“I’m a big believer in the idea that someone can come into your life for a very short period of time and have a massive influence” - John Danaher
Rare and valuable skills are useful. In the Physical Therapy world mid-2010s, dry needling, a treatment visually similar to acupuncture, fit that role. I got trained, which brought a steady stream of referrals, often from other clinicians who were punting when other forms of treatment were failing.
I remember a patient with persistent headaches referred by an excellent colleague. Let’s call her Mary.
Treating headaches can be a dicey differential diagnosis as causes range from stiff necks to brain tumors. Dry needling and manual therapy can be a very effective treatment for some forms of headaches. Consequently, parsing out what’s in front of you is critical.
In this particular case, treatment provided a couple days of substantial relief before normal symptoms would return. The temporary relief created a dependence that was difficult to break free from. It was a short term blessing and a long term curse.
When symptoms never sustainably resolved, we tried considering other factors. She was as hairstylist whose on the job demands seemed to be a causative factor. I traveled to her workplace on my lunch break and performed an assessment to see if there were ergonomic elements that might be modifiable.
Headaches, with their plethora of potential causes and influences, can create a dense fog of opacity that can be hard to navigate.
After several months, she was still a regular, obtaining no lasting benefit. My recommendations for other solutions likely didn’t have a compelling certainty behind them.
I didn’t know the answer. Maybe it was outside my realm.
When you don’t know the answer, how do you know it’s outside your realm?
One Sentence
Sometimes the solution doesn’t involve a complex web of logic.
Sometimes, all it takes is one sentence.
This sentence shines a light, lighting a flare within the darkness engulfing the patient’s condition. In this case I could not find that sentence.
I ultimately sent her back to my colleague. She was his problem again…
The Upper Left-Hand Brick
“He’d been having trouble with students who had nothing to say. At first he thought it was laziness but later it became apparent that it wasn’t. They just couldn’t think of anything to say.
One of them, a girl with strong-lensed glasses, wanted to write a five-hundred word essay about the United States. He was used to the sinking feeling that comes from statements like this, and suggested without disparagement that she narrow it down to just Bozeman.
When the paper came due she didn’t have it and was quite upset. She had tried and tried but she just couldn’t think of anything to say.
She was very serious, disciplined and hardworking, but extremely dull. Not a spark of creativity in her anywhere. Her eyes, behind the thick-lensed glasses, were the eyes of a drudge.
It just stumped him. Now he couldn’t think of anything to say. A silence occurred, and then a peculiar answer: “Narrow it down to the main street of Bozeman.” It was a stroke of insight.
She nodded dutifully and went out. But just before her next class she came back in real distress, tears this time, distress that had obviously been there for a long time. She still couldn’t think of anything to say, and couldn’t understand why, if she couldn’t think of anything about all of Bozeman, she should be able to think of something about just one street.
He was furious. “You’re not looking!” he said. A memory came back of his own dismissal from the University for having too much to say. For every fact there is an infinity of hypotheses. The more you look the more you see. She really wasn’t looking and yet somehow didn’t understand this.
He told her angrily, “Narrow it down to the front of one building on the main street of Bozeman. The Opera House. Start with the upper left-hand brick.”
Her eyes, behind the thick-lensed glasses, opened wide. She came in the next class with a puzzled look and handed him a five-thousand-word essay on the front of the Opera House on the main street of Bozeman, Montana. “I sat in the hamburger stand across the street,” she said, “and started writing about the first brick, and the second brick, and then by the third brick it all started to come and I couldn’t stop. They thought I was crazy, and they kept kidding me, but here it all is. I don’t understand it.”
Neither did he, but on long walks through the streets of town he thought about it and concluded she was evidently stopped with the same kind of blockage that had paralyzed him on his first day of teaching. She was blocked because she was trying to repeat, in her writing, things she had already heard, just as on the first day he had tried to repeat things he had already decided to say. She couldn’t think of anything to write about Bozeman because she couldn’t recall anything she had heard worth repeating. She was strangely unaware that she could look and see freshly for herself, as she wrote, without primary regard for what had been said before. The narrowing down to one brick destroyed the blockage because it was so obvious she had to do some original and direct seeing.”
—Robert Pirsig, Zen and the Art of Motorcycle Maintanence
Beautiful. The passage above speaks to the creative process in powerful language that has stuck with me for a long time.
It’s essence doesn’t involve a scientific proof or an argument.
A lecture on the evidence-based elements of creativity would not have resonated with this student.
Instead, the teacher spoke in such a way that lit a spark within the chaos of uncertainty. That is the highest level of teaching and mentorship in my opinion.
Narrow it down to the upper left-hand brick…and off she goes.
1 sentence.
Fog
The dense fog surrounds you, encroaching on every element of your being. You step carefully, slowly with your arms cast out in front of you as you navigate about the hopeless maze. You’ve been moving forward for a few minutes now, or have you? Has it been days? Hours? Years? You can no longer tell.
You turned awhile back, but can no longer maintain a sense of direction. You’ve walked miles and miles, but might be in very place you started.
You hear a snap off in the distance. You orient your view as a bright and elegant flame rises. A faint pathway emerges toward it. There are no footprints, you’ve never been this way.
Hope and potential rise as you make your way closer on this illuminated path. Something is different this time. You aren’t failing in the way you were before.
No one needed to sit you down and explain the technical details of how you could find this path. You were already capable, you just needed the flame.
Lister and Danaher
Sometime in the 1990s…
Dean Lister, an up and coming United States grappler, is invited by Matt Serra, another grappler with a bright MMA future, to visit Renzo Gracie Academy in New York City. Both are brown belts at the time, not well known martial artists.
Lister visits for 3 days. During that time he has a 3 minute conversation with John Danaher, a purple belt at the academy with a diverse background to say the least. Lister and Danaher discuss leg locks, an underdeveloped and heavily shunned element of jiu jitsu, which Lister is using with notable success at the time.
Lister makes one comment to Danaher which changes the future of grappling…
“Why would you ignore 50% of the human body” - Dean Lister
Danaher goes on to develop and entire system of leg locking that revolutionizes the quality of grappling and becomes perhaps the greatest Jiu Jitsu and MMA coach of the last 20 years.
They never spoke again. 1 point of view, 1 light, 1 spark to shine a light upon and area that had long been dark.
1 sentence.
Do You Remember Mary?
Over 5 years after Mary, I reconnected with the colleague of mine who referred her.
As we were catching up, he said something that made time stop…
“Did I ever tell you what happened to Mary???”
I froze. I dread moments like this. One of my worst fears is missing a sinister condition that I should not have.
My heart raced as I waited for him to inform me of an ominous brain tumor she had died from or perhaps the dreaded vertebral artery dissection that I should have caught and immediately referred her out for.
As I braced for the worst, I’ll never forget the words that came out of his mouth…
“She went on a gluten free diet. Her headaches completely resolved”.
That was the light. I missed it. Thankfully someone else was able to shine it.
All she needed was one sentence…
“I waited all afternoon and evening” he said.
“He appeared with the first stars of the evening. I told him what I was seeking, he asked me if I ever transformed lead into gold. I told him that was what I had come here to learn.”
“ He told me I should try to do so. That’s all he said: ‘Go and try’”
- The Alchemist