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DAVID BIANCULLI, host:

This is FRESH AIR. Im David Bianculli, in for Terry Gross.

For decades, psychologist Dan Gottlieb has used various media to make intimate conversations public. He encourages people to eavesdrop and perhaps gain solace or insight as a result. After a car accident left him a quadriplegic, Gottlieb opened a private practice, and for 25 years has served as host of a popular call-in radio show named Voices in the Family. It's broadcast on WHYY in Philadelphia, where FRESH AIR is produced.

Dan Gottlieb was in his mid-50s, and had been a quadriplegic for more than 20 years, when his grandson Sam was diagnosed with autism. Dan wrote a series of letters to Sam, describing his own experiences of being different. Those letters were collected in a 2006 book called "Letters to Sam," and Dan Gottlieb has just published a sequel. It's called "The Wisdom of Sam," and details the lessons Dan says he has learned from his grandson, who just turned 10.

Terry Gross spoke with Dan Gottlieb in 2006 when the earlier book, "Letters to Sam," was released, and when Sam, at the time, was just about to turn 6 years old.

GROSS: Why did you want to write a book of letters to your grandson?

Mr. GOTTLIEB (Radio Host): When he was born, I was a 56-year-old quadriplegic. I had been a quadriplegic for 20 years. I know my life expectancy is shortened. I live as Sartre said we should live, with death on my shoulder. I knew that anything could take me out, and I could feel that my body was beginning to fatigue.

I wanted to share with Sam what I've learned both as a psychologist and a quadriplegic, because I did not believe I would be in the world that he would see, and I wanted him to know who I was, how I saw the world. This is something most of us dont get from our grandparents. I wanted him to have that. And then when I learned that he had autism, it became more urgent. I felt I had more to tell him about being different.

And the book has turned into two things: a book of love letters for my grandson, but in a way it's a prayer for the world. The prayer is that the world becomes softer, more gentle, more loving, that the world Sam grows up in is safer than the world you and I are living in today.

GROSS: I know that the car accident that left you paralyzed nearly killed you. So that forced you to change your life. Youve had a few close calls with death in the past few years. Did those close calls almost allow you to change your life, you know, allow you to make changes that you actually wanted to make and felt like you couldnt?

Dr. GOTTLIEB: Yes. Yes. What a great question. The vision I had - have - about my accident is that when my neck broke, my soul began to breathe. I became the person I always dreamt I could be and never would've been if I didnt break my neck. And with each time I faced death, I became more of who I am and less worried about what others might think of me.

Just last time was two years ago. I've cut my practice back. I dont work quite as hard. That's a lie.

(Soundbite of laughter)

Dr. GOTTLIEB: I work I work just as hard. I dont work quite as hard on things that pay, but I work just as hard. But I spend more time with things I love. I'm involved with the Boys and Girls Club. I'm involved in more volunteer activities.

GROSS: Tell me how you think you became the person who you wanted to be, and you thought you should be, only after you broke your neck.

Dr. GOTTLIEB: My genetic loading would have me being more depressed more of the time. My parents were both mild to moderately depressed their whole lives. The good news about quadriplegia is because I felt alienated as a child, I lived my whole life up until 33 thinking that if I made enough money, I'd be okay - if I was successful as a psychologist, if I was stronger. and when I broke my neck, I lost all hope, and that was a gift.

I lost hope that I would ever walk again. I lost hope that I would ever be one of the kids again. My only choice was if I was going to live, I would live as me, not as the person I wanted to be ideally. It was liberating and terrifying.

GROSS: I mean, did you feel that there were certain pressures that you or other people had put on yourself - to become somebody who you weren't, particularly?

Dr. GOTTLIEB: We're all like that.

GROSS: No.

(Soundbite of laughter)

GROSS: Not me, ever.

Dr. GOTTLIEB: Most people I know spend their lives trying to be the person they think they should be, and never get to discover who they are. And that's the gift - one of the gifts - the fact that I can't run away from my demons, literally. I have to sit with them. The person I wanted to be - I had always dreamed of being a visionary, of being a peacemaker, but I had to be a psychologist. I had to be a father. I had to be the kind of man I thought I was supposed to be. And when I broke my neck, that was gone. I had to be the kind of man I was.

GROSS: How did the accident happen in which you broke your neck?

Dr. GOTTLIEB: I was traveling on the Pennsylvania Turnpike westbound. There was an 18-wheeler traveling eastbound. He lost his whole wheel - not his tire - but his whole wheel. It bounced across the turnpike and crushed my car. Thank God I was alone in the car because whoever else would've been there would've been dead.

And I'm also lucky that there was a car right across the street. And in that car, who watched the accident, there was an RN.

GROSS: No.

Dr. GOTTLIEB: So she ran across. As soon as she saw me, she knew I was a quadriplegic, and she knew not to take me out of the car. Me, being the person I am, when the ambulance came I said, call everybody I know to come here right away. I knew I needed a support system.

GROSS: Did they come?

Dr. GOTTLIEB: Boy, did they come.

