In the Realm of Hungry Ghosts

In the Realm of Hungry Ghosts
Gabor Maté

Gabor Maté’s In the Realm of Hungry Ghosts is a compelling tale of addiction, abuse, and compassion. Maté is a practising physician in Vancouver's Downtown Eastside, and he based his book on two decades of personal experience and countless interviews with his patients. The focus of the text is addiction, but Maté covers everything from addiction to drugs to his own addiction to classical CDs. This Canadian best-seller is written with exceptional elegance and style despite the depressing and sometimes horrific stories told within. This book would appeal to a professional audience interested in medical and treatment issues, but also to people living with "hardcore" addictions who are seeking to put their own experiences into context, to gain an understanding of their illness, and to discover a path to healing.

The author makes it clear that conventional treatment and recovery are not exactly the end goal of his work. Maté’s approach has more to do with compassion—he strives to let people suffering from addictions be who they are without judgment, and in the process helps them to reduce the harm they would otherwise inflict on themselves and the local community. Canada's ground-breaking safe injection site is housed in the same building as Maté's office and is an example of this line of thinking: if you are going to inject yourself with drugs, at the very least you should have clean needles and medical staff nearby.

Maté takes issue with the punitive nature of Canada's drug laws and with a society that "ostracizes" those who become addicted to drugs. The non-profit Portland Hotel Society, where he is employed, offers a range of programs designed to meet the basic human needs of those who live and work on Vancouver's infamous Hastings Street. Basic housing, meals, and medical and dental care are the base services offered, and when the Society can afford it, it also organizes camping trips, movie nights, and other social events to provide alternative experiences to some of Canada's most abused, shunned, and forgotten inhabitants.

Vermin, disease, and death are all too common in the lower Eastside, and the first few pages of Maté’s book alone recount details of over ten lives lost to the lifestyles associated with drug addiction. The book is a mix of anecdotes, retold stories, and hard facts. Almost every patient of Maté's is a convicted criminal, more than half are diagnosed with mental illness, and a third are HIV-positive. But amid the heart-wrenching details of poverty-stricken Hastings Street, the reader is struck with a sense of awe regarding how the book portrays these homeless, and in many ways helpless, individuals as human and therefore worthy of dignity and compassionate care. Maté himself remarks how at times he feels "full of disapproval and judgment," but he also tries to recognize that the contradiction in his personal views originates within him and that there is a power imbalance in the role he plays in their lives, and the role they play in his.

Gabor Maté

It is this element of self-reflection that makes the book groundbreaking and effective in facilitating healing. While the first 100+ pages focus on crack, heroin, and meth addictions, the later pages offer insight into the author's own "high-status" addiction: the purchase of classical CDs, of all things. The switch is not only helpful to lighten the tone of an otherwise heart-wrenching topic, but it is also a very persuasive way to influence readers to self-reflect on their own addictions. The narrative allows readers to appreciate how they too are influenced by many of the same primal urges of instant gratification that drive addiction, and to reflect on how it is that some of us get addicted to crack while others seek pleasure in food, sex, or buying things like classical CDs.

The telltale signs of addiction, such as hiding details from friends and family, are confessed by the author in the context of his addiction to buying CDs in a way that encourages readers to deepen their understanding about their lives and addictive tendencies. Aside from being written in an interesting literary style, Maté’s own story is an incredibly powerful example that generates a compassionate understanding on the part of readers of the ways in which they too could have been crack addicts if their life had been slightly different, and most especially if they were more frequently prevented from accessing opportunities to gain thorough and compassionate self-understanding.

Maté is drawn to classical CDs partly because he was exposed to them early on. Might the addicts in this book have been drawn to something else if their childhood involved different influences, cues, and precursors?

- MaryCarl Guiao

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