Second Sight (12 page)

Meanwhile, being a doctor agreed with me. It grounded me, and gave me a feeling of being in control. My psychic experiences had mostly stopped and, since medical school at USC, I had been able to recall very few of my dreams. The flow of images that used to fill me was almost entirely cut off. They were a distant memory, and strange as it may seem, I didn't give them much thought. I was worn down and inundated. My life was moving in fast motion; every moment was full. The psychic part of me was on hold. I had no time or support from others to nurture that aspect of myself. It had been replaced by my new identity as an M.D.

The emergencies kept coming, and I got used to thinking on my feet. During my psychiatric residency, so much happened so fast that I was forced into a bunker mentality. The other residents and I might just as well have been fighting a war—we stuck together that closely.

One Saturday night when I was on call at the Brentwood Veterans Administration emergency room, a Vietnam vet walked in. Six foot four with a shaved head, covered with tattoos, he had a tightly knotted noose clutched under his arm. I was aghast. The man declared he wanted to die because his girlfriend had just left him. Looking me straight in the eye, he threatened to hang himself if I didn't admit him to an inpatient ward. All right, I thought, anyone who'd go to such lengths to get into a hospital had to be taken seriously. I reserved a bed for him at once.

A few weeks later, I was in session at the Veterans Administration with a schizophrenic outpatient I was treating with large doses of Thorazine. Nicknamed Jackknife, and as always carrying a set of headphones to drown out the voices in his head, he wore a sleeveless white T-shirt and a silver cross around his neck. That particular afternoon, something set him off. Without warning, he lunged across the desk, his right fist aimed squarely at my face. Although he wasn't much taller than I, he was a bodybuilder with sculpted arm muscles. Fortunately, I had good instincts whenever I thought I was in danger: I tore out of my office and ran. We were on the ground floor, and with Jackknife trailing close behind I fled past a potted palm into the reception area. Then the security guard rushed in and restrained him as I stood trembling a few feet away. Swearing and threatening revenge, he was hauled off to the locked ward and placed on a seventy-two-hour hold for being a “danger to others.”

The wards and locked units where I worked were indisputably war zones. We didn't have the luxury of penetrating the intricate layers of a person's psyche slowly. Time was precious. We had to get people better, and fast. Continuous close calls propelled me into looking for quick and easy answers. This was where drugs such as antidepressants and lithium came in. I grew to like the idea of a quick fix, especially when someone was in great pain. It was hard for me to watch people suffer; I just didn't see the point. With medication, I had the tools to effect rapid change.

In the Mood Disorders Clinic where I was assigned during my senior year of psychiatric residency, I met a manic-depressive named Arnie who was as handsome as a soap-opera star. He had been sent to us straight from L. A. County Jail, having spent the previous night in a drunk tank. According to the police report, Arnie, stark naked, had jumped into the fountain in front of the Century Plaza Hotel. A bottle of champagne in one hand and a huge container of bubble bath in the other, he'd emptied them both into the water. Bubbles were everywhere; the parking lot was a mess. The parking attendant just wanted him out, but when he refused to leave the manager had called the cops.

Arnie hadn't come to the clinic willingly. His wife, who knew we specialized in the treatment of depression and mood swings, had bailed him out of jail and then dragged him to us. She was frantic and wanted him to get help. When I first met Arnie, he was dressed in a wrinkled business suit, furiously smoking a cigarette. He paced around my office, talking so fast that I couldn't get a word in edgewise. Without pausing for breath, he was ranting about some stock options and a financial scheme that was going to make him millions. He reminded me of a wind-up doll that couldn't be turned off. A typical manic, he had big ideas but nothing to back them up.

I immediately started Arnie on lithium. Like many manics in the midst of a high, he didn't want to be put on medication. But his wife threatened to commit him to a mental institution unless he agreed. Under duress, Arnie took his lithium capsules religiously, three times a day for over two weeks. The next time I saw him, the medication had already taken effect and he was a completely different person: calm, intelligent, charming. Since our clinic didn't offer psychotherapy or family counseling, I continued to see Arnie only once a month for fifteen minutes to renew his lithium prescription. Much improved, he was able to return to his job as a stockbroker at a prestigious downtown firm.

