The marsh really began to work on me. I felt softer there, more peaceful and more myself. One day, while sitting in the grass watching the cattails bend and blow, I felt as if the wind were trying to talk to me as it softly bent the tall stalks. It was as if we were conversing—the wind speaking and I listening—although nothing specific was being said. I was just suddenly aware. I began to get the feeling—to know—that everything in Nature is alive and can speak to me. I grabbed a few minutes of video of the scene on my phone, because I didn't want to forget it. It was comforting and also exhilarating. I wanted to know what to do about this new ability to commune with Nature; I wanted to learn more about this peculiar mode of communication.
Eventually, as the weeks rolled by, I began to wander deeper into the woods. And they began to speak to me and reveal things in their own wild way. One cold fall day, it felt as if everything were being laid bare—as if everything were full of truth. The leaves had fallen away and the grasses had withered to the ground. The chickadees were singing out their own honest cries: “Sweetie, sweetie.”
As I witnessed the pure honesty of the wild, my own untruths became more apparent to me. I needed to ask clearly for what I needed. I needed to become quiet so that I could hear. A large dead tree whose arms extended in all directions seemed to be pointing me home. A huge old pine with a mossy two-part trunk drew me in, and I began to notice that it looked like a lady buried upside down, with just her hips and legs left above ground. I became acutely aware of the season—how, as fall marched on, it became eerily silent and all the energy seemed to go underground. Faces appeared to me everywhere—in rocks and in tree trunks—and they all seemed to have different personalities and feelings. I couldn't recall ever being so aware that everything was so alive and that it was also aware of me.
It was at this point that I had my second significant dream about animals, this one sweet. There were beautiful beluga whales nuzzling my fingers as I sat at the back of a boat. The boat was riding very low in the water and so it was a bit precarious, but the sea was calm and gentle. The message from the whales was simple:
Everything looks good. Just slow down so we can communicate with you. And try to float a little higher.
CHAPTER 11
Slam-Dunk Diagnosis
“You're mad, bonkers, completely off your head. But I'll tell you a secret. All the best people are.”
Lewis Carroll, Alice in Wonderland
I made a significant discovery while on sabbatical. With some distance, I was able to see that, in many ways, I had always been different from other physicians. They seemed satisfied with medicine for life—or at least they had surrendered to the prospect. They seemed practical. Or maybe resigned. Some didn't have kids, so they were more free to commit to medicine while also pursuing parallel dreams—like playing in a metal band, rescuing injured hawks, or studying Lithuanian cuisine. I, on the other hand, had many different desires, and I wanted to do them all. Being sentenced to pathology for life now felt incredibly stifling.
Being away from the office also gave me a new perspective. I began to notice that I'd developed a certain toughness in medicine that wasn't in my nature. Even the metaphors used in my daily work seemed masculine and violent. When we made a difficult diagnosis—for example, one resulting in a partial brain resection—we said: “We pulled the trigger.” I now realized that I had allowed the field of medicine—where competition and criticism are often fostered—to squelch my own softness. In response, I had found solace among the nurturing women in my immediate work environment—the secretaries and technicians. Without their laughter and encouragement, I would truly have been miserable at work. With them, I noticed that I could be myself in a way that I couldn't with my male physician partners.
I made another connection after a couple of women acquaintances confessed that they had recently both been diagnosed with ADD. One was a physician like me; the other was a professional design consultant. I could relate to a lot of things about the consultant. She was off-the-wall funny and prone to blurting out whatever was on her mind, sometimes with mixed responses from her audience. A bit of a loose cannon, irrepressible. Hmm. That sounded familiar.
Intrigued by these encounters, and curious as to why I was struggling so much with being at home with the kids over the summer, I decided to learn more about ADD, going about it in the same way I tackled all problems—by reading lots of books and asking lots of questions. I devoured Driven to Distraction by Edward Hallowell and John Ratey, and recognized myself on nearly every page. I could see the part of me that wanted to categorize a pathology case but wasn't interested in “super-sub-sub-categorizing” it. I'm decidedly a lumper, not a splitter, which had been distressing when working with people who relished hairsplitting. For example, I found it frustrating when a colleague felt the need to run dozens of expensive and highly detailed tests to further categorize an aggressive tumor in an elderly patient who couldn't possibly undergo the chemoptherapy that would be required to treat it. I favored being practical rather than splitting hairs simply because we could. Moreover, my mentors at the county hospital where I was trained had taught me that every dollar should be spent to its best effect.
I also recognized that I worked best in the quiet of my tomb-like office with the door closed. Overstimulating, noisy, or cluttered environments (like parts of our house) confounded me. I recognized my “let's cut to the chase” tendency—an aversion to taking in too much information—and my impulsive desire for speedy conclusions. All these traits often characterize people with ADD. They can also be a strength, of course. But I began to see how they often sabotaged my relationship with Mark and my family. And I recognized that I often felt as if I were in a hurry, as if I were in a big race. But a race to where?
In fact, I put a mental check mark next to nearly every ADD symptom the authors mentioned. After finishing the book, I felt discouraged and even more confused. Could I really have ADD? If so, why hadn't it been recognized earlier—in elementary school? After all, I'd made it through all those years of schooling, including medical school, and no one had ever suggested something might be different about me in this way. I'd flourished in my professional career—at least up until now. But then I realized that, before leaving on sabbatical, I'd been finding it harder than ever to sit at my microscope.
I decided to see a well-respected local psychologist and have an evaluation done that involved testing and a lengthy personal interview. After an hour of exploratory questions, the psychologist suggested that I might have mild anxiety and perhaps a bit of a “caustic personality” (say what?). I was told to return to his office; he needed to administer some tests.
A week later, I took the computerized TOVA screening (Test of Variables of Attention) after a big old mocha from Starbucks. I thought I was slaying it. When the test was reviewed, however, my diagnosis was a slam dunk. My ability to attend to incredibly boring stimuli for long periods of time was, as Martha Beck had once so aptly described it, akin to that of a demented squirrel on meth. According to the psychologist, my ADD had probably gone unnoticed because, when I was a kid, ADD was a disease generally attributed to boys, and because I probably had an inherent IQ high enough to override most of my cognitive challenges. So when I worked really hard, I could compensate for my deficits. This made sense to me.
This diagnosis led me deeper into myself. I began to explore how it had affected me and my life. The more I learned about it, the more I started to understand why certain things were immensely challenging for me. Even typing an email in our noisy house could send my brain into overload. Watching a film about Temple Grandin's life was an epiphany for me. When Temple, diagnosed with autism in elementary school, went away to college, the noise and environment were so incredibly overstimulating that she had to find a way to calm herself. She'd observed that cattle became docile after entering the “squeeze chute” used to hold them still for vaccination and branding. So she designed and built a little “squeeze chute” in her dorm room that
effectively held her and calmed her. She called it her “gentling contraption.”
I totally got how Temple Grandin felt in overstimulating situations. I desperately needed a gentling contraption of my own, or at least air-traffic-controller earmuffs—something to help me during times of loudness and distress. I began to make connections between autism and ADD, especially the inattentive kind of ADD I suspected I had. People with these characteristics tended to spend more time in the theta-brainwave state characteristic of daydreaming, one of my favorite pastimes.
I also began to understand how I could get so much done in a very short time at work. I was in ADD hyperfocus mode, which allowed me to tune out the world and tune in to the task at hand. However, any distractions while I was in hyperfocus mode were irritating as hell to me.
It was also my ADD that apparently gave me the tendency to blurt out whatever was on my mind. A few painful “unfiltered Sarah” moments came flooding back to me with a new understanding. Like the time when I was nine and told my favorite teacher to “go to hell!” when he wouldn't let me sit out a game of dodgeball where it seemed as if the balls were constantly bombarding me. Or the time when I locked my least favorite babysitter in our bathroom until my mom got home because I was sick of her being in charge. Or all those times that I impulsively told my mother to “fuck off,” even though I knew it would get me grounded. Stealing liquor from parents, buying an ounce of pot and spending a summer smoking it with a friend. Doing tequila shots while driving around on the first night I had my driver's license. Brashly getting high in the stadium bathroom before football games while I was on the cheering squad. Telling a friend who told me she wanted to have another baby and seemed confused about how to go about it: “Why don't you just go home and have Roger stick it in there tonight?” The list goes on.
Okay, sure, I sometimes blurted things out and could be impulsive. What I let slip might not always have seemed empathetic. Or appropriate. Or polite. Or even okay. But I reminded myself that I was also valued on the foundation board on which I served because I had no problem addressing the elephant in the room when other people were afraid to speak up. My nonfiltering self was sometimes an advantage. I wasn't a bad person. I was honest—to a fault. And tender. I often burst into tears when I sensed the pain of another being.
So I spent a few months grieving for my inner little Sarah who'd worked so hard and tried to fit in. And then I began to claim my own status as a creative being. I remembered Walt Whitman's words: “I am large. I contain multitudes.” I suddenly realized that I was here to use my own strange multitudes to bring balance to the world. I began seeing this freakiness, this strange irrepressibility, everywhere. But I began to look beyond its drawbacks, and to see the beauty it could bring.
I began to expand my understanding to include other groups as well—addicts and those with depression or anxiety. I suspected that just about everybody with this type of disorder was here, not to be fixed but to learn to express themselves and (with help) find their own way.
I began to ask myself: What if we could love, accept, and circle the wagons around these folks, as I'd experienced in my own life? Then perhaps even more good could unfold.
PART TWO
Heeding the Call
“You've got to be able to make those daring leaps or you're nowhere,” said Muskrat.
Russel Hoban, The Mouse and His Child
CHAPTER 12
Throwing Bones
“I think it will come true,” said Mother, “because it is a special kind of good wish that can make itself come true.”
