In times past, one might have thought of life as a children's slide: We start at the top and move steadily down. But thanks to modern medicine, the course of our Uves is now more like a roller coaster. Yes, we move down, but along the way there are sudden, surprising upward sweeps. Each is a moment of anxiety and then thrilling relief, assuring us that we did not crash or run off the rails.
Moments like this are rites of passage, experiences that shake us out of our accustomed routine and raise us to a higher level of awareness.
In traditional societies, these rites are highly structured occasions that mark the great transitions of life, ushering people into a new phase of existence as they move from childhood into adolescence, from adolescence into maturity, from maturity into old age and finally from old age into death. Where rites of passage fade from the cultural repertory, as they have in the modem Western world, maturing into a true elder becomes all the more difficult
In many rites of passage, episodes of great fear are designed to capture the full sense of crisis that occurs at the main turning points in life. Sometimes death is mimicked, as if one were dying to one's old self and being reborn into new life. Young boys in some 'tribal societies are put through the moment of their own death and taken into the terrors of the underworld-and then guided back. Outside of religious communities, we have few rites of passage that retain the dignity and depth of these traditional practices.
Like all rites of passage, the medical crisis involves the threat of death. It may reach the point of literally endangering our lives, more so than any traditional ritual. This is the real thing, not a simulation, and like the rites of the past, it is highly structured. Medical crisis places us in the hands of professional practitioners who, like priests in the premodern world, lead us through the ordeal. When we emerge, we are in a different stage of life.
This crisis usually occurs in a hospital, perhaps an emergency room, at the hands of doctors, who often wear masks and are sometimes puzzlingly laconic. They talk among themselves as if we could not be expected to understand what they are doing. What happens all around in this strange ambience can be almost ceremonial in its solemnity and precision. Often, the procedures hurt, and they can certainly frighten: One is jabbed, cut, shaved, scrubbed, nauseated.
Undergoing an MRI or a CT scan can be a nerve-racking experience of mystification. There is often darkness; there are strange, jarring sounds; there are voices that give orders. Episodes like this rattle, rend, Darter - but they may have no spiritual meaning - at least, not yet. It is simply a close call.
MY TWO CRISES
That is how I recall thinking about the medical crises I have passed through. There have been two; the first, and most telling, came in my late 50s. When, after emergency surgery that came close to costing me my life, I returned to my senses, I woke feeling as if I had hit rock bottom: feeble, dazed unable to eat or drink or move. I learned that I had lain in the intensive-care unit hallucinating for hours at a stretch. My body felt shattered to pieces - as I have heard that shamanic apprentices feel after they have been through one of their vision quests.
For them, however, the experience is one of transcendence. For me, it was nothing but numbness and confusion. I wanted desperately to take hold of a friendly hand, as if that would keep me in one piece.
Slowly, I came to realize I had dodged a bullet, but I knew I had been through far more than that. At least I felt I should make something more of the experience than a lucky break. I wanted this event to count for more. But I realized it was up to me to supply everything the hospital and the doctor could not. I almost felt cheated. After suffering all this, I should have become wiser. …