My former brother-in-law and I are the same age and have known each other for 45 years. There have been some rocky times and even years that we have not seen one another. He was once an abusive alcoholic, and my sister left him after 17 years of marriage. Now sober for 30 years, he’s always supported her and their children. We have maintained a family connection; my kids call him Uncle.

Until recently, we saw each other infrequently; now we see each other three times a week, because six weeks ago he was stricken with Myasthenia Gravis. One week he was climbing Camelback Mountain daily and the next he was hooked up to a breathing machine. He is still in a Neuro-ICU; he’s off the respirator for several hours a day, can speak through his trachea, but still can’t swallow.

We have sat side-by-side, holding hands and talking (well mostly I do the talking, which I quite like) about the important issues in our lives. If you get struck down by a dramatic life-changing event like this, you cut through all the crap and talk about what’s real. The truth of where you are, who you are, and what you still want to be (or don’t).

Our discussions are not just existentially heavy. We also talk about what brings us the most joy, from the beautiful physical therapist, to being surrounded by the people we love. We talk about looking forward to tomorrow and what unfinished business we still want to take care of. I watch this strong, bright, competent, opinionated, hard-driving mirror of myself, as he teaches me about radical self-acceptance.

Self-acceptance is when you can look directly at the truth of your limitations and find a way to accept them and move on with your life. When we face our true selves we begin the process of changing our suffering into progress.

My brother-in-law called his son, whom he had seen or spoken to in eight years, and begged him to come see him. My nephew took a couple days to drive down so he could prepare himself for this confrontation after the great divide. Amidst the clicks, bells and whistles of modern medical technology, my nephew listened to his father whisper through the hole in his neck. His father apologized for the harm he knew had done, as well as the harm that he had done without even realizing it. For three days, my nephew listened to his father’s labored breath and shared his own truth.

Radical self acceptance is when you can look at the worst you — that person you know in your heart that you have never wanted to face directly — and take a step toward liberation. You don’t have to wait until you have to depend on a machine to breathe, before you look at the truth of your mortal limitations, and own them. Such radical self acceptance is the ultimate act of liberation.


We have known each other for 45 years, but in the last six weeks we have become brothers, and in the last week my bother and nephew have again become father and son.

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Keep moving, stay active, and you’ll stay healthy. There is a global epidemic of heart disease, and exercise has been long advocated as both a preventative and curative. Getting older people to stick to such exercise programs has been proven quite hard.

At the American Heart Association meeting (November 2006), Italian researchers reported an effective exercise for cardiac rehabilitation patients to heal their damaged hearts: dancing, more specifically, waltzing. The researchers assigned patients to a supervised exercise training program of cycling and treadmill work three times a week for eight weeks. Another group was assigned to dance classes in the hospital gym for 21 minutes, three times a week, for eight weeks. A third group didn’t exercise at all.

It turned out that the dancers had the best cardiopulmonary fitness ratings after the study period. Heart imaging showed the dancers’ arteries were better able to dilate and expand in response to exercise. You know that part of the superior performance of the dancers had to be more than the aerobic exercise; it was also about holding somebody close. Staying connected to someone with your whole being dilates and expands your body and your mind.

I first heard about this power in the mid-sixties when an old Pueblo Indian medicine man said to me, “If you can’t dance, you can’t heal.” I heard about it again 20 years later when I met an elderly lady in a New York museum who told me the whole secret of life was to “keep on moving.” I wrote about this encounter in my book, The Theft of the Spirit, which I’ll briefly summarize. A tiny, well-dressed white-haired woman stopped me at the Metropolitan Museum of Art to ask me what time it was. I looked at my watch and said it was two o’clock. She told me that she had an appointment, but her friends were not yet here and, without pause, continued talking.

She told me she was never late for appointments; she had once been a docent at the Bronx Botanical Gardens, and on and on. I wanted to leave, but I could hear my mother’s voice whispering in my ear, “What’s the big deal so you listen for a few more minutes; she’s an old lady maybe she doesn’t have anybody else to talk to.” I’m daydreaming, when I hear her say, “That’s the secret of life.” Coming back into the moment, I asked, “What’s the secret of life?” “I said sneakers are the secret of life,” she told me. She pointed down at her feet and I saw she was wearing sneakers. “What do you mean?” I asked. Pearl said “Sneakers are the secret of life because they are only comfortable when you’re moving.”


