Friday or Saturday night, end of June 2007, Patch Adams came to Ukiah to help the local hospice raise money. About 100 people-all sorts of people-came to hear him at the Ukiah City Conference Center. He spoke for a couple of hours at least about his organization, the Gezundheit Institute, through which he works to build a 40-bed completely free hospital in West Virginia, and about his life of active caring.

Night before last a friend invited me to go into town to hear Patch Adams speak. I had only a small idea of who Patch Adams is-that-from the movie-he's a doctor who heals with laughter and comedy. I had no idea how limited a picture this was. And the things he said fit wonderfully into what you wrote last, Lynette, the giving you work to put into practice in your life, and my own dilemmas. Therefore, this is a report.

Patch Adams is very tall, maybe 6'5" or more, and he wore big baggy clownish pants with blue and red and yellow chaotic patterns on them; a very bright aloha shirt with big yellow flowers at the top up by his shoulders; and a broad tie with lots of small dots on it. Half his gray hair was died blue and the whole tied back in a ponytail. He's 62 years old.

When he talks, he strides about in front of us, not up on the stage but down on the audience level, waving his arms in big gestures. For a bit, the mike didn't work, but that didn't matter too much. He has a loud voice.

He asked us first how many of us had seen the movie. There were a good many raised hands. Then he told us he'd give us the real history, since the movie employed an actor a foot too short to play him. He would give us the final foot. Later he said that the movie was Hollywood fluff and that they had not given his foundation any share of the very large profits.

The history was amazing. Later an audience member asked him what he thought about mental illness, and he related that he had been committed three times when he was 18 because he'd been a happy kid, got involved in the civil rights movement and couldn't stand what he saw human beings doing to other human beings. In the mental hospital, he realized he could use his life to make things better. He vowed to himself that he would be happy and says that for the last 40 years, he has not had a bad day. When he got out of the mental ward, he went to medical school, spent his time there studying-with horror--the healthcare system, and when he graduated, started the Gesundheit Institute.

Patch Adams is completely openly and loudly anti-capitalist. Money and greed are destroying healing (and everything else), which cannot be sold without being corrupted, so he and 20 friends moved into a 6-bedroom house and opened a free hospital. I guess that was about 1972. He says no one got paid and no one left for nine years. They kept the hospital going for 12 years. Between five and 50 people stayed there every night. Some of them were mentally ill. The whole thing was completely challenging and alive. The main order of the day was that everyone had to have fun. The only thing that was not allowed was physical violence. They learned to be creative with verbal aggression.

Even though many very crazy people came and stayed there, there was never any violence. Once people felt themselves accepted and loved, they became less destructive. He pointed out the level of loneliness and unlovedness in this society. What he noticed immediately was the extraordinary level of people's need to be loved and recognized-how utterly needy everyone is. And he decided the best way to be loved is to love. He put it into practice-active caring.

They learned to be creative with having fun through what anyone might think were awful circumstances. If a bulemic came to the clinic, he said they'd all go barf with them. They'd get involved, deeply involved, with everyone's illnesses, not treat them from a clinical distance. He abhors the doctoral value system that says "Do not touch your patient in any way. Do not let the patient into your life or let yourself into the patient's life." Where else does this precept lead to but more loneliness and neediness? How can we really heal without really touching?

He said you can imagine there was no privacy. In the bathroom at any one time, there'd be someone in the bath, someone on the toilet, someone doing his hair and someone just hanging out. He learned-he had started learning this when he was in the mental hospital-the value of friendship, deep unstinting friendship. He's a family doctor, and the first interview with a patient takes three to four hours. He wants to know everything. All the things you're not supposed to ask, he asks-how does it feel to be so terribly ugly? He visits the person's house and looks through all their drawers, attic to cellar. He wants to read private letters and journals. How else, he says, can he really know how to treat a person? He loves new patient interviews. He'll get to go to their houses and poke around.

Healing, Patch says, has to do with everything imaginable. At the hospital, they included food and farming, feelings, relationships-the whole family has to be involved, along with friends and community. The person is not healthy without a healthy community.

As you can imagine, I got more and more excited as he was giving us this history. Of course-this is what I have always believed. Everything has to be healed. It doesn't make sense to treat a pimple, when the problem lies with the entire system. Perhaps, in fact, and he pointed this out too, the pimple is the only healthy thing. In a society that's upside down, whose values are twisted out of true, it might be a sign of health to be crazy. He said that too.

