Hands

This morning I awaken early, thinking of hands — human hands.

How marvelous the anatomy and dexterity of the human hand! Four lithe fingers, each possessing three separate joints, and one thumb allow a firm grasp for manual labor or those delicate manipulations necessary for artistic expression. The same hands that clasp the wrench and shovel also finger the frets of the guitar and pluck the taut strings of the bass viol. How invaluable the fingers for the keyboard, that universal tool through which the written word captures our deepest and most lofty thoughts! Small wonder that a significant section of our motor cortex is devoted exclusively to control of the hands.

Silently, I mourn the stroke victim who at his side cradles a withered hand, firmly flexed and gnarled; unable to extend; useless.

As I take my morning tea, my hand encircles the mug, grateful for the warmth that permeates fingers, palm and thumb.

I thrust my hands beneath the spigot and begin to wash. Before donning sterile gown and latex gloves a surgeon takes care to scrub up and down each finger, dorsum and palm, even wrist and midway up the forearm. In the surgical theatre clean hands are a necessity.

The same hands that created those majestic paintings on the ceiling of the Sistine Chapel also squeeze the trigger of the Kalashnikov rifle. I imagine Michelangelo working to rub the paint stains off his fingers with a rag at eventide, while Lady Macbeth struggles to scrub the horrific blood stains from her hands in the middle of the night.

“Wash your hands!” cried Semmelweis to his medical colleagues, as they raced from the autopsy room to the labor and delivery suite, unwittingly transferring virulent microorganisms to mothers and infants. Once his mantra took hold, this simple ritualistic act produced a precipitous drop in the incidence of puerperal fever and saved countless lives.

“Dirt makes your hands strong,” the old man used to say, he who worked second shift in the slaughterhouse where I spent a summer of my youth . The farmer’s steeled hands are caked with dust and dirt to such an extent that water in the sink turns yellow-brown with washing.

“I will wash my hands in innocence,” declares the Psalmist.

Centuries later Pontius Pilate attempted a public demonstration of his declaration.

“Who shall ascend into the hill of the Lord? Or who shall stand in his holy place?” asks the Psalmist.

He who has clean hands and a pure heart.

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Lincoln

Nearly one year after I chanced a brief Sunday morning repose in Robert E. Lee’s family pew at Christ Church in the Old Town section of Alexandria, Virginia, I found myself seated in a different sort of theater to view and reflect on the issues that led to our national schism and the bloodiest conflict in American history. Yesterday at a local movie house I took in a matinée showing of Steven Spielberg’s “Lincoln.”

Drawn from Doris Kearns Goodwin’s 2005 best seller “Team of Rivals: The Political Genius of Abraham Lincoln,” Spielberg’s cinematic chronicle of the last few months of Lincoln’s administration and life provides a fascinating window into the tumultuous times that led to the conclusion of the War Between the States.

Shaped by the times into which he was born, Lincoln strove to complete the second act of the great American drama that had been initiated by the founding fathers and would be carried forward in the Civil Rights Movement a century later.

Here we see Lincoln the man (deftly portrayed by Daniel Day-Lewis) wrestling with the members of his cabinet, arguing that the time is expedient to push forward his agenda for the equality of all men. A constitutional amendment would ensure its propagation for all time — or at least for as long as the nation for the last best hope on earth might endure.

Through Spielberg’s direction and Tony Kushner’s lines brought to life by the superb renditions of Daniel Day-Lewis, Sally Fields and Tommy Lee Jones, we witness the gruesome horrors of war as well as the messiness of the political process inside the beltway. (I use that term “beltway,” because it appears as though little has changed within the confines of that circumscribed area over the past 150 years. Despite the preponderance of political spin, the wheels of democracy turn ever so slowly, both then as now.)

