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Wednesday, November 19, 2008

The Yuri Gagarin of NIH (2002)

The Yuri Gagarin of NIH
Roger P. Peters ( 1943 - 2001)



Though you are in your shining days
Voices among the crowd
And new friends busy with your praise,
Be not unkind or proud,
But think about old friends the most:
Time's bitter flood will rise,
Your beauty perish and be lost
For all eyes but these eyes.

-WB Yeats


“The modern hero is he who triumphs in the inner struggle.”

James Hillman



I only heard from Roger in times of great crisis. Once, after years of radio silence, he called from a curbside in L.A. He had just filed for his third divorce and was fleeing crazy in pain from his home in Colorado, driving his Volvo P1800 fast and living in his car until the worst of it subsided. “I’m getting divorced again, Schwartz,” he started abruptly. “I’m across the street from the L.A. courthouse. I just filed the papers. I’m heading North.” Then all was quiet for some more years. He buried himself in teaching, tracking coyotes, skiing, and writing books on cognitive psychology, trying to grab fame somehow with this next one. This was normal for Roger. He had been just this way back at New College in Florida in the sixties, when we had sat on a log by the bay and studied the emerging field of psychobiology together. Life for Roger was all full-throttle acceleration punctuated by cataclysmic crashes. As he crawled out of the latest wreckage, my phone would ring.

“Roger!,” I exclaimed with delight when the phone rang a few years ago. “How great to hear from you! What’s up?” Roger was at home in Durango. This time he did not get to the point right away. We talked of this and that. But then he blurted it out. “I have melanoma.”

I’d heard a little about melanoma, one of the most feared of all cancers. I remembered Doc Daneeka in Catch 22 was morbidly afraid of it. Doc Daneeka was a driven hypochondriac who was always sure that the latest of his symptoms were sign of some dreaded disease that would kill him and, at least by that route, get him out of the War. He studied up on fatal diseases. His favorites, I remember were melanoma and Ewings’s tumor. He liked the fulminating kinds best.

A fulminating disease was what Roger had, but he seemed typically matter of-fact about it. Once he rebounded from the first lightning-bolt of a cataclysm, Roger always spoke as if he were delivering a lecture to a large hall of his students; outlining his points logically, enunciating clearly with precise diction. He had had the mole even thirty-some years ago at New College; old photographs of him without a shirt showed it. It had never caused him any trouble. But a couple of years ago a physical therapist giving him a routine treatment had remarked upon it and advised him to get it checked out. It looked suspiciously like a melanoma to him. The physical therapist had been terribly right.

Melanoma, a physician friend of mine told me, is “sneaky.” I thought of it as a dry dandelion ball. You blow on it and the seeds fly in all directions. At least one seed had apparently scattered in Roger’s body. He hadn’t even bothered to tell me when he had the first mole removed. He hoped for the best. Sometimes it doesn’t spread. But another mole had appeared nearby. That was bad. His doctor had removed this one, too, but had taken the serious step of starting him on a year-long course of interferon. Interferon stimulates your immune function, makes you run a fever and hopefully “burns out” the dispersed melanoma seeds. Roger had just started as we spoke. He had taken a year’s leave from the university. Taking interferon, he said, was like having a mild intermittent flu. You gave yourself a shot, then you started feeling sick. You felt bad for a few days, and when you started to feel better you gave yourself another shot. Roger rolled with it. For the first time in his life, he was not focused obsessively upon being productive. For once he didn’t have a book deadline set for himself. He didn’t because he couldn’t.

Interferon was strange stuff, Roger reported, ever the meticulous observer. It gave you technicolor dreams. It also impaired your sexual functioning. No real matter, he quickly said. His girlfriend was on an extended job in another state. But she was to come home just when his year of interferon was over. “When Sherry gets back, Roger volunteered enthusiastically, “I’m going to get a 55-gallon drum of Guinness-flavored Astroglide!” That was Roger, fighting melanoma and laying in sexual lubricants at the same time.

Although he kind of breezed past it, there was one thing that told me just how serious Roger’s situation really was. “The doctor,” he said, after outlining in detail the next stage of his medical campaign, “says that if it comes back a third time, I’ve got about six weeks.”

I hung up my telephone and called our old friend Hart. “If we want to see Roger, we should see him soon,” I said pointedly. “Despite his optimism, I don’t think he has long. “Let’s go to Durango.” Hart agreed at once.

