The Art of Medicine: Moments without an ICD-10 code

Cellphone conversations during medical encounters turn me off; ofttimes I seethe beneath my carefully orchestrated demeanor. But somehow this time it’s different. more»

Interested readers can now access my latest Art of Medicine column — Moments without an ICD-10 code — recently published in the Journal of the American Academy of Physician Assistants.

Please note that all of my previously published Art of Medicine pieces can now be accessed here.


High overhead grey clouds swirl;
Off to the north a lemon sky forms.
Distant thunder rumbles, rumbles again.

Our terrier paces up and down the porch,
Then freezes before my wife,
Panting in panic.
Stooping down, she gathers
The shaking puppy in her arms,
Holds her close,
Strokes her wire-wicker face,
Whispers canine caricias in her ear.
Thunder rumbles overhead;
The puppy trembles in my wife’s arms.

Suddenly, rain descends,
Slapping the street in torrents—
A cloudburst of summer tears.

Summer storm

Those who contemplate the beauty of the earth find reserves of strength that will endure as long as life lasts. —Rachel Carson

The weather held off until I got home.

As I sat secluded in my office drafting a letter, the rains came, slowly at first, then falling with force, pummeling the back porch roof. Lightning flashed; thunder clapped. I worked feverishly, finished, and powered down the computer. Downstairs, my wife was placing platters of food on the table: sausage, scalloped potatoes, carrots. Soon my son’s SUV pulled into the driveway. We sat down to a nice meal and ate in silence.

Afterwards, we retired to the front porch to watch the storm pass overhead. “The clouds are so low they’re touching the treeline,” my son said. We looked up to see a jumbo jet rise above the far hills and sweep across the grey sky, then disappear into the fog.

Finally, off to the north the clouds began to break up, revealing a sliver of blue. Gradually, the rain tapered off and the blue splintered, bursting into a wide expanse above our heads, while off to the east a curious white wispy cloud drifted across a backdrop of yellowish grey. Suddenly, the feathered edges caught the rays of the evening sun, glowing vermilion.

The dog’s nose twitched between the spindles of the balustrade. We too sensed the clear cool air, drawing it down into our innermost parts — a cleansing coolness, clear shining after rain.