Russel Hoban, A Birthday for Frances
I was sitting at my parents’ cabin when my phone buzzed. It was Suzi, asking if I wanted to go to South Africa with her. Her cousin Brian, who worked there, was planning to marry a girl whose family lived in a remote village. He needed a family delegation to attend the lobola, or bride-price negotiation.
Strangely enough, six months earlier, Suzi and I had declared that we both wanted to go to South Africa. It had just sounded intriguing. But the possibility felt even more significant now, because it would allow me to deepen my study of wild animals.
Since my experience in the marsh, and through the animals showing up in my dreams, I'd stumbled deep into the idea of animal wisdom—that animals somehow have helpful messages they can convey to humans. I was reading every book on animal totems and shamanism I could find. My first introduction to the concept had come from Ted Andrews's book Animal Speak, which I picked up in a New Age store when we were on vacation one weekend. Because I was on sabbatical, I felt more relaxed—more open than usual and freer to explore new ideas. The store itself drew me in, and I didn't want to leave when it was time to go. It was stuffed with crystals, books, chakra charts, and statues of deities. I couldn't get enough of the atmosphere. It felt so good to me.
From Andrews's book, I learned that the power of totems is based in the belief that any and all wild animals that cross your path come bearing helpful messages. When you can decipher them, you have an easier time navigating life. I was fascinated. After reading the book, I decided to share what I was learning on Facebook. I asked if anybody wanted to know what a certain animal totem meant. I must have had fifty people comment, curious about what certain animals symbolized. The experience of conversing online with these people thrilled me. I wasn't alone. This seemed to be a clue for me. In a game of “Colder, Hotter,” I was getting warmer.
As I began to observe the wild animals that crossed my path and search for their visits’ meanings, I slowly started to internalize the ancient belief that everything that is, is alive and can speak to you. I began to notice creatures everywhere, and each one seemed to have something significant to teach me. I suddenly realized that all of the découpage I'd done back at our old house had been a kind of precognitive experience that had prepared me to make this deeper discovery. These animals were not merely images; they were alive in a completely different way. I was no longer just gluing them to surfaces; I was encountering them as they presented themselves to me in their myriad forms.
A crow stared unyieldingly down at me from a white pine, urging me to return to my desk to write. When I heeded this advice, I felt better. The creatures didn't have to be alive to speak, either. A taxidermied walrus at a shop downtown reminded me that I, like him, am one of a kind. This made me realize that I'd have no competition if I chose a new vocation. And that felt like a truth as well. I relaxed a little more. The Beasties, as I grew fond of calling everything from ladybugs to mythical creatures like dragons and unicorns, were giving me signposts in this unmapped territory I was now traveling.
Despite the incredible opportunity to travel to South Africa, however, I still had to consider travel expenses, four kids, and Mark. Even after getting his approval, I wanted to be absolutely sure it made sense to go. Two days later, sitting next to Suzi as she spoke on her phone to her cousin about the upcoming wedding, I decided to nudge the Universe for a sign and asked the only question I could think of: Where was his bride-to-be's village in relation to Londolozi—a game reserve with several lodges on the border of Kruger National Park. I'd wanted to go there ever since my parents had gushed about their visit years ago. In yet another synchronicity, Martha Beck had also written a bit about her visit there at the end of her book Steering by Starlight. If the wedding was nearby, I could build in a visit. But what if it wasn't? Was I still meant to go? We waited quietly while Brian set the phone down to ask Amanda.
When Brian came back to the phone, he told us that Londolozi's owners had built the very school that Amanda had attended as a child—in Hazyview near Kruger Park. Her childhood village was just a few miles down the road from the lodge. A few miles! Suzi and I both started laughing at this massive synchronicity. I had goose bumps buzzing from the top of my head down to my toes, something I'd been experiencing when waking up in the middle of the night all during my sabbatical. I marveled at the laser-like correlation between my African dream and the opportunit
y I was now being given. Was that how God or the Universe worked?
I had also begun to admit, in secret to myself, that I didn't know how I'd be able to return to medicine. We needed my part-time income, but I wasn't ready to stop exploring. By now, I had a few life-coaching skills, and I decided to set an intention and put it in the hands of the Universe: “If I'm meant to stay on sabbatical and not return to medicine, please show me how.” Later that month, Mark was notified that he was getting an unexpected pay hike. The amount of the increase? Almost to the penny the same amount as my part-time salary. I was flabbergasted. Mark raised his eyebrows and shrugged, not wanting to read too much into it. He was pleased and happy for me, but his body language said: “Let's be pragmatic; this money may not last.”
Newly aware that my own beliefs might be the only thing holding me back, I began to ask myself the question: “How good are you willing to let it get?”
There are no Hampton Inns out in the South African bushveldt where Suzi and I traveled to negotiate Brian's bride's price. For a few days before the lobola, some local friends snuck us into a vacant cabin at Kruger Park. We were lying in our beds taking a much needed nap when, suddenly, there was a loud knocking on the cabin door. We assumed it was housekeeping, so we asked them to come back later. Then the pounding became angry.
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