Terry Healey, Author of At Face Value: My Triumph Over a Disfiguring Cancer
May 31, 2009 | Leave a Comment
Dr. Kent: Welcome back to Sound Authors! It’s Friday again and we’re all psyched to be going home for the weekend. This is Dr. Kent, and my next guest on the show has an extraordinary tale. The book is called At Face Value. It’s written by Terry Healey. At Face Value: My Triumph Over a Disfiguring Cancer. Welcome to the show.
Terry Healey: Hey, thanks for having me.
Dr. Kent: Give me a nutshell about this book.
Terry Healey: Well, I’d like to say it’s an inspirational memoir that’s really about my experience overcoming a facially disfiguring cancer, but also probably more importantly, how I was able to eventually, over the course of several years, come to terms with that, accept myself, and ultimately in the end be grateful for the experience. It was something that really other people encouraged me to do. There was a lot of people from the support group that I was attending that just thought that it was a message that could help a lot of other people and so that’s why I ultimately wrote the book.
Dr. Kent: And what a story it is that you have to tell. How did you, there’s so many people that have gone through awful events in their life, and they kind of give up. Talk to us about how you kept going through all of this and have come out the other side.
Terry Healey: I would say that I was very lucky, actually, that I had a great support system, I had great family and friends who provided not just good solid support, but were full of positive energy. I had a medical team that I believed in from day one, who I felt could do what they had to do, that believed in me, in getting through this. So I trusted a lot of people around me and I think that helped a lot. When I spend a lot of time with cancer patients who are newly diagnosed I often hear that they’re not very keen on their doctor, or they don’t feel very good about the treatment plan that’s ahead of them. I was really lucky to have that, so it just kind of fell into place for me. But I definitely would pass that on to anybody that that support system that you have that’s around every day, if it is a medical team that you need, you owe it to yourself to go out and find the people that you connect with and that you trust.
Dr Kent: This happened to you as a young man. It’s a time in life when we don’t anticipate anything happening to us. The world is on a string, and it’s always so difficult for young people to deal with difficulties like this. Talk about the beginning of this struggle for you.
Terry Healey: I think it’s a great question. I was not unlike a lot of 20 year olds that think they’re invincible, you know, nothing serious is going to happen. I think when I was initially diagnosed with the cancer and was told I had a rare form of cancer, I still felt that way, I felt that I’ll be able to lick this thing, this is no big deal. And fortunately I was able to beat it initially and really wasn’t left with any form of disfigurement, but it was 6 months later when I had this recurrence that it really hit me, hit me hard, and made me realize that I was in for a long road to hell. This was something that was going to be life threatening, potentially and most likely was going to be very disfiguring, and so at 20 years old when you think about your life, appearances matte a lot. We’re all kind of in that mode, especially here in the United States where that’s a very important fact. So kind of grappling with those issues. Believe it or not, I think the disfigurement part became a greater challenge for me, especially given that it lasted quite a long time in terms of having to deal with that, have surgical treatments for years and years to recover from the disfigurement.
Dr Kent: I can’t even imagine what this was like, going through, as can most, I would say, a good portion of your audience is amazed that you were able to get through it at all, but then there’s another portion of your audience whom you give courage to. Talk about that part of your audience.
Terry Healey: First off, I think a lot of people on the surface will make comments like, “God, I don’t know how you got through that, I could never get through something like that.” Well, I think oftentimes we underestimate what we can get through, and you hear these stories on TV all the time about different types of adverse situations, adversities that people have to confront and deal with, and all different types of things that happen to us in life. And so, I think people underestimate, I think we all have some human instincts that help us get through that stuff, but you know, I guess I do have messages for people in that I think it’s important for people to think about what if I was faced with something? What kind of survival kit would I need to get through it. I won’t go through all those points, but when I public speak, I talk a lot about my survival kit, and some of those elements that can help other people, and I mentioned some of it before, but I think the first thing is you’ve got to make sure you’ve got a good support structure around you. You’ve got to make sure you surround yourself with positive people. But you also have to make sure that you have a purpose in life beyond whatever it is that’s hit you, and that’s probably the hardest thing, but I think making sure that there are other things that you’re always striving for, trying to look beyond the illness, beyond the condition, beyond the situation. As hard as that is, I think that’s what helped me to try to look forward and believe that there was going to be something. I didn’t know when it was going to happen, but down the road my life was going to be better. And you know, I think it’s also important, especially for males to hear this, is to talk to a counselor, to go to a support group. A lot of men resist that more so than women, obviously, and so those are things I resisted as well, but when I actually opened my eyes and opened the door to it, I found that it was incredibly beneficial and really instrumental.
Dr Kent: What a neat, on the back side of things, what a neat way to take disfiguring events in your life, not just you, but this throws everything on its head, and you’ve been able to turn it into sort of a lifetime of devoting it to people. How is that a blessing for you?
Terry Healey: It’s a blessing in so many ways. I mean, to your point, I think it is kind of my little ministry, if you will, to make sure that I’m able to get out there and talk to other people and help them, but it’s a constant reminder for me of the fact that I appreciate every day now. But it’s also taught me a lot about relationships, and I think we can take things for granted. When you’re faced with something like this, it forces you to get that fresh perspective. I’m the more forgiving person and I’m certainly more accepting of other people, and I think more tolerance. All those kinds of things are really important, but primarily the blessing for me is what you just said, that I’m able to actually get out there and have that reward of being able to help other people in different ways, and my story isn’t just about cancer and disfigurement. It’s the things that I learned and the things that I can share with other people. That’s really the greatest blessing through this whole thing.
Dr Kent: My father has been in a wheelchair for a while, and he’s completely fine, but after a car accident that he and I were in many years ago, he lost his ability to be the same human being that he was beforehand. He can’t be the runner that he always was through his life, and that puts him into the disability crowd. What I find interesting is I spoke to someone else about this very recently, is that this country sort of goes in stages. Right now there’s the Prop 8 and homosexuality, the big issue right now. There was different times when women’s rights was a big thing. Do you think disability rights is ever going to come to the forefront?
Terry Healey: You know, you hope it does. I think for any group that is not the majority, for any minority group, that’s always the greatest challenge, is how do you get the same rights as everybody else. Unfortunately, the smaller that minority group it is, the more difficult it is, the less champions there are for it and so as horrible as any of those things are until somebody becoming disabled in some way during the course of their life, the people that have the ability to reach the masses, people like Christopher Reeves, for example, they can do so much, and bring so much to the forefront and help elevate a lot of those things that are important. And just because you’re a small minority doesn’t mean that you shouldn’t receive the same benefits and be treated the same way as everybody else. So I’m certainly hopeful of that. An aside is, I think about the cancer that I had, and the fact that I try to support it, I try to provide dollars to it, I try to help fundraise for it. The problem is, it’s such a small percentage, that it’s really tough to get any mindshare, any research dollars to go toward it. So it tends to be this ignored type of cancer. And unfortunately, it’s something that affects young people, so not to say that young people are more important than old people, but if you have a disease for example, that’s hitting people that are in their teens, even though it’s a small percentage, that to me is also an important thing to focus on.
Dr Kent: In talking about disabilities, what’s interesting is that you don’t really have a disability. But your sort of experienced the same thing, probably, when you were young, and probably the most difficult thing to deal with is if you’d been in a wheelchair, people stare at you. Right? If you have a disfigurement, people stare at you. Talk about that. You’re the same guy you were, and now all of a sudden people stare at you, and they don’t quite understand.
Terry Healey: Yeah, that’s a great point. It is, if people are different, they get treated differently. If they look different, or if they act different, no matter what they get treated differently. That was the hardest thing for me, because when I was 20 years old my life was smooth sailing, and I never had issues of dealing with struggles with the opposite sex or anything like that, it was easy. And then suddenly I was this monster, if you will, and kids pointed and stared and laughed, and even adults asked a lot of questions, which made me uncomfortable. But what I think is amazing about the whole transformation, and we have to give ourselves time to transform, but over the course of many years I tried to work on the internal, as opposed to the external part of me. At a certain point I cut off and ignored this, trying to reconstruct myself back to the way I was, and instead said I’ve become really insecure, I’ve got to focus on the inside. What I found was, when I’d walk down the street in 1986 people would ask me questions. But why, several years later, in the 90’s and beyond do I never get questioned anymore, do kids never come up to me and ask me questions. It’s a rare thing now for somebody to notice that I’m different, and all I can think of is that, and granted I don’t have something that may be as noticeable as being in a wheelchair, but I think it’s how we carry ourselves, and the confidence that we have, and I think if we don’t make a big deal about being different, nobody else will. Or people are less inclined to. That’s the only thing I can think of. I look the same as I did in 1986, or 1991, let’s say. Why was I getting so many questions back then and so many difficult situations, and now it’s just so rare to have those. To me, that was a real life transforming experience, and I was lucky that it’s worked out that way.
