Thoreau’s hawk and Hopkins’s windhover

Gerard Manley Hopkins was born in 1844, the same year that Henry David Thoreau built his small house on the shores of Walden Pond. Thoreau died in 1862, two months shy of his 45th birthday; Hopkins perished in 1889 at 45 years of age.  Both poets reveled in Nature. The following selections demonstrate their literary and spiritual responses to observing an accipiter in flight.

A passage from “Spring,” in Walden
Henry David Thoreau

“On the 29th of April, as I was fishing from the bank of the river near the Nine-Acre-Corner bridge, standing on the quaking grass and willow roots, where the muskrats lurk, I heard a singular rattling sound, somewhat like that of the sticks which boys play with their fingers, when, looking up, I observed a very slight and graceful hawk, like a night-hawk, alternately soaring like a ripple and tumbling a rod or two over and over, showing the underside of its wings, which gleamed like a satin ribbon in the sun, or like the pearly inside of a shell. This sight reminded me of falconry and what nobleness and poetry are associated with that sport. The Merlin it seemed to me it might be called: but I care not for its name. It was the most ethereal flight I had ever witnessed. It did not simply flutter like a butterfly, nor soar like the larger hawks, but it sported with proud reliance in the fields of air; mounting again and again with its strange chuckle, it repeated its free and beautiful fall, turning over and over like a kite, and then recovering from its lofty tumbling, as if it had never set its foot on terra firma. It appeared to have no companion in the universe,—sporting there alone,—and to need none but the morning and the ether with which it played. It was not lonely, but made all the earth lonely beneath it. Where was the parent that hatched it, its kindred, and its father in the heavens? The tenant of the air, it seemed related to the earth but by an egg hatched some time in the crevice of a crag;—or was its native nest made in the angle of a cloud, woven of the rainbow’s trimmings and the sunset sky, and lined with some soft midsummer haze caught up from earth? Its eyry now some cliffy cloud.”

The Windhover
By Gerard Manley Hopkins

To Christ our Lord

I caught this morning morning’s minion, king-
dom of daylight’s dauphin, dapple-dawn-drawn Falcon, in his riding
Of the rolling level underneath him steady air, and striding
High there, how he rung upon the rein of a wimpling wing
In his ecstasy! then off, off forth on swing,
As a skate’s heel sweeps smooth on a bow-bend: the hurl and gliding
Rebuffed the big wind. My heart in hiding
Stirred for a bird, – the achieve of, the mastery of the thing!

Brute beauty and valour and act, oh, air, pride, plume, here
Buckle! AND the fire that breaks from thee then, a billion
Times told lovelier, more dangerous, O my chevalier!

No wonder of it: shéer plód makes plough down sillion
Shine, and blue-bleak embers, ah my dear,
Fall, gall themselves, and gash gold-vermilion.

Common_Kestrel

Anecdote of the Jar

"Claytonia virginica" 2014©Brian T. Maurer

“Claytonia virginica” 2014©Brian T. Maurer

In the woods I stumbled upon a cluster of these delicate spring beauties (Claytonia virginica) juxtaposed with a cache of empty bottles.  The still life captured by the camera brought to mind the Wallace Stevens poem “Anecdote of the Jar.”

"Spring Beauties" 2014©Brian T. Maurer

“Spring Beauties” 2014©Brian T. Maurer

Anecdote of the Jar
By Wallace Stevens

I placed a jar in Tennessee,
And round it was, upon a hill.
It made the slovenly wilderness
Surround that hill.

The wilderness rose up to it,
And sprawled around, no longer wild.
The jar was round upon the ground
And tall and of a port in air.

It took dominion everywhere.
The jar was gray and bare.
It did not give of bird or bush,
Like nothing else in Tennessee.

Lunar eclipse

Last night as we slept, I heard it was said
That the moon burned vermillion, a deep blood red,
In an amber umbra of cobalt earth—
A tetrad of shadows, and this was the first.

At midnight, or after, I opened my eyes
And blinked at the uniform overcast skies,
Then settled back down, cloaked by the night,
To dream of a blood moon shrouded from sight.

April 15, 2014

2014©Brian T. Maurer

SCT — The new attention disorder

A friend alerted me to a recent NYT article about what promises to become the next pediatric psychiatric diagnosis du jour: sluggish cognitive tempo disorder.

Dr. Russell Barkley, a clinical psychologist on faculty of the Medical University of South Carolina, has hailed SCT as “the new attention disorder,” manifested in the inattentive child who tends to daydream in class, seemingly unable to quickly process academic tasks at hand. Strict criteria for diagnosis have not been formulated as yet; but rest assured, they won’t be long in coming. Researchers estimate that close to 2 million children might qualify for the diagnosis.