Time and again, I witnessed how medications could transform lives. People who had been miserable for years were suddenly able to hold jobs, develop human relationships, become productive and functional. Prescribing medications and watching patients come alive made me feel powerful. I liked being in charge. Before this, much of psychiatry had seemed vague and inexact. There were so many different therapeutic approaches to choose from. Now, with medications, the solutions seemed clear-cut. Instead of seeing that they could be useful only in certain situations, I went overboard and became convinced that I'd found the ultimate answer.

I had fallen into the trap of believing that I'd stumbled upon a cosmic truth that stood above all others. Why should anybody waste time and money if they could be cured by a pill? With the unswerving conviction of the newly converted, buying into the prevalent attitudes that were supported throughout the clinic, I started to get cocky. I viewed my patients as being the “sick” ones and thought it my job to fix them. And many times I did. But while I was being romanced by the science of psychiatry and the position of authority that went along with it, I discovered that I was losing a treasured part of myself.

My best friend, Kathleen, lived alone on the top of Mount Baldy. I used to take my dog and visit her there, where her small cabin was perched on the edge of a wooded hillside overlooking a riverbed about thirty feet below. After the winter rains, the water would rise so high that it sounded like thunder flowing beneath her living room. In the early mornings, dressed in heavy wool parkas and thick, knitted gloves, we would take long walks along the river's edge and scavenge for unusual stones.

Before I went to medical school these walks were easy. Kathleen and I, often in silence, would follow the course of the river downstream. We would notice the textures of stones and pebbles beneath our feet, and we always returned with at least two of three remarkable ones. But since I'd become an M.D., all the stones had started to look alike and it had become harder for me to spot them. It wasn't that my vision had changed, it was just that the subtle differences between the stones became invisible to me. Finally, I had to use Kathleen's eyes to select them. When we got home and laid them out to admire on her kitchen table, neither of us spoke about my change of sight. But in my heart, I knew a part of me had gone blind.

At the same time, with my spiritual and psychic abilities seemingly on hold, only events relating to death were evoking them. During my internship—mainly medical with a three-month rotation in psychiatry—I was on call in the hospice unit of the Wadsworth VA Hospital in Westwood. This was a separated ward where terminal patients, many without families, were sent to die. One of my main jobs, I was informed, was to pronounce people dead. No one could have adequately prepared me for this task, and I will never forget the first night I spent at the hospice.

I stayed in a tiny room, a tiled cubicle on the third floor, where I passed the first part of the evening reading a science fiction novel, trying hard to lose myself in the pages or occasionally napping, if you can call it that—attempting to sleep while guarding against the shock of my beeper going off. I prayed that things would stay quiet so that the nursing staff would leave me alone. Not a chance. At two in the morning the phone rang. I groped in the dark for the receiver. The nurse on duty spoke in a bored voice. “Dr. Orloff, Bill has just expired. Could you please come down to write a note in the chart and sign the death certificate?” Her tone was so impersonal she might as well have told me my parking meter had run out of time.

The blood drained from my hands and feet. I sat up and vigorously rubbed my palms together to work up some heat. It never dawned on me that I would confront death so soon: I had done my best not to think about it. Also, I knew Bill; he was a retired bus driver in his late seventies with metastatic lung cancer. I forced myself out of bed, put on a fresh pair of socks, slapped some cold water on my face, ran a brush through my hair.

The hospital was an eerie place at night. The corridors were practically deserted, but they teemed with the lingering presence of people who had died there. Dressed in my surgical greens and a worn pair of white Reeboks, I headed down hall after hall toward the hospice, hearing the loud squeaking of my rubber soles, my stethoscope thudding against my chest.

