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Elementary Skills

Mastering the Fine Art of Observation

 

René Magritte, The Portrait, 1935.

 

IN 1877, AN EIGHTEEN-YEAR-OLD student slid into one of the two hundred seats arranged in a steep semicircle in the dark wood-paneled Anatomy Lecture Theatre, a new state-of-the-art classroom at the University of Edinburgh’s Medical School. The occupants of the room tittered with anticipation for the arrival of the appointed speaker, a local legend as well known for his deep knowledge of a wide range of subjects as for his dynamic delivery of it. He was going to teach the young students what he called “the Method,” a disciplined approach to diagnosis that relied on keen observation skills above all.

With a flourish, the man—tall and lean with an aquiline nose and piercing eyes—bounded into the lecture hall, tore off his cloaked coat and deerstalker cap, and called for the first subject to be sent in. A line of outpatients the man had never set eyes on before waited in the hallway to be presented live to his pupils.

An elderly woman dressed in black entered.

“Where is your cutty pipe?” he inquired.

The woman started. How could he know she had one? Shocked, she pulled a small clay pipe from her purse.

“I knew she had a cutty pipe not because I saw it, but because I observed her,” he told his rapt audience. “I noted the small ulcer on her lower lip and glossy scar on her cheek, sure signs of habitual use of a short-stemmed pipe that lay close to the cheek when smoking.”

Another patient limped in. The teacher called on one of his students.

“What is the matter with this man, sir?” he asked. “Come down, sir, and look at him! No! You mustn’t touch him. Use your eyes, sir! Use your ears, use your brain, your bump of perception, and use your powers of deduction.”

The nervous student answered with a guess he hoped seemed confident: “Hip-joint disease, sir!”

“Hip-nothing!” the instructor cried out. Without a backward glance, he announced, “The man’s limp is not from his hip, but from his foot, or rather from his feet. Were you to observe closely, you would see that there are slits, cut by a knife, in those parts of the shoes where the pressure of the shoe is greatest against the foot. The man is a sufferer from corns, gentlemen, and has no hip trouble at all.”

The speaker continued to divine with ever-increasing alacrity the profession, off-duty vices, and world travels of people whom he had never met.

“Gentlemen, we have here a man who is either a cork-cutter or a slater. If you will only use your eyes a moment you will be able to define a slight hardening—a regular callous, gentlemen—on one side of his forefinger, and a thickening on the outside of his thumb, a sure sign that he follows the one occupation or the other. The shade of tan on his face shows him to be a coast-sailor, and not a deep-sea sailor—a sailor who makes foreign lands. His tan is that produced by one climate, a ‘local tan,’ so to speak.”

When another student got a diagnosis incorrect, the teacher admonished, “The gentleman has ears and he hears not, eyes and he sees not!” In his view nothing was more important to discovery—in medicine, criminal law, or life in general—than finely tuned observation skills. He let no fact, however small, escape his notice, frequently pointing out what others had failed to observe: tattoos, accents, skin marking, scars, clothing, even the color of soil on someone’s shoes.

“Glance at a man and you find his nationality written on his face,” he instructed, “his means of livelihood on his hands and the rest of his story in his gait, mannerisms, watch-chain ornaments and the lint adhering to his clothes.”

If the speaker’s sharp senses and rapid-fire delivery of his deductions sound like Sherlock Holmes, it is for good reason: he was the real-life inspiration for the fictional detective. Dr. Joseph Bell, a professor of surgery, prolific writer, and a relative of Alexander Graham Bell, enthralled his young student Arthur Conan Doyle with his uncanny and uncommon yet in his words “elementary” talents. According to Bell, who often chanted, “Use your eyes, use your eyes” in his classes, the most important skill was a simple differentiation between passive sight and active assessment.

Bell’s Sherlockian summation: “Most people see but do not observe.”

What’s the difference? Doyle had Sherlock Holmes himself explain it in one of his first published short stories, “A Scandal in Bohemia,” when Dr. Watson claimed to have eyes just as good as Holmes’s.

Holmes countered, “You see, but you do not observe. The distinction is clear. For example, you have frequently seen the steps which lead up from the hall to this room.”

“Frequently.”

“How often?”

“Well, some hundreds of times.”

