Journalist Faiza Saleh Ambah

DATE February 3, 2004 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Dr. Jerome Groopman discusses his book, "The Anatomy
of Hope"
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

My guest, Dr. Jerome Groopman, writes about medical issues for The New Yorker.
He's also a professor at the Harvard Medical School and is chief of
experimental medicine at Beth Israel Deaconess Medical Center in Boston.
Another important credential that helps him understand health care is his
experience as a patient dealing with pain. He had a back injury in 1979, a
ruptured lumbar disk that left him in bad pain. His subsequent surgery only
made matters worse. As we'll hear a little later, he lived with pain for
about 19 years. His new book, "The Anatomy of Hope," considers two questions.
Why do some people find hope, despite facing severe illness, while others do
not? And can hope actually change the course of a malady, helping patients
prevail?

When you were a student, you were working with a doctor who was treating a
woman whose cancer had spread to the liver. You were working with this woman,
too. Once cancer has spread to the liver, usually, the person doesn't have
too long to go, but that's not what the doctor told this woman. What did he
tell her? You describe this in your book.

Dr. JEROME GROOPMAN (Author, "The Anatomy of Hope"): Well, I was learning, as
you say, cancer medicine, and the senior physician sort of set the path, and
he used medical jargon with this woman and with her daughter. He used the
word--he said the chemotherapy could be effective against the tumor, that she
might have a remission, and that's factually true, but when people hear that,
they think that means a cure, that their cancer could be totally eradicated.
So what we were doing was really sidestepping the truth and giving her
misinformation or incomplete information and, regrettably, false hope, and
then it all blew up in our faces.

GROSS: What happened?

Dr. GROOPMAN: Well, she became ill, as often happens, and it was clear that
we had misled her. She kept her anger quiet, but her daughter was very
bitter, and she said something to me which has never left me, and she said,
`You know, you didn't trust the fact that we could cope with this. You didn't
give us the opportunity to hope.' And I think that I felt ashamed. I know I
felt ashamed at that time, and it jarred me, and it showed me that there is no
easy formula in terms of speaking to people about this, balancing the truth
with hope.

GROSS: What did she mean that you didn't give her a chance to hope? You gave
her a lot of hope. It was false hope, but you gave her hope.

Dr. GROOPMAN: Well, I think what she meant was that she wanted to understand
what she could hope for, what was realistic? Could she hope for a remission
of months or perhaps a year or two? And also, I think when people have that
kind of knowledge, the focus of their hope can shift. They can shift it away
from the body and more to the spirit or the soul, if we can use those words;
that they can focus on their relationships with loved ones; if they're
religious, their relationship with God, and they can seek hope to repair
things in their lives which need fixing in the time they have.

GROSS: There's another issue with people with cancer. If you're giving them
false hope for a cure, and if they go through chemotherapy that is going to
give them horrible side effects, and if there's no chance of that chemotherapy
really lengthening their life in any meaningful way, then you're ensuring that
the end of their life is going to be miserable.

Dr. GROOPMAN: Absolutely. I think that it's a complex issue. Some people
I've cared for will say, `I don't want this. I don't want to suffer or to
take the risk of suffering if it's not going to extend my life, or if it's
going to extend my life only for a matter of a month or two. I'd rather use
that time, as much time as I have, for other purposes.' And yet, as I write
in the book, you have to be careful also not to rob someone of the right to
resist. One of my colleagues at the hospital, a very esteemed pathologist,
who's the world's expert in stomach cancer, developed stomach cancer, which,
according to the textbook, is incurable. And I wasn't his doctor, but, along
with the other young cancer specialists on the staff, basically said, `You
know, I would recommend he not have any treatment. He should just go home and
die, basically.' And if my advice had been followed, he would be dead, and he
had that small but finite response where he actually was cured, and he's alive
20 years later.

GROSS: Now when you think about that case, do you think, `Oh, it's because of
the hope that he had, it's because of his will and his struggle' or do you
think he's that like, you know, one of a hundred or one out of a million who,
through a combination of things, is the one that survives?

Dr. GROOPMAN: I think that without hope, you're lost; meaning that you don't
have the courage to try or the resilience to endure. But hope is not a magic
wand. It's not `I'm going to think positively and my tumor will melt' or `I'm
going to feel good and my lupus will go into remission,' something like that.
It's not magic. There are biological effects to hope, but as you say, and I
think correctly, many, many people who have tremendous hope don't succeed, at
least in a physical way. Hope is not an automatic guarantee for a cure.

