The realm of the Final Inch! . . . The work has been almost completed, the goal almost attained, everything completely right and the difficulties overcome. . . . Finishing touches are needed, maybe still more research. In that moment of fatigue and self-satisfaction it is especially tempting to leave the work without having attained the apex of quality. . . . Not to postpone it, for the thoughts of the person performing the task will then stray from the realm of the Final Inch. And not to mind the time spent on it, knowing that one’s purpose lies not in completing things faster but in the attainment of perfection.
—Alexsandr I. Solzhenitsyn, In the First Circle
Shitala Ma was on the run. The previous year at this time there had been 8,600 smallpox-infected villages in India; now there were only 25, and those paltry few were all well contained. Two-thirds of these outbreaks were importations from neighboring Bangladesh, which was the last of the heavily infected countries in the world. During the All-India Search in April 1975, almost 150,000 health workers searched 100 million homes door-to-door and discovered not a single new case, not one. Zero. For the first time during the campaign, probably for the first time in India’s history, a week went by when there were no new cases of smallpox. As our coach, commander, and cheerleader-in-chief, D.A. wrote a global summary, a memo called “The Final Inch,” reporting that Bihar was the last remaining state with smallpox in all of India, urging us to complete the task, to get to the magical zero pox number, to summon all our remaining reservoirs of energy and goodwill; to never let up even for a second. “Maybe,” he said “we are nearing the final inch.” And with that, Nicole sent me to Patna, the capital, to try to take to the rest of Bihar what we had learned in Tatanagar and Chotanagpur.
Girija and I closed up our barsatti in Delhi and left for Patna right away. With a long stretch of living there ahead of us, we set up a cozy communelike house we called the Zero Pox Guest House, with plenty of rooms for expat epidemiologists, Government of India visitors, and WHO officials to stay with us when they needed to. Living in a commune like the Hog Farm buses had taught us that nothing builds community like a shared kitchen and good food, so I hired the top Bihari cook from an old English estate to make whatever anyone wanted after difficult days in the field—English puddings, Russian borscht, or Indian masala dosa or laddus. I moved the telex into the house that Tata had set up for us in Tatanagar, with the callback code Zeropox, and our dining room quickly became the program’s nerve center.
For the next half year I traveled by jeep to every corner of Bihar, trying to imitate D.A. and urge each of our nearly four dozen smallpox epidemiologists to redouble their efforts now that we were in the “realm of the final inch.” I had a lot of time driving in jeeps over bumpy roads to think about it. The raging fires of Tatanagar and Chotanagpur had calmed enough to give me more time to contemplate the India that Girija and I had traveled from the United States to live in. It had been five years since a burst of idealism deposited me on Alcatraz Island with the American Indian occupation to deliver the baby Wovoka. It had been five years since Girija and I had run away with the circus and I had joined the Medicine Ball Caravan movie crew as their hippie doctor to live on psychedelic buses traveling across the United States, Europe, and Asia. I had spent half of those five years studying compassion, religion, and love with Maharaji, living in the ashram in the Himalayas; I had spent the other half becoming a WHO medical officer fighting smallpox. We had experienced moments of transcendental love and clarity in the ashram and had made pilgrimages that lifted us spiritually. I had also grown and matured as a leader and manager through working with Nicole and Bill. Girija and I were smitten by the intensity, riot of color, crash of sound, crush of humanity that was India.
Our love for each other was wrapped in the shared experience of India. But there was a gathering darkness in my soul from the relentless suffering and death that I had seen, and from decisions I felt forced to make that made me queasy. The faces of the children who suffered from smallpox, the young adults killed in the flower of their lives by a demon goddess, the parents whose bodies wracked with sobs of helplessness watching their children die. I had seen the faces of hundreds or maybe thousands of children with smallpox. I struggled to absorb the humanity of the staggering statistics: more than a quarter of a million Indians had gotten sick or died from smallpox since the day I left the ashram and entered the WHO office.
While I honestly believed it was the final inch, that we were close to the final case of smallpox, still there was an internal accounting. The cumulative toll was crushing. Girija and I both had a hard time sleeping. I questioned many of the things I had done—the force used with Mohan Singh, my rage at the nearly catatonic Dr. Sen as he alphabetized his books, barging into Russi Mody’s house. I wasn’t second-guessing the need to do these things for the program, but I was concerned about their impact on my heart—the growing darkness, anger, and depression overtaking me. I was beginning to turn the anger toward God.
On the Hog Farm buses, we often referred to God as “The Management.” While I had gained a new appreciation for the effect of very different styles of management by watching D.A., Nicole, and Bill, and especially the Tatas, I was starting to think of God as one hell of a lousy manager. For a supreme being who was supposed to be omniscient, omnipotent, and benevolent, there was way too much cruelty and suffering in the world. To my mind, no sin, in this life or a previous life, committed by the child, his father or grandfather, could justify the extreme suffering of hundreds of thousands of children in India and millions, perhaps billions, of human beings throughout history because of smallpox.
