Sitting at Desk on a Winter Evening

Whose post this is I scarcely know,
It’s housed inside some server, though;
I scroll it down, so sharp and clear,
To survey it before I go.

My little muse must think it queer
To interact from year to year
Within the realm of cyberspace—
Which knows no pain and knows no fear.

She shakes her head, regards my face
As if all this were some disgrace;
I fight to keep her goads at bay,
Then carry on in frenzied pace.

These days we all have much to say,
We bide our time in just that way;
We twitter, tweet and post a look
As hours tick by day to day.

The virtual world, one cosmic book,
Has snagged us all with one great hook,
While time itself, that clever crook,
Has robbed us that which we forsook.

(Apologies to Robert Frost,
Who did not live to count the cost.)

Copyright 2011 © by Brian T. Maurer

A multitude of (uni)verses

To poets
The universe
At core
Is terse—
(One verse, of course),

While at its source
The word universal
Is much more
Lyrical, versical;

And universality
Denotes a finality
Infinitely finite
(As Einstein
Calculated)—

The end’s in sight,
Though light
Years away
Einsteinian insight.

Post-modern physicists
Now insist

Our universe
Is hit or miss,

For in reality
There’s no finality:
In fact the one
Is mere multiplicality;

Not universe,
But multiverses
For better or
For worses.

It’s certainly more than
I can fathom:
Inside my brain
The (uni)verse
Remains the same—
Terse.

Copyright 2011 © by Brian T. Maurer

Poetry in medicine: Chapter and verse

In a previously published Musings blog entry, A plea for poetry in medical practice, I wrote:

Poetry (as well as good literature) is capable of stimulating the development of empathy in the reader—in this case, the clinician—and serves to enable him or her to approach the patient with an element of understanding and compassion. Such an approach undergirds the delivery of quality medical care.

In that piece I advocated for the inclusion of poetry in the medical curriculum to cultivate empathy on the part of clinicians toward their patients:

“It isn’t that clinicians are totally thoughtless people,” I opined. “In many instances they just never learned to appreciate what it might be like to stand in the patient’s shoes.”

On the heels of these words how heartened I was to peruse Dr. Pauline Chen’s recent New York Times column The Doctor as Poet, for here Dr. Chen expresses the same sentiment. more»

A Christmas story

In “A Victorian Christmas,” New York Times columnist Maureen Dowd describes Charles Dickens’ final Christmas as “painful and miserable.”

In many of his literary works Dickens had managed to find some redeeming value in Christmas.  At the last he was confined to bed, beset by sheer exhaustion and severe gout.  Even after a lifetime of literary successes, the novelist was haunted by the fear of future obscurity.

And yet Dickens seems to have come to accept the hand that fate had dealt him.  With an air of equanimity he advocated that each one of us should “Welcome, alike what has been, and what never was, and what we hope may be, to your shelter underneath the holly.”

As enlightening as Dowd’s Dickensian column is, to my mind one reader’s comment trumps it.

Bryan Barrett of Malvern, Pennsylvania, records a tale of forgiveness recalled from a boyhood Christmas long past.

In 1950 Santa was intercepted and his gifts placed in my Dad’s car mysteriously disappeared. Panic at midnight ensued; the police were informed as was the toy store owner. I accompanied my Dad to the toy store to replenish and returned home where the police were waiting with the purloined toys and the suspect. My Dad invited all inside our home where he poured Irish Whisky. He requested that the police not press charges, drive the man home with the gifts, and all drank a toast to Christmas. The following morning Dad arose early, drove to his sisters store, loaded his car with food and delivered it to the man, who had seven kids, no job, no money and was desperate. They had grown up together. My Dad arranged a job for him which he held until he retired. For many years Dad sent a Christmas food hamper to them until the kids were raised and never mentioned this wonderful incident to anyone. My Mom and yours truly were the only witnesses, other than the police and the desperate man.

Would that we all, like Barrett’s father, might practice the Dickensian tradition — both at Christmas time and throughout the year.

Mus leucopus

The mice which haunted my house were not the common ones, which are said to have been introduced into the country, but a wild native kind not found in the village. I sent one to a distinguished naturalist, and it interested him much.  —Thoreau, “Brute Neighbors,” Walden

“Something’s moving inside the walls of the family room,” my wife says. “I can hear it scratching when I’m watching TV.”

