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A slice of life

A slice of life Downloaded from https://pdfs.journals.lww.com/jaapa by BhDMf5ePHKZxZb3ruX4b9cKfbT5h3bp+v9gTtSlrchDWvVTxyN8Hif2P/rPZfAxb8td684/2m6Qj/1S0ZObgiiKJ9vD64yNdY1wI1G/v4gN3ti1fujtTJsg5898WZFuC on 02/23/2019 THE ART OF MEDICINE Brian T. Maurer, PA-C The value of experience is not in seeing much, but in “It looks okay at this point,” I say. “It’s been over 48 seeing wisely.—Sir William Osler hours since the injury. Usually, we like to close wounds within 6 to 8 hours; otherwise, they have a tendency to an I see your fi rst patient of the morning with infect. I could try to glue the edges together but the glue you?” the new student asks. “It’s a laceration, won’t stick to the greasy ointment. We’d have to scrub it “Chere to be glued.” out fi rst, then hope for the best. Because it’s superfi cial, I An interesting way to present a patient, I think to myself think your best bet would be to keep it clean and allow it as I escort the student into the examination room. to heal on its own.” I introduce myself and the student to the man sitting Gradually, the man nods his head. “If you think that’s in the chair. Immediately to his right sits a lanky youth best,” he says. “Could we bother you for a new bandage? clothed in a dress shirt and tie. The man appears to be He’s heading back to school from here. I’ve got to get to in his late 30s. Already the lines of life are etched in his a funeral.” face. The man is white; the boy is black; my student is The words stop me short. “A funeral? Who passed away?” Asian: a mix of cultures gathered together in this small “Our next-door neighbor,” the man says. space. “Had he been ill? How old was he?” “What happened?” I ask the boy. “Ninety-two,” the man says. “He hadn’t been good for Silently, he holds out his left hand, palm up. I note the a while.” clean linear laceration across the hypothenar eminence. It “Were you close?” appears as though the area has been coated with ointment. The man nods his head. “He was the fi rst to welcome There is no suppuration of the wound. us when we moved into the neighborhood 15 years ago. “I was trying to slice an orange with a kitchen knife,” the boy says. “It slipped.” I think: Not all wounds “I see,” I say. “What did you do for the cut?” “We had him put his hand under water from the tap to heal easily. wash it out,” the man says. “He’s been keeping it covered with some ointment and a bandage. I called the offi ce yesterday to see if we could get him in, but they said there He and his wife were always good to us.” He looks at the were no openings.” boy. “Things were tough; they helped us out.” I check the frown on my face. “Usually we try to see an “I’m sorry for your loss,” I say. “It’s good that you can injury the day it occurred,” I say. go.” “Actually, he cut himself 2 days ago,” the man says. “It Again the man nods his head. I open a bandage and press didn’t look that deep, so I didn’t think he needed stitches. it across the wound. “In a few days it will be healed,” I Then yesterday I remembered that sometimes cuts can be say; but not all wounds heal that easily, I think. glued. That’s when I called.” “Do you like to read?” I ask the man. Gently, I examine the wound. The moist edges separate “I like to read, but usually I haven’t got the time.” easily but the cut is superfi cial. I ask the boy to fl ex and “There’s a book you might be interested in,” I say, pull- extend the fourth and fi fth fi ngers at each joint: there is ing out an offi ce notepad. I jot down the title and hand certainly no sign of tendon involvement. him the slip of paper. “A Man Called Ove,” the man reads. Brian T. Maurer has practiced general pediatrics “It’s a modern novel,” I say. “There might be a movie for more than 30 years. He is the author of Patients coming out. It’s not great literature, but it’s a good story. Your Are a Virtue and blogs at http://briantmaurer. 92-year-old neighbor reminded me of the main character.” wordpress.com. The author has disclosed no The man stands and offers me his hand. “Thank you,” potential confl icts of interest, fi nancial or otherwise. he says. He ushers his son out. Tanya Gregory, PhD, department editor The student looks over the boy’s chart as I stand poised DOI:10.1097/01.JAA.0000531055.35373.08 to write my note. “Would sutures have been better than Copyright © 2018 American Academy of Physician Assistants glue?” she asks. JAAPA 58 www.JAAPA.com Volume 31 � Number 4 � April 2018 Copyright © 2018 American Academy of Physician Assistants Downloaded from https://pdfs.journals.lww.com/jaapa by BhDMf5ePHKZxZb3ruX4b9cKfbT5h3bp+v9gTtSlrchDWvVTxyN8Hif2P/rPZfAxb8td684/2m6Qj/1S0ZObgiiKJ9vD64yNdY1wI1G/v4gN3ti1fujtTJsg5898WZFuC on 02/23/2019 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the American Academy of PAs Wolters Kluwer Health

A slice of life

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Publisher
Wolters Kluwer Health
ISSN
1547-1896
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0893-7400
DOI
10.1097/01.JAA.0000531055.35373.08
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Abstract

