Breathing easier at the end of the day

Fifteen minutes ago I heard grown-up voices and the intermittent cry of a child from the waiting area. It certainly is taking a long time to process the last patient of the day. There must be a glitch of some kind. more»

Interested readers can now access my latest Art of Medicine column — Breathing easier at the end of the day — 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.

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On this, the first day of Spring

On this, the first day of Spring,
I rose early, showered, dressed;
Walked the dog at first light;
Drove to meet a friend for breakfast;
Replaced a rear-window wiper-blade;
Wrote two letters of condolence
For cousins recently orphaned—
Hand-addressed the envelopes,
Placed them in the curbside mailbox
And raised the red flag
To let the postman know—
Walked the dog a second time;
Buttoned my formal work shirt,
Snugged a bowtie in place;
Drove to the office to put in my time;
Watched the afternoon snow descend
From the back window by my desk;
Headed home over snow-covered highways,
Headed home in the cold winter-spring night,
Headed home to dog and dinner,
Slippers and schnapps;
Edited an article for a far-off friend;
Crawled beneath the heavy counterpane,
And drifted off to sleep—
On this, the first day of Spring.

March 20, 2015

Rorschach EKGs

There is an old Yiddish saying: “To a worm in a jar of horseradish, the whole world is horseradish.”  In short, our immediate environment influences our thoughts and perceptions.

Soon I must sit for my 6-year recertification examination in general medicine: a grueling 5-hour test consisting of 240 questions. I’ve been reviewing medicine for the past 4 months; lately, I’ve thought of little else.

I have had a smattering of additional preoccupations. After all, the routine of daily life goes on. Snow must be shoveled, walkways must be kept clean, and the dog must be taken out for daily walks.

Early this morning the dog and I ventured out into the winter cold. As we passed by the church at the end of our street, I noticed salt deposits on the sidewalk left behind after the snow and ice had melted. With scattered thoughts of the impending exam running through my mind, these formations appeared to resemble electrocardiographic (EKG) tracings.

I returned with my camera to take a few snapshots, several of which I’ve posted below. To my eye these represent specific electrocardiographic rhythms or conditions. Perhaps my medical colleagues would like to weigh in with opinions of their own.

First degree heart block

First degree heart block

Atrial fibrillation

Atrial fibrillation

Third degree heart block

Third degree heart block