Into the Magic Shop Read online

  I sat down on the edge of my bed. Had the magic worked just like it had the first time when the rent money came through at the last second? I sat on the edge of my bed, holding the phone.

  “Jim, are you there? Did you hear me?”

  “I heard you,” I answered. “Thanks for calling.”

  “Well, how would you like me to proceed?” he asked, no doubt surprised that I wasn’t jumping up and down like a man who had just won the lottery. I did not know how much the stock in the trust would be worth, but I knew I would have been a millionaire again. All I needed to do was nothing.

  “I’ll call you back,” I said, and hung up the phone.

  One of humanity’s most enduring myths is that wealth will bring happiness and money is the solution to any problem. I had lost my money, and that was a problem. Now I potentially had a good chunk of it back, and that was also a problem. I had given my word to these charities. My father had been full of empty promises, and I had vowed to myself that I would never be a man who didn’t keep his word.

  I knew people would understand. No one would expect me to willingly give away every bit of my remaining wealth in my present situation. No one would fault me. In fact, the head of the giving offices at two of the largest charities told me people renege on significant donations all the time, even after signing documents. That’s an accepted reality. People’s situations change. My situation had changed. I was no longer in a position where I could just give away millions of dollars.

  Or was I?

  I closed my eyes and imagined my heart opening. I sent love and forgiveness to myself for all the mistakes I had made. I sent love out to my parents and gratitude for them doing the best they could. I sent love to Ruth, wherever she was, because she was the kindest person I had ever known. And I sent love out to every child who was struggling with poverty, or who had parents who were addicted, or who were alone and somehow thought it was their fault. I sent love to every person who had ever questioned their own value or worth, and to every single person who thought money defined them. I closed my eyes and opened my heart. I felt something I had only ever felt once before in my life—a feeling of being enveloped by warmth and love . . . a sense of deep inner peace and an absolute certainty that everything was going to be OK—only this time I wasn’t going down a river toward a white light while bleeding out on an operating table.

  I opened my eyes and picked up the phone to call the attorney back. “I’m going to sign the trust paperwork and donate everything as planned.”

  He said, “You’re kidding, right?”

  “No, I’m not kidding. Do it.”

  As I was hanging up the phone I heard him say, “Holy shit.” And then there was just silence. I didn’t have millions of dollars, but I was still a neurosurgeon. I wasn’t going to starve. I was still going to be wealthy by any normal standards, but I wasn’t going to have a fortune. It was time to start over and truly become a person of worth and value that had nothing to do with any dollar amount. This was what Ruth had wanted to teach a young boy, but some lessons can’t be taught and have to be learned by experience to be learned at all.

  I didn’t know that, in 2007, when Accuray went public, it would be valued at $1.3 billion and my charitable trust would be worth $30 million. Even if I had known, I wouldn’t have changed my decision. In that moment I felt free, free to follow the compass of my heart, and that was priceless. The monkey that had been holding so tightly to my back and had driven me with the false belief that money would make me happy, that money would give me control, suddenly let me go. I learned that there’s only one way for wealth to bring happiness—and that’s by giving it away. I was free.

  The brain has its mysteries, but the heart holds secrets that I was determined to uncover. My quest that began in the magic shop had taken me on a journey inward, but my journey wasn’t over. I knew I had to travel outward. The mind wants to divide and keep us separate. It will teach us to compare ourselves, to differentiate ourselves, to get what’s ours because there is only so much to go around. The heart, however, wants to connect us and wants to share. It wants to show us that there are no differences and that ultimately we are all the same. The heart has an intelligence of its own, and if we learn from it we will know that we keep what we have only by giving it away. If we want to be happy, we make others happy. If we want love, we have to give love. If we want joy, we need to make others joyful. If we want forgiveness, we have to forgive. If we want peace, we have to create it in the world around us.

  If we want our own wounds to be healed, we have to heal others.

  It was time for me to focus again on being a doctor.

  • • •

  WHAT RUTH CALLED the compass of the heart is really a form of communication that exists between the brain and the heart through the vagus nerve. What research has shown is that the heart sends far more signals to the brain than the brain sends to the heart—and while both the cognitive and emotional systems in the body are intelligent, there are far more neural connections that go from the heart to the brain than the other way around. Both our thoughts and our feelings can be powerful, but a strong emotion can silence a thought, while we can rarely think ourselves out of a strong emotion. In fact, it is the strongest emotions that will trigger ruminating or incessant thought. We separate the mind as rational from the heart as relational, but ultimately the mind and heart are part of one unified intelligence. The neural net around the heart is an essential part of our thinking and our reasoning. Our individual happiness and our collective well-being depend on the integration and collaboration of both our minds and hearts. The training Ruth gave me would help integrate both brains in my body, the mind-brain and the heart-brain—but for decades I ignored the intelligence of my heart. I thought I could use my brain to lift me out of poverty, to lead me to success and give me value, but ultimately it was my heart that gave me true wealth.