After the hospital adventure/experiment came to an end, he determined to build a 40-room hospital that would also be completely free. They would never (and they never had) accept insurance, never take out malpractice insurance because that makes the relationship between healer and patient one of fear and mistrust, never accept pay for healing. No one would be turned away. In that 40 years, he has continuously applied for but not received the funding necessary to build and open the hospital. They have bought 300 or more acres of land in W. Virginia and are building with the money he earns as he gives lectures around the world 300 days of the year. He keeps none of the money himself.

He leads clowning expeditions of ordinary people, aged eight to 80, from all over the world, to war zones like Afghanistan, to orphanages in Russia and other poverty stricken countries, to refugee camps. He said he's cried unendingly when he sees the unimaginable suffering in places like these. He cares and tries to bring some joy into impossible situations.

He clowns at deathbeds. Among the "civilized," he tries-I think-to jolt us out of the civilized rut we're in. He asked in an interview how it is that a person, once she knows she's dying, can regret the inaction of a lifetime and then spend the month he has left with more inaction! Patch tries to move that along.

He asked if we didn't want to know how he manages to be a constant, without rest caregiver and not burn out. Of course, we wanted to know. He says that caring gives him total joy, fills him completely. There are seven things he thinks are vital to having a life of total fun as a caregiver: loving people, compassion, being a hero, enthusiasm, passion, [I'll have to fill in the 2 others when kate gives me her notes]. He spent a long time on each of these ways of living a life of joy through caring. He gave us lots of examples. The experience of listening to him was uplifting, hopeful, engaged, and irreverent of stultifying polite rules that keep us apart.

He is horrified at the way people view caring at the moment. He hears people say "I couldn't care less" or "I could care less" (which he says is wrong grammar-but I don't know) or "who cares?"-what do those expressions mean about our society? People couldn't care less about children dying in Iraq. They couldn't care less about children starving to death. He has held people who are dying of starvation. He asks if we can imagine how that is, what the smell is like. There's a particular smell when someone is dying of starvation he says. He says every eight seconds, someone dies of starvation-or was it a child, every eight seconds.

But it is caring that will make the difference. Isn't not caring the same as being dead? Another thing he pointed out earlier, along with the huge loneliness in this population in the U.S., is the huge lack of self esteem. He thinks that perhaps 3% of the people he's interviewed as patients have had solid self esteem. The rest of us are not confident of our own worth, of the value of our opinions, of the necessity or need or even noticing of our caring. Why care? "Why should I care?" It doesn't make any difference.

Patch Adams' life is a monument (not a dead one, a living growing moving monument) to the fact that we can make a difference. That our engaged deep caring will make things change. The rewards he says, are instant and enormous. He tells stories of the deep connections he's made going up to strangers on the street, wanting to know about everyone and everything, and willing to cross all kinds of social barriers to do it-clowning on the street, asking questions one "doesn't ask." He answers every letter he gets personally and in longhand-perhaps 800 a month. He says exactly what he thinks and feels.

During the question and answer period, the first woman asked him to give us a love poem (he has said that he has 7 hours of poetry memorized), and he chose "The Fundamentalist" by Sam Hirsch. I don't think I've ever heard a better poetry reader-just a reader, not a performer--quietly reading a poem with total expression and involvement, just the way he does everything else. He answered questions about how he views mental illness (he believes in polypolar, not bipolar, polyphrenic, not schizophrenic, and, being a hyperactive kid himself, thinks we should all be more hyperactive, blowing apart our usual notions of health and illness), what he thinks of single payer healthcare (he thinks it's good but that it isn't enough-there's so much more to health and the necessity for change involves a great deal more than money).

The last question was from a woman who wanted to have her photo taken with him. The event was a fundraiser for a local hospice, and the auditorium hadn't been filled. He asked what she'd be willing to pay for a photo with him, the money to go to the hospice. She hesitated and finally said, $2. He waved his hands and asked if anyone in the audience would be willing to pay for her to have her photo taken. A man immediately put up his hand and said he'd put in $20. I had my photo taken with him with our fingers up our noses. I'm going to send him the photo I have of a very little Annie and me with our fingers up our noses. I came away filled, happy and inspired.

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Websites for more information: http://www.iaig.ca/patchadamsbc/documents/interviewpa.html, http://www.context.org/ICLIB/IC13/Adams.htm, and http://www.chasingthefrog.com/reelfaces/patchadams.php