Lincoln the man was given to fits of melancholy. He shared his disturbing dreams of isolation and loneliness with his wife, whose own constitution frequently bordered on hysteria. Rightly or wrongly, he expected that she would bear the same grief without complaint as he himself struggled to do. One scene where Lincoln and Mary engage in a vehement verbal exchange in the bedroom brings to mind Ingmar Bergman’s “Scenes from a Marriage.” The same scene repeats in slightly different form on the floor of the House between verbally abusive representatives Thaddeus Stevens and the gentlemen from New York.

Here also we glimpse the gentleness of Lincoln the father in his dealings with Tad, his youngest son; as well as the stern uncompromising stance with Robert, his oldest, in his refusal to allow the young man to enlist. Cloaked in the power of the presidency, Lincoln will refuse to compromise on what will become the 13th Amendment; while in his Second Inaugural Address he will also advocate for a gentle reconstruction of the southern states, “with malice toward none and charity for all.”

As the final credits roll and the viewer rises from his seat, he reflects that what he has just witnessed over the previous two and a half hours is in many ways a re-enactment of the political process of the past four years. Politics is a messy profession; yet a necessary one, if as a democratic nation we are willing to struggle toward those loftier goals dreamt of in uncommon hours.

To paraphrase Lincoln’s words, if we advance such freedoms, what greater good might lie ahead for us to discover?

Graceful movements

The human body has always held a certain fascination for me since my preadolescent days.

During my 6th grade year one of the many paperback books I purchased through the Scholastic Book Club was Wonders of the Human Body by Anthony Ravielli. I spent countless evening hours pouring over the drawings and diagrams, reading through the text as though it were a sacred scripture. Looking back, I’m convinced that the words and pictures in that small tome seeded the roots of passion for a career in clinical medicine. Ravielli’s book still sits on the shelf in my study, wedged between Stuart Little and The Writer’s Mind.

•   •   •

When I open the exam room door, I find her leaning against the edge of the exam table, holding an open book in her hands, flanked on either side by her daughters, their faces mesmerized by the story she’s been reading to them.

Quickly, she finishes up the last few lines and closes the big book. “That’s it for now; Doctor’s here.”

The closed book breaks the spell. The little girls sigh and shift closer to their mother.

“It’s all right; the doctor is our friend,” she says. “He’s just going to look into your ears and mouth and listen to your chest to make sure that you haven’t got anything more than a cold.” Then she turns to me with a radiant smile and says, “Nice to see you.”

I smile back; then with my questions I proceed to gather the salient points of the medical history and perform an abbreviated medical exam. The girls are quiet, a bit shy, somewhat reticent to comply; but with some gentle coaxing from their mother the task is soon completed. I reassure her that her daughters have the sniffles — nothing serious, nothing that would require prescription medication.

“That’s what we like to hear,” she says, beaming that radiant smile. She strokes the girls’ long hair and simultaneously lays her arms across their shoulders. “Doctor says that in a couple of days you’ll be fine. Now, let’s put the books back into the box before we leave for the next kids that come in.”

I hold the door open for this threesome as they step out into the hallway, the mother shepherding the two little girls back down the corridor. To the untrained eye her limp is barely perceptible. If I didn’t know her medical history, most likely I would not suspect that she is a bilateral amputee, having lost both legs below the knee because of massive intractable lymphedema when she was a little girl herself.

In pediatric practice I see a fair number of adolescent girls who have been taking dancing lessons since their preschool days. Many of them are quite good, having learned the refined movements of point and ballet to such an extent that they seem to move effortlessly across the floor.

But none of them, I reflect, seem to move with the underlying grace of this young mother.

Canis Minor

In the predawn darkness I open my eyes and stare at the bedside clock. The alarm is not set to sound for another 20 minutes. I roll out of bed and pull on my insulated shirt, trousers and shoes.

I sit at the desk to check the e-mail account on the computer. There are two messages: one from a friend referencing a political article in the press, the other from a colleague regarding a tense situation just beginning to unfold.

