In the wee small hours

My daughter telephoned me at work to let me know that the elderly woman she had been caring for had died in the night.

She was staying with the woman and her husband in their home. The woman had liver cancer; the man suffers from dementia. My daughter cooked them breakfast, helped them bathe and dress, drove them to medical appointments, made sure they got their medications on time, kept the larder stocked.

She heard the woman moan in the night, turned her over on her side, heard the rattle in her throat. She called the hospice nurse first thing in the morning. The nurse came to the house, pronounced the patient, and signed the death certificate. Then she and my daughter bathed and dressed the body.

I could hear the exhaustion in my daughter’s voice as she related these incidents over the phone. I was certain that she had learned quite a lot while taking care of this couple, much more than she would have learned sitting in class at nursing school.

These thoughts ran through my head as I sat listening to an old Frank Sinatra LP recording after dinner. The album belongs to our next door nonagenarian neighbor; the old turntable was a gift from the elderly woman who died.

I sipped my coffee as Sinatra belted out the words to “All the Way” and softly crooned “In the wee small hours of the morning.”

In the wee small hours of the morning
While the whole wide world is fast asleep
You lie awake and think about the girl
And never ever think of counting sheep.

When your lonely heart has learned its lesson
You’d be hers if only she would call
In the wee small hours of the morning
That’s the time you miss her most of all.

Literary critic George Steiner opines that “Death is closely related to what I call real music: a certain sense of the end of time and of personal life.”

“When somebody asks how one can have an intense meaning which one doesn’t understand, music is the one place to turn for an answer.”

Right now those words seem to make infinite sense.

Moon rise over snow-capped mountains

"Moon Rise" 2013 © Brian T. Maurer

“Moon Rise” 2013 © Brian T. Maurer

The mid-day sun shone over the mounds of snow piled beside the driveway, throwing an irregular blue shadow across the thin blanket of snow on the tarmac.

As the sun climbed higher, the edge of the snow blanket melted away, leaving a narrow residue of white in the sunlight.

I snapped the photograph, turned it on its end and voilà— “Moon Rise over Snow-capped Mountains.”

Humane Medicine — Said and done

If we should become wise, we come to understand that each of us has only the day before us to live. more»

Interested readers can now access my latest Humane Medicine columnSaid and done: When the present is all we have left — recently published in the Journal of the American Academy of Physician Assistants.

Humane Medicine February 2013

Trudging toward the river

I stand in the snow, my boots buried in white. The intense mid-morning sunlight makes me squint behind dark lenses. I turn and look back at the expanse of snow over which I’ve come. My tracks pockmark the trail broken by some unknown snowshoer days before. The air is cold this morning, but the sun has softened the snow. I break through the glazed surface with each step. Every so many steps I stop to cough. It’s hard going through the deep snow in this deserted park.

The river lies up ahead, just around the bend in the trail. It won’t be long before I reach the bank, only a short distance away. Once again I stop and cough, then wipe my mouth with the sleeve of my coat. Keep going, I tell myself. Don’t stop now. Once again I look over my shoulder. It’s a long way back to the dirt road at the park entrance. I take a deep breath and trudge on.

Finally, I round the bend. The river lies ahead, shimmering through last year’s red briers along the bank. The edges have iced up. Out in the center water flows quietly beneath the over-arching blue sky. Bare trees stand along the bank in the distance. My eyes survey the scene, then stop. There, on a distant branch halfway up the trunk, rests a dense dark mass, accentuated with an unmistakable dab of white.

I lift the glasses from my nose and strain to focus through the cold. My eyes water and the image blurs. I reach into my pocket for the handkerchief that is always there. I wipe my eyes and replace the glasses on my face. The form waxes and wanes.

When I raise my hand to my mouth to stifle a cough, the black form drops from the branch. Two long lines shoot out from the bulk, pivoting on an invisible point. Suddenly, in this graceful spiral of descent the lines become wings, the dab of white becomes a head. The wings beat down, and as the bird rises against the grey backdrop of naked tree trunks, I see the white triangular tail flare. A few strokes more and the thin silhouette fades into the blue sky.

I pull my shoulders back and stand up straight. I stuff the wrinkled handkerchief into my pocket and thrust my fingers into the glove. I lift one foot, shake off the snow and take another step. It won’t be long now.

Soon I will reach the river.

"Winter River" 2013 © Brian T. Maurer

“Winter River” 2013 © Brian T. Maurer

A tapestry of song

My life has been a tapestry of rich and royal hue
An everlasting vision of the ever-changing view
A wondrous woven magic in bits of blue and gold
A tapestry to feel and see, impossible to hold.

—Carole King, Tapestry

When we arrived home from the Tapestry Singers annual Valentine’s Day cabaret concert, I counted up the musical numbers listed in the program. There were exactly twenty — a full musical score.

The songs ranged from Broadway hits to country ballads, patriotic medleys to spiritual worship songs. For two hours we were treated to poignant arrangements of pieces like Leonard Cohen’s “Hallelujah” and Enya’s “Only Time,” Jerry Herman’s “Ribbons Down My Back” and Irving Berlin’s “Anything You Can Do, I Can Do Better,” Mark Hayes’ “Consecration” and Marie Barnett’s “Breathe.” For the grand finale there was a special rendition of “Over the Rainbow.”

