Some of my best friends are holistic healers, so I’ll be forgiven, I hope, if I question what seems to have become a tenet of their faith: charge as much as you can. People, they suggest, really like spending money on themselves; just writing out a whopping check is part of their “healing process.” And so it may be. Still, it gladdens me that not everyone believes that; I’m happy Patch Adams is fixing people up for free.

I first read about Patch in New Age last year and was delighted by his notion that “healing should be a loving human interchange, not a business transaction.” The article described a sometimes whacky character with a fondness for theatrics — at six-foot-five, with a thick ponytail and a handlebar mustache, his very presence attracts attention — whose unique approach to medicine made me feel better just reading about it.

Shortly afterward, I got a letter from Fred Hean, a SUN subscriber from Darnestown, Maryland, suggesting we write about Patch and his nonprofit Gesundheit Institute which, Fred said, “is manifesting a vision of doing in the medical field what THE SUN is doing in the literary field — presenting a viable alternative to the mainstream capitalistic approach.” I in turn suggested to Fred that he speak to Patch — to me, passion for a subject counts more than journalistic expertise — and this interview resulted. Thanks, Fred.

Some background: Patch — whose real name is Hunter, which he discarded in high school because “I didn’t like the name Hunter” — was born in the District of Columbia 38 years ago.

The son of an artillery officer, he lived in Germany and Japan before returning to Virginia in 1961, when he got involved in the civil rights and anti-war movements.

His vision of running a free health care center emerged during his senior year in medical school and during his first year as an intern he opened his home to anyone who wanted help.

The Gesundheit Institute — comprised of Patch and his wife Linda and about a dozen other physicians and friends — has operated out of a series of group homes in the Washington area and in West Virginia for the past twelve years, during which it has provided free care for 15,000 people.

Based today in Patch’s suburban home in Arlington, Virginia, the group is largely supported by Patch’s part-time job (he works nine nights a month in the emergency room of a local hospital). In addition, the institute owns a 300-acre site in Pocahantas County, West Virginia, where work has begun on an ambitious alternative health community.

Patch himself recently stopped taking on patients to concentrate on fund-raising for the new facility, which will enable the institute, he hopes, to offer free care “to anyone from anywhere.” For more information, or to send tax-deductible donations, you can write Patch Adams at the Gesundheit Institute, 404 N. Nelson Street, Arlington, Virginia 22203, or call (703) 525-8169.

Gesundheit means “wellness” in German but Patch says he picked the name mostly because it makes people laugh.

— Ed.


SUN: How did Gesundheit begin?

ADAMS: When I was a senior in medical school, and not sure what I was going to do with my medicine, I took a seven-month elective in Washington, D. C. I worked in two free clinics: at Children’s Hospital, in a well-and-sick child clinic serving a ghetto, and in the Georgetown Free Clinic, at the peak of hippy free clinic time. Money never exchanged hands (sneezes!). . . .

SUN: Gesundheit!

ADAMS: . . . hah, Institute. There was no paperwork dealing with money, no question of insurance; it was all gratis work. I was able to be myself, to be a free human being. I was able to spend time with the patients; I was not in a hurry. I was able to bring patients back to my home and go to their homes. Out of that grew the feeling that the kind of relationship I wanted to have with my patients was one of friend. I loved the joyous exchange that occurred out of friendship, and I saw that on the medicinal level it seemed to be a powerful relationship in which to work. I felt drawn to a traditional “horse and buggy, go to the patient’s house, eat with them, and be their friend” kind of doctor. I returned to medical school in March of 1971 and wrote a paper describing what is now the Gesundheit Institute. It was a description of a dream: building a residential medical facility that would house staff and patients on a farm, an active arts and crafts facility, based on love. Love would be the motivation for working there and the framework in which we enacted our medicine. Linda typed the paper and liked the dream, some other people liked the dream, and when I graduated from the Medical College of Virginia in 1971, we all moved up to the Washington area.

During a year of pediatric residency, I realized that I wanted to be a general practitioner, dealing with people from birth to death. I wanted the kind of practice that was already growing slowly within our group home. I wished to begin with a two- to four-hour interview with a patient, covering as many subjects as possible about the person, and in turn, exchanging information about myself, to start a friendship that I now hold so dear in my patient interactions. Our ideal patient has grown to be somebody who is a deep intimate friend, hopefully with a lifetime connection, through letters or calls, or visits to the Institute.

