Hungry Caterpillars and Hungry Minds

The AAP decided recently to use the book The Very Hungry Caterpillar as a tool to promote healthy eating. Great idea! In fact so great it brings me back 7 years ago to a presentation I gave to my daughter’s preschool class. I used the food pyramid and The Very Hungry Caterpillar to explain healthy eating to that group of 3, 4 and 5 year olds.

You know the story right? That little guy starts off well, growing up eating lots of fruit. Then he branches out to the junk. Sausages, lollipops, cake, pie. Not surprisingly he gets a stomach ache which is only cured by a return to his prior plant-based diet. Since that preschool presentation I have time and again explained this story to my patients and given them the book (courtesy of fabulous Reach Out and Read).

When I heard about the AAP’s promotion I tweeted about it “This is great! I have used same book to teach nutrition for years!”. A fellow tweeter was surprised. His response (in 140 characters or less):

I can see the connection, but I would not have made it myself. Are the kids really open to understanding nutrition that young age?

Ah, yes. They are. Here is a little understood fact (one my mother understood well):  talk to children just as you would any other human and they rise to the occasion. If they don’t understand they will ask you. If you teach down to them they will tune you out and you will lose their respect.

This point came up again this week while I was in the locker room after a swim. We swimmers solve all the worlds problems in the locker room. I ask the vet about my “dog”. Folks ask me about their kids. The discussion Tuesday was how and when to have “The Talk”. My answer was simple: don’t. I suggested instead, that making sex ed a natural part of their upbringing week in and week out was far more effective. Don’t wait for a big talk at a time when you think they are ready or old enough. Have books to read together. Have books for them to look at alone. Talk early and, talk often. And that brings me back to the caterpillar: answer their questions as they ask them without worry for what material they are old enough to understand. Kids are curious sponges; ready to soak up whatever knowledge you are ready to offer them be about sex or caterpillars.


Pink and Purple Circles

Promoting arts education is crucially important for our kids. Before I leave the background discussion of why I need to address one last point. Arts education is often taken to mean creating and performing art. Art history is also of value. This involves art criticism, the academic study of art with its stylistic and aesthetic context. It gives us the ability to understand the sublime that is art.

Briefly, three ideas for why the contextual study of art should be included in the standard arts education:

  • Understanding what influences the framework that art hangs on allows a more enjoyable connection with it. This is likely better explained with an example. My kids all went to a wonderful parent cooperative preschool. On my workdays there I loved being at the art table. Over the years I became increasingly impressed with the influence the children had on each other’s artistic styles. There might be three kids at the table painting away. One more would join in and start painting say, concentric pink and purple circles. Soon I would notice lots of use of pink and purple and lots of circles appearing across the table. Over time I worked with the teachers to form a yearly art exhibit where we hung the kids art on the fences in the school yard. It was grouped by period and context. It was a joy to see how the kids had developed together! This ripple effect or evolution of style is seen in our study of major schools of art. Artists influence each other and create an ongoing evolution of artistic style.
  • An understanding of the evolution of tastes in art generates acceptance of diversity. Artists through time have often been scorned when they challenged commonly accepted ideals with new approaches. They take a new approach that eventually becomes the accepted norm (think pink and purple circles). Seeing this progression as it has played out repeatedly through time can teach kids an acceptance of new thinking, new looks, innovative approaches. It can help them be less judgmental of differences in those around them.
  • Understanding the mechanics of creating art is valuable. Artists work hard. Really hard. They practice day in and day out in order to produce what can often appear simple. Have you ever looked at a modern painting and thought “I could do that”? Likely, you could not. Professional artwork requires both innate talent and earned skill. Understanding this can encourage and motivate a child in their own persistent efforts.

Art is more sublime when hung on a framework of understanding. You have more fun when you can see where the story behind the pink and purple circles. Then you might be motivated to go home and try some of your own.


Black and White in Art and Life

I am having a bit of a free association sort of rainy Sunday. Funny about our minds isn’t it? The way we can unconsciously shift through the bits and pieces of what we read or hear during the week to come up with a theme of sorts. What follows is the intersection of learning about the great dance choreographer Twyla Tharp, the painter Caravaggio and thinking about a few failed interactions I have had with patients through the years.