GROSS: When you're delivering a bad diagnosis to a patient, how does your
sense of the importance of hope, reasonable hope, affect the way you give the
diagnosis?

Dr. GROOPMAN: Well, it's central to it. I think that what I do is
lay out truthfully two scenarios. I always begin with the bad scenario. I
say, `We all know that there can be a worst case, that things may not work
out, that the disease might not remit, the drugs may not work. We need to
acknowledge that. And yet, there is a real possibility that we could
prevail, and we'll do everything possible to get there,' so that the hope is
real. And then you wait for the person to respond. Sometimes someone is so
shocked and nerved by the news that they're mute, and it's important--in
situations like that, I routinely encourage someone else to be by them so that
they can ask the questions or engage more in discussion. Sometimes we need a
second visit to go over what we talked about the first time and to reinforce
the fact that there really is a chance, that there really is hope.

GROSS: Now the story that you were telling us about the doctor you were
studying with when you were a med student who gave the woman with cancer false
hope, he eventually got cancer himself, a rare form of cancer that starts in
the bile ducts. And he was going to forego any treatment because he thought
that it was hopeless, and when a doctor told him to try, he'd say, `Hey, I
play that game with my patients, but I'm too smart for that.'

Dr. GROOPMAN: He did.

GROSS: So why did he decide finally to go through with chemo or was it
radiation?

Dr. GROOPMAN: It was radiation, and I think that he had to come to terms with
the fact that there was a real chance. It was not clear. The odds were
against him, but it was a possibility and that there was a reason for him to
try. He had a very close relationship with his wife. He was very gratified
by his work, and I think that he had a sense that there was no hope because he
had no possibility of control over his circumstances. And yet, in fact, he
did. And the surgeon who cared for him had to bring him to that realization,
which is not an easy thing to do, but it taught me how difficult it is for
people to find hope in dire circumstances, but when hope is real, it's the
primary imperative of the doctor to show it and to convince a person of its
truth.

GROSS: You know, I think for family and friends of somebody who's very sick,
there is the desire to be, you know, realistic and all that, but also the
desire to just be the best cheerleader that you can, to just be as supportive
and as hopeful as possible in the hopes of strengthening the morale of the
person that you love.

Dr. GROOPMAN: I think it's very important, first, again, you never know how
things work out. People can have--I've seen many people who were handed death
sentences, which I've also, in my training, done and regret deeply. `Oh, this
disease--you have three months to live or you have six months to live,' and
now it's a year and a half or two years, or sometimes--and I've seen this
several times in my career--a new drug or a new treatment arrives at a moment
when it radically changes the prognosis. Look at testicular cancer in men.
Recently, there are new antibodies for lymphoma, which is changing the
remission rate and possibly the cure rate; childhood leukemia. These are all
diseases that were just uniformly fatal, and for those who were fortunate, a
medication arrived in time. I used to have 12 to 15 people die of AIDS that I
cared for a year, and then with new drugs, it's not a cure of AIDS, but I've
only had one person die in the last two years.

GROSS: So that means you've had to change how you talk with patients about
outcomes because the outcomes are so much better now.

Dr. GROOPMAN: The outcomes are better for many diseases, and there is a
tremendous amount of research going on, so you don't want to hold out false
hope and say, `Oh, yes, you know, there's a drug just around the corner, and
it's going to save you,' because you don't know that. But you can say
honestly that, `In a number of different diseases--breast cancer or colon
cancer, a variety of blood diseases--there is such a concerted effort that
perhaps if we can keep you in quality of life and in remission, a new
treatment will arrive that really will make a fundamental difference.'

GROSS: If you're just joining us, my guest is Dr. Jerome Groopman. He writes
about medical issues for The New Yorker. His new book is called "The Anatomy
of Hope: How People Prevail in the Face of Illness." Let's take a short
break here and then we'll talk some more. This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Dr. Jerome Groopman. He writes about medical issues for
The New Yorker magazine. His new book is called "The Anatomy of Hope: How
People Prevail in the Face of Illness."

Some of the patients you've treated over the years have found, you know,
strength and hope through prayer and faith. Other patients who you've treated
don't have that to turn to, don't have faith or religion, you know, to lean
on. You talk briefly about your father, and you say when your father was
dying, he had like just a personal philosophy that he turned to, and I was
wondering what that was.