[Disclaimer: According to the NYT article, Dr. Barkley, a perennial proponent of ADHD, has gleaned over $118,000 in consultant fees from Big Pharma in a three-year stretch between 2009 and 2012.]

The next procedural step will be formulation of recommendations for pharmacologic treatment. The most likely classes of drugs already exist. All that will be necessary is to market the diagnosis to the medical community, disseminate the possibility to the public at large through the news media outlets, and educate practicing clinicians on “appropriate treatment.”

The upshot will be an exponential number of new prescriptions written for psychoactive pharmaceutical medications dispensed to one of the most vulnerable segments in our modern success-driven society, young children.

Along with the closely related ADHD diagnosis, the beauty of such a condition is its chronicity. Once established, such neurobiological diagnoses insure the continual flow of stimulant medication through the lucrative pharmaceutical pipeline — more Soma for the masses, as Aldous Huxley might have couched it.

I shudder when I think of the sheer numbers of young brains bathed daily in the latest pharmacopeia. Millions of children are now being treated with psychotropic medication at younger and younger ages.

And if they aren’t exposed to a panacea of pharmacologic substances, most (if not all) are being bombarded with electronic media in its various forms throughout their entire day.

I wonder what the human species will look like in the next several generations.

Perhaps our grandchildren will live in some sort of virtual reality from womb to tomb, their minds pharmacologically altered to ensure a sort of peaceful compliant existence.

Orwell and Huxley were ahead of their time, but not by much.

Advocating for right care

A basic tenet of right care is doing what is best for the patient. more»

Interested readers can now peruse my latest Musings blog — Advocating for right care — at the Journal of the American Academy of Physician Assistants (JAAPA) website.

JAAPA is the official publication of the American Academy of Physician Assistants.

“Notes from a Healer” — Attachments

The little girl’s chest sounds like a deranged sonata of squeaks and whistles. She’s breathing fast — somewhere between 40 and 50 times a minute — with see-sawing motions of her belly and chest. more»

My latest installment of Notes from a HealerAttachments — 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.

Fly on Skylight

Dizzily spinning, the fly rises upward,
Drawn toward the skylight window.
Suction-cupped upside down,
With compound eyes she contemplates
The hallowed morning light,
Unknowing that a mere five millimeters
Of clear hardened silicon separate
That delicate body
From freshly fallen
Snow and sleet.

March 31, 2014

2014©Brian T. Maurer

Ruminations at the breakfast table

Lately, I’ve become engrossed in reading “The Autocrat of the Breakfast Table.” First serialized in the nascent Atlantic Monthly and subsequently brought out in book form in 1858, Oliver Wendell Holmes’ humorous musings include any number of aphorisms about life and health, purportedly shared in dialogue over the first meal of the day in a boardinghouse.

“Just as we find a mathematical rule at the bottom of many of the bodily movements, just so thought may be supposed to have its regular cycles.  Such or such a thought comes round periodically, in its turn.” (p. 56)

“Keep any line of knowledge ten years and some other line will intersect it,” Holmes observes. (p. 223)

I recently received a blanket mailing from the manufacturer of a type of infant formula touting its indication in the treatment of gastroesophageal reflux (GER) in the “happy spitter.” The communiqué referenced a clinical article on diagnosis and treatment of GER and gastroesophageal reflux disease (GERD) in children published in the May 2013 issue of Pediatrics. I read this article in its entirety twice: first, to glean the clinical information; and second, to relish the authors’ recommendations not to treat uncomplicated GER in spitty infants who were otherwise thriving and well.

According to the authors, “GER is considered a normal physiologic process that occurs several times a day in [more than 50% of] healthy infants.” As such, little is required in the way of treatment apart from parental education, anticipatory guidance, and reassurance.

A key issue is distinguishing between clinical manifestations of GER and GERD in term infants, children, and adolescents to identify patients who can be managed with conservative treatment by the pediatrician and to refer patients who require consultation with the gastroenterologist.

The authors emphasize that “lifestyle changes” should be regarded as “first-line therapy in both GER and GERD, whereas medications are explicitly indicated only for patients with GERD.”

The new guidelines strike a note of caution when discussing the dramatic increase in past years in the number of PPI [proton pump inhibitor] prescriptions written for pediatric patients, particularly infants… Overuse or misuse of PPIs in infants with reflux is a matter for great concern. [These medications] in the so-called “happy spitter” should be avoided by all pediatric physicians.

I was pleased to read this update in the light of similar cautionary comments that I had expressed four years ago in the Yale Journal for Humanities in Medicine, “Ruminating on GERD.” Hopefully, these “new” guidelines will provide “high-value, high-quality care without risk to patients or unnecessary direct and indirect costs.”

The words of the autocrat of the breakfast table ring true: “Keep any line of knowledge ten years and some other line will intersect it.”

Oliver Wendell Holmes, Sr.

Oliver Wendell Holmes, Sr.