The Calling of Saint Matthew (1599-1600) by Caravaggio

Twyla Tharp explains in her book “The Creative Habit” that she prefers to divide people in her world into two distinct categories: acceptable or not, good or evil, “committed or missing in action”. While I find the book well-written and find myself inspired by her advice, I was bothered by these comments. I recognize that for her this commitment to embracing the extremes rather than the grey zones is artistically motivational but for me, it grates against my own approach to people. I prefer to work in a grey zone embracing the nuances of the personalities I find around me.

Michelangelo Merisi da Caravaggio was an Italian Baroque painter in the late 16th century. He is known for dramatic, dark, richly and realistically depicted paintings of an often religious theme. He is also known for having been a murderer. Good (artist), evil (killer) and yet, to view him fully as one of these extremes we would miss the other side to his story and miss the influence these complex components of his persona have on each other. We would make an error of judgment.

As doctors, we give our best care and make our best diagnoses when our minds are open. I remember a professor in medical school telling me to begin my care for every patient by imagining that the patient’s illness was a tree that I stood at the foot of. A tree full of possibilities. As I tried to figure out their diagnosis I was to consider climbing along a branch chosen after a pruning of other possibilities by listening to their history. The physical exam would allow a deeper cut of the choices, lab tests, xrays and time allowing me if fortunate, to end up on the right twig with the right diagnosis.

I read a blog post today about errors made when “hysterical” E.R. patients’ complaints are dismissed.  Someone loudly and dramatically requesting that they want a certain pain medication in a busy E.R. does tend to get ignored or, written off by the doctors and nurses who care for them. These patients are judged rather than treated in the grey zone of acceptance and this judging can lead to medical errors. This brought me back to two times in the past when such bias crept into my patient care. In both cases I was “warned” before entering the exam room that the patient or parent was difficult in some way causing me to walk into the room seeing a tree with already pruned branches. And indeed, I ended up on the wrong twig at the end of the visit.

Twyla Tharp is a supremely talented artist whose approach to slotting people into good or bad fails me both creatively and humanistically. Caravaggio was a troubled man with a gift; art influenced by his turmoil or, a man of grey shades. Patient care is best done with a clear eye towards the complexity of human nature.


Connections and Bonus Questions

I just read “18 Stethoscopes, 1 Heart Murmur and Many Missed Connections” a fabulously written article in the New York Times by Madeline Drexler. She tells her story of being a model patient – a person with a medically interesting “finding” who is asked to help teach medical students. These “patients” are examined by small hoards of inexperienced medical students who have little knowledge, little skill and varying degrees of innate bedside manner.

I was fortunate enough to go to a medical school where we began examining patients – real and staged ones – from month one. I still remember many of these people well; more clearly perhaps, than those I cared for in my sleep-deprived haze of residency. As Ms Drexler describes, I am certain that back then, I too was filled with awkwardness and overtaken by my interest in the examination findings at the cost of expressing empathy.

There is one that comes to mind now. He was a model patient for my final exam in a class on physical examination. I think he might have been the bonus “question”. I had studied hard. I was tired. He was in a room behind a door I nervously opened to find the answer to what exactly was different (medically speaking) about him. There in the room, on an exam table sat this young man. He may have been 25 or so. Dark haired, bespectacled and calm. I approached him and began the work of examining his body for a “finding” of sorts. Heart, lungs, abdomen… all depressingly normal. Mouth, neck, ears…getting closer. Then to my joy I found “it” and remember well the thrill when I did. There was a big part of me that wanted to say ” Woo Hoo! I did it”! Ms. Drexler describes this reaction in other students:

“This was a student who is not uncaring or unkind,” Dr. Treadway told the class. “But in that moment she did something all of us do all the time: she was so engaged with the problem that she forgot about the person who had the problem.”

I had a favorite attending doctor in medical school. Everyone else was scared of him. I looked up to him. Sure, he asked the hardest questions and embarrassed me at times. I stood tall with the knowledge he was doing this to make me better. And, when I watched him with patients and parents I saw that all of his sternness evaporated; he became the most caring doctor in the hospital. He asked, as Ms. Drexler reminded us to do, about how it felt to be stuck there as patient or parent. When he was talking with a family it seemed that perhaps, time had stood still. He had no where else to go, nothing else that mattered more than the people in front of him.

