Ron, my friend and patient for almost 20 years, recently underwent radical prostate surgery. For a couple years they watched his PSA levels rise, which signaled the potential for prostate cancer. Many biopsies were done, and none of them revealed cancer. This year his PSA levels became alarming and he had more biopsies. In one of these samples they found cancer. It was graded, scored and defined, and then he was confronted with a multiple-choice menu of treatment options.

Ron faced this challenge like others in his life: by educating himself and taking some control of his life. He learned about staging criteria and Gleason scores; he visited renowned specialists. Each one of them had their preferred treatment plan. Some touted radical surgery (although they differed in their surgical approaches).Others advocated external beam radiation, while others wanted to insert radioactive seeds directly into the gland. There were some who said that at age 72 he didn’t need surgery at all and that hormone replacement was sufficient.

All of these treatment courses have merit, and there is no single answer for everyone, so how does a patient choose? We don’t need more information; we need more doctors to guide us through the process. The sad truth is that in contemporary medical life there are fewer and fewer doctors who step up and serve as gatekeepers and advisors. Doctors who take the time to hash out the options, give you an opinion, guide you through the crisis and afterwards as well. Patients do not need more information about cancer treatment options, they need a healing relationship with someone who is in their corner and can inspire them. In its absence, patients are feeling overwhelmed, uncertain, and afraid.

Ron knew the facts, the potential consequences, and that all of his choices came with their own scariness. We always wish we had just a little more information, a little more certainty, but it always comes down to making a leap of faith — faith that you will either land on your feet, or that you will learn how to fly.

This is how Ron prepared himself: several weeks before his surgery, we conducted a sweat lodge ceremony for him. This is a Native American healing ritual in which he had participated for years, but this time he would be the focus of the ceremony. Lots of people supported him in this dark, uncomfortable place. A place where one can face the darkness and dare to imagine a light at the end of the tunnel. After the ceremony, I asked him to carve his own walking stick and include symbols that reminded him of his sources of power and joy; it would help him on his healing journey.

The night before surgery, I flew out to Los Angeles to be with him. We ceremonially prepared ourselves and we gave him a “spirit horse.” In Native American tradition, the horse carries our spirit on its back to touch the ear of the Great Spirit. This little horse was filled with aromatic herbs and made by an artisan who filled it with love. He took it with him into his preop cubicle, and it was waiting for him later in the recovery room.

If you can’t find a doctor to be your gatekeeper, find a friend, someone you trust to serve in that role. It could be a member of your family, spiritual guide, or support group — somebody in your corner cheerleading who reminds you that you are not alone in the darkness. We need to build more supportive communities where we can tell each other our experiences, and you can start in “The Healing Café” on my website. I can’t be the only one writing. We need to be talking to each other . . . it’s like carving a communal walking stick to help us on the road.

We are all connected. Mi takuye oyacin.

P.S. If you would like more information about the spirit horses mentioned in this byte (each one unique and handcrafted), you can contact the Phoenix-based artisan directly by email: