Notes from a Healer


Brian T. Maurer

Bookmark and Share


“He gets frustrated a lot—so does my daughter.”

This grandmother reaches out to scoop the screaming 2-year-old boy up into her arms.  She holds him firmly, whispering words into his ear.  Still he struggles, pounding his small fists against her chest.

“They don’t call it the Terrible Twos for nothing,” I say, reciting the colloquialism.  “How is he coming along with his speech?”

“He knows a handful of words—mama, dada, juice, ball—but that’s about it.  His mother was a late bloomer with her speech.  She didn’t really talk much until she was three.”

I nod my head.  “You probably already know that toddlers who are behind in speech have a hard time expressing themselves.  That’s why they resort to acting out behaviors.  It makes parenting that much more difficult.”

“I know.  He seems to listen to me the best of anyone in our household, probably because I’m firm with him.  I talk to him in a no-nonsense way.  My daughter, on the other hand, has almost no control over him.  The other day, when he bolted for the street, he didn’t pay any attention to her shrieks.”

“Do you take care of him during the day?”

The grandmother nods her head.  “My daughter works full-time, so I’m the babysitter.  I don’t mind though,” she adds, kissing her grandson on the cheek.  She puts him back down, and he immediately takes off to explore the corners of the exam room.

“It might be a good idea to arrange for a baseline hearing test,” I say.  “It will most likely come back normal, but—”

“Actually, it’s already been scheduled.  We go to the audiologist next week.”

“Well, you’re ahead of the game,” I say.  “I suppose experience pays off.”

She flashes a knowing smile.  “I remember what we did when my daughter wasn’t talking at this age.”

“Have you called Birth To 3?” I ask, referring to the state-sponsored developmental evaluation service.

“He’s already been evaluated.  A speech therapist started coming to the home once a week.  But it’s so frustrating...”

“Progress is usually slow at first,” I explain.  “Everybody gets frustrated to some degree, not only the child.”

“I was going to say that it’s frustrating because he is making progress—we can see that—but unfortunately he won’t be receiving services any longer.  State budget cuts—the program’s on the chopping block.”

Now it is I who remain speechless.  I had not heard this before.  In the face of the proven worth of early intervention services, it seems unconscionable to withdraw them from one of the most vulnerable segments of our society, young children.

Our wisest political sages—Gandhi, Bonhoeffer, Churchill, Truman, Hubert Humphrey—have noted that societies will be judged on how they treat their most vulnerable citizens:  the infirm, the aged, and the children.

I lean back against the edge of the exam table and let out a long, low sigh.

These are the days of pediatric practice that try clinicians’ souls.

Suddenly, I am frustrated too.


About the Author

  • Photo of Brian T. MaurerBrian 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: October 5, 2011