I think of this man often. He motivates me still. And, what I know now after all these years, is that I am still learning. Every visit with every patient I strive to become better at listening, interacting, understanding. I reach for the ability to make them feel that time has stood still in that room with them. I am not there yet but – reading Ms Drexler’s words and remembering my attending’s gifts help me feel that I might, just might get there some day.

P.s.: The answer to the bonus question was prosthetic eye.


“You have to be a bit outside of something to see it.”

Since reading the New York Times this Sunday I have been thinking about Glenn Ligon’s quote:

You have to be a bit outside of something to see it

These words have been rolling around a bit in my head. He was describing another artist’s work and these words had a specific meaning. However – like many quotes taken out of perspective we make them our own; we give them our own new meaning. For me they brought to mind the truth that can appear when we have the opportunity to view not only art, but people a step apart from them. There can be such breathtaking  beauty found in seeing someone we care about unexpectedly before we realize they are our own.

We are usually so embroiled in the daily work of parenting that we do not often have a chance to see our children (our greatest works of art) from a view a bit outside of the experience of parenting them. A few years back I wrote a brief article about nurturing friendships in young children. Part of the advice I offered was about how to handle the end of a playdate:

When it is over and you deliver the friend to their parent take time to praise their behavior to the parent – this makes both child and parent feel good and ultimately helps strengthen the budding friendship.

Taking time to reflect positively on another child to their parent can share with them one of those magical moments of seeing their child outside their usual perspective – it indeed makes all involved feel great! This advice and Glenn Ligon’s words also came back to me in the office recently. I was seeing an emotionally challenged child and her parents. Somewhere near the end of our visit I commented on what a beautiful person she was and how her strength of character combined with her parent’s incredible support would help her rise above her struggles. As I mentioned her shining nature I saw a glimmer of relief in her mother’s eyes. For a second her haze of stress and worry parted and she could see her daughter there across the room as I did – a beautiful person with a positive future.

These times of seeing our children a bit outside of our usual view are gifts to be savored and shared. Enjoy!


Minimalist Art Provoking Maximum Discussion

An article by Carol Vogel in yesterday’s New York Times brings me to focus here on item number one in The List. The article was a review of Glenn Ligon’s upcoming retrospective at the Whitney museum in NYC. Glenn Ligon is a modern painter and conceptual artist whose work focuses on his view and exploration of American history. There is much here to use as fodder for a dinnertime discussion with your kids.

First a bit of art history to set the stage with. His work seems to fall well into the broad category of Conceptual Art. This movement followed Abstract Expressionism (think Rothko and Pollock) and Pop Art (think Warhol). Ligon’s work seems heavily influenced by a Neo-Dadaist artist: Jasper Johns (think American flags and numbers), …and if all this is making your head spin either skip on through or, see the bottom of this post for examples of work by these artists. Conceptual Art is a cool ah, concept to talk with your kids about. It very simply put, is art that focuses on ideas rather than aesthetics. The Dadaist, Marcel Duchamp was amongst those setting the stage for conceptual art by leading us to question what art is exactly and to stretch our expectations of what art should be.

The work of art is always based on the two poles of the onlooker and the maker. Marcel Duchamp

Years later, Conceptual art began to look at the context and perception of words, objects and ideas. In Ligon’s work he often uses words or phrases from other people and reproduces them in ways that urge the viewer to look longer and harder at what has been said. Taking these words into a new frame or focus pushes us to contemplate their ideas as those outside our own experience bringing us possibly, to a new understanding.  As Ligon himself said:

You have to be a bit outside of something to see it

The New York Times article about his work is well titled: The Inside Story on Outsiderness. Look with your children at his art; doing so may move them towards that first item on our List: to widen their perspective and encourage cross-experience understanding. Glenn Ligon’s art is about important and challenging concepts developed in large part by his experience as an African-American gay man  and yet, is presented in ways that are approachable. Challenging but not crushing of a child’s interest. My friend described them as “minimalist art provoking maximum discussion”.


