 
OUT OF  
THE BOX

Ron Leifer, MD

2014  
Edition 1.1

-- OISM Editions --

Copyright 2013 by Ron Leifer, MD
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Table of Contents

My Father

My Mother

Early Life: Elementary School

Judaism

Middle School

High School

College

Medical School

Internship

Residency And Szasz

Ernest Becker

The Sixties

Rudy Lombard

Agehananda Bharati

Mexico

The Farm

Buddhism

Stroke

Books by Ron Leifer

# My Father

In the religion in which I was raised, Judaism, one of the obligations, or mitzvahim, imposed on elders is to pass down to the next generation what they have learned, so the next generation may benefit and not have to invent the wheel. This is especially important for people who choose to live unconventional lives so they can have some idea of its triumphs and tragedies.

As I reflect upon my life, I realize that I have tended to associate with and make friends with people who know more than me, people that I can learn from. In this book, I shall reflect on what I have learned and who I have learned it from - especially, who I have learned it from. So these recollections are more about others than they are about me. Some of these lessons I make explicitly. Others, you, the reader, can infer for yourself.

I am an eighty year old heretical psychiatrist. The word heresy is derived from the Greek "hairesis" which means "to choose." It must be understood in relation to its opposite, best expressed by the German word "gleichschalten" which means "obligatory set up" or "forced agreement," a term used by the Nazis to impose agreement with their agenda, and is now appropriate to use in relation to conventional psychiatry, in which psychiatrists in training are obliged to accept the reality of mental illnesses, and to believe that they are brain diseases best treated with drugs, I have chosen not to believe this on rational grounds.

The First person to whom I owe a debt of gratitude, my deepest gratitude, is my father.

My father was a cvonventional man, an observant Jew and a good citizen. During the air raid alarm blackouts of World War II, he volunteered as an air raid warden who patrolled the streets to be sure that no one turned on their lights which would give the expected German bombers a clue about their location. My mother served hot coffee to the wardens out of the window of our first floor apartment. My father is my hero. Of all the people who influenced me, I was influenced most by my father. He taught me to be _what_ I am, if not _who_ I am, although they go hand in glove. He taught me how to be a warrior, not in the sense of an aggressive warrior against others, but in the sense of being bold and courageous in facing the problems of life. Although he lived a conventional life, it was clear to me that he did it by choice. He was not a sheep following the flock. His name was Jacob Leifer, known as "Jack," or "Jake" to his family and close friends and "blacky," or "Lefty" to people in our neighborhood. He was a handsome, strong man with black hair and blue eyes. My Hebrew name is R'euven ben Jakob, Ronald, son of Jacob and, often, I can feel him inside of me.

My friends often asked each other, "What kind of Jew are you?" Everyone said "Galiciana." Everyone in my neighborhood was Galiciana, which means Eastern Europe, as opposed to Spanish, or Sephardic. There were few of those because most were killed during the Inquisition. As I later learned, Galicia is an area in central Europe. It is "beyond the pale." The Pale is a corridor between Berlin, Warsaw and St. Petersburg, as far away from Rome as the persecuted Jews could go. My father was born in a Jewish cultural center in Galicia called Radatz, or Rawa, located in the foot hills of the Carpathian mountains, not far from Western Ukraine where Hasidism was born.

He and his family came here when he was two years old. He grew up on the streets of Hell's Kitchen in the lower East side of Manhattan. His father ran a horse farm in Rawa, where he bought young and sick horses, healed and raised them and sold them at a profit. Due to the anti-Semitism in Europe, he was accused of stealing horses by people who resented his success.

His father took his wife and five children and emigrated to this country, along with many other Galicians. He opened a fur shop on Twenty Seventh Street, where he bought and sorted fur skins from Russia off the boat and sold them to coat makers in the garment district. He died in nineteen twenty-eight, before I was born. My father took over the business with his brother, Myer, who died in surgery for a hernia. My father took us to visit his mother every Sunday. His mother lived on the other side of the Bronx. She was a majestic old lady with white hair piled high on her head, who sat on a throne in the middle of the living room with her adoring family seated on the floor all around her.

I knew my father loved me. I could feel it. He enjoyed being with me. He took me to boxing matches in Harlem, and to baseball games in Giant and Yankee Stadiums. We listened to baseball games on the radio together. I saw Joe DiMaggio, Ted Williams, and Stan Musial play, and, once, Babe Ruth. One day, at a Yankee game, he took me by the arm, led me up the aisle to a very handsome man who smiled broadly, stood up, nodded his head slightly, and put his hand out to greet my father "Jack!" the man said, as if they were old friends. My father introduced me to Tony Martin. Seated next to him was a very beautiful woman, his then fiance, Cyd Charise.

I had no clue who they were at the time, but I was pleased that my father felt proud to show me off. Later, I learned that Tony Martin (nee Morris) was a popular singer whose parents were born in the same town in Galicia as my father and that Cyd Charise (nee Finkl) was a movie star who had danced with Fred Astaire and Gene Kelly. Martin was very handsome, and I was struck by how he resembled my father a bit. His fiance was very beautiful. Later, as thought about this, I realized that my father mingled in high society and was well respected. As I think about how other men deferred to him, I realize that he was an alpha male, not through aggression or intimidation, but through his charm and the warm vitality of his personality. I was never an alpha male.

I preferred to be beta until I was much older. I have always looked and felt younger than I am, which created counter transference problems early in my career when I had male patients older than me. Now, there are few people older than me and I can feel alpha, I will be beta only to people I respect, like Tibetan Lamas and other people that I can learn from.

One day, my father took me outside, put a nickel in a crack in the sidewalk, stepped back and threw a tennis ball at the nickel, trying to hit it. I would catch the ball and throw it back trying to hit the nickel. I noted how good he was at it. At first, I was not so good, but I made small adjustments and got better at it. As I improved, he began to throw the ball directly to me. I noted how graceful and accurate his throws were, almost always reaching me at the center of my chest. I remember thinking that he must have played ball before.

He left school in sixth grade, didn't teach me anything about psychiatry or philosophy, but he was street smart and trained me to be an athlete, which was invaluable to me especially now that I have had a stroke. Every day is an athletic event for me, and I am grateful to him for teaching me body control, balance, and coordination.

One day, he wiggled his finger at me, as he often did, and took me to the school yard ball field where my peers were playing punchball. That is a game like baseball but without a pitcher. The batter took a pink Spaulding ball, called a "Spaldeen," threw it up and punched like a tennis ball trying to get a hit. My father stopped the game and put me in next at bat. My peers respected my father, as did everyone in the neighborhood because he was tough, honest, and could relate to everyone. He watched while I nervously threw the ball up and punched it into right field for a double. The boys accepted me as a good athlete and we became close friends. After a while they switched from punch ball to stick ball, where the hitter hit the spauldeen with a broomless broomstick, and then to softball, where we competed with teams from other neighborhoods. The leader of the group assigned me to shortstop and batting third. Thanks to my father's training, I was a very good athlete, and, thanks to my being able to copy the stances and swings of professional baseball players I had seen, and to my upper body strength I hit a lot of long home runs, some of which surprised even me and won the admiration of my friends.

My most vivid memory of my father is of one warm summer evening, when the old people in the neighborhood, as customary, sat outside on the sidewalks in their folding chairs, drinking wine, playing cards, and kibbitzing, when a gang of young men from an adjoining neighborhood came swooping in, running up and down the streets knocking the old people over. My friends and I were younger and smaller than these guys, so we stood back and watched, waiting for the older, stronger guys in our neighborhood to come and defend us, but they didn't come. I climbed a ten foot wall of the nearby school building watching as the marauders gathered on a street corner. Suddenly, my father appeared out of the apartment building in which we lived. I watched as he waded into the midst of this gang of marauders and asked in his booming base voice "who'se your leader?" They all pointed to one guy in the middle of the group. I saw my father walk up to him and ask "are you the leader ?" the man answered "yes". Then, from my high vantage point, I saw my father wind up his left hand behind his back and swing a left hook with great torque. I heard the crack as it hit the leader's chin; the man fell to the street, unconscious, and the marauders, seeing a crowd gathering lowered their heads and slinked away. My father simply walked away and went back to our apartment. I felt incredulous at what I saw because I had never seen him violent before (or after) but I felt very proud of him for for his bravery and athleticism. I think he learned this tactic when he was growing up on the tough streets of the lower east side in Manhattan. My father was not a big man, but he was solidly built and strong. He hinted to me that he was a boxer when he was a young man. The left hook he threw certainly looked like he had some experience throwing it and he loved boxing matches. This taught me to oppose bullies with courage, which was very applicable to my opposition to coercive psychiatry.

When I was in high school, he asked me to come to his store after classes. I took the elevated train and subway down town and walked to his store. He showed me different fur skins, from mouton to fox to nutria to mink and explained how he sorted them. He showed me his books and pointed out that he had assets of a hundred thousand dollars. That would be around a million in today's money. One day, he loaded a cart with boxes of furs and instructed me to wheel the cart to a coat maker. I wheeled the cart across busy seventh avenue, found the coatmaker and got a receipt. I gave the receipt to my father and he simply grunted his approval.

One day, when I was in his store, a large, ugly looking man came in and started shouting at my father. My father demanded that he leave and waved his hand towards the door, I thought there was going to be a fight, but the man meekly left. I asked my father what had happened, and he told me that the man was one of Myer Lansky's bully boys demanding protection money. He told me that knew Lansky from when they were both growing up on the lower east side; he said that Lansky was a thug then and was a thug now, and he was not going to pay him for protection.

Several weeks later, my mother and father were having dinner in our kitchen with a couple I had never seen before. My father introduced me to him as a Manhattan detective. My father said to the man, "show him your gun". I saw the man draw his gun from its holster, empty the revolver of its six bullets and hand it to my father. My father proudly handed the gun to me and told me to point it at the ceiling and pull the trigger. I pointed it at the ceiling and, with some trepidation, pulled the trigger; the gun clicked and I was glad to get rid of it.

When a friend of mine became a judge, I applied for a pistol permit and bought a six-shot Smith and Wesson revolver. My son-in law is a weapons expert with Homeland Security, so I asked him for instructions and we did target practice. He showed me some of his more advanced weapons, including an assault rifle, which is a very impressive piece of machinery. I hit five out of six bull's eyes. Previously, my father had introduced me to the local cop, named "Red," with whom he seemed to be on friendly terms. My father was a gambler. When he was courting my mother, he took her to Atlantic City often, and I heard him placing bets on the phone. He understood the spreads and often made complicated parlayed bets. One day, he introduced me to his bookie.

During World II, German submarines in the North Atlantic shut down shipping to and from Russia and, without furs, my father's business failed. After I graduated from high school, I told him I wanted to go to Cornell. He said "I'm sorry, son, I don't have the money to send you to college. You're on your own." I felt sorry for him, so I said, "OK" without knowing how I would do it, but with a determination to do it. I heard the words to mean "now you are alone"; they were my first eviction from the box. If you step out of the box you will be alone and on your own until others join you. Then you are in a different box. His words have echoed through my mind over the years, and have contributed to my independence, but also to my alienation. Now, since my stroke, they are frightening to me because I am hemiplegic and cannot take care of myself.

After his business failed, he found a job as an equipment manager in a playground way out in Queens. Later, when I had a car, I drove out to bring him home, for which he was grateful. I felt good being able to do something for him after all he had done for me.

# My Mother

My mother, Sarah Masseyaw Leifer, was born in St. Petersburg, Russia in 1902. Her mother, Rhina, died before I was born. Her father was a master of all trades. He could fix a car or build a house. He came to this country with his wife and four children to escape anti-Semitism in Russia. He settled with his family in Binghamton, New York, not far from where I live now. I knew him. He was a strong, wirey, man with grey hair and a grey moustache and goatee. At Passover, he had me sit at his right hand and read from the Haggadah "ma nish ta naw, ha lila hazeh, mikal ha lelos?" "Why is this night different from all other nights?" He was very proud of me, his eldest grandson, which also instilled confidence in me. When my mother was twenty one, she moved to New York City and worked in an ice cream parlor where my father met her.

After my grandmother died, my grandfather married an unpleasant woman whom none of his children liked. My mother took us to Binghamton every summer, where we stayed with one of her sisters, I loved my aunts and uncles and cousins. My mother was a very kind, mild woman, but she stood up to my father and they argued some. They both spoke Yiddish and argued in Yiddish so, to his day I don't know what they argued about, but I do know that their quarrels were brief and non-violent and that they loved each other.

She was a gentle, kind and strong woman. During World War II, after my father's business failed, she became a practical nurse and worked long hours at an old, public welfare hospital for the poor, Fordham Hospital, to support our family - my father, me, my two and a half year younger twin sister and brother, Morton and Gloria. They were both sweet, intelligent people, and we got along well and played together cooperatively. Morton became a professor of electronic engineering and communication at a local community college in New City. Gloria became a nurse and teacher in California and wrote the standard textbook of pediatric nursing. Because we lived so far away from each other, we could not remain close, which I regret.

One day, when I was in high school I discussed with my mother what I might do for a career. She asked me what I wanted to do and I told her that I wanted a career of travel and adventure. I told her that I had applied for a job with the CIA but was rejected because they said I had relatives in Europe. I had surmised that because my father regularly sent packages and money to his relatives in Austria. One day he received his packages undelivered and told me that he assumed his relatives had been sent to the camps or killed. He was very sad about it. After I told my mother about the CIA, I suggested that I might try the FBI, but learned that one had to be a lawyer or an accountant to be an FBI agent, and I wasn't interested in either of those. She suggested that I might like to study medicine because I was a good student and liked to help people and what Jewish mother doesn't want her son to become a doctor? So that planted the seed in my mind and I began to think about it. I liked our family doctor, Doctor Margulies, very much. He was intelligent, competent and kind, and he and my father seemed to be personal friends. After my father died, my mother moved to California and lived with my sister. I regret that I couldn't travel out there to see her because I had so many responsibilities here and didn't have the money for air fare.

