Wednesday, August 29, 2007

on the creative spirit...the role of distress, despair, and melancholy

I have often said to my friends that I will never be a great artist because I am too sane. Although spoken in jest, there is an element of truth in that notion. I am sure that if I took the time to research the biographies of renown artists, which I am not going to do, there would be support for this position. I will, however, share with you some personal, anecdotal experiences for such support.

In 1981 I left my 9 year old practice of internal medicine to pursue a career in art, working part time in a busy metropolitan emergency room. My role was to cover the vacations for the full time staff, and I did this by working full time every other quarter, and working a variety of shifts with no particular pattern. It was very haphazard and usually left me exhausted at the end of the three months.

Before the first year ended, my marriage of 18 years came to a sudden end, and I found myself in a struggle for emotional survival, facing what was to be the worst years of my life. I was a wounded soul posing as an emergency room physician.

Several years earlier, as I began the task of releasing the artist I was sure was buried somewhere beneath the years of medicine, I began carrying with me at all times, a
small sketch book. I continued to do so while on duty in the ED, and whenever possible, sketched and/or wrote about by experiences. In the 4 years I worked there I filled about 6 or 7 of these books, which in retrospect, have become a vivid journal of my life, as well as a repository of some of the best on the spot drawing that I have ever done, at least in my not so humble opinion.

But even more impressive to me was what soul healed, my sense of well being improved, I fell in love and married a wonderful woman, and I left the emergency room. I began working in an urgent care facility with no evening or night hours, about 20 hours a week, seeing only minor illnesses, injuries,and aches and pains. I continued to carry my sketch book, but to my surprise and dismay, found that I was no longer inspired to draw and write, and when I did, it was worthless dribble. The cutting edge was gone, the tension, anxiety, and stress all but disappeared, leaving only pabulum in its place. And nowhere was this more evident than in my sketch books, which I eventually put away.

Tuesday, August 21, 2007


From the journal, 2-15-03

It has not been the best of days; Patience left for a dog show early this morning with 3 of the whippets, it has been raining all day, and I am not feeling well. For the past several days I have been experiencing increasing fatigue and malaise, especially later in the day, but today it began much earlier. I tried working in the studio but with little success. I did manage to run a few errands, and that left me feeling exhausted. Thinking that what I needed was to be more active, I began walking the dogs when there was a break in the rain. We completed the first walk, but shortly after starting the second the rain returned, resulting in a very short walk. Finally, I gave in to the fatigue and the rain and gave up on being “productive”.

With the dogs settled in the front of the TV room fireplace I quietly made my way to the day bed in my study. Before I could get horizontal Maria was by my side, and I had no choice but to invite her to join me. No sooner had we settled down when Giaccomino appeared and quickly made himself comfortable next to me. Then, within minutes of one another we were joined by Delia, Fat Charlie, and Lucianno. My quiet retreat had become a canine communal event...Giaccomino under my left arm, Dehlia under my right arm and draped across my chest, Fat Charlie below her with his large head resting quietly on my belly, Maria beside my right leg, and Lucianno between my legs.

My initial thought was, this is a helluva way to relax, with 5 whippets drapped all over me. Unable to move freely, I wondered what I should do when I began to feel the heat of my companions, followed by the realization that they were there because they wanted to be with me...near close as physically possible, and that was not something to be taken for granted, but to be appreciated. I should consider myself fortunate, to have this affection so unequivocally bestowed upon me. Then I felt the heart beats, the irregular whippet hearts, beating intermittently against my chest, my arm, and my legs, and I knew that my 5 small friends were giving something to me. Something wonderfully therapeutic was being transmitted with each heartbeat and with the warmth of their unselfish bodies.

That was late yesterday afternoon. I have felt well since then.

Sunday, August 12, 2007

The Gas Issue

I have practiced medicine long enough to call a fart a fart. This may not seem like a milestone worth noting to some people, but me it carries a certain significance. For years I’ve heard myself asking patients: “ have you passed gas”, “have you broken wind”, or," have you passed any flatus since your surgery”? so many times, a patient sitting on the exam table would tell me about their gas problem, and I would have to discern, is this belching, or farting. Asking if they passed gas or broke wind sounded so ridiculous to my ears, and I’m sure most patients felt the same way. Adding to my distress about this “situation” has been my firm conviction that as a society, we are all farting more. So, one day I decided to take matters into my own hands, figuratively of course, and when someone complained to me about their gas problem I simply asked if they meant belching or farting. The brief look of confused but pleasant surprise on their face was quickly replaced by relief, realizing they would not have to hear those other ridiculous phrases. (from the journal, 2002)

Friday, August 10, 2007


Have I Told You Today That I Love You

A father’s words to his children

Written and illustrated by William F. Renzulli M.D.


The author is a physician and an artist, and indeed this book is lavishly illustrated with his bold, colorful, imaginative paintings. But in his words we see a father dedicated to the task of passing on to his children the wisdom and values he holds so dearly. His writing, grounded firmly in personal experience, is clear and succinct, each message confined to a single page. His comfort and confidence in each subject is evident, whether it be claiming a personal destiny, finding God, or dealing with love, marriage, and friendship. Facing each page of the father’s reflective text the reader is treated to one of the artist's vibrant illustrations. This small book belongs on the bedside table of everyone embracing the challenge of finding their own unique path in life.