Dr Kent: Well, it’s been such a pleasure chatting with you, I could talk all day about this book, and about your life story. Terry Healey’s website is terryhealey.com. Tell us in just about a minute about your speaking business and what projects are you working on now, and of course, how is this book doing for you.
Terry Healey: I’m doing a fair amount of speaking. I have a full time job as a marketing strategy consultant, so I have to pick these things and pick and choose a little bit, but I speak to a lot of corporations, sales and marketing organizations within those. I speak to a lot of schools, and that’s something that I find probably the most powerful in terms of impact. So, young kids in high school or even middle school, sometimes in college, who are dealing with issues of insecurity, dealing with appearance-related challenges. So those are great ones for me, and right now I’m doing a lot around these Relay for Life’s and stuff with the American Cancer Society, so supporting events with other cancer patients that are dealing with things today. So I’m trying to focus and pick those things that I think I can have an impact on and where my story will resonate. The book just kind of comes secondary, and as much as people can read and not be distracted by all the other things around them, great, if they can pick up the book, it’s an easy read. But it’s a nice complement to the book to have the ability to speak to people in groups.
Dr Kent: Well what a pleasure it’s been. The book is called At Face Value: My Triumph Over a Disfiguring Cancer. We’ve speaking with Terry Healey, and I can’t wait to talk to you the next time.
Terry Healey: Hey, thank you so much for having me.
Dr Kent: Now, my next guest on the show, as always, is a musician, and I’m going to start out playing a track from her album, and Susan Oetgen, and the group is called Likeness to Lily, and I’m going to play a track from their record. It’s called False Hopes, a beautiful track. Listen to this, and after we listen to the track we’re going to talk to her live, so come on back for that.
Steve Knopper, Author of Appetite for Self Destruction: The Spectacular Crash of the Record Industry in the Digital Age
May 30, 2009 | Leave a Comment
Dr. Kent: Welcome back to Sound Authors! The next guest on my show is perfect for the title of this show, of course. Usually I’m interviewing authors, three authors per show and one musician, and what’s fun about this book is that it hits both. Author Steve Knopper is the author of Appetite for Self Destruction: The Spectacular Crash of the Record Industry in the Digital Age. Welcome to the show. Do I have Steve on the line? I think we’re having some technical difficulties. Do I have Steve on the line?
Steve Knopper: Yeah, I’m here, can you hear me? Hello?
Dr. Kent: Now I can hear you, how’re you doing?
Steve Knopper: Can you hear me now?
Dr. Kent: Yep, I can hear you.
Steve Knopper: Sorry, ok.
Dr. Kent: Tell me a little bit about this book. Most people go into a CD shop, and they don’t think much about this, but as someone who is in the publishing end, music world, I’ve seen a lot of things change, as you certainly have. Tell us about the changes that have happened.
Steve Knopper: Yeah, absolutely. My book is on, it’s a chronology, and it begins with, it’s basically tells the story of the record industry, sort of the rise and fall. It begins with the adoption of the CD in the early 80’s, and it goes through that period when everybody was replacing their record collections from cheap vinyl LPs to more expensive CDs. And there was a huge boom in the industry, and everybody got real rich until about 1999 or 2000, and then Napster came along, and everybody got their music for free after that, and it kind of destroyed the whole model of selling CDs. Then iTunes happened, and really the record industry has been shrinking and crashing and struggling ever since.
Dr. Kent: What are some of the industry’s big mistakes. There’s so many, and it’s one after the other that we hear about and sort of laugh about. The famous one, of course is the 8-track, which wasn’t a mistake, but now it’s kind of something that we laugh about. So tell us about some of the funny stories.
Steve Knopper: Sure. I have a series of small chapters in the book called Big Musics, Big Mistakes. And they’re separate (inaudible). The first one is the CD longbacks. Remember that cardboard thing that you had to buy in order to get the CD, you had to tear this thing open and get blisters all over your fingers and so forth. That was actually created because record retailers like The Towers of the World were initially resistant to the CD, and they came after the industry basically said you don’t have to rebuild your LP racks, which would have cost a lot of money. So they created these cardboard things, side by side they were about the same width as a vinyl LP. So that was a big one, another one that I mention is killing the single. By the late 90’s, part of the reason Napster was so effective was that people were just kind of sick of having to go out and buy $18.00 CD’s that had one or two good songs on them. Napster came along right at that time, and it allowed people to cherry pick the singles they wanted for free, and then iTunes later allowed you to do it for just 99 cents. That destroyed that whole business model of selling an $18.00 CD as the only format.
Dr. Kent: And how is it, it’s such an interesting thing, now that there’s interactions directly with musicians, and musicians will put their own record labels together, and put their own music out, and this and that. Is the record industry even breathing?
Steve Knopper: Yeah, the record industry still is. Basically when we have heard of the record industry we’re more or less thinking before major record labels. Sony, DMG, Warner, Universal and EMI. And those companies are huge companies that have a lot of overhead, they have a lot of payments to make, a lot of high executive salaries. So they’re carrying a lot of freight, and they’re not doing that well with their own problems, their own business model problems. Then the economy is really giving that a hit as well. So these companies are shrinking, shrinking, they’re laying off people left and right, they’re finding it harder and harder to discover new talent and market that new talent, although that’s still going on to an extent. The question is, how that’s going to affect artists. Sort of the glass empty way of looking at it is, it’s much more difficult for the artist to take that traditional path, sign to a major record label, use its connections to get on the radio, and become a huge star. But I think the glass half full thing, which is sort of what I believe, is that no longer do you even need a major label for a lot of this stuff. You can use MySpace and Face Book and YouTube, and all these different ways of do it yourself marketing that didn’t even exist 10 or 15 years ago. Maybe you won’t turn into Beyonce, but you can still eeke out a decent living as an act if you have talent and you’re willing to put a little work into the marketing.
Dr. Kent: It’s so much fun thinking about the rise of a company like Apple and the iTunes thing. It’s so iconic. Tell me about some other iconic moments in history.
Steve Knopper: Sure. Again, Napster was sort of the most iconic of all dirt in this kind of profit, in this progression. Napster came along, everybody knew Napster, used it, millions of people were on this thing, after Shawn Fanning invented it in 1999, and it’s become kind of a symbol, when you look back, of two things. More negatively, it’s a symbol of piracy. It’s a symbol of people being able to get all their music illegally for free, and copyright infringement and all that stuff. But I think, as I say in the book, it’s also a positive legacy, or symbol as well because it showed the opportunity of the new digital business model, the new online, very convenient way of getting music where you didn’t have to go to stores and spend all that money on a CD. So therefore I think that Napster was really a major crossroads at the time. I argue in my book that the record labels at the time had a chance to make a deal with Napster, and they should have done so, but chose not to.
Dr. Kent: Is it all about money? Is all of what drives the market, is it ever what a consumer wants necessarily? It seems that Napster was, but are any of the decisions made by consumers and not money makers?
Steve Knopper: Yeah, everything in major business is all about money. That’s true in the music business as well. And you’re absolutely right, during that time period beginning in the late 90’s, even before Napster internet music was seen as an opportunity by some people in the music business. But others, higher up in the business, who had been selling CD’s a certain way for a long, long time, and then before that final LP (inaudible) and gotten incredibly rich in the process. They really had no interest in changing the business model and looking at the fork in the road, and taking the fork and going in the completely new technological direction. And that’s true of many industries. We certainly saw it with newspapers, we’re seeing it now with the auto industry. If it works, people don’t want to change it, but that’s why you have to hire high tech people and listen to them. And that’s where the record industry went wrong, is that they actually did have a lot of very credible high tech experts on their staff, very experienced people in both marketing departments and the new media, and the strategic department. All the labels had lots of people like that. But in the end the business affairs people and the people at the head of these labels didn’t listen to them and they just sort of poo-poohed them, and they went on their way selling CD’s and they wound up paying a major price for that decision.
