On Timing

Aug 13, 2022

by Fred Marshall, MD

I have been thinking about how to create spaciousness in my clinical encounters with patients and their families, and have discovered that focusing on creating space in encounters with myself and my family may be the best place to start.  

Corbett’s Glen is a lovely nature preserve here in Rochester, NY in the midst of a nearby neighborhood.  A creek cascades gently down a series of stone steps.  Now and then a bird warbles and the overhead branches sway in the breeze.  The pathway meanders gently through the woods, with just the right amount of rises and dips.  There are shady parts that open into sunny glades.  A wide variety of dogs walk their people. Time spent in ambling with loved ones here takes on a rhythm of friendliness and ease, and I invariably come away with a heightened eye for natural beauty and sense of energetic well-being.   

I have discovered that I am better at improvising on the piano after I walk in Corbett’s Glen.  Even more cool:  I am better at listening to my partner, Diane, as we improvise together afterwards, and she is better at improvising with me.  Recently, we walked for about an hour or so in the glen, then enjoyed a leisurely morning, taking breaks to sit at the piano together.  Our timing was relaxed – with Diane laying melodies on top of my chords as we explored our way into a lovely never-before-played Bossa Nova.   As we played, we discovered that we could breathe spaciousness into the music by “hanging back” with the rhythm – not playing the melodies precisely on the beat, but sometimes delaying to savor a particular dissonance before resolving it

When I’m “in the flow” with a patient, it feels like this:  there is an underlying beat that grounds the encounter, but there is time for each of us to “hang back” – to linger on a comment or let silence itself honor it.  I find that I am not so exhausted by the end of a clinic day when I have been intentional about creating this kind of spaciousness.  Preparing for a day of clinic, by reviewing the record the evening before, has made a huge difference for me in this regard.  Walking into the clinic room, greeting the patient and their family members by name, and picking up the thread of our conversation like laying down the first few chords of a Bossa Nova feels very much like strolling with them in Corbett’s Glen.  The patient’s story will come – and it doesn’t have to land on the beat – it is simply a matter of us relaxing into the spaciousness together.   

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