The images of dead bodies piled on the railway platform, the memory of dead children thrust into my arms, the rumors of vultures pulling at the pock-ridden arms of dead children played in my head day and night.
There was a missionary hospital nearby—the Jesuit Holy Family Hospital—at which I would sometimes sleep during “night halt” trips away. The priest was from the upper Midwest in the States. We joked about growing up in the same part of the country and me and my friends being chased off the baseball diamond at the University of Detroit by a bat-wielding Jesuit in a cassock. We talked about our gurus—his bishop and my Maharaji—and the motivation of love behind everything Jesus did or said. “It’s the problem of reconciling suffering with a loving God,” he said when I told him of all the death and suffering I had seen. “Most of us living in India, seeing children die needlessly, come up against this contradiction.”
One morning he saw me meditating in the hospital chapel. He sat behind me for a few moments before asking, “Would you like to pray with me?”
He kneeled and I followed suit. I had long since lost my aversion to bowing down. We meditated silently, and then he asked me whether I would like to take communion.
“Father, did you miss the part about my being Jewish?” I asked.
“No, Larry, I didn’t miss that part.” He laughed. “But it’s not important. Communion,” he continued, “is for people who are seeking a state of grace, in the presence of the living God, in communion with the Lord. I sense that you are, although you struggle. I cannot imagine that the God I serve and love would be displeased if you were to enter into deeper communion with him.”
This was a different kind of Catholic than my memory of what I had thought were Jew-hating Jesuits chasing us with a baseball bat in Detroit. These Jesuits in India felt like brothers in this dance with God. I accepted.
The ritual, the sip of wine, the incense, the scratchy old record playing music that lifted me, a sudden easing of the burden of suffering. I felt a surge that wasn’t Buddhist or Hindu; it wasn’t Christian or Jewish. It was all of them, comforting, and healing. The smallpox warriors seemed part of a mystical army of the good ones, the righteous ones working to reduce suffering through the ages. I was grateful for feeling like a small part of that history, yet it was not enough to heal my doubt about why all that suffering was necessary.
Just as I got back to Patna I received a telegram that Justin Bhakla had somehow contracted smallpox. I felt sure the diagnosis was wrong, that he might have contracted chickenpox. I rushed to see him. He had modified, or discrete, smallpox, which didn’t cover the whole skin. It presented as a mild case. We took lots of pictures and I reassured him, but I was troubled. I had been certain of his safety and told his family there was no risk. With the number of times Zafar, Justin, and I had vaccinated ourselves to demonstrate its safety, he shouldn’t have been able to contract the disease.
Dr. Kitamura, a friend of Isao Arita and a world-class immunologist from the National Institute of Health in Japan, was in Bihar testing smallpox specimens. He brought a mobile lab with him, collecting samples of smallpox scabs to take back to Japan in an attempt to develop a smallpox antiviral. I asked him to bring his lab to the Tata Main Hospital where Justin was hospitalized to draw blood, take scab samples, and help us understand what had happened. Kitamura took samples from Justin and returned to Japan, where he and his colleagues would test them.
Eventually, Justin recovered, but immediately he came down with another shower of smallpox lesions. And then another after we thought he was over it. He kept getting sick, and no one knew why. It was as though all his systems were collapsing. Justin’s family and friends now shunned me in his village. Everyone blamed me for ruining his life, and a deep suspicion grew that the protection we were offering through vaccination wasn’t real. A lot of tribal vaccinators quit. Vaccination resistance in villages increased. Many of my Indian colleagues began to doubt everything.
Just at that moment, more strange smallpox cases appeared. There was an outbreak in a village called Pawapuri, a Jain pilgrimage site near Bodh Gaya, that continued to confound us. Instead of the usual pattern of spreading from one case to three or four others, the epidemic “tree” widening as it grew, the outbreak in Pawapuri spread slowly, one case sprouting up about every two weeks. The outbreak had been hidden for six months by the time we discovered it. Because it had taken so long to find the first cases, the naysayers postulated that there remained in India hidden cases, perhaps a new strain of smallpox with no telltale symptoms. If that were the case, and an asymptomatic person could spread the disease the way Typhoid Mary had spread typhus, then eradication might, as Jankowicz had insisted, be impossible.
The Jain celebration marking the twenty-five hundredth anniversary of the birth of their founder, Mahavir, took place around the time Justin got sick. A contemporary of Buddha, Mahavir also embraced non-harm, ahimsa, as it is called by Buddhists and Jains—the principle that also motivated Mahatma Gandhi and then Martin Luther King Jr. The holiest sites in the Jain tradition were in Bihar, near Pawapuri, about an hour-and-a-half drive southeast of Patna. Jain priests, munis, and devotees were coming from all over the world to the exquisite marble temple called Jal Mandir. At our Patna headquarters, we had received well over a thousand notifications warning people in ten different countries that they had been exposed to smallpox at the temple.
