Notes from a Healer
Too Close for Comfort
Brian T. Maurer
I sit by the chair, watching the child lying in the woman’s lap. Draped supine over her mother’s arms with her head thrown back, the little girl and the woman remind me of Michelangelo’s Pietà—the dead Jesus cradled in Mary’s arms.
But this child, as evidenced by her warm skin and twitching limbs, is still among the living. Only these signs and her eyes, rolled back in their sockets, betray her condition.
“When did the fever start?” I ask the mother.
Her voice trembles in response: “I don’t know—maybe an hour ago. I can’t think.” She begins to sob.
I scan the small body, naked except for the diaper. The twitching has diminished; the respirations have become more regular. I notice no rashes of any sort on the skin.
“And before the fever came up—how was she then?” I ask, proceeding with my clinical questions.
The woman shrugs her shoulders slightly under the weight of the child. “She was fine. She was sitting on the floor, playing with her dolls. Then I noticed her eyes—they got all glazed over, and she felt hot, so hot, like she was on fire.”
Tears stream down the woman’s cheeks. “Do you think she’s going to be O.K.?” she asks, her voice breaking in the middle of the question.
“I think so,” I say, attempting to demonstrate some degree of reassurance in my voice. “It looks like she’s had a seizure from the fever. I think we should get her down to the hospital emergency room. She’ll most likely need some blood work, maybe a spinal tap—”
“Spinal tap! What for?”
I shouldn’t have mentioned the test at this juncture. My words slipped out—thinking out loud, I was already devising a plan for further evaluation. Now the only thing I’ve done is add to the mother’s anxiety.
“Sometimes you worry about meningitis in a child who’s had a seizure with a fever.”
The mother stares at my face. I look down at my shoes, away from her eyes. For some reason, I can’t face my wife in this moment.
I feel a hand on my arm. She slips it into my own and gives it a squeeze. “It must be hard when it’s you own daughter,” she says.
I nod my head in silence, then get up to make the telephone call to the hospital. I recognize the voice of the triage nurse who answers the phone.
“I’m heading down with my three year old daughter in tow,” I explain. “She’s had a febrile seizure. Can you ask one of the folks from pediatrics to meet me there? Thanks.”
I hang up the phone. Gently, my wife slips my daughter into my arms and puts on her coat. Suddenly I have become something more than just a clinician—now I am a father, too.
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 fifty-seven patient vignettes illustrating what Sir William Osler called “the poetry of the commonplace” in clinical medical practice.
Published: October 29, 2007