“Then how many are there?”

“How many? I don’t know.”

“Quite so! You have not observed. And yet you have seen. That is just my point. Now, I know that there are seventeen steps, because I have both seen and observed.”

Although we frequently use the terms interchangeably, seeing can be thought of as the automatic, involuntary recording of images. Observing is seeing, but consciously, carefully, and thoughtfully.

 

WHAT DO YOU SEE?

 

To help everyone take a personal inventory during every Art of Perception class, I show this photograph of a young woman walking outdoors and ask the simple question: what do you see? In just one sentence, tell me what you see.

 

 

Go ahead and test yourself right now. What single sentence would you use to completely and accurately describe this scene?

I’ve been doing this for over a decade now with professionals from every walk of life. People tell me about the young woman; the most astute note what she’s wearing, where she’s looking, that she appears to be holding something, and which leg she is leading with. People tell me about the large tree on the left and its lack of leaves; some go so far as to estimate its height based on the comparison of the woman, but true to Holmes’s assertion, no one ever tells me the number of branches. I hear about the bushes along the fence and the fence itself, the bench, the fallen leaves and shadows in the foreground. But perhaps most shockingly, about half of the people who view this photograph don’t mention the giant letter C in the background.

Do you see it? Did you see it originally? Did you include it in your descriptive sentence? It’s not an illusion or a postprocessing photography trick. The C really exists. Is it an important part of the photograph? Is it worth mentioning? It is, for many reasons. It places the photograph in a unique location, as a bit of research would uncover that the C is painted on a one-hundred-foot-high rock wall on the Bronx side of the Harlem River in New York City across from Columbia University. It helps establish the time frame in which the photograph was taken, since the C first appeared in all white in 1955 and was repainted to feature pale blue outlined in white in 1986. And since the C is an impressive 60 feet tall by 60 feet wide—possibly New York City’s largest graffiti—noticing such a sizable object that takes up much of the photograph is a testament to elementary observation skills.

Those who fail to see this C are normal people with normal vision who just haven’t sharpened their observation skills. What if the 50 percent who didn’t see it included the detective assigned to your robbery, or your surgeon, your boss, your boyfriend, or your child’s bus driver? What if you didn’t see the C? Missing such a large detail might not seem critical right now while you’re reading a book, but what about when you’re babysitting, behind the wheel, or just crossing the street?

Before we can really hone our observation skills, however, we need to understand the built-in biological mechanisms that render all of us at one time or another “blind” to objects, even when they’re massive, moving, or should otherwise be memorable. And we can do that with a little help from an orangutan named Kevin.

 

THE GORILLA IN THE ROOM

 

The first thing you need to know is that Kevin isn’t conscious. I’d say he isn’t “real,” but his owner, Dr. Michael Graziano, would argue those semantics, since Kevin does exist, albeit in acrylic fiber form. Kevin is a puppet.

 

Dr. Michael Graziano.

 

Dr. Graziano, another neuroscientist at Princeton and author of Consciousness and the Social Brain, uses Kevin in his lectures as a unique ventriloquist demonstration of the power of perception. While his students giggle nervously at first when Graziano, a tall man with a salt-and-pepper beard and twinkling eyes, puts Kevin on his hand, only a few minutes later they find themselves unwittingly assigning a personality to the pretend primate.

To watch the performance with eyes wide open, as it were, knowing full well that it’s a social illusion, is a fascinating experience. As much as I prepared myself skeptically—an ape puppet in the Ivy League? Really?—I found myself drawn in anyway. Kevin makes crude jokes, claims to be Darth Vader, and looks around the room seemingly independently of his master. I couldn’t help but smile as Kevin squealed in agony when Graziano finally pulled his hand free. Even though I knew it was a puppet, Kevin did seem at times to have a mind of “his” own.

Graziano attributes this phenomenon to what he calls “attention schema theory.” As we sit in his office—delightfully dominated by a colorful painted mural of a dinosaur named Science eating a scientist, who he gleefully confesses is him—he explains the basics. Since humans are bombarded with stimuli, both externally in the form of sights, sounds, and other sensory information and internally in the form of thoughts, emotions, and memories, the brain cannot process every bit of information it encounters. Instead, it must focus on some things at the expense of others. How the neurons in the human brain decide what to deal with is called attention.