Representative works discussed above:

Glenn Ligon "All traces of the Griffin I had been were wiped from existence" (inspired by words from The book "Black Like Me")
Jackson Pollock
Mark Rothko
Jasper Johns
Andy Warhol

The List

Here revisited, are the reasons I have gathered from family and friends for why children should be exposed to, taught about and encouraged to experiment with art. Art, in all its forms is of enormous value but, is being given short exposure by schools and parents often struggle with how to promote arts education at home. The list is a work in progress; please add to it on your own or, in the comments.

  1. Art exposure widens a child’s perspective, encourages acceptance of generational, cultural, social and geographic diversity. Art promotes cross-experience understanding.
  2. Knowing about art allows for a more enjoyable life-experience; allows you to feel socially connected and able to talk with people. This is an interesting point. It brings to mind the value of a liberal arts education being in part to generate well-rounded, broadly. exposed young adults who can interact with others on many levels.
  3. Art helps us remember history. Indeed, this was my point about art preserving our cultural heritage and collective memory. It preserves the past both in the physical sense but also in the ephemera of our thoughts and knowledge base.
  4. Art makes the world less plain. Yes certainly, there is this – the obvious but important view that art education allows an emphasis on the beauty that surrounds us. It helps us raise children who see that in life there is value in the simple moments.
  5. This ties into the next idea: “art makes me feel good”. Time spent learning about what makes us individually feel calm and “good” is increasingly important in this pressured world.
  6. Art can make “me feel different”. Yes, art can challenge us to stretch beyond feeling good. Kids can explore, confront and process the more difficult sides of life through art.
  7. Arts education sharpens critical thinking skills. Cassandra Whyte is credited with early work showing that artistic experiences develop creative and independent thought processes that are important throughout an individual’s lifetime.
  8. It teaches innovative thought
  9. And, teaches empathy and sensitivity to other’s experiences by exposing them to other world views, brings about a deeper understanding of the world.
  10. Teaching the arts nurtures skills (empathy, innovation, tolerance) that improve our kid’s future ability to work successfully in the global marketplace
  11. Art calms the soul and brings beauty to daily life.

Art washes away from the soul the dust of everyday life – Pablo Picasso


Shoveling Snow

Just a brief note of contemplation:

It has been a long and stressful stretch of work. Extra hours filled with lots of sick children both at work and, at home. I have been feeling the imbalance that for me occurs when my mind works overtime and my body doesn’t get out the door to work at all. So, today I was happy to be at last moving more than thinking.

I find a certain solace in repetitive brute work. Hiking steadily uphill with a big pack. Mowing the grass with a hand mower. Digging a big hole in the sand. Shoveling snow. You might guess I problem solve, create or brainstorm while grunting. No, I just completely relax. Completely zone out and… refill the tank.

Now, after first a bout of shoveling followed by a long walk in the snow, I sit, calm again. Ready maybe, to face the week ahead. Oh, its only Friday? Ahhh, good. More grunt-work tomorrow.

The Kids Answer the Art Question

As promised, I asked. At dinner a few nights ago over something kid friendly like spaghetti, I asked my three. Why dear children, is it important to be exposed to art, taught about art and encouraged to make your own? First, the surly 11-year-old grunted “History”. Then the sick 15-year-old mumbled “Dunno”.

I was saved by the 9-year-old who got the conversation rolling. He started with a description of how cool it would be to go to a museum with a friend and be able to have favorites he got to see. How fun it would be to talk about the art. That he would tell his buddy about the refrigerator paintings (take a look at Mark Rothko’s paintings to see what he means). He got the other kids brainstorming and we started their list of reasons children should be exposed to art in all its forms and encouraged to make their own.

  • knowing about art allows for a more enjoyable experience; allows you to feel socially connected and able to talk with people. This is an interesting point. It brings to mind the value of a liberal arts education being in part to generate well-rounded, broadly exposed young adults who can interact with others on many levels.
  • art helps us remember history. Indeed, this was my point about art preserving our cultural heritage and collective memory. It preserves the past both in the physical sense but also in the ephemera of our thoughts and knowledge base.
  • art makes the world less plain. Yes certainly, there is this – the obvious but important view that art education allows an emphasis on the beauty that surrounds us. It helps us raise children who see that in life there is value in the simple moments.
  • this ties into the next idea: “art makes me feel good”. And, time spent learning about what makes us individually feel calm and “good” is increasingly important in this pressured world.
  • Art can make “me feel different”. Yes, art can challenge us to stretch beyond feeling good. Kids can explore and confront the more difficult sides of life through art.

