In the Realm of the Hungry Ghosts. Gabor Mate.

Mate, Gabor. In the Realm of the Hungry Ghosts. Knopf Canada 2008. NF; 08/06

Dr. Gabor Mate (pronounced ma-TAY) is a Vancouver GP who was, when I was in university in the late 1960s, a campus radical. Only the near-elderly will understand what this meant. For the rest of you, we at that time were filled with the excitement of our “generation” throwing aside the stupid shallow values of our parents in favor of our own much better ones (there may be something less than unique about this …). And some of us (as people do in just about every imaginable situation) went a bit over the top in the view of some others. In those days as a conventional arts and science student wandering around campus in a daze I saw Gabor as a bit crazy, even narcissistic. He seemed always to take the extreme view, always appeared in public protests at the front of the crowd, and always gave what I saw as a contrived picture of a troubled, sympathetic, humane, suffering champion of the underdog. Without any other information than his public persona, I imagined Gabor Mate had one eye on the mirror as he went about converting the world. How could somebody like that be for real?

Dr Mate re-emerged for me in the 2000 decade as a doctor who was writing. He had authored several books, one on ADHD, and another called “When the Body Says No” to do with a psychological revulsion for things that offend us, with the result that we get sick…

And again without really anything to go on except envy and sour grapes, I wasn’t impressed. I was getting ready to try to write about health care myself, when one day wandering aimlessly in a bookstore during a vacuous afternoon with nothing to do at one of my administrative jobs, I picked up his latest book, Hungry Ghosts. Maybe I bought it because I felt like a Hungry Ghost, wandering all aimless there in the bookstore at 3:30 p.m. having had nothing to eat since seven o’clock the night before. Maybe the daze of my university years was still with me. Certainly I had clear memories of Gabor Mate, and so I started reading his book with an inner skeptical sneer.

But after six pages I found myself (do we really find ourselves? It’s like waking up from some kind of a reverie I guess. The proper verb really is just was) gripped and fascinated, so I faced this little crisis: I had to admit I was in the hands of a brilliant knowledgeable committed… what… teacher. I couldn’t avoid my conviction that what I was reading was absolutely beautiful.

Addiction, like ADHD (or anything else that drug industry or academia wants to make a dollar or a career out of) can be expanded to include most of us, and Mate does this. But we end up with his unavoidable understanding of how parents abandon their children. Wait a minute: addiction from parents abandoning their children? That’s his big idea. And the idea expands, with the momentum of his writing.

Here’s how it expanded for me. Most of us live our lives as a kind of false dream: I’ll go to school, go to university (or not), get a job, find a partner, have kids (or not), make some money, grow up, be happy, get old, curl up, and die. But then we carry on and live that simple morally devoid dream. Our naïve just-so story fulfills itself. But then just when we think we’ve launched ourselves into a grown-up life and living the dream is going to be fine, a complication develops: there isn’t time to do everything the dream demands in the middle third of our life. We can’t be the effective lover, romantic partner, career-winner, and parent in the same 24 hours. So that dream we cooked up in late childhood or adolescence now forces some decisions. In Mate’s reading of his own life (or my reading of it anyway) and implied understanding of most of ours, we slide without really thinking into the expedient thing: abandoning the children. Or their interst anyway.

It’s just so much easier to do the job, love the already lovable person you married, cut the lawn, cook dinner, have a couple of drinks, and crawl into bed than it is to face each and every trouble that dear darling wonderful adored annoying screaming complicated children present. So they get only the last bit of energy and time, which often isn’t even there.

It’s pretty tough not to see it in our own lives. Still, Dr. Mate is talking about his downtown East Side patients, whose early lives featured a bit more than not being the center of their parents’ attention. They were thrown against walls, lay under a bed while mother injected herself and turned tricks, were raped at the age of seven or eight (boys and girls indiscriminate) by a long string of boyfriends (and relatives), and endured being beaten up at night for fun.

He’s just saying that the need that horribly thrown-around child feels (for love, for somebody to care about her, for warmth and soothing and comfort) is a sharp need we all feel. Just because our parents are normal. And so are we children. Until we smarten up and start figuring out how to make moral choices. The book is not only about addiction.

During the third quarter of Hungry Ghosts, Dr Mate changes gears a bit and his ideology moves out of my limited range of credibility (I’m pleased to consider myself a “pragmatist”). Conrad Black and George Bush are really addicts who were abused as children; the war in Iraq is due to addiction. The expanded version of addiction that appeared to me so powerful and challenging would also apply I suppose to Che Guevera and Al Gore. I think I could have stopped reading halfway through the book still come away with something honestly wonderful.

But I finished it. And then, plucking up my courage, asked Dr. Gabor Mate to write a foreword for my own less radical, less well-written, and far less best-selling book in 2009. Very kindly indeed, he did, and I am absolutely certain he pulled, as one must in a foreword, a lot of easy punches he could’ve aimed my way. Thanks, Gabor. 7.2/9.0.

About John Sloan

John Sloan is a senior academic physician in the Department of Family Practice at the University of British Columbia, and has spent most of his 40 years' practice caring for the frail elderly in Vancouver. He is the author of "A Bitter Pill: How the Medical System is Failing the Elderly", published in 2009 by Greystone Books. His innovative primary care practice for the frail elderly has been adopted by Vancouver Coastal Health and is expanding. Dr. Sloan lectures throughout North America on care of the elderly.
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