(Soundbite of laughter)

Dr. GOTTLIEB: I was in Effort, Pennsylvania, which is about an hour from Philadelphia. And they came. They came in droves. And they still do. I am sometimes embarrassed by my wealth.

GROSS: I imagine that you dont remember the moment of impact.

Dr. GOTTLIEB: No.

GROSS: Is that a good thing, that you dont remember that?

Dr. GOTTLIEB: I think it is. The last thing I remember is a big, black thing in the sky, and that's the last thing I remember. I think, though, all of us - if we can use that metaphorically - all of us have been hit by a big, black thing coming out of the sky.

You know, it's a lump. It's a doctor saying, I think it's malignant. It's a spouse saying, I dont want to be in this marriage anymore. I'm no different than anybody else in that regard.

GROSS: Were you certain that you wanted to live while you were in the hospital...

Dr. GOTTLIEB: No.

GROSS: ...dealing with the news?

Dr. GOTTLIEB: No. No. Not at all. Not at all. I was surrounded with people who love me. I was surrounded with people who told me I had value and still, I wanted to die. I was taken to intensive care one night, and there I lay in bed in a halo vest, which is a grotesque apparatus where your head is bolted by -metal bolts in order to mobilize your neck. I'm laying there with IVs, with catheters, looking at the ceiling, wishing I could go to sleep and not wake up.

A nurse came up to my bedside one night. She said, youre a psychologist, aren't you? And I said yes. She said - not knowing I was suicidal - she said, does everybody feel suicidal at some point in their lives?

(Soundbite of laughter)

Dr. GOTTLIEB: And I said, well, its not unusual, but if you want to talk, come back after your shift. She pulls a chair up, 11 o'clock that night. We talk for an hour. Of course, it was her. She tells me about her life. I refer her to a therapist. She leaves. I close my eyes and I say to myself, I can live with this.

That woman saved my life, because she asked something of me. All these people told me I had value, but it had no meaning. She showed me that I had value by asking something of me, by allowing herself to be vulnerable with me and asking my help.

GROSS: And you continued to be a therapist. You started your own practice. You didnt have your own practice before the accident, right?

Dr. GOTTLIEB: It was a very small one. But I - yes, started my practice right after the accident.

BIANCULLI: Dan Gottlieb, speaking to Terry Gross in 2006.

More after a break.

This is FRESH AIR.

(Soundbite of music)

BIANCULLI: Let's get back to Terry's 2006 conversation with psychologist and radio host Dan Gottlieb. They're discussing "Letters to Sam," a collection of letters Dan wrote to his autistic grandson, discussing his own feelings of being different. Gottlieb was in his mid-30s when a car accident left him a quadriplegic.

GROSS: When you returned to therapy after the accident, were you resentful of some of your clients in thinking like - you think you have big problems? You can walk.

Dr. GOTTLIEB: I had that experience once. I was working with a man who was being treated for alcoholism and in a drunken stupor, he killed a girl. He got off, for some reason. I'm watching him in the chair rationalize this, wiggling his foot as he did it. And I'm thinking, I would like to kill this man for what he's done. That was the only time I felt it. I did have those emotions. When I was in the hospital, I was looking out my window at a street - at a man living on a vent, and I was envious of him. I thought, at least he can get up and walk off the vent, and I can't. And now, I'm envious of no one. No one. I dont have that emotion of envy.

GROSS: Do you think that your patients are ever - almost reluctant to tell you their problems, thinking like, oh, this will sound kind of trite because, you know, he can't walk and I'm complaining about - that my mother hollered at me yesterday?

Dr. GOTTLIEB: Yes. They do say that. I mean, my position on that is suffering is suffering. Quadriplegia is a fact. A history of child abuse is a fact. But suffering is suffering. I mean, if youre not able to sleep at night, youre suffering. I'm not suffering with quadriplegia.

There was a man in my office a couple of years ago, extremely obese man with two artificial knees, sitting in a chair that was probably too low for him. So to the end of the session - and he struggles to get out of the chair. Like, he's working hard, and I feel badly. And I'm watching, and he knows I'm watching. And he gets up, and he takes a deep breath. And he says, you know, Dan, he says, as hard as it was for me to get out of the chair, he says, I look at you and I think, thank God I can get out of the chair. Maybe I shouldnt say it, but that's what goes through my mind.

And I said, you know, I've got to be honest with you. I said, I look at you and how hard you struggled to get out of the chair and I think, thank God I dont have to go through that crap when I get older.

(Soundbite of laughter)

GROSS: What was his reaction?

Dr. GOTTLIEB: We both laughed. You know, it's all a matter of perspective. Its all a matter of how you look at it. You know, my dad used to tell a wonderful story. If I may?

GROSS: Please.

Dr. GOTTLIEB: As he got older, he used to say: I'm ready to leave this veil of tears. And I said to him, Dad, is your life that bad that youre really ready to go? And he said, some days. I said, well, tell me about those days. He said, well, I get to thinking, my wife is gone; my daughter is gone - my sister had died five years earlier - and here's my son, struggling through life every day in a wheelchair. He said, those days, I'm ready to go.