Within the first year or two of our family practice, spending a lot of time with patients, it became obvious that without a major thrust toward self-responsibility and prevention, I was going to experience a lot of frustration and sadness in dealing with the health of people, because so much of what I saw came out of the poor way they dealt with their lives — poor diet, lack of exercise, lousy relationships, lousy families, lousy jobs, lousy self-image. These were things which seemed to affect their health. The importance of faith in a person’s medical picture had not been taught in school. I started studying these things: many faiths, dietary perspectives, exercise.

At the same time I found out that as a general practitioner my role was not just to regurgitate what I was taught in medical school but to stay with someone; if what I was taught was not a solution, I still had a suffering person. I could send them to specialists but still tremendous numbers of people did not find solutions. It was then that I bumped into a man from Korea who had a doctorate in acupuncture. He was driving a cab; this was in 1972 when there were few niches for an alternative health professional. I knew that acupuncture was six or seven thousand years old and I thought something that old had to be valuable. So, acting against the law, I let this man practice in our basement. From the very first day of his practice I saw miracles, relative to my system of education. I saw that he did things with patients’ chronic diseases that I did not have any skill in doing. I started researching homeopathic medicine, acupuncture, herbal medicine, chiropractic and naturopathic practices — all words that had “quack” connotations in medical school. I found conscientious practitioners of these individual crafts, and again with each one I saw miracles. There was no system of caring that didn’t have something to offer a general practitioner like myself who needed a wide variety of solutions for a variety of problems. Over the years we’ve explored these methods in our practice. We’ve expanded our understanding of prevention and self-responsibility.

SUN: Could you talk some about yourself — the early influences on you, your desire to be a doctor?

ADAMS: I was raised in an Army family. When I was sixteen, my father died. My mother was a very loving, caring, non-critical person who raised me to believe that love was very important. I became a barometer for social inequality; in the last year of high school I was hospitalized twice for ulcers. I had a great concern for the issues of war, social injustice, civil rights, segregation, hypocrisy in religion — all things which tormented me. I did not know adults who had found avenues for dealing with these concerns and it seemed the majority of the high school students weren’t interested. I was a science nerd, and didn’t go out on dates very much. Women didn’t want to go out with me, and so I had a lot of time to stew. I went to college, but dropped out by homecoming. My uncle killed himself. I had adopted him after my father died, and so I thought perhaps suicide was a way of relief for me from all this torment in the world. It was obvious to me that the solution was love, and yet, how to live it, and why people didn’t — I just couldn’t understand.

I committed myself to a psychiatric hospital. Then I had revelations about love, and about friendship, as the only things really important in my life. I had the feeling that if I celebrated friendship, and let it inside me, I would not be tormented, that it would solve my problems. As it’s turned out, I’ve not gotten sick since I left the hospital.

SUN: Was it a conscious decision, or an opening of the heart . . . ?

ADAMS: Although I didn’t call it a revelation at the time, there in the mental hospital, wanting to kill myself, for the first time in my life I empathized with another human being. My roommate — I’ll call him Andy — had been married three times, held fifteen jobs, was hallucinating terribly, very lonely, never had any visitors, and was very much like Willy Loman in Death Of A Salesman; he was at the end of his life, and a failure in his eyes. I couldn’t believe how sad somebody could really get. I felt that my sadness next to his was nothing! I really empathized with his pain, and I saw that when my friends came to visit me, I laughed and joked, and we had fun! It was obvious to me that I was not where Andy was because of these experiences with my friends, and that was the connection. I spent the rest of the hospitalization talking with all the other patients, seeing how they had alienated their support system — the love — from their lives. There seemed a recurrent theme of being alone. I realized I was not a strong person alone, that I needed people, needed them to stay alive, for my very existence. So I made friends my God, and I’ve lived that ever since. I don’t think I’ve been out of the company of people since that time.

When I left the hospital and started working, I decided I needed to study the great thinkers and writers and see what they had concluded. So I got the almanac out, got the list of Nobel Prize winners for literature, and read all their works. And Shakespeare. And so forth. Whoever was out there. And they totally reinforced everything I had found.

SUN: I have the notion that at some point you might have withdrawn into a meditative solitude to mull over all these ideas. But you say you’ve never been out of the company of people.

