Carving and painting the medium through which we look

It is something to be able to paint a particular picture, or to carve a statue, and so to make a few objects beautiful, but it is far more glorious to carve and paint the very atmosphere and medium through which we look, which morally we can do….Every man is tasked to make his life, even in its details, worthy of contemplation of his most elevated and critical hour. —Thoreau, “Where I Lived, and What I Lived For” in Walden

Lines intersect, triangles form; a flat plane becomes three-dimensional space, and morphs into space-time, which, if theoretical physicists are correct, folds in on itself, and the past connects with the present in this moment.

I first heard the name of Henry Ossawa Tanner in an NPR interview with Bill and Camille Cosby when they discussed loaning 62 pieces from their extensive collection of fine art to the Smithsonian Institute. Henry Ossawa Tanner was an African-American artist who attended the Pennsylvania Academy of Fine Arts in 1879, where he studied under Thomas Eakins. Tanner would later emigrate to France; there he discovered a society where the issue of race mattered little.

It was during a return visit to the states that Tanner painted the piece for which he is perhaps best known, The Banjo Lesson. In this rendition a white-bearded black man sits on a chair, cradling a young black boy and a banjo in his lap. The older man supports the instrument as the young boy fingers the frets and plucks the strings: a moment of mentoring, captured in time. The pair is enveloped in light: a soft blue-white glow from the left, a warm brighter illumination from the right. The boy and the old man seem to be caught up together in this interactive moment. What they share is something more than a mere instrumental lesson.

Henry Ossawa Tanner: "The Banjo Lesson"

Henry Ossawa Tanner: “The Banjo Lesson”

Tanner’s portrait brought to mind a long-ago summer afternoon when I sat on the front porch of our house, reading a book to my granddaughter. Someone snapped a photograph of the two of us. Like Tanner’s portrait of an adult and a child, this photograph captures something more than the mere reading of a children’s book.

I think back to my early days of clinical practice, when I first learned the ropes: how to interact with a patient in the privacy of the exam room. As part of my post-graduate training I worked at an inner city clinic in the north end of Hartford. One day a boy’s name appeared on my schedule, a young Jamaican boy, recently discharged from the hospital with a concussion sustained when he was struck by a car while riding his bicycle. The discharge summary stated that he still exhibited some soft neurological signs. During this and a string of follow-up visits, it became apparent to me that something more was going on; this boy was clinically depressed.

I subsequently learned that he had been culturally displaced from his grandmother’s home in rural Jamaica when he was sent to live with his mother in an urban New England setting. During our visits the boy spoke little, but little by little I learned about his former life: how he would feed the chickens in the yard outside his grandmother’s home, the plantain trees in the yard, a lazy cat resting on the porch in the noonday sun—and the day his dog died a traumatic death at the hand of a neighborhood bully.

Much of this history I gleaned from pictures that the boy drew for me: simple pencil sketches of the house, the trees, the yard and the dog. During office visits we would look at the pictures together, and the boy would talk about what he had drawn. Little by little I learned about his life, little by little he opened up, and little by little his depression lifted.

Those were the days before the advent of SSRIs, those magical pharmaceutical substances that allow outpatient office visits to be compressed into a mere 9 minutes of time; those were the days when I had the luxury to sit with a patient and give them the time they needed—and the time I needed—to gather the data necessary for an adequate clinical assessment, to give them time to heal.

An article cited in Becker’s Hospital Review indicates that in a recent survey 65% of clinicians voiced disillusionment with clinical practice, largely because they no longer felt they had the time to listen to their patients. In short, they had lost the opportunities for those mentoring moments, when clinician and patient step outside of time into a different dimension, a place where the two of them are bathed in light—perhaps a soft blue-white glow from the left, a warm, brighter illumination from the right.

From across two centuries of space-time the thoughts of Thoreau break into my brain:

[I]t is far more glorious to carve and paint the very atmosphere and medium through which we look, which morally we can do….Every man is tasked to make his life, even in its details, worthy of contemplation of his most elevated and critical hour.