A Kodak moment

I step into the exam room carrying a small tray of supplies: one unit-dose syringe, a cotton ball moistened with alcohol resting on a 2 X 2 square of gauze, a Band-Aid dot. On the exam table the patient, a 5-year-old girl, squirms in her mother’s lap.

“She’s here for her flu shot?” I ask, merely to verify the inevitable.

“Yup,” her mother replies. “And it’s not going to be easy.”

“Most kids don’t like shots,” I mutter in a quiet voice as I slide the tray onto the counter top. “Here, let me show you how to hold her.”

I instruct the mother to turn the child to the side, sitting her on the mother’s thigh with the child’s legs draped between her own. “She can give you a big hug under your arm, around the back. Now hold her forearm with your one hand and hug her tight with the other.”

The mother complies with my instructions. As I pick up the syringe and cotton ball, like a frightened puppy the child lets out a yelp and begins to writhe in her mother’s lap. “Hold her tight,” I reiterate, as I slide my free hand beneath the girl’s upper arm to steady her shoulder.

I dislodge the needle cap with my teeth and stand poised, ready to slip the hypodermic into the deltoid muscle. Suddenly the child breaks free, kicks and screams, turns and twists, thrusts her head back and forth. Blindly, the mother sweeps her arms through the air in an effort to recapture the child. In the fray she falls to the side, taking the child and me with her down to the padded surface of the exam table.

There we lie, like the Marines in Iwo Jima, a frozen fleshly sculpture of arms and legs, intimately conjoined in intricate knots of skin, bone and muscle.

Eyeglasses cocked awry, the mother looks up at me, hugging her daughter for dear life, while I rest along the contour of her curves. The image burns into my mind. Without thinking, I say, “You know, if this were a photograph, it would undoubtedly appear as a black-and-white full-page spread in Life magazine.”

Quickly, I administer the shot. The mother releases the little girl and we all sit up. The child is sobbing, and so is the mother, as tears squeezed from her laughing eyes cascade down her cheeks.

“Thank God you’ve haven’t got a photographer in house,” the mother wheezes, as she wipes her face with the back of her hand.

Another memorable Kodak moment in primary pediatric practice to treasure.

This piece was originally published in the Spring 2013 edition of ConnAPA News.

Humane Medicine — Hauntings: When the clinical mark is missed

My thoughts drift back to my early years of training, when for nearly 2 years I spent every third night on call in the hospital setting. One night still haunts me. more»

Interested readers can now access my latest Humane Medicine column — Hauntings: When the clinical mark is missed — recently published in the Journal of the American Academy of Physician Assistants.

Please note that all of my previously published Humane Medicine pieces can now be accessed here.

Morning Mass on Mothers’ Day

A Morning Mass on Mothers’ Day

I arose Sunday morn in the misting,
Half hooded, I pulled back the shroud,
From the bed to the bath faintly listing,
With the canopy covered in cloud.

I pulled on my pants in the darkness,
I slipped on the soft cotton shirt,
I left the back door slightly open,
And trekked down the moist narrow dirt.

It was morning, all misty the meadow,
The river was smooth as a glass,
I bent by the edge of a hedgerow,
And peered through the door to the mass.

Spring beauties sat straight in the narthex,
The lily lamps towered anew,
The bleeding hearts hung by the windows,
Each one held a tear drop of dew.

And there in the front at the altar
Of a moss-covered log and a stone,
Stood the Lincoln green lad in the pulpit,
Silent and straight and alone.

I paused, turned an ear to his sermon,
Though he spoke not a word to the air,
So telling I couldn’t work a word in,
As I knelt in the silence right there.

A Mothers’ Day sermon on Sunday,
In the midst of the flowering wood,
Near the bend of the silent still water,
Where a Jack-in-the-Pulpit stood.

5/12/2013

“Jack-int-the-Pulpit” 2013 © Brian T. Maurer

Evensong

“What is that?”  My wife poked her head out of the kitchen doorway.  ”Hear it?”

