Print PageNotes from a Healer
Mothers at the Window
Brian T. Maurer
btmaurer1@comcast.net
Frequently I glimpse their faces when I dash through our front office between patients—mothers standing at the check-in window above the receptionist’s desk. Mothers waiting for forms; mothers stopping by to pick up prescriptions; mothers who drop in for an informal chat with the women in our office.
Sometimes they acknowledge me with a smile, a small offering of recognition; sometimes they continue in conversation, seeming to ignore my fleeting presence. Sometimes they attempt to flag me down to ask a question. Many times, recalling a recent telephone conversation, I can guess the question before they ask it.
There’s Ms. Fitzgerald with her red hair and milky complexion waiting with a worried look while our receptionist roots through a folder to find the request for cardiac consultation that I wrote last evening. She recently learned that her step-children’s birth mother and maternal aunt had succumbed early in life to ruptured aneurysms—one aortic, one carotid—post mortem diagnosis: cystic medial necrosis.
There’s Ms. Montgomery, a petite brunette now in her early forties, speaking in low tones about a recent unplanned pregnancy. She had just received word that the amniocentesis showed a genetic defect—Trisomy 18—and the baby would most likely not live very long after birth.
There’s Ms. Goodall, prematurely grey, looking much older than her years, signing a request to have her daughter’s records released to a gynecologist for ongoing care. Her only son died from a stroke caused by a ruptured AV malformation in the brain.
Ms. Worthington is no longer at the window. I saw her two boys for physical examinations last week. Now they’re wards of the state. Ms. Worthington died in the hospital this summer from purpura fulminans—an overwhelming blood-borne bacterial infection seeded by flesh-eating bacteria. I ordered a series of laboratory studies to screen her boys for the genetic defect that didn’t allow their mother to effectively fight the encapsulated organism in her body.
Ms. Yannopolis and Ms. Stockwell likewise will no longer appear at the window. Both succumbed to cancer in their late thirties: one colonic, the other breast. Both left three young children behind. Stoic mothers, neither one had ever mentioned that they were ill.
Most children are born healthy and stay that way. A good deal of general pediatric practice consists of well-child care. Many times it’s the mothers who provide the textbook cases of pathology, both in their words and in their own bodies.
As a pediatric clinician, most times all I can do is listen and make mental note of them, these mothers whose portraits are framed in the window. In my line of work, the family history has never been so close—and never so poignant.
About the Author
Brian T. Maurer has practiced pediatric medicine as a Physician Assistant for the past three decades. As a clinician, he has always gravitated toward the humane aspect in patient care—what he calls the soul of medicine. Over the past decade, Mr. Maurer has explored the illness narrative as a tool to enhance the education of medical students and cultivate an appreciation for the delivery of humane medical care. His first book, Patients Are a Virtue, recently reviewed in The Yale Journal for Humanities in Medicine, is a collection of patient vignettes illustrating what Sir William Osler called “the poetry of the commonplace” in clinical medical practice. Interested readers can read more of the author's writings at his website and blog.Published: September 7, 2010