ADAMS: I have been out of the company of people, but I have not sought solitude. I guess I felt I had a lot of that before I was sick, had done a lot of ruminating, and really wanted to celebrate friendship. I spent three or four years hungry to talk with everybody in the world. In a way, I set a goal to know everybody in the world, to have talked to them about their life and what mattered to them, to share ideas and hug and hold on to each other. I called up wrong numbers for hours on end, to see how long I could keep them on the line, see how much humanity I could exchange with a perfect stranger.

SUN: What did you find, doing that?

ADAMS: Oh, I just found out how much people wanted to talk, and how much fun it was to see the different ways people have of addressing a wrong number and a stranger’s curiosity about them.

SUN: You found people who were willing to talk deeply with a stranger over the phone?

ADAMS: Yes. I found that different things I said or did triggered other things; I started learning how to interview people, how to talk, how to be a different person for different people. It was fun. The more intimate I got, the more it reinforced love and caring as all that mattered. It was later that I saw love in a much broader context than just among friends. God came into the picture. Patients taught me to love God. I saw the difference between patients who were full of God, and those who weren’t; the ones full of God needed less medication, were happier, had better relationships. And not one God, I mean all the Gods, the whole tossed salad.

SUN: You have said, “I try to help people get in touch with their own personal why.” What do you mean?

ADAMS: I want to know what their why’s are, what life is all about for them. I want to cut through talk of the weather, and clothes. Let’s just call me a glorified voyeur, a nosy guy!

SUN: Richard Moss, a doctor, wrote The I That Is We. Are you familiar with his book?

ADAMS: I’ve not read it. Martin Buber, in his book I And Thou, talks about a similar idea. We are personal loving human beings, and we are group people. As long as Homo sapiens or our ancestors have been around, anthropologists have sworn we were group, tribal people. And who can mess with millions of years? I feel my search has been the joy of a variation on that theme.

SUN: Moss speaks of unconditional love as the lesson of a transformational process that took him out of orthodox medical work.

ADAMS: People are not their diseases. They are the same weak fragile beings that we ourselves are. Traditionally, a physician in general practice follows patients throughout their lives, but without touching on the quality of a person’s life, their loves, concerns, and fears, we ignore a gigantic area of resource and of disease. By the time I graduated from medical school, I knew I wanted first to be a loving physician, and an allopathic physician second. As I grew to accept more alternatives, what I really wanted to be was just a yellow pages for people; hopefully, after spending a lot of hours with somebody, it would be obvious what was important for them.

SUN: How do you define healing?

ADAMS: A healer is someone who has chosen, hopefully with humility, to try to find solutions for peoples’ problems, and solutions toward health. Healing is the summation of the interaction of all the people involved in our life; it is all of the actions, all of the people, all of the things involved in growing toward a feeling that life is of high quality.

SUN: My own idea of health is being in a harmonious state, inside with bodily systems working well, and outside in the way I deal with other people.

ADAMS: It is a matter of balance, I think. All these things are related: our body, minds, spirit, community, planet. We must integrate all of these to feel healthy. When I was in medical school, good health was the absence of disease. There was never a lecture on high quality living, being happy, fulfilled. And yet these are the agonies and truths of the requests of people who come to a family doctor. We can choose to address those issues in many different ways: by tranquilizer — to elevate the need, elevate the feeling — or by addressing individual things — diet, exercise, faith, family. Our body has such miraculous healing abilities that sometimes if you address just one thing, you’ll solve the problem. But this doesn’t detract from the idea that we still are the summation of all our input and output. Often the change of one aspect leads to such nice changes in somebody that they feel their problem is solved; if they tried any one of ten or twenty other things they might have had similar good feelings. Sometimes diet alone can change how a person feels, but if they add to that a strong faith, and add to that a good exercise program, and add to that a wonderful family connectedness, a friendship system, a relationship with nature, all the better. The more we can do, the more we integrate all of our aspects, the better and easier our lives will be.

SUN: Have you worked with terminally ill patients?

ADAMS: Like any family practitioner, I see a certain number of patients with cancer or another illness which they will probably die from. It’s a small percentage at any given time, but over a period of years, I have met a lot of them. If fear of death is as prevalent as it appears, though, most everybody is feeling terminally ill. Often, when a person brings in a concern about their life, they’re bringing in concern about their dying. You don’t know how you’re going to die. If I’m in your life and you are in my life over our lifetimes, and you’re approaching your death, then what we do now will be part of the process of dealing with your death. We’ll have moments, conversations to remember. I’ll have tried to remember the books you’ve read and the work you’ve done, because these are things that will be important when you die. The whole point of Gesundheit is a dialogue of friendship; asking patients to come and stay with us a week, we begin the process of preparing for that last week. You are terminal right now. As young as you and I are, we are terminal. How do you feel about death? What have been your experiences with death? How do you want to die? A lot of people have a fear of being an invalid, a burden, a vegetable. These are complex questions which Gesundheit wants to address.

