On a cold April morning in 1970, I stood in the Felix Neck barn with high school students on a field trip. The wind was howling outside, and all was not right with the world. It was not just the Vietnam War and the protests, it was the environment. Gobs of crude oil from a massive spill in Falmouth harbor several months before had crossed the Sound, and now oiled sea birds were turning up dead or dying on Vineyard beaches.

Felix Neck, a new sanctuary, was where the birds were being brought for rehabilitation. It was the Vineyard's version of oil spill disasters happening around the world: the '67 Torrey Canyon tanker wreck off of Cornwall England, the blown out oil rig in Santa Barbara harbor in January of the year before.

Oil from these spills matted the feathers and clogged the guts of thousands of seabirds until they could not rise up to fly, but instead starved or drowned in the black goo. Volunteers picking them up off beaches tried to save them, washing them with Polycomplex A, the chemical used to break up oil slicks, but the powerful solvent stripped their natural oils as well and left them unable to swim.

The Felix Neck barndoors were shut against the wind and there was warmth from the heat lamps over the animal pens in the back room holding rescued seabirds. We peered over the edge of a wooden box to see an oiled common eider crouched under the lamp.

Gus Ben David, the newly hired Felix Neck director, a muscular man with piercing eyes and somewhat stern demeanor, told us that instead of the solvent used elsewhere, he had washed this bird with dish soap which was gentler and avoided damage to the natural oils and fine detail of the body feathers that sealed out water and allowed the bird to float in the waves.

Gus had also tube fed the starving bird as it eliminated oil lodged in its gut, but now it was stronger and eating on its own, still regaining lost muscle and energy stores.

As we crowded closer, the eider tried to lift itself and walk across the pen, but lurched to one side and lay down. Gus reached in to adjust the bird's position. He straightened and covered the pen with a towel.

"This bird is under stress," he said, "we are trying to limit stimuli."

With these comforting acts, Gus took action to strengthen the birds' resilience, to make a difference at that interface between the demands of the environment and the delicate beating of an eider's heart, to see once again that perfection of a seabird bobbing and diving in the ocean just beyond the pounding surf.

That summer of 1970, I volunteered at Felix Neck, cutting trails, helping Gus rip-rap the ponds, cleaning the tools in the impeccable toolroom. National outcry over news stories about oil spills and dying birds had led to the first Earth Day that spring, and I felt like I was part of a worldwide growing movement to save the environment. On the Vineyard the word was out that there was someone at Felix Neck who could treat sick and injured wildlife. I'd watch cars come down the dirt road in a cloud of dust to the parking lot and someone get out and walk to the barn holding a cardboard box covered with a towel or sweater.

Gus would sit on the turtle cage outside the barn door as he received the rescued animals. He would open the box and pick up the animal in a surgically precise motion calibrated in millimeters, with a lack of hesitation or fear.

Probing the animal with his powerful hands, he would talk out loud, first about the diagnosis -- the condition of a bird's

wing, a crush injury to a turtle shell, an orphaned cottontail rabbit -- but soon also about the treatment plan. He would explain to the person what the sanctuary could provide (shelter, warmth, food and water, access to sunlight) and what it could not, such as sophisticated and expensive veterinary care. He explained the threats that awaited a rehabilitated animal -- not just of pollution but of predators and automobiles, the challenge of finding food. The hope was that with enough nurturing and time the animal could regain the ability to survive those threats.

These diagnosis and treatment sessions with Gus, and my times with him since, taught me the concept I would later call "host-environment medicine" that guides my approach as a physician. When I care for a patient, I should not only treat disease but also work to restore balance between the patient's host resilience and the stress of the patient's environment. In that way each patient encounter takes a small step towards what a rabbi would call "Tikkun Olam" or "repairing the world."

Last year I had a chance to visit with Gus in his "man cave" at the edge of the pond he had established near his house. Surrounded by wood carvings, books, binoculars and a bottle of Canadian Club, we sat in the warmth from the crackling wood stove while the December wind whistled outside. Gus talked about the state of the world, the degradation of the global environment, climate change, the changing Vineyard. Then he pointed to the flock of geese that he had raised that was circling the pond before landing, telling me how they were free to fly up into in the breezes and thermals over the Island but always returning to that pond, that sanctuary that was home.

And now it strikes me that I and so many people, young and old, whose lives Gus has touched, have been like that imprinted flock of geese, urged by him to fly free out in the world and do good, but able to return to a place like the Vineyard and find comfort and healing.

Now Gus is gone physically, (and as he would say, inevitably), but I hear his voice saying that while there is much to do for the earth and its human and animal inhabitants, we can each day take steps to restore balance in the tiniest things, and in those steps there is hope.