Holt Uncensored

Holt Uncensored


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by Pat Holt

Tuesday, December 5, 2000


    A Very Different Doctor
    'My Grandfather's Blessings'
    The Wisdom of Autograph Lines
    9,000 Letters
    A Safe Place



It's too foggy to see the view from Rachel Remen's cottage in Marin County, California, but as we climb the misty steps to this real-life Brigadoon, it's clear that all will be revealed soon.

At the top of the steps awaits Putnam, a hefty, formerly feral cat whom Remen rescued years ago. Lazing cheshirelike under a bird feeder, he calmly observes finches, hummingbirds, blue jays and an occasional blackcapped chicadee flutter overhead.

Putnam is not an aggressive cat (unlike his namesake, I want to joke), even when an army of quail marches up the railing near us like tasseled soldiers reporting for duty.

"They wait for the other birds to knock enough seed out of the tray so they can eat whatever hits the ground," Remen says. Is Putnam a little too interested in birds who get that close? we ask.

"You know, I've never had a cat who ate birds," she tells us, then smiles shyly. "I've always hoped it had something to do with the work I do."

A Very Different Doctor

What a wonderful way to put it. Remen is that very rare phenomenon, a medical doctor who "teaches" (she would say "shares") spirituality to other doctors, who counsels cancer patients at the institute she founded (Commonweal Cancer Help Program in Bolinas, California) and who's battled chronic illness -in her case, Crohn's Disease, which was supposed to kill her about 30 years ago - since the age of 13.

Even more rare, she is a bestselling author who didn't start writing until her mid-50s, and even then "didn't know what I was doing," she admits today. Nevertheless, her first book, "Kitchen Table Wisdom," sold extremely well in hardcover and became a bestseller in paperback, almost entirely because of word of mouth and independent bookseller support.

Remen prepares tea as she talks about her mother, a public health nurse who treated inner-city patients in New York, often taking her young daughter with her. The two ended many visits having tea and whatever food was available at the patient's kitchen table.

"My mother would say, 'Always accept food. Don't mind if the cup is dirty or cracked. You just want to receive of people so they know they have something to give.'

"So I would sit there as a little girl at tables made of tin because my mother told me never to talk to anyone standing up. If THEY'RE standing up, it would be okay - but you sit down."

Her mother had an ulterior purpose in bringing Rachel along. "Sometimes she had to hang quarantine signs in the slums of New York City, where loss of work time could put the family in jeopardy. Men who had to be confined got angry and shouted at her, but she would turn to them and say, "Please! You're frightening my little girl."

The awkward smile on Remen's face reveals just how scared that little girl was at the time - yet how safe she felt around those kitchen tables and how completely she absorbed her mother's compassion and respect for the people being served.

"My mother would say, 'You're a guest in their house. They have invited you into their life because they are in pain. That doesn't mean you own their life, or that you can give directives or orders or anything like that. When you accept a cup of tea, everyone gets a different view of the doctor/nurse-patient relationship."

'My Grandfather's Blessings'

Remen's mother ended up receiving a lot more wisdom from her patients then she dispensed (thus the title of the first book), as did many of the doctors and nurses in a family devoted to science.

The one great exception was Remen's grandfather, a rabbi whose interest in mysticism and the teachings of the Old Testament made him something of an anamoly in this "modern" group of academics and researchers who loved but tolerated him at the same time.

Her grandfather's love of stories and his understanding of the deeper forces within human nature that science often couldn't identify were pushed to the back of Remen's mind as she, "desperate to be successful and make a contribution to society," went through medical school (which she now describes as a "toxic environment") and eventually became an eminent pediatrician in her own right.

There was never any doubt in Remen's mind that her intention was to "serve life" as a doctor. The only question, as we learn in her next book, "My Grandfather's Blessings," was how to do it.

"As a young doctor," she writes, "I thought that serving life was a thing of drama and action and split-second judgment calls. A question of going sleepless and riding in ambulances and outwitting the angel of death. A role open only to those who have prepared themselves for years.