We would like to generate an ongoing list here of the reasons for arts education. Please add you ideas to the list. Ask your kids tonight and see if you can push them beyond “Dunno”.


The Patient’s Worst Fear or, questions that take my hand off the doorknob

In medicine physicians often talk about the patient concerns that come up in the moment we are leaving the room. The “oh by the ways”. The comments that come when the doctor has a hand on the doorknob, one foot out the door. Mostly, these are simple, quick requests (work notes, PE excuses and the ilk). But every now and then they are real humdingers.  Yesterday I had one of those moments, and it got me thinking about what I do and how I do it.

Work has been busy lately. The clinic is full of kids with colds, earaches, and influenza; lots and lots of sick kids. The volume of patients is pushing us to be very time efficient, very focused in our approaches to care. Yesterday in the afternoon a teenaged patient came in with several separate non-urgent concerns. We worked through the history, examination and plan for each of these and I needed to move on to the next patient. Make that patients – four were waiting. So when, as I was touching the door handle, their parent asked her if they wanted to tell me about another issue I admit that I inwardly groaned. Outwardly I explained that I had four people waiting and that maybe we could schedule an appointment next week to discuss this concern. But something was bugging me about the atmosphere in the room. Some alarm beeping in my head made me stop, take a deep breath and ask if I could on second thought, hear what was worrying them.

It was one of those moments that highlights how much of medicine is an art. Much of being a good doctor involves having an emotional intelligence that helps us know when to take our hand off of the door. I wish that I had never actually reached the door. I wish that I had responded earlier in that visit to the little alarm in my head.

There is lots to read on the internet now about how a patient can prepare for a visit with their doctor. Ideas about advocating for one’s healthcare. Making lists of questions to ask. All often form good advice. I would add this piece of advice for patient interaction with physicians: state your fears upfront. Tell the doctor what your biggest worry is. Tell them what keeps you up at night. Doing so is important for several reasons. We can often calm your worries better if we know what to approach. You are your child’s expert and have input that is valuable to us. We may though, need to schedule another appointment. And, of course if the doctor manages to get out the door without knowing that last “oh by the way” humdinger we may have failed to treat the one medical symptom that actually would have scared us and kept us up at night.

My teen patient will be fine now but they needed that last moment of my attention. Without it they would be very ill today. The other four patients? They waited and understood that I was late because I had been helping another child. They understood that I not been off doing my nails or reading a novel. That is for today.


For more insight into the approach physicians take to office visits read this excellent outline by BrianVartabedian. It absolutely sums up how I also try to structure a patient visit.

Preserve Arts Education; Preserve a Sense of Wonder.

The most beautiful thing we can experience is the mysterious. It is the source of all true art and science. He to whom this emotion is a stranger, who can no longer pause to wonder and stand rapt in awe, is as good as dead: his eyes are closed. – Albert Einstein

My eldest is almost fifteen and is beginning the process of planning his high school and college “careers”. This proves to be a rather stress-inducing experience; apparently very different from the casual way I approached high school. Late the other night he admitted he was worried about choosing classes for the upcoming years. So, in the spirit of facing our fears we curled up together right then and went the through the high school graduation/college entrance requirements. The school had provided worksheets and lists which we dove into. Amongst scads of science, math, and language requirements I learned that of the 230 units required to graduate only 10 of those need to be in arts education.

This made me start thinking again about the lack of value we place on arts education and the consequence of this devaluing. This is evident in the currently proposed national budget; some members of the House of Representatives have proposed deep cuts or even total elimination of the National Endowment for the Arts. This represents a huge loss nationally. On a more local level our school systems face severe budget crises and are viewing arts education as expendable – Leaving it acceptable to require only 10 units out of 230 for a young person to graduate from high school and enter college.