“But let’s not just fly,” I suggested. Let’s arrive in the proper style on motorcycles, just like the old days.” Hart was enthusiastic. We bought plane tickets, and not many weeks after met in the main concourse of the Albuquerque airport. “So how bad do you really think it is?” Hart asked, now that we could talk in person. “Roger sounded pretty upbeat on the phone.” “Roger’s always upbeat,” I countered. I’ve done a little reading on melanoma. Do you know what one oncologist said?” I asked.
“What?”
“Melanoma,” I paused,” “gives cancer a bad name.”

An hour later we were at Pedro’s motorcycle rental shop, cranking over two overlarge bikes for the trip up to Durango. Motorcycles had changed since Hart, Peters, and I had been riding buddies in Sarasota in the sixties. You used to have to stand on the crank in sturdy boots and kick the engines over. Now you just pressed a starter switch. But they roared just as loud as ever and went immensely faster. We flew out of town on old route 66, catching the old twisty main route up to Santa Fe. We leaned through the curves in the desert hills, stopping in Santa Fe, then climbing the mountains into Colorado, soaking our stiff motorcycle butts in the Pagosa hot springs. Pausing overnight, we rode the remainder of the route into Durango the following day, following Roger’s directions to his driveway.

Stopping at the bottom, we rode side-by-side up the sandy road to his house in a valley overlooking the overhanging mountains, rattling the windows with our straight-pipe exhausts. As we leaned the hot bikes over on their kickstands and pulled off our helmets a frail, back-braced, but broadly grinning Roger came out of his house to greet us. “Schwartz!,” he exclaimed, hugging me. “Hart!” “You came! And on these beasts!” He walked around them admiringly.

A mutual friend later told us that Roger had said that when we arrived it was like a whole part of his youth had come riding up his driveway. I was pleased. This was the effect that I was looking for.


Basic Natural Roger Peters.

Roger made his dramatic appearance on the New College scene in a memorable Basic Natural Science lecture on the mating ritual of the cricket. It was 1966. All one hundred of we first-year students were sitting on folding chairs in the teak-lined music room of the old Charles Ringling mansion in which we had heard so many intellectually challenging but academically wooden lectures. It was sometimes hard to keep one’s mind on the speaker as just yards away Sarasota Bay sparkled under the brilliant Florida sun, dolphins swimming along the breakwater in pursuit of jumping fish. And sitting just a few seats down from you was the entrancing and intelligent young woman with whom you had watched the sun come up sitting on that very breakwater. Having passed the night deep in conversation, you wondered if the pleasures of last night might lead to even more thrilling ones in the coming evening. Looking up from her notes, she gave you a warm glance. Yes, it was hard to concentrate on a monotonous academic monotone.

Then this little intense guy - he couldn’t be more than 5’2, shorter than his younger brother John a year or two ahead of me in school - took the lecture platform. I knew that he was a math tutor, although the catalog listed him as having a degree from Chicago in political science. But here he was lecturing on animal behavior. Well, at New College, the lines weren’t drawn rigidly. He was an incredibly dynamic, energetic speaker. He talked about the new emerging field of psychobiology, and the way that the study of animal behavior could tell you a great deal about the foundations of human experience itself. Sex, for instance. I glanced over at the young woman to my left. To dramatize, he laid out the invariable“hard-wired” fourteen steps of the mating dance of some kind of cricket. But instead of just delivering them from the podium, he danced them out.

‘First, the male cricket approaches the female cricket and waves one antenna,” he instructed, crouching down in a cricket-imitative stance, hands pointing out from the top of his head as antennae. Fixing a fetching woman in a sundress and sandals in the front row in a libidinous gaze, he suggestively wiggled one antenna at her. She colored, and the audience roared. “The female then signals back,” he intoned, leaping as if he were a cricket himself to the far side of the platform, spinning about and wiggling an antenna in the direction from which he had come. More giggles. Meticulously and dramatically, he laid out all fourteen ritualized exchanges of cricket foreplay.

