Hospital Visit

We drove down to the hospital to visit Avery. His wife called last night to tell us that he had been admitted that morning with a saddle clot in the lung. “He complained of chest pain the night before,” she told me on the phone. “He just finished radiation therapy. We thought it might have been from that. I wanted to take him back to the hospital right then, but he insisted that we wait ’til this morning. They did another CT scan and found the big clot. The doctors told us that the cancer had spread throughout his lungs, too.”

I called after I got home from work to make sure that he was still a patient there. The woman on the phone verified the room number. Maria wanted to come along, so we drove down together.

The weather had cooled considerably overnight. The humidity had dissipated, leaving behind a cool crispness in the air. Except for the sea of clouds floating on the distant horizon, the sky was otherwise a homogenous blue.

We found Avery and his wife in the sixth floor room at the end of the hall. Avery was sitting in a chair, while his wife sat on the bed. After a brief round of introductions (we had never met his wife in person before), we settled into two adjacent chairs.

Avery’s hair had thinned considerably from the radiation. He looked a bit puffy in the face. I noticed that the lump on his neck had grown in size since last I saw him six weeks ago. But his eyes were still steady, a brilliant blue like the afternoon sky.

“They gave you a nice room,” I said, motioning with my head to the banks of windows on the two sides. “Quite a view.”

“Yeah,” Avery said, “and it’s at the end of the hall, so I’m not bothered so much by the noise. ‘Course, I can’t hear so well after the radiation; but then again, that’s less that I have to put up with, too.”

“We had a big thunderstorm last night,” Avery’s wife said. “It thundered so bad it nearly shook the whole wing.”

“I like thunderstorms,” I said.

“Not me,” Avery’s wife said. “They scare the bejesus out of me.”

“I don’t like them either,” Maria said.

“I do,” said Avery. “Last night we had hail. It pounded against that far bank of windows for twenty minutes. I could hear the hail all right.”

“Are you in much pain?” I asked him.

“I was, but it’s better today. They’re giving me morphine every four hours, so that’s helped a lot. But I haven’t had to ask for it as often today.”

“I wanted to bring him in last night,” his wife said, “but he wouldn’t hear of it.”

“It worked out O.K.,” Avery said.

“How long do you have to stay in?’

“A week; maybe ten days.”

“He was supposed to start chemo on Monday. Now we don’t know what’s to be done when.”

There was a knock on the door. A middle-aged man entered the room. He had a bushy black moustache and a black stethoscope draped around his neck.

“Hello, I’m Doctor Sales,” he said. “I stopped by to see how you’re doing. Who are these folks?”

Avery introduced his wife and us. We stepped out of the room to let them talk with the doctor. Maria walked down the corridor to the other end and looked out the window. I could see her silhouette framed against the white light. She stood there a long time. I leaned up again the wainscoting and looked at the pictures on the wall. You could hear the low murmur of the doctor’s voice coming from behind the door in the room. After a while he came out and smiled briefly as he walked past me down the hallway. Maria returned and we stepped back into the room.

“Looks like seven to ten days for sure,” Avery’s wife said. “They don’t want to take a chance sending him home until the clot is dissolved. But they may be able to start chemo next week like they planned.”

The conversation shifted to dogs; I’m not sure how we got on the subject, but we talked for a good twenty minutes about the dogs Avery and his wife had over the years. Their latest one is a yellow lab mix they got from canine rescue. He’s just a pup really—only a year and a half old.

“Only problem is that I can’t leave him off the leash,” Avery said. “He likes to chase cars too much. Otherwise he’s a great dog.”

“He likes to climb in Avery’s lap. The dog must weigh fifty pounds, too.”

“He’s a good lap dog,” Avery said.

“He’s too heavy for a lap dog,” Avery’s wife said.

“Not for me,” Avery said. “Even though he knew something was up with me two months ago.”

“Really?”

“Yeah; that’s when he stopped hopping up into my lap. It was almost like he knew something was wrong with me—didn’t want to hurt me any.”

“You know, that’s true,” Avery’s wife said. “Somehow that dog knew.”

The conversation ebbed. Avery looked tired. I noticed that he was breathing a bit more rapidly now, taking small shallow breaths. We stood up to go. “I’ll try to get down to see you again sometime next week,” I said. We shook on it, and Maria and I walked down the long corridor to the elevators.

Driving north, I noticed a big red-tailed hawk soaring overhead above the highway. He seemed to be playing with the wind, his wingtips dancing on the air currents, sailing along beneath the brilliant sea of blue—that same brilliant blue of Avery’s eyes, still steady.

Four Dollars a Dozen

I caught sight of the sign posted by the side of the road: “Sweet Corn, $4.00/dozen.” On a whim I pulled off onto the dirt lane to find an elderly man turning his truck around. To my chagrin I saw that there were only a couple ears of corn lying on the wooden stand.