This annual event was the brainchild of Jana Pivácek-Cole, a talented vocalist and voice teacher, who succumbed to cancer at the close of last year. Since 1998, Jana’s Tapestry Singers, composed of former voice students of all ages,  has offered public performances to raise financial support for the Kateri Medical Clinic in the Kaduna province of northern Nigeria.

Without the benefit of Kateri Medical Clinic, thousands of Nigerians who reside in the region would have no access to medical care. Last year over 14,000 people received care at Kateri for the amazingly low cost of $5 per encounter.

As I sat through this moving musical repertoire, I reflected on our medical mission to Nigeria last summer. We saw nearly 6,000 patients in a 2-week stretch. Many more were unable to access care during our stay; although the needs were great, the workers were relatively few.

When my eyes began to water, I wasn’t entirely certain why. It might have been the poignant pieces of music I heard — or perhaps the memories of those Nigerian patients I had seen. Both sets of voices were certainly present, and together they sounded sweet and low in my ear.

In a Paris Review interview literary critic George Steiner opined:

The next Copernicus may have something to tell us about what music does inside us and how it is created. Above all, music illustrates for me that order of meaning that you can’t translate, can’t paraphrase, can’t put in any other terms, and yet which is intensely meaningful.

Some say that music can heal the heart; I know it can heal the soul. Perhaps it is even capable of moving beyond the borders of space and time to touch the lives of others in need, continents away.

“Amour” — A conversation

“So, what did you think of the film?”

My daughter raises her eyes from the menu. “It was…intense.”

“Yes. I’d say that’s a good word to describe it: intense.”

We drove to the restaurant in separate vehicles directly from the cinema, where we had taken in a matinée showing of the 2012 Cannes Palme d’Or film “Amour.”

“What scene stuck in your mind the most?”

My daughter and I both agree on the same scene, the one that is never mentioned in any of the reviews I have read to date.

“I didn’t get the part about the pigeon, especially the second episode.”

“I’m not really sure I understood that myself. The first time round he shoos the bird out of the apartment window. The second time he closes the window first with the express purpose of capturing the bird. It’s not clear what he does after that.”

“Ready to order?” The Japanese waitress stands pencil straight by our table, clothed in black. After the scenes we just witnessed, what better color? I think.

“May I ask you a question first?” my daughter says. “What’s the difference between sushi and sashimi?”

“Ah, sushi is a mixture of raw fish and rice; sashimi is only raw fish.”

“I get it; thanks for explaining that. I think I’ll have a spicy tuna roll with a green garden salad on the side.”

“For you?” The waitress regards my face.

“I’ll try the dragon roll with a salad and a bowl of miso soup.”

“Very good.” The waitress holds her hand out for our menus and disappears down the aisle.

“I’ll tell you what really upset me,” my daughter says, taking a sip of soda. “The way the daughter spoke to her mother after she’d had the stroke. I mean, there the mother is, lying in bed, practically unable to speak; and her daughter’s talking a mile a minute about buying a house and interest rates and—it was so pathetic.”

“Almost as though the daughter couldn’t focus on anything but herself and her own emotional needs.”


The waitress reappears with the salads and the soup. We spread our napkins and pull the chopsticks from the paper wrappers.

“The actress did a great job, though,” my daughter says. “It was almost like she actually had a stroke in real life, she played it so well.”

“I think she got an award for her performance,” I say. “Best actress—I’m not sure what it’s called in Europe.”

“They both did a good job—both she and the guy, too.”

“A very realistic performance,” I agree.

The waitress stops by to clear the dishes and brings us our entrées.

“So, do you have to go back to look in on Evelyn and Randy this evening?” I ask my daughter.

“Technically, no. The hospice nurse might drop by. But I’ll probably give them a call just to check in. Evelyn feels better when I call.”

“Did you talk with the hospice nurse about her prognosis?”

“A little bit. She told me less than three months. I never noticed how yellow her eyes were before today.”

“That’s usually not a good sign when you’ve got liver cancer,” I say.

“I guess not.”

We turn to the food on our plates in silence. After a bit I say, “Maybe it wasn’t such a good idea for me to take you to see that particular movie.”

“No, I think it was good that I went. It brought up a bunch of stuff that I’m dealing with right now—even if it was hard to watch.”

“It’s always hard to watch,” I say, fumbling a piece of sushi with my chopsticks.

Emmanuelle Riva as Anne in Amour

Lost sonatas

Had we been writ three-quarter time
I could’ve waltzed you round the floor;
We might have made the perfect rhyme—
A couplet in three-quarter time,
Perhaps a score, or more.

Were we composed allegro pace
Our eighth notes would have danced!
We might have rushed up tempo, faced,
And held the note, entranced—
A coda of romance!

Across the sky time cast our stars
Yours rose, while mine had set;
Sonatas hold so many bars,
And strings possess no fret;
Still—no performance, no regret.

2013 © Brian T. Maurer