“Maybe it’s a bug of some sort,” I say, thinking of various beetles, carpenter ants and termites.

“No, it’s too big for a bug.”

“You think it might be a squirrel?” I say, recalling similar sounds I’ve heard in the attic late at night.

“It might be. It makes quite a racket.”

I retreat to the computer, google “crunching sounds in the wall” and pull up 20,300,000 hits in 0.30 seconds.

One post describes the likely source of such sounds:

“Mice are mainly nocturnal, so you are probably dealing with mice if only at night. I say whatever you think you have, you’ve got something smaller. So if you think it is a hippo, it is probably a raccoon. If you think it is a raccoon, it’s probably a squirrel. If it sounds like a squirrel, it’s probably mice. Everything sounds louder at night when you’re trying to sleep.”

As I read through several additional posts, I hear a munching, crunching noise in the ceiling overhead. Whatever it is that’s making these sounds, it’s a good bet that there is more than one of them.

I retire to the basement to find my Have-A-Heart trap resting on the window sill. I pick it up, dust it off, check the mechanism to see that it still functions properly and traipse upstairs to the kitchen.

I find an unopened jar of natural peanut butter in the larder and break the seal, stirring the oil into the thick peanut paste. I use a kitchen knife to scrape a small amount on the treadle inside the trap.

I find an electric lantern and ascend the stairs to the attic, trap in tow.

The attic is cold and cluttered with bags of old clothing and boxes of books. I move a few items to make a pathway to the back corner and gently rest the trap on one of the floor boards. Then I retreat down the hatchway and let the wooden stairs fold back up into the ceiling.

That night I waken to a scratching sound in the ceiling above the bed. The sound does not travel, but stays in one place. I drift off to sleep. If something is in the trap, it can wait until morning.

I rise early, before first light, pull down the hatchway and climb the creaking wooden stairs to the attic. I hold the electric lantern high to illuminate the path through the clutter. Both doors of the trap have been tripped.

I pick up the cage and peer through the mesh. There, huddled in a corner, a white-footed mouse hunkers down.

I carry the trap with the mouse downstairs to the kitchen and place it on a wooden stool. I brew a cup of coffee and sit watching the mouse. It wiggles its nose; its whiskers tremble.

Wee, sleekit, cowrin, tim’rous, beastie,
O, what a panic’s in thy breastie!
Thou need na start awa sae hasty,
Wi’ bickering brattle!
I wad be laith to rin an’ chase thee,
Wi’ murd’ring pattle!

I’m truly sorry Man’s dominion
Has broken Nature’s social union,
An’ justifies that ill opinion
Which makes thee startle
At me, thy poor, earth-born companion,
An’ fellow-mortal!

Coffee mug in hand, once again I ascend the stairs to shower and dress. I tie a bow around the collar of my shirt, pull on my grey tweed coat, and regard myself in the mirror for a fleeting moment before descending to the depths of the kitchen, where the mouse waits, shivering in the trap.

I doubt na, whyles, but thou may thieve.
What then? poor beastie, thou maun live!
A daimen icker in a thrave
‘S a sma’ request.
I’ll get a blessin wi’ the lave,
And never miss’t!

I pull on my coat and cap and step out of the back door into the cold, carrying the trap in a gloved hand. It’s a fifteen minute drive to the other side of town across the river. I stop by the woods and unceremoniously open the trap. The mouse leaps to the ground and scurries away beneath the leaves, making one last brief crunching sound.

Now thou’s turned out, for a’ thy trouble,
But house or hald,
To thole the Winter’s sleety dribble,
An’ cranreuch cauld!

But, Mousie, thou are no thy lane,
In proving foresight may be vain:
The best-laid schemes o’ Mice an’ Men,
Gang aft a-gley,
An’ lea’e us nought but grief and pain,
For promised joy.

The Descendants

Imagine that you are a 40-something lawyer, married with two daughters, living on the island of Oahu, and the sole administrator of a century old land trust; somewhat estranged from your wife, who recently incurred a head injury in a boating accident that landed her in the ICU.

You find yourself suddenly cast in the role of primary parent, unsure as to how to relate to your rebellious children in your wife’s absence; when you discover that your wife was having an extramarital affair. To complicate matters a bit further, your wife’s physician informs you that your wife has been declared brain-dead. Soon life support will be withdrawn and she will be allowed to die.