Dr. GROOPMAN: My father was a free thinker. I was brought up in a home where
there was both tradition, as well as doubt. And he didn't have a sense that
there was necessarily an afterlife. None of us knows whether there is or
there isn't, really. But what he did feel and he communicated to me was that
there was memory; that who he was as a person and what he taught his children
would live on after he was gone, and he found great comfort in that.

GROSS: So the way you describe it, it sounds like your father didn't exactly
have a deep sense of religion to turn to, but he had some kind of larger
personal understanding of life and death that he was comfortable with, and
that he was able to turn to to put his own impending death in some kind of
perspective.

Dr. GROOPMAN: He did. You know, I think people often assume that only
individuals who are deeply religious can cope with facing their mortality. My
father was remarkable. Well, he was a man I loved very deeply. And he saw
death as a natural part of life. I'm sure he was afraid of it on some level,
but on the other hand, he has seen it. He had been a soldier in the French
front and in World War II, an American soldier. His own father had died when
he was relatively young. And he looked for ways to find strength and to find
courage outside strictly of a theological framework. And he found it in
memory, the power of memory; that who he was as a person and what he had
taught his children would live on after him.

GROSS: One chapter in your new book is devoted to your own story. You had a
serious back problem in 1979. You want to just describe what your problem
was?

Dr. GROOPMAN: Well, I had ruptured a disk and I was a marathon runner. I was
young and very impulsive and went doctor shopping until I found a surgeon who
said that he would fix me and everything would be set, and I'd be back doing
sports aggressively, and he would fuse the lower part of my spine. And I
underwent the operation, and I woke up and I couldn't move my legs, and there
had been a complication during the surgery, and for months, I was in
excruciating pain, and he basically said that this would be my fate, that the
pain would subside somewhat, but that I would be severely debilitated for the
rest of my life. And, in fact, for 19 years, I lived that way. I lived as
though I were inside an electric fence. Every time I would try to venture too
far, walk too far or lift one of my kids or something like that, my back would
go into spasm. So this was the narrative that played in my mind. And then it
turned out he was wrong.

GROSS: Well, you went to see a specialist, and I love this part of the book.
The specialist told you that you were worshiping the volcano god of pain. Who
is this god?

Dr. GROOPMAN: Well, I saw a very brash, in your face, physical medicine
doctor, a physiatrist, named Jim Raneville(ph). And he swaggered in and he
said just what you said, Terry, `You're worshiping the volcano god of pain,'
meaning that every time I felt pain, I would bow down and retreat, lie down
and stop. And, in fact, my interpretation of the pain was that it was danger
and harm, but the truth was that that pain was reflecting the fact that my
muscles had atrophied, my ligaments had contracted, and I had to disregard the
pain, and I had to build myself up through a very gradual but persistent set
of exercises to overcome the pain. And then, in an incredible way, my
functioning returned, and I became largely pain-free and I could live again.
I felt I was reborn, and I stopped worshiping that god.

GROSS: And this doctor also told you that you had to erase the memory of pain
from your muscles, and I've read that in other places, that muscles and nerves
actually remember pain in a way, and the more they experience it, the more
good they are at activating pain real quickly.

Dr. GROOPMAN: That's absolutely true. In fact, I saw a paper in Nature, a
very prestigious British scientific journal, about a year ago showing in
models of pain that there are actual changes in the circuits in the spinal
cord and the brain so that it's sort of this vicious cycle where, as you say,
you keep imprinting in your mind and in your body these pathways of pain, and
they become much more acute.

GROSS: Now, you know, when I was reading this part of your story in your new
book, "The Anatomy of Hope," I was thinking about two things. One is, you
know, were you going to have that ability to hope, to be hopeful enough to try
the regimen that this physiatrist wanted to put your through, but also were
you going to have the trust to trust him with your body? Because you knew
that, you know, in the past that if you pushed too far, overexerted yourself,
there would be consequences to pay. So if this guy, if this physiatrist was
leading you in the wrong direction, you'd be suffering consequences instead of
getting better, and that issue of hope and trust, I think, are really
intertwined, and it's difficult to put your trust in the hands of somebody you
don't really know when the consequences could mean lots of pain.