# Early Life:  
Elementary School

In my early life, Iwas very much inside the box. I didn't step out until later during my psychiatric training when I saw how cruel psychiatry can be. I learned two lessons in elementary school that are worth passing down. I worked hard and got good grades, which proved important, as I shall tell. I was not, and am not brilliant, so I had to work hard to get good grades. If you want good grades, or good anything, you have to apply yourself and work hard. The girls in my class were brilliant, worked hard and regularly got good grades. I was very impressed and inspired by them.

The second lesson I learned is that the atmosphere of the school, or any organization, is created at the top. In my school, P.S. 105, the principal was Mrs. Goodwin, a dignified woman with whom the students, uniformly white and Jewish, could identify as a grandmother. She required the students to dress in green and white on Fridays. The boys had to wear white shirts and green ties, and the girls had to wear white blouses and green skirts, no pants allowed. Wearing uniforms one day a week helped the students to identify with each other and with the school. On Friday mornings, Mrs. Goodwin called assembly, over which she presided. All the students gathered in a courtyard between two wings of the school. Mrs. Goodwin stood on the roof of a one story high wing, a royal figure who spoke to the assembly from on high. Her message was inspiring. She pointed out that all the students were related as brothers and sisters in the same school family. She urged us to be kind to each other and said that, if we were all kind we would all feel kindly treated. She warned against bullying and cheating and promised that bullies and cheaters would be expelled. She closed by telling us that she loved us all and that, if we had any problems at home or at school we could come to her and she would help. Then we all milled around chatting until the bell rang announcing our next class. The lesson here, I believe, is that obligatory curricula devised by distant bureaucrats don't work, but principals and teachers who can relate to and inspire the students, and with whom the students can relate and identify, do work. It makes no sense to me to have a white principal and white teachers at a school where the students are mostly African-American. They need African American leaders and teachers, even if, or especially if, they are ex-cons. At the sixth grade, the students graduated and were assigned to a middle school. The brighter students were allowed to skip a grade and were assigned to a special, advanced school, Olinville Junior High School, P.S. 113. I was, fortunately one of those and it shaped my life.

# Judaism

When I was eight years old, my parents enrolled me in Hebrew school, which was located in the neighborhood synagogue. I studied the Hebrew language and reheased with the rabbi the portion of the Torah that I was to read on my Bar Mitzvah day. Of course, I didn't understand a word of it. An experience that would be repeated when I attended Tibetan Buddhist rituals. I studied and practiced two religions and didn't understand the language of either of them, although English language translations were available in both, but I was too immature to understand the spiritusl meaning of either of them.

Later, when I was a psychiatric resident, I joined a group led by a Chabadic rabbi studying the Old Testament. We were reading the section of Exodus in which God commands Moses to occupy Canaan. Moses ordered his general, Joshua to destroy Jericho and all the other towns in Canaan, the promised land of "milk and honey." I was shocked by the cruelty and brutality of Joshua as he conducted his divinely authorized campaign. At the same time, I was studying meditation with the Hindu monk, Aheha, who taught "ahimsa" - non-harm, that was practiced by Ghandi to free India from British colonial rule. As a physician who had taken the Hippocratic oath to do no harm, Hinduism appealed to me more than Judaism. Later in life, after my stroke, I have turned back to Judaism. I fasted on Yom Kippur a few days ago. This is not a case of no atheists in a fox hole (or is it?). It is a case of returning to my roots, especially as I think about my life.

H. H. The Dalai Lama has said that his religion is kindness and that it is not necessary to reject one's native religion. One can adopt from Buddhism what works and appeals, which begs the question how does one reconcile Buddhist atheism with Jewish monotheism? The Bal SHEM Tov differed from the other rabbis of his time in that, while other rabbis were studying the Torah, he was sitting in a forest communing with God. I think of God as the seamless, intelligent energy of the universe, who is immanent (omnipresent) and transcendent at the same time. I once had what I believe to have been a direct encounter with God about which I shall tell later.

# Middle School

My experience at Olinville shaped my life. Oddly enough, the key experience happened in Spanish class. The teacher, Mr. Anthony Navarro, was taking a Master's degree in education at Colombia University. As I later learned, the humanities departments at Colombia were all heavily influenced by psychoanalysis, which was at its maximum influence at the time. Mr. Navarro had assigned us to read the story of Alladin and the magic lamp in Spanish. At one point he asked the class "Why did Alladin go down into the cave?" We all speculated about it and he suggested the stereotypical psychoanalytic interpretation of wanting to return to the womb. The idea stunned me and, after class, I went up to him and told him that I wanted to learn more about human motivations. He said "ok give me a day." The next day he gave me a copy of Freud and Breuer's "Studies in Hysteria." At thirteen years old, I was reading Freud! I found the book fascinating. I was not only intellectually fascinated by Freud's explanation of the women's symptoms, I was sensually aroused by his intimate look into their inner lives. When I realized that Freud was a medical doctor, I remembered my mother's urging me to study medicine. I decided then and there to become a psychiatrist and never wavered. Also in the class was Ted Shapiro, my best friend with whom I travelled every day by subway from Pelham Parkway, where we lived, to the Olinville Avenue station and then walked a few blocks to the school. He, too, was given Freud to read and he, too, became a psychiatrist, a respected professor of child psychiatry at Cornell medical school.

# High School

Sadly, I didn't learn anything worth reporting in my high school classes. I spent most of my time playing basketball and reading on my own. The police formed the police athletic league, PAL, a competition among neighborhoods in each borough for borough championship and city championship. My friends and I won the Bronx borough championship and were scheduled to play Harlem, who won the Manhattan championship. We were very nervous travelling through Harlem because it had a reputation for violence. We took the subway to upper Manhattan and, as we were walking through the streets, we heard gunshots, but our police representative and advisor was with us and urged us on.

Both sides played well in the first half and the game was close. In the second half, a team mate threw the ball to me in the back court and, as I advanced the ball, I noticed that my defender was a step behind me. So I accelerated and drove to our basket and laid it in. I was fouled and scored the foul shot. The next time we had the ball, I did it again. My friends and I played well as a team and we won the game and were champs of Bronx and Manhattan. The next game, we played Queens for city championship but they were taller than us at every position and, in spite of playing well, we lost. Losing was a valuable experience because it humbled us. I, in particular, needed to be humbled, because the love of my parents and my previous successes had primed my narcissism. Everybody loses at some time in life, and learning how to lose gracefully is a valuable lesson. I also learned that, in team play, individual effort is important, but team cooperation is more important.

At home, I read voraciously. I read all of Richard Halliburton's travel books, and read and studied with great interest Bertrand Russell's History of philosophy, which awakened my love of philosophy.

I told my father that I wanted to go to Cornell because they had naval R.O.T.C. He said "sorry, son, I don't have the money to send you to college, you're on your own." I gulped and said "OK" having no idea how I would do anything, but those words reverberated in my mind to this day "YOU'RE ON YOUR OWN," which I interpreted to mean "YOU'RE ALONE". These words have reverberated through my mind ever since, contributing to my self reliance, my narcissism and my isolation.

I did well enough in high school to be admitted to Queens College in Flushing, one of the free city colleges.

# College

I decided to go to Queens College which, at the time, was in rural Queens, rather than City College which was in hectic Manhattan. Queens College was quite a distance from where I lived in the Bronx, so some class mates of mine and I hitch hiked to school. We were almost always successful because we were young, travelled with books in small, mixed groups of boys and girls. It was more difficult hitching home in the dark, but I learned that where there's a will, there's a way.

At Queens, I had to major in biology and chemistry in order to meet the pre-requisites for medical school (I especially disliked chemistry), but I minored in philosophy and took as many courses in it as I could. Ironically, I was assigned to write a biology honors thesis on neurotransmitters, which is the main subject of psychiatry today.

My favorite class was the philosophy of science with an excellent teacher. We studies logical positivism and read Reichenbach, Carnap and Schlick. Logical posivitism rejects metaphysics and regards science as consisting only of facts without narratives.

I also took a course on John Dewey with Ralph Sleeper. Dewey was my favorite philosopher. He was still alive and teaching at Colombia when I took this course, and I regret not having gone to meet him.

Lesson to the next generation: as you live now, you are creating memories for your old age, so don't miss opportunities that you will regret later.

My favorite course however, was physical education. I had a wonderful teacher who took an interest in me because of my enthusiasm and taught me intramural wrestling. Queens did not have an intercollegiate wrestling program. Collegiate wrestling is very demanding. One is totally exhausted after three, three-minute rounds, but I was in the best shape of my life. I could hold on to a pole with two hands and extend my body ninety degrees to the pole and parallel to the ground. Another lesson: hard work pays off.

I did well enough at Queens to earn Phi Beta Kappa. I applied to all the medical schools in New York City but was rejected by all of them even though Christian students with lower grades than I were accepted. I was told by my biology professor that New York schools didn't accept Jews. Anti-Semitism was widespread in those days, which is why, I believe, so many Jews joined the civil rights movement of the sixties. I was, however, accepted by the Upstate medical school at Syracuse.

# Medical School

I took a bus to Syracuse two days before classes were to start, in order to find a room to live in. I found a house with rooms rented mostly to medical students. As I entered the house, I met a man who was also an entering student looking for a room. He introduced himself as Bob Daly from Watertown. I didn't even know where Watertown was, but we liked each other immediately and agreed to share a room. We studied togeher and have been friends for sixty years and are still friends. The first half of the first year was devoted to human anatomy and histology. On the first day, our professor, Dr Phillip Armstrong, had us wait outside the dissecting room while he explained to us what would happen. We were to break into groups of four and choose a table on which there would be a cadaver that we were to dissect. Bob and I joined with Paul Parkman and a man from Hungary named George. Paul was a very intelligent man from Weedsport. Having grown up in a Jewish community of a hundred thousand people, it was an exotic experience for me to meet Christian men from upstate New York. Paul went on to graduate cum laude, along with me and three other students. He later worked as a researcher at the National Institute For Health and discovered the measles vaccine which has saved thousands of lives. Bob and I have remained friendly with Paul although not as close as we are with each other.

We entered the dissecting room and took a table with an oil cloth covering a cadaver, Dr. Armstrong instructed us to remove the cloth and inspect the body for signs of trauma or disease. We uncovered the body and there before us lay a dead human body. This was an epiphany for me and, I assume for every student in the room. It was almost a sacred moment as it was the first time I or any of us had seen a dead human. The only information that came with this corpse was his name, which was Joseph Goldstein. We stared at him for a long time. I was thinking that he and I were the only Jews at that table and that he was once alive, like us, and we would one day be dead like him. This was the fate of all human beings. That was a sobering, enlightening thought. I also thought how rarely most Americans see a dead body and wondered what effect that had on the living. Dr. Armstrong wisely dismissed the class early, and we all walked back to our rooms talking about what we had seen.

The next day he instructed us to cut the abdomen open and examine and identify the abdominal organs. Instructors wandered the room, available to answer questions. This day we were all squeamish and a bit shocked at what we were doing to this man. By the following week we rested our lunch on his thighs as we dissected his abdomen. Humans can adjust to anything. The dissection was very detailed exposing and identifying every organ and their blood supply. At night we studied an anatomy text that described what we had seen and missed seeing. The anatomy tests were very detailed, asking for essays describing the organ's blood supplies and relations to each other. George, whom we all liked, didn't speak English well, did poorly on the exams and withdrew from medical school after a few months.

At the end of the anatomy section, Joseph was a scrambled heap of tissue scraps that were disposed of respectfully by the medical school staff. Next came histology. We were all required to buy our own microscopes. I couldn't afford one, so my beloved aunt and uncle, Esther and Stanley Potter, who lived in Binghamton, bought an expensive Zeiss microscope for me. In class, we were given slides of various normal and pathological tissue with detailed descriptions and asked to study them. I was amazed that every organ was composed of distinctive tissue cells. The organ looked very different when inspected grossly with eyes and when inspected under the microscope. Later when I studied Buddhism this difference helped me to understand the paradoxical aphorism, "things are not what they seem to be, nor are they oherwise." Organs are made of cells, yet the cells and the organ are the same. In histology exams, we were given test slides and asked to identify them.

The second half of the first year was devoted to biochemistry. I had taken biochemistry in college, so the subject was not entirely strange to me, but it was very intense. In the first two weeks, we covered everything that was covered in a semester of college biochemistry. We covered physical chemistry, which has to do with the body's acid-base and electrolyte balance, and then went on to study the biochemistry of metabolism, especially the Krebs cycle, which converts food into energy and waste. On one of the tests, I got the biochemistry right, but made a mistake in the math and the professor gave me a grade of C. I objected on the grounds that it was not a math test, but the professor correctly reminded me that, as a doctor, a math error could make the difference between the life or death of a patient. He was right, and I remembered this lesson when I was an intern and had to make a difficult calculation for a potassium infusion that saved a patient's life. As they say, "the devil is in the details."

I was relieved when I passed through the first year with decent grades. The first half of the second year was devoted to physiology, which I liked very much and did very well at. I recall a day that was a turning point in my life, when we were doing an experiment on the electrical stimulation of muscles. I was very obsessive about performing the experiment precisely that day, and I noticed the chairman, Gordon Moe, looking at me. After the second year I was working as a busboy at the Concord Hotel in the Catskills, which is how I earned my money for the school year, when I received a message that Dr. Moe wanted to see me. I hitched my way back to Syracuse and met with him in his office. He offered me a summer job as his assistant in his lab. It was a much better job than my job at the Concord, and better paying, so I called the Concord and resigned and started to work with Dr. Moe. He was working with an associate, Dr. Mendez, a Mexican physiologist, They were experimenting on cardiac arrhythmias on dogs, preparing them with heart lung arrangements, hooking the heart up to a monitor, and injecting the dog with various drugs to induce and stop various irregular rhythms. My job was to choose a dog from the many they had at the medical school for experiments, anesthetize it and set up the heart lung preparation. I love dogs and, at first, I was hesitant and felt guilty for using them in experiments that killed them, but Dr. Moe persuaded me that it was for the greater good, since cardiac physiology was not well understood and many humans died from arrhythmias who might be saved by our work, so I carried on with great sorrow and guilt. After I had prepared the dog, Dr. Mendez administered the drugs through an I-V that I had set up, and he analyzed the results.

