My Blog Personal Thoughts and Verses Entry Date:2023-01-31 04:04:37Some brief thoughts about trust and physician-patient relationship I just read and referenced here a powerful review of the “Trust Crisis” in healthcare by Linda Kazar (The Trust Crisis - Proto Magazine). This is subject I have always been interested in-now 56+ years since entering medical school. I will be writing more about this in future posts but as I just read this article for the first time, I wanted to share my thoughts on how I have tried to engender trust, confidence and better caring for my patients. The embryo of trust begins at the first meeting between doctor and patient. When meeting a new patient, be humble and appreciative that that patient has chosen you to care for them. Always remember the privilege that is ours as physicians. Show confidence but not arrogance. Look at the patient as did Maimonides: “…never see in the patient anything but a fellow creature in pain “. Whenever possible, meet the patient dressed a non-clinical consultation room / office. Listen to the patient’s ‘story’ without interruption. Try to learn as much as you can about his / her life. Discuss their concerns, their fears and needs for this visit. If this is an office visit, after the exam, return to the consultation room / office to discuss visit. This is time consuming but important to cementing the initial encounter. Allocate more time for a new patient. Explain to the patient what they can expect from you. The patient should leave your office feeling that they have found not only a doctor but an advocate. You should leave the office feeling uplifted that you have ‘helped’ and contributed to the well-being of another patient. Sometimes, we meet a patient for the first time in an emergency situation like the Emergency Room or Labor and Delivery Floor. The challenge to gain trust is more difficult here as there are almost always time constraints. Here is where words, body language, eye contact and overt demonstration of ‘professionalism’ takes over. We must engage with every patient and engender confidence. Remembering and practicing our privilege to care and treat these “new” and mostly vulnerable patients that we meet in acute situations as we would for any other patient is paramount. Always promote and practice one standard of care for all and teach the same. Immersion. One concept I have always tried to practice is immersing myself in my patient’s care. If complications develop, if outcomes become unexpected, if patients die; do not abandon them or their families. These situations require attention, compassion and indeed test our abilities as physicians. The easier path might be detachment and avoidance, but I believe this is not the best one. Transparency and honestly, apology and continuity of care can be healing for our patients, their families and for us. Trust can and must be attained but it takes effort and attention. When patients come to us for care, they are vulnerable, needy and many times frightened. They are seeking professional, high quality and ‘human caring’. Making them feel comfortable, safe, hopeful and confident with our care, in our care, will begin the trust required for healing. Entry Date:2023-01-30 14:22:43Some brief thoughts about trust and physician-patient relationship I just read and referenced here a powerful review of the “Trust Crisis” in healthcare by Linda Kazar (The Trust Crisis - Proto Magazine). This is subject I have always been interested in-now 56+ years since entering medical school. I will be writing more about this in future posts but as I just read this article for the first time, I wanted to share my thoughts on how I have tried to engender trust, confidence and better caring for my patients. The embryo of trust begins at the first meeting between doctor and patient. When meeting a new patient, be humble and appreciative that that patient has chosen you to care for them. Always remember the privilege that is ours as physicians. Show confidence but not arrogance. Look at the patient as did Maimonides: “…never see in the patient anything but a fellow creature in pain “. Whenever possible, meet the patient dressed a non-clinical consultation room / office. Listen to the patient’s ‘story’ without interruption. Try to learn as much as you can about his / her life. Discuss their concerns, their fears and needs for this visit. If this is an office visit, after the exam, return to the consultation room / office to discuss visit. This is time consuming but important to cementing the initial encounter. Allocate more time for a new patient. Explain to the patient what they can expect from you. The patient should leave your office feeling that they have found not only a doctor but an advocate. You should leave the office feeling uplifted that you have ‘helped’ and contributed to the well-being of another patient. Sometimes, we meet a patient for the first time in an emergency situation like the Emergency Room or Labor and Delivery Floor. The challenge to gain trust is more difficult here as there are almost always time constraints. Here is where words, body language, eye contact and overt demonstration of ‘professionalism’ takes over. We must engage with every patient and engender confidence. Remembering and practicing our privilege to care and treat these “new” and