"Service was larger than ordinary life, and those who served were larger than life also. But I know now that this is only the least part of the nature of service. That service is small and quiet and everywhere. That far more often we serve by who we are and not what we know. And everyone serves whether they know it or not."

I think of this while looking past Remen to the bird feeder outside as the fog seems to open up all around us. Shafts of sun cut through the thick dark fog clouds to highlight the bay below us and the mountain towering behind her.

This house was the first property she ever bought, she says - it used to be a broken down little cabin that she has gradually, during well over a decade, repaired and upgraded so that now its A-frame is glorious to behold.

Inside, its bookcase-lined walls, hidden skylights and comfy furniture seem even further softened by a luxuriously thick white carpet. The sense of inner stillness, of calm and love of nature make this a sacred place, as heavenly as the cloudy pillows outside nudging the windows and Putnam acting like a little lamb as birds dance around him.

The Wisdom of Autograph Lines

Thanks to that intersection of science and mysticism, Remen grew up listening to people in every setting - especially, these days, as she, "the most painfully shy person in the world," finds herself touring the country to make public appearances for her books.

"I'm always grateful to independent bookstores," she says over molasses cookies at her own kitchen table, "for brining me to places I've never dreamed of. Now you take Albuquerque, New Mexico, where I went to visit Changing Hands bookstore.

"At Albuquerque, you get off the plane thinking it isn't possible that anyone could know you for 2000 miles. But the people who run independent bookstores see the selling of books as a service, so I feel very close to them.

"At Changing Hands a few hundred people showed up, and in the autograph line, a woman asked me to inscribe the book to her. 'My name is Gretchen,' she said, and when it was clear I couldn't place her accent, she added, 'I'm German.'

"I had just handed the book to her and she, in the midst of taking it from me, wanted me t understand something I didn't quite get, so she said again, 'I'm GERMAN.'

"I looked at her and realized she was about 10 years older than I, which put her about the right age for being a member of Hitler Youth when she was young. Even now as I'm talking it was an electric moment. Because as the two of us continued to hold the book, she said, 'Thank you for writing this book. It has healed me.'

"You know, when you do autographings in bookstores like these, there is always one person with a story - sometimes more than one. I'll tell you, I would WALK to Changing Hands in Albuquerque to hear that story."

9000 Letters

In fact many more have come to Remen in the form of some 9000 letters as readers' stories pour in. One man in Texas wrote that he could not find the words to tell his dying father how much he loved him. The hospital social worker gave him a copy of "Kitchen Table Wisdom" in which he read of two men climbing a mountain who spoke in practical terms about advancing up the face of each cliff but could not reveal the depth of emotion they felt about their interdependency.

"The man in Texas said he read that story to his father, who commented on it, and they had such a long conversation about it that they went on to the next story, and the next and the next until they read the book twice. In his letter, he told me that his father had died six weeks before, and he was writing because he wanted to thank me for 'giving us the words.' Imagine. It seems so simple, but some things take a lifetime."

Remen's tall, slender body bends so gracefully forward to drink her tea that with her shock of white hair and wide, searching earth-brown eyes, she reminds one of a birch tree bending with the wind, seemingly delicate yet so tensile and resilient it may endure forever.

A Safe Place

Certainly what she has started among doctors and medical students - meetings and courses where everyone "rewrites the Hippocratic Oath, redefines healing as an art, and discovers that they themselves have the wisdom, and life experience, and intuition they can trust" - will endure beyond her own lifetime.

One hopes that one day she'll write about that, too. Imagine asking doctors to hold hands and meditate, to draw pictures on big sheets of paper "using brand new little boxes of crayons that smell just like kindergarten."

Asking them to "draw that part of yourself," says Remen, "that you aren't able to give enough attention to," the doctors join with medical students, nurses, professors, hospital chaplains and others to express "the qualities they see as slipping. The words they come up with are love, kindness, nonjudgmentalism, tenderness, compassion and more."