After several weeks of this, Dr. Moe called me into his office and told me it was time for me to do an entire experiment by myself. He told me what drugs to use. With great trepidation, I picked a dog, prepared it and ran the experiment. I took the results which were recorded on a ribbon of paper and showed them to him. He examined them, nodding his head with a look of pleased surprise and looked up at me and complimented me for the good work.

The third and fourth year of medical school were the "clinical years," when we worked in the hospitals working up new patients, following the old patients and drawing blood every morning for tests that their doctors had ordered. I became a very skilled phlebotomist. We also were presented with lectures by professors in all the specialties, i.e. cardiology, nephrology, neurology, and psychiatry. The psychiatry lectures were presented by the professor and chairman, Dr. Edward Stainbrook, who was also a Ph. D. in psychology. He punctuated his lectures with quotes by philosophers such as Kierkegaard and Nietszche, as well as by Freud, merging my interests in philosophy and psychology and reinforcing my determination to become a psychiatrist. A few weeks after I performed my solo experiment, Dr. Moe called me in and made a life changing offer. He offered me the opportunity to get a dual degree, an M.D. in medicine and a Ph.D. in physiology. I asked him if it could be in nervous system physiology, or was it only cardiac physiology. I might have been interested in the former, but I didn't want to spend my life dissecting dogs, so I thanked him and told him that I was sorry, but my heart was set on understanding people, and I was going to go into psychiatry.

I later learned that, for centuries, psychology was a part of philosophy until scientific method was turned to the mind by Wilhelm Wundt in the latter part of the nineteenth century. My life would have taken an entirely different course had I accepted his offer. The last medical student who took a dual degree in medicine and biochemistry, Irving Weiner, became a professor and chairman of the biochemistry department and, later, dean of the medical school. I do not have the temperament to be a dean so I don't assume that I would have had the same fate.

I was offered a job as an emergency X-Ray technician in the Syracuse VA hospital in return for room and board. Bob Daly also took this job, and we shared a room in our third year, I also took a job washing glassware for a professor of biochemistry. Thus, I was able to work my way through medical school for which my father and mother were grateful. In my third year, I was elected to Alpha Omega Alpha, the medical honor society, analogous to Phi Beta Kappa. It was a special honor, because it was usually awarded in the senior year, and I received it as a junior.

My mother sent me some money here and there, as she could afford it, as well as boxes of her wonderful chocolate chip cookies. I went home as often as I could to see my family. My father drank a lot, but was a quiet, good natured drinker. He also smoked two packs of unfiltered Camels every day. One night when I was there, he had what I later realized was a heart attack. My mother nursed him through it. In my fourth year, my brother, Morton, who worked as an electronics technician while he was earning a degree as an electrical engineer, gifted me with a '47 Pontiac, which enabled me to get around Syracuse and visit Bob and his family in Watertown and their lovely cabin on the St. Lawrence River.

After graduation, we spent several weeks studying for our board exams, which we both passed, We celebrated by playing eighteen holes of golf, which I had never played before. Bob was experienced and played well, but I was terrible. Advice to the next generation: if you are going to play golf - which George Bernard Shaw called, "a good walk spoiled" - take lessons.

When we graduated, my mother and her sister, Esther and her husband, Stan Potter came up to celebrate with me. The graduating students walked on to the stage one by one to have their name called and receive their diplomas from the Dean of the medical school. When my name was called, the dean added "cum laude" I was shocked and said so. My friend Paul Parkman and three others were also cum laude. Needless to say, I felt very proud to have been able to work my way through medical school and graduate with honors. No doubt it added to my already well cultivated narcissism. My mother was also very proud of me and said so.

# Internship

While I was working at the VA, Lloyd Rogers, the chief of surgery, befriended me. He was open with me about being gay and being physically attracted to me, but he never did anything improper and remained a good friend. He allowed me to assist at some minor surgeries, hoping that I would become a surgeon, but I didn't like standing so long and I reaffirmed to him my intention to study psychiatry. He was a graduate of the University of Rochester medical school and persuaded me that Strong Memorial was the best internship in the country. So I applied and was accepted there. I saved two people's lives and killed one person. One person I saved had suffered cardiac arrest from drinking the methyl alcohol in sterno. The emergency room physician had cut open her chest, massaged her heart back to functioning, called a surgeon to sew up the incision, and sent her to a ward. I was called and told that, on the way up she had another cardiac arrest. When I arrived in her room, the student nurse flirtatiously handed me a pair of scissors, challenging me to open her up again. My experience with the dogs came in handy and, without hesitation, I cut the stitches and opened her chest. I asked for a pair of sterile gloves and massaged her heart back to pumping again. The surgeon closed her up again and she survived.

The second person I saved was more complicated. She was a post partum woman who continued to vomit and was becoming progressively weaker. Her doctors couldn't figure out what was going on. I came on duty at night and reviewed her chart. I noticed that her blood potassium level was dangerously low. I called the resident physician to discuss the situation. We discussed the pros and cons of giving her an IV potassium infusion. The resident shook his head and said she was my patient and it was my decision. I mulled doing nothing and waiting until morning for her own private physician to decide, but the nurse came to me alarmed that she was unconscious and weakening. So I carefully calculated how much potassium chloride would be required to bring her blood level up to normal. I was mindful of my biochemical professor's advice that accurate calculation could make the difference between life and death. Too little potassium chloride and she might continue to weaken and die. Too much could kill her. Potassium chloride is the drug used to execute convicts sentenced to death. It stops the heart. So I calculated carefully and administered a moderate dose mixed in 500 ml saline IV. The decision to mix the salt in an IV was influenced by a previous mistake I made that killed a patient. I decided that it was up to me to do something. So I calculated how much potassium would be required to bring her blood level up to normal. I regularly sent a blood sample to the lab to monitor the rising blood level. Soon, she regained consciousness and was talking.

Several weeks prior to this incident, I was called to see a man suffering from an acute asthma attack. His private physician didn't come to the hospital, but talked to me on the phone and instructed me to administer a dose of theophylline slowly. He didn't tell me to put it in an IV. So I followed his instructions and injected the drug directly into the man's vein slowly, following his instruction. But it was not slow enough; I should have put the drug into a slow drip IV. After a few minutes, he gasped and died. He died from a combination of my inexperience and poor instructions from his doctor. This was not the first instance of iatrogenic death that I witnessed, but it was the first and only one I caused.

Death from doctor's mistakes are more frequent than people want to know. This convinced me even more strongly to go into psychiatry. You can't kill people by talking with them, and the promiscuous use of psychiatric drugs was not common then as it is now, and psychiatric drugs can kill. I still feel guilty about the death of that man, but I learned from it and administered potassium to that woman in an IV and have been aware that medicines can both heal and kill. The woman's doctors later discovered that she was vomiting due to a duodenal ulcer which blocked passage of food from her stomach to her intestines.

The medical school faculty were so impressed by what I had done that they invited me to present the case to them at grand rounds, which was unheard of. It was usually the other way around, the staff presenting to the interns.

On February 28th of 1958, my first year of internship, I received a call from my mother that my father had died of a heart attack. I was doing an intake evaluation of a new patient and thought I could continue, but I was so upset I couldn't and had to excuse myself and ask another intern to take over. I got permission to go on family leave and flew down to New York to join my family sitting shiva. I was stunned by the loss of my father and still miss him. I stayed with my family for ten days and regretted that I had not chosen an internship closer to home. At the funeral home, I sat in front of my father's closed casket. I wanted to see him again, so I asked that the upper part of the casket be opened. The rabbi refused, saying that it was against Jewish law, but I insisted, so they opened the upper part and I stared down at my father's dead face. The memory of it has haunted me since. I was heartbroken that I did not have a chance to hug him, tell him I love him and thank him for what he had done for me. So I did so silently in my mind.

At the cemetery, as his oldest son, I was obligated to throw the first shovel full of dirt on his coffin. I looked down and there was his coffin, deep in the grave. I threw a shovel full of dirt on to it and can still hear the hollow sound of its impact. I returned to Rochester by bus, but petitioned the hospital for release from the internship on the grounds that I wanted to finish my training so I could take care of my mother.

Bob Daly had taken a one year internship and was going to return to Syracuse for a residency in psychiatry. He told me about Szasz, whom I had met in my last year of med school, which made me eager to study with him in the residency. I was not impressed by the psychiatry department at Strong. The professor and chairman, John Romano, was a very nice man who mostly preached kindness, but ruled over involuntary patients and approved of shock treatment, and I never really learned anything from him, in fact, I was once ordered to press the button on an involuntary patient who was pleading not to be shocked. My gut told me there was something wrong with that, especially when I saw him struggling with post shock amnesia. He had forgotten what he was depressed about!

The second luminary in the department was George Engel, who held a dual professorship in psychiatry and medicine. He taught me how to read EEGs. One day, when I was reading EEGs with him, he asked me what book I was carrying. It was "Operational Philosophy" by Anatol Rapoport, a very important book in the philosophy of science. Engel said "I wish I had time to read books like that." At that moment, I thought, "the man doesn't read." I knew I wasn't going to learn anything interesting from him and it strengthened my resolve to go to Syracuse and study with Szasz.

# Residency And Szasz

I was very happy to be back at Syracuse. The residency group was an interesting group. There was Bob, who also loved and read philosophy. He was married and had four children, and had studied with Jesuits, the philosophers of Catholicism. There was John Sandt, who has a Ph. D in literature; Eugene Kaplan, who was a close friend of Bob and I, and later became chairman of the department, Tod Kniffen, an intelligent and charming man, who later became a psychoanalyst in Baltimore, Lou Patrizio, with whom I roomed for two years, and Gene Cary, who became a close friend.

Szasz had a classical European education in Budapest. He was the most widely read man I have ever known. In 1939, at the age of nineteen, he left Hungary with his brother to escape fascism and came to Cincinnati. As an undergraduate majoring in physics, he was first in his class. In medical school in Cincinnati, he graduated first in his class. He served in the navy for a few years, then moved to Chicago and became a psychoanalyst at the Chicago school of psychoanalysis.

When Marc Hollander, who was also a Chicago psychoanalyst was appointed chairman of the department at Syracuse after Stainbrook left for USC, he brought his friend, Szasz, with him as full, tenured professor. Before he left Chicago, Franz Alexander, the president of the Chicago school of psychoanalysis, offered Szasz his job if he would stay, but Szasz chose to come to Syracuse where, he thought he could speak more freely as a tenured professor at a medical school. Wrong.

Tom was married to a sweet, sassy Lebanese woman named Rosine. She was a very good cook and Tom was proud of her cooking. They invited me to their home many times for dinner and Tom's favorite Viennese chocolate cakes. They had two daughters, Margo and Suzy. Margo is now a dermatologist at the Menninger clinic and Suzy is a high tech librarian. Suzy has lupus. Tom was a very loving father but, as he became more famous and began to travel and lecture, Rosine left, moved to a motel, they divorced and, after a few years, she committed suicide. Years later, when I was visiting Tom at his new home in Manlius, I asked him if he wanted to be married again. He chuckled, shook his head no and said, "I'm not a very good husband." I replied that I wasn't either. The difference between Tom and me, aside from him being a conservative and me being a liberal was that he was always a European gentleman and I was sometimes a blunt, crude, Bronx Jew.

Our resident group was taught by the faculty to diagnose and treat all the mental illnesses classified in the DSM IV. We also had one seminar a week with Szasz. In the first seminar, Szasz warned us that he would not be teaching conventional psychiatry all of the time. He was out of the box of conventional psychiatry and taught me to step out, but it was my choice because his reasoning convinced me that it was the right thing to do, both morally and intellectually.

The first book he assigned us was _Philosophy In A New Key_ by Susanne Langer. The new key she was referring to was that proposed by Ludwig Wittgenstein in _Phiosophical Investigations,_ namely that all philosophical problems were problems of language, symbolism and meaning. Szasz told us he was proposing to examine the language of psychiatry from this point of view.

The next book he assigned was Gilbert Ryle's _The Concept Of Mind_ , from the tile, it would seem to be a reasonable book for psychiarists to read, but most psychiatrists, without philosophical education, wouldn't understand it. In this book, Ryle examines DeCarte's theory of mind "Res cogitans," from the point of view of Cantor's and Russell's "theory of sets." The theory of sets classifies words as names of objects and classifications or "sets" of objects. For example, oranges, bananas, melons, grapefruits are names of fruits, but "fruit" is the class name for these items and not another member of the class. Mistaking the class name for a member of the class is a "category or logical error". Ryle gives as an example of a category error a man who comes asking to see a university. So he is taken to a university's campus and shown class rooms, the administrative buildings the library, the sports field, and the campus. He says "thank you very much, but where is the university?" and goes wandering around the campus looking for the university, as if it is another member of the set he has seen. He has made a category error.

Ryle also points out that myths are not fairy tales. They are category. They are the presentation of words in one category that refer to another, like "team spirit." A man goes to a baseball game and says "I see all the players but where is the team spirit, as if it is another player. A myth is a fairy tale told in one language, but whose meaning is told in another. The man who looks for the university as if it is another member of the set he has seen, is making a category error. Ryle argues that, while Descartes has direct experience of his own mind, he doesn't have direct experience of the minds of others. The problem of other minds became a big issue among philosophers of language. Ryle points out that we make inferences about other people's minds based on their words and behavior, which belong to a different logical category than minds. Decartes' error is a category mistake.

