max

As my regular readers know, son Max recently completed navigating the medical school application/interview process and made the decision to attend school at Case Western Reserve.

In mid-July, Eddie and I kvelled as he received his white coat (during an emotional and inspiring ceremony at the University). The year-one med students at Case are an impressive/interesting bunch of young men and women, and we were thrilled to applaud each and every one of them as they embarked on the long journey toward becoming physicians.

Max has taken it upon himself to line up opportunities to "shadow" docs from all different disciplines. This week he tagged along with a palliative care doctor. He wrote about the experience and agreed to let me share it here:

With regard to patient care and the actual palliative care doctoring, the first thing I noticed ­before we even saw a patient ­ is that Dr. M had a full hour scheduled for new patients. This relatively generous amount of time seems to me like a huge plus compared to the 15­ minute time slots that I understand are imposed upon primary care docs.

As much as I disliked God’s Hotel, the required summer reading before starting school, the author’s message about the power of ‘slow medicine’ appealed to me and was, as far as I could tell, a central tenet of Dr. M’s practice. Big plus.

Without a doubt, Dr. M’s clinical interactions with her patients stand out as the highlight of my experience. In the four hours I spent with her, we saw a whopping total of three patients, all of whom presented widely varying personal histories and demographics, but who all shared terminal cancer diagnoses. The first patient, a gentle, older black man, was sweet yet reserved. He didn’t push Dr. M with a challenging attitude or pull at my heartstrings with a particularly moving story of his diagnosis and the challenges I imagine that’s brought him. Dr. M reciprocated his gentle attitude and worked with him to make sure he was receiving the medications he wanted (emphasis on the medications he wanted) to help manage his pain.

The next patient, a middle-­aged white man, transported me straight back to my soup kitchen days with his rough­-and­-tumble ‘everyone’s out to get me and screw the world’ attitude, from which he didn’t spare Dr. M, to be sure. He spent his whole hour complaining, understandably so, ­about his pain, his bad luck in life, and the fact that Dr. M didn’t want to give him an exact timeline on how long he had left to live. When she finally relented and provided the vague answer of ‘months, not years,’ he assumed a 6­-month prognosis and let it rip from there. Expertly wading through the slew of angry and logically incoherent complaints and irrelevant questions that followed, she finally got him to crack on an issue that placed a rock­-solid lump in my throat: ‘Who are you going to talk with about your frustrations when you leave my office?’ Sadly and unsurprisingly, he couldn’t count a single person who he thought would care to hear that he was going to die sooner than later. Despite his attempts to push the world away from him as the world pushed him slowly away from it, Dr. M planted the seed in his mind ­that despite all his protests, perhaps he could talk with a professional at the hospital. But maybe ­­only if Dr. M really thought there was a top-notch person who didn’t suck like all the others he had apparently tried. Her perseverance and unrelenting care for her stubborn patient moved me and made me want to do what she was doing.

The last person we saw, a thirty­-something Latina mother of one, couldn’t have been a more stark contrast from dude number two. She smiled profusely and showed grace with everything she said as she let the chemo run its course during her chat with Dr. M. She talked about how excited she’ll be when her son makes it to college in five years, despite the fact that, as Dr. M mentioned to me afterward, she herself will have already succumbed to cancer. This woman gave me a first­hand glimpse at one of the strongest shows of courage I’ve ever seen.

That Dr. M got to participate in these incredibly trying times in her patients’ lives made me think very highly of palliative care. When asked, she told me her favorite part of being a palliative care doc is that she’s uniquely positioned to help her patients in ways that other doctors can’t. ­­ I’m inferring that she was talking about her ability to help people feel comfortable as they near life’s end.

It was an incredible experience.

Good luck to Max and all the other year-one med students. May their sense of optimism, idealism, doggedness and compassion serve them well. And here's to the established doctors who will inspire them on their journey

by the sea, by the sea, by the beautiful sea

My friend Dawn turned me on to a fascinating article in Salon.com called "Why Our Brains Love the Ocean: Science Explains What Draws Humans to the Sea." You can read the entire piece here.

