Every time I caught a fish, I wondered how something so small could have such clear, pure strength. It kept reminding me of another sensation, from another realm. The fish on the line, I eventually realized, felt like the baby, kicking inside you. Or the shocking, life-hungry pull of the baby on the breast. Perhaps fishing is like quickening for men, a long and patient wait for a few electric moments when they feel connected to another life.

Hasn't anyone thought to look at outcomes as a logical way to figure out what really works? Not until recently. That tells you how far out of the picture the patient has been.

There seems to be a hole in the culture where mothers went. Then, when their kids went off to school or stopped having ear infections every three weeks, they emerged from the mother zone, and like everyone else, they forgot where they'd been. Amnesia surrounding motherhood is the rule, not the exception.

Simple intervention - the time spent with a patient - is a very powerful ingredient of the patient-doctor contract. The evidence is against the traditions such as surgery for back pain being true - the evidence says it doesn't work.

Given the ... multidisciplinary philosophy, I was surprised by the absence of alternative pain approaches - the whole spectrum of cranial-sacral massage, healing-touch therapy, and other hands-on skills that are a lifeline to many people with chronic pain. Alternative therapie are hard to evaluate, but that's no reason not to explore them.

When a mother comes home with her new baby, she will find her abstractions are all concrete now. 'Freedom' now means being able to take a shower. 'Mobility' means being able to reach the glass of water on the dresser while not breaking the baby's suction on the breast. 'Flexibility' means being able to push the Record function on the VCR without dropping the baby.

Motherhood is like Albania- you can't trust the descriptions in the books, you have to go there.