47. Thank U, India
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My first wife and I ended up in India due to many complex factors, but some major ones
stand out. First, as mentioned, I had crossed the Arising and Passing Away again on my August 1994, nine-day retreat at IMS, and somehow it strongly sparked my interest in doing something more directly helpful to people than the electrical engineering program was likely to lead to, so I began seriously thinking about medical school again for the first time since I took my MCATs after my sophomore year in college. Second, on the last day of the retreat at IMS, Christopher mentioned that we were all welcome to join him for his yearly ten-plus-ten-plus-seven-day retreat in Bodh Gaya, India, that coming January.
Then, I met with a member of the UNC-Chapel Hill Medical School Admissions Committee, who looked at my rambling path and said, “You know what would really pull this application together? Go immunize Tibetan yak farmers, relocate Rwandan refugees, or something like that.” So I began writing letters. It turns out that finding volunteer positions overseas is not something I am very good at. I wrote many letters to many organizations offering to help, and the only response I got back from all those letters was a single small, hand-written note from a nun at Mother Teresa’s Missionaries of Charity (that I still have) which said simply that they couldn’t give me anything—food, lodging, or money—but that if I wanted to come help, there was a need. Based on that small piece of paper and the promise of a longer meditation retreat where the Buddha himself got enlightened, off to India we went.
My year in India changed me more than most other years of my adult life. In retrospect, I am extremely grateful for that year, but at the time I was so in it that I didn’t appreciate it as much as I do now. Though service work was not new to me in the context of church, Boy Scouts, hospital volunteering, and so on, going from Raleigh, North Carolina to New Delhi, India—whose beggars and commission agents hit you like a screaming wall of technicolor insanity when you walk out the door of the airport—was a total sensory assault. Things only grew more so as the year went on.
What I found most striking about India is that everything is right out in the street in its full range of wonderful to horrible in a way that is very different from the United States. Birth, sickness, old age, and death are all right there. I watched bodies burn on the river Ganges in Varanasi. I saw drugged babies rented to beggars to increase their daily take. I was robbed, molested, harassed, and generally taught remarkable lessons in impermanence, boundaries, and the human condition by the good citizens of India as they understandably tried to survive and be okay in that chaotic yet wondrous place.
If you have grown up in a place like India, this doesn’t surprise you. But, coming as I was from suburban USA, it was beyond eye-opening and into the realm of brain restructuring. Similarly, when I came back from India, it was like the symphony suddenly stopped, the doors closed, and everyone was in a building or a car, and most of what I saw when traveling around were just structures and machines rather than fragile, resilient humanity in all its glory and misery. This was similarly shocking, as I had gotten used to seeing everywhere what life’s rich pageant had to show.
Beyond just seeing it, I found that India is interactive in a way that the United States is not. People everywhere wanted to talk, to sell things, to ask for gifts, to take me to their shop, hotel, or home, to steal what I had, and to teach me things. Many of them, had you asked them, would never have said they wanted to teach me things, but that was what I finally realized they were doing, though I often didn’t appreciate this at the time.
It is no accident that the first noble truth taught by the Buddha is: there is dukkha, and that this teaching was first given in India, where suffering, just one aspect of the word “dukkha”, is everywhere and glaringly obvious. I should add that I spent most of my time trying to help people in some of the poorest parts of Calcutta and in some extremely poor villages outside Bodh Gaya, which are some of the poorest and most corrupt parts of India, so my perception is a bit skewed. What sick and twisted trick of my Dark Night had dragged me to these places at the bottom of the barrel of the human condition I have no idea, but I now feel that something odd was doing its spiritual work, though I didn’t think of it that way at the time.
The deformed beggars, the starving children, the flies and mosquitos, the coal smoke–filled air, the heroin addicts, the lepers, the people with visibly horrible diseases, and the staggering corruption: all that I got to know almost immediately, but it was mostly visual, auditory, and olfactory, even though it also had a deep emotional impact. However, when I began to get some of those diseases myself, lose weight, and become an intimate part of the dance as India began to do its remarkable work on me, that was when some of the deeper truths of dukkha really hit me, rather than just on the cushion investigating the three characteristics.