The next book Szasz assigned was his own infamous, but now classic _The Myth Of Mental Illness._ Following Ryle, Szasz argues that mental illness is a myth in the sense that it presents words allegedly about other people's minds in the language of medicine, a myth he calls "the medical model." It is as if "broken heart" and "spring fever" are medical illnesses. The word "mental" refers not to the mind but to other people's words and behavior, based upon which we make inferences about their minds. The word "illness" belongs to medicine and bodily states. So the term "mental illness" is a double category error, or myth.

After reading Langer and Ryle, my interest in philosophy was reawakened and I enrolled in a program for a Master's degree in philosophy which I was awarded in 1964. My mentor was A. R. Louch. a Cambridge trained philosopher of language. Studying with Louch placed me directly in the lineage of the later Wittgenstein.

When the residency was over in 1961, Hollander invited me to join the faculty as an assistant professor, I was delighted.

After the publication of his book, Szasz was invited to testify for a man in a _habeus corpus_ hearing for his release from Marcy State Hospital. He agreed and anticipation was high in the Syracuse psychiatric and legal communities to hear what he had to say. Mr. Chomentowski was hospitalized after he sold his gas station to an oil company and they tried to seize his property before the agreed date. He chased them off with a shotgun, the police were called and he was committed to Marcy State Hospital.

On the stand Szasz was asked about the psychiatric language in the hospital record. He was asked about the word "blepharism," which means spasms of the eyelids. He answered "what they call blepharism which sounds like a medical symptom, I call "blinking." He continued to decode the psychiatric language into ordinary language, making fools out of the hospital psychiatrists. In the audience, sitting at the hospital's lawyers table and coaching them was Abraham Halpern, the Syracuse Commissioner of Mental Hygiene. Halpern reported to the State Commissioner of Mental Hygiene, Paul Hoch, that there was a psychiatrist on the staff of the Syracuse Psychiatric Hospital, which was a state hospital, that didn't believe in mental illness. Hoch ordered the director of the hospital to ban Szasz from teaching or seeing patients there. The trouble was that the Director of the hospital, Szasz' friend, Marc Hollander, was also the chairman of the department of psychiatry. By banning Szasz from the psychiatric hospital he was also censoring a member of his academic department for his writings.

Hollander felt bound to obey Hoch. Szasz responded by boycotting department meetings which were held at the hospital. Every psychiatrist in the department was also on the staff of the hospital. Szasz was frightened and angry that his friend, Hollander, had turned against him.

# Ernest Becker

When Stainbrook resigned in 1956, the man he appointed to lecture on anthropology to the medical students, Douglas Haring, also resigned and recommended as his successor a newly graduated Ph. D., Ernest Becker. Becker joined the department at the same time as Szasz and attended his seminars. When Becker and I met we immediately liked each other and became close friends, Becker was an unusual anthropologist. He was out of the box by personality and by choice. He didn't do traditional field work. His mentor, Haring, accepted Becker's service in WWII and for the State department in Paris as a cultural attache as field work. Becker told me that he was really working for the CIA, meeting with his Russian counterpart on a bench in the Toulerie gardens and relaying what he learned back to Washington. Haring was a Japanese specialist so Becker did his dissertation on Zen, which becamehis first book _Zen: A Rational Ctitique._ We had a lot in common. We were both Jewish, we were both interested in the history of ideas and we both loved Italian food and had dinner together once a week for many years. He came to my house on a lake every day for a swim which we attended Szasz' seminars together, We met and talked about them for hours When Szasz boycotted the Syracuse psychiatric hospital, we boycotted it in sympathy with him and in protest against the suppression of speech. Becker and I had adjoining offices and often worked long hours into the night discussing our work. His lectures to the medical students formed the basis second book _The Birth And Death Of Meaning_ which is an anthropological and psychoanalytic view of the evolution of the human mind. Like me, Becker could be rude and crude and was contemptuous of the empirical psychologists who worked noisily in adjoining offices, He called them "number mumblers." In turn, they were contemptuous of him, calling himself "a man of science." They called him a "poet" and disregarded his writings.

In departmental meetings where scientific papers were presented, he criticized the medical model, he was an eloquent and bold speaker. When he boycotted these conferences in support of Szasz, they became dull and boring and he was sorely missed. He and I shared the understanding that, for centuries, psychology belonged in the province of philosophy. When I was studying philosophy and reading Dewey, I referred him to Dewey and he became a fan also. Dewey led him to Tillich and theology. I was with him in his office one day when he received a call from Hollander, demanding that Becker come to his office to explain why Becker was dissuading medical students from studying psychiatry at Syracuse. Medical students were concerned about the controversy in the department and asked Becker, who was their favorite, if it was worth taking their training there, Becker dissuaded them, I heard Becker say to Hollander "No I will not come down to the hospital. You banned Szasz from teaching there. I'm not a member of the hospital staff I'm a member of the medical school faculty. If you want to talk to me, you come up to the medical school." Then, with a quizzical look on his face, he hung up. I asked him what happened. He chuckled and, with a look of concern on his face said "He fired me!"

Then began his long, tragic, peripatetic career. Haring gave him a one year contract in the anthropology department. The next year, Tom Green gave him a one year appointment in the school of education. Then, Becker took a one year sabbatical in Rome to study the history of Western civilization, the product of which was _The Structure Of Evil_ (1968). Then, Erving Goffman left Berkeley for the university of Pennsylvania and recommended Becker as his replacement. At Berkeley, Becker was a outspoken opponent of the war in Viet Nam and was fired. The students, who loved him, protested and offered to pay his salary with student funds, but the administration refused. He had his ten minutes of fame in Time nagazine. He got an appointment to the University of San Francisco, but resigned in protest when Hayakawa called troops on campus to repress a student demonstration against the war. I visited him in San Francisco and he was livid and insisting it was his moral obligation to take the heroic high road. After a period of nervous waiting while his children were being born, he received an invitation to join the faculty at Simon Frazer University in Vancouver where his wife, Marie still lives. He visited me here, on my farm in 1972, and told me he had a major work in publication. He also asked me about a funny feeling he had in his left ear. Soon after he returned to Vancouver, he was diagnosed with colon cancer. I then remembered that a small branch of the vagus nerve, which serves the intestines, innervated the outer ear and I wondered if this was a symptom of his cancer. He was operated on, but the cancer reappeared and had metastasized to his liver. He died in April, 1974, an unknown, unappreciated, exiled intellectual. Two months after he died, he was awarded a Pulitzer Prize for _The Denial Of Death._ Ever since these events, I have been a vigorous proponent of free speech, especially speech or writings critical of prevalent ideologies. Two thoughts come to mind as I review this history. History teaches that new ideas are first denied, then ridiculed, then accepted as something we have always known. The person who is right when society is wrong is in a perilous predicament. Think of Galileo and Bruno, who was burned at the stake for suggesting that the Earth revolves around the sun and not vice versa as the Catholic Church derclared. Becker (and I) grew weary of criticizing psychiatry without suggesting a new view of the problems with which psychiatrists deal. He then wrote _The Revolution In Psychiatry_ which presents a new way of understanding schizophrenia and depression without the medical model. The book and he were completely ignored by psychiatry. To my knowledge and his it wasn't even reviewed in a psychiatric journal. Psychiatrists would do well to read this book today rather than looking for the causes of these problems in the brain, but psychiatrists don't think about the way they think, and they don't read anything that doesn't have statistics in it because they believe that statistics make science.

In 1966, after he resigned from San Francisco State, he went on sabbatical for a year in Rome to investigate the history of Western civilization. The result was _The Structure Of Evil_ (1968) in adumbration of _The Denial Of Death_ , this book attributed human suffering over the centuries to the human desire for heroic self assertion.

# The Sixties

Most of today's young people have no idea what it was like to live through the sixties, yet the sixties shaped our world of today more than we think. It was a turbulent time, exhilarating, liberating, and paranoid. I lived my teen aged years through WWII. F.D.R. was president from the time I was born until he died. and most of the people in my neighborhood were patriots and loved him. We grieved when he died. A friend of mine and I took the subway down town to 42 ND st. and asked every soldier we could find for their autograph. Soldiers were heroes to us and there was no division in the country about the war. If one word could characterize my experience of the sixties it would be "alienation" - being exiled from the box. I had wanted to be a doctor for a long time and I was very happy in medical school and internship. I was looking forward to following in Freud's footsteps and becoming a psychiatrist. When I found out that the state and mainstream psychiatry were trying to repress Szasz, and when I witnessed how people were treated in psychiatric institutions, the philosopher in me's love of the truth came out and I decided that psychiatry was a fraud and a tyranny that I wanted to understand and expose. I began to think about psychiatry as a social rather than a medical enterprise. So I began to write ny first book _In The Name Of Mental Health: The social functions of psychiatry_ which was published in 1969. At first, I sent it to Basic Books who agreed to publish it. Hollander became disgusted with the dissension in the department tha he had caused and resigned, taking a position as chairman of psychiatry at Vanderbilt University medical school. He appointed David Robinson as his successor. After a few months of waiting, I received a call from Irving Kristol, then editor at Basic Books, apologetically telling me that he could not publish the book after all because it was out of the box. The psychiatrist he sent it to for a reading told him that if he published the book psychiatrists would boycott Basic Books. Since psychiatrists were one of his main audiences, he explained, he could not afford that. Years later, I called Kristol to confirm this story and get his permission to write about it. He said yes to both. I then sent the manuscript to Jason Aronson at Science House and he couragously agreed to publish it. He made it a main selection of Science House book club and received 9000 orders. He told me that 6000 of them were returned, the highest ever from his book club.

When Robinson read the book, he came into my office and told me he was not going to renew my appointment, I did not have tenure, so, in effect, he was firing me - throwing me out of the box. Szasz had tenure Becker and I did not, but some unscrupulous members of the department designed a plot to lure Szasz into insubordination for which he could be fired. Szasz hired a lawyer from the Syracuse law school, Geoyge Alexander, who brought in the ACLU who found that Szasz' rights had been violated and the department let him be. I went to Alexander for help and he refused on the grounds that the med school could not fire me for writing a book, but they could fire me without giving a reason. I appealed to the AAUP and the local chapter found that my rights had been violated, but the president of the school, Calysle Jacobsen, ignored them.

In a meeting with Jacobsen and Robinson, Robinson said that he fired me because "he had too many French teachers" meaning that, with Szasz and me in the same department, it would get the reputation of being an anti-psychiatry center and the NIMH would defund the residency program. Every one else in the department could agree with each other that mental illness is a real disease, but if I agree with Szasz that it is not, that would be too much. Lies need defenders, but the truth does not. According to AAUP rules, I should have been given a year's notice, but I was not, so Jacobsen extended my appointment for six months.

After I recived my Master's of philosophy, Paul Meadows, the chairman of the combined sociology anthropology department at the university, offered me a job as instructor in sociology. I taught two classes for many years, one on deviance, the other on personality development. This brought me back to an intellectual atmosphere that I loved. Becker and i formed an interdisciplinary group of professors that met regularly at my apartment to discuss ideas, but it fell flat because people could only talk about their own discipline. Interdisciplinary thinking requires interdisciplinary thinkers.

The sixties are known by a sound bite as the era of sex, drugs and rock and roll. There were plenty of those but there was more to it. In Syracuse, there was a vibrant black community between the med school, the university and the downtown department stores. The university and the suburban communities further out demanded faster access to down town. So the powers that be decided to build a highway from the university to down town, which required destroying the black community. The problem was that the blacks could not move to the suburbs because of racial discrimination in housing. A group of people organised to stop the destruction of the black neighborhood until a fair housing law was passed to correct the injustice. Leading this group were Ron Corwin, a white man from New York City, and Rudy Lombard, a black man from New Orleans.

# Rudy Lombard

Rudy, one of the great men in my life, was the vice president of the national CONGRESS of RACIAL EQUALITY (C.O.R.E.) under its chairman, James Farmer. Rudy had desegregated Woolworth's in new Orleans with a sit in and won a law suit in front of the Supreme Court (Lombard vs. U.S.) He also led the voter registration drives in Mississippi and Louisiana. He was a tall (6'4") strong, good looking man who came to Syracuse to earn a D.SS. at the Maxwell school at Syracuse. Meadows introduced me to him. With the cooperation of George Wiley, a black chemistry professor, who founded the National Welfare Rights Organization (WRO), he organized picket lines at City Hall to advocate a fair housing law. The lines were composed of welfare mothers and students, Black students at the university could not find housing in the suburbs. Racial discrimination was rampant in this country. It was a big deal when Jim Brown was allowed on the football field. He is the best athlete I've ever seen, bar none. I joined the picket lines, singing "We shall overcome" with the welfare mothers. I Felt more of a belonging there than I did at the department of psychiatry. This period was very violent. Few people remember how violent it was. It was dangerous to be a civil rights worker, or to be black. The realization of how widespread racial discrimination was disappointed me in my country, that talked freedom hypocritically. When it became apparent that the city was not going to respond to our peaceful protests, Rudy called for volunteers to sit in at the mayor's office and be arrested. I volunteered. Ron Corwin was sitting in front of bulldozers, preventing them from destroying the black neighborhood, so I figured I could sit down in the safety of city hall. It was very well organized and coordinated with the police department. A group of us sat down in front of the mayor's office, the police came and peacefully led us downstairs into paddy wagons that took us to jail. I remember the officer in the wagon with us looking at us with a menacing face and pounding his night stick into his hand, saying "good thing for you we're not in Russia" as if he wished he could beat us with it but everyone sat stoically. When we arrived at the court yard of the police station, he got out of the wagon first, beat his stick against his hand and said "you're on our territory now" as if we were beating him unfairly in the wagon. I was the first white professional in Syracuse to commit civil disobedience - one more step out of the box.