If you’ve followed this convoluted cinematic plot so far, you can readily guess at the myriad emotions that Matt King (George Clooney) is experiencing all at once: grief at his wife’s passing, anger at her for her marital infidelity, frustration in his attempts to parent his two rebellious daughters, and a twisted need to find and inform his wife’s lover so he also can say goodbye to her before it’s too late.

These are the sorts of swirling concomitant emotions that no one man should have to bear, yet bear them Matt King does with a subtle helping of grace to get him through.

Alexander Payne’s “The Descendants” takes pains to examine each of these scenarios in heart-rending detail juxtaposed against a subplot of wrestling with the decision for disposition of the family land trust. Although there are moments filled with welcomed comic relief, for the most part the viewer finds himself pulled into the emotional turmoil depicted on the big screen.

Some years ago I attended a conference on the island of Kauai. I recall much of the landscape depicted in the film, from the pristine beach at Hanalei to the Na Pali cliffs rising 4,000 feet up from the sea.

Despite the beauty of the countryside and the lulling Hawaiian music, “The Descendants” is no adventure in paradise. The human condition is the same the world over, no matter the culture or the socioeconomic status of the family.

Yet in the final scene we witness this fractured family of descendants somehow bonding again, silently sharing the warmth of the counterpane that lay across the mother’s hospital bed and bowls of ice cream on the loveseat in front of the TV.

Humane Medicine — An unlikely afternoon hero

She sits quietly on her mother’s lap. A child’s blanket is draped over the crook of her left arm, the corner clutched tightly in her left hand close to her mouth. The right arm lies pronated across her thigh. The mother strokes her hair, whispering into her ear. Together they form a portrait which might have been painted by Mary Cassatt. more»


Interested readers can now access my latest Humane Medicine column — An Unlikely Afternoon Hero: When being there is good enough — recently published in the Journal of the American Academy of Physician Assistants.

All good things must come to an end

He was standing on the lower driveway at the back of the house, hands in his pockets, looking out over the expanse of back yard. Both the knoll and the distant flat land were covered with evergreen trees. At the far end the land turned into the marsh of a beaver swamp.

He was dressed in coarse khaki coveralls. An old jacket soiled from years of physical labor hung from his shoulders; a red faded ball cap rested on his head. He turned to the sound of our feet shuffling on the back porch. We had come as we always do this time of year to tag a tree for Christmas.

My daughter reached for one of the packets in the plastic wash tub. The green paper listed the price of this year’s trees with instructions for tagging your selection in the field. I raised a hand in greeting and pushed back my cap. “I see you’re still in business,” I laughed. “We’ve come to pick out a tree.”

He turned and ambled up the stone steps to the porch. His face looked drawn and gaunt. He accepted my hand in greeting. “Yes,” he said, “although this will be our last year. We’re putting the house up for sale. No guarantee that the new owners will want to continue the backyard Christmas tree business.”

His words caught me up short. We had been getting a tree from him every Christmas for the past 25 years. Although I only saw him twice a year — the day we came to tag a tree and the day we returned to have it cut — I had come to regard him almost as family.

“I’m sorry to hear that,” I said. “I suppose everyone has the option to retire at some point.”

He smiled. “Yes, I suppose that’s so. Don’t really want to give it up, but I’m getting on in years. Turned 82 this year, and I can’t handle the work anymore.”

“Where will you go?”

“McLean’s,” he said, naming the local assisted living facility on the other side of the hill. “Gotta face it — age eventually catches up with all of us.”

He turned and looked out over the hillside. “I put my heart and soul into this business. Planted our first trees in 1965 — forty-six years ago. At first I only planted the flat land. Kept the hill open so my kids could go sledding in winter. After they grew up, I planted the slope as well. That’s my youngest son raking down there — he’s 52 now, too old for sledding.”

His son looked up from his work and smiled. “You folks need any help finding a tree?” he asked.

“No, we’re regulars,” I told him. “We’ll fill out the tag and the card and head out to make our selection.”

“Say, could I interest you in a sled?” the old man said. He pointed to three wooden Lighting Gliders leaning up against a table on the porch. “We had a tag sale last week, but these didn’t go. My kids used them when they were small. They still work fine — you can actually steer a sled like these, not like those newfangled plastic jobs that go wherever they’ve a mind to.”