Wednesday, August 8, 2007

Being a physician means...

Medicine has been my life’s work for over 40 years, full time for all but 12 years. For 20 years I practiced general internal medicine, and 12 years were spent in emergency rooms and urgent care facilities. It is from this broad experience that my opinions and observations are drawn. I have experienced medicine before and after the introduction of managed care and have seen the effects or market forces on my profession. As you will see in the progression of this blog I am critical of many of these effects.

The opinions I express are mine alone; I do not claim to speak for any group, association, or other formal agents of the medical profession.

What follows was written for my daughter Beth who practices internal medicine in Delaware. She is a wonderful physician (an absolutely objective opinion) and I am immensely proud of her.

1. Be yourself

Patients know that you are the doctor, so there is no need for posturing or being doctorish. Just be yourself, comfortable and relaxed, and talk to or with the patient as you would with a family member or friend. Don’t be afraid to share some of yourself with the patient, it will greatly enhance the relationship, put them at ease, and encourage them to be more open with you. Don’t hide your person behind the persona of the physician.

2. Smile

If there is any one single thing you can do to help a patient (or anyone else) feel comfortable, it is to smile. Nothing is more intimidating than a somber or stern appearing physician approaching a patient, especially one is sitting there partially or completely disrobed and overwhelmed by some specific concern or worry. And, unless the clinical circumstance dictate otherwise, or your own personality precludes it, use humor as a tool to win the patient’s confidence and help put them at ease. There is no reason why a visit to the doctor’s office can’t be pleasant, if not fun.

3. Be attentive

The patient deserves all of your attention. They have only a few precious minutes in which to tell their story, and they need to know that you are listening. It is not necessary to sacrifice this in order to use time more efficiently.

4. Anticipate a patient’s fear or concern

It is not always enough to listen to the patient’s complaints; sometimes it is necessary to anticipate those fears and concerns that they are unable to articulate. For example: a patient with an obviously benign symptom may have a real, hidden fear of cancer, so great that they are unable to even ask about it. It is a good habit to end each patient encounter with the question...”do you have any questions”, or, “have I addressed all or your concerns, or even, is there something you are really worried about or afraid of”?

5. Be respectful

Being a physician does not give us the liberty to disregard the usual rules of etiquette and behavior. Unless invited to do otherwise, address all patients, especially those older than you, as Mrs. or Mr.. A good general rule is: if you wish to be called Dr.....then address your patient as Mr. or Mrs., or Ms. Once a long term relationship has been established, first names may become appropriate.
Respect children and adolescents. Address your questions to them and not their parents.

6. Be tolerant of the weaknesses of others

Accept people for what they are, and do not be too quick to judge them if they don’t meet your own standards of behavior, lifestyle, and living habits. Remember, everyone is entitled to poor judgment. Your task is simply to make sure that they have the right information on which to make that judgment. Don’t get in a snit if a patient doesn’t accept your wise advise.

Recent acrylic 48x60"

Monday, August 6, 2007

Journaling, is it for you?

Many of my postings will be taken from my journals, usually with some editing and revising. I began writing in a journal in the mid to late 1970’s when I discovered it to be a useful tool in helping me get through n very tumultuous time in my life. What was initially a haphazard exercise initiated by emotional turmoil and confusion soon became a daily routine. For the past 30 years I have started t every day with 15 to 30 minutes spent in my journal. It helps in so many ways: to clarify my thoughts, to understand my feelings and my behavior, and to see solutions to what I thought were hopeless problems, to name just a few. The entries may be mundane and diary-like, deep and soul searching, or simple silent cries for help, depending on what my needs may be.

From the beginning I have written on paper kept in a 3 ring binder using only a fountain pen. On rare occasions I had to resort to ballpoint or felt tip pens and hated them. During the winter of 2002-2003 I developed rather severe arthritis in my hands that was severe enough to make writing impossible, and I turned to the computer. Fortunately the arthritis resolved completely in several months and I could return to my fountain pen. What I find interesting is that while the computer is my preferred means of all of my other writing, it simply doesn’t work for the journal. For some reason I need the feel and the intimacy of pen and paper and the freedom from format and grammar that the primitive instrument provides. I get pleasure out of the feel and the sound of the pen moving across the paper. There is a more direct connection between my emotions and the words as they escape from the pen than there is with the computer. In addition I can place words and lines wherever I want them, using the spacing and placement of text to emphasis my thoughts or ideas, something I can’t do with the computer. Of course whether or not anyone can read my writing remains to be seen. Perhaps that is another advantage of the pen and paper.

Getting Started

I have thought about starting this blog for a long time, always putting it off because I could never clearly define its intentions and format. It finally occurred to me that if I waited to have all the i’s dotted and t’s crossed it would never happen. So, here it is; along with millions of others I have stepped into the world of blogging.

I consider myself an incredibly fortunate man, blessed not only with amazing parents, family, and wonderful people in my life, but also with circumstances and opportunities to pursue a life of my own design. At least one of my intentions in this blog is to pay homage to those who have contributed to my successes and wellbeing.

I claim the right to deviate far of course from time to time as the spirit moves me, and, on occasion (or even occasions) to use this venue to promote my commercial endeavors.

My goal is to have one to three postings a week. If you think this site would be of interest to others please feel free to pass it on to them. Your comments and other feedback will be appreciated.