She also instructs them to "write three lines asking for help in bringing your vision of medical care closer to everyday life. And the words to begin this are: 'Help me, give me, show me, love me, enable me to, may I' - this is the language of help.

"The idea is to write these things so that medicine isn't something that tells you what to say, what to wear, how to live, when to sleep, what to read. It becomes our own medicine. When they stand up and read these things to each other, you can't tell who's a doctor, a first-year medical student, a rabbi, administrator or nurse.

"At the end, we hope simply to create what might be called a space of harmlessness, the basic quality of the Hippocratic Oath. We don't want harm inside the profession either. We don't want to judge each other or engage in criticism or competition.

"When they create this place of harmlessness, people can see their normal shape and size. What emerges they sometimes call 'magical' after we're done, but what it is, I think, is a safe place."

By the time we leave, all the seed that has fallen from the bird feeder onto the deck is gone and sun streams through the trees to illuminate a bright blue bay below. Rachel picks up Putnam and points out the giant mountain, Tamalpais, now clearly visible and seeming to blaze red against a turquoise sky.

For some reason I remember what the mother of her last patient said many years ago (as recounted in "My Grandfather's Blessings") when Rachel decided to leave a comfortable practice and "follow a dream of a different sort of medicine."

Tears filled Remen's eyes as she made her doubts about "throwing away my career as a pediatrician" clear to Delia, the single mother who had been on welfare and accused of child abuse (without cause, Rachel discovered) when they first met.

"Very gently Delia reached across and laid her hand on mine. She reminded me of the terrible night on which we had met. How no one had heard her, no one had believed her. Her baby had almost been taken away.

" 'This hospital is sick,' she told me, 'can't see, can't hear, ain't got no heart, no soul. They all that way. Maybe you doan' see lotsa little baby patients anymore, but you is still a doctor. Only you just got one big patient now."



Dear Holt Uncensored:

Regarding your inspiring description of the Monterey festival and the panel with Jane Smiley, Jeremy Tarcher and David Loye. Sounds like level heads and honest minds prevailed. Must say I agree with all of them. Having been there and done that - there is not one solution to publishing - but thank goodness there are more options than there were five years ago. 

My only quibble - when you look at what POD or E publisher to use - it matters little what other titles they stock (as to David Loye's comment) because very few people happen upon self-published titles or search through websites on a whim looking for one to buy.

Authors who go this route have to get out there and hand-sell their titles by using viral marketing and give readers the specific link to their own book on the sites where it is for sale.

This is key. If you say - my book is for sale at AB.com bookstore - your reader will get lost in the virtual stacks, so to speak. I learned this the hard way. You have to link to and give the reader the exact url for your book's own "For Sale" page - whether that page is at the JustBooks website, Booklocker's website or Amazon's. 

I should also say that I know Angela, owner of Booklocker - who Loye sort of recommends - in fact she's my co-author on a new book coming out in January called "How To Publish and Promote Online." Cheesy titles or not - Angela is outselling every other E and POD publisher online. She's up to over $15,000 a month in sales and growing every month. What's more she is as honest as they come. And at least a dozen authors who she's helped published have gone on in one way or another to bigger and better careers by virtue of having put their books for sale at Booklocker.

Sounds like an ad for her - I'm sorry - I've just been very impressed with how she's built and now runs her business.

M.J. Rose

Dear Holt Uncensored:

I share your concern about the appalling ignorance of the First Amendment to the US Constitution that seems to exist in this country. However, I suspect the confusion is deeper that you might think. In the USA, people learn to take short cuts in all things including serious matters like individual rights. We speak of "freedom of speech" and "freedom of religion" without any qualification. That leads people to believe that such freedoms are unlimited. It is important to get the First Amendment (and the rest of the Constitution) clearly fixed in mind before trying to draw any conclusions about its meaning.