I said, But Dad, those things are true every day. Tell me about the days youre not ready to go. He says, I'm not thinking about those things. It's all perspective. It's all where your mind lands, is how you read your life and how you experience it.

GROSS: Well, he was ready to kill himself because youre in a chair, and of course youre not feeling that way about it when he's saying this.

Dr. GOTTLIEB: Well, the truth of the matter is...

GROSS: You were?

Dr. GOTTLIEB: No. No, not at all.

(Soundbite of laughter)

Dr. GOTTLIEB: The truth of the matter is, I would much rather be a quadriplegic than be a parent of the quadriplegic.

GROSS: Really? Why?

Dr. GOTTLIEB: Oh, the helplessness he felt, watching me every day in his life. The powerlessness, the stories he told himself about my suffering - I mean, I can't imagine. I've watched both my daughters be ill, and I suffered more than they did. I watched my wife, when I went back to work as a quadriplegic - I was hospitalized for a year, and I went back to the clinic I worked in, and it was very difficult for me, and the staff was unkind to me - and her rage and helplessness at them.

Meanwhile, I had the ability to work it out with them. I was in there. I worked it out with them. I was fine. She could never forgive them because the person she loved was suffering, and there was nothing she could do about it. You know, the famous psychoanalyst Sheldon Kopp said the most difficult part of love is dealing with your helplessness in the face of a loved one suffering. And that's what it means to be a parent of the quadriplegic.

GROSS: You mentioned earlier that you are part of the first generation of people with quadriplegia who have lived into their late 50s - that, you know, medical science has gotten to that point. And so - and youve nearly died a couple of times. Youve come really close. At the same time, you have people who have been able-bodied, weren't in accidents, and who have died. Your ex-wife died. Your sister had a brain tumor and died. I'm just kind of thinking of like, the relative length of life - that the people who had seemed healthy have already left.

Dr. GOTTLIEB: I dont know how to respond, Terry. You know, Franklin Abbott, a sociologist, said that we couldnt have life without death; we couldnt understand it. The closer I come to death - and I feel I come closer every day, feel it, know it, touch it - the more that happens, the more precious I feel daytime is, nighttime, colors, knowing you, being here, writing this book, the more grateful I feel for what I have.

The imminence of death just makes life more alive. I dont know, Terry, if we could do it without smelling death.

GROSS: Youve done a radio show at WHYY in Philadelphia for many years. How many years it? Twenty?

Dr. GOTTLIEB: Twenty.

GROSS: So does therapy help you as an interviewer? You know, do the skills of a therapist help you with the skills as an interviewer on your radio show?

Dr. GOTTLIEB: Very much so.

GROSS: Mm-hmm.

Dr. GOTTLIEB: Very much. They started off helping me. And then I had to hone them because I could sit for 50 minutes, easily, with one patient and be very interested, but that doesnt make for good radio, the kinds of questions I've asked. My years on the radio - has helped me hone my question and get to the heart of things very quickly.

GROSS: So radio has helped you as a therapist?

Dr. GOTTLIEB: Radio has helped me as a therapist a great deal. I'm much more efficient as a therapist. One thing I learned - a patient came to me years ago and she said, I feel like my soul is a prism, and everybody I know only sees one color, and nobody sees the whole prism. And I thought, that's the way to be a good therapist. That's the way to be a good parent, a good spouse, a good lover - is to see the prism of somebody else's soul. And that's what I do as a therapist, as a radio interviewer, even as a friend. I work very hard to see the prism of somebody else's soul, and that's what my questions are geared towards: help me see the prism of your soul.

GROSS: It sounds like you have a really good perspective on life and death, and on your physical limitations with quadriplegia. And you said before, there's no one that you envy, like youve put that kind of envy behind you. Are there times, though, where it just gets to you, and you dont have such a clear view, you dont have such a good handle on the world and your emotions and all of that?

Dr. GOTTLIEB: Oh, often. Often. I dont feel envy. That doesnt mean I dont suffer. I remember a couple of years ago, I was driving in my van and I saw somebody jogging - on a drive - one spring day, and I just burst into tears. I had to pull over to the side of the road, I was crying so hard.

I suffer greatly. I suffer that my bladder is failing, I suffer. I feel great pain during the day. But I say to people: My body is broken, my mind is neurotic, and my soul is at peace. And that is really true. It's really true. I suffer with my body. On occasion, I suffer with my mind. And my soul really is at peace -today. And I pray it's at peace tomorrow, too. And I pray its at peace when I'm in my death bed.

GROSS: Well, Dan Gottlieb, thank you so much for talking with us.

Dr. GOTTLIEB: Terry, thank you. It was delightful.

BIANCULLI: Psychologist Dan Gottlieb was speaking to Terry Gross in 2006. His book, "Letters to Sam," in which he wrote advice and observations to his young, autistic grandson, has been followed by a new sequel, "Wisdom from Sam," published in April by Hay House.

Coming up: film critic David Edelstein on two new documentaries. This is FRESH AIR.

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