Saturday, June 13, 2015

The Mind and the Power of the Spoken Word

My usual drive home from work last night.  It was a late night and on these nights I get to listen to Terry Gross interviews on Fresh Air.  In two interviews, I heard two excerpts of speech that for both the content and the way they were delivered were just compelling.  Gross typically replays interviews of famous people that she has interviewed right after their deaths.  Her interviews are generally so comprehensive and have offered insights into the person that they serve as great memorials to that person and their work.  The first in an excerpt from an interview with Christopher Lee, the actor.  I have seen him in many roles, but remember him best for his work in Star Wars and Lord of the Rings.  He died last Sunday at the age of 93.  In these sentences, Gross asks him how he decided to play Dracula.  Only the words are listed below.   The interview occurred 25 years ago and he would have been 68.  Listen to the audio to capture how these sentences were delivered spontaneously:

LEE: "I never thought of him as - I never thought of him as a vampire, ever.  I mean, the blood is the life.  That's one thing you have to bear in mind.  And it is for all of us, isn't it?  Here's a man who is immortal.  Here is a man who, through being immortal, is a lost soul.  Here is a man who experiences the loneliness of evil, something he can't control, who wants to die but there is a force in him, a malefic force, which drives him to do these terrible things.  I said earlier the character is heroic, based on the real man - a war leader and a national hero, I may say, in Romania to this day - Vlad the Impaler....."

The second interview was with several people to commemorate the life of jazz great Ornette Colman who died this week at the age of 83.  He discusses how he innovated a type of jazz that was so controversial that it polarized people to the point that they would show up in clubs where he was playing and fights would break out over the music.  People would swear at him and try to strike him.  One of the musicians interviewed said that he witnessed Coleman being punched in the face over his music.  Here he tells Gross about his instructions to his fellow musicians about how to play his innovative style of music:

ORNETTE COLEMAN: "I had - originally, I had told them, I said, you know, the bass - the basics of music is first learning how to play music on the instrument that you choose to play.  Secondly, to eliminate the problems of having a style that get in the way that you think or feel.  And third is to not get so hung up in the technique of your instrument that you cannot play music anymore.  So - and I demonstrated those kind of things to them.  And since I first started, I was using just the trumpet, the bass and the drums, which was not lots of musicians at that time, so it was very simple for me to give them the information that I had figured out."

Equally interesting are the musicians interviewed and their descriptions of Coleman, his music, and the times.  They are Don Cherry, Denardo Coleman, and Charlie Haden who were all members of Ornette Coleman's quartet.  It seemed evident to me, that their performances were ground breaking.  They are all dedicated musicians at the top of their game, but more than that - they know how to work together.  At one point Gross asks Ornette Coleman a question about about working with his son Denardo.  He comments on the nature of the question and basically concludes that he likes to work with someone who knows what he is trying to achieve.  I strongly encourage listening to the recording of these men and their descriptions.

These interviews are very interesting to me from a number of perspectives.  The first is the experience of having your fantasies exploded.  If you watch a lot of films, there may be a time when you say: "I can do that." or "He/she acts the same way in every film".  That certainly might be true, but it also might be true that you are seeing a small fraction of the person in that particular role and it is difficult to have an appreciation for everything that went into it.  I have seen Robert DeNiro movies since his first critically acclaimed role in Bang the Drum Slowly.  I saw that in a dilapidated theatre in northern Wisconsin and it was apparent he brought a lot to the role.  But it wasn't until I saw him interviewed by James Lifton about 40 years later that I had an appreciation of the level of art he was exposed to in his childhood or how early he had started in acting.  

It is easier to appreciate the genius of musicians.  The only thing that is needed is an instrument and your own feeble attempts at trying to create music.  Even the most basic rock and roll requires more than casual effort.  I was trained to play cello and clarinet in grade school and high school and like most people let it slide after that.  Science and athletics seemed more important.  With the rudimentary training, I think that I can safely conclude that jazz, especially creating an entirely new and controversial style of jazz is a sign of real genius.  This excerpt from an interview with Charlie Haden, jazz musician and bass player for Coleman.     

CHARLIE HADEN:  "I was 19 years old, and we played all day long. And he had a room full of music strewn all over the floor, the walls, the ceiling; he was constantly writing music.  And he told me before we started to play, he said, Charlie, I've written these pieces now and here's the chord changes.  Now, these are the chord changes that I heard inside myself when I was writing the melody, but these are just a guide for you.  I want you to be inspired from them and create your own chord structure from the inspiration or from the feeling of what I've written.  And that way, constantly a new chord structure will be evolving and we will be constantly modulating, and we'll be listening to each other, and we will make some exciting music.  And that's exactly what happened."

