The Art of Medicine: Dispensing empathy in the pediatric setting

Slowly, the student nods her head. On this, the last day of her pediatric rotation, she has learned a valuable lesson: listening to the patient with an empathetic ear will generally hold you in good stead. more»

Interested readers can now access my latest Art of Medicine column — Dispensing empathy in the pediatric setting — recently published in the Journal of the American Academy of Physician Assistants.

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

What’s so memorable about Memorial Day?

For many Americans Memorial Day marks the beginning of the summer season with parades and afternoon cookouts on the grill; yet the roots of this holiday go much deeper than that. Come and learn about the historical significance of this most sacred of secular holidays in a presentation by one of our local veterans, Brian T. Maurer, at the Simsbury Public Library on Thursday, May 24, 2017, at 1:00 PM.

A veery in the wood

Last Saturday, the penultimate day of the annual spring census, dawned bright and blue. My list of birds had grown over the past week to more than 60 species. I grabbed my binoculars and headed down to the path that runs along the river, anxious to capture whatever sightings I could before time ran out.

Almost immediately, I was greeted by the song of a redstart from somewhere in the canopy overhead. Catbirds darted in and out, mewing from the bushes. The river ran high in the wake of recent rains, and from across the silent swirling eddies the sounds of warbling vireos came sharp and clear.

Up ahead something darted across the trail into the brush. I froze, brought my binoculars up, and focused into a tuft of trembling leaves. A black-masked yellow throat busily gleaned a twig. Momentarily, he sounded his witchety-witchety-witchety call. As I paused to record his name in my notebook, another call echoed through the wood.

Breathless, I strained to listen. There it came again, distant but unmistakable: flute-like notes, slurred together in a series of descending trills.

Carefully, I stepped along the trail, taking care to avoid snapping a branch or twig underfoot. The air was cool and clear; and when the bird sounded again, the refrain became sharper still.

I stood for several minutes, steeped in this song, and wondered at its beauty.

The song of the veery (Catharus fuscescens) has been described in various ways, each a sincere attempt to capture the refrain, each falling somewhat short of the actual performance. The Cornell Lab of Ornithology reports it as “a series of variations on veer, descending slightly in pitch, resonating as if whirling through a metal pipe.” Nineteenth-century observers called it “an inexpressibly delicate metallic utterance…accompanied by a fine trill which renders it truly seductive.”

The best way to experience this woodland singer is to head to the forest on a clear, cool morning in spring and listen. At some point, the patient observer is sure to be rewarded.

Spring warblers in the treetops

I hear, and have for a week, in the woods, the note of one or more small birds somewhat like a yellowbird’s. What is it? Is it the redstart? I now see one of these. The first I have distinguished. And now I feel pretty certain that my black and yellow warbler of May 1st was this. As I sit, it inquisitively hops nearer and nearer. It is one of the election-birds of rare colors which I can remember, mingled dark and reddish.   —Thoreau’s journal, May 10, 1853

One morning this week I wandered through the woods along the path by the edge of the river. Periodically, I paused to focus my binoculars on a short, slight movement in the trees. During these moments I became aware of the cacophony of calls from the canopy overhead. Similar songs emanated from various quarters. It took a bit to tune my ear to pitch and tone. Patiently, I stood, waiting for signs of movement among the budding branches. At last I was rewarded. The canopy was ripe with small black and orange warblers, redstarts most assuredly.

Over the course of these past few mornings I have identified by sight and sound any number of species: the blue-winged warbler, the black-throated blue; the yellow-rumped variety and the black-and-white; the yellow warbler and the chestnut-sided. The warbling vireos have declared their return as well, mostly through their distinctive songs high in the treetops.

Thoreau reveled in the return of the warblers in spring, when the green forest is splashed with dabs of color—

Within a few days the warblers have begun to come. They are of every hue. Nature made them to show her colors with. There are as many as there are colors and shades.  —Thoreau’s journal, April 19, 1854

Digital media use: Updated guidelines for busy clinicians

If you’ve got a moment to spare in your typical 24/7 online presence, consider perusing Licata and Baker’s timely JAAPA article “Updated guidelines on digital media use by children.” (Disclosure: It’s only available online, so access is limited through your digital smartphone, electronic tablet, notebook, laptop, or desktop device.) more»

Licata and Baker provide the busy clinician with an overview of the American Academy of Pediatrics updated guidelines for counseling parents and children on the judicious use of electronic devices.

Read more about these updated guidelines in my latest entry on the Musings blog of the JAAPA Editorial Board here.

JAAPA is the official publication of the American Academy of Physician Assistants.

The Art of Medicine: Under the radar

He sits on the edge of the examination table, this young man of 23 years: shoeless, sockless, his feet dangling down below the tattered hem of his worn trousers. A faded gray pullover is likewise threadbare. With one glance, I ascertain the reason for this visit. more»

Interested readers can now access my latest Art of Medicine column — Under the radar — recently published in the Journal of the American Academy of Physician Assistants.

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

Words that heal

Blessed are they that mourn, for they shall be comforted.

There once was a physician who had twin daughters. One grew up to become a psychiatrist. The other developed schizophrenia as an undergraduate. She poured out her anguish through words with pen on paper. Eventually, she became a published poet. Of the two daughters, which one was the healer?

In order to diagnose, a psychiatrist must learn to listen to the patient. Now there are many practicing psychiatrists who base their pharmacological treatments on symptoms alone. Medication regimens are adjusted based upon the patient’s response to the drug. Sometimes the dose is increased to enhance the effect of the drug; other times the drug is discontinued because of untoward side effects. Much of pharmacological treatment comes down to trial and error. Many times medication can help, but in the end a pill cannot heal a soul.

Freud, regarded by many as the father of psychiatry, once wrote: “Wherever I go, I find a poet has been there first.”

Throughout the centuries poets have pursued the art of crying out, of putting pen to paper (or stylus to papyrus), crafting words as conduits to transmit their anguish, their deepest longings, their joys, their sorrows. Many have written in part to help themselves to heal. When we read their words, we enter in to their anguish, their longings, their joy and their sorrow; and when we do, we ourselves may experience some degree of healing as well.

It doesn’t take a college degree to become a poet. One must only open oneself up to the suffering of the soul, to face one’s demons, to record the emotional truth of the spiritual state, to capture the passion (and in this instance I refer to the root meaning of that word: to suffer) in a few brief lines which may, if one is lucky, last for an eternity.