So talking to S has inspired me. And reminded me of all the things that I’ve given up to follow this path that I’m on.

Was it more than a year ago when E came out to S.D.? We sort of had the same conversation back then, about how the sacrifices demanded by the practice of medicine have really constrained the ability to be creative.

Except for this damned blog, I don’t really write any more. Oh, I manage to scribble something now and again into that Moleskin journal that I carry around with me. But it’s been a year, and I still haven’t made much progress.

I don’t take pictures any more either. And I don’t believe the idea that I may have just gotten sick of all the sunrises and sunsets, all the mountains and valleys and rivers and beaches here in So Cal.

My soul is dry.

The other thing I miss dearly is music. Oh, I’ve been making my iTunes Library fat, and I’m constantly running out of hard drive space. But I don’t remember the last time I sang. Or the last time I played on my keyboard, or strummed a tune on my guitar.

The question isn’t whether or not I need to do these things. The question isn’t how to balance things with work. The question is: what do I really want out of life? The Word, and the Song, have never been just activities for my amusement. They give my life another dimension, another way to express who I am. And when I’m caught up in the moment of creation, of participation, I feel alive in a way that is vastly different from how I feel when treating people in the clinic or on the wards. I’m not trying to say one is better than the other, only that one is not enough.

But medicine is a harsh mistress. For this art, must I sacrifice all other arts?

So how does it all fit in? How do I make one art give meaning to the other arts? In the same way it makes no sense to keep people you love dearly in separate spheres, never to meet or shake hands, it just doesn’t make sense to keep all these things strictly delineated.

Medicine isn’t called an art just for nothing. There is a creative dimension to it, a nurturing, a fostering aspect. In the same way that I can obsess over a stanza or a paragraph, in the same way that I practice the sequences of chords or work on the melody, there is something transcendent in healing someone (or, I guess, more realistically, optimizing them so that their body—and spirit, too—can heal.)

Oh, make no mistake. There’s plenty of science in medicine. Without it, medicine would just be empty ritual. Like the priests of Ba’al cutting themselves around the stone altar to try and coax their god to work some magic.

But for some reason, we insist on this artificial separation of science and creativity. Even when the dominant narrative of science—from Galileo to Newton to Einstein, and beyond—has been one of effusive creativity, fraught with the awe of the beauty of the intricate universe.

Advances in neuroscience that make it very clear that the brain is not a digital computer, but an emotion-based pattern recognition machine. Rather than being anathema to our reasoning processes, emotionality has always been a selective advantage. Our emotions are finely tuned over the millions of years of evolution to respond adequately to our natural environment, and while our unnatural environment sometimes wreaks havoc on our souls, we’ve adapted pretty well to that emergent behavior known as civilization.

One can interpret urbanization as a complete break from nature, but decades of the study of cities has demonstrated that city-building is not so different from other natural processes, in terms of accretion and destruction, of spread and retreat. The fractal patterns that arise from settlement and gentrification aren’t too different from those that instruct how trees form their branches and their leaves, how mountains and shorelines and rivers evolve, how neurons ramify and synapse and prune, how blood vessels grow to feed and drain parts of the body. As much as we try to deny it, we humans are children of this world, and everything we do is evidence of it.

Creativity is the basis of civilization, and to deny this makes us less than human.