Volume 56, Number 3 - Summer 2010

 

By Stephen Weiss, MD

I have been in practice at Kaiser Permanente for the last 21 years. I have a doctorate in mental health from UCSF and prior to medical school practiced psychotherapy. My bachelor’s is in American poetry.

My favorite Attending during residency had a voice like a frog with a bone stuck in his throat. He would say in exasperation, “When you don’t know what is wrong with the patient, don’t order another test. Stop, go back and take a history!!” My uncle, a psychoanalyst, gave me similar advice before I started in practice: “If you don’t know what’s going on, shut up and listen.”

I should listen more often.

For many years I’ve told my patients that anyone can quit smoking or change their diet and exercise after they have their first heart attack or stroke. I wonder out loud if they have any suggestions on how I can help them make these fundamental changes before an adverse event. What I don’t share is that life has grabbed me by the throat and demanded my attention more than once. In 2001, I had a stent placed for a 99% proximal LAD stenosis. I had ignored anginal symptoms for over a year. That got my attention. In 2004, I fell off a bicycle and had a massive intracerebral bleed and was paralyzed on my right side for almost two months. That too got my attention. 

Each time, after a few years, I forgot those lessons. As unbelievable as it may sound, I have been ignoring exertional angina for the last 12 months. I am not alone; most physicians ignore their own health. When did you last see your doctor? When did you last take your own medical advice? We all pay attention when something goes wrong. How do we listen before that happens?

Life grabs you by the throat and demands that we pay attention. 

Photography is the art of paying attention. My philosophy on how we live our lives can be seen in my photographs. I refer to the extensive shadow I use, not as darkness, but as the absence of light. I believe we start unformed in a place where light is absent, and during our lives we move from the unformed into the light that defines us.

If every good photograph tells a story, then portraits are biography. For the last five years, I have been interviewing and doing portraits of spiritual leaders in small communities, and my focus now is on such figures in the Central Valley. During conversation with my subjects, I work to find aspects of their biography that can be expressed visually with composition, pose, and how they engage the viewer. 

I began thinking about this project in biography as I traveled on Highway 5 over the years, visiting my sons in Southern California. Highway 5 had become an irritant that my wife and I sped through as fast as possible. I began to wonder who lived there and the nature of the valley communities. On a trip home, I got off above the grapevine and drove north on Highway 33 along the east side of the valley. For much of its length, 33 is a small road wandering from town to town along levees, between fields and past the industry that supports agriculture. I saw that driveways were often miles apart. Where do people in such places meet and maintain community? I decided it was in the churches, mosques, synagogues and other places of worship. 

The portraits I am now composing of the leaders of these small congregations are the stories of how they found their way to spiritual practice and what sustains them in their work. Recently I have accepted that this project has become my own spiritual quest. I am doing my best to pay attention.

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Pastor Michael Rogers, Bethany Lutheran Church, Kerman, CA

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