Swim Away

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.