The Jains refused to be vaccinated because vaccine could not be produced without killing cows. Their logic bothered me. They did everything to avoid hurting even an insect, yet they seemed unwilling to lift a foot to stop a preventable disease that killed millions of children.
I set up a meeting with one of the munis from the Jain Lal Mundir Temple in Delhi. I showed him the postcard with Maharaji’s picture and told him about his prediction that it was God’s will that, through the hard work of dedicated health workers, smallpox would be eradicated. This muni knew of Maharaji. He knew, too, that Maharaji rarely made public predictions. Convinced, the muni wrote letters to all the other Jain munis on our behalf explaining why the Jain community had to get behind WHO’s smallpox eradication program. While acknowledging in the letter that animal lives were in fact taken to create the vaccine, he further explained what the vow of ahimsa actually means. One must do his or her best not to kill insects or any other tiny creatures, he argued persuasively, but one must also make sure to do as little harm to people as possible. If we can end a disease that has killed so many millions—and would continue to kill many millions more—then vaccination is a small price to pay for a very great good. His words, which WHO printed on flyers distributed throughout Jain communities, stated that sacrificing a cow to create smallpox vaccine is, as Neem Karoli Baba had said, part of lifting this one form of suffering from humanity.
At the Jal Mandir, Girija noticed a flyer saying that our old meditation teacher Goenka, who had taught us both our first lessons in meditation, was hosting a ten-day silent Buddhist meditation retreat in a nearby Jain monastery. It wasn’t easy to find the time for a retreat in the middle of the campaign, but Girija insisted. I was stressed and becoming more irritable and angry; she knew better than I that if we didn’t take time to refresh ourselves spiritually, we would drown emotionally.
In the hills of Rajpur, the Jain temple was carved of white marble with delicate soaring arches. The grounds were exquisitely landscaped, alive with animals, and lush with flowers and hedges. Birds darted in and out of the courtyard. Every morning, Girija and I woke to their chattering and singing for the first meditation session at four o’clock.
Goenka began and ended every one-hour silent meditation session with the same metta (loving kindness) chant, which translates from the Pali as, May all beings be peaceful. May all beings be happy. May all beings be free.
When he finished the opening chant on the first day, I was neither happy nor at peace. My mind darted from face to disfigured face of infected children, their fragile arms and legs covered with pustules, their mothers wailing. Even as my brain knew we were near the end of the battle with Shitala Ma, my heart was flooded with memories of pain and death. There in the retreat, surrounded by the peace and calm of my companions, I started to sob. I could not talk to Girija because we were supposed to keep silent for the full ten days; I could not explain my pain over being devoted to a God who seemed to be a sadist. Sitting in meditation, I kept trying to find evidence of the compassionate and loving God Maharaji had shown me. But over and over I was stuck in one recursive thought: What kind of crime would have to be committed for a merciful, omniscient, omnipotent God to deal this kind of suffering on a baby, or on all of humanity? With each session, I became more agitated, more uneasy. I was spiraling silently into depression and anger.
Five or six days into the retreat, an hour into a session, there was a rustling at the back door, followed by the stomping of heavy boots. A deep American voice yelled out, “Goenka, what makes you think you’re so fucking pure?”
Goenka was silent. No one moved or turned around.
“Goenka, who gave you the right to judge everybody?”
Silence.
“Goenka, I know you’re a fucking fraud.”
The tirade became relentless, over and over: “Goenka, I know you are a fucking fraud!”
I wanted to hide under my meditation cushion; I suspected we all did. But just as suddenly as he appeared, the American left. The eyes of the meditators remained closed, I noticed as I peeked at the stoic, white-robed rows of Jain monks. Goenka’s metta chant closed the session. We left the hall as usual.
The next morning everyone was restless. Goenka began again with the metta chant, but the room felt like a worm squirming to avoid being pulled out of a bucket and stuck on a hook. Goenka ended the session with the same metta chant: May all beings be peaceful. May all beings be happy. May all beings be free. Another day went by in silence.
The morning after that, following the opening chant, Goenka finally addressed the group. “My friends,” he said, “two days ago we had an unexpected visitor. He disturbed our search for equanimity. I thought I would tell you how I view this. If you were here in order to take a course on driving a car, but you had none to drive and your friend said, ‘Please, borrow my automobile,’ you would say, ‘Thank you for providing the vehicle on which to practice.’ If you were trying to become a chef and didn’t have a kitchen, and a friend offered his kitchen, you would say thank you. In every instance when someone loaned you something for you to learn with, you would be grateful. This unexpected guest came and he lent us his anger. He had more than he needed, so he lent some of his anger to us. What are we here to learn? It is to never be angry but to try to be equanimous. We are here to learn to convert the anger others feel or even hurl at us into peace and equanimity. We should send that young intruder our thanks and our love.”