“We don’t magically become aware of something,” Graziano says. “It’s an act of the brain processing data.”

By walking us through the experience of attributing a social awareness to an orangutan puppet, Graziano allows us to feel the otherwise automatic process.

He is quick to point out that attention, while hard to capture, is also finite. We do not have an unlimited capacity for decoding every single stimulus, both external and internal, that we encounter.

“It’s partly a source-parsing problem,” he says. “In many ways, your attention focuses you. You attend to one thing, and effectively your brain suppresses or filters out everything else.”

It’s hard to believe what the brain sometimes filters out, as evidenced by another simian experiment, this one involving a woman dressed as a gorilla.

In 1999, Harvard psychologists Daniel Simons and Christopher Chabris set out to prove that even though our eyes may be open and looking right at something in our field of view, we don’t always see it—an anomaly known as “inattentional blindness.” They re-created a famous 1970s video experiment in which a woman with an umbrella walks through a scene of students passing basketballs; test subjects were asked to count how many passes were completed, and in doing so, many missed the woman and her parasol entirely. Simons and Chabris’s new version made the unexpected intrusion even more dramatic by taking away the woman’s umbrella and putting her inside a gorilla costume. Just as in my Columbia University letter C experiment, half of the participants of their study failed to notice the gorilla even when she was on screen twice as long as the woman with the parasol, looked directly at the camera, and thumped her chest instead of just walking straight through the crowd.

Fifteen years later, inattentional blindness experiments continue to prove that conscious perception requires attention, and that attention is selective. If our attention is absorbed by anything, even a task as mundane as counting, we can miss something else huge (and hairy) right in front of us.

Inattentional blindness can affect the best professionals in all fields, even those whose job entails looking for details. Attention researchers at Harvard Medical School did their own version of the “invisible gorilla” experiment by superimposing a two-inch gorilla on slides of lungs and asking radiologists to review them for cancerous nodules. Eighty-three percent of the radiologists never mentioned the gorilla shaking its fist at them from inside the slide.

Sometimes inattentional blindness has deadly effects. Boston police officer Kenneth Conley was pursuing a shooting suspect on foot when he ran right past a group of fellow police officers beating a man so viciously that the victim was left with severe head and kidney damage. When federal authorities investigated the assault, no officer would admit to taking part in or even seeing the incident. Conley was called to testify and admitted that he had been right there but had not seen the beating. Investigators did not believe it was possible to miss such an event, and Conley was convicted of obstruction of justice and perjury, removed from the police force, and sentenced to three years in prison.

While Conley could only attribute his inability to see the fight he ran right past to some kind of “tunnel vision,” a claim even the Supreme Court did not buy, psychologists Simons and Chabris of the woman-in-the-gorilla-suit experiment believed the officer was suffering from inattentional blindness. To prove it was possible, they re-created the situation with volunteers, asking them to jog after a man and count how many times he touched his hat. The joggers were led right past a staged fight scene; 67 percent of them failed to see it. Simons and Chabris published the results in a paper titled “You Do Not Talk About Fight Club If You Do Not Notice Fight Club.”

We are all so susceptible to inattentional blindness that we often miss important information. We can work to overcome this inborn tendency, however, by teaching our brains to have better attention and observation skills. Samuel Renshaw, an American psychologist whose research on vision helped the armed forces quickly recognize enemy aircraft during World War II, believed that “proper seeing is a skill which needs to be learned, like playing the piano, speaking French or playing good golf.” He claimed that just like a pianist’s fingers, the eyes could be trained to perform better. Likewise, multiple studies published in the Journal of Vision have confirmed that we can increase our attention capacity dramatically with challenging visual attention tasks. Studying provocative, intricate, multidimensional, and even off-putting art affords us exactly that opportunity.

 

OBSERVING ART

 

The success of using art to enhance observation skills among medical students was proven in 2001 by researchers at Yale. A two-year study published in the Journal of the American Medical Association found that those who studied artwork improved their diagnostic skills considerably but that their actual observational skills, specifically “their detection of details,” also increased by 10 percent. Dr. Irwin Braverman, professor of dermatology at Yale School of Medicine, called the 10 percent improvement “statistically significant” because it showed that “you can train someone visually to be a better observer.”