The man stopped and opened the truck door. “Looking for some corn?” he asked. “How many you want?”

“I’ll take half a dozen if you’ve got some.”

The man counted the ears. “Only three here, but I’m heading down to the field to pick some more. You’re welcome to follow me down if you like. I’ll be back in twenty minutes.”

I nodded. “I’ll follow you,” I said.

We pulled out onto the macadam road. It was a short drive to the field. I followed his truck through the break in the trees and parked behind him in the grassy meadow.

The man disappeared in among the stalks of corn while I waited at the edge. A cool breeze dampened the early afternoon heat of the sun. I looked out over the expanse of the meadow and saw a monarch butterfly landing on some clover. Sounds of crickets reverberated in my ears. I thought about my boyhood days back in Pennsylvania farm country, and sucked in a deep breath of the sweet summer air.

It wasn’t long before the man reappeared, bearing a white plastic bag full of freshly picked corn. “Here you go,” he said, handing me the bag. “I’m not sure how many are in there, but there’s enough.”

“Thanks so much,” I said, handing him two dollars.

“It doesn’t come any fresher than that.”

“I guess not. I appreciate you offering to let me follow you out to the field. You’ve got a nice spread here. How many acres in all?”

“One hundred and fifty now, but we used to have over five hundred. Had to sell off a parcel up on the mountain side—a meadow where we used to put the heifers out to pasture. Didn’t have any real use for it after we sold the dairy herd back in 1985, although I did like to go up there on occasion just to walk around.”

“Pity you had to sell it.”

“I felt bad about it, but times change; and we needed the money to keep the farm going.”

“I grew up in farm country down in Pennsylvania. A lot of those family farms are gone now, turned into housing developments.”

The man nodded. “One good thing,” he said. “So far the fellow that bought the land from me hasn’t done anything with it. I’m happy about that.”

We stood together in silence for a moment. I noticed the man’s trifocals. “How many years have you been farming?”

“All my life,” he said. “Just celebrated my 79th birthday. I was born in 1928.”

“Good for you. You look like you’re in good shape.”

“Funny,” he said, “I don’t feel old at all. I’m fortunate that I can still put in a day’s work and feel good. The farm’s been in our family for three generations now, and my grandson thinks he’d like to take it on.”

“You must be proud,” I said.

“Well,” he said, “we’ll see if he can make a go of it. It would be nice to see the family continue to farm the land.”

The old man told me the name of the farm. It had a hyphenated name. “The second name is for my brother,” he explained.

“My brother was two years older than me. He enlisted in the service during the Second World War; went over to fight in Europe, but didn’t make it back. We got a letter from a fellow in his unit. They had been captured by the Germans, and the allies were shelling the area at the time. This fellow said a shell exploded near my brother. He didn’t know exactly what happened to him, but he told my parents that he didn’t think my brother made it, so they knew that much.

“Then, twenty years ago, we got a letter from the Department of the Army. They said they were in process of moving some graves in that area, and had written to the families of the dead. I guess some fellow wrote back to tell them that he had survived—he didn’t know who was in that grave, but it sure wasn’t him. So they opened the casket and found my brother’s dog tags with the remains. We decided to bring him home. He’s buried in the local cemetery just up the road.”

I stood still and watched the man’s face as he told the story.

“I didn’t know him that well,” he said. “We were never what you’d call close, but I remember going out in the back yard and throwing a football with him. He was a good egg.”

“It must be nice having him home again,” I said.

“You know, it is.” The man’s eyes got misty. “It was nice talking with you,” he said. “Enjoy the corn.”

“I will. Can I swing around here in the field to get back on the road?”

“Sure thing. I’ll go up and watch for traffic.”

I set the bag of corn down behind my seat and climbed into the car. The man was standing in the middle of the road, waving me out. I lifted a hand in greeting as I turned onto the pavement.

Four dollars a dozen; two dollars a half. Bargain prices for freshly picked sweet corn. I couldn’t help thinking that the old man had benefited from our brief encounter a bit more than just two dollars. I know that I had as well.

Sculpted in Stone

“It’s such a lovely summer afternoon. Let’s take the dog out for a walk down by the river.”

Reluctantly, I put my book aside, search for my battered felt hat and meet my wife outside on the driveway. Leashed, the dog is already panting in the afternoon heat.

We stroll down the street and cross the bridge to Old Hartford Avenue past the newly christened Old Stone Village—refurbished historic houses converted into a condominium complex. Today there is an open house, and we stop to chat with the realtor. He shows us one of the units for sale and hands us a card.

On the way back we hop the guardrail and descend to the river. A multitude of cedar waxwings dart about above the water, feeding on the latest hatch of insects. I point out their field marking—the yellow edge of the tail—to my wife.

We pick our way along the bank to the base of the old bridge abutment. Great redstone rocks are strewn over the steep slope. “There must have been a retaining wall here at one time. It may have been washed away in the flood,” I muse.

