Today, I discovered the website of Dr. Pam Pappas, MD.  She is a local psychiatrist and homeopath here in the Phoenix area.  In shuffling through her various writings, I came across the following article, which really speaks to me.  Thanks, Dr. Pappas, for your beautiful writing – and the dose of hope all true healers (even those of us “in hiding”) need as we navigate the mess that our medical system has become.  It is up to us to preserve and expand the habitat… and to find our place within it.


Pamela A. Pappas MD, MD(H)
© 2005
Ivory-billed Hope

Imagine yourself deep in southern woods, your kayak gliding through swamp water studded with giant cypress and tupelo trees. Your paddle stirs decaying tannin-brown debris; pungent air fills your lungs and moistens your skin.    Your senses are attuned to beauty, movement and sound.  You know what lives here — or do you?

In these hardwood marshlands, there used to live a woodpecker so big, so raucous, and such a feathered spectacle that people called it the “Lord God Bird”.  Also known as the Ivory-billed Woodpecker, it was nearly two feet long in black and white splendor, had a three-foot wingspan — and beneath its red pterodactyl crest, had fearsome, glinting yellow eyes.  It definitely got the attention of naturalists wanting to shoot it or draw it!

Image courtesy

Alexander Wilson had done both in 1809, smuggling a live Ivory-billed Woodpecker into a Wilmington, NC hotel even though it shrieked loudly beneath his coat.  Locking the bird in his room, Wilson left briefly to tend his poor frightened horse.

Dust and flying bits of plaster greeted his return a few minutes later; the bird clung near the ceiling, having pecked a 15-inch crater in the wall for escape!  After a frenzied wrestling match, he tied its leg to the room’s mahogany table.  Then he
wondered: could the bird be hungry?  He ventured into town for something it might eat.  Re-entering his room (without any beetle grubs, unfortunately), Wilson found the angry bird atop what was now a pile of mahogany chips.  He drew quickly, while
the furniture lasted!

He later wrote:  “While [I drew him] he cut me severely in several places and, on the whole, displayed such a noble and unconquerable spirit, that I was frequently tempted to restore him to his native woods. He lived with me nearly three days, but
refused all sustenance, and I witnessed his death with regret.” *

Though it had previously ranged from Texas to North Carolina, people thought this bird extinct since the late 1800’s.  After all, the Civil War had left them with an insatiable appetite for wood to rebuild their homes.  So they cut down the forests in
which the Ivory-billed Woodpeckers found their food . . . and these majestic birds gradually disappeared.

That is, they disappeared except in the imaginations of a few optimistic souls who kept searching for them.  Every now and then someone would tantalize with questionable sightings, but the bird is frequently confused with its more widespread cousin, the Pileated Woodpecker.   Sporting a similar wild red crest and its own cacophonous drumming, it is certainly impressive to see.  But it’s smaller, black-backed, and has a grayish bill with a maniacal, laughing cry far different from the kank-kank-kank tin-horn sound of the Ivory-billed.

Again, imagine yourself kayaking in Arkansas’ Big Woods in February 2004. A huge black and white bird flies above you, and disappears behind a tree.  Could it really be what you think it is?  Heart leaping, you glimpse it again, and want to be sure.

You call in professional birders for help.  They canoe into the same area you paddled in, just a few days before . . . and when they see your critter flapping in their binoculars, grown men weep with joy.  These two experienced ornithologists simultaneously identify a bird that has not been seen in the US for over 60 years.  It is an Ivory-billed Woodpecker, and a landmark discovery!

Science publishes frame-by-frame video footage, showing that conservation really can keep habitat alive.  Stirred at finding something feared lost, people galvanize efforts to save that deep forest bottomland.   According to John Fitzpatrick, co-leader
of the Ivory-bill search effort and director of Cornell Lab of Ornithology:

“Since the first sighting, this has consumed us. We have dedicated our time and our dreams to protecting and conserving this area. These woods are my church. There is no bird like this in the world.”

Organizations such as the Nature Conservancy, U.S. Fish and Wildlife, Cornell Lab University of Arkansas, and several others are banding together towards this goal.

It could happen in medicine too.

Imagine yourself in a swampland of managed care madness.  You wade through medical charts, endless phone calls, harried nurses, and patients with insurmountable problems overflowing their 8 minute appointment slots.  You’re hungry, having missed lunch; you have 12 patients yet to see and are on call tonight.  Your son has a soccer game that you will miss.  The insurance company is late with its payments to your practice this month, but regular with its ‘withhold’ fee. Mrs. Kleeman is dying of her cancer, and wants to talk with you about further treatment.   Her son wants to sue you because her tumor metastasized.  It is all too much, too chaotic; you just want to dictate your notes and get out of there.

In your heart there used to live a compassionate, gentle spirit who enjoyed caring for patients.  S/he felt called to medicine, and worked with genuine enthusiasm – where did this spirit go?  Its necessary habitat is dwindling, endangering survival.

Once a strong population, this physician species itself is declining.  People tell stories of having seen such individuals long ago, but are there current sightings?  Do any still live?


I am one of the optimists, knowing that the Soul of Medicine does live – even when in the background. I seek this with passion, tenacity, and openness. Physicians embodying it can be covert, remaining in the underbrush for fear of being ridiculed
or worse.  However, with enough care and attentiveness, hearts and souls can be revived so that it’s safe to come out.

What habitat do we need to preserve, so the Soul of Medicine can flourish? Community, forgiveness, and regular doses of joy might be a start.  This would be accompanied by firm individual hold on boundaries – each of us knows the time and
circumstances required for our best work and most fulfilling life.

Connection with Spirit in our own personal way might help also.  Learning to accept ourselves and each other with kindness and respect would further replenish us.  How else but well-rested, supported, and fed, can we offer ourselves to patients needing
care?   We end up flailing with beaks and claws to escape, otherwise.  An alternative might be numbness, an equally dire outcome.

The Ivory-billed Woodpecker embodies 2 archetypal poles at once: extinction and lost glory on one end, perennial hope on the other.  Thanks to a team of committed and cooperating seekers, it flies exuberantly into our awareness — live, noisy, and
vibrantly real.

This robust vitality defies pronouncements of death.   And yet, what might have happened if that first kayaker had not appreciated what he was seeing, that beautiful day in the swamp?

“I thought, ‘It’s extinct.  You can’t see an extinct bird.’  I knew it was impossible, but there it was.  It was the most wondrous thing that’s ever happened in my life.” [Gene Sparling, that intrepid kayaker] **

I believe it can be likewise for us as physicians, and for the Soul of Medicine.  Each of us needs to trust, acknowledge, and appreciate what we find within ourselves – even if it seems fleeting.    Meeting in small, intimate groups such as Dr. Rachel Remen’s Finding Meaning in Medicine and others is a way to renew ourselves, and to collectively nurture needed habitat.  Carrying metaphorical or even tangible binoculars helps too – we can be open to the miraculous, despite what’s called “impossible”.

Are we anything like this mythical woodpecker who survived in a swamp?  Can we transfer this Ivory-billed hope to our profession and those we serve?  Lord God, what a bird!  And Lord God, I believe we can.

*Hoose, Phillip: The Race to Save the Lord God Bird.  Farrar, Straus and Giroux, 2004.
** Weidensaul S: The ivory-bill and its forest breathe new life.  Nature Conservancy, Summer 2005, pp 22-31.