"What are you doing, Beggar?" asked my mother .
"Nothing," I replied.
"What's 'nothing?'"
"Nothing special."
"Well, if it's not special, why are you doing it?"
"Because there's nothing else to do."
Samuel Becket, the playwright, must have been a fly on the wall during that conversation, because he wrote, "nothing is more real than nothing." A. A. Milne, too -- it sounds like something Christopher Robin would say. To me, it meant simply, "I'm playing by myself, I'm happy; please, don't insist we stop and analyze it." How a kid like that turned out to be an extrovert, beats me, but he did.
At some point, even the most lively writing collaborations turn into late nights at the computer, all alone. At least they do for me. I've mentioned before how Lynn Smith and I burnt up the phone lines and closed down the restaurants putting our book together. But when it came to unscrambling the notes and wedding words with ideas, it was solitary work.
Interestingly, I don't think writing is necessarily introverted. I "hear" these words as they appear on the screen. In courses on rapid reading, one of the skills a person learns is how to see the lines without hearing them at the same time. Reading a novel, you naturally want to become part of the story, but plowing through a tome like Kaplan and Kaplan's two volume Textbook of Psychiatry, you want to get to the point.
I suppose it's like the difference between singers and entertainers. A singer focuses on interpreting the song; an entertainer is trying to capture an audience and bring them into the experience as participants. I can't write without conceiving of someone reading and listening to these words, spoken their own voice, just as I hear them in mine. This not imagination; I don't daydream you into flesh and blood. More akin to conversation than a letter, writing is delayed dialogue and the space between what I'm doing at this very moment and you're doing when you read this, is called breathing room.
If you foolishly ignore beauty, you will soon find yourself without it. Your life will be impoverished. But if you invest in beauty, it will remain with you all the days of your life. ~ Frank Lloyd Wright
I was prowling a dockside gallery on my first (and only) visit to Rockport, Massachusetts, when a watercolor of a Vermont farm in the moonlight, with snow covering the roofs of the barn, house, and surrounding fields, caught my eye. The price tag was nearly as large as the painting, but the artist assured me in five years I'd never miss it. He was right, though it was hard to believe at the time.
Mostly, my "artistic purchases" have been limited to unframed posters that share wall space with Western art I inherited from my parents. Artifacts from childhood -- a well-worn teddy bear, spurs, the saddle my father made for my fifth Christmas -- vie for space on bookshelves or rest atop the large brick mantle in my study. A small clay bust of a cowboy I gave my father one year stares out from my mother's antique china cabinet. It's my tip of the hat to sculpture.
One print has a story. It depicts a white wolf leaping from one ice flow to another, and it hangs over my desk. A patient's donation that never found a home on the psychiatric unit, I placed it in my broom closet of an office where it dominated the west wall. By the time I was packing for medical school, it had become such a significant, albeit silent, partner in my work that leaving it behind felt like abandoning a friend.
Often, when conversation in therapy lagged, or a patient was particularly taken with the image, I'd ask, "Do you think s/he'll make it?" Depending on how hopeful or hopeless they were feeling, their answer ranged from ambivalent to certain. One patient, as we were preparing his discharge, said to me, "I used to worry about that wolf, but not anymore; he -- or she, maybe -- is going to be just fine."
Eventually, the print became an image of my own journey, first from Colorado to medical school, and now, through the stress of board exams and rotations to come. The ice reminds me of flagstones floating on a cold, dark blue path. One slip and it's swim for it, but that doesn't matter because home lies at the end and one way or the other, s/he's not stopping until the door is in sight and there's the warmth of a fire within.
Oh yeah, this wolf's going to make it all right.
(Photo of "White Wolf Leaping" by the author; print copyright by Jim Brandenburg)
It's doubtful anyone would seriously use cricothyroidotomy in a song lyric -- I guess we can't have everything. Still in all, there is such a thing as poetic justice, since a cricothyroidotomy can save a life by creating an airway when it's impossible to do so by intubating, i.e. inserting a breathing tube into a patient's trachea. This is what handsome, daring TV docs do with a switch blade borrowed from a gang member, sterilizing both the knife and their patient's neck with a splash from a bottle of Jack Daniels another gang banger conveniently has in his pocket.