I got giardia and amoebiasis, as well as various other forms of bacterial dysentery, more times than I can count, but at least twenty. I lived on something called Tiz DF (tinidazole plus diloxanide furoate) and sometimes ciprofloxacin. When I got hookworms, I took a veterinary de-wormer called Kit-Kat, not to be confused with the Nestlé candy bar. We got dengue, which we actually got in Cambodia in an attempt to do service there that didn’t work out. It hit us on the plane to Bangkok on our way back to India, and I simply lay nearly prostrate for a week with fevers to 104°F in a cheap, un-air-conditioned hotel in Bangkok, feeling like I was going to die or tear off my aching head. I was so weak I was barely able to stand for about five days, crawling slowly down the stairs to get a bit of Pad Thai and drink some water before slowly crawling up the stairs back to my room to lay semi-delirious and pouring sweat in the un-air-conditioned summer heat of Bangkok, wishing my splitting headache would finally end.
I got hepatitis (likely E, as I was vaccinated against A and B, and later tested negative for C) while in Bodh Gaya, and got my second case of hookworms while I had that, but, given that I had no idea what Kit-Kat would do to my liver, I left them untreated, tolerating their total creepiness until finally I wasn’t yellow and I could walk without terrible pain in my bloated liver. I also passed a five-millimeter kidney stone while I had the hepatitis and the hookworms, and at that point, now about 135 pounds at six feet tall, dark yellow, all I could think while I lay there in broken misery was, “If one of those mosquitos humming around the outside of my mosquito net gives me malaria, I am truly a dead man.”
After about eight months of almost continuous, mostly gastrointestinal illnesses, strangely my body suddenly seemed to come to terms with the Indian flora and the illnesses stopped. My weight didn’t come back until I finally got home, but at least there seemed to have been some sort of truce. I was still drinking the local water, still eating the cheapest street food, still crossing large rivers full of sewage barefoot to get to the villages that I was trying to help, still getting bitten by a lot of mosquitos, but somehow it was like my immune system had figured out what it needed to do and I was finally sort of okay. But by that time, I was moderately traumatized and Dark Nighting so hard that I hardly seemed to notice or care, as the illnesses just seemed to be one more element of a great wave of total misery that was breaking me down.
Backtracking to the early part of my time in India, when I made it to Calcutta after a month in India and started to work at Kalighat, Mother Teresa’s Home for the Dying Destitute, I think I was in shock, but not the sort of shock that was immediately obvious. I don’t think that people looking at me could tell I was in shock, nor did I myself recognize that I was in shock at the time—that dawning realization about what my experiences in India had done to me would surface much later.
At the time I was energetic, engaged, interested in trying to make a difference, getting up early, walking to Kalighat, the Kali temple for which Calcutta is named, with its women lined up and down the street with goats for sacrifice, going in to the Home for the Dying Destitute, helping the men who lay there. They had tuberculosis, cancer, large sores, missing limbs, blind eyes, and other serious health problems. One of them strangely was a Danish tourist who had gotten hooked on cheap heroin, spent all his money on it, ended up homeless living on the streets where he shot up with dirty needles, and finally got such large, infected sores in his arms that significant portions of flesh were simply gone and you could see large swaths of arm bones through the gaping holes. He was an oddly smart, educated, articulate, and personable fellow, dying there in that home of charity in India. Like I did with the others, I helped him change his bandages and take his medications, brought him food, helped to keep him clean, as his arms barely worked anymore, and did my best to try to ease his suffering in what limited ways I could.
I think that the initial shock partly insulated me from what was going on in the radically altered circumstances I now found myself in, allowing me a moderate degree of functionality. We were living on cheap street food, eating in the cheapest restaurants, cooking what cheap food we could buy in the local markets and cook on a little kerosene stove on the roof of Hotel Modern Lodge, an un-air-conditioned but relatively secure hotel in the skanky end of the tourist district in Calcutta. We did our laundry in a bucket, showered with cold water (which was okay, as it was already hot by February, and just got hotter as the months went on), and purified our water with a hand-pumped camping filter and betadine (which would eventually trash my thyroid gland). When the monsoon came, the streets flooded two to three feet deep in sewage for a few blocks, and we had to walk carefully to avoid falling into the manholes that were opened in such circumstances to help the streets drain. I give thanks to the other volunteers we met there for their camaraderie, support, and exemplary dedication to helping people.
After a few weeks at Mother Teresa’s, I switched to a street clinic called Calcutta Rescue about forty-five minutes north of the hotel by bus, where I mostly worked in the pharmacy and the vitamin A project, but did a few other office and logistical tasks as well. The clinic saw about 200–500 patients per day and more patients down the road by the river at an affiliated clinic for those with leprosy. We got there early, stayed late until everyone had been seen, then would take the buses home through the maddening Indian traffic to the hotel, cook food, try to sleep in the sweltering heat, get up, and do it again. The patients were generally extremely poor, many with tuberculosis, many with other serious health issues already mentioned, many with parasites, some starving, and we would try to give them what food and medications—as well as wound care and other helpful things we could—depending on what we had available at the time.