Dr. Kent: I was the kind of guy when I was in college that was a little CD obsessed. I remember so many people of my music-philic friends who had whole walls of their house devoted to CD’s. Then talking through the years with folks, there’s still people that have whole walls full of LP’s. You can’t really have a whole wall full of mp3’s.
Steve Knopper: Yes, that’s true. I’m the same as you, I’m 40 years old, so I grew up right during that time. I was in high school and college, right during that time when they were in that changeover from LP’s and CD’s, caught the tail end of getting obsessed with buying LP’s and having a big collection, and then obviously kind of grew up with CD’s and doing the same. Yeah, I’m actually looking right now at my wall of CD’s, and I really like it, and I like that physical way of collecting records, and it’s sad to me that that’s a relic, that it’s kind of going out of style. But on the other hand, you’re right to make the point that there’s something romantic that’s lost, because you can’t have wall of mp3’s. But the iPod is pretty cool. It’s pretty iconic, and I think if you’re a college student who’s grown up and come of age with music over the last 10 years, I think that you’re going to feel just as warmly and just as nostalgic as we do for CD’s about that moment when you got your first iPod, and you looked on it, and you realized you could carry 10, 20, 30, 40,000 of your favorite songs and play whatever one you want, and that’s a very, very powerful and cool idea. So I do a lot of these interviews, and a lot of people bring up the same point, which is isn’t there something lost. The physical collection going out, isn’t there something lost? I think that’s true, but I also think that you have to look at the flip side of it as well, which is something really that’s gained.
Dr. Kent: And one thing that I’ve started to do is one people jettison their old record collections, I like to record my vinyl into my iPod. I’m a big iPod freak too, and I’ve actually revived the classic feelings and the kids really can feel like they’re connected to that music, because it’s so diverse, and you can put anything in there, live shows, live shows have been revived again. So talk about how has the music itself changed? Because what’s interesting is you talk about the industry kind of scrambling and trying to figure out what to do, what have musicians done? And I know part of that is in how they can release live shows and things that they might not have done before because they had to print 10,000 copies, or something like that.
Steve Knopper: I think that’s a really excellent point. I think you’re talking more about what established musicians can do as far as getting out different types of outside material, and stuff like that. There are a lot of ways of doing that, if the musicians are willing, than there were even 10 years ago. There’s YouTube. When YouTube first started, as you remember, before the real copyright issues really kicked in, the stuff that you could see on YouTube was basically the entire history of music on video and DVD and VHS and TV, was right there, right in front of you for free, and that was a really cool moment. For fans, not necessarily for people who have the rights for that stuff. But still, you can go on YouTube and find all kinds of really interesting stuff. Live recordings, there’s another site that’s not totally supported by the original artists, there’s a little bit of controversy there, but there’s this site called Wolfgang’s Vault, I don’t know if you’re familiar with that, but they basically bought all the rights to the old King Biscuit radio shows, and also to Bill Graham’s Fillmore Auditorium recordings from the 60’s all the way up, and there is some fascinating stuff in there. My two favorite artists to buy bootlegs of are Bruce Springsteen and Who, and there’s a lot of amazing material for both of those artists there. So this whole internet thing has kind of broken open a dam. I was actually just on a panel at South Heights Southwest last week, and one of my fellow panelists was Kim Quirk, who used to be in the band Too Much Joy, and is now with Rhapsody, and he made the point that when Napster came out, he thought there was no one who could be a bigger Clash fan that him. He had all, no on could go deeper into the Clashions catalog than he could. He thought he was as deep as he could possibly get with rare Clash and Joe Strummer recordings, and he said when Napster came out he realized ok, I’m going (inaudible). So I think that’s dated in and of itself. Obviously he has some more complex opinions about was Napster a good or a bad thing. But I think that sort of sums it up in a nutshell, that this sort of internet stuff is a real opportunity for precisely the type of chance that you’re talking about.
Dr. Kent: And you know, an interesting thing that I’ve found is that a lot of musicians that are sort of the octogenarian crowd, a lot of them are resistant to some of this stuff, but a good number of them say you know what, if I’d have had this when I was a kid, man, it would havd made everything so much easier. As a musician, and I see, even my students, with their iPods, I’m amazed how much variety of music they get and how educated they are about music.
Steve Knopper: Yeah, I spoke to a high school class here in Colorado where I live a few weeks ago, and I walk in to talk about the record business, and as I walked in a couple kids were arguing at their desks, they must have been 16 or 17, about whether or not Robert Johnson actually sold his soul to the devil. I hear that often. I’m a huge Robert Johnson blues fan, and so I actually, we all go, all the music fans, rock music or pop music, go through this process of, “Oh, I heard the Rolling Stones hit, where did that come from?” So you go back and look through the Muddy Waters and Howard Wolf, and then you go back and listen to Robert Johnson. You just keep going back, and you learn all this stuff, and you and I when were kids buying CD’s and LP’s, the only way to do that was to raise some money and keep making these trips back and forth to the record store. Which on one hand is awesome, you know. It’s just a great rite of passage thing as a kid. But there’s a great power to be able to just do all that stuff at your computer. You know, iTunes certainly enabled you to do that, and streaming services like MySpace now, and Rhapsody. Not everything’s out there, but it probably will be, and very soon. If it were 1980-whatever, and I was 14 and I was sitting in front of my computer going, “Wow, I can do that whole process and go back as far as I want, just by sitting here for an hour,” I think that’s an incredibly powerful thing, and it just supports music enthusiasm across the board, and I think that’s good.
Dr. Kent: So was Napster kind of like the audio YouTube? I have several colleagues that always talk about, “Why is there no YouTube for audio?”
Steve Knopper: Yeah, well, that’s a complicated, that’s a really good question there, it’s got a complicated answer. The YouTube for audio, music, audio recordings from the time of Napster had issues, legal issues, involving who has the rights to that. Obviously all these things were fought in the courts, who has the rights to various songs, and various audio recordings. And that was really meticulously wrangled through in various court decisions involving Napster, and all these different other places. But then, when YouTube popped around, I guess it was 2004 and 2005, people realized that they really hadn’t gone through that same discussion for music video. Kind of the difference between music video and audio is that you can dowload audio really easily, and it’s leading to a mass huge collection of songs for free, and illegally, as you know. But it’s a little bit more difficult to do that for video, and so YouTube became kind of a middle ground option where you can rent all this stuff by streaming it on the YouTube website, but you can’t actually buy it and own it. So, that was a long winded way of saying it’s just two different things. The YouTube for audio right now is being worked out. Rhapsody is one answer to your question, you can go to that website pay twelve bucks a month, and you can stream whatever song you want, but you can’t really own it. Another example that’s kind of developing is MySpace music. I never thought MySpace music was that big a deal, but just in the last few weeks I realize that all kinds of records are out there for free streaming basically. There’s like 27 YouTube albums on there, there’s the new Kelly Clarkson on there, there’s all kind of stuff on MySpace you can get. (inaudible) So the answer to your question is it’s developing. So sorry I got a little complicated there.
Dr. Kent: So tell us, in closing here, I mean I could talk with you for hours about this, I love it. How’d you get into this, and obviously the book’s done very well by you, and how did you get into this and come up with this one?
Steve Knopper: Well, basically I’ve been covering the music business a long time. I started out just by being a music writer and a music critic. I became a freelancer in 1996 and I realized that everybody was writing about music. I wanted to write a record review for a major magazine, I had to compete with a billion people. But if I wanted to do a news story about the music business, and interview 20 people, it’s a little bit harder to do that, but then the competition among people who can do that exact thing is not as much. And it’s easier to find story ideas that no one else is pitching. So that’s sort of how I got into it, and I originally wrote for Billboard, and then I wrote for Spin, and now I write for Rolling Stone about the same topic. I had done a piece for Wired a couple years ago about trying to kill my computer with viruses. Basically just clicking on all the stuff you’re not supposed to click on, and downloading all the spam stuff. I wounded it pretty well, and the story ran and got some attention. And someone from New York called me and asked if I had any book ideas. And then the story gets kind of long and drawn out, but the short answer is I sent him ten ideas and he liked one of them, and eventually we had a book deal.
