When I was first a mom I was astounded on a daily basis by the experience. Not to mention, exhausted. The now 15 y/o then wanted to nurse constantly. For hours on end, day and night we would sit together – him happily suckling and me? Well, honestly I was bored. There was a certain low-level trapped feeling; a feeling of being stuck yet again sitting tethered to the little creature. Don’t get me wrong, I loved breast-feeding and we made a great team. It did however, take a while to settle into the experience. That settling came when I learned to enjoy those moments of enforced peace.
There is great beauty to sitting absolutely still and giving into the process of nursing. I had to relax and let the world spin around me – the clothes unwashed, the dinner cold, the business of life unattended to. And in those moments of peace I would often think my clearest thoughts.
Again I find myself forced to sit still on a spinning planet. Forced by an injured leg, to let go of the multitasking productivity the working mother in me prizes. My family laughed at me last night as they scurried around on their good legs and I sat on my hurt bum watching them. They laughed because I mentioned that having my hamstring tendon torn is a lot like breastfeeding. Huh? No one stayed around long enough to hear why; but I kept thinking about this idea. My life is so full of mothering and work. So full of electronic medical records, blogging and Twitter. So filled out by friendship. So full that I lack, almost completely, time for quiet reflection. Now, in a space without the ability to scurry I am left sitting and relaxing. A novel experience? No, but one that is nice to return to.
I am reading Twila Tharp’s book The Creative Habit. She has taught me much about my own developing creative habit. One of the first chapters talks about the squelching effect on creativity of background noise. Noise both literal and figurative. She suggests turning off our computers, our music and skipping the newspaper for a period of time to understand the effect they have on us. That was hard advice to swallow; I have always worked with music playing. I started to drive my 20 min to and from work without the radio. At first the silence was a bit uncomfortable but as the days passed I found that my mind was productively wandering. Bits and pieces of my days were knitting themselves into coherent stories as I drove quietly along.
Breast feeding, healing and silent driving. Less tweeting, less laundry, simpler dinners. Soon I may be positively Zen-like sitting here watching them all run around. Hopefully I will at least, synthesize a few blog ideas while I watch.
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.
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.