  The brain knows a lot, but the simple truth is it knows a lot more when it joins with the heart.

  Mindfulness and visualization, the current names for what Ruth taught me, are wonderful techniques for getting quiet, eliminating distraction, and journeying inward. They can increase focus and help us make decisions more quickly, but without wisdom and insight (opening the heart) the techniques can result in self-absorption, narcissism, and isolation. Our journey isn’t meant to be an inward journey alone, but an outward journey of connection as well. When we go inward, and our heart is open, we will connect with the heart, and the heart will compel us to go outward and connect with others. Our journey is one of transcendence, not endless self-reflection. There’s a reason stock traders are using meditation techniques; these techniques help them become not only more focused but, sadly in some cases, more callous. This is what Ruth warned me about before she taught me to visualize. Yes, we can create anything we want, but it is only the intelligence of the heart that can tell us what’s worth creating.

  There is an epidemic of loneliness, anxiety, and depression in the world, particularly in the West. There is an impoverishment of spirit and of connection with one another. Studies show that 25 percent of Americans have no one that they feel close enough with to share a problem. This means that one out of every four people you see or meet today has no one to talk to, and this lack of connection is affecting their health. We are wired for social connection—we evolved to be cooperative and connected with one another—and when this is cut off, we get sick. Research has shown that the more connected we are socially, the longer we will live and the faster we will recover when we get ill. In truth, isolation and loneliness puts us at a greater risk for early disease and death than smoking. Authentic social connection has a profound effect on your mental health—it even exceeds the value of exercise and ideal body weight on your physical health. It makes you feel good. Social connection triggers the same reward centers in your brain that are triggered when people do drugs, or drink alcohol, or eat chocolate. In
other words, we get sick alone, and we get well together.

  By giving up my last remaining wealth, I learned the lesson I was too young to comprehend during my time with Ruth. The grand finale of the magic that Ruth taught me was the ultimate insight that the only way to truly change and transform your life for the better is by transforming and changing the lives of others.

  Ruth taught me techniques and practices, but by taking the time to teach me, by giving me her time and attention, she taught me the greatest and most real magic there is—the power of compassion to not only heal each of our own wounds of the heart but the hearts of those around us.

  It’s the greatest gift, and the greatest magic.

  ELEVEN

  The Alphabet of the Heart

  Mississippi, 2003

  Everything is beautiful at a distance. After returning to medicine, I could look back at my life in Newport Beach and see the beauty in every mistake, every wrong turn, and every misguided belief about what mattered most. The first thing that I had told Ruth I wanted in 1968 was to be a doctor, and after watching all my money and most of my friends disappear, I knew that being a doctor was my most powerful magic.

  I was not sure exactly how to proceed following the dot-com crash or whether I wanted to continue in the role I had at Stanford as a clinical professor of neurosurgery. My interest in entrepreneurial activities was at its lowest then. I had in the past served as a consultant to hospitals that had difficulty providing neurosurgical coverage or were interested in developing neuroscience centers of excellence. I wanted there to be the best neurosurgical care possible, especially in areas where the majority of the population lived in poverty.

  One day, out of the blue I was asked to advise a public hospital in southern Mississippi. As it was an hour from New Orleans, a city I loved and where I had gone to medical school, and it was a free trip, I said yes. The hospital was the primary provider of indigent care in the area, and as happens often many doctors didn’t want to provide such care, as the reimbursement is very low. In addition, in this case, a private hospital run by a large hospital chain was incentivizing many of the specialists to practice at their institution, thus further exacerbating the situation. The problem was not only a lack of adequate neurosurgical coverage but a lack of coverage in the areas of neurology, orthopedics, and stroke care as well. I assessed the situation and explained to the hospital administration that there was a problem with the way they were making offers to potential doctors. They needed to explain that these doctors had the opportunity to be part of the development of a regional center of excellence. Not just to appeal to their egos but to that part of them that was present when they first became doctors . . . the ability to make a difference.

  To create this regional center would require a large sum of money. Following the presentation, the board unanimously voted to fund the vision to create a neuroscience regional referral center if I would agree to be the director of the program. It was an opportunity to lead an effort that would have a major impact in a place that really needed it. I surveyed colleagues and friends, none of whom could understand why I would voluntarily leave the weather of Northern California and the vibrant intellectual community of a major academic center. But after multiple visits to Mississippi, meeting wonderful people, and seeing a real need, I decided to make the move. In a fairly short period of time, I was able to recruit an extraordinary set of colleagues who enthusiastically engaged in the development of the center.

  Many people in the United States don’t appreciate that on almost all measures of quality or efficacy of healthcare, their country is in the last quadrant while having the most expensive care of all industrialized (first-world) countries and the least satisfied patients. What is also not appreciated is that every other industrialized country in the world offers universal healthcare to all of its citizens with better outcomes and much lower costs.