Dr. Kent: It’s wonderful, I love it. The fascinating thing about it is that you come to all of this from I think a really fresh perspective. We’re so used to hearing, “Oh, that damn MySpace,” or you’ll hear it from the other end, “Oh, iTunes has really changed the whole world, and it’s so perfect, and everyone has such a tact. And so I think what you’ve done brilliantly is sort of bring everyone together and tell the whole history.
Steve Knopper: Well thank you very much, that’s what I realize is that nobody had actually really told the story from the perspective of the people involved. I interviewed something like 280 people for this book, and they were the people who were right there in it, negotiating, and I realized no one had done kind of a journalism book, kind of like what you just said, kind of fleshing out exactly what you just said. People basically know what happened, but not too many people know the inside details of what happened, and that was my goal, and I’m just really gratified that people seem to like it.
Dr. Kent: Well, it’s so cool. So where can we find your writing online, do you have a site?
Steve Knopper: Yeah, I do, I have a website. It’s KNOPPS.com. My last name is Knopper, so that’s my long time nickname.
Dr. Kent: Well, Knopps.com, and we can check out all of his writing and I hope that also the piece from wired is up there somewhere? I gotta go check that out. The book is called Appetite for Self Destruction: The Spectacular Crash of the Record Industry in the Digital Age. You gotta pick this book up. Thank you so much for chatting with me.
Steve Knopper: Thank you for having me, I enjoyed it.
Dr. Kent: All right, my next guest on the show has an extraordinary tale to tell, Terry Healey wrote a book called At Face Value, and it’s really unbelievable the story that he has to tell us throughout more than 30 surgeries on his face, and has an incredible life story to tell. Come on back for that in just a minute.
Darren Littlejohn, Author of The 12-Step Buddhist
May 29, 2009 | Leave a Comment
Dr. Kent: Welcome to Sound Authors! It’s Friday again today, and this is Dr. Kent. I’m excited to have three authors on the show and one musician, as always. Some great books on the show today. I’m going to speak later on in the show to Steve Knopper. He’s the author of Appetite for Self Destruction, that’s a great book about the crash of the record industry these days. Later on in the show, At Face Value, by Terry Healey, an incredible memoir. At the end of this show is a group called Likeness to Lily, and Susan Oetgen from that group. We’re going to listen some of the music and chat with her. Without further ado, at the beginning of this show I’ve got a fellow on named Darren Littlejohn, and he’s written a book called The 12-Step Buddhist: Enhance Recovery from Any Addition. Welcome to the show, Darren.
Darren Littlejohn: Hi. Thanks very much for having me, pleasure to be here today.
Dr. Kent: So give us all a nutshell of this book.
Darren Littlejohn: This book is about deepening recovery for anyone who is either involved in a 12-step program, or wouldn’t be involved in a 12-step program because they’re afraid of the Judeo-Christian religiosity. It’s for anybody who knows an addict, anybody who treats addicts, anybody who’s suffering from any kind of attachment related (inaudible), and it’s applicable to what Buddha said, “All beings who suffer.” So we’ve combined the 12-steps, which are about attachment gone wild, and Buddhist terminology attachment is one of the root causes of our suffering, but in the addict it’s way out of control. So we try to get sober and get free of our attachment in the extreme form with the 12-steps. This really illuminates the Buddhist path because this is, after all, what the Buddha taught. This is hard to see if you’re, it’s easier to see, I should say, if you’re an addict already. So the two paths have a way of really complimenting each other and illuminating the nooks and crannies where it might otherwise be a little difficult to see.
Dr. Kent: Tell me a little bit about, to the non 12-step person, and to the non-Buddhist, give us some introductions into those two different worlds.
Darren Littlejohn: For the non-addict, everybody, of course we go from the Buddhist perspective. So everybody, according to the Buddhist teachings, suffers from not getting what we want and thinking that whatever it is that’s going to make us happy is really what we call I Buddhism the inherent cause of happiness. So in other words, one of my teachers always uses the reference of chocolate cake. And if chocolate cake were the cause of happiness, I would simply back up a truckload to my front porch, have an unlimited supply of chocolate cake, and obviously we know that that’s ridiculous. After your second piece you’re sick. So chocolate causes a temporary happiness. But then if we have too much of it, it becomes the cause of suffering. So for the non-addict, even if you’re not a food addict, we can look at these examples in our own life. Anything that we think is going to make us happy: more money, better job, better house, (inaudible), things along those lines. We start to examine this and see that, hey wait a minute, what I thought was going to make me happy is not really the source of true happiness, any way you look at it. And for the non-Buddhist, those terms are what work best, just looking at the three types of common known Buddhism, which are attachment, aversion, which is, when we don’t get what we’re attached to, we simply turn that around into something we don’t want and have an aversion towards entering. In 12-step terms we get a big resentment over it. So you don’t have to be a Buddhist to really understand attachment, and the fact that what we think we want is not in the long run every enough to make us permanently happy. As a matter of fact, most people don’t even believe that total, absolute happiness is possible. Most people don’t believe that ending suffering is possible. So all beings suffer according to Buddha. That’s the first simple truth. Life is suffering, it’s not a negative, it’s an observation. What it means is basically what I’ve just described. What we think makes us happy in the long run really doesn’t, so there’s something more, maybe something on a spiritual plane. That’s basically what the chapter’s about.
Dr. Kent: And describe for us also, many of us know the 12-step program. I have many family members who have gone through it, but it is deeply Christian most of the time. Talk about what inspired you to, clearly it’s coming from something personal in you. But what inspired you to do the 12-Step Buddhist? It makes a lot of sense, and I know that, for example, Native Americans use some of the 12-step processes with their own religion. Where did you get this idea?
Darren Littlejohn: I started in the 12-steps in 1984, and I had a sobriety period of ten years. During that period I moved through the various (inaudible), and metaphysical Christianity, the science of mind, all of these types of positive thinking, and could really very much have Judeo-Christian Creator God monarcheistic based philosophies, which were really well suited to 12-step recovery. Then I got into mediation pretty seriously, after a few years in recovery. I found myself in a spot, after a few years of sitting, staring at a blank wall, I was practicing Zen Buddhism, I found myself in a spot where what I saw really wasn’t improving. What I was looking at, as I followed that path and noticed my body, labeled my thoughts, after years and years of that with therapy and 12-step recovery, and education and psychology and so forth. I found myself in a really dark, depressed place, and I didn’t want to look anymore, it wasn’t looking too good. I couldn’t really get past that block. The concept of praying to something that was going to fix me, or putting responsibility for my life outside of myself. Even though I was willing to surrender and willing to follow the steps and principles, I never really felt that that task really amounted to much, I terms of un-enduring happiness. So after all this week, after ten years of sobriety, all kinds of zen mediataion therapy and everything else, I found myself in a place that was dark enough for me, that I made the choice to go back and try the various substances of my addiction again. So when I came back, because that doesn’t work, because the disease is incurable, the disease doesn’t go away with abstinence It actually continues and sort of deepens. So when I came back in 1997 I had to re-examine everything that I’d ever thought about before, and I got very much a good vibe again in 12-step recovery and zen Buddhism, and psychotherapy, but it wasn’t I found the teachings in Tibetan Buddhim. Which really explained a lot, and it went into a lot of detail of various types of methods and visualizations and practices that went hand in hand with the 12-steps. So that inspired me to continue my spiritual path and to really stay involved in both the 12-steps and in Buddhism. But I found that the problem I had is that in the 12-step program most people settle for just as much spirituality as is necessary to get sober through the day. Most people aren’t capable of a real, super deep seekers are looking with a real spiritual (inaudible). Some are, maybe not to a degree, but the people who are super into it are few and far between. And those are the people who really stand out and become sort of legendary in the 12-step treatment community. In the Buddhist community I found that I was sort of an addict… when an addict speaks, particularly from the disclosure that we use in 12-step rooms, we basically tell anybody anything, we air those feelings, whether or not its appropriate, until you learn better. But we really learn how to kind of be raw and truthful, and after many years of that, it’s pretty hard to tone down. So, finding myself being in the Buddhist groups, sharing, or having relationships or communications with teachers and so forth, it’s really kind of awkward. Then I thought it was a bit odd that I would be so honest. “Wow, that’s such a wise thing.” I’d say, “Oh, that’s not wise, I heard it in a meeting.” So I really had to learn instead of doing one or the other, instead of graduating from the 12-steps and finding a better, spiritual path, which leads to more disease and relapse, at least it did in my case, and in the case of many others. Instead of choosing this or that, I had to learn how to do both and find the similarities. What we talk about in 12-step meetings is (inaudible) the difference is. I found so many profound similarities between the 12-steps and Buddhism that I started blogging about it and eventually got a lot of feedback, people really enjoyed the writing. I decided to put those thoughts together, and came up with a lot of methods for the book after I started working on it. I found that there is actually a lot more than I even, I really think I just scratched the surface in the book, to be honest with you. Even though there’s a ton of chapters, and most people are finding it to be pretty dense work to get through it. I feel like there’s actually a lot more to be said on the topic.