What is the cost of this devaluing? Put differently – what is the value in teaching kids arts? We teach art and teach about art because doing so:

  • sharpens critical thinking skills. Cassandra Whyte is credited with early work showing that artistic experiences develop creative and independent thought processes that are important throughout an individual’s lifetime
  • teaches innovative thought
  • widens perspective, encourages acceptance of generational, cultural, social and geographic diversity
  • teaches empathy and sensitivity to other’s experiences by exposing them to other world views, brings about a deeper understanding of the world
  • Therefore, teaching the arts nurtures skills that improve our kid’s future ability to work successfully in the global marketplace
  • calm the soul and brings beauty to daily life

Art washes away from the soul the dust of everyday life – Pablo Picasso

  • preserves our cultural history and heritage; preserves our collective memory

My son and I filled in the worksheet with lots of science, language and math. And art? Well, not so much. He moaned at my suggestion of various art classes let alone art history. His groaning made me realize that I had before me, fodder for another great dinnertime conversation. Tonight I am going to ask them why I talk so much about the arts. Why I drag them to museums? Why we have lots of paint, pastels and paper? Why are our walls covered with art? They may generate some new ideas from my list above. I’ll get back to you with them.

If you want to help promote arts education yes, of course generate your own dinner table conversation. You can also look at the work of the Americans for the Arts Action Fund.

Perfection. Pressure. Price.

I have tried hard to avoid adding to the general buzz surrounding the “Tiger Mother”. I resolved to stay out of the fray. Really I did. But, a convergence of discussions with reading a review of the book has pushed me into adding my thoughts to the collective. I’ll be brief.

Twice this week I have had conversations about girls feeling the pressure of attempting to be “perfect”. One girl was in tears telling me that she was trying hard in all she does (arts, sports, school) to literally be perfect. The pressure had brought her in to see me. The mother of another talked with relief about how her junior high aged girl was moving away from a friend who on the surface seemed so very “together” that her child had been feeling the strain of trying to keep up.

I had heard of the Tiger Mom; she sounded quite awful when I listened to the general hub bub. Then one day earlier this week I found myself stuck in a waiting room reading a review of her book in Time magazine. A review that was surprising. I tend to try to look at life from all sides and enjoyed finding through this review that perhaps the feline had some good ideas for raising children after all. Do I agree with them all? Well no, of course not. However, she has some powerful theories about the value of hard work and repetitive practice. I went home that evening and announced to my kiddos that from now on they were going to practice their instruments longer. Everyday. No more nice mom.

However what is clear to me about her child raising technique is that it is fraught with danger. The danger that comes when a child is held up to perfection as the yardstick by which they are being judged and by which they judge themselves. So the question becomes how to find the balance. How to push our children to work hard, really hard so that they become the best versions of themselves they can be, while also teaching them of unconditional love. For with this love comes an innate self-confidence and strength that will allow them to use their hard-won skills in creative and meaningful ways.

Perhaps we explain to them that perfection is not obtainable. It is defined individually and changes with the viewer’s perspective. That it does not actually exist. Nor would it be desirable if it were found. Our children need to accept that life is messy and people are complex. The friend who seems so together, so perfect, may have hidden flaws. The people we most enjoy being with, those that most fill us with joy, are often those that are flawed. Take one of my dearest friends. She is great looking, can make any item of clothing look like haute couture, is kind as the day is long, a great athlete and, a bit of a slob. Yes, a slob. But, we all love that about her. It makes it easier to be with her. Her house is great to be in – enter there and immediately relax for, while there you know what really matters the most to her: your friendship.

Our challenge as parents is to endorse maximum effort and to teach the embrace of the diverse, unexpected and messier parts of living life. How do we proceed? Perhaps by opening this dialog with our kids. Ask if perfection is a goal? Is “perfect” possible? At what cost? Let me know what you learn.

What is in a title? Or, Rapunzel Redux.

This weekend I went with my daughter to the Crocker Art Museum in Sacramento and saw a work named Rapunzel #10. It was breathtaking and moving. Literally moving. It was a computer generated image of hanging flowers swinging in a computerized breeze positioned in a stairwell. As we walked up to begin our afternoon of art-looking, we were both taken by its beauty. So much so that at the end of the day, after lots of great art (and a yummy piece of cake and tea) we went back to Rapunzel. We sat in the stairwell, side by side quietly watching the flowers swing in the breeze.