SUN: In the Eskimo culture, when older people see their death approaching, they call all their friends and relatives together and have a big going out ceremony. That’s the accepted way to die, surrounded by your friends and family, giving your last goodbyes. I imagine that the outlet for grief and sadness there would be so much easier.

ADAMS: Yes. The current model of stuffing people away in intensive care units, with tubes, and bleep-bloops — that’s fine in an auto accident, for an emergency room. But to hide our dying away from the living has created fear. If dying were the natural process that it was before this century, there would be a lot less concern, fewer fears.

SUN: Would you compare the so-called traditional medical establishment with the holistic approach?

ADAMS: I can compare it with our approach. There is not a holistic approach; almost anything that is not the traditional hospital, doctor, nurse, pharmacy, surgery, laboratory, is called holistic. The chiropractor and the massage therapist would be as much a model for holistic health by the current definition as what we’re doing. The “tradition” we are contrasted with — the present pharmaceutical-medical-industrial complex — is no more than forty years old. The tradition in medicine, as I see it, comes from Hippocrates, Paracelsus, William Osler — other traditions. I think that we’re different from most current medical practice in four or five major areas. We don’t charge money. Of course, most holistic practices are just as guilty of high cost as traditional medicine. We try to address the dehumanizing issue in health care by working in the context of friendship, by having our patients live with us, by going to their homes. We try to address the horrors of the malpractice problem by not carrying malpractice insurance, not owning anything, not fearing loss, not practicing defensive medicine. We address the horrors of the third party insurance reimbursement plans — Medicaid, Medicare, Blue Cross Blue Shield — by never accepting payment from any of them. And finally, we try to address the big problem of iatrogenic disease — physician-caused disease — by being very close to patients, trying gentle solutions first, spending a lot more time and following people closely. I’m not saying we are free of this concern; anyone would lie to say they haven’t ever made a problem worse. But I think our kind of care — living with the patients in a facility — allows for a greater chance of catching a mistake before it’s a big problem.

I saw the difference between patients who were full of God and those who weren’t; the ones full of God needed less medication, were happier, had better relationships.

SUN: Have you ever had any legal difficulties without malpractice insurance?

ADAMS: None. To my knowledge, we’ve never had anyone even come close to suing us. I can’t imagine a lawyer taking on the case; we don’t carry the millions of dollars worth of malpractice insurance, we don’t own anything, and our salaries aren’t very big. Since lawyers get a percentage of what they make, we’re not nearly as attractive to them as a heavily insured person. I’m not saying it won’t happen, but I like to think that the reason we’ve had no trouble is not so much that we don’t have anything to sue for, but that we’re friends with our patients, and they accept the fact that we make mistakes. One of the reasons we encourage self-responsibility is to lessen the need to treat people, and the risk of hurting them.

You set yourself up by going to a doctor, whether it’s us or anybody else. When you take your care out of your own hands, you are taking a gamble. I won’t tolerate malpractice insurance because I will not practice in fear.

SUN: People come to doctors, or other “experts,” because they feel they don’t know enough about keeping themselves healthy. They want advice, opinions, if not outright help.

ADAMS: I talk to people about self-responsibility. I give them nutrition and exercise books, talk with them of faith and family — any avenue toward pursuing self-responsiblity. It’s the most exciting thing I do. When somebody comes in, healthy and wanting to stay healthy, really wanting to listen, to try things, and open up, then I am just happier than a pig in a poke. Their interest is thrilling for me. I want them to know the breadth of possibilities, ways they can be healthy. I don’t want to push any particular way; I just want to push the idea that as you move closer to caring for yourself you will be healthier.

SUN: And self-responsibility includes recognizing when you don’t know and where to go for help.

ADAMS: Absolutely, reaching out when you need it — for a surgeon as well as for a holistic wellness kind of interaction. Self-responsibility is very broad — from picking up the trash on the side of the road, to involvement in the nuclear issue, to voting. If I plant the idea that you really are a responsible person, that your life and life around you is affected by you, even though you’re only one person, life can become very exciting.

SUN: Let’s talk about your plans for the hospital facility in West Virginia.

