One Good Move

  By Nina E. Cerfolio MD

Suddenly, in 2011, my eyes no longer functioned as translucent lenses. Waking up with blurry vision was terrifying. I could not read, which for me was horrifying. I immediately scheduled an emergency appointment with my ophthalmologist of twenty-five years. After he tested my vision, he exclaimed, “ Your intraoptic pressure is suddenly elevated. You have glaucoma, which usually affects diabetics and the elderly. It’s rare in someone as young as you. I will have to do surgery to get the pressure back down.” I asked, “Isn’t there anything I can do to get the pressure down without surgery?”  He responded, “No, leaving the pressure elevated is dangerous as your vision may remain impaired.” So I scheduled the eye surgery. Still I thought, there had to be something I could do.  I also wanted to know why this was happening.  But in my heart, I already knew.  At that point, I’d known half of the reason.  What followed was an experience beyond my physical sight that brought the other half of the why squarely into focus.

Back in August 2005 I was poisoned by a Russian KGB agent while doing humanitarian medical work during the second Chechen war (which is a whole other story). After my initial symptoms, I subsequently developed chronic inflammation, recurrent pneumonia and GI parasitic infections, arthralgia, autoimmune disorder and twenty food allergies. After many years of extensive medical research , doctor visits and biological testing, we realized many of my symptoms were consistent with exposure to man-made anthrax. So when the ophthalmologist said that my intraoptic pressure was elevated, it made sense to me.  Anthrax causes inflammation, and swelling creates elevated pressure, even swelling in the eyes.                                                  

I had exactly one month before my scheduled eye surgery.  Armed with my predisposition to achievement and driven by an ever stronger desire to avoid surgery, I went to work to find something, anything I could do that would reduce the elevated pressure in my eye.  One month to find the correct answer to, ‘What can I do to heal this?’.  With just thirty days to make a move, it had to be a good one. My chosen move can best be described as a spiritual journey. I turned inward to look for answers, determined to face with courage whatever I found. Though simple in principle, the move involved a lot of nuanced layers. I found a lot.

I’d grown accustomed to receiving hard medical news and feelings of frustration with conventional medicine’s failure after my poisoning to identify and treat the etiology. I had already become my staunchest advocate and begun to supplement my medical regime with alternative approaches. I began to more fully accept the responsibility to change myself and facilitate my healing, physically and spiritually. This journey is now fourteen years long and has resulted in dramatic improvement in my quality of my life. Though details of my quest are too numerous to specify here, I will offer the briefest of outlines. 

All of what I did to heal, I did within a spiritual context. By this I mean I viewed my life as a practice to foster insight, change, compassion and transcendence. I began to seriously meditate and open my heart to the unity of all life. I came to see my suffering as the price I had to pay for awakening to a greater truth about myself and the world.  And I came to understand that suffering was optional. Though I didn’t know that truth yet, I felt sure I’d discovered the right path for finding it. I wasn’t simply seeking to be well again. I was changing the way I thought, felt and acted, about the past and present. I was changing the way I lived. For the first time I was attending to both sides of my life: the life I was living and the life that was living me. 

One of the many exercises I did during this time was to still myself and listen to an insight offered by my illness, in this case glaucoma. The insights came with a feeling of love that I cannot properly articulate, a love that seemed given from the beyond. This sense of love carried no judgment with it, rather complete acceptance. It made me see that I judged and in so doing limited my vision to a flawed world that always needed to be fixed, an impossible goal since everything is forever in a state of breaking.

I had not seen the other side of this: that everything is also in a state of making, of becoming, and the forms of being are most precious because they are so terribly vulnerable, because they break. To see the first side and not the second fosters belief in a discouraging and destructive half-truth. 

