Monday, June 18, 2012

Avocations


     This afternoon I plucked 53 succulent figs from one of my fig trees!  It was the first crop of the season and, as with all first fruits of nature, tasted like the best in the world.  The abundant rainfall of the past two weeks, following months of drought in Florida, plumped up the figs so that they had wandering cracks in the thin purple cuticle reminiscent of the fragmentized paint, when you look up close, of fruit in still life paintings by Goya.  I gathered the figs, delicate and velvety, into the makeshift apron of my t-shirt, listened to the birds who trilled in the branches of a nearby oak tree waiting for their chance at the harvest, and rejoiced in the resplendence of summer. 
     Last week I dug up the last of the potatoes from my garden.  There were fire ants competing with me, now that they had discovered my booty, but I didn’t mind the formic acid sting of their bites too much. The longer one lives in any climate, it seems, the less its caustic elements disturb the body or one’s life. Burrowing with my bare hands through the dark sandy soil full of compost and potato beetles to discover these knobby round tubers, then hosing them off and imagining ways to prepare them for the table, seemed like the most fun I’d had all week.
     Not that doctoring isn’t fun.  But the extreme mentation of the work demands its compensation.  Most physicians have hobbies that engross the senses;  the body doesn’t like to be ignored for long.  I cogitate my way through the week, analyzing each pleiad of symptoms for a declaratory--and diagnostic--pattern.  I listen to my patients’ circumlocutory stories for hidden personal meanings:  the allegory, the fear, the memory of long ago.  Then I need sensory relief.
     One patient digressed for 20 minutes about a clamorous family reunion the prior week, before it occurred to me that her mother was missing from the story.  As it turned out, it was the three-year anniversary of her mother’s death from bone cancer.  The patient’s back pain, a new symptom and the reason for her visit, was an expression of “anniversary grief,” a way of remembering her mother and suffering the loss which had been magnified, albeit unconscious, by the family reunion.  If this had been a 6-minute visit I could have done nothing more than write a prescription for anti-inflammatory medication.  But with the additional time solo doctors allot I could afford to allow the patient to “tell her story.”  Meanwhile I listened with a third ear for its personal meaning.  She was pointing, so to speak, to her real problem which was sadness about her mother and her own need for mothering. Longing was a weight she carried on her back.  We were able to shift the session to a remembrance of her mother:  What did she miss?  What was her favorite childhood memory?  What would her mother have done, had she been there, at the reunion?  What would she like to say to her mother, if she could, now?
     Spine x-rays weren’t necessary at this visit, nor was a referral to a rheumatologist.  The patient did not walk out with a handful of prescriptions and I didn’t need lab tests to determine what was wrong.  I listened my way into the diagnosis, and I listened my way through the treatment.  I witnessed her suffering;  I empathized with her--who doesn’t have suffering that reverberates when someone tells a story of loss?  The human-to-human connection was the effective therapy.  It was therapeutic for both of us.  
    I am thinking all week long.  But on the weekends I like to get my hands in the soil.  I plant flowers and weed the garden.  I fill the hummingbird feeders, I wash the dogs, and I hang clothes on the clothesline.  Today I am cooking a pot of lentil soup, cutting the vegetables into cubes on an old wooden cutting board, peeling garlic that will leave an acrid trace on my hands all week, stripping thyme and oregano from their aromatic stalks in the luxuriant herb bed out back.  Before dinner I will run through the pine forest until my muscles grope their way back into my body, until my lungs remember:  this is air, this is honeysuckle, this is humidity, this is earth, where you were born.  Such plebeian activities restore me to my senses, taking me down from the realms of thought into the world of nature which has created the human bodies I touch and worry over all week.
     Most of the doctors I have known need hobbies that take them away from the philosophical concerns that underlie doctoring.  Why do people suffer?  Why do some suffer more than others?  What is cancer?  What is depression?  How can we help one another?  Who really needs help?  The answers to these questions are not linear. They must be sought outside the world of science, in the groundedness of being, where spirit speaks through the senses.  For some doctors a response to deep questions is felt on a ski slope or golf course, for others it’s in the photography studio, community orchestra, or mountains.  For me, digging potatoes, planting flowers, and running through the woods are the activities that carry a voice from the far reaches of my soul, saying, this is worthwhile, everything has meaning, keep on going.  

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