Dr. GROOPMAN: Absolutely. And this doctor is very wise because he saw that.
He could read it in my face, and in a very brash way, he said, you know, `BS
talks, but reality walks,' meaning that I had to take the plunge and trust
him, as you say, and I was very leery of this, because I had suffered
terribly. But what was interesting was that when he showed me that there was
hope, when he said, `Here's a possible path,' I felt at the same time this
tremendous uplift, and I felt actually my body become more supple and I felt
more ready, and every time I went through the program, which was very arduous,
and I started to have pain, I would try to retrieve his words and retrieve the
image of him towering over me as a way to spark hope and a way actually to
dampen the pain.

GROSS: So how has this experience with your own back and after 19 years
finding a therapy that was effective for it, how has that affected how you
talk with patients?

Dr. GROOPMAN: Well, it's shown me that hope can be very, very powerful, and
it's also taught me that not only is there a mind-body connection, but there's
also a body-mind connection, that when my body began to recover, my feelings
of pleasure in life and my sense of hope were much more powerful. And so I
try to support my patients through a difficult time physically, and when they
begin to feel better in their body, you want a domino effect. You want that
to be catalytic so that it can reinforce hope, and that one looks to hope in a
way to then give them the courage and the resilience to push to the end.

GROSS: I want to thank you so much for talking with us.

Dr. GROOPMAN: Thank you. It's been a pleasure.

GROSS: Dr. Jerome Groopman writes about medical issues for The New Yorker and
is a professor at Harvard Medical School. His new book is called "The Anatomy
of Hope."

I'm Terry Gross, and this is FRESH AIR.

(Announcements)

GROSS: Coming up, we call Saudi Arabia and talk with journalist Faiza Ambah.
She's performing the hajj, the Muslim pilgrimage to Mecca, with her two
sisters and is keeping a journal for The Christian Science Monitor. And David
Bianculli reviews the updated version of "Tanner '88," the pseudodocumentary
about a candidate in the presidential primaries. It's being shown on the
Sundance Channel.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Journalist Faiza Ambah describes her experiences
while on the hajj, or Muslim pilgrimage to Mecca
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

About two million Muslims from about 120 countries are now performing the
hajj, the annual pilgrimage to Mecca. Every Muslim is required to make the
pilgrimage at least once if they are physically and financially able to. The
pilgrims symbolically re-enact events in the lives of Abraham, the first
Muslim, his wife, Hagar, and their son, Ishmael. Performing the hajj absolves
the pilgrim from all previous sins, but only if the prayers and rituals have
been performed with sincerity.

Faiza Ambah is a journalist of Saudi descent who's now making the hajj with
her two sisters and is keeping a diary for The Christian Science Monitor. On
Sunday, about 250 pilgrims were killed in a stampede. Ambah was at that site
just a few hours earlier.

Faiza Ambah wrote for an English-language newspaper in Saudi Arabia for three
years, and then spent five years covering the Persian Gulf nations for the
Associated Press. She now lives in Arlington, Virginia. We called her
yesterday in Mina, a short distance from Mecca, where many pilgrims stay.

Why did you want to make the hajj, and I'm wondering if you are doing it more
as a journalist or more as a religious seeker?

Ms. FAIZA AMBAH (Journalist): I thought about doing it more as a journalist.
I wouldn't have actually gone on the hajj this year if I wasn't going to write
about it. My sisters called and said, you know, `We're going. Do you want to
come?' and they didn't really think I would join them, because they know that
I'm not very devout, but there was something intriguing about the idea of
being with them and about writing about it, so I said, `OK, fine,' and I
agreed.

GROSS: And it sounds like maybe you've had a change of heart while you were
there, and it's becoming more of a religious journey than just a journalistic
one?

Ms. AMBAH: I don't know what it is. I mean, we're sleeping two or three
hours, you know, every eight or 10 hours. Our days are upside-down, and, you
know, there's a group of us, 10 people together, among two million people,
just praying and talking, you know, going through--listening to religious
sermons and trying, you know, not to argue, because it's part of the hajj.
Part of a successful hajj is not arguing, not gossiping, thinking more--you
know, letting go of the worldly and you know, trying to become more spiritual.
And I do feel something. I do feel a difference. I feel lightness. I don't
know if it's because I've been eating better and sleeping less, or if it's
because it's actually, you know, two million people praying and you're all
together and doing one thing, moving from one place to another, all with sort
of one goal.

GROSS: Two million people is a lot of people. Would you give us a sense of
the magnitude of the hajj and what it feels like to be among two million
religious pilgrims?