I remember a mother who had a few children with her, one of whom was a little girl who appeared extremely tired, sick, and emaciated. The child was probably two years old, but functionally she seemed like a very sick one-year-old. Through a translator, I asked the mother what was wrong with the girl. With apparent calm dispassion that likely masked terrific agony, the mother explained that she was starving her daughter to death, something the mother had done with previous daughters, as she was very poor, had no money for the girl’s dowry, and needed to be able to feed her sons. That is one of many similar encounters I would have at that clinic, if that gives you a sense of the place. While there was something about the fact that we were all there to help that did make the misery more bearable, still, those sorts of situations can strike very deeply, sometimes deeper than we may realize at the time.
I remember the heroin addicts who lived in the alley just outside the hotel door. There were typically five or ten of them—long-haired, naked, skinny as rails, covered in dirt and ash, and covered in sores from infections by dirty needles. I recall some lying there high as kites, others clearly in withdrawal, shaking and vomiting, others shooting each other up with little brownish vials of cheap heroin. What I noticed is that nearly everyone else in India seemed to want to interact with tourists except the heroin addicts. They didn’t look at us, didn’t seem to see us at all, didn’t ever say anything to us, as though they were existing in some parallel ghost realm that was only loosely connected to this one. I can’t help but think of them two decades later whenever I hear the phrase “hungry ghost realm”.
I remember coming home from the street clinic one day and there was one of them lying on the ground with his arm deep into the open sewer that ran along the alley, slowly crawling along, arm about two feet into the sewage, apparently looking for something. I was curious and, as the heroin addicts never interacted with us at all, I stopped to watch what he was doing. He ignored me and my curiosity entirely.
For about five minutes he felt along the bottom of the sewer, carefully, patiently, inching his naked body along the ground, and finally he stopped, a small smile crossed his face, and he pulled out a syringe from the bottom of that Calcutta sewage. He licked the bare needle, broke off the top of a small vial he had concealed in his other hand, drew up, shot up right there, and lay back in a daze on the street, dirty needle still hanging from his arm. It struck me that, when you are shooting up with a needle from the bottom of a Calcutta sewer, you have likely fallen much lower than you ever thought you could fall. I wondered at that point who he had been before, what his parents felt about him, what any children he had might have felt about him, and how much longer he could possibly live.
That snapshot of his suffering would be driven even more deeply home some months later. I was again coming home from the clinic and saw the same man, sitting on the street cross-legged and crying, tears streaming down his face. In his hand was a single white index card that was perfectly clean. He had managed to gather seven extremely small pieces of colored chalk in a little pile on the ground to his side, and had drawn a rainbow on the index card. He was staring at the rainbow and crying his eyes out.
I realized there was likely nothing at all I could do for this man, but something in his weeping humanized him for me such that months of being in shock could no longer be kept at bay. It felt like that man had torn my heart out, as if suddenly the pain I had somehow managed to numb partially, so that I could do the work and live as I was living, came crashing in with the full force of a tsunami. The hairs on my arms still rise now over twenty years later when I think of him. I am deeply grateful to that naked, dying, addicted artist, though I would greatly prefer that he hadn’t been dying in misery on the streets of Calcutta, and that I hadn’t needed something like that to shock me into realizing what was going on.
It is said that the Buddha left his pleasure- and distraction-filled life in the palace for the first time at age twenty-nine with his charioteer Channa, saw four people—an aging man, a sick man, a dead man, and an ascetic trying to find the end of suffering—and rapidly came to deep conclusions about the nature of suffering right then. I was obviously dense as a post in comparison. I had also come from a sheltered palace, suburban North Carolina, and it took some six months in India, seeing tens of thousands of people suffering in horrendous ways, until finally something in that moment with the weeping addict slapped me into reluctant appreciation for the depths and realities of human suffering. Shortly thereafter I felt a deep need to go on retreat, so off to Malaysia we went.
While this may sound like a horribly clichéd thing to say, I am truly, consciously, and actively grateful every single day that I am lucky enough to live in a remarkable place, have good food to eat, have good medications, and amazing resources to help patients. I am very grateful that I have my health and that I didn’t end up dying some horrible death in India. Lack of gratitude is endemic where I live, which is ironic, as it is the richest country on Earth.
It is also worth mentioning that I didn’t go to India with the intention of purifying my karma or anything like that. I went to help people, for meditation, for adventure, to try to resolve my spiritual crisis, and to learn something about myself and the world, but I don’t remember ever thinking while I was there, “Wow, I hope all this hard work, suffering, and accumulated good karma from serving the destitute gets me a good rebirth or gets me to stream entry fast!”
