musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

Who has heard the seasons pass?


Is absence the same as presence? Is it simply the opposite end of a spectrum in which both have identifiable, if different, properties? If something isn’t there, we don’t see it, and although we can maybe imagine it, that’s not really seeing it, is it? Surely the presence of something exists in a different Magisterium than its absence: a different order of being, perhaps. ‘To be, or not to be: that is the question,” as Hamlet says, contrasting existence with non-existence, although in an admittedly different context. When a thing is not, it cannot share the same properties as a thing which is though… Can it?

How about a different thing: sound? I am not alluding to the old question about whether a tree falling in a forest with no one around to hear it really makes a noise; I resolved that to my satisfaction before I left high school. Nor would I stoop to the solipsistic befuddlement that any sound not heard by me does not exist -although I only changed my mind about that after I foolishly attempted to argue my case with a philosophy professor in a university seminar.

Still, in terms of sound, I must confess that I remain confused. Can its absence exist for me as an object -an entity which I can actually hear and process in my brain? Is silence, in other words, a thing? Until I happened upon an article in the Scientific American, I would not have thought so.[i] Short silent intervals were introduced in a recording of a noisy room and then participants were queried as to how long one silence lasted compared to another. The same has been used for interspersed sound beeps with similar results. In other words, we process sound in a similar way that we process silence: we hear them both.

Of course the poets have known this from the start, but until the Simon and Garfunkel song The Sound of Silence, most of us didn’t give the idea much thought: it was a powerful metaphor, perhaps, but hardly scientific. And yet, think about it: ‘If silence isn’t really a sound, and yet it turns out that we can hear it, then hearing is more than just sound,’ as one of the authors of the study said.

Actually, I suspect we already knew this: as the saying goes, ‘Silence speaks louder than words’ sometimes, doesn’t it? In fact, though, we often hear other things in a sudden silence like, say, traffic outside the window, the person sitting in the next seat breathing, or maybe even the sound of our own heart beating; silence –true silence- can be elusive. But the fact that we can time its duration, suggests that at the very least we are timing something; you can’t time nothing… Come on, eh?

It reminds me of the long-time fascination I have had with holes -yes holes. I wrote an essay about them a few years ago entitled Holier than Them.[ii] I mean, can a hole exist without the accompanying non-hole that surrounds it? Like silence, does it not depend on something to which it can be contrasted? Of course, you can measure the dimensions of a hole, just as it would appear you can measure something about a silence, so where does that leave us…?

It seems to me that with both silence and holes, there is something that is special, although I’m not quite sure what. Perhaps it may be the boundaries that define them; they both seem to require contrasts to delineate their presence. Neither a hole nor a silence can have an independent existence without acknowledging their dependence on something which they are not; a day is not a night, but requires the absence of a night to define it as a day… much, I suppose, as ‘tall’ depends on its difference from ‘short’. Neither are useful concepts without a comparison as a gauge. Okay, I’m becoming as much at risk of becoming entangled here as silence is with, well, non-silence.

I’m retired now, but in my former busy life as an obstetrician/gynaecologist in clinical practice I quickly recognized that at times my job was not so much to do something, as to listen. Remaining silent can often be as therapeutic as offering suggestions; I began to realize that listening is a form of boundaried silence as much as the batter of a doughnut is the container for its hole. I suppose listening is not nothing, because there are facial expressions and body language that also define its boundaries, but I suspect it is still heard albeit in a different way from what the article talked about. It, too, requires an appreciation of contrasts and edges: not-listenings, which are quickly noticed by the talker.

I remember shortly after I first opened my practice, an elderly lady came to see me with a list of complaints which I duly noted in her chart in cursive script (computer logging was still years in the future then). Apart from her voice, the only sound in the room was the sound of my pencil (I could rub graphite things out more easily than with ink, I suppose), and after a few moments I had the impression that she seemed to be talking to the pencil; when it stopped, she stopped: silence for silence. The pencil was writing, and I, well I was listening silently on the other side of the desk.

Suddenly she smiled -whether at me or the pencil, was difficult to tell at first, because her eyes seemed to be riding on the eraser end of the pencil. Finally, she sent them on an exploratory trip to my cheeks where they eventually perched and stared up into my eyes.

“You know,” she said, “I feel better already. I could tell by the way you held the pencil that you weren’t going to lecture me about my complaints. Your silence was refreshing, doctor… I suppose what I really needed was to be heard, not advised.” And her smiled broadened across her face and her eyes danced and twinkled on my cheek. She was quiet for a moment and then sighed -rather happily, I thought. “I’m old now and I’m content with that. ‘The rest is silence,’ Hamlet says at the end of Shakespeare’s play…”

I learned a lot from her, I think. The lady died a quiet death, several months later after suffering a stroke while playing golf. And me? I learned to listen; and I learned the value of silence -whether or not it’s something we can hear, if we really try…

[i]https://www.scientificamerican.com/article/do-we-actually-hear-silence/

[ii] https://musingsonretirementblog.com/2019/03/03/holier-than-them/

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