  It has been shown that childhood poverty has a profound effect on one’s health and ultimately future. Of course, I was well aware of this from firsthand experience, but when I moved to Mississippi this reality was again brought home to me. I remember being on call in the emergency room and seeing a child who had had a seizure and was now unresponsive, requiring a tube to be inserted into his windpipe to allow him to breathe. An emergency brain scan had been performed showing a large mass in his right temporal lobe compressing the normal structures of the brain and the brainstem. I spoke to the child’s parents, who told me that he had been suffering for some time from an ear infection. Because they did not have insurance, the child was being seen by a nurse practitioner at a free clinic. He had repeatedly gone back because the antibiotics he had been given were not working, and he continued to complain of worsening ear pain and ultimately of a massive headache. They had no money to see a physician. The child had become confused and disoriented the day before, and they thought it was due to his fever. His parents finally took him to the emergency room after the seizure. To get there they had to call a neighbor to drive them since they didn’t have a car.

  I walked into the exam room and saw this beautiful child with a breathing tube on a ventilator. His frightened parents were at his bedside. I introduced myself and quickly examined the child, who had a widely dilated pupil on the right, and a slightly dilated pupil on the left. He was unresponsive, and his exam was consistent with pending brain death. I informed the parents that I had to act immediately to save the child’s life and I asked them to leave the room. The scan had shown a mass that extended from the region of the right mastoid, that part of the skull that contains the ear canal, into the temporal lobe. With the child’s history it was apparent that this child, whose ear infection should have easily been treated, had developed an infection of the mastoid bone that extended into the brain, resulting in a brain abscess. Such brain abscesses are rarely seen in this day and age. I quickly prepped and draped the child, clipped the hair over the temporal region, anesthetized the skin, incised the scalp, and drilled a burr hole overlying the area of the abscess. I then inserted a needle, and as I aspirated, pus filled the syringe. So much pus that I had to change the syringe three times.

  I then took the child to the operating room, but it was too late. He was brain-dead. I left the operating room and walked into the waiting room. The parents stood. I could tell by how they looked that they were used to disappointment. I informed them that I had done everything I knew how to do to save their child’s life and was not able to do so and that he was brain-dead—his body now only being kept alive by machines. After their tears and grief, they thanked me for trying, and my heart broke for all the times in their life people had not cared enough to try.

  An ear infection or lack of health insurance should never cause a child’s death.

  Almost two years later, Hurricane Katrina struck. For many who had the ability to leave, it was an easy decision. Yet many more were stuck, stuck in a place of huge devastation, where recovery would take years if not decades. I struggled trying to decide whether I should leave or stay after the storm was over. I had come to assist the community, and I was enjoying caring for patients who truly needed help. We were building a resource for the community that would last into the future.

  By this time, I had remarried a wonderful woman I had met shortly before giving my Accuray stock away. We had a young son, and my wife found it very difficult to live with my long hours and the daily reminders of devastation from Hurricane Katrina. Ultimately, we decided that she should move back to California with our child permanently, and I would remain in Mississippi but travel back and forth to California every six to eight weeks for a visit.

  Many colleagues and friends couldn’t understand why I just didn’t leave permanently with my wife. The reality was that while that would have been easy, I couldn’t face all those in the community, many of whom were now close friends and had believed in the vision that I had offered for that hospital becoming a regional referral center. For two more year
s I stayed and for several years after I remained deeply involved in this center, which became the center of excellence that I had envisioned so many years before. I finally left having built something that was, in fact, bigger than myself. After losing my wealth, I was committed to helping others, and this center, serving the needs of the poor, felt in a way like atonement for the years I had spent pursuing wealth and power.

  As I was contemplating returning to California, I realized I very much wanted to go back to Stanford. I also had been wondering what it was about Ruth’s teachings that seemed so compelling and realized that at their core they were about opening the heart. Acting kindly and compassionately with intent. One of my fascinations was to understand how the brain and heart worked and interacted. Could compassion, kindness, and caring have signatures in the brain?

  When I returned to Stanford on the neurosurgery faculty, I began meeting with colleagues in psychology and neuroscience to discuss what work was being done in this area. It turned out that there were a small number of researchers who were doing groundbreaking work on how being compassionate, altruistic, and kind affected the reward centers in the brain and positively affected their peripheral physiology. Compassion and kindness, it turned out, was good for your health. This research became my top priority, and I recommitted to the skills Ruth had taught me but developed them to better reflect the lessons I had learned. My notebook had been destroyed in Hurricane Katrina, when our house flooded, but I constantly replayed my conversations with Ruth in my head, hoping to gain new understanding, decades after the fact, about what Ruth had taught me. I immersed myself in the research that now was proving scientifically the benefit of all that Ruth had taught me. I wanted to study what it meant to open the heart and to understand why Ruth had emphasized this as being the most important. Just as I had made a list of my goals so many years before, I made another list of ten. A list of the ten things that open the heart.