In Tatanagar, I was angry at what I thought was a huge, uncaring corporation in a company town undoing all the good the smallpox team had done elsewhere in India. I was angry at the bureaucrats. In Delhi, I was angry at the secretary of health who tried to extort me. Everywhere I was angry at the bureaucrats. I was angry because a woman handed me her dead son and there was nothing I could do.
The American intruder was a jolt to the quiet of the retreat. I had been trying to use the peace and quiet of meditation like a tranquilizer—his raw emotion forced me to face the anger I carried with me. I was angry because I couldn’t square the circle of a supposedly loving God and the horrific suffering that I saw day after day, body after body. My mind went back in time and space, back to Kainchi, reeling and sobbing while Maharaji stood on my hand, later saying, “It is better to see God in everyone than to try to figure it all out.” Oh, I wish that’s the way I felt.
A month into our time at Patna, on May 17, 1975, came smallpox’s final gasp in India, an echo from the dying embers of an ancient scourge. An unvaccinated eight-year-old boy in Bihar named Manjho developed fever and rash. He would be the last domestic case of smallpox in the history of India.
M.I.D. called the Central Team back to Delhi for a small, wary celebration to mark the moment. He asked everyone to predict whether there would be any more cases of smallpox, any importations or hidden foci that would turn up later. Most of us thought there would be many importations from Bangladesh. The votes were written, sealed, and pinned to the wall of Nicole’s office.
A week later, a thirty-year-old homeless woman named Saiban Bibi from the village of Thauri in the Sylhet district of Bangladesh developed symptoms of smallpox. An ancient place, Sylhet is a finger of Bangladesh thrust into three states of India—Meghalaya, Tripura, and Assam, where Saiban was discovered by smallpox workers. No one ever found out why she traveled the short distance by train to beg for food at the Karimganj railway platform, which is located just across the border from India, but she was poor, alone, most likely hungry, perhaps dazed by her disease. Smallpox workers scouring the area found her within three days of the onset of her rash and immediately reported the new case to Zdeno, who, having worked in Mongolia for five years and at home in hilly terrain, was now in charge of the Assam district. He flew there from Delhi that same day. Although she brought smallpox with her from Bangladesh, the Indians, after some back and forth, counted her as one of their own and recorded her illness as India’s last case of killer smallpox.
The speed with which Saiban Bibi’s case had been detected was an exclamation point on the self-sacrificing work of almost 150,000 Indian search workers who had made by then nearly a billion door-to-door house calls. One woman infected with smallpox had entered the country of half a billion people and had been detected almost immediately, in a few hours. The area where she’d been found, between Assam and the village of Thauri in Bangladesh, was contained and a ring of vaccination miles in diameter was completed within a few days of Saiban’s first setting foot in India. There were zero additional cases of the disease. In 2016 terms, this remarkable achievement would be comparable to epidemiologists discovering the first case of Zika in Brazil, not the millionth, or quarantining the first case of Ebola in West Africa within twenty-four hours instead of the six months it actually took.
The national surveillance system was so good it was almost impossible to believe. To make sure we weren’t drinking our own whisky, we hired an outside assessment firm, which asked more than one million Indians several questions, most notably, “Who is Indira Gandhi?” and “What is the reward for reporting a case of smallpox?” The survey revealed that more Indians knew how much the reward for reporting smallpox was than knew who the prime minister was, which made us even more confident that we had gotten our message to every corner of the country.
Immediately after the last case, India entered its obligatory two-year period of surveillance. As for M. I. D. Sharma’s game of predicting when the last case in India would occur, both he and Nicole made the best guess, sharing the victory as one, just as they shared leading roles in the conquest of smallpox. I was thrilled with our external progress. I wasn’t so sure about my internal progress.
By August 15, 1975—India’s Independence Day—less than two dozen people in the world, all in Bangladesh, harbored Variola major, killer smallpox. The team could taste victory. Not a single new case of smallpox had been reported in India in three months, since the sad case in May of Saiban Bibi, who had come already quite ill from neighboring Bangladesh into Assam to beg for food. We had no illusions that smallpox could not be re-exported to India from Bangladesh—it was now the only country in the world with Variola major—but it was progressing toward eradication: at last report, officials there announced a tremendous, almost unbelievable drop in reported cases in five months, from nearly two thousand to only sixteen active cases of Variola major. Dozens of epidemiologists were dispatched to the borders to prevent the spread of smallpox back into India. Though India would only remain free of smallpox if Bangladesh succeeded in finishing off the disease, Prime Minister Gandhi and her government were ready to declare to the world India’s independence from the shackles of the world’s most ancient plague.
For India’s annual freedom celebration, WHO and the government planned a global telecast from New Delhi, the first of its kind. Several reporters came for the event, including Lawrence K. Altman, a physician and writer for the New York Times who had also trained under D.A. Henderson as an epidemiologist at CDC. The idea was to play off India’s dual independence: from the domination of hundreds of years of colonial rule and from thousands of years of Variola major.