The night before the two of us had gone to see the movie “Tangled” also a reference to the story of Rapunzel. This coincidence made me pay special attention to the title of our stairwell art and to ask her, when it comes to art, “what is in a name?” This question blossomed with the hanging flowers into a good discussion. My daughter noticed that in another equally notable exhibit we saw that day The Color of Light, that the painter named many of his paintings “Phenomena”-this or “Phenomena”-that. We started asking why? What was he asking us to pay attention to? With the installment Rapunzel #10 a placard asked us to consider the story of Rapunzel and the image’s relevance to addiction and child abduction in contemporary society.

Hmmm…I just wanted to enjoy the emotionally and literally moving flowers. I wanted to meditate on my own response and here was the artist jumping into my experience and demanding that I turn my thoughts elsewhere.

What is in those pesky names? Perhaps ask your kids at dinner tonight. Why do they think an artist leaves a work named “Untitled”. Why would they instead choose a powerful reference like “Rapunzel”? How does that change our experience? Perhaps – turn the question towards a book your child is reading: why did the author choose the title… can you come up with a different title? Or, look together at some art and discuss the names you find. In reference to the name of his work Women and Bird in the Night, Joan Miro in a rather satisfying explanation said:

It might be a dog, a woman, whatever. I don’t really care. Of course, while I am painting I see a woman or a bird in my mind, indeed very tangibly a woman or a bird. Afterward it’s up to you.

A Turkish artist, Ihsan Cemal Karaburçak, explained his very different approach of leaving works untitled:

I essentially do not give titles to my paintings. A landscape could portray any given place. What does it matter! A tree, a house, a mountain, a cloud, a flowerpot or an apple can be found at anytime, anywhere. The important thing is how it is tempered with, how it is interpreted and depicted. The object is only the means through which the artist reflects his inner world on a board or on a canvas. What matters is the inner world of the artist.

Or, create some art of your own and try coming up with names. You may of course end up choosing “Untitled”.

Jennifer Steinkamp‘s website has a video of one installment of Rapunzel.

Paul Jenkins is an abstract expressionist painter. This means that simplistically put his work is in the same general category of other artists I have written about here, Rothko and Pollock. You can see his Phenomena at his website.


TV dinners

I enjoyed Dr Vs post about writing being a habit despite the kids and puppy (oh I know that combination all too well).  I read his link to The Myth of the Perfect Writing Environment … I took his message to heart. I tried to get up at 5 AM like him. Really I did….but eww? It was dark out? And cold? Ick.

So, to get my writing in tonight I let the kids watch Home Alone 3 and eat dinner on the floor in front of the TV.  I’m guessing that is not what he meant me to do? But, they don’t watch very much TV really, and most of the time they are sitting with me at the table being force-fed art history so its okay – right?

Why February is hard for Pediatricians

It has been rough in the office lately. January is always rough for pediatricians…February is worse. Everyone and their sister is sick, the doctors all get sick too, those of us left standing work extra….Oh well. At least the great thing about pediatrics is that the kids are still cute and make us smile.

Part of what makes the days hard is also that many of the parents who come into our offices are exhausted from lack of sleep and worry. They need our help also. But when so much of the time all we have to offer is the dreaded diagnosis of yet another viral  infection  they feel frustrated. Sure, parents come in for reassurance – they want the piece of mind found in knowing their doctor did not hear a pneumonia or see an ear infection. However, much of the time there is often the hope that they will be handed a medicine that will help their child and get the parent some much-needed rest. I know. I’ve been there; I too have kind of secretly hoped there really was an ear infection to be found because I knew that could be “fixed”.

Too often we can’t offer a fix; we can only offer the diagnosis of “viral infection”. Let’s face it – that is read by the parents in our office as having the subtitles: “I’m back on my own with my sick child” “no sleep tonight” “I wasted my money/time”.  And for us as physicians honestly, handing over the diagnosis that clearly deserves an antibiotic is much easier, much more satisfying than saying yet again… it is “just” a virus (of course this concept of a viral infection being a “just” could take up a whole other blog post).

