Close to the Bone. Jean Shinoda Bolen

At each one, the gatekeeper told her that she must take off something she was wearing to pass through. Each time, Inanna, shocked that this should be so, responded indignantly with the words: “What is this?” Each time, she was told: “Quiet, Inanna, the ways of the underworld are perfect. They may not be questioned.”

      Her magnificent headdress, the crown that designated her authority, was removed at the first gate. The lapis necklace was taken from her neck at the second gate, the double strand of rich beads was removed from her breasts at the third gate. She was stripped of her breastplate at the fourth gate, of her gold bracelet at the fifth gate. The lapis measuring rod and line were taken from her at the sixth gate. At the seventh gate, she was stripped of her royal robe. Naked and bowed low, she entered the underworld.

      Over and over, at each gate, symbols of power, prestige, wealth, and office were taken from her. Over and over, at each gate, the removal of something else that covered her, was unexpected. Over and over, she would say, “What is this?” and be told, “Quiet, Inanna. The rules of the underworld are perfect. They may not be questioned.”

      Whenever a person becomes a patient and enters a hospital, the experience is not unlike Inanna’s. Metaphorically, there are a series of gates to go through and at each one, something is taken away. At the door to the hospital, he or she unwittingly crosses through the first gate. In increments, thereafter, a patient is stripped of dignity, choice, and authority. However important the patient is in the world, however significant he or she is to someone else does not matter here.

      The second gate is the admissions desk, where each person signs a number of papers in order to be admitted, receives a hospital number, has a plastic identification band fastened around a wrist, and may be given a receipt in return for surrendering valuables.

      The third gate is usually the hospital room. Here each patient takes off street clothes which are reflections of individuality and status and puts on the standard hospital gown that often is ill-fitting, too short, and open up the back.

      Then there are the other gates through which a patient is taken on a gurney or in a wheelchair—to radiology for X-rays or more sophisticated tests, to other specialized rooms for blood tests or to have various scopes inserted into orifices or through body walls in order for the doctor to see inside the body.

      When surgery is called for, the patient passes through more gates, to the preoperative area, into surgery, then into postoperative or intensive care, and in going through these particular gates loses both consciousness and usually a part of the body.

      In coming to terms with having a life-threatening illness, a person often is stripped of emotional defenses as well. Denial, intellectualization, and rationalization may go, exposing a person to the painful realities of their lives as well as of this illness. Addictions that kept feelings at a distance are taken away. People who use work and activity alcohol or drugs to numb their feelings no longer can do this (though television, which may be the most common addiction, is immediately turned on at many hospital bedsides).

      When psychological defenses dissolve in the context of life-threatening illnesses, a descent into the underworld of depression and fear can occur. A dissolution of defenses against knowing the truth may reveal an emotionally and spiritually barren life, an empty marriage, or a meaningless job, as well as the reality of the seriousness of the medical condition and accompanying fears.

      Metaphorically and actually, illness and hospitalizations strip us of what covered and protected us in many ways. Indignities happen, and a “What is this?” protest may be met by words and attitudes from hospital staff that resemble those that Inanna heard: “Quiet, Patient. The orders of the doctor are perfect. They may not be questioned.” Even when our physicians are healers whom we trust, and they as well as the others communicate what and why whatever is being done is required, and even if we are fully involved in the decision making, the journey is still similar to Inanna’s. There are still gates we go through, which strip us of persona and defense: we become exposed and bare-souled.

      This stripping away makes it possible for us to reach depths within ourselves that we otherwise might not reach, where whatever we consigned there or abandoned or forgot about ourselves, suffers the pain of not being remembered or of not being integrated into our conscious personality or allowed expression. In remembering, we find ourselves connecting with soul. What is actively sought in a depth analysis may be inadvertently revealed as a result of having a disabling physical illness or entering a hospital with a condition that will take a patient through a difficult and uncertain course, through making a descent into the underworld. Psychological depth is the realm of Ereshkigal, as is death. When death takes on a reality and becomes close, soul questions arise.

      The Underworld of Shadow and Depth: Ereshkigal's Realm

      As Inanna can symbolize our upper, outer, or in-the-world personality, the part of us who is somebody in the world, so can Ereshkigal represent our unseen aspects and memories that we have kept hidden in the shadow or innerworld. Ereshkigal can be a symbol of the cause of our suffering that we have ignored or depreciated and can only approach, humbled and made vulnerable by adversity. Ereshkigal is unattended when we deny whatever is personally meaningful and authentically true for us and are walled off from this gnosis or felt knowledge. Going through the gates to our feelings and fears occurs when we incrementally go through layers of resistance to accepting the reality of illness.

      People also make a descent with Inanna when they have gradually disabling illnesses that chronically worsen mental or physical health, illnesses that fall into a diagnostic limbo between the body and the psyche—environmental allergies, chronic fatigue syndrome, and psychosomatic illnesses—or they have infectious or hereditary diseases that involve multiple systems and are progressive. The descent may take years, with the onset of a new set of symptoms, subsequent tests, and prescriptions and procedures, like other gates to pass through.

      Chemotherapy and radiation patients make an Inanna descent. Each treatment is another gate. After the second or third chemotherapy treatment, hair often falls out in clumps. On this descent at this gate, you surrender your head of hair, and even if you were expecting it, this is a shock. For women especially, it is a loss that strikes at identity and femininity. It is often a low point, a depressing time. The face in the mirror is unfamiliar. “Who is this?”

      Inanna was naked and bowed low when she entered the underworld. She had been humbled and stripped as she descended, but the ordeal was not yet over. When Inanna came into Ereshkigal's presence, the goddess of the underworld was not happy to see her. Filled with wrath and judgment, Ereshkigal gazed at Inanna with the baleful eyes of death and struck her dead. Then Inanna's body was hung on a hook, where after three days, it began to decompose or turn into a slab of green meat.

      Inanna and Jesus: Transformation of Suffering

      Inanna's fate at this point reminds me of Jesus and the series of betrayals, humiliations, and punishments he suffered on the way to the cross and as he hung from it on Good Friday until he was dead; his body was put in a tomb, hers hung on a hook for three days. When illness strikes, people do feel betrayed and humiliated by their bodies, and pain is pain whether from a whip or being nailed to a cross or from some source beneath our flesh. In the midst of suffering, many people feel like Jesus, alone and in pain, on the cross crying out, “My God, my God, why have you forsaken me?”

      Just as hanging on the cross was not the end of Jesus's story, hanging on a hook was not the end of Inanna and her myth. She too was brought back to life, significantly transformed. In the language of the soul, death is a major, recurring metaphor. On the spiritual journey, death of the old personality is required for an initiation, transformation, rebirth, or resurrection. On the medical journey, patients often feel like Inanna: the hospital feels like an underworld in which they are stripped and humbled, and then unconscious under anesthesia, they literally become a slab of meat on an operating table. Or after a series of tests and treatments, each of which takes them deeper into an unknown, fearful world, patients feel metaphorically left hanging on a hook awaiting news that they can come back to life.

      In the bowels of the hospital, or the receding