The nurse working the graveyard shift, leisurely sipping a can of Diet Coke, handed me Bill's chart and led me to his bed. An old checkered sports coat he had proudly worn when his daughter came to visit was draped over the chair in the corner. Bill's body was covered by a newly laundered, starched white sheet and on it I could see the impression of his form. Truly, the last thing I wanted to do was uncover him. But I couldn't just stand there forever. Finally, my arm reached down to turn back the sheet. His face! I kept staring at it. Except for the cadavers we had dissected in anatomy class, I had never viewed a dead body. Bill looked stiff and smooth, more like a wax statue than a human being. I slowly reached out and touched his cheek. It was still warm.

What next? I blanked out. How to tell if someone's actually dead? I knew there were specific signs to look for, but what if I made a mistake?

I had to do something, so I placed my index finger over Bill's carotid pulse. Nothing. But maybe it was so weak that I missed it. I looked over anxiously to the nurse for help, but she was busy chatting on the phone. I fumbled for my flashlight, then shined it into Bill's eyes. His pupils were fixed and dilated. What a relief: That meant he really was dead. Even so, I continued the protocol. I pricked the skin on the sole of his foot with a pin I used to test for a pain response during neurological exams. Nothing. Then I sat on a chair beside Bill and waited. I really had to get myself together. This was going to take a little time. I didn't want the nurse to see that I was shaken and badly needed to think things through.

I had always imagined that when people died they would look much the same as in life, only more peaceful. In part, that was true, but there was a factor I hadn't accounted for. On the surface, Bill's features hadn't changed, but I became acutely aware that now only the body remained, plastic and hollow, a mere shell. But there was something else going on that I couldn't ignore, even though I might have liked to: I sensed Bill's spirit nearby, watching what was taking place in the room. Had it tapped me on the shoulder, I wouldn't have been surprised. In fact, it felt as real to me as the nurses and orderlies on the ward. And then I became conscious of another feeling. As the minutes passed, I understood more and more clearly that Bill's torment had ended: What remained I could only describe as love. There was the unmistakable presence of a human spirit, distilled to its purest form. Body now obsolete, it had survived death with a life of its own. I was filled with awe.

Working in the hospice was always difficult; some nights I received as many as two or three calls. But each opportunity to witness a death deeply moved me. I began to seek it out, waiting and watching for that moment when the spirit leaves the body. In my months on this ward I was privileged to be present with several patients at the time of their death. In each case, the instant death took hold, there was an incredible silence. Not that the normal hospital activities stopped or that the staff passing by were any quieter. This was a silence surpassing all sound, penetrating every pore of my being, as if the silence knew it well, was in fact part of my substance. The sensation wasn't creepy or cold; it was warm, soothing, and kind, radiating peace.

Psychically, my impression was that an alchemical reaction had occurred: The body died, the silence graced and entered it, and after a pause of seconds or even minutes, its essence was transformed into love. Always, I sensed I was standing at the threshold of a great mystery, the point when life as we know it is completed and the spirit takes hold. The nights I spent at the hospice strengthened my conviction that although the body is temporary, the spirit lives on.

I didn't share my observations with my fellow UCLA interns. Convinced that they wouldn't understand, I didn't want to jeopardize my position in our tight-knit group. I was afraid of being ostracized, of seeming weird, untrustworthy. It meant more to me than anything to be taken seriously. We had been taught about the physiology and mechanics of death from the standpoint of medical science. Spiritual theories were never discussed. That was for rabbis, ministers, and priests. We were just struggling to make it through a day, trying to get all the IVs done, the blood drawn, our rounds completed to get home for a few hours' sleep. For whatever reason, we kept our distance from the issues that surrounded dying. Wanting to fit in, I tried to repress the terrible conflict I felt in not openly acknowledging what I knew to be true. No matter what the cost, however, I wasn't going to be the one to bring up such taboo topics.

My thoughts and feelings about death, however, gave me some comfort; they provided the main link to my psychic life. As for my spiritual life, these thoughts and feelings solidified my connection with a compassionate, transcendent intelligence permeating every aspect of the physical world…and beyond. For now, I chose not to speak about this part of my being. And though it may have seemed remote from me, it wasn't gone. Still alive, my spirituality was in a secret place that no one else could touch.