Ms. AMBAH: There's almost a festive air, like a medieval fair. It feels a
bit like a medieval fair, and these are--Mina is not big. It's a valley, I
mean, sort of partly enclosed by mountains. It's not a very big city, but
there's asphalt roads and half of the asphalt roads have pilgrims actually
lying down there with their mats, eating, sleeping, praying, so you've got
pilgrims that are actually living outside in the open air. You've got cars
trying to pass. You've got people walking, you know, from their tents to the
Jamarat, which are the pillars where, you know, you stone the devil, so it's
really crowded.

The only other time I've been in a crowd like this, but it was not of this
magnitude, was when you go in or out of a concert. There's that human traffic
jam where you sort of walk a couple of steps and just stop, walk a couple of
steps and just stop. But here, it's like people going back and forth, you
know, all different nations. You hear, you know, all different languages and,
you know, a lot of it is out in the open air and a lot of people are just
living like that, so it's quite nice. I mean, we're very lucky. Our
accommodations are very comfortable, but you know, people just seem to be
enjoying this religious--it's sort of like religion camp.

GROSS: Like religion camp? What did you do...

Ms. AMBAH: Yeah.

GROSS: Yeah, go ahead.

Ms. AMBAH: For example, in our camp we've got a women's praying room and a
men's praying room, and every evening after sunset there's all--you know, you
don't have to, but a lot of the men just sort of socialize in the prayer room
and talk. There's a cleric there, a preacher who gives a sermon. After the
sermon, everybody who wants to ask a question is--they ask all kinds of
questions, you know, `Is this blessing? Is this OK?' The women ask
questions, you know, `Is smoking permitted during the hajj? What happens if a
man looks at me? What do I do?' So in the separate praying rooms you've got
men and women with, you know, female clerics and male clerics, so there's a
social atmosphere as well. They play games, there's contests, they ask
religious questions. So in that way, it's just like religion camp in the
sense that the lectures we hear are about religion, the contests are about
religion, the sermons, but there's a social air to it.

GROSS: On Sunday, there was a stampede that killed at least 244 pilgrims, and
this was during the stoning of the pillars, which is a part of the hajj.
Would you explain what the stoning of the pillars is?

Ms. AMBAH: What I understood is that it represents a sort of re-enactment of
the prophet Abraham when he was asked by God to sacrifice his son and the
devil was telling him not to do it and then he threw pebbles at the devil to
tell him to go away, and then God replaced his son with a sacrificial lamb.
So it's a re-enactment of that. But I just came back from there, and it's a
lot of fun.

GROSS: A lot of fun?

Ms. AMBAH: Yeah. It was really--I mean, it was really fun. There's
something very child--you know, some kind of childish pleasure you get when
there's, you know, thousands of you sitting there, you know, throwing pebbles
at a pillar representing the devil. And I saw people--I saw on the floor
shoes and slippers. People had thrown shoes and slippers at the devil, so
there's sort of a certain release when you're done with it that's quite maybe
primordial. I don't know. I mean, I enjoyed it. My sisters and I came out
like our team had just won the Super Bowl or something. We're like, `Oh,
wasn't that great? Oh, I feel so great. I feel like a million bucks. Oh, I
feel much lighter.'

GROSS: But, you know, if everybody's throwing stones and pebbles and shoes at
these pillars, don't they also hit people?

Ms. AMBAH: I hit a couple of people when I first went, and I was so close
today that I got a couple of stones in the back of my head, and I just smiled
because I remembered that that's what I did. ...(Unintelligible).

GROSS: But that's dangerous, isn't it?

Ms. AMBAH: No, that part is not dangerous. It didn't hurt at all. The
dangerous part is that you've got so many people trying to do the same thing
at the same time at the same place, and it's very crowded, and you've got
groups of foreign pilgrims who come 50, 60, 80 sometimes together, and they
want to stay together because they don't speak a language. If they get
separated from their group, you know, they're not going to find their way back
among two million people, despite the fact that, you know, all the delegations
have like flags stitched on their--a lot of them have flags stitched on their
costumes or their veils or their vests. But the scary thing is going there
and getting lost. But the pebbles--I mean, I got hit by several pebbles
today, and I did my--you know, by mistake, I hit a couple of people. That
part is not--they're small, because they have to be the size of chickpeas...

GROSS: Uh-huh.

Ms. AMBAH: ...and you have to pick them from either Mina or Muzdalifah. And
that--I mean, to me that wasn't painful, and the dangerous part is when you've
got like groups who are trying to get in and out and stay together, and people
are going very close to the pillars, which is where I was today, and trying to
get out--back in a crowd of, you know, tens of thousands of people.