ADAMS: We have 310 acres in Pocohantas County. Set up in a land trust, it will be owned by the constituency it serves. We are planning to build a 25,OOO-square-foot facility to provide bedspace for thirty patients and house the staff. This collective house will have a library, quiet areas, noisy areas, music areas, meeting areas, therapy areas — hopefully the atmosphere of a loving, funny, cooperative, creative home family life. First we want to build a 6,000-square-foot shop for woodworking, the dirty crafts like pottery and silkscreening, ones involving use of chemicals, and noisy crafts like mechanical work. We’ll use the shop to build the facility, and as a place for our arts and crafts development. We believe one of the ways we’ll support ourselves is through selling our arts and crafts. Most of the staff have highly developed crafts, creating pieces that are beautiful and very well-made.

SUN: So it will be a community, not just a hospital but a whole village.

ADAMS: Exactly. We’re a family with health skills. We want to be as exemplary in our farm work, appropriate technology, land use, and arts and crafts as we are in our medicine. We want that holistic approach. We want to build a full performing arts center, plant several orchards, and put in a lake to be used as a fire hydrant as well as for fish farming, recreation, ice skating. So, on any given day, patients who are ambulatory can stroll through a wide variety of gardens, work in the food garden, work with the children, do arts and crafts, sports, hobbies. They’ll be working and serving other people, learning, and relaxing, all while their health issue is being dealt with. Too good to be true!

The medical service will include full medical and dental service to the surrounding area. It’s a medically under-served area, and we would like to fill that need. Our primary medical focus will be on inpatient care of people who will come from anywhere in the world to get our variety of techniques, our kind of loving environment, as a way to deal with their situation. My goal is to have everything from faith healing to surgery. When we open — when we cut the ribbon — we will have at least six physicians practicing chiropractic treatment, acupuncture, homeopathy, herbal medicine, and a number of other healing modalities, along with surgical, OBGYN, and psychiatric services. Full service is what we’re talking about, a full range of service within both traditional and alternative medicine.

SUN:Do you already have a lot of these people?

ADAMS: More than we need, more than we could ever wildly use in one facility. Of course, the dream is people’s interest in us trying to create similar facilities, giving us places for all these helpers to work. There are many people who want to stop the kind of care that they’re giving now and do something like we’re doing.

SUN: How is this all going to be paid for? It sounds beautiful but how will it work?

ADAMS: Well, we have done it for thirteen years. We have had at least 15,000 people in our environment, and it’s grown more vibrant and real than ever. Most of the money has come from the staff working part-time elsewhere, and pooling their earnings. The bulk of the money for building our facility has come from donations from other people. We also have a clientele for our arts and crafts. We’ll have no trouble continuing to use part-time job income. The annual operation of our facility, including salaries, will cost about $200,000 — about $120,000 to run the facility and $80,000 or so for salaries for 25 to 30 professionals, each paid the same amount. Ideally we’d like to be fully supported by donations. If we had 10,000 people on a mailing list, and each of those people sent in $20 a year, that would give us, for the cost of a subscription to a newspaper, a full facility. Last year we got $102,000 in donations, half of what we think we need. Right now I have a job at St. Elizabeth’s. If we sent in one doctor a week, and if we had six to ten doctors, that would bring us $110,000. It just costs us one of our doctors. We will pay for it, lower our standards, live on our interdependence. People will bring pies, an old car, a book that we need, grain for our animals. The idea will live because too many people insist on it — the bottom line — and because it’s cheap. For less than the cost of a surgeon, they’ll have a full facility. We realize that it’s fairly unbelievable, and we have only our past to draw on. This will be a new page, a new chapter. We are going on faith that solutions will come for this as they have come for us in the past.

SUN: Faith in the beauty and inherent qualities of the idea and the people involved.

ADAMS: Yes. And once we’re open, foundations are more likely to give us support. We’ve gotten four foundation grants for parts of our work. I can’t help but think we’ll be very rich.

SUN: What will be the decision-making process in this facility?

ADAMS: Right now I’m the acting dictator — uh, director — of Gesundheit, because it’s a vision that came out of my thoughts and because, once we left our facility in 1979, the staff insisted that we have an acting director to oversee and keep the fantasy, and I was chosen as that person. The plan now is for me to be in this position until two years after we’ve opened, at which time it will be thrown up to our constituency and to the staff to see what they would like. At that point I would like to step down — unless both of these groups insist on me continuing — and let a board of directors of the people we will serve and representatives from the staff work together to determine the policies for guidance. We’re continually exploring ways of government. Until 1975, we operated on one person, one vote. That is a very good system if there’s another system that holds the vision. It is important for me that the vision is held true — no fees, living with our patients, not carrying malpractice insurance — that we define what our absolutes are and allow flexibility in everything else, having a minimum number of rules. It’s a tough issue.