mostly vulnerable patients that we meet in acute situations as we would for any other patient is paramount. Always promote and practice one standard of care for all and teach the same. Immersion. One concept I have always tried to practice is immersing myself in my patient’s care. If complications develop, if outcomes become unexpected, if patients die; do not abandon them or their families. These situations require attention, compassion and indeed test our abilities as physicians. The easier path might be detachment and avoidance, but I believe this is not the best one. Transparency and honestly, apology and continuity of care can be healing for our patients, their families and for us. Trust can and must be attained but it takes effort and attention. When patients come to us for care, they are vulnerable, needy and many times frightened. They are seeking professional, high quality and ‘human caring’. Making them feel comfortable, safe, hopeful and confident with our care, in our care, will begin the trust required for healing. Entry Date:2022-12-25 13:49:57Here is a verse I wrote and now redicate to celebrtate and honor the hopes for the New Year, 2023: Secret World gather every morsel of hope, precious gift, and open your eyes to its wonder; common images, earthly sights, hourly routines that maintain the equilibrium of why and how we live. delight in what are your joys and then for just a brief moment let them close and paint upon the canvass of your souls, portraits of secret longings that come alive in these minutes of solitude called dreaming; art forms to dance from the palette as you revel in a secret world of unspoiled vision and immortal promise. Copyright 2022 Michael R. Berman, MD. All rights reserved Entry Date:2022-11-02 13:31:11Longing for Amalthea A poem for Thanksgiving (Amalthea was the horn of the goat that nourished Zeus) i. Dream... of infinite oceans to nurture infinite life; And rivers too, their flow and rush through time, That nudge the silt and sand, like knives, To furrow banks where thirsty Game and fowl find feed and fuel; While in the lush of groves and pastures, Lavender scents and primrose petals Sweeten the air, and distant vines climb skyward And fruit trees bloom and spring wheat, sown In perfect rows, await the autumn's scythe and sickle. Dear autumn when greens turn umber and the harvest Of the summer’s crop calls before the frost, When cows and deer and lambs Remain to graze on gentle sloping hills As the days of fall are waning and are lost. ii. Dream... To cherish cornucopia; The beautiful; the bountiful; The tasteful flesh and fish, Seeds and nuts, Fruits and gourds; Grains to flour, flour to bread; Morsels to beget the thread Of meals that weave lifelines Into the fabric of our every day; And with every breath and thought, As we taste the meal and feel alive in every way; The meal that makes us, us. Entry Date:2022-09-29 18:06:14The Din a clamor. louder than the searing noise of jackhammers, trucks, motorcycles and the like, pains my ears: gunshots and sirens, screaming parent’s tears; just children you know, dead now. a disordered, senseless waste of human life and vigor, granted to every person, every child. and yet i ask: of those who escape the leaded missiles from wanton guns; and are not starved of chance to breathe tomorrow, the freshest air of country mornings; of chance to know the youthful joys of endless suns… …of those whose idle deeds and deaf ear bring no reprieve, i ask: "what clamor do you hear?" For those who can see and feel and fear the horror calling at our doorsteps. To those who cannot. © Copyright 2022 Michael R. Berman, MD. All rights reserved Entry Date:2022-09-29 18:06:11The Harvester I am a planter in the garden of life where seeds and seedlings struggle to dance to songs of the wind and hide tears in rainfalls of the morning yet reach afar to embrace the trellis of humanity and become the harvest of eternal renewal. Entry Date:2022-09-29 18:05:08Ages For all children world-wide to live and grow and thrive in peace and health. Raindrops fall uncounted and anonymous. Through ages amid floods and famines, quakes and quagmires, hurricanes and holocausts, progenies flourish. Joyful tears fall one drop by one, and imprint in our hearts forever, nurture to our children-and theirs- whose flesh holds the seeds of our contentment: when they grow, we are their source, when they flower, they are our sun. and our tomorrows become a lamplight. All else is nothingness. Entry Date:2022-09-29 18:04:37Some thoughts about Social Justice from the REPUBLICAN President Gen. James A. Garfield in his presidential campaign Speech 1880 " …They went in the spirit of the soldiers of Henry at Agincourt, of whom he said: "For he today that sheds his blood with me, Shall be my brother; be he ne'er so vile, This day shall gentle his condition." And it did gentle the condition and elevate the heart of every worthy soldier who fought for the Union, [Applause]and he shall be our brother forevermore. Another thing we will remember: we will remember our allies who fought with us. Soon after the great struggle began, we looked behind the army of white rebels, and saw 4,000,000 of black people condemned to toil as slaves for our enemies; and we found that the hearts of these 4,000,000 were God-inspired with the spirit of