“The purpose of the instructor, a great Michigan professor named Marian Kinget once pronounced, “is to dramatize certain insights.” The cricket lecture, remembered fondly by friends who were there with me in that room thirty-five years ago, conveyed an insight that piqued curiosities on my part that have driven a lifetime of study. Back then I couldn’t know with what power Roger would come into my life. “Who was that masked man?” I questioned a classmate after the lecture. “That class, my friend, was Basic Natural Roger Peters. And that’s the guy himself.”


Sitting on the Log.

By a year later Roger and I had become fast friends. We both loved motorcycles, we both loved adventure, and we both had become completely absorbed in the emerging field of psychobiology that I had first heard of via the crickets. Back when the field was small, we could do the heady thing that is so rare in modern scientific fields - we could read every article that came out. Then we’d talk about them.

One spring, Roger signed up to teach only one tutorial, and I signed up to take it. That administratively took care of his teaching and my course requirements for the trimester. We developed a rhythm. Starting early in the mornings, we would read the literature. Then, after lunch, we would meet on our tutorial log in a little clearing by the bay. Roger would fish under the log and fish out our mason jar, we’d roll a joint, and talk. “What about this new holographic theory of memory in Pribram’s Scientific American article?” I’d ask. “Is this incredible, or what?” And we’d talk animatedly about Pribram’s experiments and his new theory, which promised to replace the old localized idea about memory storage. We’d connect it with other things that we had read and thought about, about the behavior of people around us, and even society, in the midst of sixties turmoil. Everything was fodder for our conversation. This conversation continued between us, despite long interludes, for the rest of his life. These are things I speak of to no-one, anymore.

In doing psychoanalytic psychotherapy, which has become my profession in later life, I have learned the truth of the dynamic formulation of intrapsychic conflict. You conceive a wish, and against this experience a fear. The wish draws one forward, and the fear pulls back. In describing this, Freud captured a basic quality of the experience of living. I have come to see that the nature of the conflictual struggle in a life is determined in part by the intensity and energy of what analysts term libido, and which I think of as soul-force. In some people the energy of the soul seems very weak; in such people the intensity of the struggle is weak also. Desire is weak, and fear strong. When resistance to moving forward arises, it is not so hard to distract and subdue the resulting anxiety: some television, a few beers, maybe a little shopping makes it possible to continue what one is doing without too much discomfort. With others, however, the soul-force is massive, and the fear also. Here one sees a great and even illuminating struggle, with massive suffering. One may see a life-course characterized by stratospheric flying interspersed by cataclysmic crashes.

I remember hearing a story about the great composer Stravinsky. He had written a piece for violin which a great violinist in an orchestra had struggled with hopelessly. Finally throwing down his violin in disgust, the violinist shouted to Stravinsky, at the podium, that the piece “unplayable.” “Yes,”Stravinsky replied. “What I am looking for is the sound of someone attempting to play it.”

This was like Roger’s life - riveting music punctuated by broken strings, jumping up and down on the violin like a frustrated Daffy Duck, followed by great heights of musicianship. As often as Roger proclaimed another “peak experience,” he was alternatively dusting himself off of broken glass, broken telephones (he once put one that had brought news that displeased him through a small hole in his kitchen wall, followed by the kitchen chairs.) When he married his second wife, a very nice woman who struggled with depression as much as Roger struggled with more animated crashes, we referred to them as a couple as “R & B:” not for Roger and Bonnie, as they thought, but for “Rhythm and Blues.” Roger was all Rhythm.

This was the story of Roger’s life. Back in college, one of those sudden torrential downpours started when Roger realized that he had left his car windows open. Rocketing out of the door of the science lab without looking to the left or right he stepped right in front of one of the maintenance crew’s pickups, which caught him square on the bumper like the sweet spot on a baseball bat, whacking him in a low, sickening arc into the sandspurs alongside the road. When I dashed over to pick him up, he groggily pulled himself up on my arm, waved off any offers of medical attention, and insisted that I drive him not to the hospital but to a friend’s house, where he staggered in and collapsed on the couch, regaining consciousness later that evening to go stiffly about his remaining business.

On another occasion, running in late to teach a class he neglected to see that the glass door to the room was closed until he was on the other side of it, covered with glass and dripping blood on the carpet. Girls screamed as he started to ready his lecture notes regardless, and he was forced to retreat, staggering into my girlfriend’s room to be cleaned up and bandaged. As his motorcycle riding buddy, it seemed to me that he was saved from vehicular disaster only by his lightning-sharp reflexes.