Dr. Ken: Well, it’s so fascinating. Let’s talk about the issue of Buddhism. It’s a very accepting religion. I had a fellow on the show about a year ago who wrote one of the Dummies guides on Buddhism, and he sort of explained a lot of it. It’s a fascinating and very accepting religion, whereas Christianity isn’t necessarily all that much. Talk to that a bit.
Darren Littlejohn: I have kind of a saying I made up here, don’t throw the Buddha out with the bathwater. You can look into the deep teachings of Jesus through the Sermon on the Mount, for example, and you can see, for example, teachings on karma if you just take the principle of we reap what we sow. If you really take that principle and you look at karma and you look at Buddhism you can see that we’re talking about the same thing. However, people hear what they want to hear, people take the message and turn it into whatever they want. So I don’t discount the teachings of Christ on any level. As a matter of fact, many Buddhists feel that Jesus was a Bodisapha, or a very highly developed practitioner, maybe a Buddha, the completely awakened one. So there’s really no discounting of the teachings, but the way people behave is a little bit flighty there. There’s some room for improvement in a lot of it. And even Jesus said, “Don’t cast your pearls before swine,” and what I think he meant by that was if people aren’t really ready for the truth, try to give them what they can handle. Give them the teachings that they can deal with. You can even see there’s some Buddhism in the very beginning of what was recorded orally, and later written down, from what Buddha taught, was one type of system. That later evolved into other types of systems, which were much more advanced, much faster paths, and not everybody’s ready for that kind of thing. Some of us, for example, I would say, we just need to keep our mouths shut and not cause any harm to anybody else, and that’s enough of a spiritual practice. For others of us, we can get involved with other types of practice, which actually start to utilize some of the energy that we have, and to work with the breath and visualizations and so forth, and actually instead of repressing anger completely and shutting it off, you really start to kind of use the energy to try to assimilate that, and integrate that into our daily life. So Buddhism to me is really more of a mind science, and a massive system of methods, which are available to help transform the sufferer into one who is completely awakened and free from all suffering, just like the Buddha. Within that framework, there are fundamentalists in Buddhism. There are fundamentalists in Christianity. So I think that if you really use the teachings of Jesus, you’re not so far off from the teachings of Buddha. I wouldn’t say that they’re completely the same, and there are philosophers out there who talk about the similarities and differences, but who are the people that you want to associate with, and how are they living their lives? That becomes a different conversation. This is the same in the 12-step community, for example, we have a saying, stick with the winners. So when a newcomer walks in there, just coming off the street and detoxing from crack or oxycotin, or something really bad, and we tell them here’s what you do, find those people who have what you want in recovery, and go ahead and stick with them. And that really works to a high degree for many people. However, depending on the group that you’re involved in, and that location in the country that you’re at, and the individual who happens to be the one that who touches you or that you connect with, you might get involved with some really sick people. There are sick people in the 12-step community, that’s why we’re all there. We say, it’s a good thing we’re not all sick on the same day, luckily. But again, within the 12-step community you will also find fundamentalists who are really kind of fascist and militant about their value system. I’ll give you an example of that. In the AA literature it says we realize, we know, and we have been told, when it comes to prayer and meditation and things like that, the world’s diverse and full, go find them. We’re going to talk about matters medical, (inaudible) and religious. I went to a meeting not too long ago, on Thanksgiving, and there was a guy slamming his hand on the table saying, “This is the only book I read, and the only book I’ll ever need.” And I was just wondering if you read the part in that book that said go read other books. So we don’t want to throw the Buddha out with the bathwater, we don’t want to throw the teachings of Jesus or Buddha or the 12-steps out, because some people, out of their own fear, stick to a rigid viewpoint, to the point where they feel that they’ve got to impose those belief systems on others. The 12-steps is supposed to be free and open for us to have a higher power of our own conception, but many, many people feel that it’s very Judeo-Christian oriented, and that if you don’t come along with the group thing, that you’re not welcome, and they don’t feel comfortable. And that’s what I like about the audience that I’m trying to address with my book, The 12-Step Buddhist.
Dr. Kent: Well, it’s been a fascinating discussion. I could keep talking with you all day, but I have to get to my next guest. I’d love to have you on again and talk more about this. It’s so deep. The book is called The 12-Step Buddhist: Enhance Recovery from Any Addiction. There’s a lot more specifics that I wanted to get into and we didn’t have time for, but there’s some real plans in this thing, and it’s a useful book for a lot of people. Where can we find out more online?
Darren Littlejohn: At the12stepbuddhist.com. I’ve got podcasts, daily tips, some blogs, all kinds of resources and other information on there. And you can order a signed copy of the book right from the website.
Dr. Kent: Well thank you so much for chatting with us.
Darren Littlejohn: Thanks for having me, I’d love to talk to you again sometime.
Dr. Kent: The 12-Step Buddhist: Enhance Recovery from Any Addiction, by Darren Littlejohn. It’s got a foreword by Robert Thurman. Go out and pick that up, it’s a gorgeous book, and some pretty amazing content for all of us. Most of us know someone going through the recovery process, pick up a copy of this book and go to the12stepbuddhist.com also, or Google Darren Littlejohn. My next guest on the show is going to be a very exciting one again. This is a good show today, and Steve Knopper is the author of Appetite for Self Destruction, and we’re going to talk about the record industry and how it’s having trouble here in the digital age. So come on back to that.
Mariam Adam of the Imani Winds
May 28, 2009 | Leave a Comment
Dr. Kent: My next guest on the show is a musician, of course. On the fourth part of every show we feature authors of sound and we’ve got the Imani Winds up ahead. I’m going to play a little piece by them, by Ravel, this is Le Tombeau De Couperin, I’m not very good at French. It’s by Ravel, beautiful piece by Imani Winds. We’re going to listen to that, and then we’re going to talk to the clarinetist.
(music)
Dr. Kent: What a gorgeous rendition of that. And it’s my honor now to speak to a member of the Imani Winds. I’m speaking with Mariam Adam. Are you there?
Mariam Adam: Yes, I’m here. Thanks for having me.
Dr. Kent: What a gorgeous sound. Tell me first about that Ravel piece.
Mariam Adam: Well, it’s a piece that was originally for piano and then rearranged by Ravel himself for the orchestra, and that’s probably on of the more well known versions of the Le Tombeau De Couperin, and it was a piece that was actually dedicated to his friend that had fallen in the first World War. But then it was transcribed for the wind quintet by a horn player actually. And it’s one of the few pieces that has transcribed well for the wind quintet, and is written in such a lush way that you don’t often get to hear these five instruments. So I think for that reason alone it has an appeal to every type of listener, classical, contemporary, and even some people hear a little bit of the jazz element in the movements.
Dr. Kent: Yeah, that’s a fascinating thing about your music is that it’s got a real edge to it of, it’s got the jazz in it. We’re going to listen to some piet solo later, and you’ve got a whole bunch of different elements coming together in all of your music.
Mariam Adam: Yep, that’s our M.O. (laughter) Have to put in a little bit of everything.
Dr. Kent: Tell me about the group. Where do you guys play? You’ve got all these things going on, and of course something that’s very fascinating about the group is you’re all African American players. Talk about all of that.