Allison West is living proof. When I first met her, she was a medical student at New York University, fresh from a small town in Georgia. One of West’s favorite pastimes was strolling through art museums, and Manhattan had them to spare. She wasn’t an art major, though, so she didn’t have a practiced way of looking at paintings; she just enjoyed them each for a few moments before moving on to the next. So she was excited to find out that her medical school offered the Art of Perception course, and she signed up.

“I had no idea how much I was missing,” she remembers. “I like to think of myself as a very observant person, and I didn’t see the Columbia University C staring me right in the face! I felt like I had been walking around with smudged lenses coloring everything, and I didn’t even know I was wearing them!”

After learning how to observe rather than just see, West noticed that the way she encountered and documented her patients changed dramatically.

“In a typical report, I used to write something like: ‘Middle-aged white male reclining in a bed. He has tired eyes, pale skin, a somber expression, and is wearing a hospital gown. His surroundings are plain: bare walls, white sheets with a bloodstain on the right side of the bed.’ Descriptive, but very clinical,” she tells me. “After the class, I started writing down, ‘He has a crossword puzzle in his hand, a local newspaper written in Spanish at his side, card on the bulletin board reads ‘Get Well Soon, Grandpa.’’ Where I used to just see flowers in a room as a sign of an ill patient, I now pay attention to what kind they are and if they’re wilting, who sent them, and when.”

West also now notes what stuffed animals may be lying on the windowsill, what TV show the patient is watching, and what books are on the bedside table.

“These new details that I’d never noticed before might not tell me a diagnosis,” she explains, “but they give me something just as important: information about what motivates the patient to live, how he can live best with his illness, and what sort of alternative treatments he might consider to palliate his suffering.”

Like a modern-day Dr. Bell, West uses what she initially observes to uncover even more. Seeing the Spanish newspaper at one patient’s side prompts her to investigate his diet at home: Is it rich in Hispanic foods that might worsen his condition? What does he do for a living? Can he return to a job that will engage his mind and help his overall healing? What are his favorite pastimes and hobbies? Will he be able to take them up again during his recovery?

“Knowing that he likes to build model trains might seem like an insignificant detail for a doctor to know,” she says, “but quality of life is key to recovery, and knowing that he can return to an activity he loves can mean all the difference for a patient.”

It’s made all the difference for West as well. She is now a doctor specializing in internal medicine at the University of Chicago Medical Center and was profiled in New York magazine’s 2012 “Best Doctors” issue.

Like any other skill, observation can be mastered with practice. In his 1950 book The Art of Scientific Investigation, Cambridge scientist William Ian Beardmore Beveridge gives the following instructions: “Powers of observation can be developed by cultivating the habit of watching things with an active, enquiring mind. Training in observation follows the same principles as training in any activity. At first one must do things consciously and laboriously, but with practice the activities gradually become automatic and unconscious and a habit is established.” Practice also makes permanent, as neuroscientists believe that practicing new skills rearranges the brain’s internal connections. So technically, biologically, we can wire our brains to see better.

We can do this with exercises that improve our attention and memory, as both are integral to observation skills. And we’ll start with art.

Without looking back, try to recall the painting at the beginning of this chapter on page 23. Can you visualize it? I’ll give you a hint: it’s a still life spread out on what appears to be a table.

If you can’t quite remember the painting, you’re in good company. In my class I show the same picture quickly as I introduce myself, and many people don’t pay attention. If you have no idea what I’m talking about—a painting? What painting?—because you flipped right past it, don’t worry, you’re still in good company. A lot of us have learned to skim or skip over the beginnings of things to get to “the meat,” but when we do that we’re quite possibly skipping over vital, valuable information. We’re going to learn, starting right now, how not to do that.

Turn back to the painting on page 23. I love this particular, peculiar work because you don’t have to know anything about art or who painted it, when, or why to appreciate the striking visual scene: a seemingly ordinary place setting starring an open, unblinking eye in the oddest of places. Study the picture for a few minutes, and then come back.

 

 

Welcome back! So, what did you see? Let’s start with the basics: How many objects were on the table, and what were they? Try to remember as many as you can.