Seated in the parlor, I looked up from the book in my lap.  A series of notes sounded in the distance, reminding me of some long ago boyhood dream.

I marked my place in the text with a finger and rose from the love seat, padded to the kitchen and stood by the open back window.  The tall maple trees in the neighbor’s back yard stood silhouetted against the twilight sky.  Three fluid notes sounded from deep within the wood, over and over again.

“That’s a whip-poor-will,” I said.  ”I haven’t heard one of those for years.”

Actually, this was the first whip-poor-will I ever remember hearing in these parts since we moved here three decades ago.

Perhaps this was a harbinger of good things to come, I thought.

And then, just this morning…

Cinematic review published in IJUDH

Brian T. Maurer’s review of Emilio Estevez’s epic cinematic journey “The Way” has been published in the International Journal of User-Driven Healthcare.

The International Journal of User-Driven Healthcare (IJUDH) is a refereed, applied research journal designed to provide comprehensive coverage and understanding of clinical problem solving in healthcare.

Interested readers can access the article here.

“Notes from a Healer” — Up to her neck

I recall seeing this mother with her older son two months ago. Unlike this robust younger brother, her first son was born 12 weeks premature and subsequently faced myriad medical problems. He grew poorly and manifested developmental delays over the first two years of life. She certainly had her hands full caring for him. more»

My latest installment of Notes from a Healer — Up to her neck — is now online, newly published in the Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine is an online journal fostering discussion about the culture of medicine, medical care, and experiences of illness. Interested readers can access a list of editorial board members and regular contributors here.

Spring beauties

Spring pig

“A little girl is one thing, a little runty pig is another.” E. B. White, Charlotte’s Web

E. B. White opens his children’s classic with the birth of a litter of spring pigs. One of them, the runt of the litter, will just make for trouble; and so Mr. Arable is poised to do away with it.

“This is the most terrible case of injustice I have ever heard of,” announces Fern, his daughter, the young girl who will save the pig on her own terms.

Thoughts of Fern ran through my head when my younger daughter pulled into the driveway with a large yellow bin sitting on the seat beside her.

“What you got there?” I asked.

Proudly, she pulled the bin from the car and held it down so we could see inside. There, nestled in with old newspapers and several towels, lay a pink spring piglet.

“The sow at the farm had a litter, but she killed all of them except for this little guy. We rescued him from certain death. His name is Lucky, because he’s lucky to be alive.”

She carried the yellow bin into the kitchen and sat it on the floor. From her pocket she pulled a plastic baby bottle, filled with formula. “Wanna feed him?” she asked, handing me the bottle.

I pushed the rubber nipple gently against the piglet’s pink snout. He soon latched on and began to suck and swallow like a hungry newborn.

“How does he get along without his mother?” I asked.

“He’s got his own bed under a heat lamp at the farm. He’s gotta be fed nearly every hour round the clock. I’m usually up with Mr. Christensen anyway, so I offered to take a couple of feeding shifts over the weekend.”

Mr. Christensen is the octogenarian that my daughter takes care of during the week. He’s got Alzheimer’s dementia. My daughter makes his meals, bathes him, helps him get dressed, drives him to the adult daycare program at the assisted living home, and makes sure he gets to his doctors’ appointments on time. She did the same thing for his wife up until she passed away this past February.

Lucky dropped the nipple from his mouth and lay down in the bin. He pushed against the towels with his snout and closed his eyes. For all appearances he looked to be one contented piglet.

“Are you going to keep him here overnight?” I asked my daughter.

“No, he might get cold. He’ll probably do best in his own bed under the heat lamp. I just wanted to stop by and show him to you.”

She picked up the bin with the sleeping piglet inside and carried it back outside to the car. The engine roared to life.

“I’ll drop by sometime next week for dinner,” my daughter said. “I’ve gotta get back to the farm to look in on Mr. Christensen.”

