Sunday, January 29, 2012

The Sway

My son's hands are moving back and forth quickly over the finger board of the violin. The bow bounces back and forth rhythmically. Like most every day, he is painstakingly practicing. He moves from one piece to the next, pausing to make adjustments. When he's done, he turns the pages back and starts again.

Eight months ago he stared at the gleaming instrument. For the first few weeks he practiced his plucking. Then, in no time, he was bowing. Now he plays a plethora of songs and learns something new each lesson.

The sounds coming from his violin are becoming less squeaky. The melodies are more constant and the clarity of each note is beginning to shine.

But more remarkable than his technical acumen, is the joy that is growing in his heart. He has started to smile as he plays. His lips curl upwards despite the furrowed brow of concentration.

Yesterday, toward the end of practice, he came to one of his favorite pieces. As he played his legs bent slightly, and his eyes began to close. Instead of the rigid stance so often practiced, his shoulders began to sway. For just a moment, his body and the notes dancing off the violin had become one.

It was pure ecstasy.


Unlike many other endeavors, music allowed my son to reach this moment without mastery. Only a novice, the feeling and emotion transcended his abilities. It will be years before his technical skills will match the expression of his body.

But we all have witnessed someone who's abilities and training match the emotion of the instant and reach "the sway". I am reminded of watching Michael Jordan dominate during a championship series, or Barack Obama deliver a speech. There is a point when years of education meld with thousands of hours of practice to produce a sum that is greater then the parts. This can't be taught. It is cultivated over back breaking effort and indomitable will.

Mastery is often difficult to quantitate.


There is a time when physicians also reach "the sway". It is usually after ten or fifteen years of practice when the doctor-patient relationship loses the rigidity and transforms into an elegant dance. Diagnosis and treatment are not only cogitated but also felt.

As a conductor, the doctor learns to anticipate the vibration of the instrument as well as sense the emotions of the musician.

Anyone who has been lucky enough to interact with a clinician during this period, will recognize how powerful the relationship can be.

It is a time of grace.


I worry about what is happening in medicine. We are losing our physicians at the prime of their careers. They are leaving clinical medicine for greener pastures. They are pulling back, abandoning the hospital, and cloistering their abilities behind the veil of increasingly specialized offerings.

Those clinicians who are choosing to continue are finding that they have to trade in their dancing shoes for boxing gloves. We fight with insurance. We fight with pharmaceutical companies. We fight with the government for the right to trust our instincts.

"The sway" is becoming fractured and labored.

That which has been lost,

may never be retrieved.

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