Michael Ortiz Hill

As a registered nurse at UCLA Medical Center and an initiated healer in a Central African tribal tradition, I try to be scrupulous about when my two vocations must be kept strictly separate. Sometimes, however, they are one and the same.

I'd arrived on the oncology floor at the change of shift and within minutes was called to the bedside of a Middle Eastern woman, mid forties, metastatic cancer: two interns arranging the paraphernalia for a needle biopsy of a rectal mass. The woman spoke little English and hadn't been forewarned. She grabbed my wrist in terror. With my free hand I ran my fingers through what little hair she had, and while she winced with the injection of lidocaine, I sang a Shona song to the Mother of the water spirits. "Close your eyes and let the song carry you," I said. Her grip softened, and I was happy to see the young doctors had also softened. Initially bearing the clinical distance of an unpleasant task, they became warm, affable and impeccably kind to this dear, frightened woman. In Zimbabwe we would say that the spirits had descended.

I always arrive at work a few hours early to meditate and pray before the long night begins. Last week I got up and walked out of the chapel adjacent to the lobby to stretch my legs and came upon a Lakota Indian, Lone Eagle, and his companion Morning Dove. Lone Eagle was explaining to the receptionist that their son, David, had a car accident and was in ER. "I have brought my medicine," he said, opening a small suitcase with an eagle feather, braided sweet grass, ritual objects, "and I need to do some doctoring." I introduced myself as someone who also carried a medicine tradition and told him I would be honored to mediate with the hospital. Off we went to ER, sharing stories about bearing these old ways within hospitals. He was not in the least surprised that we would meet this way. "Spirit is bringing medicine holders together from so many parts of the world," he said.

ER was sheer chaos, and so I clipped on my name tag, draped my stethoscope around my neck and drew to myself a professional persona. The beleaguered charge nurse took me to be staff relief until I explained, "Actually, we have a very unusual situation here..."

As someone who has practiced as a nurse for fifteen years, I'd never seen such responsiveness, elegance really, in which a little sanctuary of silence opened up within the madness of a very busy emergency room. Within minutes, David, his broken neck in a brace, was wheeled in on a gurney from CT scan. In a corridor between patient rooms and the nursing station, Lone Eagle arranged the ritual paraphrenalia of doctoring, ran the eagle feather over David's body, prayed quietly in Lakota and wept.

When he finished, I offered to sing. "Please do," he said. I ran energy through David's feet. Singing, I called on Obatala, the Father of light.

These stories are really two moments in the same story. There is much that could be said about the beauty of traditions of medicine converging, but what lingers is the luminosity that abides when people stumble into a conspiracy of kindness. Recently I've wondered if it's simply the presence of the healer, the willingness to step forth as a healing presence that is the gist of the matter, not our technology or our ritual acumen. In that presence, the work of medicine can move with grace and generosity, whatever the tradition.

The initiation of a healer in Africa is about being stripped to the bone so presence can shine, so that one can begin to rely on its intelligence. For myself, the path that led to initiation was curiously direct. The unrest following the Rodney King verdict in 1992 led me to ask hard questions about racism and interracial reconciliation. I began exploring the dreams blacks and whites have about one another and was intrigued to note that African-Americans carried the same core images of whites that Bantu people have borne since the Portuguese arrived in Central Africa in the late 17th Century. Further studies showed me how important the water spirit tradition was among those who were taken as slaves. Eventually I went to Africa to talk to a native dream teller about the patterns I was seeing. Augustine Kandemwa, a healer who works with the water spirits, understood my intent from our first meeting in 1996. A child of apartheid Rhodesia, my questions touched his own longings. "The water spirits are peacemakers," he explained. That very night he began my first initiation into the way of the ancestors. Stripped then to the bone and stripped again and again: My apprenticeship continues.

Much of my training the past few years has involved assisting Augustine in the healing of sacred illness -- those diseases caused by the ancestors themselves so that the afflicted might be a vehicle for spirit's efforts to serve the living. A young healer such as myself had to learn how to bridge the world of the invisibles with the village, for only the invisibles are able to heal sacred illness and their way is initiation.

At first one might think nothing could be further from the ambience of a modern American hospital than a little African community wrestling with spirits, but once I started seeing UCLA Medical Center as a village, the differences became less and less important.

An anthropological oddity I face whenever I return to work is that in Western medicine, doctors and patients live in distinctly different cultures. Matters of the sacred haven't been a medical concern in the West since the Renaissance, but the majority of my patients and their families see healing as intrinsically tied up with spirit. I don't expect "sacred disease" to enter into the Western lexicon any time soon, but there is no doubt that for many the ordeal of illness and the possibility of healing call up the deepest questions of faith. I see the hospital as a hive of initiatory dramas that I meet as well as I can.