I heard this and thought about the true genius of Coleman as a manager.  Imagine if you worked for a guy like Ornette Coleman doing any less complicated work.  A person who told you, well here is the basic structure of your job, but I really hope that you can innovate within these constraints and create new ways to do it.  It is difficult to find areas in life where somebody had that kind of vision in terms of people working together to create something but Ornette Coleman clearly did.

I talk to people for a living and have for 30 years - typically 60 to 90 minute initial interviews.  I don't like to impose too much structure, but I do have to cover at least 200-240 information points in varying degrees of detail.  Many of the people I talk with are like the above excerpt from Christopher Lee.  They are brilliant and have a command of the language.  Their vocabulary is excellent.  I gauge it by how many low frequency words they tend to use.  The words can't be jargon.  They have to be the same words that we all have access to in a dictionary.  I was taught at one point that there is a rough correlation between compound sentences and intelligence.  I usually comment on both the vocabulary and sentence structure in my dictations that record the results of the interview.  In some cases I comment on the emotional impact of a more objective observer - how someone standing in the room might be affected.  Psychiatrists are limited in the range of descriptors that they can use, largely because the field has limited itself to significant psychopathology.  That is fine for clear situations when those descriptors occur, but what about the majority of situations where they do not?  I like to push the envelope and explore those situations.  What if I am talking to a person who most people would see as being charismatic and that is the overwhelming aspect of the interview?  What if the person talks as if they are reading their answers out of a book containing compound sentences and low frequency words?  What if they are surprisingly different than what it says on the consult request?  Can I make those determinations?  I routinely do.

Another interesting aspect of these interviews is the time dimension.  In the course of clinical practice it is common to hear clinicians compare notes on how they conduct their clinical practice.  There are various external and internal rules applied to come up with the duration of interviews.  The entire duration of the interviews with Lee and Coleman were 15 minutes or less, but they were excerpted from longer interviews.  In psychiatry at some point, a decision by the psychiatrist is made about how much (if any) non-clinical discussion can occur.  The clinical discussion is driven by the billing and documentation guidelines determined by governments and insurance companies.  I have found that rarely accounts for all of the relevant treatment factors.  At the minimum, there is some source of stress at home or at work.  Some additional issue or question that requires a more detailed discussion.

In other interviews, I hear amazing stories like Charlies Haden's description of meeting Ornette Coleman.  One of a kind experiences from the full range of absolutely inspiring to absolutely traumatic - communicated to me with a full range of positive to negative emotions.  Not everyone is a genius, but everyone has a story to tell or history to give.  I have spent all of my life spinning that information down to see if there are any syndromes in that hinterland that is two standard deviations out past most human behavior.  I don't really know when it happened but at some point, I realized the importance was in all of the information.  I realized that when somebody says: "How much time do we have doc?" or "Do you want the short version or the long version?" that the correct answers are "All the time you need." and "The long version."  If the long version gives enough detail about the person's life, it allows me to say: "There is absolutely no way that you have that diagnosis from the history you just gave me."  It gives me more than enough to answer the more common question: "So doc - am I crazy?"

You never really know the whole story without all of that information communicated directly to you by the person who lived it.

George Dawson, MD, DFAPA


Listen Back To A 1990 Interview With Actor Christopher Lee - June 12, 2015  Interview and Transcript.  NPR Fresh Air with Terry Gross.

Fresh Air Remembers Jazz Innovator Ornette Coleman - June 12, 2015  Interview and Transcript.  NPR Fresh Air with Terry Gross.


The photo of Ornette Coleman:  By Nomo michael hoefner (Own work) [CC BY-SA 3.0 (], via Wikimedia Commons.


  1. Wait, you mean Charlie Haden had to be in the room with the rest of the band and constantly paying attention to subtle clues? Why didn't he just mail in some tapes of walking bass lines? I guess free jazz in 1960 hadn't gotten the memo on the wonders of collaborative care.

    1. There are also lessons here for the way doctors are managed in health care systems. Every one of those managers that I have ever met could take a lesson from Ornette Coleman, instead of applying the usual micromanagement techniques, telling physicians to just work faster, or that the most creative part of their work (teaching and research) did not "count" in terms of productivity. Coleman was all about an innovative high quality product.