There went my sense of patriotism that I was so proud of during WWII. Now I felt alienated from my country. We were fingerprinted and photographed like the dangerous criminals we were. I joined Rudy in sitting, instead of standing when the natonal anthem was played at sports events. When Rudy was evicted from the apartment he shared with Corwin, my wife, Betty, and I invited him to live with us in our house on Jamesville Reservoir. He wrote his DSS dissertation there. I later heard that one of the liberal members of the psychiatry department who hated Szasz advocated that I should be fired for getting arrested during working hours when, presumably, I should have been in the hospital guarding and harassing involuntary patients.

The war in Viet Nam was escalating and experts on South Asia and China were invited to give "teach ins" on the war which made it apparent to many that the war was one of a long series of interventions in Asia by Western powers. Protests against the war were taking place at universities across the country and Syracuse was no exception. I joined the protests and noticed that we were being photographed by university security. The chancellor of the university at the time, William Tolley, beat some protesters with his cane. There took place mass firings of faculty and it did not go unnoticed that most of them were either protesters or outspoken Marxists. I was fired by the dean of the faculty. Meadows resigned in protest and took a job as chair of sociology at the State University, of New York in Albany. He invited me to join the faculty there and even sent me my teaching schedule for the first year, then I was called in by the dean of the faculty, a little man named Perlmutter, who told me he was not going to approve my appointment. I asked him why and he told me it was because I hadn't revealed to him that i was protester in Syracuse. I protested that Meadows knew because he was on the protest lines with me, but Perlmutter said "We don't want protesters on our campus." So there I was, just starting out in life and already fired by a medical school and two universities. One step out of the box leads to others. People who step out of the box are thrown out be people who are too afraid to step out of their boxes, or too stuck in them. I do not discourage anyone from stepping out of the box, nor do I encourage it. It should be an informed conscious choice with awareness of the possible consequences.

# Agehananda Bharati

Becker introduced me to a professor of anthropology, Agehananda Bharati, Ageha, as we called him was a Hindu monk and an anthropologist. He was born Catholic in Vienna as Leopold Fischer. He was extremely bright and proud of it. He became acquainted with some Indian students in Vienna and taught them English and German in return for them teaching him Sanskrit and Hindi.

When the war started, he joined Chandra Bose's Indian legion as a cook. Bose joined the Germans to fight the English because they were occupying India. After the war, Ageha was accepted as an Indian and spent a year in a British prisoner of war camp. He was eventually released and sent to India where he entered a monastery and became a monk in the Dashanami Sannyasin order, an order of wandering monks. Agehananda literally means "homeless bliss." He was an autodidact and read voraciously in Western philosophy and Hinduism. He walked the length and breadth of India with a staff and a bowl, begging for food. He was a left handed Tantrist, who used what was forbidden by the right handers as a vehicle towards enlightenment and, when Nehru came to power and outlawed Tantra, he was expelled from India. He moved to Japan wrote, published and taught meditation. When he became known for his writings, he was invited by Herbert Guenther to teach at the Institute for Far Eastern studies in Saskatchewan, Canada. Gunther, who also had once lived in Vienna was an internationally known and respected Buddhist scholar. When the anthropology department at Syracuse was looking for an Asia scholar, they hired Ageha as an assistant professor. He wrote and published prodigiously and rose through the ranks to professor and chairman of the department. He was a tall (6'5") round man (300 lbs.) who was very charismatic in twelve languages. Although he was a monk, he loved good food, baroque music, and women. This was not lascivious, since Indian culture worshipped the male and female sexual organs. He loved to tell jokes and laugh. At the monastery where the monks practiced tantric sex, the Dashanyami order was an advaitist (non-dualistic) Shivaist (the destroyer) order that was preoccupied with death and sex. He told me that, when he was initiated, he and other initiates were taken to a crematorium on the banks of the Ganges River where they sat on corpses through the night while staring at an image of Shiva while coyotes roamed up and down the aisles nipping at their toes. He also told me with great humor that while the monks were practicing Tantric sex with their consorts, he would walk around the monastery with other monks talking about serious things. In Tantric sex, the monk brings himself to the brink of orgasm without ejaculating, merging with the divine in that moment of bliss. While he was circumambulating, he said, he would often hear a monk cry "oops" and broke out in a belly laugh. He taught me the advaita Vedanta of his lineage.

Ageha want back to India once every year to meet with his guru, the Shankarcharya. On the way, he would stop in Switzerland and legally buy calibrated Sandoz LSD which had not yet been declared illegal. He asked me if I would like to experience it. I was young, foolish and adventurous and I agreed. He set up the experience as if it were a sacred ritual. We fasted the day before and prepared a sumptuous feast for when we came down and were hungry. He gave us and himself took 150 micrograms of LSD. It took 30-45 minutes for the effects to kick in. The first effect was a sensuous anxiety. This may seem contradictory, and it has to be experienced to be known, but we all experience something like it when we are about to have a pleasant experience that we are slightly nervous about, like playing in an important game, or receiving an award in public, or having sex for the first time or any time. It was suddenly replaced by sensual distortions, mostly visual, or an out of body experience. Ageha, who loved Baroque music played recordings of Bach's partitas, Vivaldi concerti and Handel's water music and Royal Fireworks Suite all played with old instruments. The effect was astounding. I can't speak for other minds, but I could see the Music, a phenomenon known as synesthesia, the merging of sensory experiences. It was the most delightful, vivid musical experience I have ever had. Then we each became absorbed in our own experiences. Mine was examining a beveled ashtray, which had become a labyrinth of light. After about six hours we came down, famished and enjoyed the buffet we had prepared while excitedly telling each other about our experiences. I took LSD with Ageha about twenty times. Each experience was different. Sometimes I got focused on a blade of glass or a painting or thankha that Ageha had brought, or a line of thought. Once I had a bad experience. The face of a woman friend, who was taking acid with us, began to look like a witch, I became frightened and had a panic attack. I thought I was dying. Afterwards, I could understand why people might commit suicide or commit other dangerous acts while high on LSD and I developed a respect for the dangers of the drug and did not, and do not recommend that anyone take it. I also learned empathy for patients who suffer panic attacks and learned how to treat them. I went to a quiet place with my wife who was very comforting and supportive and waited for the panic to subside, which it did in a few minutes. The more I fought it, the stronger it became. I learned that the way out of a difficult time is through it. The way out is through. That was a valuable lesson I learned for my life and for helping others. Everything is impermanent, everything passes, joy and pain too.

One time, Ageha asked me if I would like to experience the "white light" which was supposed to be the mark of Nirvana or union with God. Again, being young and foolish and adventurous, I said I did. He instructed me to go up to my bedroom, shut off all the lights so it was absolutely dark, take off my clothes, lie down, and let myself die. I gulped with anxiety and asked him "how am I supposed to die?" He said "just imagine it, your mind will take care of the rest." He added "if you get too anxious, set yourself a problem to solve, Buddha said 'your ego is the sum of your problems,' if you set yourself a problem, your ego will reconstitute."

So I went upstairs and did as he instructed. I took off my clothes turned off the lights so I couldn't see my hand in front of my face, set myself the problem of finding my pack of cigarettes, and imagined that I was dying. I became very anxious and anxious about being anxious so I searched for the cigarettes. As I did, my anxiety disappeared and I was OK. I went downstairs and told him what had happened. He grunted knowingly and asked me if I wanted to try again. I was foolish enough to leap into the abyss again. Nietszche said "If you look into the abyss, the abyss will look back." So I went upstairs and tried again. This time, I was determined to go through with it. As I imagined myself dying, I was above my body looking down on it. I watched myself turn into a corpse, my skin turned to leather and fell off. I saw my skeleton - all with a feeling of curious indifference - then my bones crumbled away and, suddenly, I was in the midst of this mysterious white lightt. I shouldn't say "I" because I had no sense of myself being there. The light had a slight bluish hue, extended in all directions without boundaries, and was comforting, kind, and seemed to be smiling. I felt that it was a loving energy. Suddenly. The thought appeared "that's it! I've seen it." No sooner I had the thought, the light was gone and I was aware of myself naked, sitting at the bottom of my bed. I rushed downstairs to tell Ageha what I had experienced and he said "yes, that's it." He told me that he gave seven times the dose we took to his guru who sat still for six hours, then told him that was it but he shouldn't use LSD to get there any more, he should do it through meditation. That was the last time either of us took LSD. I don't recommend it. People have asked me what I learned from this experience and I can honestly answer "nothing." Anything that I say I learned would just be something I have made up. Or, I might say that I learned that there is nothing to be learned from the experience of nothingness. Much later, after I heard the stories of people who had died, were prounounced medically dead, and had the experience of being in heaven and coming back, I realized that I had been in the presence of God. Our experiences were so similar. In both cases we had the experience of dying, of hovering above and seeing our dead bodies, of letting go of the life we had with no desire to go back, feeling peaceful and content, and finding ourselves in the presence of a loving energy. I now believe that the light was not a hallucination caused by the LSD, but the revelation of a different level of reality - a seemless energy that underlies everything but is invisible when we are in an ego state. That light had all of the qualities that theists attribute to God. I am now aware that that energy is everywhere although I have never again experienced it so vividly. I expect to experience it again when I die, at which time I will say to it "hello God, it's me again."

Then, I asked Ageha to teach me meditation, After we came down from the trip and had our food, he took me upstairs to my office, asked me to sit on the rug, taught me the proper posture, which is crosslegged with the head and spine pointed towards the ceiling like an arrow, and instructed me to rest my mind on my breath and allow and observe the thoughts arising and decaying without being distracted by them. He told me I should practice this for two hours a day for two years and he would teach me more later.

I faithfully practiced this meditation for two years during which we had many conversations which sharpened my understanding of it. The essence of his teaching was that our pain is caused by our thinking about past and future through the emotions of desire, fear, regret, and guilt. Meditation trains the mind to stay focused on the present moment thus, eliminating the causes of our pain and distress.

A year later, he taught me a modification of the original lesson. He told me that this technique was used by sadhus (spiritually powerful mystics) to deal with pain. He told me to imagine a light in the center of my chest, As I breathe out, the light become brighter and, as I breathe in it becomes darker. He also gave me a special mantra to coordinate with the breathing and visualization. I practiced this for a long time and he taught me how to anesthesize parts of my body like yogis can do. I became good enough at this that I could go to the dentist and have work done with no or little anasthesia. The secret is that the mindfulness of breathing, the coordinated, fluctuating light and the mantra keeps the mind so busy that there is no room for the pain, or it is off to the side.

I studied with Ageha for fifteen years, during which time Tibetan Lamas were coming to this country, driven out of Tibet by the Chinese invasion. Ageha noticed that I was attracted to their teachings, especially those of Choyam Trungpa Rinpoche, and he advised me to find a Buddhist teacher, warning me that "Buddhism is not a path for the faint hearted."

# Mexico

When Becker went on sabbatical to Rome, I decided that it was a good idea and I wanted a sabbatical too. But where to go and what to do? I didn't want to go to Rome or Europe, that would be tracking Becker too closely. Besides, I had been to Rome and travelled in Europe in 1964 and didn't want to go there again. I thought of going to India and studying with a master, but I had Ageha and Buddhist masters were coming to this country in large numbers. So I didn't need to go to India to learn from them, didn't want more head experiences, I wanted a real life, down to Earth adventure. So I decided to drive across the country and then down to Mexico. Betty and I sold our little sports cars - I had a wonderful little white Daimler. We bought a Volkswagon station wagon that we could sleep in. We rented our beloved house in Jamesville and set off across the country. I had saved $15000 and with the advice of Szasz and our mutual friend, Roger Yanow, who was a stockbroker, I invested it in a rising market and it grew to $30000. I had the choice then to keep working and make more money or to have the adventure of a lifetime. So the question Iasked nyself was "What is more important to me, money or life experience?" Did I want the adventure of a lifetime? Mindful of how short life is, that every doctor has remembering the adventures of Richard Halliburton, I chose the adventure. When I was on the faculty, I taught at state hospitals across the state. At Binghamton State Hospital, the wife of a professor of philosophy at Binghamton University was present and she told her husband, Pat Brown, about me. He wanted to meet me. He had a group of young, intelligent hippie acolytes around him and introduced me to them. I was ten years older than them, and far older in life experience, but we had in common our anti-racism and anti-war values. When they found out what Betty and I planned, they asked to go too. So five of us piled into the Volkswagon sharing the driving, headed for California. At night, we stayed in camp grounds where we met many compatible travelers. We stopped in Eudora, Arkansaw to visit Betty's brother, whose wife's family owned a farm. Social difference between the white owners and black owners was very obvious, but we didn't see any abuse. We also stopped in Claremont to visit my old philosophy professor Al Louch who was then teaching there, but there was uncomfortable tension between him and his wife, so we moved on to San Fransico. Becker and his wife, Marie, invited us to stay with them, so we did for a week, Ernie showed us around San Fran. He was learning classical guitar so he played for us and he and I had plenty of time to talk, mostly about our writing, but he told me how sad he was to leave San Francisco, and how anxious he was because he had a child and one on the way, but no job in sight. He emphasized how important it was for him to do sometng heroic. One day, Betty and I went to Haight Asbury where we found an opium den. For a little money, you could rent a booth with a mattress and a tab of opium and a pipe. It was legal. A cop walked in, looked around and left. The opium dreams were very peaceful, vivid and pleasant. I could understand how China could get hooked on opium. It would be difficult, if not impossible for a society to be productive if its people were addicted to opium. Becker introduced me to Erving Goffman who had come to visit, but we didn't have much time to talk. I told him how much Szasz appreciated his work and that I read his work in my residency.