SUN: Have you had any legal squabbles with the local authorities in West Virginia?

ADAMS: Not at all. Fortunately, West Virginia has very few building codes. Fire codes, handicap codes, and sanitation codes are the primary ones. We’re very interested in meeting their demands, because obviously if people wanted to close us down, our neglect in these matters would make it easy. All of our licenses and code work will be in order.

People will bring pies, an old car, a book that we need, grain for our animals. The idea will live because too many people insist on it.

SUN: To what extent, in a conscious way, do you feel this project is spiritually inspired?

ADAMS: Unquestionably it is what we believe in, if that is what is meant by spiritual. To serve God is the abstract that I think all the staff hold as true. All of the people who help us in some way feel that it’s their spirit world, or faith, that the work addresses most. I didn’t start out saying I was serving God; I said I was going to serve humanity. Since I’ve become a doctor, they have come to mean the same: to serve the planet, nature, and individuals. I would defy somebody to undertake such a project without having something so powerful to serve. It takes big powers to serve big projects.

SUN: Have you ever felt the vision slipping?

ADAMS: There have been little times all along when people questioned the overall picture. In 1979, when the family of people we’d lived with since 1971 said they wanted us to cut back, I didn’t sleep for fourteen days and did a tremendous amount of crying. It was very tormenting for me, realizing that in a way I had to choose between my service and my friendships. I chose the service because I knew that in the long run the friendships would always be there; I did not get the feeling that if I chose the friendships, the service would always be there. I felt I could live more easily with the conflicts of losing the friends than giving up on the dream. And I didn’t see an alternative dream in focus, another variation. I didn’t see a substitute that involved cutting back. I saw cutting back as self-serving, and it just wasn’t something I could do. That was a very, very painful time. Now, five years later, the friendships are all solid as a rock.

SUN: How do you deal with images of authority and power which may be projected on you by patients?

ADAMS: Often with practical jokes — by being nutty, being real. Living with me and seeing my mistakes, they realize I am not an infallible person. Sometimes I’ve intentionally made mistakes. Sometimes I just do wrong because that’s what happens. It’s very destructive to build up dependencies. It serves nothing but the desire for power to make a person dependent on another person, or a drug, or a particular method. I assume a role of imperfection.

SUN: Or even the role of a fool.

ADAMS: Playing the fool is easiest for me. There are few things like a horse’s ass to nip a person’s worship in the bud.

Being a happily married person, with a family, has been helpful. Patients know how hard it is to do, and they can see us working on it. I very frequently say that I don’t have the answer, I don’t know what can help you, let’s see if somebody else can — even if I think I know the answer.

SUN: As you say that there is a mischievous smile playing on your lips.

ADAMS: I’m a karmic chameleon. Boy George and I have a lot in common. I don’t know all the answers, I’m a doctor of Gesundheit who doesn’t have a system. What I offer somebody is avenues toward quality of life. But if they say, “Come on Patch, I need some help, I can’t change my ways,” then not having the answers, or having a very difficult answer, is a big help.

I’ll give you an example. Somebody called up wanting me to help his girlfriend who was addicted to Valium and now wanted to get off it. I don’t know if you’re familiar with the book I’m Running As Fast As I Can. There are a lot of people dependent on their tanquilizers, trying to get off, not feeling they can, and wanting a magic way to get off, you know, “Presto, I’m off.” I think there are magical ways to get off, but you’ve got to try a hundred magic tricks in hopes that one will work for you. People tend to want the McDonald’s fast food approach.

Three or four people called me before the woman herself called. It’s difficult when people don’t assertively call to help themselves. Her picture was that she thought she was a lot stronger than anyone else believed. Over the phone, long distance, with someone looking for immediate solutions, I always look first for the self-responsibility solutions. Wean yourself off, I say, and if you have problems give me a call, call on your support system, pray, meditate, or exercise — whatever will help support you while you’re going through withdrawal. She says, “Yes, I can do that, I’ve done meditating, I’ve done those things, I’ll do them.” She starts withdrawing herself, starts panicking, doesn’t call me, doesn’t do the things she was encouraged to do, and then says, “Well, you said that this guy would save me and he didn’t do it.”