Before heading out to the gym for my morning workout, I shoot off a quick reply to the colleague, then sit back to scan the online article. I’m halfway down the page when I feel the pressure of two paws on my thigh. Our terrier has come to greet me this morning, hoping to have her ears and back scratched, as is her wont.

As I reach to pet her, she drops down on all fours and stands by the desk chair, close enough to allow me to stroke her fur while I continue my reading. When I pause momentarily to click on the link to the next page, the dog immediately rises up on her hind quarters and once again firmly plants her paws in my lap.

This small morning ritual continues until I’ve finished with the article. I click to close the browser, then rise to my feet to make my way down the stairs in the darkness to retrieve my coat, cap and duffel before heading out the back door. True to form, the dog yelps and scurries about the kitchen as I pull the door closed behind me.

The night is cold; the stars burn brightly in the clear sky overhead. I unlock the car, toss my bag in the back seat and climb in behind the wheel. Soon I am rolling down the street.

In the center of town I head north to the intersection where I will bear left to pick up the road that leads to the gym. I pass beneath leafless trees silhouetted against the night sky. Just above their tops, off to the left, I see a quadrangle of stars tilted at an angle immediately before the familiar three-starred belt of Orion. This is Canis Major, one of Orion’s hunting dogs, rearing up with its paws toward Orion’s thigh.

And just above Sirius, the Dog Star, stands Canis Minor, the little dog, looking up with her dark eyes, expectantly waiting to have her ears petted and back scratched.

November Snow

With falling snow
A certain silence descends
And for a moment
Behind the white curtain
Time stops.
All of that which makes up a life
Those things of burning importance
Suddenly seem of no importance now.
Only the snow
The snow descends,
Obliterating the sea of senses;
Only the snow
The snow descends,
White-washing the world
In numbness.

2012©Brian T. Maurer

“Notes from a Healer” — Would It Weren’t So

Should — like would and could — is merely a remnant of the subjunctive tense in our modern tongue.  As is the case with other archaic words in the lexicon, confusion sometimes arises with their use. more»

My latest installment of Notes from a Healer — Would It Weren’t So — 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.

The black cat

Fifteen minutes after the last trick-or-treaters padded down our front walkway and disappeared into the night, I extinguished the porch light.

Idly, I selected a few bite-sized remnants of  leftover candy from the bowl, stretched my shoulders and plodded upstairs to the bedroom. I shed my shirt and pants, pulled on my pajamas and crawled into bed, reaching my iPad from the bedside table. What to read on this hallowed eve?

After a quick search I pulled up Poe’s “Cask of Amontillado.” As I scrolled down the screen, the brevity of the understated lines added to the horror of this tale told by a madman. Afterwards, I read “The Black Cat,” an equally gruesome story, cast as the confessions of a nearly insane alcoholic.

I reached for the switch, turned out the reading lamp and pushed down deep under the covers.

Early this morning I awoke with the image of Poe’s one-eyed feline fiend seared into my brain. I groped for my heavy socks and retreated downstairs to the kitchen to make an urn of morning coffee. Outside, the lifeless leaves rustled in the darkness.

Coffee mug in hand, I retraced my steps up the stairs through the back bedroom to the office. I sat down at my desk, mechanically checked the e-mail accounts and read the headline news. Afterwards, I set to work editing a manuscript, and was deep in thought, occasionally correcting a line of text, when I felt a presence in the room.

Fingertips on the keyboard, I turned my head toward the narrow doorway. There in the middle of the scuffed hardwood floor, staring directly at me with her cool green eyes, sat our black cat.

Briefly, she licked her fur, then meowed twice. When I paid no attention, she approached my chair and meowed again, louder this time.

I sighed, saved my work, pushed back the chair and followed her downstairs to where she stood by the front door, waiting expectantly to be freed from the catacombs of the house.

I threw back the deadbolt, opened the door a crack and shuddered at the blast of cold air. At length she slipped out and disappeared into the predawn darkness.

Illustration by Aubrey Beardsley (1894–1895) for “The Black Cat,” by Edgar Allan Poe