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Dr. Jeff Kane: On fantasizing

Dr. Jeff Kane
Columnist

A dermatologist spoke at a medical education lunch at our local hospital. Typical of his specialty, his talk featured color slides depicting skin lesions. Some photos, of course, challenged the audience’s ability to continue eating, but we’d known to expect that.

Describing a slide, he said, “This illustrates the kind of lesion you get with Type A skin.” With the next slide, he said, “This one, though, is more characteristic of Type B skin.”

On and on, Type A and Type B. Finally, one doc said, “Excuse me, but I’ve never heard of Type A and Type B skin. Where is this in the medical literature?”

The dermatologist looked shocked. He said, “It’s not in the literature. It’s my fantasy.”

Does pain exist just to torture us, or by demanding our attention might it encourage us to change our behavior?

The room erupted. Several attendees, outraged, pounded the table and stormed out. The presenter called after them, “What’s the matter? Don’t you fantasize?”

I guess not. They wanted facts.

Call me deviant, but I was delighted by the presentation. Where would science be without fantasy? It inevitably precedes those rare gems, facts. Scientists have no idea what to explore in this universe until they murmur, “I wonder…”

Albert Einstein, arguably the archetypical scientist, hardly ever entered a laboratory. His revelations came to him while lying on his back in his sailboat on a Swiss lake, daydreaming, wondering. He wrote, “The most beautiful experience we can have is the mysterious. It is the fundamental emotion which stands at the cradle of true art and true science.”

So I’m happy to admit it: I fantasize continually, often about healthcare.

For example, I wonder if illness bears rhyme and reason. Is it always an unmitigated misfortune, or, by temporarily evicting us from our regular habits, does it offer us the opportunity to examine our lives? I wonder if pathophysiology (what goes “wrong” in our workings) might sometimes be a form of body language — our deeper selves expressing an encoded message. Does pain exist just to torture us, or by demanding our attention might it encourage us to change our behavior? When is it OK to die?

Here and there I see a few docs who wonder, too, about the source of their patients’ illnesses and sometimes even express that to them. As poet — and pediatrician — William Carlos Williams observed, “To treat a man as something to which surgery, drugs and hoodoo applied was an indifferent matter; to treat him as material for a work of art somehow made him come alive to me.”

Jeff Kane is a physician and writer in Nevada City.


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