Breathing easier at the end of the day

Fifteen minutes ago I heard grown-up voices and the intermittent cry of a child from the waiting area. It certainly is taking a long time to process the last patient of the day. There must be a glitch of some kind. more»

Interested readers can now access my latest Art of Medicine column — Breathing easier at the end of the day — 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.

On this, the first day of Spring

On this, the first day of Spring,
I rose early, showered, dressed;
Walked the dog at first light;
Drove to meet a friend for breakfast;
Replaced a rear-window wiper-blade;
Wrote two letters of condolence
For cousins recently orphaned—
Hand-addressed the envelopes,
Placed them in the curbside mailbox
And raised the red flag
To let the postman know—
Walked the dog a second time;
Buttoned my formal work shirt,
Snugged a bowtie in place;
Drove to the office to put in my time;
Watched the afternoon snow descend
From the back window by my desk;
Headed home over snow-covered highways,
Headed home in the cold winter-spring night,
Headed home to dog and dinner,
Slippers and schnapps;
Edited an article for a far-off friend;
Crawled beneath the heavy counterpane,
And drifted off to sleep—
On this, the first day of Spring.

March 20, 2015

Rorschach EKGs

There is an old Yiddish saying: “To a worm in a jar of horseradish, the whole world is horseradish.”  In short, our immediate environment influences our thoughts and perceptions.

Soon I must sit for my 6-year recertification examination in general medicine: a grueling 5-hour test consisting of 240 questions. I’ve been reviewing medicine for the past 4 months; lately, I’ve thought of little else.

I have had a smattering of additional preoccupations. After all, the routine of daily life goes on. Snow must be shoveled, walkways must be kept clean, and the dog must be taken out for daily walks.

Early this morning the dog and I ventured out into the winter cold. As we passed by the church at the end of our street, I noticed salt deposits on the sidewalk left behind after the snow and ice had melted. With scattered thoughts of the impending exam running through my mind, these formations appeared to resemble electrocardiographic (EKG) tracings.

I returned with my camera to take a few snapshots, several of which I’ve posted below. To my eye these represent specific electrocardiographic rhythms or conditions. Perhaps my medical colleagues would like to weigh in with opinions of their own.

First degree heart block

First degree heart block

Atrial fibrillation

Atrial fibrillation

Third degree heart block

Third degree heart block

In the pauses

“Only in the pauses between things, in the brief contemplative spaces of just being, can we catch a glimpse of love itself.”
Gerald G. May, The Awakened Heart

I was up early this morning, clearing the overnight snowfall from the driveway in anticipation of the next storm, which is slated to start tonight and continue through Monday into Tuesday morning. The NOAA site is predicting 8 to 14 inches for our area.

The streets in the village have taken on the appearance of Olympic luge runs, with snow piled high on either side; the surrounding wooded hills sit in sentinel silence, dusted with confectionery sugar.

As I herringboned the driveway with the snow shovel, a gaggle of Canada geese passed by low overhead. You could hear their wings beating the air, and for several seconds the sporadic honking was deafening. I paused to watch them melt into the morning greyness of sky, thankful for a minute of rest before resuming my Sisyphean task.

The long winter of our discontent is not without its moments of common grace.

Snowbound

The master map described our plight:
The snow would start half through the night,
Continue on, come morning light,
And taper not until the night.

We woke to white flakes falling down,
Which blanketed the entire town,
While inside comfort, warmth and bed
Held us in our homey stead.

I donned my cap and coat and boot
And leashed the puppy’s rough cut suit;
Together ready, both astute,
We bounded down the powdered chute.

Being small, she couldn’t abide
The heavy drifts on either side;
We made it halfway down the street
Before she shook on frozen feet.

I picked her up and held her close,
Then turned and headed to the house,
Retracing steps through heavy blow
And biting, needling, stinging snow.

Back inside the kitchen warm,
I paused to brush a whitened arm,
Then headed back outside to clean
The heavy drifts from winter’s scene.

Two hours I worked; with shovel cut
The deepest swaths down to the rut,
While at my back the neat trimmed track
Filled up again with powder flak.

Into the house I frozen stomped
With little circumstance and pomp;
Pulled off my boots and tossed my scarf
Across the chair just by the hearth.

The call came through, announcement made:
Another day of work was stayed.
Elated then, without a sound,
I sat and read his poem, Snow-Bound.

2/2/2015

2015©Brian T. Maurer

When the art of medicine becomes business as usual

It’s Saturday morning, the last day of my 6-day workweek. Twelve hours have elapsed since I finished my previous shift at the after-hours care center. I step in through the front door, valise in hand, to find my assistant seated behind the reception desk. “How does it look?” I ask him.

“Ten appointments so far,” he says, “last one at 10:30 a.m.”

I do a quick mental calculation — roughly 9 minutes allotted for each patient. And there’s no telling how many additional walk-ins might show up over the course of the morning. more»

Interested readers can now access my latest Art of Medicine column — When the art of medicine becomes business as usual — 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.

Snow Ghosts

Morning snowflakes dapple
Gnarled naked branches
Then cascade down,
Deluging the landscape
In white.

I clear the driveway,
Move the car,
Shovel again;
Step inside,
Now numb from cold.

At noon the wind whips up
Over frozen fallow fields:
Snow ghosts
Suddenly rise and swirl
Above rows of cornstalk stubble—

Phantoms form,
Dart, dash, drive—
Then dissipate
Into a windbreak
Of winter trees.

1/9/2015

2015©Brian T. Maurer