Wednesday, January 26, 2005

Consultation




I was listening to -- ausculting, as we say in the biz -- someone's lungs. More precisely, I was listening to breath as it passed in and out of bronchi and alveoli, listening for the whistles and crackles that would signal infection. It's flu season, and hoardes of patients have passed through the clinic with countless variations on the theme of fever chills body aches runny nose sore throat cough. I was tired, bored, peevish and, I must confess, spacing out as I stood behind Ms X. marching the stethoscope down her thorax. In fact, I found myself staring out the window.

The windows of my two exam rooms face a weedy rock ledge. Chain link gates with posted warnings -- FALLING ROCK ZONE -- keep would-be peeping Toms out of the narrow space between the building and the ledge, although, once, I saw a small boy sprint past. It's a pleasant view -- rock, branches, vines, leaves, an occasional bird, plenty of snow of late, and, depending on the time of day, shafts of sunlight pouring down from overhead.

So I was half ausculting and half gazing out the window and suddenly I noticed the speckled beige of empty swallow-wort pods suspended from some intricately coiled vines.

I like swallow-wort. I first encountered it on the chainlink fence in my yard. It was one of the first plants I found in my field guide: I identified it, then swaggered about like a junior botanist. This past spring I was astonished to discover that tiny, stellate brown flowers precede the graceful, tapering pods.





And I also admire the skeletal autumn and winter remains of this ubiquitous vine. As I walk by the river the bright beige speckled pods and the intricately coiled vines unfailingly draw my eye and I experience -- what ? -- pleasure ? Aesthetic pleasure ? I see it and I want to keep looking. It's interesting, engaging -- the contrasting colors, the structural complexity. Something about it attracts me and holds me there. It speaks to me, in a way, and I, looking, speak back. It's a kind of dialogue, conversation. In that moment weed and I form, if not a single organism, at least a single organic system.





But that day, as I listened to Ms. X's breath sounds and stared out the window, I felt nothing of that pleasure. It was a pretty enough specimen of swallow-wort, and yet seeing it I felt indifference, almost revulsion. You'd think I'd be pleased to find a weedy secret companion to my dreary clinic duties. So what was this ? The weed was mute. Sullen. Sequestered behind glass. Like some kind of horrid, alien specimen. Just a dead vine, in the trash slough behind the clinic. I was morose, distracted,in vitro, wanting to be anywhere other than where I was, anyone other than who I was. Poor Ms. X was obediently chugging away, on the verge of hyperventilation, oblivious to the fact that her inattentive internist was having a little pseudo-Sartrean semi-existential confrontation with a dead weed outside the window.

"OK," I said, lowering my stethoscope, "your lungs are clear. Have you by any chance had any nausea ?"

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