The medicine of art: A picture’s worth

A mother and her 12-year-old son stand with their backs to me in the corridor just outside my office, studying the framed print that hangs on the wall. As is the case with most works of art, there is a story behind this one. more»

Interested readers can now access my latest Art of Medicine column — A picture’s worth — 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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“When we know” republished

Nothing jolts the mind more deeply than glimpsing the subject line of an unexpected e-mail as you simultaneously come to the sudden realization that someone you had at one time known and respected is now no longer counted among the living….

Originally published on this blog (May 11, 2014), “When we know” has been reprinted in the 2014 summer issue of the Journal of Dermatology for Physician Assistants (JDPA), Volume 8, Number 3, page 58.

Interested readers can also access this piece here.

Author to address Quinnipiac PA program class of 2014

Brian T. Maurer has been invited to address the graduating class of the Quinnipiac Physician Assistant program at nine o’clock in the morning on Monday, August 4, 2014.

He will speak to the new graduates on “Something of Value: The Art of Medicine.” Maurer’s presentation will include insights from his 35 years of practice in pediatric medicine, crafted in his book, Patients Are a Virtue.

“We learn the practice of medicine through the complex process of integrating knowledge and skills with wisdom and insight in our interaction with the patient. Although the medical record forms a composite history of the patient’s illness; for the clinician, it may be the illness narrative that ultimately imparts some degree of healing to both practitioner and patient alike.”

“You have learned the science of medicine; you have delved into its business. Now it is time to recall the art of its practice, for it is only in the practice of the art of medicine that you will sustain yourselves from day-to-day over the span of your professional careers.”

On contemplating the death of a high school teacher

Mostly I remember the thermos and the pipe.

He kept both in the storage room behind the massive black slate counter that sat at the front of the chemistry classroom. A big man with reddish-brown hair that hinted a Scotch-Irish ancestry, he towered behind that counter when he taught, frequently using the overhead projector to illustrate chemical formulae — compositions of molecules and thermodynamic equations. During breaks or between classes, he would step into the storage room for a cup of warm coffee from the thermos or a draw on his briar pipe.

His father had been a chemist before him and worked for one of the industrial giants. He hinted that at one time his dad had made a number of discoveries in the company laboratories, discoveries which remained with the firm and for which he received little recognition — monetary or otherwise. This was a source of great consternation for him.

He had done a stint in the army early in life, as was the case with many young men of that era, and served in Korea. After discharge, he remained in the reserve, serving with a unit at Fort Indiantown Gap. The additional income came in handy for a family of six, and at some point in one of our conversations he confided in me that staying on in the military helped to keep him young.

He and his young wife bought a big old home near the center of Linglestown, which I visited on occasion when I was home on leave from the service. As I recall, the big white house had an expansive back yard with a small orchard of sorts. We spent an evening in conversation over a bottle of Chivas Regal which I had brought as a gift. The bottle didn’t last the night. I ended up sleeping over on the couch, none the worse for a time of extended discussion.

One evening while I was still in high school we attended some sort of educational dinner sponsored by industry. He drove us to the function in his old car, which he used to joke could run on kerosene. I don’t remember much of the evening, only the pleasure of the company of older and I assumed wiser men.

When I told him I wanted to study biology, he retorted that I should press on for a career in medicine. “Why would you want to know about a bug crawling around on the ground, when you can study the complexities of the human body?” he argued. Now here I am in my 35th year of medical practice, contemplating retirement.

Later he would write a letter of recommendation for me to attend a small undergraduate school known for its forte in the sciences. “I had to tone it down a bit,” he said. “The first draft made you look too much like a saint.”

During one of our after-school conversations, he pointed out several good-looking girls in my class. He counseled me that a young man should not be too quick to commit to any one young lady in particular. Playing the field was a wiser approach. Indeed, that is how one amassed what in those days was known as a little black book.

We spoke about literary subjects. He told me about Hemingway’s success as a young man. “‘The Sun Also Rises’ was a good first novel, but it was ‘A Farewell to Arms’ that cemented Hemingway’s place in the American literary canon,” he said.

Secretly, he wished to become a writer. He shared several ideas for books of his own. Some were science-fiction based — one about a cleaning woman who fell into a nocturnal time warp and was whisked away to another world to become a primordial Eve. Another drew upon his boyhood experiences, events that occurred in a wooded lot in the neighborhood where he grew up.

“I never had a whole lot of direction in life,” he told me. “In the end I had to figure things out on my own.”

Perhaps that is the way it was for most of us.

2014©Brian T. Maurer

2014©Brian T. Maurer

When we know

Nothing jolts the mind more deeply than glimpsing the subject line of an unexpected e-mail as you simultaneously come to the sudden realization that someone you had at one time known and respected is now no longer counted among the living.

There are those who mentored us in our youth, perhaps a handful of special individuals — special for their presence, their wit, their innate intelligence and their caring — those who we envision visiting again to let them know how appreciative we are of the interest they took in us as students; to reminisce about former times and to discuss the current state of the world.  We jot their names on a mental list, and tell ourselves that one day, one day soon, when we can tear ourselves away for a couple of days from the rat race that has become our life, we will look them up and pay our respects.  And then the obituary notice arrives and suddenly we realize that the opportunity has passed and will not rap on our door again.

In addition to providing me with a solid grounding in chemistry, this particular mentor taught me a way of looking at the world.  In numerous discussions after school he gave me informal lessons on various ways through which we come to understand things in life — in short, how we know what we know.  The technical term is epistemology.  I recall being so taken with this concept that as editor of our high school newspaper, I devoted a large part of an interview with this teacher to that very subject. Much later in life those same seeds appeared in an essay I authored to launch an open access online journal for humane medicine and the medical humanities, Cell2Soul.

In addition to his scientific and philosophical bent, this teacher also shared a secret desire:  he wanted to become a writer of stories, in particular science fiction.  He outlined his idea for a novel during one of our chats, a novel he was in the midst of writing at the time. Whether it was ever published or subsequently abandoned, I don’t know.

Ironically, although I posted a piece about him on this blog sometime ago, I doubt that he ever saw it.

The best I can offer is an observation that that knowledge which is imparted to us by our mentors provides a way for us to carry them forward after they are gone. If we are diligent mentors ourselves, perhaps one day these torches will also be carried and in time passed along by those we have taken the time to instruct.

Author to address Quinnipiac PA program class of 2013

Brian T. Maurer has been invited to address the graduating class of the Quinnipiac Physician Assistant program at nine o’clock in the morning on Monday, August 5, 2013.

He will speak to the new graduates on “Something of Value: The Art of Medicine.” Maurer’s presentation will include insights from his 34 years of practice in pediatric medicine, crafted in his book, Patients Are a Virtue.

“We learn the practice of medicine through the complex process of integrating knowledge and skills with wisdom and insight in our interaction with the patient. Although the medical record forms a composite history of the patient’s illness; for the clinician, it may be the illness narrative that ultimately imparts some degree of healing to both practitioner and patient alike.”

“You have learned the science of medicine; you have delved into its business. Now it is time to recall the art of its practice, for it is only in the practice of the art of medicine that you will sustain yourselves from day-to-day over the span of your professional careers.”