If you feel around the thyroid cartilage located midway from your chin and the base of your neck, you'll feel a little peak. Move your fingertip downward and you'll feel a little space followed by another ridge below that. The space is precisely where Dr. Young and Handsome makes his incision, following it by inserting the barrel of a pen, a hollow coffee stirrer, or whatever the prop guys think will make women swoon from week to week. It's an intimate conversation with the Adam's Apple.
Anyway, this what I learned to do today -- perform a cricothyroidotomy. How to make women swoon was apparently taught in another group and naturally, I missed out on that one. Nevertheless, it was exciting for me to learn a procedure because, for one thing, I know very few of them and for another, in psychiatry we rarely do them. Surgeons get scalpels, hemostats, clamps, and all kinds of neat things to work with, but in psychiatry, our primary tool is ourselves.
True, we have medications, but unlike those who are new to the field and presume psychiatric illness can be cured with a swift turn of the pen on the ever-ready prescription pad, veterans know psychiatry to be, probably, the most interpersonal of medical specialties. We can't repair broken hearts with a new valve like our cardiothoracic surgical counterparts. And even though our incisions are bloodless, they cut deeply, and healing takes time. Lots of time and lots of patience.
Psychiatry is still medicine, however, and particularly so in osteopathic medicine where we take the mind-body interface seriously. The challenge is to maintain an awareness of the presence of one while treating the other. This is why I enjoy learning the skills of physical medicine -- they work on the larger context of the organ I know the best and frequently realize I understand the least. People are incredibly complicated and yet, as the Psalmist writes, "fearfully and wonderfully made." There's no end to what you can learn and every day brings forth something new.
(Psalm 139:14; Creative Commons image via Wikipedia)
Every now and then I find myself asking if it's really me, doing the medical school thing, or if I've morphed into someone else. Ever have that experience -- or one like it -- where you're doing something you'd never have imagined? It's the kind of thing I can easily envision other people involved in, especially when I look around at my fellow students, most of them younger, some not so. We're seated in a crowded lecture hall, the air conditioning not quite adequate to the early season warmth, with carbon dioxide levels rising, trying to focus on a projected X-Ray image of what the lecturer swears is a normal chest.
I see us, with our shared struggles and mutual concerns about the end of the year, pending board exams, third-year rotations, and never cease to be amazed. How did the generosity of people, hard work, the grace of God, and sheer dumb luck all combine to get me here? Someone saw potential and for that, I'll be eternally grateful, but it still blows me away nonetheless.
In a few minutes I'll go back to studying the family history of bacteria and later on, more X-Ray images and the ins and outs of DNA. I can't get over how all of this has become part of my daily vocabulary. I'll switch on House, MD, and before I know it, call out the answer to a diagnostic question he's posed to his team.
Subtle changes, largely outside conscious awareness, surface off-handedly, making one realize they're adopting an identity that's new. It can happen in any situation, but this time it's happening to me and when I notice it, I have to say something, if for no other reason than to pinch myself and make sure I'm awake.
And not dreaming.
(Creative Commons image entitled "Mother of Dreams" by breezeDebris via Flickr)
Small talk, that polite interpersonal banter of the socially-skilled, has never been my strongest suit. I know the dialect and can parse verbs and decline nouns with the best of them, so it's not for want of facility that I mention this. It's mostly that I consider words to be valuable quantities, so much so that I hesitate using the word "quantity" to describe them. Well-selected, well-spoken words launched humans toward the stars. I hate trivializing or reducing them to casual comments about the weather and the state of one's digestion. Especially when they can do so much more.
Henry Drummond, attorney for the defense in Jerome Lawrence and Robert E. Lee's Inherit the Wind, says, "I don't swear just for the hell of it. You see, I figure language is a poor enough means of communication as it is. So we ought to use all the words we've got. Besides, there are damned few words that everyone understands."
Damn it, small talk simply doesn't go anywhere. It hangs in the air like the aroma of cauliflower boiling in my mother's kitchen when I was young, smelling up the whole house. I realize there's a time and a place for it, such as when you're meeting someone for the first time and you'd like things to go further than an introduction, but you're not certain where or how. Transitional talk is okay. It's when there's nothing but, that bothers me.
I'd rather ensconce myself with a stranger, talking in depth about anything, than verbally tip toe around a cocktail party, sampling this conversation and that. I'm just not a good hummingbird. You've seen them, I know, flirting with blossoms but never sticking around long enough to say they've become acquainted. A little handshake of the beak and they're gone, looking for the next dip of dew. That's fine if all a person wants to do is pollinate. I prefer building a nest first, even if it's only for a few minutes, a port in the storm that leaves me feeling I've touched, and been touched by, another human being, even if we part without knowing each other's name.