If you can recall that there were five—a glass, a bottle, a knife, a fork, and a plate with a slice of something on it with an eye in the middle of it—then good for you! If you can tell me that the glass was empty, the bottle full, that they were above the plate and utensils, that the fork was to the right of the plate and the green-handled knife to the right of the fork, and the eye was a blue-gray, even better!

What food was on the plate? I’ve heard “a pancake” quite often, but if you look closely, you can see thin white marbles of fat throughout, growing thicker at the edges; it’s really a piece of ham. Bonus points if you noticed the dark red staining on the glass.

Now let’s really observe. Go back and look at the painting again but even more closely, more slowly this time. Savor the stain on the side of the glass. Puzzle over whether or not everything is really on a table. Notice the light reflecting off the surface of the bottle, glass, and silverware. Calculate which direction the objects’ shadows are pointing. What could be causing the reflection and shadows, and where would we look for such an object? Appreciate how an image that might seem simple at first glance is really a complex series of relationships—why is the bottle full if the glass is already stained? The fact that we keep uncovering more questions and more details the longer we look is how we know we’re not just seeing but observing.

Now, without turning back, draw the painting yourself, capturing as many details as you can. When you’re finished, go back and compare it with the original, noting anything you might have missed. Add those details to your drawing.

To further enhance your retention abilities, wait an hour and then draw the painting again. Again, go back and correct it by adding any missing information.

You can also practice on a single everyday object: your watch, your handbag, or a water bottle. Select something with a lot of detail, and really study it for one full minute. Then put it away or cover it up, and write down as many details—shapes, colors, textures, words, measurements—as you can. Retrieve the object, but instead of subtracting time, add it. Observe the same object for three times as long, or three minutes, and see how much more you can find. Do this with a different item every day for a week, and you will notice by the end how the practice has increased your ability to focus and remember what you’ve seen.

The more you exercise your memory skills, the better you will become at them not only in these specific tasks but in your general observation of life as well. One of my students told me she used to walk around her neighborhood every day for exercise, listening to music, not noticing anything, just trying to log her thirty minutes. After taking my class, she decided to reengage her senses on the exact same route, and the differences were startling. She noticed cracks in the sidewalk, handprints in cement she’d never seen, a secret bike path. She said it was as if she were “seeing with new eyes.”

Similarly, the more you consciously observe your environment, the more natural the process will become. To engage your sense of awareness, go outside at lunchtime, plant yourself in one spot, and practice observing every single thing that crosses your visual path. Doing so will help train your eyes to look beyond what’s right in front of you or what you are used to seeing.

Arthur Conan Doyle’s real-life inspiration, Dr. Joseph Bell, didn’t have ESP or X ray vision. He wasn’t able to see more because he was born with a superhuman power. He just practiced using his powers of observation on a daily basis. We all have the same abilities; we just don’t always know it.

In the early 1980s, Philadelphia physician Arthur Lintgen received international attention when he demonstrated his uncanny ability to “read” vinyl records on a television show. Dubbed the “man who sees what others hear,” Lintgen could look at a phonograph record with the label completely obscured and quickly and correctly detect which classical piece it played by simply studying the grooves. Expert after expert tested the veracity of his claim, and all came to the same conclusion: Lintgen’s ability was legitimate.

Lintgen was able not only to identify the recordings’ titles and composers but also to relay how many movements were in each piece, how long each movement was, the volume and percussiveness of each movement, and sometimes even which orchestra had recorded it. He did so not by reading the music on the record but by examining the smallest physical details on them. He looked at the spacing, coloring, and contour of the grooves and then correlated that with his knowledge of the patterns in classical music; for instance, he knew that a Beethoven symphony has a longer first movement in relation to its second, and could recognize that pattern.

Lintgen didn’t have special eyes; in fact he was extremely nearsighted and wore thick glasses. He simply looked at a record closely and consciously and practiced looking until the process of identifying the piece become quicker and more natural to him. We can all do the same.

That’s not to say we all see things the same way. The way our brains choose to sort through the millions of bits of information available is unique to us and entirely dependent upon our own perceptual filters. To see like Sherlock Holmes, we need to be familiar with them because, whether we realize it or not, they are altering our observations.