I began to embrace my vulnerability and see my competitive, relentless drive to achieve for what it was psychologically: a failed defense against a cruel childhood. I decided to stop having to win at all costs. I decided to stop hurting myself because I felt unworthy and needed to be punished for not being good enough. I decided to stop being blindly driven by my fear of inadequacy. I decided to let go of my obsession with victory. I admitted to myself that my deep distrust of others had alienated me socially and foreclosed the possibility of real intimacy. I sought a new way of being in my life that allowed me to be authentically connected to people I love. I decided to open up and let go. Once I made these deeply moving decisions, my life began to change for the better. 

The scars of the shortage of mothering in my family came up – the shortage that had lured my sister and I into a competitive trap from which I am trying to transform into a more loving relationship. Different memories of my own mean behavior as a kid began to surface. When I was eleven and my sister three, I played a sadistic game of “lifeguard.” I would push her into the deep water and prevent her from getting to the ledge to rest. Treading water till she was exhausted, I then “rescued” her, by pulling and returning her to safety.

I remembered another example of my childhood meanness in my relationship with two sisters who lived across the woods. I was friends with the two sisters, one older and the other girl younger than me. The older sister and I often teamed up against her younger sister. We excluded her from our games and often treated her cruelly when she lagged behind or took too long to get dressed before we all went out to play. I revisited memories like these and memories of how I was treated at home without judging or feeling sorry for myself. I simply felt them deeply and let the new feelings that resulted from feeling them in this way guide me.   

I realized that I had carried my mean behavior into my relationships with men, taking my example from the way my mother treated my father and other men. Every Sunday she mocked the good-looking, younger man who collected money at our Catholic mass. After smiling sweetly at him and putting money in his basket, she stuck her tongue out at his back and whispered to me and my brothers that his bow tie made him look like Bozo the Clown. I always wondered why she laughed behind his back. Was she secretly attracted to him? As far as I could see, he did nothing to deserve her derision. Perhaps his self-containment and ease put her own self-loathing into sharper relief. 

Later I unconsciously repeated that pattern with men that I dated––the sweet smile masking contempt, though I often become openly abusive. I shared a bottle of wine over dinner with Beau, a blond haired, blue-eyed “master of the universe” who worked on Wall Street.  Beau seemed confident and happy, making my “inherited” self-loathing and feeling of unworthiness more apparent. I made the mistake of drinking more than one glass of wine with dinner. I felt tipsy and the rest of the night became a blur. When I did not hear from Beau for several days, I became convinced that he had not contacted me because I was not pretty or skinny enough. When he finally called me, I asked him why it took so long. He said, “Don’t you remember saying, “ I hate you and fuck off?” Reminded of my verbal assault, I had a vague recollection and felt utterly mortified. 

Winning and dominating was a black and white sadomasochistic world, one split between winners and losers. In that world, my sickness as a result of suspected anthrax poisoning and my childhood made me a loser, despite my accomplishments. Now I began to realize the destructive limitations of that vicious viewpoint. In denying vulnerability, change and mortality, I denied reality. That winner-loser viewpoint excludes all other viewpoints except its own. It turns life into a sick dogma where hatred, fear and loathing reign supreme. In that world love does not exist. In leaving that world I discovered that human reality is vulnerable, complex and uncertain.

 My illness forced me to live with uncertainty. At first I hated it, but as I began to accept it, I learned much more about myself in a painful but beautiful way. After my transformation, I gradually learned to surrender to a greater receptivity to the unknown, which created an enhanced spaciousness in my psychoanalytic relationship to further allow my patient’s becoming. As a result of becoming ill, I learned to surrender, which required a certain pliability and lessening of my brittle defensiveness to have more faith to dive into the uncertainty of the unknown. 

I wanted to open my eyes ever wider to see what was within and before me. I was educated enough to know that many learned people would find that goal so vague as to be laughable. “To see what?” they might ask. “To see the reflection of your own faith-based perspective? To see what your mind has staged for you to see? To see your neat little attempt to rationalize your miserable illness into some major transformative quest?” Yes, yes and yes, but with one profound caveat: To see what happens when one surrenders to the power of life and meets one’s fate with open arms and an open heart. 

