Ecology, Art, and Medicine

Physician_and_patient,_13th_Century_Wellcome_M0007082Although MindfulBiology.org grows from the whole of my life experience, medical education provides a key source of nourishment for the project. It is therefore worth looking at the reasons behind my decision to become a physician.

Enrolling in medical school would have made more sense had I a different personality. One of the physicians who trained me said I reminded him of a jazz musician, and he didn’t mean it as a compliment. He perceived, accurately, that I felt more like an artist than a doctor. I distrusted convention and tended toward dreaminess. In case it isn’t obvious: both these traits make it difficult to thrive in a clinical environment. Aided by some strokes of good luck, I eventually found my way to a field that fit me pretty well, my shortcomings notwithstanding. By the time my career was cut short by neck disease, I’d built a reputation as a skilled oculoplastic surgeon. But the sense that medicine had been a misguided choice dogged me from early in training until my last day in practice.

So how did I end up in medical school? A seed of interest in biology had been planted by my grandfather, who lived in rural Indiana and taught me to enjoy tending the land. The roots of that passion grew deeper during youthful camping trips, including a solo hike of the 211-mile John Muir Trail at age sixteen. I entered college intending to become a field biologist. But in the late seventies studying nature wasn’t considered important science, and by my junior year I’d gravitated toward weightier fields. I enrolled in a biophysics graduate program in order to apply mathematical methods to neuroscience.

For reasons of chance rather than choice, I ended up in a retinal neurophysiology lab, where the experimental work entailed dozens of unsuccessful runs for every fruitful one. I found the research frustrating, while the laboratory felt disconnected from nature.

In other pieces on this site I’ve mentioned my history of psychological problems, which had a lot to do with childhood loss, abuse, and neglect. My first major depression descended while I struggled with graduate work, and coincided with a painful breakup and the recent death of my grandfather. The psychologist I consulted strongly encouraged switching to medical school, telling me he had wished to become a physician himself but lacked the grades. Rather than validating my interests, gifts, and vulnerabilities, he convinced me of his viewpoint: doctors earned good money and enjoyed high status, and those perks would lead to happiness.

Soon after beginning medical school, I realized that although it wasn’t hard for me to grasp the scientific material, a lot more was required. Feeling out of place, I paid attention when classmates talked about why they went into medicine. Some had physician parents and had always planned to become doctors. Some were children of immigrants—including one from a family of migrant farm workers—who seemed to be pursuing the American Dream. Others had helped loved ones with major health problems, like the classmate whose brother suffered from cystic fibrosis. A handful of my fellow students were simply compassionate souls who felt called to ease suffering. Only a relative few had begun with a love of biology and, like me, chosen medicine because it seemed the most reliable career path.

Most of those who were biologists at heart intended to become researchers rather than clinicians. That was my initial plan too, but during hospital rotations I discovered that working with patients felt rewarding. What’s more, despite my rebelliousness and difficulty sustaining focus, I had an aptitude for clinical work. My ability to integrate medical data with human narrative proved robust, and I began to think of myself as a clinician.

In trauma rooms and surgical suites I came into my own. Intensity heightened my alertness, and doing good clinical work felt almost effortless. Long hours on the wards proved more difficult; when tired I lost focus and sometimes forgot key lab tests and medications. By using checklists I was able to compensate, though with occasional scary lapses that I quickly pushed out of mind.

Seduced by the eye’s beauty, I chose ophthalmology as a specialty, which required overlooking the fact that it requires obsessive focus on detail. My tendency to lose concentration led to several painful experiences during training, including some that caused patient harm. Fortunately, I gradually found my way to eyelid surgery. This subspecialty suited me well, since it was more forgiving than surgery inside the eye and depended on artistic sensibility. Though it never felt like a calling, I’d found a good line of work that was fun while it lasted.

Every contour of the trajectory that transformed me from budding naturalist to eyelid surgeon informs MindfulBiology. The work would be impossible without the anatomy and physiology I learned in medical school. Also important is the way clinical practice places human biology in the context of human suffering. MindfulBiology aims to improve our appreciation of the body, and this won’t be authentic unless dysfunction is addressed. Knowing what old age, sickness, and death look like is key, but so too is viewing them as natural processes. To accept pain and illness as parts of nature requires that we place bodily deterioration within the frame of a planet-wide ecosystem, in which decay of past generations fuels the vitality of future ones. And to see such cycling as beautiful requires both an ecologist’s and an artist’s eye.

Mindful Biology views humans with compassion, as organisms that struggle in environments very different from the ones to which evolution adapted them. It recognizes that people sometimes choose poorly, and that living with ease requires us to forgive ourselves and others for being human. What’s more, MindfulBiology calls us to recognize the nobility of every life. It helps us remember that human bodies shine with the same magnificence as virgin forests and wave-swept beaches, even when they’re failing. Medical experience is thus a major pillar of this website, but so too is love of nature.

A career as an ecology professor might have suited me better than one as a surgeon, but things worked out in the end. And although I’m disappointed in the young man who entered medical school with shaky motives, I’ll grant him this: in due time his decision led to a direction that feels authentic and holds the potential to increase human contentment.