GROSS: Is that what sometimes leads to a stampede? Because Sunday was hardly
the first stampede during a hajj.

Ms. AMBAH: No, it was the worst one, but it wasn't the first one. The
Jamarats are, you know, very scary and very dangerous, and there's two levels.
There's a ground level. At the ground level, there's three pillars and then
there's a bridge, and you can stone the same pillars from the upper level,
which is where we went today, and under the bridge, there's an echo, and when
you know that people have died here before, you get tense. It's kind of
scary, and the first day I went, we heard an ambulance that wasn't even
nearby, and people started running. So, you know, a combination of huge
crowds, you know, people already scared, they don't want to get left. They
want to go ahead and finish this rite, to go home.

I mean, it was funny. When I was going there today, I'm thinking, you know,
more than 200 people died here yesterday, and still throngs were coming, you
know. Huge throngs of people were just moving, moving, moving towards the
pillars to accomplish the rite.

GROSS: My guest is journalist Faiza Ambah. She's currently performing the
hajj, the annual Muslim pilgrimage to Mecca, and is keeping a journal for The
Christian Science Monitor. We'll talk more after a break. This is FRESH AIR.

(Soundbite of music)

GROSS: Let's get back to the interview we recorded with journalist Faiza
Ambah. She's currently with her two sisters, performing the hajj, the annual
Muslim pilgrimage to Mecca. She grew up in Saudi Arabia.

Now I read that security is particularly high this year because of fear of a
possible attack by al-Qaeda, which has struck Saudi Arabia in the recent past.
Is that something that you've been worried about?

Ms. AMBAH: No, I haven't. I know that that's a fear. I know that last
week, five cops were killed. I heard that they also arrested seven suspects
recently, and I know that coming in and out of Mecca, there's been heightened
security. They double-check everybody, or they check for IDs, but once you
start sort of in the hajj, I think you really do leave a lot of the world
behind, just trying to get your rites accomplished, you know, listening to the
sermons, trying to get some sleep.

GROSS: After the stampede on Sunday, was it difficult for you or for any of
the other people that you know or that you've met on the hajj to maintain the
spiritual focus, you know, knowing about the possible danger and also about
the loss of so many lives?

Ms. AMBAH: Well, when I discussed the stampede with my sister, I was very,
very deeply sad and touched by it, because just the loss of life seems to me,
you know, so terrible and so unnecessary, and I had just been there six, seven
hours earlier and I was thinking, you know, did I see any of the faces that
disappeared, you know? I just--you know, it was just like--touched me because
for some--yeah, because even though there's two million of us here, I did feel
a bond with those people. And I said this to my sister, and she said, `Well,
it was their time to go, and you know, God chose for them to die during the
hajj and they died martyrs.' But I still felt it was, you know, a very sad
thing to happen, and it did scare us more.

But, you know, it's the whole concept of hajj I think is faith over human
nature and faith over your instincts and faith over everything else. It's
like, you know, people have died here but this is a rite we have to
accomplish. We came here for the hajj, you know, let's do it.

GROSS: Is it considered an exalted death to die during the hajj?

Ms. AMBAH: It's considered--yeah, they're considered martyrs if they die
during the hajj, because once you've accomplished the plains of Arafat, all
your sins are totally absolved and you act like a newborn, so they've gone
straight to heaven.

GROSS: What has surprised you most about the pilgrimage so far?

Ms. AMBAH: I was surprised a little bit by my own reaction to it. I'm
usually quite stubborn, and, you know--but I sort of decided to let go this
time and enjoy it and I didn't think it would get to me, but it has.

I also didn't realize that this kind of luxury was possible. I mean, I
thought I'd be sleeping in a tent and I'm sleeping on a bed, and we've got,
you know, a buffet and it's just very comfortable. I feel a little guilty.

GROSS: Because other people are sleeping on the street?

Ms. AMBAH: Well, no, I mean, not because of them, just because I thought
that--you know, I thought there was supposed to be a little bit more hardship
in it.

GROSS: Oh, I see.

Ms. AMBAH: I mean, it...

GROSS: Personal sacrifice.

Ms. AMBAH: Yeah. I mean, we've walked long distances and just going out and
accomplishing some of the rites has been physically demanding. I mean,
yesterday at the Kaaba, during the Sai, which is a re-enactment of Hagar
searching for water for her son, Ishmael, there were times when we couldn't
move. I mean, we were just standing. We're supposed to, you know, do this
walking, about seven times walk back and forth between the hills of Safa and
Marwah, and there were points where we couldn't even move forward it was so
crowded.