I ran my hand over the steel runners of one of the sleds. The stenciled name had worn off the wood after decades of weathering and use. “How much?” I asked.

“Ten dollars.”

“Deal,” I said.

I opened my wallet and fished out a bill. We stood the sled in the shade by the side of the house, and walked past the old man and his son down the slope into the forest of trees to make our final selection.

A tree is just a small part of Christmas, of course; some would say an insignificant part, merely a household decoration that temporarily graces a home as the year draws to a close. Yet it provides a familiar ritual to those who select it and cut it, bind it to the car roof and bring it home, dust the snow from its branches and trim it with decades old ornaments, some of which have been lovingly preserved through several generations, under which the presents appear on Christmas morning, those gifts freely given without regard to merit or standing, tokens of love and grace.

“Notes from a Healer” — A Bad Day

The child is lying face down on the exam table. She’s dressed in a johnny top that’s too short for her lanky frame. Her hair is clipped short, like a boy’s. She’s got a tuft of cotton wadding wrapped around her left index finger; the thumb on the same hand is thrust into her mouth through pursed lips. more»

My latest installment of Notes from a HealerA Bad Day — 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.

A toothsome conversation

Henry spends several minutes explaining the intricacies of Bonezai Skeleton Warrior, one of the latest Lego creations. Bonezai Skeleton Warrior sits atop a Lego chopper wielding his bone-handle battle-axe. “He’s got 2,400 Earth strengths,” Henry tells me. At seven years of age, Henry is a master Lego builder.

Henry recently lost four front teeth. Three new ones have grown in; the fourth is coming along nicely.

“What happened to your baby teeth?” I ask Henry.

“I put them under my pillow and the tooth fairy came in the night and took them and left me a quarter for each one.”

“Ah, very good. What does the tooth fairy do with the teeth she collects?”

Henry stares off into space for a moment. “She uses them to build a tooth castle,” he explains.

“What, exactly, is a tooth castle?”

Henry regards me as though I should know better. A tooth castle is self-evident, sort of like the truths enumerated by Thomas Jefferson in the Declaration of Independence.

“I saw the tooth fairy once,” Henry confides.

“You did? When?”

“I got up early one morning and put on my bathrobe and slippers and went outside to see the tree with the hole in it. You know, the sort of hole that a squirrel might use for its nest.”

“I know just the sort of hole you mean,” I tell him.

“Yes, well, I was looking at the hole when suddenly the tooth fairy flew by and disappeared into it.” Henry sweeps his hand through the air to emphasize the speed of the fairy’s flight.

“Really?”

Henry nods his head. “Yes, you see the hole leads down to a secret underground passageway to the tooth castle.”

“My goodness. How lucky you were to have seen her. What did she look like?”

Henry thinks a moment. “Well,” he says, “she had red hair streaked with pink and purple. And she was wearing an orange dress with yellow stars—and triangles too.”

“I suppose she was unmistakable.”

“You can always tell,” Henry informs me.

“Have you ever read One Morning in Maine?”

Henry shakes his head. “What’s it about?”

“It’s a story about a girl your age who loses her first tooth. She has to decide what to do about it. In the end she decides to make a wish on it.”

“And does her wish come true?”

I nod my head. “Yes, it does.”

Henry contemplates the idea of wishing on a lost tooth. “Next time I lose a tooth I’m going to wish for—”

“Ah, but you mustn’t tell anybody your wish, or else it won’t come true.”

“But how will they know?”

“I suppose you could tell them if it did come true,” I say.

“This portends a dilemma,” Henry’s grandfather tells me.

“It does; but this very same dilemma is addressed in the book.”

Henry’s grandfather writes down the title of the book and its author. “We’ll have to look for it in the library,” he says.

Henry seems to be content with this plan.

I push up from the table and rise to my feet. “I must be going now,” I explain.

“It was very nice to meet you,” Henry says. We shake hands. “My fingers are rather short,” he says, almost apologetically.

Henry holds his hand up against mine and we compare finger lengths.

“They seem to be growing well,” I observe.

Henry inspects his fingers. “They’re fine for building Legos,” he says.

“And wiggling loose teeth,” I tell him.