Roger’s appetite for walking the razor’s edge reached its highest form in relationships with women. The complexities of a relationship with one woman seemingly not enough, Roger often arranged relationships with two women at a time, constantly calculating their respective travel paths so as to avoid encountering one when he was with the other. Once, walking down Main Street in Sarasota with his girlfriend Marci, he suddenly spotted his wife walking toward them, who had suffered a breakdown and was presumedly in the psychiatric ward. Marci felt a sudden push in her back and found herself propelled through the open door of a shop, as Roger ran forward to see his wife and redirect her away from the scene. Marci had to find her own way home. Later, of course, he was deeply and sincerely apologetic to her - as he always was after such near-misses and disasters. Supplicating angry women was a regular necessity of Roger’s early romantic life.

This diminished as Roger grew older, but never disappeared. In his early fifties, he wrote a letter to a sometime girlfriend when he realized that he owed a letter to another. Hitting the “find/change” command on his MacIntosh, he printed personalized but identical versions to both: every “Kristy” became a “Jordan.” He sent both out. A few weeks later he received replies from each of them, who were friends. Both Kristy and Jordan sent him copies of the same reply, word-for word. They had just had lunch together.


Despite the many “crashes” he experienced, Roger was like the legendary motorcycle-jumper Evel Kenevil: always rolling out of some flaming crash to jump to his feet, arms held up to show the crowd he was OK. A few ribs taped, and he’d be back off the ramp, whether that was tracking wolves by light plane and snowshoe in Northern Minnesota, working out a new theory of how human intelligence evolved from the cognitive mapping necessary to track prey, passing Robert Redford’s sport’s car on his bicycle down a precipitous mountain road, high and outside, teaching his classes, writing another book, getting married again. “Our relationship has deteriorated to the point,” he wrote me in the midst of one marriage, “that we communicate exclusively through slammed doors.” Yet he would always try again. How can you not love someone like that?

The melanoma had reappeared, despite the year on interferon. It was a reversal surely signifying his imminent death. I spoke with him by phone. “Yeah, I was really bummed out for a day,” Roger admitted. “But now I’m seeing if I can qualify for a Phase I trial at NIH.” As a researcher, Roger knew better than I that a phase I trial is the stage of experimentation in which they try to find out merely if last-resort patients can survive the treatment. No matter: Roger didn’t dwell; he was always ready to try the next thing.


I woke up last night from a dream in which my doctor had biopsied my intestines and told me that I had a fatal malignancy, from which I would soon die. My doctor did, in fact, recently tell me that he has detected some abnormality with my liver. It is probably not a cause of significant alarm, but I am scheduled to see a liver specialist in Philadelphia. Maybe she will do a biopsy with a long hollow needle through the abdomen - that is how they do it, I know. So the dream may tell me that I am more worried about this than I realize. Or it is even possible that the dream tells me that I am in fact fatally ill - dreams do tell such things sometimes. What the dream makes me think most of is Roger - how for four years he must have had such dreams, only to wake up always to find that it was true.

“Look,” Roger said in Durango when I asked him about what was thinking about death, while he pumped his daily massive dose of antibiotics into an IV line taped to his arm, “either I live or I don’t. If I live another month, I get to go deliver a paper at the APA conference in Hawaii and visit Richard Waller up in his rainforest. If I live until fall, I get to go back to teaching my favorite course and go hunting. If I die, I don’t think I’ll have any experience at all, so it won’t be unpleasant.” When he got finished with the IV, we went out to walk and look up at the mountains he loved, in the bright Durango sky he had warmed to years ago when he had moved there. He was, as always, ecstatic at the view. “Up there is where I hunt elk,” he indicated, pointing his finger along the high ridgeline. “Maybe again.”


Yuri Gagarin

Roger and I had both been in elementary school at the birth of the space age, when Soviet cosmonaut Yuri Gagarin had ridden the first rocket into space carrying a man - at least, the first one we know of. Gagarin, a prime physical specimen, had walked into his capsule. After he hit earth at the end of the experience he was too weak to walk alone. Roger checking into the National Institutes of Health was like Yuri Gagarin climbing into his space capsule.. Checking in, he seemed a man in perfect health: we took energetic walks about the grounds and talked animatedly. I drove regularly down to Bethesda from my home in Harrisburg, this was the longest that Roger and I had been able to spend together since college, and we made the most of every minute. Roger was happy about feeling good again after recovering from almost dying last year. He was his old self again. It was only the results of medical tests that revealed him a sick man; a candidate for the last-resort of all last resort treatments, an experimental stem-cell transplant.

