The issue of clinician burnout may be taken to another level, that of moral injury, defined as an inability to provide high-quality care and healing in the context of healthcare delivery. more»
Advocates of the patient-centered medical home tout the desirability of having all of this information in a central repository, readily accessible, complete. Supposedly, such a system will drastically reduce duplication of services, reduce the likelihood of medical error, and subsequently cut the cost of medical care. Conceptually, it all sounds so good—too good, as the adage goes, to be true. more»
Be they birthdays, graduation days, or anniversaries, we tend to mark our lives by milestones, those significant dates and times that help to define who we are and give meaning to our existence. more»
Throughout 2017 Physician Assistants have been celebrating the 50th anniversary of the profession.
Leaning in, I listen.
The whoosh resounds in my ears,
Pulsating with each regular beat,
As though an elf were clearing his throat:
Harsh, holosystolic, grade 4 of 6,
A VSD most assuredly:
But this ventricular septal defect
Is coupled with infundibular stenosis,
An over-riding aorta,
And right ventricular hypertrophy.
It takes an echo to follow the flow of Fallot.
Leaning in, I listen.
The whirr-buzz sounds in my ears,
Repeated ad infinitum from the bush.
I scan the wood, raise twin prisms,
Peer toward the sound.
A blue-winged warbler
Drops off a high branch,
Disappears behind spring leaves.
Momentarily I catch
His sine qua non:
The black eye streak;
The whirr-buzz echo
Of his call.
2017©Brian T. Maurer
Motionless she lay
In the muddy road
Near a puddle.
As the dog approached,
She righted herself,
Lifted her orange-and-black
And took flight:
One more immigrant
Who had managed to cross
The Mexican border
If you’ve got a moment to spare in your typical 24/7 online presence, consider perusing Licata and Baker’s timely JAAPA article “Updated guidelines on digital media use by children.” (Disclosure: It’s only available online, so access is limited through your digital smartphone, electronic tablet, notebook, laptop, or desktop device.) more»
Licata and Baker provide the busy clinician with an overview of the American Academy of Pediatrics updated guidelines for counseling parents and children on the judicious use of electronic devices.
The present arrived at Christmas,
Bound with bow,
A white ribbon tied just so,
Caressing the slender tome
Of Emily Dickinson poems.
Carefully, I undid it,
Teased the knot free,
Tossed it to the
Back of the bookshelf,
Out of sight,
Out of mind.
Months later I searched
For a sash to bind up
A bouquet of white roses,
A gift for the grandmother
Of a 10-year-old boy now dead.
The white ribbon lay
Exactly as I had left it.
Gently, I wrapped the roses,
Bound with the tie that binds,
Placed the bouquet
In the grandmother’s arms,
Where it rested like a newborn
Now fast asleep.
Later, I let the gift giver know
I had recycled the bow,
Passed the tie on to the next in need.
When my text came through,
They were steeped in
Multiple trauma cases in the ED:
A motor vehicle accident victim;
Two gun shot wounds, both children.
“Your anodyne arrived when most needed,”
We hand each other along in life
Until the circle completes itself,
And we recognize the ribbon
For what it has become.
New puppy pounces on tossed toy,
trots it back,
paws pounding on wooden floor;
mouths, chews, searches for squeak;
dashes behind sofa—
head protrudes below skirting,
disappears, darts out,
gnaws the wooden foot;
onto the white pillow at my wife’s feet;
tracks the single strand of yarn
dancing to the crochet baton above;
attacks ball in basket and sprints,
paws thumping on rug;
in a woolen mesh.
The eve of Valentine’s Day he died,
Hours before the mad rush for roses began.
We learned of his death this morning—
When the belated e-mail arrived.
Red roses for beloveds,
Yellow for friends,
Lavender for mothers,
White for the departed.
I bought a red rose for my wife,
A burnt rose for my daughter,
A white rose for the little boy.
Years before I had inscribed him
A copy of Maggie Brown’s “Runaway Bunny”
And left it with his grandmother.
(The author, to demonstrate
Her robust surgical recovery,
Leapt out of bed,
Gave a Can-Can kick in the air,
Threw a pulmonary embolus
And promptly died in Nice.
No one expected her untimely death at forty-two;
We knew the boy was dying at nine.)
Our new puppy fetches
The old toy again and again;
Silently, we eat a hot meal
To ward off the wintry chill.
In fading sunlight
The white rose
Sheds its petals,
One by one.
In between low granite walls
Two workmen stand in snow,
Watching as the steel rod falls
To pound the earth below.
Some distance from their younger years,
I pause in my descent;
The pounding sound pricks up my ears
And echoes some lament.
Further by the frozen stream
Woodpeckers tap their tone;
In winter stillness, cold extreme,
Ice floes crack and groan.
In the distance whistling sounds
Break through this winter day;
The noontime ironhorse resounds
And bleats a hollow neigh.
Down among the bittersweet
Descending in a rush,
Bluebirds peck the russet meat
And flit among the brush.
Small warm-breasted fires burn,
Reminding me in winter’s chill —
Though every creature waits his turn —
I move among the living still.