Do we listen well enough to recognize depression when we hear it? The Band is among my top 5 greatest bands in rock and roll history. Almost everyone knows their songs, although many don’t know who’s singing them. Drummer Levon Helm is a personal hero. Robbie Robertson was such a magnificent guitarist that Eric Clapton wanted to join the Band. Garth Hudson was a musical genius (listen to the improvised organ solo at the beginning of Chest Fever). Rick Danko was a reluctant star (Stage Fright). And Richard Manuel was delicate, beautiful, wild and fragile songwriter and piano player.

During their years together, the Band was known for their collaborative musicianship and shared responsibility for singing. However, it was widely acknowledged that Richard Manuel was the emotional, soulful lead singer for the group. Richard wrote some of the Band’s most haunting melodies and his aching baritone and sweet high falsetto could make you cry. But Richard was troubled and he told us in his classic Whispering Pines: a heartrending cry of exquisite loneliness.

Band – Whispering Pines

If you find me in a gloom, or catch me in a dream

Inside my lonely room, there is no in between

Whispering pines, rising of the tide

If only one star shines That’s just enough to get inside

I will wait until it all goes ’round

With you in sight, the lost are found

Foghorn through the night, calling out to sea

Protect my only light, ’cause she once belonged to me

Let the waves rush in, let the seagulls cry

For if I live again, these hopes will never die

I can feel you standing there

But I don’t see you anywhere

Standing by the well, wishing for the rains

Reaching to the clouds, for nothing else remains

Drifting in a daze, when evening will be done

Try looking through a haze

At an empty house, in the cold, cold sun

I will wait until it all goes round

With you in sight, the lost are found

Songwriters: ROBERTSON, ROBBIE / MANUEL, RICHARD G.

Whispering Pines begins in an empty room in a house previously shared by Richard and his wife Jane surrounded by desolate piney woods and a fog enshrouded Northern California coastline. The atmospherics are solitary and gloomy as Richard hopes for the return of the lost love that once belonged to him. The star is a single ray of love and Richard believes “if only one star shines, that’s just enough to get inside.” But his hopes are not fulfilled. “I can feel you standing there, but I don’t see you anywhere.” Richard was finding it increasingly difficult to write having lost his sense of worth and confidence.

This creative emptiness is reflected in the lyrics. “Standing by the well,” (well of creative ideas and energy) “Wishing for the rains,” (rain to replenish the dried up well of imaginary images and lyrics) “Reaching to the clouds, for nothing else remains,” praying for something to give his life meaning. The reference to the “cold, cold sun” is a concise and elegant description of something sunny but no longer brings any warmth or joy. In the last verse, Richard and Levon Helm engage in a call-and-response duet that is simultaneously one of the most beautiful and saddest conversations in all of rock and roll.

The simple ending of “With you in sight, the lost are found” was almost certainly written by Robbie Robertson who came to his aid when Richard couldn’t finish his plea for help. On March 4^th, 1986, Richard Manuel committed suicide in a hotel room in Winter Park, Florida while touring with the reunited Band.

I thought of Richard Manuel today when I was seeing a young woman who was almost finished with a perfect twin pregnancy. As I applauded how well she had done, I could not understand why she remained so anxious, unsmiling and on the verge of tears. Fortunately, she was my last patient of the morning and without a crowd backing up behind her, we talked a bit more. With just a few more questions it became obvious that her joylessness over her successful twin pregnancy was a manifestation of a major depressive disorder.

I asked her if she had discussed this with any other doctors. She said that she’d tried, but the last doctor never looked up at her while typing on a computer and asking her “routine” questions. I’m sure that my friend Constance Guille, a perinatal psychiatrist, will be able to help her, but I also reflected on how close I’d come to not listening to her either. The current medical system in the United States is not set up to deal with psychiatric issues. Sterile questionnaires that are filled out in the waiting room (then filed away) for a $20 up charge, 10 minute slots for return patients, and electronic medical record pressures to document everything on the computer before you can move on to the next patient.

We must not lose or forget the importance of listening to our patients. We must learn to pick out the melodies and lyrics that whisper depression. There are multiple pressures not to. We should have all listened more carefully to Richard Manuel in Whispering Pines. I pray that this young woman with twins will get the help she needs to lead her out of the gloom of her lonely room.

A good video to practice your listening: http://www.bing.com/videos/search?q=Whispering+Pines+by+the+Band&FORM=RESTAB