Always the observant scientist, Roger immediately grasped the theoretical problem. Cancer cells are always floating in the body, he reminded me. Why, then, do some cancer cells take hold? Obviously it must be some failure of the immune system. So the idea was to transplant his brother’s functioning immune system into him, replacing his compromised one. To get the transplant material, his younger brother John came to Bethesda and donated blood. Taking it into the advanced labs at NIH, technicians centrifuged out all of the new, embryonic stem cells from which new white cells, macrophages, could grow, and put them aside. Then they set out to kill Roger’s existing immune system to get it out of the way.

So-called immune systems are hardy. That’s why you remain alive. Killing one involves injecting toxic agents so powerful that they destroy the bone marrow itself. With no immunity, ordinarily you would die. You would die, that is, unless you were in the world’s most advanced research hospital, with skilled nurses working constantly to keep you alive. From a seemingly healthy man, Roger retreated into a man curled up in his hospital bed, burning up with raging fevers over 105 degrees, retching constantly, lost in agony. Agony, I recall, was the term technically denoting the last stages of dying, when one was literally “in one’s agony.” But this agony was one that wasn’t allowed to proceed to death. In a brief period of lucidity, Roger quipped that his IV pole was so hung with antibiotic bags that “it looks like a Christmas tree.” Nurses, doctors and lab technicians worked to identify the specific bacteria that were trying to wipe him out. He ended brief phone calls by a hurried need to hang up as he was overcome with wrenching dry heaves.

Looking back on that terrible period, once he was able to speak once again, Roger told me that the suffering had become so all-consuming that at a certain point he lost the sense of “I” from which one experiences suffering from. He was just all pain, spinning lost in a dark void. I have read that this is the ultimate state that torturers aim to create in their victims. The phrase of my old friend Ivan Illich came to mind: medicalized torture.

When he came out of this, and stopped shaking, there finally came the signal day: they wheeled Roger up to the lab to have brother John’s stem cells dripped into his veins. I downloaded a microphotograph of a microphage engulfing a cancer cell for him to past on he wall by his bed and use as a focus for visualization exercises. Roger was going to leave no effort undone in the quest to survive where no-one had survived before. “You, Roger,” I proclaimed one day, are the Yuri Gagarin of NIH. You volunteered to be shot off into a place where nobody has been, to advance human knowledge. One day there is going to be a bust of you downstairs in the lobby.” Three months later, another college friend and I held him under each shoulder to help him to climb the three steps to her house, where we tucked him into her bed. It reminded me of that old joke: “The operation was a success, but the patient died.” Roger himself never thought of regret; he only set himself to the next goal, whether it was taking the correct complex schedule of medications, walking a few more feet the next day, or working a few hours on his latest book manuscript.


Road Trip

Roger was subsequently hospitalized for short periods for fevers, and, six months after he had arrived in Bethesda, was ready to be discharged from this last hospitalization to go home to Durango. He had tickets on a 6:10 AM flight. We arranged for me to show up at his room at 4:00 AM the morning of his departure. He was going to take a cab to save me the trouble, but this was hardly the way to celebrate such an event, I told him. “It’s just another road trip!” I admonished him. “I’ll be here.”

When I appeared at 4:00 AM, having caught a few hours rest on a friend’s couch on Capitol Hill, Roger had his duffel packed and was ready to go. I pulled the car up to the silent entrance, and we set off. Before us, the lights of the sleeping city arrayed themselves: the lights of the Capitol dome, of the Washington Monument, the highways along the Potomac. Early flights lowered themselves on the flight path toward National Airport above us, following the river to the runways. Roger was excited.

As we drove, we remembered road trips together of so long ago: driving in my Corvair Spider convertible across the middle of Florida, taking turns shuttling a friend’s Bultaco Metralla to West Palm Beach, where we all spent a memorable week aboard a sailboat called the Volante that Waller and Hazelhoff were crewing. We recalled road trips before daybreak on our motorcycles down the old Tamiami Trail from Sarasota to Sanibel Island, arriving over the causeway as the sun came up over the mainland behind us.

