On becoming a caregiver

Back in the 1970s, responding to what he saw as the depersonalization of medical care, psychiatrist and cross-cultural researcher Arthur Kleinman began to examine the difference between illness as experienced by the patient and disease as diagnosed by the clinician. Such was the beginning of a hopeful attempt to reverse the trend of depersonalization in medical practice. more»

Interested readers can peruse my latest JAAPA Musings blog post, newly published in the Journal of the American Academy of Physician Assistants.

A Kodak moment

I step into the exam room carrying a small tray of supplies: one unit-dose syringe, a cotton ball moistened with alcohol resting on a 2 X 2 square of gauze, a Band-Aid dot. On the exam table the patient, a 5-year-old girl, squirms in her mother’s lap.

“She’s here for her flu shot?” I ask, merely to verify the inevitable.

“Yup,” her mother replies. “And it’s not going to be easy.”

“Most kids don’t like shots,” I mutter in a quiet voice as I slide the tray onto the counter top. “Here, let me show you how to hold her.”

I instruct the mother to turn the child to the side, sitting her on the mother’s thigh with the child’s legs draped between her own. “She can give you a big hug under your arm, around the back. Now hold her forearm with your one hand and hug her tight with the other.”

The mother complies with my instructions. As I pick up the syringe and cotton ball, like a frightened puppy the child lets out a yelp and begins to writhe in her mother’s lap. “Hold her tight,” I reiterate, as I slide my free hand beneath the girl’s upper arm to steady her shoulder.

I dislodge the needle cap with my teeth and stand poised, ready to slip the hypodermic into the deltoid muscle. Suddenly the child breaks free, kicks and screams, turns and twists, thrusts her head back and forth. Blindly, the mother sweeps her arms through the air in an effort to recapture the child. In the fray she falls to the side, taking the child and me with her down to the padded surface of the exam table.

There we lie, like the Marines in Iwo Jima, a frozen fleshly sculpture of arms and legs, intimately conjoined in intricate knots of skin, bone and muscle.

Eyeglasses cocked awry, the mother looks up at me, hugging her daughter for dear life, while I rest along the contour of her curves. The image burns into my mind. Without thinking, I say, “You know, if this were a photograph, it would undoubtedly appear as a black-and-white full-page spread in Life magazine.”

Quickly, I administer the shot. The mother releases the little girl and we all sit up. The child is sobbing, and so is the mother, as tears squeezed from her laughing eyes cascade down her cheeks.

“Thank God you’ve haven’t got a photographer in house,” the mother wheezes, as she wipes her face with the back of her hand.

Another memorable Kodak moment in primary pediatric practice to treasure.

This piece was originally published in the Spring 2013 edition of ConnAPA News.

Humane Medicine — Hauntings: When the clinical mark is missed

My thoughts drift back to my early years of training, when for nearly 2 years I spent every third night on call in the hospital setting. One night still haunts me. more»

Interested readers can now access my latest Humane Medicine columnHauntings: When the clinical mark is missed — 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.

Morning Mass on Mothers’ Day

A Morning Mass on Mothers’ Day

I arose Sunday morn in the misting,
Half hooded, I pulled back the shroud,
From the bed to the bath faintly listing,
With the canopy covered in cloud.

I pulled on my pants in the darkness,
I slipped on the soft cotton shirt,
I left the back door slightly open,
And trekked down the moist narrow dirt.

It was morning, all misty the meadow,
The river was smooth as a glass,
I bent by the edge of a hedgerow,
And peered through the door to the mass.

Spring beauties sat straight in the narthex,
The lily lamps towered anew,
The bleeding hearts hung by the windows,
Each one held a tear drop of dew.

And there in the front at the altar
Of a moss-covered log and a stone,
Stood the Lincoln green lad in the pulpit,
Silent and straight and alone.

I paused, turned an ear to his sermon,
Though he spoke not a word to the air,
So telling I couldn’t work a word in,
As I knelt in the silence right there.

A Mothers’ Day sermon on Sunday,
In the midst of the flowering wood,
Near the bend of the silent still water,
Where a Jack-in-the-Pulpit stood.

5/12/2013

"Jack-int-the-Pulpit" 2013 © Brian T. Maurer

“Jack-int-the-Pulpit” 2013 © Brian T. Maurer

Evensong

“What is that?”  My wife poked her head out of the kitchen doorway.  “Hear it?”

Seated in the parlor, I looked up from the book in my lap.  A series of notes sounded in the distance, reminding me of some long ago boyhood dream.

I marked my place in the text with a finger and rose from the love seat, padded to the kitchen and stood by the open back window.  The tall maple trees in the neighbor’s back yard stood silhouetted against the twilight sky.  Three fluid notes sounded from deep within the wood, over and over again.

“That’s a whip-poor-will,” I said.  “I haven’t heard one of those for years.”

Actually, this was the first whip-poor-will I ever remember hearing in these parts since we moved here three decades ago.

Perhaps this was a harbinger of good things to come, I thought.

And then, just this morning…

2013 Pileated 5-8-2013 0022013 Pileated 5-8-2013 0042013 Pileated 5-8-2013 0072013 Pileated 5-8-2013 010

Cinematic review published in IJUDH

IJUDH
Brian T. Maurer’s review of Emilio Estevez’s epic cinematic journey “The Way” has been published in the International Journal of User-Driven Healthcare.

The International Journal of User-Driven Healthcare (IJUDH) is a refereed, applied research journal designed to provide comprehensive coverage and understanding of clinical problem solving in healthcare.

Interested readers can access the article here.