The First Amendment states: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances." Of course, the US Supreme Court has now interpreted the Fourteenth Amendment to impose the first ten amendments on the several States as well so we can say that all legislative bodies in the USA are also prohibited from making such laws as listed in the First Amendment.

Please forgive the digression but I can't make my point without it.  When a polling group asks questions like you quote in Holt Uncensored #201, they are not really asking about support or knowledge of the First Amendment. We do not have freedom to publicly say anything we like anywhere we like without subjecting ourselves to consequences. Legislative bodies shall not make laws that prohibit speech, as such, but they may pass laws regulating the time, place and manner of certain speech in the interest of public safety. Government schools may not endorse a particular religion by practicing or allowing others to practice that religion at any official activity of the school. The alternative of allowing all religions and those who actively reject all religions to practice equally at official school functions is simply impossible and so would rule out anything related to the practice of religion at school especially including the Christian and Jewish form of prayer usually practice in the USA. Of course nothing prevents people from forming their own school to teach whatever religion they wish, so long as they are not teaching people to kill, maim, etc in the name of religion which then results in those people doing those things or trying to do them.

My point here is that if you wish to test people on their understanding of the First Amendment, you should really understand it yourself and your questions should reflect that understanding. The practical problems that arise from the simple statement of the First Amendment have occupied courts throughout the country for two hundred years and still new issues arise. Congress may not make a law forbidding me to use very insulting racial or religious language, but if I use such language to start a fight, I might be in trouble anyway. Congress can make a law forbidding me to use that language and any other language to start a riot or induce a mob to seriously breach the peace, start a fire, beat someone, or the like.

I do accept your premise that far too many people neither understand nor support the First Amendment. However, a poll with questions like you quote does nothing to help or measure those problems. We should certainly teach the First Amendment, and indeed all the US Constitution, in the public schools, I have my doubts that it can be done well enough to produce the understanding we need. Who would teach it? With all the problems of understanding evidenced by the court cases arising each year, how could you get agreement through state boards of education of just what views to adopt? The way to teach such complex issues it to engage the students in discussions about the issues raised for them by the language and role playing of decided court cases which takes a lot of time to do right and very well trained and interested teachers.

So here is another one of those fundamental matters that will not be included because too many people do not understand it now and cannot agree with others what to include. What do we do with those things we don't understand? Why, we ignore them and go on to something else.

Do keep this series going. I find much of interest in what you and your readers write.

Gerald T. Richards
Antioch, California

Dear Holt Uncensored:

Ok Holt, you opened up a can of worms, so here goes.

1. Freedom of speech is not an absolute, for example you can't cry Fire in a crowded room. You also cannot wrongly says things about a person.

2. Find for me in the Constitution the words "separation of church and state." Don't bother looking, it isn't there but it's on everyone's tongue.

3. St. Paul said, "All things are possible but not all things are profitable." Good advice. We can do (or say) many things, but there are some we should not do (or say). Many of the things that are said or done are out of anger rather than any need of freedom to say or do something.

4. Ten Commandments as rule to live by? Well unless we think that stealing, lying and adultery are good things, it's not a bad place to start. Oh, wait a moment, we do want to do those things if it serves us so you're right blow that off and any other rule which we can't twist, argue, or ignore as we please until we get OUR way.

5. What do the polls you site mean? The majority should be listened to? Or should the minority continue to beat away at the majority until their way (the Enlightened and Anointed minority) win?

Arden Olson

Holt responds: The concern expressed by these and other readers reminds me that I didn't give out the Freedom Forum's website (www.freedomforum.com ) or the number (800 830 3733) to consult for copies of the report of this survey, "State of the First Amendment 2000." And please pardon my shortcuts: I do think there are fundamentals on which we all agree about the First Amendment, and these were the basis of the questions asked by the survey.


Holt Uncensored provides this forum for the free and uncensored exchange of thoughts and ideas from writers of all callings. The opinions expressed here are not necessarily those of Pat Holt or the Northern California Independent Booksellers Association.

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