Notes from a Healer
Brian T. Maurer
“It says right here,” Milton indicated with his finger, “that you can safely use docusate sodium to remove ear wax at home.”
My friend Milton subscribes to several health publications, one of which he had laid open on the restaurant table that morning. Knowing my profession, he likes to ask my opinion on such things.
“Yes, that’s right,” I acknowledged, lifting a forkful of eggs to my mouth. “I remember the first time I saw that done—years ago one of the medical residents showed me that trick one night in the emergency room. She put a few drops of Colace into a kid’s ear and plugged it with cotton. When we looked half an hour later, voilà—the wax was gone.”
“Where did it go?” Milton asked, his curiosity piqued. Milton is an engineer from England; and like most engineers, he likes to know how things work.
I shrugged my shoulders. “Who knows? It just disappeared—like magic.”
From the look on his face I could tell that Milton was impressed. He had been searching for the holy grail of ear wax removers since he was fitted for his hearing aids several years ago. Daily use of the small audiologic units resulted in a build up of wax in his ears, which periodically needed to be cleaned out.
“Where can you get hold of this stuff?”
“You can buy it over the counter in any drug store. It’s sold as a stool softener.”
“A stool softener? You mean, people use it to treat constipation, too?”
“That’s its primary use, yes.”
Milton had to think about this for a minute. I chewed another mouthful of eggs and took a sip of coffee.
“So actually you could use the same stuff for both problems?”
“That’s right. You just have to identify the particular problem, and make sure the substance is put into the appropriate orifice.”
A puzzled look crossed Milton’s face. Perhaps it was more of a frown. Looking back, it was probably the look of an engineer waxing philosophic over morning eggs and hash.
The following week, again during breakfast, Milton informed me that he had tried the docusate sodium experiment.
“I put a few drops in my ear, just like you said.”
“How did you make out?”
“It worked like a charm. The wax disappeared.”
“Yeah. So then I thought, well, if it worked for the ear, perhaps it might work for the other end as well.”
“You mean you tried it for constipation?”
“Well, it didn’t seem to work as well.”
“No? How much did you take?”
“Take? Don’t you mean, ‘insert’?”
“You mean you—you used it for constipation like you used it for your ear wax problem?”
“Isn’t that the way it’s done?”
“Not exactly,” I said. “Colace is an oral preparation; you take it by mouth for constipation.”
Milton sat back in the booth. A look came across his face not unlike that of an English engineer considering the philosophic side of orifices.
“Well, that explains it then,” he said finally. “I just supposed that if it were good for the gander, it would work for the goose.”
Waxing nostalgic, I recalled an incident from my early days in practice. I had prescribed a course of amoxicillin for a baby with a middle ear infection. The child was so small that the antibiotic had to be dosed with a dropper.
The mother called me up the following day to report that the preparation wasn’t working. “Every time I try to drop it in, the medicine just runs right out of his ear,” she told me.
That’s when I learned that an essential part of prescribing medication was to specify the method of delivery—in this case, by mouth.
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: February 1, 2009