon. Raise your hand if you are profoundly concerned about the future of humanity. Raise it high so everybody can see. Notice to unanimity. If it’s any help for you, that’s every audience in seventy country for twenty-seven years. People are profoundly concerned about our future. But are they acting revolutionary?

What profoundly means for me, since that’s the important word in that statement, is that if we don’t change from a global value system nested in money and power over to one nested in compassion and generosity, nothing I study, nothing I visit or see gives me any sense we will survive this century as a species. And the relationship to care is, you think, “Now, what the hell is the answer? Peace on earth? What’s the answer? No hunger? What’s the answer? Justice for everybody? Women safe everywhere?” Well, of course it’s to love everybody. One way you know you love somebody is you don’t hit them. You don’t smash them in the face. “I love you dear. [Inaudible].” And if you have food, you share the food. And if you see injustice, you speak up, and you act.

So when you care, you are the answer. When you’re caring about others, when you’re giving of yourself to other people, this is the answer. If you’ve heard of Joseph Campbell and his work with myth and heroes, there’s an archetype of a hero of that person, however small they are, to go and tackle the giant dragon, and this is what you are when you care. You dare to take yourself next to human suffering and to give of yourself, and that’s heroic. So since this is a medical group and I know you are caring people, I’m going to count to three, and you’re going to yell out, “I am a hero.” Okay? One, two, three. Not bad. Not bad. I’m a hero. I’m telling you you’re allowed to feel that. Your caring is the solution to the problems of the world, to care for people, to care for all people, to care for the nature. That is the answer. It’s that simple on paper.

So I want you to think again now, since you’re in the healing arts, most of you, or a teacher, or a social worker, whatever you do – a parent. Think of some moment this month where it was very clear your care mattered. Where you may have thought it was nothing, but they thought it was something big. It could have simply been that you’re sticking up for somebody, whatever it is, but I want you to think about that and feel its heroic nature. In peace and justice, it’s not the sword that is heroic; it is the gesture of love.

So I know you have that in your thoughts, and so we’re going to count to three again and really let it out, you know, maybe even give it some shoulder action. Okay, yeah, that’s right. One, two, three. So it’s hard to burn out if you’re thinking, “I’m a hero,” right? “I’m a hero, God, this is horrible.” It really sends an unhealthy message. If care doesn’t invigorate you, what is going to invigorate you? So you want to stress, “I am a hero. Yes. I am a hero, alright. Yes. Thank you.” Would you stand up and do that heroes dance? Yeah. That’s what we’re talking about. You’re out as a hero. And see, you know how it is, how you get someone enthusiastic about something, you’re enthusiastic about it. So you go to another country, you try a particular dish that was incredibly delicious; you bring it back to share with somebody. If you are caring and you show your excitement and heroic life, other people might want to do it.

A third reason I love to care is kind of related to this thing. What is the job of care, job description? To love? That’s my job. Got to go to work and love. If you think about it, that’s your job, and when you care, whether you’re a teacher, a social worker, a surgeon, nurse, whatever it is, your job as a parent is to love. That’s your job description. Got to go love.

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