If only I'd met you when we were still alive. ~ Jack Nicholson, The Bucket List
That may not be the exact wording, but it's close enough for government work. I've never seen The Bucket List, though I know the premise. Two guys with terminal illnesses take off to tick off a list of things they wanted to do before they died. I was munching a chocolate chunk scone this morning when I ran across it, and hearing this line, did what any writer worth his salt would do, and that's head for the computer.
To female readers, this is a red flag. Saul Bellow said, "All a writer has to do to get women is say he's a writer. It's an aphrodisiac." Whether that's true or not, I wouldn't know -- maybe it has something to do with being a famous writer and I'm definitely not there yet -- but I can say, that at any given moment, maybe even the moment, your writer-lover is likely to suddenly adopt a distant look and dash away to your lap-dancing competitor, a "electrifying" chick named Dell (or Apple). It's nothing personal, but if you want to put her in her place, ask what he's thinking, memorize it, and feed it back to him later. All's fair in love and writing.
Anyway, back to Jack's line. What came to mind, mid-way between the television in the living room and my study at the other end of the house, was the look in the eyes of my dancing partners last night when I finally began getting the steps right. You have to remember, I'm inclined to approach this whole thing like a medical student with a master's degree in concentration, determined to get an A on the final. The women are moving with a swing of the hips, unnervingly reminding me that they're women, while I've got rigor mortis -- I'm stiff as a board.
But a couple of times, everything came together and my mind switched into neutral. My body took over, the steps fell in line, and I thought I heard my Guardian Angel sighing, "At last!" from a corner of the room. Of course, I straightaway forgot everything I'd learned, got my feet tangled together, tried to think my way out, and couldn't do a darned thing. When it was right, however, my partners looked at me and "Wow..." trickled from the corners of their eyes.
I wonder what my life would have been like had I learned to dance when I was younger. I know, it doesn't sound like that big a deal and maybe it isn't, but I'm thinking about the feeling of confidence I take away every Saturday when I walk down the stairway from the second floor, arts-district studio, step outside, and the cool night air hits my sweat- soaked chest. I'm the same guy I was when I arrived but I feel different. I feel like I can do things and they're waiting for me round the next corner. I honestly don't know what I would have done, but I'm glad I'm learning what I can do now, while I'm still alive to find out.
(Creative Commons image of couple at 8th Annual University of Michigan Ballroom Dance Competition by Wigwam Jones via Flickr)
I've had an idea lately that I really can't prove -- it's purely speculative -- and it is that much of our misery as adults stems from ignoring what we considered important as children. It may have for its inspiration, the AARP commercial that presents a series of over-40 adults, each one telling the audience what they want to be when they grow up. It gets your attention because of the incongruity; you usually expect something like this from kids. But here they are, people who, ordinarily, should have had their act together for a long time, talking about what they'll do, when they do.
The implication, of course, is its never too late to reinvent yourself and its only too late to stop trying new things when we're six feet under. But there's something about the ambitions of childhood that makes them surface in late-night party conversations among close friends, long after the casual (or uninteresting) guests have gone home. Someone asks, rhetorically, if anyone ever imagined doing what they are when they were kids, and it takes off from there.
What I think is happening is, an attempt to create a sense of continuity between who we imagined ourselves to be and the person we've become. And I think it's discontinuity between these two that generates a lot of the dissatisfaction that can bring adults into therapy. The feeling that one has gotten "lost" somewhere, or they don't recognize themselves when looking into the mirror.
I'm not suggesting the solution is to walk into the boss's office on Monday morning with a note reading, "Goodbye, farewell, this is it," and then set off on a quest to become whatever. But I do think ignoring what we once thought important is like dismissing a critical part of ourselves as unimportant, producing a tenderness that is easily irritated and we can't say why.
What we dismiss has the tendency to become associated, over time, with shameful, and what we associate with shame gets hidden. Hiding saps energy and promotes defensiveness. When others come too close, we find ourselves irritable, and that's why. Getting reconnected with oneself nurtures wholeness and a feeling of being at peace. It's not as scary as it sounds and most of the time we're not alone. It's part of growing up.
(Creative Commons image via Wikipedia)
