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Notes from a Healer

The Pyramids of Giza

Brian T. Maurer
btmaurer1@comcast.net

The Great Pyramid of the Giza Plateau on the outskirts of Cairo, Egypt, was listed by Antipater of Sidon as one of the Seven Wonders of the World.  It is by far the oldest of the ancient Wonders and the only one still in existence.  —Giza Necropolis, Wikipedia

It is hard to believe that these children are teenagers now and that their older siblings are away at college.  They were newborn babies when first I saw them.  Their parents, newly arrived from Egypt, had come to America for a better life.

Like many immigrant families, these folks return periodically to their country of origin to touch base with their extended family.  Over 30 years of medical practice I have come to know quite a few immigrants who confided that they felt cast adrift, unable to settle the question of where they truly belonged.  In effect, they felt as though they had become sojourners without a permanent country.  Wherever they happened to be at the time, they carried the acute awareness of an emotional tug from their other home halfway round the globe.

Today the father has brought two of his younger children—a boy and a girl—to the office.  The boy has jammed a finger playing basketball; the middle joint is swollen.  The girl has had a cough for two days.  The father clears his throat repeatedly as he explains their symptoms.

I address each child in turn, taking a history of salient points, performing a cursory examination to satisfy myself that each one is in fact healthy with no problems that need major medical intervention.

At first the father is reluctant to accept my assessments.  “You’re sure he doesn’t need an x-ray of his finger?  You’re certain she doesn’t need an antibiotic?”

I explain the rationale for minimal treatment.  The children will get better.  All that is needed is a little bit of time.  Finally, he relents.  “Okay.  Thank you very much, Doctor.”  He shakes my hand and offers a smile.

“And how is your wife?” I ask, for it is usually the wife who brings the children to the office for their medical appointments.

He shrugs his shoulders and avoids my eyes.  “She is—she has—a little cancer, of the breast.”

This comes as a shock.  “I didn’t know.  When did she get sick?”

“Three months ago,” he says.  “She’s had a mastectomy, and now, next week, she will start chemotherapy.”

“No radiation?”

He shakes his head.  “Maybe afterwards, they say.  We will have to wait and see.”

“Did they take the nodes from under her arm?”

“Yes,” he nods.  “The cancer was in them as well.”

By the sound of things, the prognosis is guarded.  “We will hope for the best,” I say.  “Tell her I asked about her.”

He smiles one of his big toothy smiles.  “I will,” he says.

On the shelf of the credenza in my office three miniature pyramids rest side by side.  They were a gift from this man’s wife, given long ago when she returned from a trip to Egypt.  Together they form a set, models of the three major pyramids of Giza: Khufu, Khafre, and Menkaure.  Each one is constructed of thin sheets of beaten brass coated black, etched with hieroglyphics.

Over the years the corner of one of them corroded slightly at the base, spilling a small number of white crystals onto the dark wooden shelf.  At first I thought these were grains of sand from the Egyptian desert, but on closer inspection (which involved a taste test), I realized that they were crystals of sodium chloride—common table salt—the same physiologic substance found in the sea and in the plasma of human blood.

If you consider the myriad antigens now identified, there are numerous classifications of human blood.  In addition to the well-known ABO and Rh groups, there are more than 200 minor ones—Kell, Lewis, Duffy, Kidd, etc.—as well as the HLA types.  But despite these clinically significant antigens, the basic components of blood plasma remain: salt and water.

We speak of a person being worth their salt; we talk of someone being the salt of the earth.  For the most part we use these phrases to refer to common folk—those people who daily bear up against the throes of life and meet them squarely on, no matter which country they happen to reside in.

They are the quiet fighters who have learned above all, like the ancient pyramids of Giza, to stand.  I marvel at their fortitude, their endurance, their refusal to yield.  Yet when the time comes for them to step down, they do so quietly, with an element of common grace.

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: January 04, 2012