High overhead grey clouds swirl;
Off to the north a lemon sky forms.
Distant thunder rumbles, rumbles again.

Our terrier paces up and down the porch,
Then freezes before my wife,
Panting in panic.
Stooping down, she gathers
The shaking puppy in her arms,
Holds her close,
Strokes her wire-wicker face,
Whispers canine caricias in her ear.
Thunder rumbles overhead;
The puppy trembles in my wife’s arms.

Suddenly, rain descends,
Slapping the street in torrents—
A cloudburst of summer tears.

Summer storm

Those who contemplate the beauty of the earth find reserves of strength that will endure as long as life lasts. —Rachel Carson

The weather held off until I got home.

As I sat secluded in my office drafting a letter, the rains came, slowly at first, then falling with force, pummeling the back porch roof. Lightning flashed; thunder clapped. I worked feverishly, finished, and powered down the computer. Downstairs, my wife was placing platters of food on the table: sausage, scalloped potatoes, carrots. Soon my son’s SUV pulled into the driveway. We sat down to a nice meal and ate in silence.

Afterwards, we retired to the front porch to watch the storm pass overhead. “The clouds are so low they’re touching the treeline,” my son said. We looked up to see a jumbo jet rise above the far hills and sweep across the grey sky, then disappear into the fog.

Finally, off to the north the clouds began to break up, revealing a sliver of blue. Gradually, the rain tapered off and the blue splintered, bursting into a wide expanse above our heads, while off to the east a curious white wispy cloud drifted across a backdrop of yellowish grey. Suddenly, the feathered edges caught the rays of the evening sun, glowing vermilion.

The dog’s nose twitched between the spindles of the balustrade. We too sensed the clear cool air, drawing it down into our innermost parts — a cleansing coolness, clear shining after rain.


Anticipatory guidance: Not just for patients

“There you had the opportunity to see what sometimes happens when we fail to provide proper anticipatory guidance to parents. Things devolve into disasters, and they’re much harder to fix.” more»

Interested readers can now access my latest Art of Medicine column — Anticipatory guidance: Not just for patients — 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.

America the Beautiful

Up the long hill
On our morning walk
We cross a side street,
The dog and I;
A car slides to a halt,
The passenger window descends,
An acquaintance from long ago
Hails me by name.
He’s now moved on
To assisted living,
Misses his work, misses
Young people in the office.
“Growing old is for the birds,”
He says, offering a hand
Devoid of several digits.

Further along,
Within the next block,
My neighbor steps out of his car,
Transfers the smoldering cigarette
To offer me his hand.
I point to the corner house
Across the street.
“Have you seen Paul?”
I ask him.
No, he shakes his head.
“He left without saying goodbye,
The house is in foreclosure.”
“How much they ask?”
“It will probably go to auction,”
I explain, pacing my words so he can follow.
“In Iraq I have much land,
Big wholesale business,
Import-export,” he says.
“In the war I lose everything.”
I wait in momentary silence.
“Now I try to begin again.”
I search my mind for something to say.
“Old biblical proverb:
Get knocked down seven times,
Get up eight.”
He nods his broad head
And smiles.

I sit on the front porch, reading.
The street sweeper whirs by,
Making two moist circuits,
Disappears at the far end of the block.
The postman zips down the street,
Snapping mailboxes open and shut.
His tiny truck coasts to a stop
Before our house,
The ever-present cigarette
Dangling from the driver’s mouth.

Two doors down
A tree climber drops
The topmost branches
Of an ancient copper beech.
Thy hit the ground with a thud.
“How old you think it is?” I shout.
From his eyrie perch he shrugs a shoulder.
“One hundred years at least,” he says.

My wife fills the birdbath and
Waters the irises.
A neighbor pauses with her dog
To admire the gardens.
“Your wife has a green thumb!”
A brown wren recites the liturgy
From his front porch pulpit
On the white wicker chair.

The church bell strikes noon.

My wife chats with the next-door neighbor
Over the scalloped picket fence.
I don my Panama hat
And saunter down to the park.
A white-eye-ringed duck
Escorts her brood of seven ducklings
Through murky still waters
Behind the tennis courts.
Pickup trucks and SUVs
Sprawl along the shoulder
Of the cul-de-sac at
The end of the road.
Dogs leap and race,
Owners bark commands,
Beers in hand.
A red-bearded man rolls a cigarette.
“I can get seventy out of a single pouch
Of American Spirit tobacco,” he says.
“It’s organic.”

The lone Latino man fishes the millrace
For food to feed his family.
Every evening he stands on the bar,
Casting a line into the current.

I retrace my steps up the hill.
Two doors down
Beneath the stately groomed trunk
The tree climber feeds
Dropped branches into his chipper.
“Comin’ down this evening,” he says.

Hot, tired,
I turn into my driveway and pause,
Push back my hat,
Look out over the flowerbeds:

There, in the freshly-manicured lawn,
A sentinel stand of forget-me-nots.

"Copper Beech" 2016©Brian T. Maurer

“Copper Beech” 2016©Brian T. Maurer

2016©Brian T. Maurer

Physician assistants and nurse practitioners in outpatient surgical settings

In the May issue of JAAPA, Salibian and colleagues present an independent research study that examines the use of PAs and NPs in outpatient surgical subspecialty settings. more»

Readers can now access my latest musing — PAs and NPs in outpatient surgical offices — at the Journal of the American Academy of Physician Assistants Editorial Board blog.

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