The whole idea of the kind of physicians we are was as alien to her as it is to most people. It’s not that I have a solution, you follow it, the problem is solved. There are doctors like that, wanting to take all the credit. I tell you I don’t have the answers. You try these things, and what I’ll do is be in the process with you. But I don’t have the answers. Her feeling was that by calling the person with the big reputation she was going to get off her pills.

I like to start with the statement that I’m a loser. I’m a failure. I can’t help you. “Sorry, I can’t help you,” is often how I begin an interview. Tongue in cheek I say don’t look for the answer in me. I work on a lot of answers and hopefully find one that works for you. I certainly will encourage your search.

I keep my mistakes around me, my failures. I’m not ashamed of them. I’ve tacked up a great statement by Melville, which I don’t know by heart, but it’s the equivalent of, “If you haven’t failed, you haven’t tried.” And another: “He failed in this, he failed in this, he failed in this, he failed in this . . . he was elected President.”

SUN: Abraham Lincoln.

ADAMS: Yes. He failed in everything. That’s me. I don’t want to be known as having the answers. I want to be known as frightened of the answers.

SUN: Of the pat, commonly-accepted answers?

ADAMS: Outside of self-responsibility, everything to do with medicine is frightening to me. I don’t know which system, whether it’s homeopathy or acupuncture, surgery or internal medicine, is your best answer. And it scares me to think that you want me to make the decision for you! That’s why I want to have all the modalities in one room, have us all working on it, and hopefully the person will get a feeling for what they want to try. And they’ll have time to try the gentle ones before the less gentle ones. And they’ll be around people observing them, so if what they’re trying isn’t working, they’ll be encouraged to try something else.

SUN: The initial interview — several hours long — would certainly seem to help steer toward a modality that might help the person.

ADAMS: I’m basically afraid of being a doctor. I’m particularly afraid of being a doctor on my own. I can’t take it. I want a lot of help. I want not to be “The Doctor.” But, at the same time, I’m happy to get into anybody’s life. How’s that for a non-answer? Next question.

SUN: Being a physician and coming into contact with people who suffer, how do you keep your own balance?

ADAMS: I try to concentrate on the joy of a patient’s trust rather than on the picture of their pain. And their suffering is theirs. My suffering is mine. I try very hard to keep that view, no matter how sad and pathetic the situation is. I try to accept how great my own life is — great marriage, children, friends, the opportunity to follow my dreams, a tremendous number of hobbies. I’m able to follow every one of my dreams. I try not to lose sight of that. For me to be sad for a minute is a lie. It’s just not sad, it’s great!

SUN: That’s a wonderful perspective.

ADAMS: People make fun of me saying great, but it is great. “How’s it goin’?” “Great!” “Oh, you always say that, Patch.” I want to respect the greatness of life, and give thanks for how large a slice of the pie I’ve been given. I don’t want to belittle in the slightest all the great things that have come my way. I try to let that affect me, let my wife, my friends, affect me.

SUN: How do you stay healthy?

ADAMS: I do my own variations of the techniques I recommend to other people. I stimulate my God feelings, feelings of family, friendship, nature. I know I need them. One of the main reasons I feel healthy is that I know I need the things that matter to me, and so I medicate myself every day.

I, think the single most important force in my health is an ability to live a give-and-take in love with a lot of people. A lot of people let me love them, and I let myself love a lot of people. I live in the happiest imaginable household, communally, with friends. I’m happily married, with a super wife, a wonderful child, and another one coming along. I live and worship all the parts of God that matter — friendship and nature. I have Emily Dickinson’s love for the blade of grass and the spectacular volcano — each holds wonder for me. Wonder and curiosity are key parts of my health. I’m always interested, and always amazed. I speak first of health as if I had no body, because I want to impress upon people that you can be healthy and paralyzed.

I read a tremendous amount, I study art and music and let the great creations of mankind affect me. I have a very large number of hobbies. I pursue almost every interest — juggling, rope-walking, unicycling — some that will take forever to learn, and some things that take a moment.