Here are two of my favorite paragraphs:

"Our innate relationship to water goes far deeper than economics, food, or proximity, however. Our ancient ancestors came out of the water and evolved from swimming to crawling to walking. Human fetuses still have 'gill-slit' structures in their early stages of development, and we spend our first nine months of life immersed in the 'watery' environment of our mother’s womb. When we’re born, our bodies are approximately 78 percent water. As we age, that number drops to below 60 percent — but the brain continues to be made of 80 percent water. The human body as a whole is almost the same density as water, which allows us to float. In its mineral composition, the water in our cells is comparable to that found in the sea. Science writer Loren Eiseley once described human beings as 'a way that water has of going about, beyond the reach of rivers.'

We are inspired by water — hearing it, smelling it in the air, playing in it, walking next to it, painting it, surfing, swimming or fishing in it, writing about it, photographing it, and creating lasting memories along its edge. Indeed, throughout history, you see our deep connection to water described in art, literature, and poetry. 'In the water I am beautiful,' admitted Kurt Vonnegut. Water can give us energy, whether it’s hydraulic, hydration, the tonic effect of cold water splashed on the face, or the mental refreshment that comes from the gentle, rhythmic sensation of hearing waves lapping a shore. Immersion in warm water has been used for millennia to restore the body as well as the mind. Water drives many of our decisions — from the seafood we eat, to our most romantic moments, and from where we live, to the sports we enjoy, and the ways we vacation and relax. 'Water is something that humanity has cherished since the beginning of history, and it means something different to everyone,' writes archaeologist Brian Fagan. We know instinctively that being by water makes us healthier, happier, reduces stress, and brings us peace."

On our way back to Portland from Manzanita yesterday, we stopped off at Cannon Beach, mainly because we could see from the road that it was "socked in." (That term was first recorded in 1944, back in the early days of aviation. A pilot would have to look at the windsock to determine flying conditions. If you couldn't see across the field to check the windsock, then you had no business taking off.)

 Photographing while walking around in "heaven" is an opportunity I never pass up.

the beach

Did you happen to read the opinion piece in the NYT today about how the beach is overrated? The writer complained about getting sand in various crevices, feeling uncomfortable spilling out of her swim suit, thinking of herself as fat and sloppy compared to the toned bodies all around her, "slimy lengths of seaweed," fearing sharks, etc.

Walking along the beach in Manzanita, Oregon tonight with Eddie, the sun slowly dipping into the horizon, the sound of the surf nearly deafening, our footprints sweetly lagging behind us in the ribbons of sand, I felt nothing but complete serenity. I was also in awe of powers that are so much larger and more forceful than any of us will ever be.

Feeling happy and humble at the water's edge.

dorothea lange

Lange, by Paul Taylor, 1934

One of the preeminent and pioneering documentary photographers of the 20th century, Dorothea Lange was born Dorothea Nutzhorn on May 26, 1895, in Hoboken, New Jersey.

When she was 7, Dorothea contracted polio, which left her right leg and foot noticeably weakened. Later, however, she’d feel almost appreciative of the effects the illness had on her life. '[It] was the most important thing that happened to me, and formed me, guided me, instructed me, helped me and humiliated me,' she said.

Just before Dorothea reached her teen years, her parents divorced. Dorothea grew to blame the separation on her father and eventually dropped his surname and took her mother’s maiden name, Lange, as her own.

Following high school, Lange, who’d never shown much interest in academics, decided to pursue photography as a profession. She studied photography at Columbia University, and then, over the next several years, cut her teeth as an apprentice, working for several different photographers, including Arnold Genthe, a leading portrait photographer.

By 1918, Lange was living in San Francisco and soon running a successful portrait studio. With her husband, muralist Maynard Dixon, she had two sons and settled into the comfortable middle-class life she’d known as a child.

Lange’s first real taste of documentary photography came in the 1920s when she traveled around the Southwest with Dixon, mostly photographing Native Americans. With the onslaught of the Great Depression in the 1930s, she trained her camera on what she started to see in her own San Francisco neighborhoods: labor strikes and breadlines.

In the early 1930s, Lange, mired in an unhappy marriage, met Paul Taylor, a university professor and labor economist. Their attraction was immediate, and by 1935, both had left their respective spouses to be with each other.

Over the next five years, the couple traveled extensively together, documenting the rural hardship they encountered for the Farm Security Administration, established by the U.S. Agriculture Department. Taylor wrote reports, and Lange photographed the people they met. This body of work included Lange’s most well-known portrait, 'Migrant Mother,' an iconic image from this period that gently and beautifully captured the hardship and pain of what so many Americans were experiencing. 