Liberty, and that they were all our friends. [Applause.] We have seen the white men betray the flag and fight to kill the Union; but in all that long, dreary war we never saw a traitor in a black skin. [Great cheers.] Our comrades escaping from the starvation of prison, fleeing to our lines by the light of the North star, never feared to enter the black man's cabin and ask for bread. ["Good, good," "That's so," and loud cheers.] In all that period of suffering and danger, no Union soldier was ever betrayed by a black man or woman. [Applause.] And now that we have made them free, so long as we live we will stand by these black allies. [Renewed applause.] We will stand by them until the sun of liberty, fixed in the firmament of our Constitution, shall shine with equal ray upon every man, black or white, throughout the Union. [Cheers.] Fellow-citizens, fellow- soldiers, in this there is the beneficence of eternal justice, and by it we will stand forever. [Great applause.] A poet has said that in individual life we rise, "On stepping-stones of our dead selves to higher things," and the Republic rises on the glorious achievements of its dead and living heroes to a higher and nobler national life. [Applause.] We must stand guard over our past as soldiers, and over our country as the common heritage of all. [Applause.]" From From <https://www.pbs.org/wgbh/americanexperience/features/garfield-campaign-speech/> Entry Date:2022-09-29 18:04:15“Sadness moistens my brow like mist, while silent tears coalesce upon my cheeks…” An excerpt from my poem, The Mist —————————- We who practice our honorable and privileged profession with an ethic to place our patients’ care above all else; we understand the covenant of trust we must uphold, and know the importance of the confidentiality required to achieve this trust. We have taken the oath of Hippocrates -centuries old-containing this passage or similar words: “…And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets…” ( Hippocrates of Cos (1923). "The Oath". Loeb Classical Library. 147: 298–299.) We are sworn to uphold our patient’s privacy enshrined in these words. How alarming that we now are forced by some laws to violate the inviolate oath we took. From where will come reason? Yes, “sadness moistens my brow…” Entry Date:2022-09-29 18:03:59Andira In memory of all children who have died and are dying from the ugliness of starvation. Beneath their feet the parched leaves crack. Lifeless, fallen branches fracture. To mend the pains of endless thirst. A mother cradles to her chest, The newborn child upon her breast, And while gazing towards the cloudless sky. Asks why to be born if now to die? Wasted by their arid land, Children beg with outstretched hand Their feeble voices impotent, To cry; A Death-Watch all too silent. Yes, hunger cries but finds no ears, None to help their doleful tears. Impoverished people bearing sorrow. Starved today; Entombed tomorrow. Andira is a genus of tropical tree found in Africa known as a "rain tree". Entry Date:2022-09-29 18:03:30 Read my letter to the editor in the New York Times regarding maternal deaths and access to abortion Entry Date:2022-09-29 18:02:44Below is my tribute to Earth Day, 2022 In Search of Manu "The earth we abuse and the living things we kill will, in the end, take their revenge, for in exploiting their presence we are diminishing our future." Marya Mannes, 1958 "The Earth does not belong to man; man belongs to the earth." Seattle, Chief of the Suquamish Indian Tribe, 1851. i. I fear for my cherished land, With a sorrow in my heart, As I witness our modernity Tear the fragile earth apart. I look above, the chromatic skies Where hawks and eagles soar, And tremble silent with my thoughts: They'll be safe-harbors nevermore. In pain I bare witness as Emerald columns of evergreen, Majestic redwood, oak, and elm, Vanish from our forests' scene. And of our noble canyons Where the mighty rivers roar, Weakened by the will of time, They collapse upon their shores. Yes, I fear for my cherished land, With a sorrow in my heart, As I witness our modernity Tear the fragile earth apart. ii. I cry for my nation's living, Nature's children who must endure Imminent peril of extinction, Man and beast, rich and poor. Ancient species' sacred homes, Vanquished by iron plow; A necropolis of whooping cranes, Condors, wolves, and spotted owls. Habitats of graceful beauty, Perfumed flowers, and plumage, Fragmented, isolated, wasted By our civilization's pillage. Nor are spared the vibrant seas, Where fish and whale and dolphin’s swim; Struggle to survive a refuge Ravaged and polluted: humankind's destruction. Yes, I cry for my nation's living, Nature's children who must endure The imminent peril of extinction, Man and beast, rich and poor. iii. I'll be father to my land, The earth is my estate. I'll be teacher to its children. So shall be my mandate: I'll not hand industry license To effuse waste in our precious waters, Which destroy the ancient ecosystem: Tantamount to mass slaughter. Through treaty, vow, and summit, My pledge to global neighbor: Deter cataclysmic collapse; So our survivors be our inheritors. Through my sovereignty I will affirm That mankind and earth are entwined. Flora and fauna and each human being, Cohabit one home; pray we thwart its decline. Yes, I'll be father to my land, The