Then, down to Mexico. Our hippie friends went their own way, looking for women and pot. We drove down the Pacific Highway to San Diego and then into Mexico through Tijuana. We headed towards Mexico city, stopping for the wonderful market at Guadalahara. Mexico City was noisy and polluted, but we explored the Aztec monuments and collected some replicas of Aztec sculpture. Then on to Acapulco, stopping at Cuernavaca and Toluca, the silver city. We found a wonderful trailer park in Pie de la Cuesta, literally the foot of the coast, an outcropping from the mainland with the ocean on the west side and a lagoon on the east. The ocean was turbulent with waves sometimes 20 feet high, but the Mexicans body surfed in it and taught me how to do it. Sunsets were magnificent epecially when enhanced with a few puffs of Acapulco gold. We had found paradise and wanted to stay, but when we saw other people's rigs, we realized that the Volkswagon bus was too small to live in for very long. So we decided to go back to the states and get a more suitable rig. So we drove to Vera Cruz and took a freighter to Tampa and then New York City. A cool black man we met in Acapulco asked if he could hitch a ride with us to Mexico City in return for some special marijuana he bought at the docks called "panama red sin semilla." We agreed. We headed for Vera Cruz hoping to catch a ship home and avoid the long drive, and we dropped him off in Mexico City. He handed me three joints and warned me to be very careful because they were very strong. In Vera Cruz, we got food poisoning for foolishly eating a salad washed in contaminated water. We got a ticket for ourselves and the bus on a freighter headed for NewYork City with a stop in Tampa. While we were on the Gulf of Mexico, Martin Luther King was assassinated and the port of Tampa was closed by striking dock workers. We stayed for two nights in Tampa with my old friend Josef Dellagrotte, who was teaching history at the University of Florida. We met in Syracuse where he was working his way through a Ph.d. in history as a barber. We made an instant connection and have been friends ever since and are still friends. I learned from him that old friends are precious and hard to make. So stay in touch with your good friends. After a lovely fish dinner we smoked one of the joints the mysterious black man gave me, and after a few minutes we began to laugh. The joint was like LSD, perhaps laced with it and we both realized that we were off on a trip that we could not stop that would last five hours. Thanks to my training with Ageha whom Josef also knew, the trip was no problem for me or for him.

When the port opened we got back on the ship and headed for New York. We stayed at my parent's apartment, where I grew up and then headed for Syracuse, where we stayed at Betty's parent's house. When you travel, you have to have a place to stay if your trip is interrupted. We researched various kinds of travel homes and settled on a truck camper with a motorcycle carried on receptacles on the front. We set it up then started back for Pie de la Cuesta. This time, we headed straight for Nogales, then down the central highway to Mexico City.

We headed down to Oahaca and explored the Oahacan temples with a Spanish couple we met there. We made the mistake of smoking another of the joints with them, in an effort to connect with them, but it didn't work. I focused on being high in a cemetery and thinking about the people who lived and died. This what was left of them. All things shall pass, even our sun and Earth.

We drove north to Mexico City, then West to Acapulco. The most amazing thing about that drive was the silence between Oahaca and Mexico City. The only other place I "heard" that silence was at the Grand Canyon. I imagined that was a common experience in the mountains of Tibet, and a great aid to meditation. In Acapulco, we drove to the camp grounds in Pie de la Cuesta and were assigned the same wonderful space we had in a corner of the grounds adjoining the beach. We spent a few days lying in the sun and swimming in the surf.

Walking down the beach, we met many Americans living there. One was a tall, good looking American we were told was a marijuana smuggler, who spent all day cleaning his .45 pistol. Another was a Hell's Angel running from a charge of murder in the U.S. One day, we went on a motorcycle ride with a group of Hell's Angels to a waterfall. Everyone was very friendly.

I was very impressed and imagined myself to be a Hell's Angel. We also met a group of seemingly benign hippies who became attached to us. We became friends. One day they introduced us to a couple, an American man and a Mexican woman who told us there was a village in the moutains, the woman's home, where the people were sick but had no doctor. They asked me if I was willing to go up there, examine the people, and diagnose the problem. I Agreed. We drove in my truck, Betty and I and their leader, David, in the front and five men riding in the bed of the truck. We drove up the road, north towards Ziuatenejo for a half an hour when David instructed me to make a right turn on to an unpaved trail that led up the mountain. We drove for another half an hour on a winding trail across three creeks until we suddenly came upon a clearing surrounded by huts. This was the village of Santa Rosa. We were greeted warmly by the jefe, the chief, who took us to his hut and fed us shrimp and rice. The food was good, but my appetite was spoiled by the chickens running freely through the dusty, dirt floor of the house. Then, the woman we originally met, whose home was this village and who spoke English took me house to house to examine the people. I had with me my little black doctor's bag with my stethoscope, a reflex hammer and a few other diagnostic tools. I observed that many people had or had a history of sore throats, many had heart murmus, arthritis, and a history of bloody urine, all symptoms of strep infections and their sequellae. Many also had enlarged thyroids, a symptom of lack of iodine in their diets. One very old woman had a hard mass in the left lower quadrant of her abdomen, which I diagnosed as malignant metastatic colon cancer and told her family to take her to a hospital in Ziuatenejo. After I had examined all the people in the village, I noticed the jefe and some others, armed with pistols and rifles mounting horses and heading further up the mountain. David told me they were headed for the marijuana fields to harvest some plants. David had traded my services for marijuana. We headed back down to Pie de la Cuesta. David later asked me if I would drive up again and bring some marijuana down or let him borrow the truck to do it, but I refused both. Didn't want to spend my sabbatical in a Mexican jail or lose my truck and have no way to get the camper back home. He gracefully accepted my refusals.

David found another way to bring the marijuana down and rented a house in the hills of Acapulco to process it. He told me that the jefe had sent word that we were invited to a wedding in the village. So I bought a large amount of penicillin, enough for a therapeutic dose for everyone there, and cases of iodized salt and we drove up again and distributed them to everyone in the village. We also noticed some federal doctors in the village lecturing to the people which was not a good sign for us. It meant that the police knew about us. I also noticed that the villagers were using a toilet upstream and drinking water downstream, which was probably the source of their infections. I advised the jefe to reverse it, to make the toilet downstream and drink the water from up stream. David hired a Mexican artist to make hollow face masks and packed the marijuana into them. One of his friends had offered to carry the masks over the border by train. Apparently he had done this before successfully. We spent days at his house listening to the Beatles and watching them pack the masks.

One evening after dark, Betty and I were leaving to go back to camp when a truck stopped in front of the house and a man opened the door of the truck with a gun in his hand pointed at us. I grabbed Betty's hand and rushed back into the house. This made David and his friend's paranoid and mindful of the axiom "just because you're paranoid doesn't mean there's no one after you." I reminded them of the counter axiom "if you think someone's after you there probably is." They decided to pack up and run to safety in Ziuatenejo. They were arrested in Ziuatenejo and sent to the prison in Acapulco. Mexican prisoners have to pay for their food and they were broke, so I nervously visited them in prison and gave them money, I didn't know whether the Mexican authorities believed that we were part of the smuggling group.

A man at the campground who had befriended us asked if he could borrow my motorcycle. He was good natured and seemed harmless enough so I loaned it to him. The problem was that he fell off it, broke his shoulder and abandoned the motorcycle. This was a problem because Mexican customs had noted that we drove into Mexico with a motorcycle and they wouldn't let us leave without it for fear we had sold it which would be illegal. A Mexican family who lived on the beach had befriended us and I went to the head of the family asking for help. I was the godfather of one of his daughters so he agreed to help. He drove me on the road to Zuatenejo looking for the crashed bike, which we didn't find. On the way we spoke Spanish which I was learning. He told me he was once police chief on Pie de la Cuesta. I asked him if he ever killed any one. He shook his head yes, he had killed six men. I asked him why he killed them? He answered, "they were bad men." We couldn't find the bike so I asked him what I could do to leave the country? He advised me to go to the police department in Mexico City and tell them what happened. They would give me papers allowing me to leave. I gulped with fear. I didn't know if the police were looking for us and we had to walk into their headquarters and ask their permission to leave the country? Betty and I packed to leave. She cut my hair which had grown to hippie length. I put on plaid shorts, trying my best to look like a tourist and we headed for Mexico City with great anxiety. The policeman at the desk was very sympathetic, apparently because theft is very common in Mexico. Travellers beware, Mexico is like our wild west once was.

As we passed through Mexican and American customs and were searched by both, the thought occurred to me that, I had just started out in life and I was not only alienated from my profession and my country, I was a fugitive. On the one hand, it was painful, on the other hand it was liberating and freed my mind for heresy.

# The Farm

When we returned to Syracuse we moved back into our house and I resumed my apprenticeship with Ageha and started private practice again. Our young hippie friends had returned from the West coast and came to visit us. We all felt alienated from racist, oppressive American society and they suggested that we buy a piece of land together and live cooperatively in a commune counter cultural style. It was a daunting challenge, but Betty and I agreed. They were still at college in Binghamton, so they looked for land between there and Syracuse. They found a beautiful six hundred acre parcel, a bankrupt potato farm owned by the bankruptcy lawyer. He asked forty five thousand dollars for six hundred acres, seven thousand down and he took a mortgage on the rest. The boys came up with half the down payment and I came up with half. We split the monthly mortgage payment. The land had two dilapidated houses on it. They took one and Betty and I took one. Betty and I had adopted our beautiful daughter in 1970. We continued to live in Syracuse and commuted to the land on weekends to work on the house. It was a difficult time because the heavy pace of decisions brought us into conflict. LESSON #1 learned: never to build a house withyour wife or husband; #2 Beware of what you want, for you may get it.

The boys borrowed money for seed and farm machinery and started to farm, at first, growing hay and oats. There was a large, well constructed barn on the property and we all enjoyed harvesting the crops and stocking the barn. After a few years, with all that feed stored in the barn, the boys began to buy cattle at auction, raise them and sell them, Betty and I grew tired of commuting. The farm was (is) in Richford, close to the lovely town of Ithaca, So I thought of relocating my practice to there. I took a job at the Tompkins County mental health clinic, which is a good way to start a practice in a new town. The director was Robert Hamlisch who, coincidentally, grew up a few blocks from me in the Bronx. We got along well at first, but the commute from Syracuse was long and arduous and I often came late in bad winter weather. The secretaries complained and Bob warned me that I had to be there the same time as them or he would have to fire me. LESSON #3: beware of the secretaries, they run the show.

It was a harsh winter and, despite my honest efforts, I was late occasionally. The secretaries continued to complain and Bob, wary of a mutiny, fired me. So I rented an office in Ithaca and opened a private practice, which was soon very successful. I lived in the camper, which was still on the back of the truck and occasionally slept in the dilapidated house. We hired some local carpenters, the girlfriend of one of whom was a Cornell of the Cornell family. They took the old house down and began to construct a new one under Betty's direction. Her father was a skilled carpenter and she knew a lot about it too. When they took the old house down, they found beautiful, hand hewn beams that probably dated back to the eaerly ninteenth century. They also found papers in the walls of Frederick Douglas that indicated that the farm was part of the underground railroad. I donated the papers to the Cornell archives. There were also some super dilapidated buildings which locals called the "slave quarters," where escaping slaves slept when they stopped to pick potatoes on their way to freedom.

New York boy that I am, found it thrilling to come back to the farm after work and to see the fields of grain or the boys on tractors harvesting them. At one point, they had a hundred cows in a pasture. I was not a participant in the farm, either as a financier or a profit taker. I had an adequate income from my practice, but I did love the hard work and exercise of throwing hay bales around in the barn. We developed the ritual of all having dinner together on Saturday nights. Jim, their leader and spokesperson had a daughter the same age as ours, as did a neighbor with whom we were very friendly. So, for many years it did feel as if we had accomplished our utopia of a family commune, so far. Then came the oil crisis of the late seventies which put pressure on farmers because rising gas prices made it difficult to make a profit. In New York state, which used to be a haven for farmers, family farms were failing all across the state.

LESSON #4: Treasurethe good old days. They are good and old because they are gone. These days will be your good old days when you are old. Soon enough. Nothing lasts. LESSON #5: Getting old is much more difficult than I thought it would be. When I was young and thought of myself getting old, I imagined that I still had a young body. As you get older, you get weaker. Treasure the good old days because they are good and gone. These are your your good old days, because you are young and they will soon be gone. Nothing lasts forever. This is a truism that is difficult to appreciate until you have lost something - your body or your paradise. LESSON #6: Don't presume you know your future or how you'll die, whatever your genetic history or inheritance may be. My father died of a heart attack. I survived a heart attack and a stroke. Who knows? I now have a hangnail and a little break on the skin of my thumb, which has become infected and turned into an abscess under the nail. I never heard of anyone dying from a hangnail but WHO KNOWS? The abscess could spread up my arm, settle in my brain and kill me. We are all like the man who jumped from the top floor of the empire state building, people on every floor heard him muttering to himself "So farr so goood."

Who knows? We all live in a state of suspense.

As it became more difficult for the boys to make a living on the farm, Jim came to me and asked if I could co-sign for a mortgage on the land so they could keep it. I was very reluctant to mortgage the land, because if they couldn't pay it off we would lose everything. We had already sold our house in Syracuse and that money had gone into building the new house on the farm. Jim saw that I was reluctant and angrily shouted "You mean you're not going to sign?" implying that I would be responsible for Paradise lost. He came charging at me shouting. He kept pressing and promised that I could have a lien on his machinery, so that, if they couldn't pay the mortgage on the land, the machinery would cover it. I trusted him and we shook on it. I'm not very fond of lawyers, but that taught me LESSON #7: "TRUST YOUR FRIEND, BUT LET YOUR LAWYER HOLD YOUR HORSE."

As things got tougher, my hippie friends began to grow marijuana to supplement their insufficient farm income. At first, it was a little patch for their own smoke, which they could no longer afford. Gradually, it grew bigger. One summer, I was to meet Betty and our daughter in Cape Cod. When I arrived they were not there and the owner said they left in a hurry and she seemed very upset. I called Jim and he told me "the farm's been busted," so I hurried back.