In retrospect, I do believe—in some way that a strict scientific materialist might think was some mix of crazy and/or irrational—that somehow doing all that work there did help to purify something karmic and help my meditation practice probably much more than I will ever know. That was never my goal, intent, or even thought at the time, as I just didn’t know any better.
Beyond the karmic opportunities, which you will find anywhere there are people, India had many other remarkable qualities. Out of that muck and insanity come extraordinary things. It is not just ancient India, the India that brought us the Vedas, the Upanishads, and the Buddhadharma, but also modern India. There are deep aspects of spirituality and beauty to be found there. I met true living saints there who were humbly and inconspicuously serving some of the most impoverished people in the world. I met numerous people with deep spiritual realizations, many of whom were seemingly ordinary folk doing very ordinary things. I met people who were amazingly happy, bright, and cheerful despite circumstances that would bring many to unmitigated despair.
I remember the many street children I got to interact with, and the children out in the very poor villages where we tried to help. Those with the physical and mental ability to do so played, laughed, joked, danced, skipped, and seemed to enjoy themselves despite being among the most underprivileged people in the world and dealing with circumstances that modern civilization, if it actually is that, should have eliminated long ago. I often find myself thinking back to those kids and the profound lessons their sunny attitudes and just being themselves taught me, and that however bad I may think I have it, it could be a hell of a lot worse. For most people and creatures on this planet, it is. That recognition naturally prompts gratitude, and that helps immensely when I am faced with the comparatively milder challenges of my daily life. As the Alanis Morissette song says so well, “Thank U, India!”
Another practical point here is that, should you find yourself in your meditation practice or just your life feeling sorry for yourself or becoming overwhelmed by your issues and life, particularly if your circumstances are, in relative terms and compared to the rest of the world, good to great, then think about stepping outside your comfort zone and going to try to help someone less fortunate than yourself. The very least you will learn is that you could have it much worse. Far beyond that, you will likely make friends, help people, and spread the spirit of doing good in the world, and you will likely be cured of self-pity forever or for a long time.
Even beyond that, as you probably already know, you will likely learn very important lessons from the people you find in the ditches, deserts, and dungeons of this world, as many who live there have had to learn profound spiritual lessons to survive, lessons you might not yet know, or at least such has been my experience. Thus, should you go to help people, expect them to be the ones helping, growing, and blessing you, though not in the ways you likely expected. Just as many of the best addiction counselors are themselves recovering addicts, and many of the best psychiatrists have their own experiences with crazy, just so, many people who are living at the proverbial bottom of the barrel of the world have had to grow spiritually in surprising ways to cope with that.
Further, many of the other people you find alongside you helping to ease the world’s suffering may be living saints in disguise, and there is much to be said for hanging out with living saints. Getting out of our palaces and bubble bath zones, assuming we are lucky or unlucky enough to be living in them, and getting our hands dirty helps broaden our horizons, expand our awareness, and make this a process about something much bigger than ourselves. Even if you are just a complete spiritual materialist or narcissist concerned only with your own spiritual growth, development, and attainments, there is much there for you in the world of serving others, which, word has it, is the point of all these traditions. Paraphrasing the Fourteenth Dalai Lama: If you are going to be selfish, be wisely selfish, and do what is truly in your own best interest, which in this case means trying to help others.
In that same vein, as it were, I believe that the experiences I had while trying to help people but often failing to make what seemed like any significant difference, getting sick, and realizing that I had it pretty darn good helped me to get over myself just a teensy bit. Thus, when I was finally able to go back on retreat in Bodh Gaya, retreat seemed like such a refuge, such a blessing, so precious, so clean, so sane, so safe, so stable, so beautiful, so quiet, and such a fortunate set of circumstances that I could make much better use of that time because the contrast with Calcutta and the outside world helped me to truly cherish the incredible opportunity I had.
Death by disease, auto accident, or other bizarre circumstances no longer seemed to be just moments away, as it had so often seemed on the outside. Here, on the retreats, were order, true “civilization”, clarity, peace, and an opportunity finally to go deep to see how to deal personally and directly with suffering, undistracted by the colorful madhouse that was the streets of India. I could let my guard down and plunge deep into the waters of techniques and teachings that also originated in the wonderful, profound aspects of India. Thus, what might conventionally be thought of as the good and the bad of India were both of supreme value, finally, and that is one of the lessons that slowly sank in during that year or so, and in the years that followed.
