Monday, February 24, 2014

Now You See Me -- Or Do You?

I am easily delighted. I'm also easily entertained, though when I was little, hearing the words, "I'm bored," exit my mouth was my mother's cue to reach for the Bayer (aspirin). My attention could be as difficult to hold as a kid's hand in an amusement park. I loved the films Houdini (1953) and The Great Imposter (1961), starring Tony Curtis, and still do. Both were about illusion, magic, "now you see it -- now you don't." The impossible becoming possible with the blink of an eye.

I remember seeing my first and only, sword-swallower in a traveling circus when I was five or six. We lived in the country, as I've mentioned before, and a circus, with three rings under the bigtop, arrived at our local fair grounds. They had all the acts you associate with larger operations like Ringling Brothers or the Shrine Circus, including a fellow who had himself shot out of a canon. A young, pretty, blond-haired girl astride a dappled Welsh pony, stole my heart and galloped through my fantasies for weeks afterward (sigh). 

I saw my first "Punch and Judy" puppets the same night, in the side-show. I remember how a devilish puppet, clad in black, crept onto the stage to scare Punch. With a menacing voice, he said, "I am the Devil." Punch responded, sarcastically, "Well, you look like the devil!" I'd heard my mother use that phrase often enough to get the hint. When Punch and Judy appear in The Santa Clause (1994) each Christmas, my mind replays that evening.

Anyway, like I said, that's also where I saw my first sword-swallower. He stood next to Punch and Judy's stage, and with great flourish, proceeded to swallow a decorative sword which he said was "only a toy," and then what he insisted was a "real" blade. He even stepped behind a flouroscope so the audience could see the instrument of death inserted vertically through his mouth with the tip resting benignly in the curve of his stomach. When medical school and gross anatomy entered my life a few centuries later, I realized there was no way on earth that sword could have done what the flouroscope displayed. It was a "trick," an illusion, but one that delighted me as a child and continues to do so when I think of it.

I'm certain this is why I love the film Now You See Me (2013) with an ensemble cast including Jessie Eisenberg, one of my favorite new actors. It just delights me. The story revolves around four magicians who have been mysteriously contacted about membership in a secret society called The Eye, which is dedicated to preserving pure magic, righting wrongs, and overcoming injustice. As the plot moves forward, it includes tricks worthy of David Copperfield, slight of hand, hypnosis, and has the lead characters pursued by the FBI. Honestly, I could scarcely contain my inner child the first time "we" saw it.

Some have described Now You See Me as evidence The Illuminati have taken over Hollywood in an attempt to pull the wool over our eyes, deceive our better judgment, and secretly promote a "New World Order." Critics proclaimed the film's illusions were unrealistic and its ending unsatisfying. Personally, I wonder if we were watching the same film. I was captivated from the outset and couldn't wait for the credits to roll before hitting the restart button. Once was not enough and the second, third, and fourth viewings triggered my sense of delight as readily as the first.

Now You See Me isn't merely a story -- it's a yarn, a rambling and implausible tale, according to the Concise Oxford, though the film doesn't ramble and any implausibility lies in the eye of the beholder. There is no moral, such as you'd expect from a fable, but it does make a point, i.e. the ego can be so wrapped up in its own perceptions that it prevents us from realizing we're one, two, three steps behind what's taking place right in front of our us. I've been there, haven't you?

It also reminds us that to be captivated by wonder, we need to have a little faith, to suspend our natural disbelief, and be willing to trust. Not everything needs to be explained, as the film urges, and some things are best left unexplained. I'd agree, particularly when they make us feel like children, fascinated by what defies reason and once again, believing that anything and everything is possible.

(Creative Commons Image by ictusoculi via Flickr)

Saturday, February 22, 2014

Michael Palmer. Any Age is Far Too Young

 
For years I'd entertained the fantasy of crossing the Colorado state line from wherever I happened to be, with the windows rolled all the way down and Rocky Mountain High blasting on the stereo. It was going to be my fanfare, like the opening bars of the Star Wars theme or Superman, announcing to the world I was home at last. 

