In medical school a professor once said to a group of 150 bright-eyed students that we would decide on a diagnosis within 30 seconds of a patient starting to give their history. He said this would be true 95% of the time. I was offended. It implied that I would turn off my brain and see what I expected to see. Turns out he was right. Most of the time I can finish the story within the first few seconds. Common things happen commonly in the life of a surgeon.
Occasionally, however, there is a little something off. Usually this comes a little later in the story. The pain is acting oddly.
Although we all experience pain differently, some more, some less, I see pain move in to people like wind or a miasma and it‘s personality, its way of moving is typical one to another. Appendicitis starts with a stomach ache generally and then robs the appetite, then moves to the right side, where it settles until something is done. But this kid has a sore throat you say? Pain came on without nausea? Hmmm. Pain is not being himself. I get suspicious. What I do is still take the appendix out, but sure enough, it was enlarged lymph nodes in his abdomen from the Strep throat we knew he had. The appendix came out because we can‘t afford to be wrong about that.
I love this part of my job when the patient reliably tells me what is going on and I actually hear it, even if it doesn‘t change what I do. It is a good reminder that I am still listening and that I am still interested in getting to know pain. It feels good to be an observant person – something that is at the core of my fabric anyway. Sometimes I have missed the turn in pain‘s plot. I always have a hard lesson in front of me when I stop looking and listening, no matter how many times I have heard the story.
In any story, the same is true. I make up that I know what the potential for beautiful phởtos is at my house, in my town, in this moment. I act bored and superior and I start losing out. The truth is that every moment has something new if I look and try. Not trying is the end of art. So even in a simple moment of Rose swimming away in a natural pool in Hawaii there is the whole story of that day for me. This moment holds the whole story. It holds the smell of the guava when she picked it off the tree for us as we walked out. Just before this, Rose jumped off some rocks into the water. Just after, I took 50 shots of water and rocks that I didn‘t keep but I loved taking, while she lay at the edge of the pool mediating and radiating tranquility. The couple we me there, the tide rising, the joy, the sun on my back, the perfect coolness of the water. All of that story is in this story, this picture, of the arc of her wrist and the water shedding, falling like a curtain after a wondrous play.