My wife stoops to pick up a rock—a much smaller stone, smooth and grey with two flat surfaces and irregular edges. “This looks like my grandfather’s whetstone that I brought back from Spain,” she says.

“It does look similar,” I agree. “It reminds me of those stones for sale in the gift shop at the Florence Griswold House.” We had trekked down to Old Lyme to view the collection of paintings by American tonalists and impressionists the day before.

“I didn’t notice them. Do you think anyone will mind if I take this one home?”

“A rock is a rock,” I smile. “Finders keepers.”

We push up the steep slope and cross the barrier onto the street. My wife hands me the rock to carry. I turn the stone over in my hands, feeling its smooth coldness. Uncut, yet having two flat faces, it reminds me of headstones in the cemetery on the hill.

“When I was in high school, there was a boy two years behind me who used to sculpt stone like this one,” I say. “He had a wild head of hair, and always kept to himself.”

“What happened to him?”

“Academically, he came to nothing—a hopeless case. But artistically—” I pause to remember, “the stones he sculpted were quite beautiful: round and smooth with clean curved lines. They were on display in the art room. It was a pleasure to turn them over in your hand.”

“So, did he become a great artist?”

I stop and stroke the stone again, feeling its cold smoothness in my hand.

“No. He never graduated high school. They found him one day with a bullet in his brain—self-inflicted gunshot wound. His other hand cradled a stone he had been sculpting—smooth and grey with clean curved lines.”

My wife pulls the dog up short on the leash. “Why did he do it?”

“No one knew. He came from a large family; his parents had split up. Like a lot of other young impressionable artists, the world killed him, I suppose.”

We retrace our steps across the bridge. I cradle the stone in my hand and pause to watch the waxwings dancing above the water in the late afternoon light.

Author to address 2007 graduates of Quinnipiac PA program

Brian T. Maurer will address the graduating class of the Quinnipiac PA program at three o’clock in the afternoon on Monday, August 6, 2007.

He will speak to the new graduates on “Something of Value: The Art of Medicine.” Maurer’s presentation will include insights from his 28 years of practice in pediatric medicine, crafted in his book, Patients Are a Virtue.

“We learn the practice of medicine through the complex process of integrating knowledge and skills with wisdom and insight in our interaction with the patient. Although the medical record forms a composite history of the patient’s illness; for the clinician, it may be the illness narrative that ultimately imparts some degree of healing to both practitioner and patient alike.”

“You have learned the science of medicine; you have delved into its business. Now it is time to recall the art of its practice, for it is only in the practice of the art of medicine that you will sustain yourselves from day to day over the span of your professional careers.”

Sunday Morning Saunter

Five-thirty; first light. I lie in bed, listening to the sounds of morning. Outside the window, a barely perceptible breeze rustles the leaves in the maples that tower above the house.

I arise with the sun, quietly dress, pad down the stairs to the kitchen and out the back door. Overhead, against the backdrop of blue, a stream of wispy white cotton-candy cirrus clouds stretches across the sky. Thistle finches fly by, their tiny yellow bodies punctuating the morning blue.

I follow the narrow path around the back of the house and descend the small grassy incline to the front yard. A woodpecker has been busy chipping at the shakes on the side of the house. I notice the tiny pile of wood chips among the ferns near the foundation.

Across the yard on the front knoll, a sea of black-eyed Susans stirs slightly in the morning air. Wild pink roses cling to the white arched trellis that marks the entrance to the front walk.

I retreat to the back yard and stand by the fence. Lithe stalks of hosta, heavy with pale purple flowers, bend toward the morning sunlight.

A few more steps bring me to the pond, where I pause to look into its depths to find the leafy branches of the maple tree silhouetted against the sky. The words of Thoreau come to mind: “Heaven is under our feet as well as over our heads.”

Across the fence stands our neighbor’s garden: rows of tall tomato plants staked with old hockey sticks, a silent testimony to Yankee thrift and prudence: “Use it up, wear it out; make it do, or do without.”

Chickadees call from an adjacent apple tree as they flit among the branches searching for a breakfast of insects. A catbird lights on the roof of the garage, runs along the peak and disappears down the other side. Over by the stone wall a thistle finch, perched on a slender sprig, bobs up and down like a tiny gymnast practicing his morning trampoline routine.

The sun climbs higher, scattering light across the expanse of the garden. A potted stand of red impatience suddenly turns a brilliant crimson. Overhead, maple leaves rustle; the breeze has come up again.

Here I am reminded of Scott Russell Sanders’ words: “Heaven is not so much a place as an experience.”

“Notes from a Healer”—Patient Understanding

Taking the time to explain things in detail to a patient promotes trust in the doctor-patient relationship; but sometimes it’s the clinician that requires understanding as well.

Interested readers can peruse my latest “Notes from a Healer” column—Patient Understanding—in the Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine acts as an online clearinghouse for manuscripts dealing with humanities in medicine.