GROSS: Have a lot of people been talking about politics, and by politics I
mean the war in Iraq, the United States presence in Iraq or terrorism?

Ms. AMBAH: We had one discussion about local politics yesterday, and then my
sister kept reminding us that that's not the spirit of the hajj.

GROSS: Right.

Ms. AMBAH: You know, we sort of had a political discussion and we were, you
know, each arguing what we thought about, you know, what's going on in Saudi
and how that should be treated and the issue of terrorism and what needs to be
done about that, and my sister reminds us three times, you know, she said this
is not what we're supposed to be talking about in the hajj.

GROSS: And...

Ms. AMBAH: And it really is supposed to be a total spiritual immersion.

GROSS: You know, this is a terrible comparison, but a secular and totally
wild and different version of what you're talking about would be something
like Woodstock. Do you know what I mean? Where there's like so many people
coming together...

Ms. AMBAH: Terry, I swear to God, this is exactly what I was thinking as I
was walking today.

GROSS: Really? I was afraid to bring it up.

Ms. AMBAH: I said this out loud. I said to my sisters, you know, `This is
like a Muslim Woodstock.' That's what it feels like, the sort of bohemian...

GROSS: Uh-huh.

Ms. AMBAH: ...sort of bonding, you know, groups of people, some are lying on
the floor, you know, everybody sort of doing the same thing but doing their
own thing at the same time.

GROSS: Right.

Ms. AMBAH: You know, it's sort of a collective experience that's also very
private and personal. And you know, these were my thoughts as I was walking
back from the Jamarat today, and everybody was sort of happy because we just
accomplished the thing and, you know, some people were going back, some people
were still going, and I just thought, you know, this is almost from Woodstock.

GROSS: Yeah, and experiences like that make you wonder, OK, if all these
people can come together and get along and be peaceful and share a deep and
common experience, why is it so hard to get along outside of that? Did you
have that feeling, that there's something very special and very wonderful, but
that's probably like not going to last outside of the context?

Ms. AMBAH: Yes. And I think that's one of the things that they're trying to
remind us. I mean, this closeness that you feel now, this bonding, this
getting along, this, you know--I mean, people here from over 170 countries,
this is possible, this is how it should be. But I find that maybe one of the
reasons it's easy to maintain is because it is five to six days.

GROSS: Right.

Ms. AMBAH: Maybe this whole spiritual immersion and forgetting about
everything else is not possible for longer periods. I don't know. But it's
really nice for the short time that it--I mean, it's a first for me, and it's
fun. I'm enjoying it and I'm almost sad to have to see it end.

GROSS: Well, thanks for sharing some of the experience with us. I really
appreciate it.

Ms. AMBAH: Thanks, Terry.

GROSS: Faiza Ambah spoke to us from Saudi Arabia, where she's performing the
hajj, the annual Muslim pilgrimage to Mecca. She's keeping a journal for The
Christian Science Monitor.

Coming up, TV critic David Bianculli reviews the updated version of "Tanner
'88," the pseudo-documentary about a candidate in the presidential primaries.
This is FRESH AIR.

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Commentary: Pseudodocumentary "Tanner '88" is worth watching
again
TERRY GROSS, host:

Sixteen years ago, director Robert Altman and "Doonesbury" creator Garry
Trudeau collaborated on an ambitious TV series for HBO that created a
fictional candidate for president, and filmed him rubbing up against actual
candidates, reporters and citizens. That series was called "Tanner '88," and
it's back for a repeat run in another presidential election year. TV critic
David Bianculli has this review.

DAVID BIANCULLI (TV Critic): Why watch a fake documentary series about a fake
presidential candidate who mounted a fake campaign 16 years ago? I've got
three very good reasons. The first reason is that, believe it or not, "Tanner
'88" is still relevant. Sixteen years ago, the Republicans controlled the
White House and there was a pack of Democratic hopefuls jockeying to
outmaneuver one another in the early primaries and caucuses. The Democrats
ended up running then against George Bush, just as they're running now against
his son.