As for my physical body, each year I grow closer to eating a healthier diet. I don’t know that there is a healthy diet, for me or anyone, but each year I eat better — less refined, more wholesome foods, less junk food, fewer sweets — than the year before. I put fewer poisons in my body that the year before. And I’m wild for exercise. I do regular heart-lung and joint flexibility exercise. I have stamina. I’ve never figured out how much sleep I need. Though I know the rule is six to nine hours of good sleep a night, I’ve never been near that average. I don’t know if that hurts me or not. I certainly sleep when I’m sleepy, and would recommend that for people.

The only things in my life I feel any “unhealth” about are the horrors of this planet — the ecological, nuclear, and war situations. They are always there, threatening my health, and I feel much better by trying to address them.

People make fun of me saying great, but it is great. “How’s it goin’?” “Great!” “Oh, you always say that, Patch.”

SUN: And not shoving them aside, pretending they don’t exist.

ADAMS: Yes. And not feeling that I’m helpless, but making an example, living an alternative, researching and understanding the horrors, knowing the enemy, but not just condemning them.

SUN: What are your thoughts about home birth?

ADAMS: My only hesitancy comes when it hasn’t been a well thought out, conscious choice. Our child was born at home and it was the highest moment of my life, the single most intense time of my existence.

My wife talked me into it. As a physician I was afraid if something came up, that I would have to be a doctor for this new thing, and I did not want any responsibility on that level. My wife convinced me that I would not have to.

I don’t think home birth is for everybody. I don’t think anything’s for everybody except love. Death is assured us, and our need for love of some kind is a truth, and that’s about it for truths. I don’t belittle a woman or her husband wanting another kind of delivery. I want to celebrate the birth, and hope they have as much fun in theirs as I had in mine.

SUN: What do you have to say about psychic surgery? I’m not even sure what it is.

ADAMS: It’s just the name given to one of many health modalities that lend themselves to “quack” lettering. In the hands of a very caring, humble person, the tools of the healer are simply the magic of his trade. If they know their limits, and know why it is people seek them out, and don’t consider their system to be the only answer, then I understand and support their system of health care. Whether it’s sleight of hand, whether the event itself is true and meaningful, isn’t as important as the person who is there for help — the reasons they are there and why they’ve chosen that specific health professional. There is a need for the astrologer, the tarot reader, the faith healer, the psychic surgeon — and reasons not to lump them all together as Western medicine tends to do. They hold miracles. People were astounded when Freud went through mental hospitals and allowed the lame to walk and the blind to see. During Victorian times, mental hospitals were full of what Freud called “conversion reactions” — people who couldn’t walk, yet without a clear physical reason. I mean, there was a physical reason but when they dealt with their problem, they were able to walk. That was magical. If you ever sat in on open heart surgery you would be amazed at the magic. I have friends who have gone to psychic surgeons and felt positive about the experience. But if they do their healing art for greed, or to enhance their own self-worth or power, then I’m afraid of any of the techniques in the hands of that kind of professional.

If a magician can help a person — if smearing shit on their face solves their problem — then I would be the first to throw the pie. There’s no technique that should be belittled because it has no validity, because it has an air of magic or mystery attached to it. It should be belittled only on the basis of the greed and power and arrogance that can come from that interaction.

SUN: Individual qualities belonging to the person, not to the technique itself.

ADAMS: Yes. I saw an astounding movie when I was a medical student, shown in an anthropological light rather than the arrogant Western medical light. I was thrilled. It was a film of a trepanning operation. Have you ever heard of that?

SUN: Cutting into the skull.

ADAMS: It was astounding. A woman was possessed, sick, by the tribe’s standards, and had all the manifestations of real illness. She went to their witch-doctor doctor, and for the price of a goat or sheep, and three strings of beads, he operated on her. Using no anesthetic, no sterile technique, he exposed the brain — all this being filmed — and let out the demons. I have a memory that he used manure compresses or something. In any case, it was the equivalent of craziness, relative to our science. He closed the person up, and shown a couple of weeks later, they were thrilled, everyone was happy. One man’s meat is another man’s eggplant — another woman’s eggplant.

I only care that something works. I believe physicians are there to serve the patient, not to serve themselves. If something can work who gives a damn whether or not it would work in a double-blind study?

Now if it hurts a lot of people. . . . We don’t know how many people went to their witch doctor, had their brains opened up, and died of meningitis. But in the context of that tribe, they go with the flow. Just as in the context of our tribe we do radiation, and sandpapering for acne, and operations like hysterectomies for no reason at all. C-sections for normal deliveries. There is madness in all healing arts, and great abuses. Jim Jones is a good example. Just as Mother Theresa is a good example.