Maiam Adam: Yeah. Imani Winds is a group that definitely looks the way that we do for a reason. Valerie the flutist had the name of a group before she even had the members of the group about 11 years ago and I knew her from summer festival out at Aspen. We moved to New York at the same time to go to grad school, got this group started, had no idea where it was going to go, although she always says that she did, and I believe it. But the group started out as African American, Latino musicians in classical music, one, to give the composers a similar background of voice. Another reason to give younger players that look like us role models that we feel we didn’t necessarily have growing up on our instruments. And also to really give a new direction to chamber music, and maybe a little bit of evolution of what chamber music is coming to. You know, we’ll always have the classic pieces like Ravel, and for us classic pieces also mean Milton and Carter and things from the 1940’s and 50’s. That’s about as recent as we get for the great works. But that led Imani Winds to take a path that was, one, educational, as well as slightly groundbreaking just for the reason that there weren’t many wind quartets out there doing what we do, and having two composers in the group, and think that is really the unique trump card that we have. That we have two composers who don’t just transcribe things, they write original works, and they’ve had us as their guinea pigs for many years, so they’ve gotten quite good at it. It has allowed us to expand into many different genres and bring it to our audiences. And there’s always a little bit of something for everybody on our program. And the places that we end up playing.
Dr. Kent: And on your website, imaniwinds.com, that’s i-m-a-n-i winds.com, there’s some incredible information about your group. And the bio page is just an incredible collection of folks. A number of awards, the degrees like you said, the composers, the incredible jazz and classical performers. What’s it like to play in such a small group with so many fantastic people?
Mariam Adam: Well, it’s wonderful. It really is wonderful. I think because we get along. People see that, and it comes through in our music, and I think that is also a rare thing that people say in chambers, in the groups, is that we have fun on stage, we have fun with the music. Everybody is really kick butt on their instruments. It’s a technical term. So we have a lot of freedom because of that, and not a lot of restrictions. Also, when it comes to our proper on stage, and we have stage etiquette, but also we speak to the audience and we allow them to respond to us, and we try to break down that wall that has been the stigma of classical music concerts. So we’re at Carnegie Hall and Alice Kelly, and all the big halls of New York, and all the big venues across the state. But we definitely want to celebrate the joy that we have in music and bring that infectious energy to other people. And that’s not something you get to see all the time, and I think that’s why we’ve had the longevity that we’ve had, because we love doing what we’re doing, we know we’re very lucky, to be a full time touring wind quintet. But we also work very, very hard with it, and that includes getting up at 8:00 in the morning, 7:00 in the morning, to go play for little kids in schools in every city that we visit, to bring this love of music to them.
Dr. Kent: It really is extraordinary also, for me, I have a background as a composer, and I went to Stonybrook, which I know you’re horn player did. You have a specifically, a commissioning project that’s aiming for people that wouldn’t necessarily be writing this kind of music, and featuring, well talk about that a little bit.
Mariam Adam: Yeah, the Legacy Commissioning Project started out as a commissioning project to celebrate being ten years together, same people. And it’s really evolved into a mission and a movement to get new music into the chamber music repoirtoire, especially for the woodwind quintet, because there’s a lot of woodwind quintet pieces out there, but they’re not all very good. And because people don’t have a group to write for a lot of the time, and to experiment with, they tend to write in a very similar style. So we’re getting composers like Jason Moran who is an incredibly, eclectic avant gardi and yet contemporary and down home swinging jazz pianos. And then you have Stephan Harris, who is also just multi talented. Percussionist, vibrafonist, composer, band leader, and Tanya Leone. Simoncho Hin is a ute player from Palestinian background. And these are all people who come from completely different angles but we’re forcing them, essentially, to write for us. But with the idea that they get to collaborate and we get to come back to them and say look, this is an amazing idea, why don’t you expand on this. Or, guess what, this doesn’t work. So we have feedback with the piece, and that is also to ensure that the piece is going to have legs beyond the premiere, and beyond this first world premiere that would happen. Because a lot of times that’s what would happen with commission pieces and then you never hear about them again. And we want to make sure these pieces stick around, so that they’re written well and that the person who’s writing kind of outside of their norm, ends up feeling comfortable in it, and successful.
Dr. Kent: Absolutely. I encourage everybody to go check out imaniwinds.com. I love your last album, and we’re going to play a track from that coming up ahead, Liver Tango from Master Piazzolo, which is a very brave piece to play, and it’s an incredible version of it. Are you working on any new recording projects?
Mariam Adam: Absolutely. We always have a couple in the pipeline, but one of them right now is going to be the Legacy Commissioning project pieces. We have one by Alvan Singleton. We have the piece by Jason Ran, we have a piece by Stephan Harris coming up soon. We also have a great piece that was part of the commissioning project by Roberto Sierra that’s written for string quartet, plus wind quintet, which I think is going to be a new genre. I’m so excited about it. I love the sound, I love the power that we get with these two groups together. And Valerie Coleman, our flutist, also wrote a piece to go with the concerts, with this collaboration of the string quartet. So we’re going to be recording that. We have a wonderful piece by Bucky (inaudible) who wrote (inaudible) for us called (inaudible) over Havana, and we might be putting out things in singles. But we also have a couple albums that we’ll put together from these Legacy Commissioning project pieces. And there’s always something new on the horizon, so yes, please get into our website and check out Alejandro. So we’ll probably be near somewhere near somebody soon. We’re all over the place.
Dr. Kent: Well I love it, incredible music. I hope to talk to you again after some of these CDs come out. It’s great stuff, and keep doing it.
Mariam Adam: Absolutely, and make sure you check out the Christmas album that we had, that’s the one that keeps giving back every year.
Dr. Kent: Oh, Ill bet, I’ll beat it does, yeah.
Mariam Adam: It’s great fun.
Dr. Kent: No Christmas songs here, but I want to play the song from their last Grammy nominated album, and this one’s called Libra Tango from Aster Piazzolo. Thank you so much for chatting with me, Mariam Adam.
Mariam Adam: Thank you for having me.
Dr. Kent: And the website again is imaniwinds.com. Go check out their music. It’s amazing stuff. So we’re going to listen to the whole track called Libra Tango from Aster Piazzoli, by the Imani Winds.
(music)
Dr. Kent: What a beautiful piece. I’m going to cut it off right there, but if you want to listen to more go to imaniwinds.com. That’s a piece called Libra Tango by Aster Piazzola, as performed by the Imani Winds. Check them out. It was such an honor chatting with Mariam Adam about her group, and her performances on the clarinet. And earlier in the show today we talked to Paul Austin. I could have talked to him for several hours about his riveting stories from the ER. And before that we talked to John Gilmore about his memories of Marilyn Monroe. And at the very beginning of the show, of course, was the incredible, inspirational story of Missy Jenkins, who not only survived a school shooting, but she’s starting to really get her story out there into the world, and she changes so many people’s lives with it. Well, have a great week, today is the first day of spring, and I hope you have a great one, and pick up a good book in the meantime.
Paul Austin, Author of Something for the Pain: One Doctor’s Account of Life and Death in the ER
May 27, 2009 | Leave a Comment
Dr. Kent: Welcome back to the show. My next guest is Paul Austin, and he’s the author of a book called Something For the Pain. The ER is a place that we see on television in sort of glorified light, and we see in real life as sort of a more difficult life. Hopefully we won’t have to see the inside of an ER too much, but we appreciate the doctors so much. It’s my honor to speak to Paul Ethan Austin. Welcome to the show.
Paul Austin: It’s my pleasure.
Dr. Kent: So tell me about this book, Something For the Pain.
Paul Austin: The title Something For the Pain, the subtitle One Doctor’s Account of Life and Death in the ER. It’s about the way my job almost wrecked my family. It turns out that the ER can be a really stressful place to work. There’s an abundance of human suffering. It turns out that you work rotating shifts, and at least in my case it turns out I took a lot of stress home with me. So one of the major points of the book is the way in which someone’s job, you can bring that stress home with you and it can damage your family and your relationships in your family, and kind of what I did to kind of mitigate those factors.
Dr. Kent: It appears like we had a little station break and I apologize for that difficulty, and I’m back on the show now, live. I welcome myself back on the show, and we have Paul Austin, the author of Something for the Pain: One Doctor’s Account of Life and Death in the ER. We still have you?
Paul Austin: Yeah, I’m still here.
Dr. Kent: Sorry about that. So tell me, we were in the middle of, the ER is not only difficult for, obviously there’s scores of people waiting in the waiting room, thinking about their families, and scared about their loved ones, but that stress kind of carries on, it sort of sticks to your clothes when you go home.