D.A. flew in from Geneva with WHO director general Halfdan Mahler. They congratulated Prime Minister Gandhi for India’s success in smallpox. They planned to fly from Delhi to Dacca after the telecast to meet with Sheikh Mujibur Rahman, the prime minister of Bangladesh. Director-General Mahler had planned to have an urgent meeting with the Bangladeshi prime minister about how to handle what might be the last remaining cases of smallpox in Bangladesh and the only cases of Variola major in the world. The United Nations feared that the Bangladesh government’s clumsy attempts to subdue civil unrest by razing slums around the capital of Dacca would make everything worse: slum dwellers might be moved out of the epidemic-ridden capital city and relocated to the countryside, carrying with them incubating smallpox.
The very day of the planned telecast, celebration, and meeting, however, Sheikh Mujibur Rahman was assassinated by a group of conspiring generals. The new regime, convinced there was a military threat from Pakistan, quickly sealed off the Bangladesh borders. But sealed borders did not work to keep torrents of frightened Bangladeshis, afraid of another war, from rushing into India. We feared a repeat of the massive and bloody migration of Hindu refugees from Muslim Bangladesh that had occurred during the war in 1971. Pakistan’s generals were in the process of being charged with war crimes for the atrocities committed at that time. Prime Minister Gandhi declared martial law. And now, if refugees came again, they would bring smallpox into disease-free India.
The New York Times probably had hoped Larry Altman would go to see the last cases of smallpox in Bangladesh, but with the borders closed, we arranged for him to go to Patna instead; Bihar was the last program in India still running full throttle. Altman was interviewing recent smallpox survivors and epidemiologists in the field when he became trapped by record floods following the annual monsoon season. The city of Patna was swallowed by the water. Altman was stranded on the roof of the apartment building in which we housed team members and guests.
Many other smallpox workers were trapped on housetops and hills in the areas near the Ganges River. Health Minister Karan Singh, M.I.D., Mahendra Dutta, and our new friends from Tata helped coordinate daring search-and-rescue operations. I hitched a ride on an Indian Air Force jet from Delhi to a makeshift runway outside of the flooded area of Patna. After switching to a helicopter, the air marshal took me to tour the devastation. It was surreal to view Patna from the helicopter, the city’s few multistory buildings barely poking their pastel-colored heads up over the high waters. The landscape, which a week before had been a network of roads connecting farms and traveled by bullock carts, was now a mass of waterways dotted by makeshift rowboats and life rafts, transporting goods, food, and people from wet to dry land. From the air, I thought we spotted Altman’s roof, but our helicopter could not land. We dropped some cooked food and water on the nearby rooftops and mapped his location, but Altman would have to endure another five days of vomiting, dehydration, and watching countless snakes swim past before he was able to get out by cobbling together bamboo poles and air mattresses into a raft. In the report he cabled to the Times, he wrote, “The life of the half million people of Patna seems to have shifted to the roofs.”
If there had been any smallpox left in Bihar, the rapid exodus of people fleeing those floods might have reignited another epidemic. But there were to be no more cases in India. Though we had gone three months without a new case of smallpox in India, we still had twenty-one months of the surveillance period before we could declare the country finally free of Shitala Ma. Once the Indian Army had set up stations for the worst-hit victims of the flood, I drove around Patna in a jeep caravan to make sure the team was as dry and well fed as possible. We used the system we had set up for vaccine and needle distribution to now distribute food and dry clothing, got provisions to those who were in a safe place, and helped rescue those who needed evacuation. Team members in Tatanagar and South Bihar who were less affected by the floods continued their search-and-surveillance system. Finding no smallpox, they turned their focus to tracking down diseases that might be mistaken for smallpox, most notably chickenpox, scabies, and impetigo.
When the waters receded from Patna, the smallpox surveillance system was put into place to make sure Bihar state remained at zeropox. Girija and I flew back to Delhi to our little barsatti with the big air conditioner to find out where Nicole would be sending me next. Yom Kippur was coming up, and I felt in need of atonement. Altman’s moving accounts of the smallpox campaign and the Bihar flood triggered a surprise call. A cousin I hadn’t seen since childhood, Gen. Robert Solomon, was touring Pakistan with the U.S. Army War College and wanted to pop over to Delhi for a family reunion with our other cousin, Myron Belkin at the Associated Press. Although I had been vocally against the Vietnam war, and Bob Solomon had been one of the faces of that war, most of my family had been army in one way or another. All three of my mother’s brothers had served, and my dad was in the Michigan National Guard cavalry. Bob Solomon had become a lifer in the military, rising to be a rare Jewish general.
Three American cousins—a peripatetic journalist, a general in civilian clothes, and a radical hippie-turned-UN-medical-officer—met in India to celebrate the holiest of Jewish holidays among the last of the Jews in India.
