How to pronounce "transplants"

Like many of us,

I've had several careers in my life,

and although they've been varied,

my first job set the foundation for all of them.

I was a home-birth midwife throughout my 20s.

Delivering babies taught me valuable and sometimes surprising things,

like how to start a car at 2am.

when it's 10 degrees below zero.

(Laughter)

Or how to revive a father who's fainted at the sight of blood.

(Laughter)

Or how to cut the umbilical cord just so,

to make a beautiful belly button.

But those aren't the things that stuck with me or guided me

when I stopped being a midwife and started other jobs.

What stuck with me was this bedrock belief

that each one of us comes into this world with a unique worth.

When I looked into the face of a newborn,

I caught a glimpse of that worthiness,

that sense of unapologetic selfhood,

that unique spark.

I use the word "soul" to describe that spark,

because it's the only word in English that comes close to naming

what each baby brought into the room.

Every newborn was as singular as a snowflake,

a matchless mash-up of biology

and ancestry and mystery.

And then that baby grows up,

and in order to fit into the family,

to conform to the culture,

to the community, to the gender,

that little one begins to cover its soul,

layer by layer.

We're born this way,

but --

(Laughter)

But as we grow, a lot of things happen to us

that make us ...

want to hide our soulful eccentricities and authenticity.

We've all done this.

Everyone in this room is a former baby --

(Laughter)

with a distinctive birthright.

But as adults, we spend so much of our time uncomfortable in our own skin,

like we have ADD: authenticity deficit disorder.

But not those babies --

not yet.

Their message to me was:

uncover your soul

and look for that soul-spark

in everyone else.

It's still there.

And here's what I learned from laboring women.

Their message was about staying open,

even when things are painful.

A woman's cervix normally looks like this.

It's a tight little muscle

at the base of the uterus.

And during labor, it has to stretch from this

to this.

Ouch!

If you fight against that pain,

you just create more pain,

and you block what wants to be born.

I'll never forget the magic that would happen

when a woman stopped resisting the pain

and opened.

It was as if the forces of the universe took notice

and sent in a wave of help.

I never forgot that message,

and now, when difficult or painful things happen to me

in my life or my work,

of course at first I resist them,

but then I remember what I learned from the mothers:

stay open.

Stay curious.

Ask the pain what it's come to deliver.

Something new wants to be born.

And there was one more big soulful lesson,

and that one I learned from Albert Einstein.

He wasn't at any of the births, but --

(Laughter)

It was a lesson about time.

At the end of his life, Albert Einstein concluded

that our normal, hamster-wheel experience of life

is an illusion.

We run round and round, faster and faster,

trying to get somewhere.

And all the while,

underneath surface time is this whole other dimension

where the past and the present and the future merge

and become deep time.

And there's nowhere to get to.

Albert Einstein called this state, this dimension,

"only being."

And he said when he experienced it,

he knew sacred awe.

When I was delivering babies,

I was forced off the hamster wheel.

Sometimes I had to sit for days, hours and hours,

just breathing with the parents;

just being.

And I got a big dose of sacred awe.

So those are the three lessons I took with me from midwifery.

One: uncover your soul.

Two: when things get difficult or painful, try to stay open.

And three: every now and then, step off your hamster wheel

into deep time.

Those lessons have served me throughout my life,

but they really served me recently,

when I took on the most important job of my life thus far.

Two years ago, my younger sister came out of remission

from a rare blood cancer,

and the only treatment left for her was a bone marrow transplant.

And against the odds, we found a match for her,

who turned out to be me.

I come from a family of four girls,

and when my sisters found out that I was my sister's perfect genetic match,

their reaction was, "Really? You?"

(Laughter)

"A perfect match for her?"

Which is pretty typical for siblings.

In a sibling society, there's lots of things.

There's love and there's friendship and there's protection.

But there's also jealousy

and competition

and rejection and attack.

In siblinghood, that's where we start assembling many of those first layers

that cover our soul.

When I discovered I was my sister's match,

I went into research mode.

And I discovered that

the premise of transplants is pretty straightforward.

You destroy all the bone marrow in the cancer patient

with massive doses of chemotherapy,

and then you replace that marrow

with several million healthy marrow cells from a donor.

And then you do everything you can

to make sure that those new cells engraft in the patient.

I also learned that bone marrow transplants are fraught with danger.

If my sister made it through the near-lethal chemotherapy,

she still would face other challenges.

My cells

might attack her body.

And her body might reject my cells.

They call this rejection or attack,

and both could kill her.

Rejection. Attack.

