Then ahead I saw a small, dark shape perched on the sand, well back from the water. As I drew closer, the shape revealed itself to be a bird, sitting back on its tail feathers. It was vaguely penguin-like, about eighteen inches tall, with black back and head, white breast and cheeks.

Eleven years ago I woke up to find the room spinning. In the soft blue-gray light of morning, the walls folded and slid and picked up speed. I pressed my body hard against the mattress, frantically searching for something to hold on to, but everything was moving with me.

I’ll tell you what we don’t do: we don’t call the person’s doctor, or dial 911, or drive people to the emergency room. We ask what’s going on for them — not what’s “wrong” with them or if they have been given a diagnosis. If they do mention a diagnosis, we ask what it means to them. If they talk about voices, visions, suicidal thoughts, or injuring themselves, we meet this with calm curiosity. We’ve found that what helps people move through such feelings is being able to talk openly about them. Unfortunately many people don’t talk openly in clinical environments for fear that alarms will be sounded.

I stood inside the entrance of Central State Hospital in Indianapolis, Indiana, waiting to get patted down. It was my first visit to the institution, in 1992. I was twenty-four and had been working in the field of disability and mental health for two years.

I’m convinced the most accurate way to gauge your survival odds when you have cancer is not by the size, type, or grade of the tumor but by the size and splendor of the tropical-fish tank in your doctor’s waiting room. If it’s over thirty gallons and stocked with anything neon, you’d better start wondering why they want you so calm.

There are some things I take for granted: that when my car is serviced, the air in my tires will be checked; that when I buy free-range chicken, the bird was running happily in the grass right up to the moment the ax fell; and that when I go to my doctor with excruciating abdominal pain, she will, without prompting, examine my abdomen.

In our culture, when you have a medical problem, you visit a doctor, who writes you a prescription; then you drive to a pharmacy and pay thirty-two dollars for a medication. There are few surprises or slip-ups. But if you decide to single-handedly reconnect with a lost ancient lineage of herbal wisdom, you may end up with a short spear of garlic bearing down on your eardrum.