Betty and I were not involved or implicated The police focused on Jim, whose project this was. The plot was discovered because one of Jim's associates boasted in a bar in Richford that he had lots of pot. Two forest rangers in the bar and heard him and, without a warrant came up snooping and found some marijuna plants between rows of corn. Police focused on Jim, whose project this was. He pleaded guilty and was sentenced to weekends in jail in Owego. During this turmoil, Jim's wife left him and he sold his equipment to pay his bills without a word to me. LESSON #8: OLD TRUISM: KEEP YOUR FRIENDS CLOSE AND YOUR ENEMIES CLOSER. NEW TRUISM: YOUR ENEMIES CAN HURT YOU BUT YOUR FRIENDS CAN HURT YOU WORSE.

# Buddhism

In 1980, when Ageha suggested that I look for a Buddhist teacher, I searched for a Buddhist monastery. I found Karma Triyana Dharmachakra, KTD, a Tibetan Buddhist monastery in Woodstock, New York. The name means "practice center of the three yanas."

"Yana" means "path." The three yanas are : Hinayana, or Theravadin, Mahayana, and Vajrayana. I drove there and was greeted by Gnodrup Burkhar, the abott's translator. I asked to become a student of the abott. He made an appointment for me in three weeks. I returned in three weeks, eager to meet my new teacher. Gnodrup greeted me again and apologized. The abott was presiding over a monthly ritual and could not meet with anyone. The ritual, or sadhana, was nungne (nung nay), a purification ritual devoted to Avlokitsvara, the Buddha of compassion. Gnodrup invited me to attend the ritual "just to experience the abbot's presence." I had no idea what he meant by that. He told me there was to be no talking except for chanting, no eating and no drinking. I gulped and entered the ritual room which was filled with participants sitting on meditation cushions and chanting. I was given a cushion and a place to sit and a pamphlet with the chants phonetically spelled and translated into English. On a side of the room was sitting this man in maroon and yellow robes chanting silently. His presence filled the room. I had never experienced a person with such a commanding presence. Yet, he sat perfectly still, only his mouth was moving. He radiated silence. I joined the chanting, glancing at him now and again. I could feel his inner silence in the same way I could experience the movements of a skilled athlete as he played the game. I was reminded of the silence between Oahaca and Mexico City. In retrospect, I learned more from Rinpoche's presence than I did from reading books about meditation. Neuroscientists hypothesize that this inner mimicry is due to "mirror neurons" that imitate another person's movement or, in this case, silence, that help animals to adapt. If you want to learn to meditate, read books about the technique, practice it, but be sure to sit in the presence of a master. They are not easy to find.

The sadhana lasted for two days, Saturday and Sunday. It was arduous and required a lot of effort, perseverance, and patience, which are virtues in Buddhist psychology and should be taught to our children as well. My knees and hips ached the first day, but I stuck with it thinking that if I could get through one day, I could get through another. Past the half way point, I felt euphoric, as if I had conquored myself, which I had.

At the end of the sadhana, I felt that I had accomplished something, and later learned that the word "sadhana" means "to accomplish something spiritual." It felt like an achievement and it was one of the most useful things I have ever done. I made another appointment to meet with Rinpoche privately.

I returned a month later and every month for five years.

At my private meeting with Rinpoche, I asked him to teach me meditation. He taught me the "seven Dharmas of shine" (sheenay). He put a lot of emphasis on posture. The seven Dharmas are: sitting cross legged, in Lotus posture, if possible (but this may only be possible for children, yogis, dancers, and acrobats): the spine should be straight, pointed at the ceiling like an arrow, the eyes can be open or closed, but if open, pointed to the floor about a foot in front; the thumbs should be touching the fourth finger, an old Taoist technique for recirculating the "chi," or life energy; the tongue should rest on the palate; and the anal muscles should be contracted to prevent the loss of chi. The technique is to breathe naturally and rest the mind on the breathe. As thoughts come, and they will, observe them arising, passing through like a breeze, and disappearing into nothingness. Take this as a lesson on impermanence. Everything happens this way, bad things and good things. The skill to be learned is to find a balance between effort and relaxation. Too much effort is a flaw in technique. Too much relaxation is a flaw in technique. Rinpoche told me "think of yourself as the keeper of a flame on which your people depend for warmth and cooking. Keep your eye on the flame. Don't allow it to flare up and burn the village down. Don't allow the wind to blow it out."

Rinpoche gave me the same instructions as Ageha did. He told me to practice for two years before he would teach me vajrayana tantra. I asked Rinpoche if it was ok to teach others what he had taught me. He nodded yes.

When I returned to Ithaca, I started a meditation group called "the Ithaca Dharma Society. We met for meditation and discussion once a week. It was a great group of bright people and I took some of us to KTD to meet with Rinpoche. He advised us to show compassion for the victims of crime. A member of the group asked him " What about the perpetraters of crimes?" He said that they deserve compassion too because they will suffer the punishment. Buddhists don't proselytize but it is considered meritorious to teach those who want to learn.

The next time I had darshan (seeing) with Khenpo Rinpoche, I had been studying and practicing the Lo Jong. Lo means consciousness and Jong means something like "cultivation" or "training". So Lo Jong means "cultivation of consciousness," Trungpa Rinpoche calls it "training the mind." It began as the seven points of Atisha and Geshe Chekhawa. In the twelfth century, the Gelugpa Kadampa lineage transformed it into 59 aphorisms or slogans, one of which is: "rest in the alaya." I had no idea what this meant, so I asked Khenpo Rinpoche. His answer was pithy but inscrutable, he said "don't be distracted." I had no idea what that meant either. Disracted from what by what? I thought about this for a long time and learned other terms for alaya: "storehouse consciousness" "unborn awareness" - Himalaya means "storehouse of snow" - and more inscrutable terms. I gained some insight when I learned that alaya is a level of consciousness, the eighth in some systems of Buddhist psychology. So, I investigated the other seven.

I don't pretend to be a Buddhist scholar or a guru, but I can share my experiences and what I have learned from others. Everyone must conduct their own inquiry. The first five levels of consciousness are familiar to all of us - the five senses: sight, hearing, smell, taste, and touch. The sixth level of consciousness is the mental stream of thought. The seventh level, interesting enough, is called "confusion" - consciousness which is focused on the self. Self consciousness is confusion consciousness because it solidifies the fiction of self. To understand the alaya, it is best to focus on one of the sense consciousnesses. For example, vision. When we see a bird, for example, we are, or can be conscious of two things, the bird, and the fact that we are conscious of it. That is a hint of the alaya conscousness. All the olther sense consciousnesses register in the alaya which is why it is called "the storehouse," not because it stores them, but because it "registers" them. Every sense consciousness is the consciousness of something. It is called "unborn" until it takes an object. I find it helpful to think in terms of host and guests."

In one of his discourses, Buddha asked his disciples "do you know the all?" Remember, he was a Hindu. The "all" is "cosmic consciousness," Brahman, and its manifestation within the individual person, the "atman." This is "Buddha nature." Then, Buddha said "close the gates," meaning don't allow any guests to enter the senses. He regarded resting in this state as the remedy or antidote for human suffering which is caused by "picking and choosing" positive and negative sensory states and thinking about past and future experiences. The antidote to suffering is to make an effort to keep attention focused on the present moment and take life as it comes without "picking and choosing." Then, remarkably, he said "release the antidote." This leaves the mind in a state of unself-conscious consciousness, which is the alaya. It is a difficult state to achieve. You may think you've acheived it, paradoxically, because of the desire and effort to achieve it, but, paradoxically, if you think you have, you are self-conscious and haven't. Your ego, or self consciousness is involved, a state that Trungpa Rinpoche called "spiritual materialism" the emotion of pride which serves the ego.

The guests of each consciousness come for a while, then leave. The alaya is the remaining clear consciousness. "Unborn" because it has no content, or guest. It cannmot be achieved by making an effort to achieve it, although effort is required at the beginning until it can be let go. Not easy to achieve, and if you achieve it, you won't know, but you will have the presence of the Rinpoche.

Jamgon Komgtrul Rinpoche, one of the four regents of the Karma Kagyu lineage was giving a teaching and a sadhana. He asked that all the psychotherapists in the audience meet with him. At that meeting, he asked us all individually to tell him about Western psychotherapy. He said that he thought that Buddhism would come to America through psychotherapy and asked us to organize a thousand person conference on Buddhism and psychotherapy. Five of us, including myself, volunteered for that daunting task. What would draw a thousand people? and how would we raise the money to start organizing it?

We began to meet weekly to figure it out, One of the members of our group, a social worker who lived in Woodstock, who shall remain unnamed by me, suggested we start a pyramid scheme, which was popular in New York City at the time. She told us that she had gone to Rinpoche, told him about and he approved. I read in a newspaper that police were investigating pyramid schemes, which are felonies in New York State, and were arresting people. I realized that it would be a disaster for Rinpoche, the monastery and Buddhism if this scheme was discovered and I vetoed it. Instead, I suggested that we sell advance tickets at a discount to members of the monastery and use that as seed money, but we needed an attractive program to do that.

I explored the idea with Szasz and asked him if he would be interested in being one of the main speakers. He tentatively agreed. After he died, one of the commentators on Fox, Charles Krauthammer, called Szasz "an author that everyone knows but no one has read." I thought that Szasz' fame or notoriety would sell tickets in New York City, which is overflowing with psychotherapists, but who else? I thought of Ronnie Laing, whom I had never met, but I knew knew me because Ageha met him in Sri Lanka, gave him a copy of my book, and told him about Szasz and me. I tried to contact Laing in England, but learned that he was in Tahiti with his family, so I contacted him in Tahiti and he agreed to speak also.

It became obvious to me that several members of the group, one in particular, Mark Finn, a psychologist who worked at a state hospital were hostile to Szasz, Laing, and me. I asked him to suggest other speakers and argued that it would not be possible to attract a thousand people with unknowns as main speakers. He could not think of anyone else so, he reluctantly, accepted Szasz and Laing. I knew Allen Ginsberg and thought of him as an entertainer during intermission.

I met Ginsberg through a friend of mine, Stanley Diamond - a brief digressin on Stanley because he was an important influence: Stanley was a friend of mine, Stanley Diamond was an associate professor of anthropology at Syracuse. Becker introduced me to him and we became close personal friends. He was a bright, strong man. We lifted weights and jogged together. He had a tendency to get into bar fights. When he was eighteen, during WWII, he joined the Canadian army and saw action in North Africa. He did field work in an Israeli kibuttz, in Nigeria and in Romania. His mission was to understand primitive, or original socities as a basis for the critique of civilization. He was an admirer of Roussau. He wrote a book called _In Search For The Primitive_. After he moved to the New School to become their first chairman of anthropology, I visited him in New York. One day, he took me on a secretive mission and, suddenly, I was in Allen Ginsberg's apartment on the lower East side and introduced me to him. Ginsberg was very friendly and tried to teach me how to sing OM MANI PADME HUM but my voice didn't come near his resonant voice. Gregory Corso was there too, obviously very unhappy with my presence. I invited Ginsberg to do the intermission entertainment and he accepted.

With this roster of people the tickets went out and the money came flowing in. Because of the conflict in the group, I went to Rinpoche for advice. He advised me to rely on my meditation, to act with good intentions, and to respect the lineage. I did my best to follow his advice, but, as I shall tell, I apparently did not do well enough.

Laing asked for $1800 for air fare. Szasz asked me if there was an honorarium. He usually received thousands of dollars to speak. I went to the committee and they approved $400 for him. When I told him about it, he was not happy with the difference between what he and Laing were being paid, but he agreed to do it as a favor to me.

On the night of the conference, we were surprised and pleased to see the huge auditorium at International House filled to overflowing. I had invited a variety of American Buddhist teachers and psychotherapists from Naropa Institute, a Buddhist college in Boulder, Colorado to partake in small discussion groups and the conference went well. I asked permission of the group to give a talk and they kindly agreed, over the objections of the aforementioned two persons who were hostile to Szasz, Laing, and me. I gave a talk on the common ground of Buddhism and psychotherapy and criticized psychiatric coercion as unkind and the concept of mental illness as insubstantial.

After the conference, my chief adversary on the committee introduced me to the author, Mark Epstein, who shook my hand and said sheepishly "I stay away from controversial subjects." I thought, unkindly, "that, indeed is a thought without a thinker" which is the title of a book he wrote. A man I didn't know came up to me, put his hand aggressively on my chest and said menacingly "if you think you're going to blend Buddhism and anti-psychiatry, you're mistaken." I swiped his hand away from my chest and asked him where he worked. He gave me the name of the same state hospital that Finn worked at.

Several weeks later, the group was called together to discuss the making of the conference. I complained that Szasz had only received $200 and asked that the $200 more that was agreed upon be sent to him. My two unnamed adversary's claimed that they had agreed to pay Szasz only $200. A heated argument ensued. I was very rude to a member of the group, Elise Frick, who was not the unamed person, in fact, Elise and I got along very well, she was very congenial. So I owe her an apology, which I make here, and regret that I could not make in person. The idea of a second conference was raised, and I expressed my doubt that this group could do it. Later that year, Jamgon Kongtrul Rinpoche was killed in an auto accident in India and the Buddhism psychotherapy project fell apart.

Several months later, I received a call from Ngodrup, the translator, asking me to withdraw from the program because members of the group did not want me involved. While the two unnamed members were away from the planning for different personal reasons, Mark Finn to study for his psychology licensure exam, and Susan Pasternack went on vacation, leaving me alone to continue to organize the conference, I accumulated $700 in expenses for telephone calls. I asked to be reimbursed. They refused. I asked my lawyer to sue for it. I sued only the Americans, none of the Tibetans at the monastery, and certainly, not Rinpoche. My lawyer wrote the board of directors of the monastery, who were all Americans, that I would drop the lawsuit if they would meet with me and talk. They refused and we won the lawsuit and paid the money which the lawyer kept as his fee. Still at the beginning of my career and fired from a medical school, two universities and a monastery because of my association with Szasz. When I told this to Rudy who lived outside the box as a civil rights activist, he chuckled and said "you must be doing something right."

In 1992, the Tibetans opened Namgyal monastery in Ithaca and offered classes in Tibetan language, debate, psychology, and philosophy. The teacher was Bill McGee, A brilliant Sanskritist and Buddhologist, "GYAL" means "Conqueror" and the prefix "NAM" is an intensifier. Namgyal means "extreme conqueror," not of anyone else, but of one's self. Aristotle said something like, it takes more courage to conquer one's self than to conquer others. The curriculum at Namgyal is the same as the curriculum ai Namgyal monastery in Dharmsala and was devised by H.H. the Dalai Lama in 1985. I became a full time student, meaning I took all the classes.

In the second year, Bill, who was paid very little, asked for a raise. He had a family to support, The monastery turned him down because registration for classes was low and they didn't have enough money,

One day, I received a call from a monk that the geshe, the abbot, wanted to see me. A geshe is a highly trained Lama and the abbot of the monastery. I went up to his room and found him sitting naked in front of a mirror. He asked me how the monastery could make more money. A committee of monks and teachers was formed to discuss the issue and I was invited to attend, A consensus was reached that registration for classes was so low because the curriculum was too esoteric for ordinary Americans. There was a great interest in Buddhism in the Ithaca community, but it had to be presented in an American idiom. This was true when Buddhism spread from India to Tibet, to China, to Japan, and to other countries in South Asia, it had to be adapted to the culture and existing religions of each country.

The monks asked me if I would present a course in the American idiom, and I agreed, I taught two sessions with my friend, David Patte, who taught Buddhism at Cornell. He presented ideas in the traditional language and I translated into an American idiom. The room was full both sessions. I presented the same ideas to a class at KTD which was well attended and praised. I was invited by my friend, Mu Soeng, then director of the Barre Center for Buddhist Studies to give a seminar there, but a member of the audience asked me a question about her sister's schizophrenia. She didn't like my answer, and complained to the staff. That man at the conference was right. I should have known better than to combine Buddhism and criticism of psychiatry. The monks at Namgyal also cancelled any further seminars, even though they were well attended. They said that the abbot at Namgyal Dharmsala didn't want Namgyal Ithaca to become another Dharma center, such as were springing up all over the country. Hewanted the traditional curriculum taught, even though it was beyond the capacity or interest of Americans to learn it. So I was "released" from Namgyal.

I decided that I would present my ideas in books, rather than classes. So I set about writing _The Happiness Project_ , which is an examination of human mental and emotional suffering from the point of view of the three poisons. With the help of David Patte, who reviewed it and recommended it, Snow Lion Publications published it in 1996. Then, continuing with my psychotherapy practice and seeing many angry people, I decided to apply the same paradigm of the three poisons to the problems of anger, aggression and violence. Snow Lion published it in 2006 as _Vinegar Into Honey._ It was very well received. I applied and tested its principles in therapy and many patients used it successfully.

# Stroke

Then, three years ago, I was sitting in my office between patients when I felt a severe pain in my upper left abdomen. It was not sharp or crushing, it was more like a cramp, and I assumed it was intestinal. When I stood up to check it, however, I felt a pain in my jaw. It occurred to me that the pain might be cardiac, so I (stupidly) drove to my doctor's office for an EKG. I should have gone to the ER. As he was taking my EKG, I noticed that it was not normal, but I didn't know what it was. He sent me back to the waiting room and, as I was standing there, I felt my heart go into ventricular fibrillation. I recognized it from the many times I had induced it in dogs. It's like a vibration in the center of the chest that spreads throughout the body. As I recognized it, I began to pass out. As I was falling, I thought that I was dying, which I was. I put out my left arm to break the fall and, as I did I "commanded" my heart to beat again. That sounds strange, so I must explain it.

When I was practicing the meditation that Ageha taught me with the light at the center of my chest, I learned how to slow my heart down. It is a simple technique that I have taught to my patients who have panic attacks, but it helps to have had four years of meditation practice. The technique is to focus on the heart rhythm, get in beat with it. Then focus on the interval between beats and prolong it by imagining holding back the next beat. I was able to slow my heart rate down by ten beats per minute using this technique. So, as I was falling, I focused on my heart and imagined a beat. It was a nonverbal visualization of a beat. At the same time, my left arm broke my fall. To be honest, I don't know if it was my mind or the shock of breaking the fall that started my heart beating again, but it started up again. A few seconds later, the doctor came in and told me I was having a heart attack, that he had called an ambulance and they would be right there. In a flash, I was on a stretcher, in the ambulance, on the way to the hospital.

The ER doctors stabilized me quickly and admitted me to an acute care ward. I had some pain in my chest, but one tablet of codeine relieved it and I, surprisingly, felt fine. When the doctor came in he told me that I needed to be catheterized, but their unit wouldn't be open for a few days, I could wait or I could go to Syracuse or Rochester to have it done.

A kind nurse persuaded me to have it done sooner rather than wait. My daughter lives in Rochester, so that's where I chose to go. The next day, I was in an ambulance again, on my way to Rochester. The EMT at my side was very kind and supportive. After a short wait, I was on my way to the catheterization room and a nurse was shaving my pubic hair. I felt the doctor pressing something gainst my right inguinal at the top of my thigh. It didn't hurt at all and I was curiously indifferent through all of this. Indifferent, but curious, as a doctor. Just felt feeling of pressure. Then he shouted triumphantly "We're in!" I felt him manipulating something. Again no pain. Then he began calling out code names for stents which the nurse handed him. More manipulations. No pain. After three calls, the computer screen above my head went on and I watched the catheter wash away the clot and saw that the rest of my coronary arteries were perfectly clean.

I rested in the hospital for two days, then I was discharged to my daughter's house, where I remained for a week, feeling fine and happy to be with my daughter and grand daughters. After a week, my son in law, Leroy, who is an officer with Homeland Security, drove me home.

The first night at home, I felt fine and slept well and was optimistic about being able to continue my life. The next day, I didn't feel so well, nothing specific, more like a mild flu. At night, I noticed my heart was skipping an occasional beat, but Iwas not alarmed. I often had extra beats. That night, I dreamed that a storm blew me out of bed on to the floor. My left arm was trapped beneath me and blown up like a balloon. I could not move. I tried As hard as I could and I was very thirsty. Next thing I knew, Betty was standing in the doorway of my room calling my name "Ron, Ron!" I heard her say. Then "oh Ron you've had a stroke." Then, I realized what had happened. I was still curiously indifferent. I can't explain it but I am grateful for it. I believe that my experience as a meditator helped. Back in an ambulance again headed to the hospital. In the ambulance, I noticed that I was in atrial fibrillation and I must have thrown a thrombus from that.

In atrial fibrillation, the two small chambers at the top of the heart are fibrillating and sending erratic signals to the ventricles, so the heart beats rapidly and erratically. The blood in the atriums stagnates and pools and form clots. It is a treatable condition that I had once before, while working on the Buddhism psychotherapy conference, and I watched as the cardiologist gave orders to administer drugs that would stop the fibrillation and dissolve the clots. Finally, I heard the physician's assistant who was administering the drugs through an IV shout "converted" and I felt my heart beating in normal rhythm. My left side was paralyzed so I was admitted to a physical therapy and rehabilitation ward.

I was taken to physical therapy every day where the physical therapist, a strong, kind man, moved my left leg passively, trying to help my body remember the connection between brain and leg, or form new ones.

Often, the doctor asked me to move the toes on my left foot. I looked down at them and commanded them to move but they sat motionless in silent disobedience. I didn't have the same intimate friendship with my toes that I did with my heart. One night, when I called a nurse for a urinal, I tried again and lo and behold! they wiggled, proving the advice in one of the I Ching readings that "perseverance furthers." In Buddhist ethics, perseverance is a virtue.

Next, the physical therapist had me use my strong right arm and right leg to stand up and to take a few steps holding on to parallel bars, then started to do some squats. I was surprised at my ability to do this. Again, I thanked my father for teaching me to be an athlete. Soon, I was walking down the halls of the ward holding on to railings on the walls. I was ecstatic. The world opened up to me again.

After a few months, the therapist told me that he had taken me as far as he could with his equipment, so I had to go to a special rehab facility. It was difficult to find a place because my stroke made me emotionally labile. I angered and cried easily. Only one facility was willing to put up with me, Elmtree rehab center. I thought a lot about my emotional fragility because I wanted to understand it as well as control it without psychiatric drugs that were offered as control. I examined my anger from the point of view I presented in _Vinegar Into Honey_ and confirmed that it was (is) a reaction to the feeling of helplessness, which is understandable after a paralytic sroke. So I had to work on accepting my disability. I understood my sadness and crying as grieving for the self and the life that I had lost, as if the prestroke me was another person to whom I was attached. I thought, ironically, that I had lost my life, but I wasn't dead yet. So I had to let go of the person that I was and make a life with who I am now.

For a short time, I wondered whether I wanted to live with such a severe disability and considered suicide, but rejected it as cowardly and hurtful to myself and hepeople I love. I learned a valuable lesson from a Lama about this. I was driving him to New York City where he was studying for his Ph.D. at Colombia. He told me hat he had been studying for a Ph.D in India when he was travelling by train to see his mother when the train stopped at a station. It was a hot day, so he got off the train to get a drink. When he returned to his seat, the only copy of his dissertation was gone. So he thought that maybe the person who stole it thought it was valuable and needed it needed it more than he did. It was gone so, in his mind, he gave it away. He told me that the pain doesn't come from losing something. It comes from trying to hold on to what we have lost. So, in his mind, he gave away his dissertation to the thief. We all have to let go of life when we die, so practicing giving it away while we are alive would help us to die peacefully, instead of struggling to hold on to what we must inevitably lose.

I have found that pushing away in our mind what we have lost or will lose helps to let go of it. It also helps to see it as a sign of personal strength to be able to do this. Peace and happiness require personal strength.

After I finished grieving for the me that was gone and, with the help of my caregivers, established a daily routine in which I view every day as a challenging athletic event, I learned to accept my disability, My caregivers established a daily routine for me in which I view difficult tasks, like taking a shower and going to the bathroom as athletic events. When I felt that my life was stabilizing, I started to write again. I wrote a book on all the negative emotions from the point of view of the three poisons, called _Engagements With The World: Emotions And Human Nature_ making a trilogy with my previous two books.

My dear friend Mack Travis, who visited me often and took me out for movies and dinners, generously financed the self publishing of it in 2013. I can't thank him enough. He gave my life new meaning. Then he encouraged me to write these recollections, which has been a mixed experience for me because my life has had so many successes and failures, so many ups and downs, that I am now re-experiencing. Now as I approach 81 in September, I wonder what comes next or what I will make happen next (I'll take it as it comes).

As I struggled with my hemiplegia, the Jewish holidays came and I fasted on Yom Kippur and prayed to the Jewish God of my childhood. I don't think this was a case of an atheist in a fox hole (or was it?). I think of it as returning to my Jewish roots. As the Dalai Lama said "Buddhism does not have to be _instead_ of your native religion. It can be _in addition_ to it." That is how I think about it. The adversity of struggling with my stroke brought me to God again as part of my growth.

THE END

Richford, New York,  
September 29 2013.

# Books by Ron Leifer

The following books by Dr. Leifer, MD, are available in paperback and ebook edition.

## Vinegar into Honey: Seven Steps to Understanding and Transforming Anger, Aggression, and Violence

  *  Published by Snow Lion/Shambhala, 2008

  * Pages: 144

Our desires and our fears are woven into a tangled web of conflicts. We want both to eat dessert and to be thin. We want money but don't want to work. Anything that threatens our sense of self and its striving for happiness is perceived as a threat to our very lives--the response to which is defensiveness, anger, aggression, and violence. _Vinegar into Honey_ proposes a new paradigm for understanding the relationship between stress, anxiety, anger, and depression. Leifer provides detailed instructions for working with anger and other painful emotions. The process of transforming suffering into equanimity and compassion is central in Buddhist psychology and practice. Each of the steps in Vinegar into Honey reflects views and methods drawn from Buddhist tradition. Leifer's work holds promise for psychotherapists and their patients individuals seeking to understand and work with their anger and people interested in the interface of Buddhism and psychotherapy.

## Engagements With The World: Emotions And Human Nature

  *  Published by Xlibris, 2013

  * Pages: 156

After fifty years of futile research on mind and behavior, trying to find their causes in the brain, without success, psychiatrists and psychologists are turning their attention to the emotions, also looking for their causes in the brain, also without success. The problem is that there is no generally accepted theory or paradigm for understanding the emotions.

William James suggested that such a paradigm must meet two criteria: (1) it must explain each individual emotion (i.e., anxiety, anger, depression, etc.), and (2) it must relate all the emotions to each other. This book presents such a paradigm. It is based on the accepted biological principle that all organisms from the lowest to the highest function in two biological motives, which I call bipolar reactivity.

All organisms seek pleasure and/or that which sustains and promotes life, and all organisms seek to avoid pain and/or that which threatens or disables life. Interestingly, this biological principle corresponds to a basic principle of Buddhist psychology that the pain we cause to ourselves and to each other is caused by the Three Poisons: desire, aversion, and ego. Desire and aversion link humans to the great chain of being, and ego distinguishes humans from all other beings and recognizes our unique capacity for symbolic reactivity. I have used this paradigm for fi fty years in my practice of psychotherapy and have found it very useful for understanding my patients' mental and emotional pain and helping them to understand and heal themselves.