Paul Austin: Yeah, it really can. That’s probably true with a lot of different jobs. This job is, the need is so great, there’s so many people who have a very valid claim to your time and attention. Sometimes the ER can kind of be the bottom of the funnel of the people needing to come into the hospital, and we’re trying to get people in and out safely and quickly. Understandably people can get really impatient. Nurses, more so than docs, but just about anybody that works in the ER, the people can take out their frustrations in way that they wouldn’t in their doctor’s office, or at an upscale restaurant or bar. Sometimes people can, understandably, vent their frustrations. Add that to people having heart attacks, or people in a car wreck, or someone who’s not breathing, their could be a lot of other serious medical problems of which these are all kind of a background. So the nurses and docs, and nursing assistants and ward clerks and housekeepers, all the people in the ER have to kind of figure out a way to give good care and be emotionally present to the people who need it, but yet keep their own defenses up. So that’s another aspect of the book, is how can one remain compassionate in what has become an increasingly industrial environment. So that’s another theme of the book, is how to kind of regain your compassion if you get burned out, or how to understand what compassion means.
Dr. Kent: Well, I know when I was in the emergency room I had a doctor there who made me feel really at ease, and it’s such a strange place, it’s not meant to be a warm and inviting and friendly, but at the same time, what does a doctor do to save patients’ lives, to make the at ease? And how much of that do you take with you, and how much can you leave behind?
Paul Austin: I’m glad you had a good experience. I’m so relieved for people who say they went to the ER, and they may have had to wait a while, but the doctor was nice, or the nurses were nice, or the people were competent. I think a lot of us that work in that environment are just hoping that the person we talk to had a good experience, because it can be a place where people wait a long time. Sometimes a doc or nurse may speak sharply when they don’t mean to, and I’m so glad you had a good experience. One thing that I’ve come to think about compassion is that it’s not an emotion. When I started as an undergraduate I was working my way through college as a nursing assistant in an emergency room. I was the guy who cleaned out the bedpans and pushed the stretchers to take people upstairs, and did that to pay for school. At that point I thought that compassion was an emotion, I thought it was something you felt. I have come to believe that it’s more of a discipline, that it’s more of a habit. It’s a work habit, just like a carpenter keeps things plumb and square, a carpenter measures twice and cuts once. A carpenter makes sure the angles are right before he nails it together. I think a good doc or a good nurse views compassion in a similar way. I think it has less to do with emotion and more to do with maybe philosophy or one’s personal belief system about the role of caring for people. I’ve come to the conclusion that it involves kind of opening your heart and closing your heart as a situation demands. Like, if someone comes in that’s critically ill, or they’ve stopped breathing on the way in, that requires a sort of, there’s kind of a drill that docs and nurses do together, it’s very much a team, and we kind of all know our roles, and it’s more like a pit stop at a race track than it would be an emotional event. It’s more of a technical event at that time. You really need to close down your emotions. You need just to function quickly, and efficiently and pleasantly and professionally, and without feeling much. Then later, you may need to open your heart some. It’s like if a mom comes running into the ER and her baby’s blue and not breathing, and the heart’s not beating. They hand it to the nurse, and the nurse comes running back to the ER and says we need a doctor in Room 7 now. I go in, and the nurses are trying to stick IVs in the baby, put an airway in, you put a tube down their windpipe. And then the next step is to get IV access to give them meds or fluids for whatever they need next. Often just opening the airway will do a whole lot towards resuscitating a child that age. But say you’ve got an airway in, you’re breathing for the baby with a little bag through the tube down their mouth and into the windpipe, and you’re stuck on IV. The nurses have tried a couple times and have not been able to get an IV. The next step is to establish an intraosseous line. That’s an IV that goes into the bone of the tibia. The lower leg has two bones, pretty good sized bones, called the tibia and a smaller one called the fibula. But you just stick a needle right into the bone itself. The fluid goes into the bone marrow, and from the bone marrow into the bloodstream. And it gets into the bloodstream almost instantaneously, it’s almost as good as an IV and it’s a lot faster. And to do it you just hold the baby’s little leg in your hand, and the needle’s kind of like a finishing nail. It’s a pretty good sized needle, and it’s got a little pea handle on it, and you just jam it down into the bone. You hear kind of a crunchy little pop as it goes into the bone. So it goes into the skin and through the muscle and pops into the bone. If it wiggles, it’s not into the bone. It needs to feel like a nail that’s been driven into wood to know that you’re in the right place. And then you hook an IV tube and then you go to the next step. That process of jamming a needle into an infant’s lower leg is kind of a brutal procedure. The child doesn’t feel it because they’re functionally dead, or out of it, but you practice on chicken bones, on chicken legs, at least when I was training that’s what we did. But you feel, it’s not something you feel much about. You just pop through that step and go to the next step. You bring a very, not a harsh persona, but you bring a, you want to get things done attitude to do that procedure. Now, when you talk to the mom, or the dad, you can’t bring that forceful, stick a needle in the bone personality, that would be cruel. You have to kind of open your heart and take a deeper breath and relax your shoulders and unclench your fist when you’re talking to the family. So that’s kind of a little quick example of a time where you need to be kind of harsh, or hard, kind of bring something forward that will squeak us through a problem, and then kind of open up, and soften up. What I’m trying to do, and what I think I’m getting better at doing is closing down my emotions when I need to, and opening them up when I need to. Sorry to talk so long.
Dr. Kent: Well no, it’s fascinating, and that kind of insight is, especially with these shows on television that are so obsessed with the ER, and you wonder how much of it is right, and in a lot of cases it really is brutal stuff that you have to do, but you have to do it to save people’s lives. It makes a lot of sense that you can’t come up to someone and say I just rammed a needle into your baby’s bone. You can’t do that, right?
Paul Austin: You can’t say the baby’s got a heartbeat, but probably going to be brain dead.
Dr. Kent: Right, exactly.
Paul Austin: You can’t say that. In the room, once you get then, say you get a pulse, yeah, you can’t be just real blunt with people, that would be cruel. I think TV shows do a great, great job at what they’re good at. They’re real good at getting the sights and sounds of an ER. Like if you watch that TV show ER. I’ve seen copies, I’ve seen a show or two. Not recently, so I don’t know if it still does it, but it did a real good job of getting kind of that pace, getting that sound, getting the feel and texture of the moment. I think they do an incredible job with that. They don’t, very few TV shows are able to kind of get beneath the surface of what the spiritual experience of it is, or the emotional experience, or the real experience is. And that’s what the book, I was hoping, in the book I wanted it to be as much literature as a book. I want it to have literary value just in its prose, just in the way the nouns and the verbs work on the page. I want them to be good. I was just thrilled when Norton decided to publish it, they’re my publisher and they’re known as a big, literary press. I was just so thrilled that I had at least my editor’s satisfaction, or created a work of literary value, as well as a book that’s kind of pretty honest about what my job’s like. But I think that literature can get at that. I think a good book can get at what’s really happening on the human level, or where your heart is level, more than maybe a TV show.
Dr. Kent: Right. Part of the reason this book is unique is that it’s something we really all experience in our lifetimes, the ER. If you’ve recently been to the ER with a family member, you might not want to watch a show like ER because it’s so real-seeming. But what’s your take on, you talked a little bit about it, but doctors really do need to steel their emotions in some ways. I don’t know, I think a lot of people don’t know if they could do it, in terms of where you start out in med school, operating on cadavers, and then you’re dealing with painful things all the time. How do you steel your emotions to do it?
