Diagnosis, Discernment, and Birding: Part 2

A few weeks ago one of those “scary” messages popped up on my car’s dashboard screen. 

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Next step – get on the internet. 

It turns out that the key thing is to look at the grille shutter to see if there is anything stuck in it. If it’s stuck open there isn’t a problem. If it’s stuck close it’s still not life (or car) threatening unless the engine overheats. Sounds straightforward… but, you have to know where to look. 

Since (of course) we were over 200 miles from home when this happened, we went to the local dealer and asked if there might be someone who could look to see if it was stuck open or closed.

“We’d have to run a full diagnostic scan first.”

“But we just need someone who knows where to look to just look.”

“We can’t do that. There aren’t any technicians available and they require the scan first.”

(At this point we decided to take our chances and assume it was open)

“You know, we are both doctors…”

He interrupted to say “So you know how important CT scans are!”

I smiled and said, “Not if all you need to do is pull out a splinter.” 

from The Making of a Diagnostic Mind by Alexandra Sifferlin

The art of diagnosis in medicine starts, very importantly, with the story. It’s actually astounding how often that will make the diagnosis. At the very least, it narrows down the possibilities. (which we call “the differential”). 

The physical exam is next, to refine the differential diagnosis and guide you in deciding which tests to order. Even if the triage team has ordered the tests first (like in a busy ER) it’s still very important to go through these steps in order, starting with a “blank slate” so you don’t fall into the trap of the many ways our brains succumb to bias (especially anchoring bias).

Designed by John Manoogian III

What makes this process, the art of diagnosis in medicine (as opposed to my car) unique is the intent. Because we always go through this process for someone else. We make a diagnosis as the first, important step in healing another human being. 

Photo by Mary Brandt

Birding is about healing ourselves

We don’t “diagnose” a bird when we go birding. There are some similarities – We look at “field marks” and listen to the songs the same way we collect data from a patient. We also create a “differential” i.e. the list of birds that fit our findings. 

But there’s is one big difference – the intent. Birding is not something we do for someone else, it’s something we do for ourselves. 

Photo by Mary Brandt (on the way to High Island via the Bolivar Flats)

There’s a reason so many people flocked (no pun intended) to parks during COVID to take up birding for the first time. It’s a focused way to be outside and experience a little bit of forest (or lake, or field) “bathing”…to connect with sounds and sights that resonate on a soul level.

Anyone who birds a favorite park over and over knows intuitively why they keep going back: It just feels good. Being in nature—pausing in it, sitting with it, discovering its wonders—brings a sense of calm and renewal.

audubon magazine

Discernment is about healing the world 

And then there’s discernment, which comes from a different, deeper intention. 

“Discernment” implies more than than just identifying a bird or making a diagnosis. We discern the difference between right and wrong, the correct path in our career, which of two important choices we should make … in other words, discernment helps us find our way in a moral or spiritual sense. Which is why discernment can be is a spiritual practice based on “noticing the movements within your heart and soul — your desires, thoughts, emotions — and identifying where they are coming from and where they are leading you.” 

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Compassionate action emerges from the sense of openness, connectedness, and discernment you have created.

Joan Halifax

Don’t Look Away

Photo source

It’s a hard morning in the world today, a morning that follows a series of hard mornings. I feel like we are being inundated with surplus suffering, that our world is carrying so much pain. But as much as we would like to look away, it’s not what this moment calls for.

We need to nurture hope.

Last year, Rebecca Solnit wrote this essay about the despair many of us are feeling.. .and what to do in response to that despair. She helped me understand how to respond to feeling overwhelmed by darkness, how to reclaim our agency so we can shine light into the world.

Hope is a discipline, not a feeling. Which means, like all disciplines, it can be nurtured by specific practices – telling the truth, showing up, being angry (and using that anger appropriately), courage, and using stories to restore ourselves and our communities.

Tell the truth. We don’t have pretend things are ok or try to gloss over the horror of blood on a beach after a celebration of light, in fact it’s a disservice if we do.

When we choose hope we become part of the movement that boldly looks hatred in the face and says out loud “Not this.” When we choose hope, we hold space for others so they, too, can begin to see the possibility of change.

Mary L. Brandt

Show up, don’t give up. Presence is far more powerful than most of us give it credit for. Choosing to not look away is a form of presence. So are vigils, cards written to console, protests, prayers, and quiet petitions.

First of all, hope does not mean saying this is not bad, and it does not mean saying that we can defeat it. It just means saying we will keep showing up. That we will not give up.

Rachel solnit

Be angry. Rebecca Solnit quotes Rev. Dr. Renita J Weems who reminds us that “rage is a form of prayer” because rage is not primarily about anger, it’s about the love and care that underlies that anger. Use the anger as fuel to carry out what love demands of you.  

“The true soldier fights not because he hates what is in front of him, but because he loves what is behind him,” GK Chesterson once wrote, explaining why it’s so easy to lose sight of the prime mover that is love.

Rachel solnit

“Make your mind an independent republic of hope.” This may be my favorite of these disciplines. Human beings are hard-wired for fear. We can’t change our primitive (and protective) fears…but we can choose to override them. Said a different way – We can let ourselves be “colonized” by fear (which is almost always what lies beneath hatred and anger) or we can courageously choose to be “an independent republic of hope.”

“Hope it’s not something you’re born with, it’s something you make. It’s something you decide. And then it’s something you do. You get up every morning and you make it again. The next day you put it on just like you put on your shoes.”

Barbara Kingsolver

Study the heroes. Remind yourself (and your fearful brain) that there are teachers of hope we can emulate. It’s not just about looking for masters of hope… There are heroes of hope everywhere. By all means read about the heroes of history, but don’t forget to look for small acts of heroism, too … acts of kindness or courage, signs of solidarity, courage in the face of oppression.  

We learn who we are and our place in the world by telling stories. There is none more familiar or beloved than the hero’s journey, the tale of one who bravely decides to go into the unknown. It is a universal narrative, spanning time and culture. Yet as the spiritual writer Henri Nouwen once observed, “the most personal is the most universal, the most hidden is the most public, and the most solitary is the most communal.” Hearing another person’s courageous journey, we can’t help but consider our own.

Mariann Budde

Lay up stores of love, care, trust, community and resolve. The practice of hope, of refusing to give in to despair, requires great care. There are times when the darkness feels overwhelming, times when we all need to be able to access our stores of spiritual nutrition and support. Take care of yourself, build genuine community, and keep your moral compass in good working order for the times you will really need it. Make it a practice to collect stories of love, care, trust, community, and resolve, stories you can return to when your reservoir of hope runs low.

The Universe is made of stories, not of atoms.

Muriel Rukeyser