Preventative medicine for the ages . . . don’t stop dancing till you stop breathing.

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The whole world has heard about “Ashley,” a nine-year-old girl with Static Encephalopathy, a severe brain impairment that leaves her immobilized. Her parents are deeply committed to her; they call her “Pillow Angel” because she stays right on the pillow where they place her and shines her blessings upon them. Ashley is unable to walk, talk, keep her head up, roll-over, or sit up by herself. She does not speak or eat and is nourished through a feeding-tube.

When Ashley was seven she began to show early signs of puberty, and her parents became concerned that one day their Pillow Angel would become too big for them to lift, move, or take out. Doctors informed them of a treatment known as “growth attenuation” where they could permanently stunt her growth with drugs and surgery.

These parents have their daughter’s best interest at heart. They are motivated only by love and will care for Ashley the rest of their lives. There is no real question that she will be better cared for by her parents than by any long-term care institution, and she will probably live significantly longer because of that care. There is no doubt it would be easier for them to handle her in the future, so they decided to keep her small. All of the doctors and administrators in the Seattle hospital believed they acted in Ashley’s best interest and that she and the family were thriving.

Ashley’s case was reported in the October Archives of Pediatric and Adolescent Medicine. It described the ethical dilemmas, surgical procedures (removal of Ashley’s uterus and breast tissue), and the drugs being used to keep her at 4’5” tall and weighing about 75 lbs. for the rest of her life. The case has caused an outcry — groups from feminists to disabled rights groups are demanding an AMA ethics panel look into the case. I think this public discussion is wonderful and applaud the Seattle doctors for reporting the case.
This is the basic ethical question: Is it acceptable to perform invasive medical procedures on a person with a profound disability because it makes it easier for that person to be cared for? I cast my vote that it’s basically wrong; it can never be ethical to deal with one’s own (or society’s) comfort at somebody else’s expense; we don’t sacrifice others to save ourselves.

This is the new “Sophie’s Choice” of the scientific age. We have the technical capacity to alter the profound impact of nature’s “mistakes.” This is a slippery slope. Modern parents of severely cognitively disabled children (or profoundly physically disabled children) could feel pressured to have their kids undergo such procedures to avoid agonizing future choice about whether to send their fully grown child to an institution.


Ashley might have had breasts, periods, and weighed 120 pounds and her parents would’ve still loved her. They are great parents and would have done the best they could, for as long as they could, no matter what. Ashley would’ve done the best she could, for as long as she could too, and all would have felt blessed. Ashley is a Pillow Angel whose presence on earth teaches us something about compassion, respect, and the awesome power and blessing of love.

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Doris and Ethel both in their eighties, share a room in a local long-term care facility, for people who have moderate to severe dementia. .They don’t know why they live there or quite how they got there, as a matter of fact they don’t remember a lot; not names or faces, and reality is sometimes elusive.

Doris and Ethel were nurses when they were younger; both lived through the Depression, World War II, lost husbands, have children and grandchildren. They are best friends and pass their days knitting hats and talking to each other. They never run out of things to talk about, and they love to knit.

It takes them a couple of days to finish knitting a colorful hat. When completed they are donated to the Salvation Army which distributes them at a homeless shelter. These hand-made hats are deeply appreciated, and sometimes Doris and Ethel get thank you notes from recipients that make them cry; they say this is their family. These two old ladies care for each other, and they are cared for by others. Neither of them will be cured of their dementia, but they are healed.

Healing is a spiritual expedition rather than a physical one, which is why we can be healed even if we can’t be cured. Healing is about connecting to something other than ourselves. It doesn’t matter if the connection is personal or if it’s cosmic, but it has to remind us that we are not alone on the journey. Healing is having the courage to see ourselves just as we are, and to find a way to come to every day with anticipation and joy. The process of healing has less to do with getting better, than it does with getting real.


Doris and Ethel remind us all, that if we care for somebody and somebody cares for us, we can live life until our last breath.

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