A few milligrams of morphine sulfate to take the edge off the pain; a little conversation to take the edge off the fear; coffee for sister, or father at the bedside -- these ritual acts in a different key are familiar from Africa: circling the sacred grove to protect the heart of vulnerability in which the soul is transformed. Sometimes I'm asked to pray, sometimes merely pose the pregnant questions. "How do you make sense out of all this?" or "You've been through hell. What is it that sustains you?"

This last question is almost always answered in the same way: "My faith keeps me going," and "My kin or community hold me up." If I had to name the essence of the rite of initiation that happens in a thousand ways in the hospital, it's about being undone by fate and reimagining one's life within a web of human interconnection which is in turn sustained by an unseen source. Again, this is familiar from Africa -- but Americans bring their own wild poetry to it.

Mike DePonce, for example. At 29, Mike was diagnosed with a rare form of bone cancer. Months of chemotherapy and radiation, bleeding gums, nausea, unit after unit of blood, the loss of a third of his femur, he and his wife Sheba finally entered that mysterious country called "remission" where they lingered for two years.

There is something unsinkable about Mike and Sheba which I can only describe as the appetite of life for life. Together for only nine months before Mike's diagnosis, when I ask what keeps them going, it seems to boil down to loving each other passionately, wanting to bring a child into the world, faith, prayer and a rather astonishing community of support.

Mike is a firefighter by profession. He explained, "When there's a problem, firefighters just go in and fix it. But when I got sick, it's the first time nobody knew what to do. My hair was all gone from chemotherapy, and a buddy came up with an idea for a fundraiser -- The Great American Shave Off. For a $20.00 donation, folks had their heads shaved. They also sold baseball caps with my badge number on them. Guys on duty would drive up in the truck, jump off and in five minutes drive away bald." Firefighters, some of their sons, friends from high school -- all together about 170 bald heads became a public event on the streets of Santa Barbara. In addition, for well over a year, Mike's buddies have been working his shifts, protecting his medical benefits.

I confess I've known Sheba since she was a girl. A "daughter-once-removed," I've watched her become a woman of great presence and integrity. When things get dark, the prayer she has come to rely on is, "Teach me what I need to know."

"What we are going through is so life changing. The prayer is not about a cure exactly. Of course we want that. But the prayer is deeper. It's about faith, about listening, paying attention to what God might want."

There are very few tribal rites that equal the intensity and risk of a bone marrow transplant -- the obliteration of the immune system and the razing of the body's capacity to produce its own red blood cells -- and then, the regeneration of this fluid world that makes life possible. Many don't survive. When I heard that Mike and Sheba had made the choice, I knew we were at the threshold of what Augustine calls "proper initiation."

Every night at work I would gaze stolidly at the computer, watching Mike's lab values crumble as intended. When his already low white blood cell count dropped to a twentieth of what it had been the previous morning, he was in danger. I knew it was time to sing.

The threshold songs are songs of support and protection, the invisibles in a circle around the bed. They are also songs that the spirits might reveal what God intends so the soul is fed by the mysteries. Mike had been asleep much of the day, but when I sang, he roused, soft and lucid. I took a drop of blood from Sheba's finger, mixed it in water with Mike's fever sweat and called the ancestors -- a traditional offering in a styrofoam cup. I called also the spirit of fire to this man who knows something of fire. An incomparable ally, that one, a fierce warrior. Finally Mike and Sheba cast the oracle to discern the path through: challenging but ultimately benevolent. When the clock said 7:00, I saw I must step back into time. Down the hall, my night shift was starting.

As Mike prepared for his bone marrow transplant, his community once again came to the fore, eagerly donating more than enough blood and platelets to carry Mike through his descent. At this writing I leave an orange, a little honey, sweet wild lilac at a creek and sing her a song on Mike's behalf. The blood of Mike's community will soon be his life's blood. Such is the mystery that his life has delivered him to.

In traditional societies initiation is never a private matter: It renews the culture itself. When Sheba quoted a poem by one of Mike's friends, "Stand together we stand tall/We will not let a brother fall," I hear the vigor of a loving community but also an echo of the Yoruba proverb: "If we stand tall, it is because we stand on the shoulders of many ancestors." And I imagine the young men fresh from the forest, their heads shaved and the ritual white clay washed from their bodies. They have returned to the village, these ones, and now they are men and greeted with drumming and song. The elders smile because they know the world will continue.