Paul Austin: I think getting the emotional armor up into place isn’t that big a challenge. At least for me it wasn’t, maybe for my classmates and colleagues and co-workers it is. I think that the bigger challenge is how to poke some holes in that armor. What can happen is that, ok, you’ve seen the ER. I don’t know about other types of medicine, but maybe in radiation oncology, where it’s kind of a foregone conclusion that people have an illness that will probably be terminal, and all we’re going to do is shrink down the tumor enough to ease the pain, or gain a couple years survival. It may be in that situation there could be some emotional ferocity, because we’re not expecting a miracle here, so the doctor doesn’t feel that they’re a failure if the patient dies. But at least in the ER the expectation is that we’re going to resuscitate somebody, that they don’t send people to the ER to get started on hospice. They send them there because they want us to fix the problem. So if you’re the person who’s going to have to fix the problem, if you fail to fix the problem, your defenses come up pretty quickly. I think that may be human nature, to kind of feel a little defensive that someone said that, or whatever the bad outcome might be that you did your best, but couldn’t forestall the inevitable. So I think most ER people, if you start in the ER all open hearted and caring and being very emotionally involved with everything that happens, those people kind of quit. They tend to get in the way while they’re there, and then they finally quit because it’s just too emotionally painful. Other adaptations can be like cynicism, people can become kind of hard and cynical. Another thing is joking. I joke a lot at work, and sometimes the humor’s cynical and sometimes it’s not cynical. But I think that if you get too well defended, if you had scrubs that are made out of Kevlar and Teflon, which are bullet proof and nothing sticks, it’s hard to drop that when you go home. If you’re too well emotionally intact, if your barriers are up, if you’re defended against the emotional cost of doing the work, when you get home you have a hard time relating to your family, or to your friends, neighbors and stuff. So I think that the more interesting and maybe more pertinent question is how can people that work in high stress environments learn to open up a little bit, close down a little bit, open up a little bit, close down a little bit. So that when they get home they’re not closed down. Even at work they’re not closed down. It sounds like your ER doc was fairly open, right, your ER doc wasn’t some hard ass who came into the room and told you this, told you that and then left. He listened to you. What was your experience like?
Dr. Kent: I remember one thing that was neat for me, it was a specific situation, of course, but he had been a Medic in Vietnam, cause I actually went back and thanked him later on, and this is another question.
Paul Austin: Good for you.
Dr. Kent: That’s the other question, is I felt like this person had changed the course of my father’s life, and I was just sitting in the next room pretty much, with a broken arm. But you do kind of play God sometimes in the ER and some people probably do come back and say thank you.
Paul Austin: Mmm hmm. I even get some thank you notes. But it’s hard to catch us there.
Dr. Kent: Are there certain stories that kind of carry you through the years?
Paul Austin: Yeah, it’s hard to catch an ER doc at work because we work such rotating and crazy shifts. Sometimes we get notes. And most often they’ll bring by some brownies or something to thank the doc or the nurse, and that just means a lot to us.
Dr. Kent: Give us a story of something that happened that you didn’t think you could save someone and something happened, and you know…
Paul Austin: Ok, well here’s a story. This isn’t in the book, but about 8 or 9 years ago I was getting really burned out. I mean, the people who are unhappy are so verbal in the ER. They’ll call the nurse words that you can’t say on the radio. They’ll call me a word you can’t say on the radio. They’ll tell us to hurry up, “Well, hurry up.” I was getting kind of burned out. And there’s a lady came in, the paramedics brought her in. Probably a 75 year old female, she was in respiratory failure, she was just (hacking noise) with respiratory effort, just open mouthed breathing, and she was sweaty, she was pale. They couldn’t get an IV when they brought her in, so they just kind of brought her in and dropped her off and I was going to try to stick a tube in her lungs to get her on the breathing machine so we could figure out what was going on. The nurses were having a hard time getting an IV. You can’t intubate them until you paralyze them. There’s a medicine that we give them that relaxes all the muscles of the body so they can’t fight you when you’re sticking a tube down in their trachea. So I was kind of wishing the nurse would hurry up and get an IV so we could tube, and they got one. We gave her the medicine, and she just went flaccid, so I could stick the tube in her lungs, and I couldn’t get the tube in. Epiglottis is a little trap door that covers up the vocal cords, and she had this big, floppy epiglottis, and I couldn’t get under it. So the pulse ox is going down, the alarms are dinging off. So we put the mask back on her and puffed her back up and then I’m trying to stick that tube in between her vocal chords again and couldn’t see it. And we put the mask back on her face and squeezed that bag to puff air into her lungs. On the third attempt, finally, thanks be to God, I got it. I got the tube in, and by this point I was sweating as much as she was. It was just really uncomfortable. But we got her through, got her on the ventilator, she went off to the intensive care unit, and then I forgot about it. The shift went on and we saw other patients and kept people moving. A couple days later one of the nurses said, “Paul, you know that kind of chunky, white lady you had a hard time tubing?” I said, “Yeah, yeah, what about her?” “Well, she made it out of the unit and she’s on the floor now.” I said, “No kidding?” She said, “Yes, she’s on a regular ward and they’re hoping to let her go home in a couple of days.” She had been in congestive heart failure and we had given her some Lasiks and meds to make her pee, and we got her out of a case of heart failure. Anyway, so I thought I’ll go upstairs and introduce myself, and she will say thank you for saving my life, and then I’ll no longer be burned out. I thought, I have a strategy here. I was working the day shift, so I got off duty and went upstairs. Still had on my scrubs and my tennis shoes, and I went up top two, and I’ll just call her Ms. Smith. I forget her name. I said, “Ms. Smith, I’m Paul Austin. I’m one of the ER doctors, and I’m the one that took care of you when you came into the hospital.” She said, “Who are you?” I said, “I’m Paul Austin, one of the ER doctors. I took care of you in the Emergency Room.” “Are you a paramedic.” I said, “No, no, I’m just a doc.” “Cause those paramedics were so nice.” I said, “Yeah, they were nice, they were really nice. The reason you remember them and you don’t remember me is cause you weren’t conscious by the time you got to me. By the time you got to me your breathing was so bad that you lost consciousness, and I’m the one that put the tube in your windpipe to hook you to a breathing machine so we could get that fluid off your lungs.” She said, “You would not believe how sore that tube made my throat.” (laughter) What do you have to do to get a thank you from this lady? But I said, “I’m sorry it made your throat raw, but I’m glad they could get it out.” And she said, “Well, I guess I should say thank you.” Yeah, just say it, lady, so I can go home. (laughter) And she finally said, “Well, thank you.” I said, “You’re welcome.” But it was so funny. On the elevator back down to the ER locker room to get my stuff, I thought, you know, lady, you have no idea. She was oblivious. There she was, with her little pink nightgown and eating a little powdered doughnuts, little bits of white sugar all over her chest she was kind of brushing off, had no idea of how close she came to dying. I mean, that would have been boom, end game, and move to the next patient. But what I had to do, the nurse was new, and the respiratory therapist was new. I mean, the team knows, we all know when we do a good job, and we all know when we kind of blow it. So you get a lot of, I think most all of us that work there so value their relationships with the folks at work. And one thing I really like about the ER is that the nurses and docs, it’s first name, it’s not Dr. Austin. Some of the new nurses, just right out of the nursing school may say Dr. Austin, but no, just call me Paul, we’re good. And the nurses are real free to come back and say, “Are you sure you mean 10 milligrams.” “Oops, no, you’re right, 1 milligram, you’re right, decimal place.” The nurses are real good about telling me what they think. “Paul, I don’t think she was on a breathing treatment.” “Oh, ok (inaudible).” Where as nurses on the floor and maybe in other specialties, it’s not quite as equal a relationship. But the ER is real democratic kind of place, and a place where pretense and puffiness isn’t tolerated much by the nurses or the docs. We just want to move people through and it’s a great group of people to work with. I used to be a fireman for the city of Highpoint, and it was real similar like the firefighters back then. Now they got one more fire department, which is a good thing. When I was there it was all guys, but the guys at the firehouse, I mean, they believed in putting out fires and pulling people out of the houses. And there’s kind of an innocence to that. And the need, the kind of cynicism and joking and comments about the drunk in Room 2, I think most of the people I work with bring an innocent desire to help people under stress. Sometimes if I’m maybe feeling burnt out, or if I’m working too many night shifts or too many evening shifts, I have to remind myself I get to work with some of the best people I’ve ever known, just on a regular basis.
Dr. Kent: Well it’s a fascinating discussion, and I have a feeling that we could talk for hours. And this book Something For the Pain surely is chock full of these kind of stories. And I’m definitely going to crack my copy. The book is called Something For the Pain, and we’ve been chatting with Paul Austin. Tell us where we can find out more.
Paul Austin: It’s on Amazon. It should be at your local, independent book store. I have a website, paulethanaustin.com, and you can get links to the book, but it’s on Amazon.
Dr. Kent: Absolutely, and the book is Something For the Pain: One Doctor’s Account of Life and Death in the ER. It’s been such a pleasure chatting with you.
Paul Austin: It’s been a pleasure, thanks a lot.
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