I had not been to Yom Kippur services in years, and this was my first visit to a Sephardic synagogue. Starting off the Yom Kippur sundown-to-sundown fast, the Kol Nidre service was attended by two handfuls of men, barely enough for a minyan. There was no rabbi, no one seemed to know the right prayers, and the volunteer cantor, an Eastern European diplomat, was lousy. In the midst of the confusion, my cousin the general stood up, walked to the front of the prayer room, and out of his mouth came beautiful, melodic Hebrew chant. None of us knew that the warrior had studied in rabbinical school to be a cantor. He pushed me to lead prayers and told the small gathering that I was a kohain, born of the Jewish priestly caste, but I was useless; maybe I could have chanted something in Sanskrit rather than Hebrew.
My dad’s birthday, in September, often fell on Yom Kippur. He would have been seventy years old that year. I recited the Kaddish, the mourners’ prayer, for my dad, for the thousands of kids who had died of smallpox. I was troubled by the news I’d just gotten from Kitamura—the results of Justin Bhakla’s tests. The mystery of his illness was finally solved. Justin had a previously undiagnosed genetic anomaly, a near total absence of the most important part of the immune system, immune globulin IgM. Because of his condition, Justin could have died from any infection—a cold, the flu—but he didn’t. He would, two years later, succumb to complications of his disease, and I couldn’t escape the feeling that I had put him in harm’s way. Often I thought that if we had finished smallpox a couple of months earlier or if Justin had evaded contact with a smallpox case for just a little while, there would have been no smallpox left in India for him to catch. I visited his home, spent time trying to explain his illness to his family. After his death I would tell his parents of all the good Justin had done. I did not know then that my words were meaningless. Three decades later, when my own beloved son, Jonathan, who was about Justin’s age, died from lung cancer, everything sounded hollow deep inside the black hole of my grief and I plunged into darkness for years. Physicists like Stephen Hawking say that a black hole is so dense that light can’t get out. The black hole of grief is the opposite; light can’t get in. Justin trusted me, his family trusted me, just as I trusted the vaccine; but we did not know he had been born without an immune system.
I was missing having a guide. Lama Govinda had decided to take up his students’ offer to bring him to Mill Valley, California, for medical treatment. I missed Maharaji with everything in my soul. I felt as bewildered and alone as I’d felt that day at the Tatanagar train station.
Going to the northeast of India, to the foothills of the Himalayas, along the extensive border between India and Bangladesh, where some of the last cases of smallpox had been, was a welcome respite. It was the time of year when the white peaks of the Himalayas set off the brilliance of the red poinsettias, which grew dozens of feet high, clinging to the branches of tall trees—the white, red, and green framed wide-open spaces of the Himalayan valleys. Nicole sent me to oversee the repeat searches in the Himalayan foothills in the eastern part of India—Darjeeling and Assam—and then Sikkim. It was a comfort that Girija was able to get the internal Indian visa so that we could travel together. We flew to Calcutta and drove for a day up to Darjeeling, the tea-growing area dotted by Tibetan Buddhist temples. Its name, Thunderbolt Land, comes from the Tibetan words “dorje” (thunderbolt) and “ling” (place). From Darjeeling we crossed into neighboring Sikkim, the small Himalayan kingdom about to be annexed by India. There, the facial scar survey showed that the last big smallpox outbreak was before the beginning of the WHO program. Convinced we could take Darjeeling and Sikkim off our list of regions to worry about, I sent off my report to Nicole, and Girija and I went off on our own.
We visited the Tibetan-style gompas, monasteries, and temples, but mostly we wanted to visit the Sixteenth Karmapa, the Tibetan Buddhist master of destiny, of karma, whom we had seen several times over the past two years.
The first time Girija and I had heard the name was when we were on our Himalayan trek with Wavy and Bonnie Jean. She was pregnant, and I was weak from dysentery. But much more dangerous, Wavy and Girija had hepatitis; the whites of their eyes were yellow as lemons. If I had been a more persuasive doctor, I might have been able to convince them to stay put and wait out the rainy season in the mountains before attempting the dangerous return. But I was afraid Girija and Wavy wouldn’t survive if we were stranded in the mountains by the monsoons.
The trek down the mountains was terrifying—early rains made for slippery terrain and we tired easily, even without our packs, which our two Tibetan sherpas, Dawa Thondrup and Sonam Mundo, carried. Several times we got to the edge of the Kali Gandaki River to find that the only way to cross the gorge one thousand feet above the roiling, rocky river was on tree branches, sometimes not much wider than a fist, that had been laid across it. Dawa Thondrup and Sonam Mundo danced across the trunks over the raging river carrying seventy-pound baskets of Wavy’s toys and my medical supplies. They were chanting a prayer I had never heard before—“Karmapa Khyenno,” Karmapa knows—like saying, Karmapa knows, the Master of Karma knows how hard your life is; God knows the struggles you have, and God is the Karmapa. I was frightened, but Girija was frozen. I went in front, coaxing her as she scooted on her belly, hugging the trunk. The Tibetans returned to help us, always humming, “Karmapa Khyenno.” As Hog Farm guru commissioner I asked who this Karmapa was, a god or a lama, but the answer was vague: to the sherpas, he was both.
