Lumps, Bumps & Lore

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Lumps, Bumps & Lore- Nancy Hillis MD & Bruce Sawhill PhD

On Friday after swimming, Bruce’s elbow blew up with no prior indication.

At one point, he set his elbows down on a table, and felt an odd squishiness in the left one.

It almost felt like an errant sock had gotten inside of his long-sleeve t-shirt in the dryer.

Upon inspection, there was a soft bump the size of a golf ball protruding from his elbow, like the cartoon character Popeye.

Popeye cartoon character. Note elbows.

It caused no pain whatsoever, but looked terrible.

Nancy, ever medically diligent, examined my elbow and noted swelling, redness, and heat.

Was it bursitis? Cellulitis? Gout?

She questioned me: Did you injure it? Is it painful? Have you been doing some kind of repetitive movement?

No, I answered to all of the above.

She researched the affliction. It appeared to be an inflammation of the bursa, a benign condition known as olecranon bursitis.

Bursas are the equivalent of lubricating oil in machinery, they are at their best when you are completely unaware of them.

In medicine there are many sayings and one of them is: “Common things happen commonly.”

Bursitis was the likely culprit, but Nancy worried about cellulitis, a more ominous malady, because it was red and warm.

She demarcated the area of redness and heat with a Sharpie marker so we could track whether it grew larger over the coming days.

Many Forking Paths: The Trailhead Problem

But then an odd thing happened.

While Nancy researched online, we ran into a case of many-forking paths. It could be this, it could be that, it needs attention, it doesn’t, etc.

Bruce calls this the “trailhead problem.”

Since we love to walk, we often find ourselves at trailheads to go into the wilderness.

This is where it is easiest to get lost, within earshot of the road.

Why is that?

Because large numbers of confused people have set out on the trail, and it takes a while for geographical necessity to squeeze the options down.

If you were to look at the area within 500 meters of the trailhead from the air, it would look like a bloodshot eyeball of meandering use trails, splitting and rejoining and randomly ending.

Typical trailhead

Too many choices!

So we made an appointment at Urgent Care.

After a 45 minute wait in a sterile room, just at the point when we thought we had been forgotten, a cheerful, seasoned MD walked in and talked nonstop for about 15 minutes.

The upshot: It’s bursitis, it’s probably not serious, take some ibuprofen if it bothers you and watch out for any worsening of the redness and swelling that might indicate more is going on.

He had seen many cases like this before, and resonated with our observation that Bruce had no idea when or how he bumped his elbow to cause the swelling.

The good news: he could continue swimming.

This is where it gets interesting.

None of what the doctor said disagreed with any of Nancy’s findings. Was it really necessary to spend a chunk of a fine Saturday afternoon in a little room with fluorescent lights and uncomfortable chairs?

We talked it over later and decided we did the right thing by coming to the clinic and getting another doctor’s eyeballs on the problem.

Lore

This comes down to the idea of “lore.”

Lore is the unwritten footnotes to any specialized action.

Our loquacious physician at Urgent Care had seen enough swollen bursa in his career to give a confident diagnosis and plan of action. It was different from reading about it in textbooks or online.

Even though the Web makes it easier than ever to access information, it can be unhelpful in that it creates the “trailhead problem.”

What does this have to do with artistic creativity?

Miles Of Canvas

This is what Nancy calls “miles of canvas.”

There is no substitute for experience, of knowing how paint will flow or dry or mix, how fingerings on the cello will affect the sound of a musical piece, what turns of phrase in your essay will emotionally resonate.

Lore & Artificial Intelligence

Those of you who follow such things may counter that there are instances in medicine where computers do a better job than people, mostly associated with imaging.

This is an area of computer science called “supervised learning,” in which a computer program is trained on “annotated” images, such as MRIs or X-Rays.

Annotated means each image used in training the program has a result associated with it obtained by human analysis, such as “tumor” or “no tumor.”

A computer program can incorporate more images than any single MD can observe in a lifetime, so it is a way of accumulating a vast amount of a certain kind of lore.

Even if the computer is better at evaluating mammograms and identifying breast cancer (for instance) than most MDs, it is not capable of replacing the judgment of the doctor, as imaging is just a small part of the diagnosis.

It’s tantamount to using a calculator for math, it is the “how” but not the “why.”

It speeds up the math but doesn’t tell you why you’re doing it in the first place and what you’ll do with the result.

Artistic Creativity & Lore

In artistic creativity, there is not a single diagnosis as there can be in medicine. Different artworks affect people in different ways.

The “trailhead problem” is not a detriment, it is an asset to discovery.

It is important to try many different approaches to see what works for you.

There is no single path that is hidden and awaiting discovery, there are many possible paths. You as an artist create your own lore by traversing the landscape of discovery.

The lore is an intertwined mix of the general and the personal, unique to you.

You must start, and start again, and keep going.

Your choice

With gratitude from our studio to yours,

Nancy & Bruce

P.S. Here’s a fun little video of my beautiful friend Dana Dion, receiving The Adjacent Possible Guidebook. Dana is one of 25 amazing artists in the book.