The art of observation

He explained patience. He said it was the most important thing of all to remember, this: that when you wanted to see something very badly, sometimes you had to stay still, stay in the same place, remember how much you wanted to see it, and be patient.  —Helen Macdonald, “H is for Hawk”

I brought the binoculars up to my eyes and adjusted the knob, easing the fuzzy silhouette into focus.  It was a big hawk: that much was clear from the sheer size and the hooked beak.  The biggest species of hawk in our region is the Red-tail, and the female Red-tail usually outweighs the male; but the colors of this bird didn’t quite fit.

There was a smattering of white spots across the shoulders on either side; they formed a V on the upper back.  The head was dark, the throat lighter in color; and the buff breast was streaked with dark broad patches.

Then there was the tail: dark brown regularly interrupted with black horizontal bars, extending well beyond the folded wingtips.

Majestically, it perched atop the Celtic cross on the pinnacle of the brownstone church steeple, emitting a series of screeching cries.

Another bird, similar in coloring but smaller in size, answered from his perch in the uppermost branches of the tall dead spruce on Winthrop Street.

I eased closer, pausing after several steps to bring the binoculars up and observe the detail of the plumage.

Finally, after twenty minutes, the big hawk lifted its hindquarters, spread its broad wings, and dropped off the steeple, soaring to a cluster of far trees.  I caught a glimpse of the tail against the overcast sky: definitely not a russet red.

Back at the house I studied a copy of Sibley’s Guide and searched online.  Finally, I found it:  a juvenile Red-tail.

There is an art to identification, where perception, perseverance and patience reward the persistent observer.

The clinical encounter: an about-face?

Gradually, over the past decade we have been replacing face to face conversation with virtual interaction through cybervenues such as FaceTime and Facebook. Somehow, our social intercourse has not been not the same.

Face to Face. This slender volume rests on the bookshelf, a remnant from one of my graduate courses in counseling. The course was run as an encounter group. Participants had to work out the particulars of their interactions. Some of it was rough going; some of it wasn’t pleasant. You had to be an astute observer of body language, tone of voice, facial expression. Some of us were pretty adept at guarding our emotions; others wore their hearts on their sleeves. We didn’t necessarily agree with one another, but we heard one another out — at least, those of us who chose to interact.

In a group setting mutual support evolves through empathetic listening. To do so, you must be physically and psychologically present in the moment.

Similar interactions take place every day in the clinical encounter. We clinicians spend most of our day interacting with patients in the physical realm. With the advent and widespread use of the EMR (electronic medical record), face to face time has dwindled. Now the screen competes for our attention. No longer face to face with the patient, we tend to miss or overlook those subtle clues inherent in posture, facial expression, and body language.

Third-party payers are now advocating telemedicine as the latest and greatest means to improve access to healthcare and trim costs. In turning our eyes toward the future, might we actually be performing an about-face, as our physical face time recedes into the sphere of virtual reality?

A picture may be worth a thousand words, a video transcript even more; but I question the degree of meaningful healing that can take place in a virtual universe.

A veery in the wood

Last Saturday, the penultimate day of the annual spring census, dawned bright and blue. My list of birds had grown over the past week to more than 60 species. I grabbed my binoculars and headed down to the path that runs along the river, anxious to capture whatever sightings I could before time ran out.

Almost immediately, I was greeted by the song of a redstart from somewhere in the canopy overhead. Catbirds darted in and out, mewing from the bushes. The river ran high in the wake of recent rains, and from across the silent swirling eddies the sounds of warbling vireos came sharp and clear.

Up ahead something darted across the trail into the brush. I froze, brought my binoculars up, and focused into a tuft of trembling leaves. A black-masked yellow throat busily gleaned a twig. Momentarily, he sounded his witchety-witchety-witchety call. As I paused to record his name in my notebook, another call echoed through the wood.

Breathless, I strained to listen. There it came again, distant but unmistakable: flute-like notes, slurred together in a series of descending trills.

Carefully, I stepped along the trail, taking care to avoid snapping a branch or twig underfoot. The air was cool and clear; and when the bird sounded again, the refrain became sharper still.

I stood for several minutes, steeped in this song, and wondered at its beauty.

The song of the veery (Catharus fuscescens) has been described in various ways, each a sincere attempt to capture the refrain, each falling somewhat short of the actual performance. The Cornell Lab of Ornithology reports it as “a series of variations on veer, descending slightly in pitch, resonating as if whirling through a metal pipe.” Nineteenth-century observers called it “an inexpressibly delicate metallic utterance…accompanied by a fine trill which renders it truly seductive.”

The best way to experience this woodland singer is to head to the forest on a clear, cool morning in spring and listen. At some point, the patient observer is sure to be rewarded.

Spring warblers in the treetops

I hear, and have for a week, in the woods, the note of one or more small birds somewhat like a yellowbird’s. What is it? Is it the redstart? I now see one of these. The first I have distinguished. And now I feel pretty certain that my black and yellow warbler of May 1st was this. As I sit, it inquisitively hops nearer and nearer. It is one of the election-birds of rare colors which I can remember, mingled dark and reddish.   —Thoreau’s journal, May 10, 1853

One morning this week I wandered through the woods along the path by the edge of the river. Periodically, I paused to focus my binoculars on a short, slight movement in the trees. During these moments I became aware of the cacophony of calls from the canopy overhead. Similar songs emanated from various quarters. It took a bit to tune my ear to pitch and tone. Patiently, I stood, waiting for signs of movement among the budding branches. At last I was rewarded. The canopy was ripe with small black and orange warblers, redstarts most assuredly.