Downloaded from https://pdfs.journals.lww.com/jaapa by BhDMf5ePHKZxZb3ruX4b9cKfbT5h3bp+v9gTtSlrchDWvVTxyN8Hif2P/rPZfAxb8td684/2m6Qj/1S0ZObgiiKJ9vD64yNdY1wI1G/v4gN3ti1fujtTJsg5898WZFuC on 02/23/2019 THE ART OF MEDICINE Brian T. Maurer, PA-C The value of experience is not in seeing much, but in “It looks okay at this point,” I say. “It’s been over 48 seeing wisely.—Sir William Osler hours since the injury. Usually, we like to close wounds within 6 to 8 hours; otherwise, they have a tendency to an I see your fi rst patient of the morning with infect. I could try to glue the edges together but the glue you?” the new student asks. “It’s a laceration, won’t stick to the greasy ointment. We’d have to scrub it “Chere to be glued.” out fi rst, then hope for the best. Because it’s superfi cial, I An interesting way to present a patient, I think to myself think your best bet would be to keep it clean and allow it as I escort the student into the examination room. to heal on its own.” I introduce myself and the student to the man sitting Gradually, the man nods his head. “If you think that’s in the chair. Immediately to his right sits a lanky youth best,” he says. “Could we bother you for a new bandage? clothed in a dress shirt and tie. The man appears to be He’s heading back to school from here. I’ve got to get to in his late 30s. Already the lines of life are etched in his a funeral.” face. The man is white; the boy is black; my student is The words stop me short. “A funeral? Who passed away?” Asian: a mix of cultures gathered together in this small “Our next-door neighbor,” the man says. space. “Had he been ill? How old was he?” “What happened?” I ask the boy. “Ninety-two,” the man says. “He hadn’t been good for Silently, he holds out his left hand, palm up. I note the a while.” clean linear laceration across the hypothenar eminence. It “Were you close?” appears as though the area has been coated with ointment. The man nods his head. “He was the fi rst to welcome There is no suppuration of the wound. us when we moved into the neighborhood 15 years ago. “I was trying to slice an orange with a kitchen knife,” the boy says. “It slipped.” I think: Not all wounds “I see,” I say. “What did you do for the cut?” “We had him put his hand under water from the tap to heal easily. wash it out,” the man says. “He’s been keeping it covered with some ointment and a bandage. I called the offi ce yesterday to see if we could get him in, but they said there He and his wife were always good to us.” He looks at the were no openings.” boy. “Things were tough; they helped us out.” I check the frown on my face. “Usually we try to see an “I’m sorry for your loss,” I say. “It’s good that you can injury the day it occurred,” I say. go.” “Actually, he cut himself 2 days ago,” the man says. “It Again the man nods his head. I open a bandage and press didn’t look that deep, so I didn’t think he needed stitches. it across the wound. “In a few days it will be healed,” I Then yesterday I remembered that sometimes cuts can be say; but not all wounds heal that easily, I think. glued. That’s when I called.” “Do you like to read?” I ask the man. Gently, I examine the wound. The moist edges separate “I like to read, but usually I haven’t got the time.” easily but the cut is superfi cial. I ask the boy to fl ex and “There’s a book you might be interested in,” I say, pull- extend the fourth and fi fth fi ngers at each joint: there is ing out an offi ce notepad. I jot down the title and hand certainly no sign of tendon involvement. him the slip of paper. “A Man Called Ove,” the man reads. Brian T. Maurer has practiced general pediatrics “It’s a modern novel,” I say. “There might be a movie for more than 30 years. He is the author of Patients coming out. It’s not great literature, but it’s a good story. Your Are a Virtue and blogs at http://briantmaurer. 92-year-old neighbor reminded me of the main character.” wordpress.com. The author has disclosed no The man stands and offers me his hand. “Thank you,” potential confl icts of interest, fi nancial or otherwise. he says. He ushers his son out. Tanya Gregory, PhD, department editor The student looks over the boy’s chart as I stand poised DOI:10.1097/01.JAA.0000531055.35373.08 to write my note. “Would sutures have been better than Copyright © 2018 American Academy of Physician Assistants glue?” she asks. JAAPA 58 www.JAAPA.com Volume 31 � Number 4 � April 2018 Copyright © 2018 American Academy of Physician Assistants Downloaded from https://pdfs.journals.lww.com/jaapa by BhDMf5ePHKZxZb3ruX4b9cKfbT5h3bp+v9gTtSlrchDWvVTxyN8Hif2P/rPZfAxb8td684/2m6Qj/1S0ZObgiiKJ9vD64yNdY1wI1G/v4gN3ti1fujtTJsg5898WZFuC on 02/23/2019

Journal

Journal of the American Academy of PAs – Wolters Kluwer Health

Published: Apr 1, 2018

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