The second reason is that "Tanner '88" is great television. It didn't start
out that way, because Robert Altman and Garry Trudeau basically were inventing
the genre as they went along and the first episode, which was about
campaigning in New Hampshire and aired the night before the primaries, tried
too hard and was too broad and satirical. But just as Jack Tanner, the
fictitious candidate played by actor Michael Murphy, quickly found his footing
and his voice and momentum, so did "Tanner '88." The tone became a lot more
serious, and focused on the process of mounting a campaign and getting votes
or failing to.

After the second special, HBO committed to a series, and those 11 episodes
will be repeated Tuesday nights on the Sundance Channel. It's the first time
they've been televised since Ronald Reagan was in the White House.

The three stars of "Tanner '88," the ones who are paid actors, are Murphy as
Jack Tanner, who looks and sounds a little like Gary Hart, Pamela Reed as
campaign manager T.J. Cavanaugh, and Cynthia Nixon, now co-starring on HBO's
"Sex and the City," as Tanner's politically committed 19-year-old daughter,
Alex. Other featured actors include E.G. Marshall and Harry Anderson.

But the most fascinating supporting players in "Tanner '88" are the real
politicians Altman and his cast and crew encounter while trudging through the
actual campaign trail. The fake candidate, Jack Tanner, shakes hands with the
real Gary Hart and Bob Dole, and has a lengthy, introspective conversation
with Bruce Babbitt just after that real presidential candidate dropped out of
the race.

Years before the behind-the-scenes look at the Bill Clinton run for president
was documented in "The War Room," Altman and Trudeau were making it up as they
went along on "Tanner '88," and though the candidacy is fictional, the process
was real. When a focus group laughs at an early Tanner campaign ad, the
candidate meets privately with his staff and speaks from the heart about his
message and motivations. His remarks are sparked by his opinion that none of
the other Democratic candidates in the race that year, including Richard
Gephardt, Joe Biden, Michael Dukakis and Al Gore, got the answer right to a
very simple question: Who's your favorite Beatle?

(Soundbite of "Tanner '88")

Mr. MICHAEL MURPHY: (As Jake Tanner) And there are people who tell you that
our noisy dissent, our raucous squabble weakened us as a country, caused us to
lose our supremacy. Don't you believe it. We are the envy of this world.
Why? Because throughout our history, we have always maintained that we could
do better. We've insisted that we could do better. We've always been willing
to reinvent ourselves for the common good. And in our darkest hour, leaders
really have always stepped forward to hold the American people to the
responsibility of citizenship. Well, it's time for that kind of leadership
now, T.J., and I'm not sure that's me but I'd like a chance to find out.

Oh, and in case you young people are still wondering, the right answer's John
Lennon.

BIANCULLI: I promised three reasons why you should watch "Tanner '88." In
addition to its relevance and its excellence, here's number three: To update
the Sundance Channel rebroadcast, Altman and Trudeau got together and filmed
new openings for each episode, openings in which the three principal actors
look back, in character, and reflect on the 1988 race.

Altman has called "Tanner '88" the best work he's ever done, and his
enthusiasm for this is obvious. These new openings, written by Trudeau, are
delightful, and they bring the series and the characters right up to date.
Here's Cynthia Nixon as Alex Tanner, then Michael Murphy as her father, in one
such new introduction.

(Soundbite of "Tanner '88")

Ms. CYNTHIA NIXON: (As Alex Tanner) I can still see him as president. I
completely can. I don't know if you've seen the drafttanner Web site. The
graphics are a little lame, although maybe not to a layperson. Anyway, I was
talking to one of the founders, a graduate student of his who's incredibly
cute, by the way. I don't know what he's doing in graduate school, but he
told me that everything is there for an independent run: committed backers,
the meet-up capability, a campaign blog, flash mobs, all the key pieces. All
we need is the candidate.

Mr. MURPHY: (As Jake Tanner) Has she gone mad?

BIANCULLI: Maybe it's not so crazy, but maybe it's just not the right time.
People from show business seem to mount playful runs for the presidency at
20-year intervals. Will Rogers ran as a joke in 1928 until voters started
taking him seriously. Howdy Doody ran in 1948, but he was just a dummy. In
1968, Pat Paulsen from "The Smothers Brothers Comedy Hour" ran, sticking his
toe in the same pond that "Tanner '88" would dive into 20 years later. So
maybe 2008 is the year for Tanner or for someone else. Meanwhile, let's take
what we can get. Cast your vote for the Sundance Channel and "Tanner '88."

GROSS: David Bianculli is TV critic for the New York Daily News.

(Credits)

GROSS: I'm Terry Gross.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.