Girija and I later went from Vrindavan to our first Goenka retreat in Bodh Gaya, where Buddha had achieved enlightenment. When it was finished, one of the attendees, a French Canadian named Daserat, told us that the Karmapa was nearby in Sarnath, where Buddha had given his first teaching. Girija and I had seen the Karmapa’s photo on hippie buses and at meditation centers. His name was fresh in our minds from the trek in Nepal. He seemed to be if not divine, certainly ubiquitous.
The Karmapa was staying at an Indian government Circuit House in Sarnath like the one we had shared with the Dalai Lama. A handful of Westerners from the meditation course were curious, so we went to see him as a group. We gathered in a sitting room; the Karmapa came out, sat down with us, and we all talked with him, casually, just like in darshan with Maharaji. Accompanying the Karmapa was Jamgon Kongtrul, a twenty-year-old, highly ranked incarnate lama. Daserat, who had just returned from Canada with the hottest new Polaroid camera, asked the Karmapa if he could take his picture. “This is brand-new technology,” he explained to the lama. “You don’t have to wait for the picture to be developed by someone else. I can take the picture and then in ninety seconds it will be ready.”
The Karmapa smiled, admired the camera when Daserat showed it to him, and readily agreed; he and Jamgon Kongtrul posed. As soon as Daserat pulled the paper from the camera, the Karmapa looked at his wristwatch and started counting off the seconds. Maharaji never had a watch and never let us take pictures; somehow it felt too materialistic for a spiritual teacher. “Okay, ninety,” the Karmapa said. “Ready?” Daserat ripped off the paper, and the Karmapa admired the photo.
Then he said something in Tibetan to an attendant, who disappeared into the back and returned with a box. “Now let me take your picture,” the Karmapa said. “We can do it with my new Polaroid camera, which only takes sixty seconds.” I bellowed involuntarily with laughter. In this remote part of India, there were no other instant cameras within a hundred miles. We were all swept up in the Karmapa’s organic, embracing, effervescent laugh. The room felt like a glass of champagne, and we floated upward with the bubbles.
Friends in the government arranged a car to drive Girija and me the fifteen or twenty steep winding miles from the Sikkim capital, Gangtok, up to the mountaintop on which the Karmapa’s monastery, Rumtek, was situated. We had written ahead that we were coming but never got a response; we didn’t even know if he was in residence.
Situated high in the Himalayan foothills, Rumtek looked like it had been transplanted from Lhasa. The square structure was only two or three stories high, but it was imposing nonetheless, its roof dotted with pagodas painted in brilliant oranges, greens, blues, and maroons. The original monastery, built in Tibet by the Twelfth Karmapa in the mid-1700s, had been destroyed during the Chinese invasion of Tibet in 1959. The structure in Sikkim was then only a decade old, built as a replica of the original after the Sixteenth Karmapa had fled Tibet.
We lucked out. When we arrived at Rumtek, the Karmapa was there; monks took us to a waiting room and served us butter tea. Girija and I had both felt orphaned when Maharaji died, and in the Karmapa, we saw the potential for a new spiritual friend.
The sun was setting and it was getting late. The Karmapa interrupted a prayer session and came to welcome us briefly and introduce us to his translator, Achee, who spoke excellent English. Achee showed us around Rumtek before making arrangements for our meals and taking us to the guest house. We wanted to retire early as Girija had not been feeling well since we arrived in Sikkim.
Near daybreak, Girija woke up feeling like her skin was on fire. She had hives all over her body and was having difficulty breathing. Thank God I had my medical kit with me, which included antihistamines for what was likely an allergic reaction to something in Gangtok. For the next twenty-four hours we did not leave the guest house; Girija slept off and on, but I did not. I stood over her all night, making sure she was breathing, worrying about what would happen if I ran out of antihistamines; she was brave but she kept getting worse. I kept increasing the dose of antihistamines and giving her lots of fluids. Karmapa sent his doctor, a Bhutanese physician with additional training in Tibetan and Ayurvedic medicine. He agreed on the diagnosis, sent someone to Gangtok to replenish my supply of antihistamines, and brought some calming herbs and teas. Every day the Karmapa sent several lamas to check on us. It was three days before Girija was back to near normal.
When Karmapa asked us how we had ended up at Sikkim, Girija and I went through the history with Maharaji and his prediction that smallpox would be eradicated. Karmapa spoke about the Buddha’s approach to the inevitability of human suffering. He was excited about the idea of eliminating the terrible form of suffering he remembered witnessing in Tibet as a boy. He laughed at our story of sleeping with the Dalai Lama.