I believed, deeply believed, after all I’d been through, that there was something to see, something real and incredible and beautiful, beyond the narrow frame of one’s ideas and projections. One could say I’d developed faith in a beyond I did not yet fully recognize. I felt it was close, like a great storm, brewing over a turbulent horizon that would one day sweep me up in its majesty. Meanwhile, I waited and prepared and helped myself heal. I took every setback as a practice, as a preparation. 

Suspected anthrax poisoning and resulting glaucoma was my spiritual wake up call.  I took impaired vision to be symbolic as well as physical, seeing it as a condition of my total existence. Not only was I impaired in seeing beyond my critical do-or-die perspective, I tended to find fault with everything and everyone, part of my family inheritance. My distorted vision kept me pathologically joined to my family and fearful to be vested in happiness. The vestige of my childhood wounds prevented me from fully laying down my cudgel. A large part of me remained mistrustful of pleasure and joy.   My life and perspective had become so misaligned that I literally could not see the forest for the trees. How could I? My intraoptic pressure was elevated. 

My insights generalized to my work with patients. I realized my mother had partly accompanied me into my psychiatric psychoanalytic practice, which could have an undercurrent of judgment. Despite my being psychoanalyzed, at times my mom still sat above my right shoulder reminding me that all I did was a failure. Through meditation, I began to be slowly liberated from my maternal identification of being a failure and released into the vastness of a more expansive, nurturing identity. By a larger part of me leaving her at the door, I began to see my patients not so much as suffering from some form of psychopathology but as precious living and dying beings, engaged in a poignant struggle to grow and discover their own creativity and in some instances, their spirituality. I welcomed their “symptoms” as letters from the unknown meant to help me in guiding them.

With a joyfully decorated Christmas tree resplendent with perfectly decorated gifts lying underneath tinseled branches, single-handedly as a child with a different opinion, I could “ruin” my mom’s holiday dinner, which she said in front of family and friends because mom knew only how to live an emotionally impoverished life. As a result of healing metaphysically from glaucoma, I began to really, truly see with a wider, more expansive lens that I was not the virus that infects and “ruins” my relationships and life. I began to be able to look at my family more honestly to see their infirmities and resisted blaming myself for not being loved or for them not loving themselves. I realized I did not cause, nor was I responsible for, their limitations, which was quite painful because it meant letting go more deeply of my desperate wish to be seen and loved by them.

For the first time in my life, I noticed that certain insights had taken root in my existence and rather than being just interesting thoughts had become living perspectives. This is what I came to deeply believe – that for me, all this is spiritual truth, but I would never be so arrogant as to insist on its veracity to anyone else. All are equally welcomed to take from it or walk away. Here is what I saw with my newfound spiritual sight:

I saw that, radically speaking, I am neither above nor below anyone and that the idea of equality derives from an even deeper truth: not one of us has more intrinsic right to live than anyone else. I saw that significant sentience is not simply confined to human beings but falls across a spectrum and is distributed amongst the vast array of life forms and that all life should be accorded with respect and dignity. As creatures bearing the treasure and burden of a sophisticated intelligence and consciousness, wielding expansive technical power, we can be the guardians of these life forms or their destroyers.

I saw that the separation of the body and the mind and the self from the world that was so much a part of my Western medical school training and practice is only part of the story. There is no such thing as only a physical illness, even when one is poisoned; and there is no such thing as merely a mental illness. Everything that occurs in the mental realm results in a physical consequence, and everything that occurs in the body results in a mental consequence. Furthermore, the world I inhabit is the one I embody, the only one I will ever know. In that world everything I do counts. What happens to me happens to that world and what happens to that world happens to me. I may separate them, body and mind, self and world, for the sake of convenience and practical action, but I delude myself when I believe the separation is real.

This sense of reality led me into a deeper insight. I began to see that all the boundaries that separate us, even the borders of our own flesh, are permeable and ultimately illusionary––that at base everything that comes to exist derives from a primordial and inviolable unity. I am one and I am many. I am separate and I am not separate. I am born and I die. Yet, as I am all this––what was, what is, and what will be––and as all this, there will never come a time I cease to exist. The most important relationship I will ever have is the one I have with the totality. The idea of that relationship is utterly abstract and transcendent, but the experience of it is concrete and immanent. This relationship with totality is based on faith and practice and is the ground of all of my other relationships. 