On a warm Indian Summer day in October, 1997, I did that very thing, driving my Ford pickup truck across the invisible boundary between Wyoming and Colorado, leaving the East Coast behind, little knowing in a few years I'd find myself on the same highway, retracing the miles back. Also little knowing that in forty eight hours, I'd be awakened by a story on NPR's Morning Edition with news I never wanted to hear. John Denver had been killed in a plane crash. I felt like I'd crashed with him. 

It was the same autumn I met author Michael Palmer in print. Michael and I never met in the same way John and I had, but we corresponded briefly, discovering how our experiences dovetailed by email. He'd been involved in the Massachusetts Physician's Health Program, working with physicians, like himself, whose lives had been affected by psychiatric illness and/or substance abuse. As a psychotherapist, prior to medical school, I also worked with doctors enrolled in the Colorado Physician's Health Program. Michael was in recovery, as he revealed years earlier, and I was attempting to recover a life I'd never known. Michael was a writer, I was trying to become one, and he offered me generous encouragement.

I found his books while prowling the Boulder Public Library, looking to feed a growing interest in medical fiction. At the time, I wasn't convinced it was even remotely possible to include medical school in my future, though I wanted to, quite badly. Reading about medicine was becoming a kind of therapy, much as writing had been for Michael, and his books helped overcome my fear that, not only had I missed the bus marked "medical school," it was gone for good. I had yet to learn there is no optimal time for going after what matters most to us, there's only now and what we do with it.

Michael was my companion during the months preceding premed coursework, when I hung onto to the ridiculous fantasy that a doctorate in clinical psychology would be enough. He helped me face the inevitable truth that nothing would ever substitute for my becoming a psychiatrist and I'd best get on with it. I learned from him how recovering a life is just as grueling and just as rewarding as what he'd gone through himself.

I'm glad I shared some of these things with him, especially now. We never know how tenuous life is, not really. We go through the daily grind with the unconscious assumption time is on our side. We do this a lot when we're younger or at least I did. We think only older people die, whatever "older" means, and if it happens to a peer, unless we know them personally, we conveniently overlook the obvious fact it could easily have been us, had the cosmic tumblers turned up our numbers instead of theirs.

The reason I'm glad I shared those things with Michael is this afternoon I learned he passed away, quite suddenly, a few months ago. He'd been in Africa, on safari, and had barely gotten back to the States when he experienced a heart attack. I can't help but think how appropriate it was for him to have been on safari; for reasons I don't quite fathom, I've always associated him with Hemingway. Michael was 71 and far too young. I feel certain he would agree, any age is far too young.

(Obituaries for Michael Palmer, MD, may be found here: New York Times and Boston Globe. Michael's final novel, Resistant, can be accessed via michaelpalmerbooks.com)

(Creative Commons image by cdrummbks via Flickr)

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Wednesday, February 5, 2014

Mission Impossible


It started out a typical morning -- Oh, you'd rather it was a dark and stormy night? Good idea. I like that; here goes...

It was a dark and stormy night. The wind was howling, trees swayed like hula girls (hula girls? In Maine? Maybe on a fuzzy dashboard.) and rain lashed my windshield as I pulled out of the parking lot. Eager to get home, I didn't notice the cassette lying on the seat next to me until I reached over for my gloves. It couldn’t have been mine; I hadn't listened to a cassette recording in years. Who's been in my car, I wondered, when, and why?

I pulled onto the shoulder and gave my discovery the once over. There was no label, it didn't smell like gasoline, gunpowder, or anything obviously lethal. I hadn't dallied with anyone's girlfriend, wife, or ex, and besides, the local boys wouldn't use a tape; they'd run me down with a really big truck and then shoot me for good measure. Thinking I was fairly safe, I inserted it into the player -- with my hand on the door latch, just in case. 