As we spoke of his medical “space shot.” Roger was characteristically optimistic. The previous afternoon, as we went down for his final blood tests before discharge, Roger pulled the Nurse aside. “Can you do a HIV test while you are at it?” he asked her. “Having an AIDS-free test printout is a good thing to have in your pocket on a date,” he offered me, by way of explanation. Was this the very definition of optimism, I wondered to myself, or of denial? Perhaps it is not so simple to say.

As we drove to the airport, we spoke also about deep changes that Roger had experienced within himself during this humbling experience of serious illness. Roger had not been especially given to such deep conversations about feeling, but during his illness this had changed. We had had many deep conversations about both of our struggles during his last year - conversations that were as much solace to me as they were to him. Isn’t this what friendship is, after all? We had our troubles - him especially - but we were not all alone.

In our conversations, Roger told me something that he had never expressed clearly. During most of his life, he confessed, he had felt driven mercilessly to produce. Friends always came second to this compulsion. This, of course, I knew. But I didn’t realize how deep it had gone. I knew that Roger always was writing a book against some deadline, preparing a class, organizing a new program - and before that getting his PhD, getting into graduate school - the series of stiles along his personal track had been endless. I had written a song about him - and me too, I guess - a long time ago. It was called the “PhD Blues,” and started:

When I was a little boy
In the wheatfields green
I asked my mother
What would become of me?
She said “Hey - listen up, my son,
You know full well,
You must get your PhD
Or roast eternally in hell.”

There was always that feeling about Roger, as if he were trying to produce enough, somehow, to be loved. Roger confessed that for all his years on the faculty in Durango he would come home each night and have a stiff drink to calm the desperate feelings of not having accomplished enough that day. Yet, as is so often paradoxically true, love was all around him. It was his illness, he told me, that finally caused him to see this. It was only when he could not produce in any way, but could only be cared for, that he came to see that he didn’t have to produce anything in order to be loved by his friends. His friends surrounded him - at home, in Durango, they took turns sitting with him, bringing him food, taking him to doctors, taking simple pleasure in his company. When he came East, his Colorado friends handed him off to the group of which I was a part. For this, Roger had to produce nothing - no books, no articles, no lectures.

Back in the spring on Hart’s and my motorcycle trip, Roger had taken us over to see his ex-wife Rita, who he had not seen himself for some time. Like most exes, they usually confined their talk to their now-grown daughter. But today Roger mentioned how he had been in the hospital there last spring, in intensive care. He was in terrible pain and it was expected that he might die. For a long time he was heavily medicated and unconscious. “I know,” Bonnie replied quietly. “I was there.” “You were?” Roger asked, turning to her in astonishment. “Every day, Roger,” she said softly, touching him softly. Sitting on the front steps, Roger started to cry.

When the final recurrence of the melanoma came, there were no other hospitals to go to, even in Bethesda. His brother John flew in from California with Roger’s daughter Eden. His close friends came to be with him. I talked with Roger by phone. He was characteristically doing “real good.” John was more sober. It would not be long now.

In the end and in this place Roger, who had struggled and worked all of his life unsuccessfully to find love and caring, found himself in the center of a warm and loving family. It was nothing he had to work for. There, dying in his home in Rockies, surrounded by those who loved him, he was curiously but obviously happy. At the end, when the cancer spread to his brain, the magnificent mind that had shone so brilliantly all his life began to misfire on a few cylinders, as he would have put it could he still describe such things. Finally, John told me, he lost his ability to speak. “How are you, Roger?” John asked him. Roger flashed him a grin and raised his hands from the bedsheets: Two Thumbs Up. Then he died.

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www.aboutdrschwartz.com Dr. David B. Schwartz questions such modern technological solutions. Inspired by the radical psychiatrist R.D. Laing and others, he brings neglected attention to the most powerful therapeutic force of all: curative relationships. He proposes that psychotherapy is but one form of the ways that human beings have cared for each other throughout history. This universal curative force can be brought to a laser-like focus in psychotherapy, but is equally available at a sidewalk café table. Engaging clinical storyteller Dr. Schwartz illustrates his claims in compelling and universal ways that remind us of the essential humanity of human beings and their experiences, in which true recovery can be achieved.