Over the course of these past few mornings I have identified by sight and sound any number of species: the blue-winged warbler, the black-throated blue; the yellow-rumped variety and the black-and-white; the yellow warbler and the chestnut-sided. The warbling vireos have declared their return as well, mostly through their distinctive songs high in the treetops.

Thoreau reveled in the return of the warblers in spring, when the green forest is splashed with dabs of color—

Within a few days the warblers have begun to come. They are of every hue. Nature made them to show her colors with. There are as many as there are colors and shades.  —Thoreau’s journal, April 19, 1854

Words that heal

Blessed are they that mourn, for they shall be comforted.

There once was a physician who had twin daughters. One grew up to become a psychiatrist. The other developed schizophrenia as an undergraduate. She poured out her anguish through words with pen on paper. Eventually, she became a published poet. Of the two daughters, which one was the healer?

In order to diagnose, a psychiatrist must learn to listen to the patient. Now there are many practicing psychiatrists who base their pharmacological treatments on symptoms alone. Medication regimens are adjusted based upon the patient’s response to the drug. Sometimes the dose is increased to enhance the effect of the drug; other times the drug is discontinued because of untoward side effects. Much of pharmacological treatment comes down to trial and error. Many times medication can help, but in the end a pill cannot heal a soul.

Freud, regarded by many as the father of psychiatry, once wrote: “Wherever I go, I find a poet has been there first.”

Throughout the centuries poets have pursued the art of crying out, of putting pen to paper (or stylus to papyrus), crafting words as conduits to transmit their anguish, their deepest longings, their joys, their sorrows. Many have written in part to help themselves to heal. When we read their words, we enter in to their anguish, their longings, their joy and their sorrow; and when we do, we ourselves may experience some degree of healing as well.

It doesn’t take a college degree to become a poet. One must only open oneself up to the suffering of the soul, to face one’s demons, to record the emotional truth of the spiritual state, to capture the passion (and in this instance I refer to the root meaning of that word: to suffer) in a few brief lines which may, if one is lucky, last for an eternity.

Wings of eagles

“I saw the eagles again today.”

I looked up from the plate of food resting before me on the dinner table. “Where?” I asked.

“They were gliding in the air overhead just this side of the mountain,” my wife said. “I was out for my morning walk when I looked up, and there they were.”

Individually, we had sighted eagles in the village over the course of the past year, but they had always been solitary birds, sometimes perched or soaring above the river. Earlier this month was the first time that my wife and I had seen two mature birds together in flight.

“Where did they go?” I asked.

“They kept circling, then eventually they disappeared over the ridge.”

Quietly, I closed my eyes and watched them: circling, soaring, clockwise and counter-clockwise, currents of air pulsing through the tips of their long wings, white heads and tails glistening against the morning clouds.

Ever since I was a boy, I had always dreamed of seeing an eagle. I had studied plenty of pictures, emblems on the national shield, photographs on postage stamps, drawings in books on birds of prey.  I had watched native American dancers whirl about to the beat of drums, their headdresses adorned with eagles’ feathers twisting and turning in the air. Later, as a sojourner of sorts, I had kept a watchful eye over the course of my travels, always on the lookout, hoping one day to catch a glimpse of a mature eagle in flight.

Decades passed before I finally got the chance to see a one; and now here they were in pairs, soaring  above the small village that we have come to call home for nearly forty years.

Hope can bring us a long way.  Sometimes we wait years to witness our childhood dreams fulfilled. Perhaps hope requires a healthy measure of time to bring us to the point where we become capable of appreciating such gifts, long-awaited but yet unseen.

A short list

A bucket list can be long or short, simple or more intricate. Some bucket lists carry expensive price tags; others not so much.

The bucket list of a young boy is understandably different from that of an old man. Boys look up to contemporary heroes; old men tend to look back to boyhood heroes long gone. Who can say what wishes might wash through the mind of a young boy as he nears the end of his short life?

I know of such a lad who, weak and wounded, had voiced a burning desire to see the original Declaration of Independence. In his debilitated state a trip to Washington, D.C., wasn’t feasible; he could barely sit up in bed at home. But somehow the word went forth, contacts were made, officials were informed, with the upshot that the curator of the National Archives arranged to close the public exhibit for a short period of time, long enough to skype a private showing for this youngster lying in bed at home several states away.

I’m told that the curator himself had been handed a terminal diagnosis, although in his case it would be some time, certainly much more time than had been granted the young boy; but time resides in the moment, and one moment lived in the now is priceless compared to hours or days of dulled awareness.

The curator explained the history of the document to the boy: the discussions that formulated the radical ideas that underpinned it, the drafts done by Jefferson, the changes by Adams and Franklin, the appended signatures giving approval and consent. The camera focused on the text of the parchment itself, penned in Timothy Matlack’s fine hand, punctuated by John Hancock’s signature centered among the other fifty-five below.

I am not certain how long this private showing lasted: perhaps several minutes, perhaps half an hour, perhaps an eternity; but in the end the boy’s wish was granted, and an invisible check mark was placed next to the item on the short list, signifying its completion.