My view in no way faults those struggling with any illness, or the personal paths and journeys with illness others take. I write with neither certainty nor arrogance. It is faith and direct, personal experience from which I speak. Though I am deeply committed to my viewpoint, its very nature carries an aversion to imposing it on someone else.  To blame someone for being sick is both ignorant and cruel. Likewise, suggesting my viewpoint is ‘right’ or the only way is arrogant. While those with chronic illness will have different manifestations than my own, key to our recoveries, I believe, is learning the lesson of surrender. 

Surrender involves releasing oneself from the bondage of ego and discovering the unity and acceptance underlying being. It is the opposite of submission, which means feeling like a puppet and a victim. Slowly, I continued to learn how to rest and let feeling flood into me, so I could begin to have deeper and more nurturing relationships, starting with the one I have with myself. Anthrax laid me low but humanized me, leading me to accept my fragility and learn greater self-love and intimacy. In many ways, anthrax brought me home. Unable to distract or divert and exhaust my body through exercise, my spiritual dimension became awakened through stillness and meditation, and I began to embrace the beauty and gifts of my vulnerabilities. This recognition began to catalyze my shift into a higher state of enhanced love, with a previously unknown sense of limitlessness. 

I meditated. I prayed for strength. I took my supplements. I kept my mind clear and my heart opened. I practiced. I kept my faith. I more fully accepted my situation while taking more responsibility for it. I changed the way I lived my life.  I waited patiently. 

On the day of the follow up appointment – thirty days after learning I needed surgery, my ophthalmologist tested my pressure. At first he shook his head and angrily hit his instrument, muttering to himself. When he finally convinced himself that nothing was wrong with his tonometer, he incredulously told me my pressure was normal. He chalked it up to my ‘intense ironman and ultramarathon exercise regimen.’ I didn’t bother to tell him that I was no longer able to work out as I once did. I did not need the surgery. To this day my intraocular pressure remains normal. That was the last time I saw him. 

As a result of becoming ill, my spiritual awakening consisted of an active awareness of transcendent aspects within myself that not only created a profound interconnectedness with something much larger than myself, be it God or the Cosmos, but also was essential to my recovery. Through my spiritual growth, suspected anthrax poisoning ironically provided a path, for both myself and many of my patients, to shift from submission (signified by the need either to acquiesce or rebel) to surrender (signified by being open to and expanded by the subjectivity of the other). In this journey, we can begin to discover and uncover our authentic souls. In my journey, I gained spiritual sight while healing physical sight.  


About the author

Nina E. Cerfolio MD, Assistant Clinical Professor of the Icahn School of Medicine at Mount Sinai, is an award-winning / internationally recognized board certified psychiatrist and psychoanalyst practicing in New York City.  In practice for 30+ years, Dr Nina Cerfolio’s success rests in her unique approach, which integrates traditional psychiatric training with her decades of spiritual training. She is a champion of fitness for greater mental health and an active writer and speaker advocating mindful psychiatry to help others transcend emotional suffering and adversity to find healing, happiness and fulfillment.

  She has been featured on national TV and numerous international and national news outlets including, National Geographic Adventure for winning the Half Marathon on the Great Wall of China, the Daily News for her humanitarian work during the Chechen genocide, and the Yomiuri Shimbun (Japan’s national daily newspaper) for her work as a first responder at Ground Zero. She has been published in peer-reviewed journals and presented her original work on the psychological influences of spirituality and trauma in national and international venues. Dr Nina Cerfolio is honored to be named one of Castle Connolly Top Doctors, NY Times 2018 & 2019 Top National Physician, Leading Physicians of the World, America’s Top Psychiatrist, Top Psychiatrists in New York, Patient’s Choice Awards & America’s Most Compassionate Doctors.