I watched her back down the driveway, negotiating the tight turn into the street. She waved from the open window. In that moment, she seemed supremely happy.

I reckon spring piglets will do that to you. Taking care of older folks who can’t fend for themselves does that as well.

“Lucky” 2013 © Brian T. Maurer

Brace and bit

Last Friday evening after dinner my wife asked me to walk down to the Pinney house with her. Barely five feet tall, a petite Mrs. Pinney, along with her daughter and son-in-law, was busy sorting through household items to be put up for sale Saturday morning. Mr. Pinney, who had been a big man, passed away late last fall; he was 80-some years old. He left behind a shed of tools and paraphernalia—many items that Mrs. Pinney wouldn’t be able to take with her when she vacates the property later this spring.

The son-in-law was in the back yard, seeing if he could get the small cement mixer to run. The belt on the pulleys hummed along happily, turning the old spattered orange drum. In the garage there rested a walnut a gun cabinet, several old wooden surf-casting rods, and various yard implements such as rakes, hoes and spades.

The shed adjacent—the former site of the Pinney cigar factory—housed a workbench laden with all sorts of tools: a drill press with scores of different sized bits, hammers, jack planes, socket wrenches, screw drivers. A table saw stood in the middle of the floor next to a small jig saw with the original manuals describing their operation and upkeep. A chest of drawers opposite the workbench held old coffee cans full of various types and sizes of nails and screws. Next to this, on a shelf along the side wall, rested an old Coleman stove and lantern with sentinel cylinders of white gas. Centered before the rear wall stood an antique cast-iron stove, complete with removable top to access hotplates for cooking. Immediately behind the stove a short supply of split firewood lay stacked against the rear wall.

Mrs. Pinney told me how Mr. Pinney had got his hand caught in the table saw several years back. The blade mangled three fingers on his left hand. A Hartford hand surgeon put the fingers back together in two separate operations: the first lasted five hours, the second three. With the exception of some residual stiffness of the index finger, Mr. Pinney had nearly full use of the hand up until his death.

“Here is the grips he used to strengthen his hand after the accident,” Mrs. Pinney said, lifting the implement from a nail on the shelf.

“What’s this?” my wife said, picking up a bent metal bar from a bin near the table saw. “Some sort of crank?”

“No, it’s part of a tool,” Mrs. Pinney said.

“It’s called a brace and bit,” I explained. “It’s an old-fashioned hand drill. You insert the drill—they called it a bit—here, and then lean on the wooden knob as you turn the crank. It was part of any carpenter’s tool box.”

My wife bought a number of pieces of porch furniture: a small table with two wrought iron chairs and the wicker rocking chair that Mr. Pinney used to sit in with his ever-present cigar most summer evenings.

“How long were you married?” I asked Mrs. Pinney.

“Fifty-five years,” she said. “I was 17 on my wedding day. By the time I was 21, I had 3 babies. Now I’ve got 4 great-grandchildren, with another one on the way.”

Afterwards, on our way home, we stopped off at the cemetery. It took a while, but we located the Pinney family plot beneath the ancient maple near the arborvitae hedge. A granite stone bore the dates of Mr. Pinney’s father and mother. His mother was a Fahey, an Irish schoolmarm. We couldn’t find Mr. Pinney’s marker; sometimes it takes a while before it’s set in place.

Humane Medicine — Vestigial reflexes, gut reactions

Several years ago, when I was laid up for 6 weeks with a fractured ankle and hand after a hiking accident, my wife decided to get a dog. She and my daughter drove to the pound to scout out prospective candidates. They came home with a scraggly terrier, rescued from certain annihilation.
 more»

Interested readers can now access my latest Humane Medicine column — Vestigial reflexes, gut reactions: When time is not enough to heal — recently published in the Journal of the American Academy of Physician Assistants.

Humane Medicine April 2013