“How will you know when your smallpox work is finished?” Karmapa asked.
I explained the facial scar surveys; the house-to-house searches; the reward, which by that time was 1,000 rupees; the near-absence of any cases of Variola major in the world. Of the last fifty cases of smallpox in India, perhaps half had been importations from Bangladesh to the Indian states near Bhutan and Sikkim.
“Have you searched Bhutan?” he asked.
“No,” I answered, “but there is a team on the way there now.”
I asked whether Karmapa could bless us for our future work. “Do you have a picture of Neem Karoli Baba?” he asked. I did and handed it to him.
After studying the picture, Karmapa said, “Neem Karoli Baba was a great being, one who knows the truth, who is capable of extraordinary feats. I can never replace Maharaji, but I will do my best to help you. Before you leave I will give you the most precious gift. We call it the Triple Gem. I can give you refuge in the Buddha, the dharma [teachings], and the sangha [community]. These two lamas can witness the ceremony.” We didn’t know exactly what that meant or whether we were supposed to convert to Buddhism, but as Maharaji often said, “Sub ek,” “All one.” We were up for anything.
Over the next week, we attended ceremonies and mugged for photos with Karmapa, Jamgon Kongtrul, and another prominent young lama, Sharmapa. We sat for meditation with dozens of monks. Karmapa often returned to the question of the eradication of suffering. A single disease could be cured, he argued, but suffering itself is part of the human condition as long as we remain trapped by ignorance, hatred, and obsession, even in their mildest forms. It was up to individuals to eradicate their own personal suffering through insight and the extinction of negative emotions. But he told us it was a blessing to be part of eliminating any kind of suffering.
Karmapa set up the refuge ceremony on the roof of the monastery for our final day. When we climbed to the top of the building, we found the entire community of monks gathered there. Karmapa’s brightly painted and brocaded throne was adorned with flowers and white silk scarves. Elaborate offerings of food, flowers, and saffron water in delicately patterned silver bowls were set before an altar full of golden Buddha images. Large trumpets made of human thighbone, and twenty-foot-long curved brass horns, echoed throughout the valley like alpine horns. Above the baritone blast hovered the nasal tones of some kind of Tibetan oboe. Cymbals crashed in a slow and unpredictable rhythm. Some of the most important of the Karma Kagyu and Nyingma lamas alive at that time—Lama Ganga, Khenpo-la, Bardor Tulku, Drupon Rinpoche, Dzogchen Ponlop Rinpoche, Sharmapa, and Jamgon Kongtrul, all in brocaded robes, formed the initial procession. There was a rainbow floating improbably in the cloudless sky; it was one of the most magical settings in the world. I assumed others were coming for the refuge ceremony, but Karmapa was doing this all for Girija and me. We stood by our cushions on the roof in front of Karmapa’s throne.
The Karmapa took his seat, and it was as if the final pieces of the universe’s puzzle fell into place. Though the rooftop was open, the area felt suddenly contained. We took our seats.
And then I got cold feet.
“Rinpoche,” I said as Karmapa picked up his dorje, the ritual scepter representing the Buddha’s compassion, and began to ring his bell.
“Yes, Larry?” He stopped.
“I really want to do this, but I don’t want to be disloyal to Neem Karoli Baba. He’s my guru, and I’m not sure how taking refuge in Buddha, dharma, and sangha affects my commitment to him and what he has taught me.”
“Don’t worry about that,” Karmapa said as he laughed warmly. “There is no difference just because the rituals and traditions are different. Taking refuge doesn’t mean you will become a Buddhist unless you want to. Your teacher was a bodhisattva—a great being who worked to benefit all. The teachings emanate from the Buddha of Compassion, who is also a bodhisattva.
“During the ceremony, when I say, ‘Do you take refuge in the Buddha?’ you think of taking refuge in Neem Karoli Baba. The same when I ask, ‘Do you take refuge in the sangha?’ then you think of your satsang. Dharma is the spiritual path, so when I ask, ‘Do you take refuge in the dharma?’ think of the dharma your guru gave you, your karma yoga. So you take refuge in those things. It is the same.” Sub ek, all one. Perfect.
The ritual resumed; we repeated the vows in Tibetan after Karmapa. He gave Girija a soft and loving smile and a Tibetan name, Karma Sonam Chotsu. I became Karma Sonam Wangchuk.
Later that day, while we were sitting with him in his quarters, Karmapa said, “Rumtek is your home. Just like the home of your father and mother. If you have trouble getting back here, I will help you.”
I was so moved I couldn’t look up at him; I was afraid I would start sobbing. I spotted a small dorje on the carpet. I picked it up and handed it to Karmapa, who tied it to my mala, my prayer beads. I sat back to meditate and, just like Maharaji had done so many times before, Karmapa threw an apple in my lap.