Print PageNotes from a Healer
Earmarked Evidence
Brian T. Maurer
btmaurer1@comcast.net
“My son says his ear’s all clogged; says he can’t hear. I’m sure it’s wax; he’s got the waxiest ears of any kid on the planet.”
Three decades of practice have taught me to always listen to the mother of a pediatric patient; she’s usually right in her initial assessment.
I look into this boy’s left ear and stare at a wall of brown debris. “He’s had his ears flushed before?” I ask, knowing the answer.
“Many times,” his mother assures me. “Last time you pulled out a pencil eraser.”
I dash out of the room and return momentarily with a 50-ml syringe and two small basins, one to hold the warm water for the irrigation, the second to collect the dregs of the flushing.
The boy presses the plastic blue kidney-shaped basin below his ear as I fill the syringe with warm water and begin to pump it into the opening of the canal. Brownish yellow particles stream out into the basin. “Looks like you’ve been making popcorn in your ear,” I remark, showing the contents of the basin to the boy and his mother.
“I’m not surprised,” she says. “He’s been swimming in a pond near our house.”
“Let’s have another look,” I say, inserting the otoscope into the boy’s ear. A tiny brown object appears to be wedged halfway down the canal. “Did you put anything into your ear?” I ask. The boy shakes his head.
Once more I exit the room and return with a pair of ENT forceps. “Hold very still,” I say, “don’t move.” Gingerly I insert the forceps into the boy’s ear, squeeze them together and withdraw a small brown sandwich-like object.
“What is that!” the mother squeals with a look of disgust. “A piece of pond kelp?”
I lay the object on the exam table and carefully undo the folds. Slowly, a flat circular form takes shape. It has a hole in the middle—a small flat round doughnut.
“It looks like a paper reinforcement, the kind you use for holes punched in school papers stored in a three-ring binder.”
I look up at the boy; he shrugs his shoulders.
“Impossible!” his mother cries.
I look at her with questioning eyes.
“He doesn’t use a three-ring binder—all of his notebooks are spiral-bound.”
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: August 2, 2009