Near the end of Girl, Interrupted, Susanna Kaysen revisits a painting she first encountered as a teenager: Vermeer’s “Girl Interrupted at Her Music.” As an adolescent, she saw the image as unfinished. The girl in the painting has turned her attention elsewhere. The music is not gone, just momentarily set aside.
Years later, nothing about the painting has changed. But Kaysen has. What once looked unfinished now appears complete. The pause is no longer a flaw; it is part of the composition. The interruption is not a failure of continuity, but its condition.
I thought about that imagery while reading Dr. Carol Scott-Conner’s essay, “A Tale of Three Breasts,” published in Intima: A Journal of Narrative Medicine. On the surface, her essay describes an interview for a fellowship position—routine, professional, almost mundane. But like Vermeer’s painting, it is really about how perspective changes with experience, and how medicine trains us not just to know differently, but to see differently.
The pivotal moment is deceptively simple. During the interview, a plastic surgeon asks a breast surgery fellowship applicant to draw a breast. The request instantly disarms her. Her polished answers evaporate. She produces tentative circles, then a half-moon—drawings that are not exactly wrong but not fully formed either. They are the kind of sketches we make while we are still learning to speak in our own voice.
What the candidate draws, she explains, is what she has been taught to draw for patients: simplified shapes, symbols that stand in for something more complex. It is not ignorance that is exposed here, but early formation; the way trainees rely on abstractions before they develop their own way of seeing.
After the interview, when the interviewers themselves take up pen and paper, three entirely different breasts emerge. The radiation oncologist draws through the breast, revealing heart and lungs beneath, carefully shading the structures she must protect while delivering treatment. The plastic surgeon sketches an elegant silhouette, shaped by gravity, symmetry, and aesthetic ideals. Scott-Conner, the breast surgeon, draws anatomy: ducts, lobules, lymph nodes, pathways of cancer spread. Each image is precise. Each is incomplete. Placed side by side, they do not produce the breast. They produce medicine’s breast: segmented, instrumental, shaped by professional identity and necessity.
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This is where Girl, Interrupted begins to take on a deeper meaning. Early in training, medicine feels like interruption itself. Students and residents live in a constant state of pause corrected, redirected, told not yet. Confidence feels deferred. Mastery always seems just out of reach. Like the applicant holding her pen, we are acutely aware of what we cannot yet do.
Over time, however, professional identity forms not by eliminating interruption, but by reframing it. Kaysen does not imagine the music resuming in Vermeer’s painting. She recognizes that the pause belongs there. Likewise, experienced clinicians come to understand that their particular way of seeing, however narrow, is not a failure, but a contribution.
Scott-Conner gestures toward this insight with remarkable restraint. She invokes the parable of the blind men and the elephant, familiar to anyone in medicine, yet freshly felt here. Each specialist touches a different part of the same body and mistakes it for the whole, until humility intervenes. Multidisciplinary care, the essay reminds us, is not merely logistical. It is epistemological. No single perspective is sufficient, yet all seem necessary.
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This lesson extends far beyond breast care. Medical training is, at its core, a long apprenticeship in selective blindness. We learn what to foreground and what to ignore. Psychiatrists learn to hear meaning in silence. Surgeons learn to privilege what can be cut. Radiologists learn to trust images. Administrators learn to see systems. Each perspective is adaptive, and each becomes dangerous when mistaken for totality.
The risk is not specialization itself but forgetting that it interrupts something larger.
Scott-Conner ends her essay imagining the young applicant later that night, practicing her drawings, determined to be ready the next time she is asked to draw a breast. It would be easy to read this moment as ironic. Instead, it feels tender. Of course she practices. That is what medicine teaches us to do when we are interrupted: rehearse, refine, try again.
Yet hovering beneath the scene is an unspoken truth Scott-Conner herself seems to know well—that there is no single correct drawing. No final version. No view that completes the picture.
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Many clinicians recognize this realization only later, when they revisit an old case, an old belief, or an old piece of art and discover that it looks different now—not because it has changed, but because they have. What once felt like inadequacy reveals itself as development. What once felt like certainty begins to feel dangerously thin.
Medicine, in that sense, is a lifelong encounter with interrupted music. We enter expecting a finished symphony and instead find pauses: uncertainty, failure, reinvention. The temptation is to rush past them. Wisdom lies in learning to sit with the pause, to understand it as part of the composition.
The breast, like Vermeer’s girl, waits patiently for us to grow into a more disciplined way of seeing.
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Dedicated to my colleague Carol Scott-Connor, MD, PhD, MBA. Her essay was chosen among a select group of essays, short stories and poetry culled from the archives of Intima: A Journal of Narrative Medicine and is scheduled for publication in March in Where It Hurts: Dispatches from the Emotional Frontlines of Medicine.
Medical training is, at its core, a long apprenticeship in selective blindness. We learn what to foreground and what to ignore.