Those words had a familiar ring

in the context of being siblings.

My sister and I had a long history of love,

but we also had a long history of rejection and attack,

from minor misunderstandings to bigger betrayals.

We didn't have the kind of the relationship

where we talked about the deeper stuff;

but, like many siblings and like people in all kinds of relationships,

we were hesitant to tell our truths,

to reveal our wounds,

to admit our wrongdoings.

But when I learned about the dangers of rejection or attack,

I thought, it's time to change this.

What if we left the bone marrow transplant up to the doctors,

but did something that we later came to call our "soul marrow transplant?"

What if we faced any pain we had caused each other,

and instead of rejection or attack,

could we listen?

Could we forgive?

Could we merge?

Would that teach our cells to do the same?

To woo my skeptical sister, I turned to my parents' holy text:

the New Yorker Magazine.

(Laughter)

I sent her a cartoon from its pages

as a way of explaining why we should visit a therapist

before having my bone marrow harvested and transplanted into her body.

Here it is.

"I have never forgiven him for that thing I made up in my head."

(Laughter)

I told my sister

we had probably been doing the same thing,

carting around made-up stories in our heads that kept us separate.

And I told her that after the transplant,

all of the blood flowing in her veins

would be my blood,

made from my marrow cells,

and that inside the nucleus of each of those cells

is a complete set of my DNA.

"I will be swimming around in you for the rest of your life,"

I told my slightly horrified sister.

(Laughter)

"I think we better clean up our relationship."

A health crisis makes people do all sorts of risky things,

like quitting a job or jumping out of an airplane

and, in the case of my sister,

saying "yes" to several therapy sessions,

during which we got down to the marrow.

We looked at and released years of stories

and assumptions about each other

and blame and shame

until all that was left was love.

People have said I was brave to undergo the bone marrow harvest,

but I don't think so.

What felt brave to me

was that other kind of harvest and transplant,

the soul marrow transplant,

getting emotionally naked with another human being,

putting aside pride and defensiveness,

lifting the layers

and sharing with each other our vulnerable souls.

I called on those midwife lessons:

uncover your soul.

Open to what's scary and painful.

Look for the sacred awe.

Here I am with my marrow cells after the harvest.

That's they call it -- "harvest,"

like it's some kind of bucolic farm-to-table event --

(Laughter)

Which I can assure you it is not.

And here is my brave, brave sister

receiving my cells.

After the transplant, we began to spend more and more time together.

It was as if we were little girls again.

The past and the present merged.

We entered deep time.

I left the hamster wheel of work and life

to join my sister

on that lonely island

of illness and healing.

We spent months together --

in the isolation unit,

in the hospital and in her home.

Our fast-paced society

does not support or even value this kind of work.

We see it as a disruption of real life and important work.

We worry about the emotional drain and the financial cost --

and, yes, there is a financial cost.

But I was paid

in the kind of currency our culture seems to have forgotten all about.

I was paid in love.

I was paid in soul.

I was paid in my sister.

My sister said the year after transplant was the best year of her life,

which was surprising.

She suffered so much.

But she said life never tasted as sweet,

and that because of the soul-baring

and the truth-telling we had done with each other,

she became more unapologetically herself

with everyone.

She said things she'd always needed to say.

She did things she always wanted to do.

The same happened for me.

I became braver about being authentic with the people in my life.

I said my truths,

but more important than that, I sought the truth of others.

It wasn't until the final chapter of this story

that I realized just how well midwifery had trained me.

After that best year of my sister's life,

the cancer came roaring back,

and this time there was nothing more the doctors could do.

They gave her just a couple of months to live.

The night before my sister died,

I sat by her bedside.

She was so small and thin.

I could see the blood pulsing in her neck.

It was my blood, her blood, our blood.

When she died, part of me would die, too.

I tried to make sense of it all,

how becoming one with each other

had made us more ourselves,

our soul selves,

and how by facing and opening to the pain of our past,

we'd finally been delivered to each other,

and how by stepping out of time,

we would now be connected forever.

My sister left me with so many things,

and I'm going to leave you now with just one of them.

You don't have to wait for a life-or-death situation

to clean up the relationships that matter to you,

to offer the marrow of your soul

and to seek it in another.

We can all do this.

We can be like a new kind of first responder,

like the one to take the first courageous step

toward the other,

and to do something or try to do something

other than rejection or attack.

We can do this with our siblings

and our mates

and our friends and our colleagues.

We can do this with the disconnection

and the discord all around us.

We can do this for the soul of the world.

Thank you.

(Applause)