As Taylor would later note, Lange’s access to the inner lives of these struggling Americans was the result of patience and careful consideration of the people she photographed. 'Her method of work,' Taylor later said, 'was often to just saunter up to the people and look around, and then when she saw something that she wanted to photograph, to quietly take her camera, look at it, and if she saw that they objected, why, she would close it up and not take a photograph, or perhaps she would wait until… they were used to her.'

In 1940, Lange became the first woman awarded a Guggenheim fellowship.

- from Biography.com

russell lee

Yesterday I emailed a link to my Eastern Kentucky pictures to everyone on my distribution list. I heard back from many - with very positive response. That always makes a photographer, who tends to work in somewhat of a vacuum, feel really good!

If you did not receive the link, here it is.

A photographer friend, whose work I admire very much, wrote that this new work reminded him of Russell Lee's (1903 - 1986). It had been a long while since I'd looked at Lee's work. I enjoyed doing so and thought I'd share some of his images here. Another photographer friend suggested shades of Dorothea Lange, whose work I'll share tomorrow.

Here's a quick bio first:

In 1927 Russell Lee married painter Doris Emrick and soon began painting. Shortly thereafter the two moved to a small artist's community in Woodstock, NY. Over the next few years Lee struggled with painting, and in 1935 he bought a camera to try to help him visually. He fell in love with photography.

During his stay in Woodstock, Lee began taking photographs that reflected his concerns for the struggling working class. In 1936 he became interested in a group of photographers in Washington D.C. that were doing socially documentary work. As a result, Lee met with Roy Stryker, the director of the photography project for the Farm Security Administration (FSA). Stryker hired Lee as well as Walker Evans, Dorthea Lange, Arthur Rothstein and others to create a body of propaganda photographs to document the success of federal rural relief projects. Soon Russell Lee was photographing throughout the Midwest for the FSA documenting the plight of farmers through the Great Depression and droughts of the 1930s. In the midst of all of his traveling, Lee's marriage to Doris ended and in 1938 he met and married newspaper reporter Jean Smith. They began working together, Lee taking the photographs and Jean writing short essays about the images. By 1940 Russell Lee was known as one of the best photographers working for the FSA.

During the next several years Lee, like many FSA photographers, helped the government with the war effort by taking photographs for the Air Transport Command. When the war ended he took a short break and then did some more work for the government photographing the conditions of the coal miners in the Rocky Mountains and Appalachia. Between 200 and 300 of Russell Lee's images were used in the fight to clean up the coal industry. In 1947 Roy Stryker contacted Lee about taking some industrial photographs for a project he was developing for Standard Oil of New Jersey. Lee's images concentrated on how oil and it's products related to peoples everyday lives. Over the next several years Russell Lee focused on industrial photography. In 1965 he began teaching at the University of Texas and this remained one of his passions until he retired in 1973.

- From the Lee Gallery website

one more

Here's another image I made at Stinson Beach. Before the fog burned off in the morning, the light was exquisite. On this particular morning, we canoed to the lagoon where the harbor seals lounge on the sand bars during low tide. Of course, my favorite image is not one of the harbor seals, but of the back of Eddie, who was sitting in the bow of the canoe.

stinson beach

I've been enjoying some family time at Stinson Beach on the California coast. Loving the light.

ida

These are stills from Pawel Pawlikowski's film "Ida." I saw this stunning film last night and have not been able to get the images, setting and characters out of my mind. Not that I really want to.

From the NYT review by David Denby: "We are so used to constant movement and compulsive cutting in American movies that the stillness of the great new Polish film 'Ida' comes as something of a shock. I can’t recall a movie that makes such expressive use of silence and portraiture."

Again, David Denby: "Clearing away clutter, Pawlikowski almost never moves the camera; many of the scenes are just long-lasting shots, fed by a single light source that often puts the faces in partial shadow (what we understand of these two women will always be limited). Sometimes the figures are positioned at the bottom of the frame, with enormous gray Polish skies above them, as if the entire burden of a cursed country weighed on its people."

These are only a few of the starkly haunting images that crushed me last night. Please go see the movie so you, too, can be moved and inspired by 80 minutes of gorgeous black and white photography on a movie screen. It's a sad, bleak tale - one that revisits one of the darkest moments in history and which raises difficult questions surrounding those who survived it.

You can read Denby's review here.