Then there are the even harder visits when we find an ear infection but need to embark on the discussion of “to treat or not”. Claire McCarthy, M.D. recently posted a wonderful article about this very discussion: Shades of gray: Why medicine isn’t always as clear-cut as we’d like. Her words and perspective have stuck with me through the past rough days at work. They have helped to reassure me and to guide me.

The practice of pediatrics is not unlike the practice of parenthood: full of uncertainty, impossible to understand completely and done best when the child is more important than anything else. We’re coming at it from different places, but we’re in this together.

Thank you.

Dinnertime Art Continued: Art in the Moment

What do Jean-Michel Basquiat, Tino Sehgal and Andrew Goldsworthy have in common?

Well, I didn’t really expect you to get that one. But the answer to this question is one worth discussing (in the ongoing dinner-table conversation with your kids that I have by now stirred up).

Jean-Michel Basquiat was an American who began as a graffiti artist and developed into a respected painter of canvases hung in galleries and museums. I was fortunate this year to see an extensive retrospective of his work in a museum. His paintings have an Afro-Carribean influence and also show hints of the influence of other artists of his time. But, for the purposes of our conversation, think of him as a graffiti artist. Andrew Goldsworthy is a british sculptor who works primarily in the outdoors making site-specific and land art. He makes art created out of what he finds in nature. Breathtaking, monumental art made of icicles, twigs, leaves and piled rocks. Tino Sehgal is an artist who creates situations meant to move his audience, meant to make them think but – not meant to be preserved. His work occurs in museums but is not documented in anyway. I recently saw his work “This Progress” – an installation of progressive encounters with people who walked with me, asking me questions (“what is progress?” “is progress always good”) as I ascended the spiral at the Guggenheim museum in New York. While my memories are sharp, there is no image to link here for you to see.

The answer to my question is that all three men created in part, art meant to be temporary. Graffiti and land art are to more or less degree ephemeral in nature. Sehgal’s work is designed to be such. When you look at each of these art forms you find an unarguably appealing nature to them. Certainly Goldsworthy’s is the most widely approachable so, start there. What is it about the fleeting nature of his work that adds to its beauty?

I asked my children this tonight at dinner. I admit, the 15 y/o rolled his eye a bit but then, even he joined in the conversation. They all agree that Goldsworthy’s installments are “really cool” but we struggled with the question of what their impermanence adds to the art. Does its fleeting nature make it more precious and therefore simply more valued (volunteered by the 9 y/o)? Do the changes that occur as Goldsworthy’s sculptures are decayed by the forces of nature (tides, wind, heat) allow for our own interpretations; our own artistic input in how we see them? Do my memories of Seghals situations similarly add to the interpretation of his art? Questions of vandalism aside, I find something magical about the creation of a graffiti mural that will soon simply become a canvas for the next artist.

Is there something about art meant to be physically transitory that makes us pause and stretch our mind’s eye to really take it in? We are perhaps, encouraged to be really in the moment with this art that is by nature of the moment.

To start your own discussion at home try watching these two very different but equally moving videos: Goldsworthy in action and graffiti being created. Consider making some of your own art at home as Meg Schiffler and her son did described in her terrific blog post for the SFMOMA Andy Goldsworthy: Big Tears (Part 1) and A Gift to the Backyard (Part 2).

Thanks and the sound of falling trees

All week I have been struggling with an existentialist question. I am certain that it is one that many new bloggers face:

If you blog and no one reads it, did you write at all?

I did not really begin this blog to gain readers, true. I started it to have a creative outlet, to practice writing, to improve, to challenge myself and to get some of the thoughts about art, parenting, and daily life out of my head and onto “paper”. I have struggled a bit with the scope of this blog; I have questioned the combination of blogging about art/parenting/pediatrics.

Somedays I am too busy trying to balance clinic and home to come up with a good idea to write about. More often, the ideas are busting out of my head begging to get written about but the time is short.

Mostly lately it has seemed sort of quiet around here. Then tonight, I logged on and noticed an unusually high number of visits to my site today. A bit of research led me to the reason why. Bryan Vartabedian, MD of and his post highlighting voices from the medical blogosphere that he has enjoyed; those that are unique and compelling. I am, quite simply, honored to have been included.

It seems perhaps that my fallen tree made a sound after all.