A dispassionate male voice I might have accused of belonging to Lawrence Fishburne under other circumstances, said, "Good Evening, Mr. Beggar. Your mission, should you choose to accept it, is to answer the question, 'What is a D.O.?' in 140 typed characters or less. Whether you include spaces is entirely up to you. For what it’s worth, your team suggested we do something physiologically impossible with this, so you're on your own. This message will self-destruct in 5, 4, 3, 2...hiss, whirrrr, click."

Acrid grey-black smoke billowed from the CD/cassette player and I swung the door wide, leaning out into the rain and coughing like Doc Holiday in Tombstone (1993) or Wyatt Earp (1994). Somebody from the AOA with a taste for cloak and dagger, I thought, who else? Talk about Mission Impossible. Wait a minute, isn't there supposed to be theme music playing? Where's the thump-thump, thumptha thump-thump signaling I'm about to do something really cool? Mmph. Budget cuts.


What made my task resemble Tom Cruise leaping from a speeding train was the subject matter. It's hard enough to express meaningfully when you've got all night. My "assignment" -- in reality, a sort of contest, but it's more fun this way -- was going to present a challenge. How can we explain the "DO essentials" to the average person for whom "doctor," often as not, refers to an MD? It's like trying to fit an elephant comfortably into a box designed for an engagement ring and expecting it to be recognizable as an elephant when the box is opened. At this point, 140 characters started to resemble the penance given a petulant soul doing time in Purgatory. And then it got worse.

Pretty much everyone agrees, the care and feeding of both types of medical doctor is virtually identical, with the exception that DOs are also trained in the delivery of Osteopathic Manipulative Medicine. On that basis, the question might be raised, why not have the same degree? By itself, is OMM sufficient reason to warrant separate licensing, specialty boards, and so forth? In other words, why not just make all physicians DOs and be done with it? I have a sneaking suspicion the American Medical Association might have something to say about that. Not to mention my best friend who is an MD and one of the most osteopathic of physicians I've ever known. Yet, even he will admit that he and I, MD and DO, are better together than we are separately, and that is due to the differences in our training, not the similarities.

Our training is the overall critical factor and if the training received by DO and MD physicians were truly mirror images, an identical designation would make lexicographic sense. Despite appearances, they are not, however, and not merely because of OMM. Osteopathic medicine is oriented differently and this takes us to the heart of the matter.

Hippocrates said, "It's more important to know what sort of person has a disease than which disease a person has." He could have been speaking as a DO because osteopathic medicine focuses on persons, both as individuals and as members of a community. It conceives of them as complex entities who experience themselves and their environment in ways inclusive of cognition, emotion, and physical embodiment. Their behavior is goal-directed and they are prone to regard the search for meaning as a sublime pursuit. Their bodies are a model of integration in which the part affects the whole and nothing affects the whole without also affecting the person whom it visually represents. Ultimately, the person is everything.


Person-centered care has become a hot topic lately, especially at medical conferences. For osteopathic physicians, however, person-centered is far more than a hot topic, it is a pervasive and all-inclusive, soul-deep conviction that conditions every aspect of the doctor-patient relationship. It isn't a practice emphasis, it is our defining feature. It isn't something we do, it is who we are.

I'm way beyond 140 characters and we haven't even hinted at the role played by OMM or the osteopathic preference for finding and treating the cause of disease rather than symptoms alone, whenever possible. See what I mean? The elephant is so big and the box so very small.

Still, I did accept this mission, so I'd better get cracking. You'll forgive me if I keep one hand on the door latch. Maybe the tape wasn't a "bomb," but that doesn't guarantee my solution won't be. A D.O. is a medical doctor, dedicated to the care and treatment of persons, in sickness and health, of all that they are and wish to become, and a great deal more, besides. 140 characters without spaces. You know, I think I'm starting to hear music.

Thump thump, thumptha, thump thump...

(Creative Commons Image by Baptigrou via Flickr) 
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