earth is my estate. I'll be teacher to its children. So shall be my mandate. A poem to celebrate Earth Day, 2022 © Copyright 2022 Michael R. Berman, MD. All rights reserved Entry Date:2022-09-29 18:01:48Today, more than ever, health professionals must recognize, appreciate and cherish the meaning in their work. “Meaning is the antecedent of commitment, and the original meaning of our work is service. Service is not a relationship between an expert and a problem; it is a human relationship, a work of the heart and the soul.” Rachel Naomi Remen, MD Recapturing the soul of medicine West J Med. 2001 Jan; 174(1): 4–5. doi: 10.1136/ewjm.174.1.4 PMCID: PMC1071213 PMID: 11154646 Entry Date:2022-09-29 18:01:29The following poem is a poem about the wonder of birth and childhood. Elyssium Our first born cries. A golden dream with Expectations as promising as The expansive petals of the Sunflower....and hope, To learn the provinces Of a virtuous world: Kindness compassion, Benevolence, caring, Integrity, tolerance, delight In sharing... as she emerges From her veil of childhood to Bathe in the joys of her Life; Elysium in Greek Mythology is the abode of the blessed; the paradise or happy land. Entry Date:2022-09-29 18:01:07Façade Love insists our hope Hidden in winter’s façade. A child. An image. A memory. A promise. Yet, We shall unveil its wonder; …The gift of tomorrow, And why we love, today. Entry Date:2022-09-29 18:00:45Trophós Dedicated to nursing colleagues, world-wide Fortunate are those Whose lives are touched by you. You overwhelm the pity of physical agony, You care when caring seems lost. You cry when caring has lost. You smile when your kindness creates peace. As no greater worth is there Than for you to share what Rests inherent in your heart: Your art, your soul, your sense Of right and wrong. And above all, A righteous ethic that strives, Without pretense, to heal, lifelong. Trophós from the Greek: “a care-giver, sustaining someone by nourishing and giving tender care like a nurse” Entry Date:2022-09-29 18:00:25Some words I spoke at a memorial service for pregnancy and neonatal loss: I am honored to be able to participate in this service tonight as my heart reaches out to all here tonight who have experienced the loss of a child. While the death of a baby is a catastrophe and a tragedy which shatters good, secure and confident lives in a matter of moments, the sharing of feelings of such profound loss with one another at a service such as this and beyond can actually beget a healing experience. One bereaved mother has put this in another way: : “Strangers we may be, but we are all connected by the loss of a child, and that makes us all soul mates.” Like yourselves, countless mothers and fathers and those close to them silently grieve with little resolution over the loss of their pregnancies, newborns and children. Seeking reprieve from their sorrow, they cry and yearn for solace and hope, many times for years following their loss; cries that are but a muted weeping of despair as a child so longed for is not born, or is not born alive, or cannot be conceived. Pained by these losses, their lives seem devoid of hope. Yet they-you- prevail, for within each of us is a timeless, enduring spark of divine hope, a uniquely human greatness that permits us to challenge adversity and courageously face the unexplainable suffering of our souls and bodies. To realize the existence of this divine hope is a most cherished purpose, for with it our lives have promise and reason. Infertility, pregnancy loss, neonatal illness and subsequent death are among the most painful losses we can experience, for they deny us a family and leave sightless our vision for immortality through generations of the future. Moreover, a child not born is likewise denied the delight to revel in the simple beauty and endless wonder of this divine hope. Memorial services such as this, ceremonies and tangible items of remembrance are vital for healing after the untimely death of the child, born or yet to be born. They give us permission to remember and cry publicly as well as privately. Memories are what remain of our lost children, invisible bonds between mother father and child, everlasting. Remembering and praising our lost children can make darkness, visible. Perinatal loss entails a "unique bereavement" and is an "exceptional" type of loss, for a child is not expected to die before his or her parents. Across all cultures, the parent-child relationship is and has been the most enduring and significant. The natural processes of birth, life and death should follow in an orderly and rational sequence and through one’s lifetime. Any death but death from "old-age" after a "rich" and fulfilling life is premature. Yet when parents like yourself see their child die, or carry the burden of an unborn demise, they live with this disruption of said natural order forever. There has not been nor is there now one common and standard way to manage the recovery from such grief, for it’s shadow has been and will be indelibly imprinted in the minds and souls of these parents. Bonding between mother and father and child or expectant child occurs and must be recognized. Death tears this apart. The issues of mourning, of lost promises, of sadness and above all, of maintaining faith must be addressed. The impact of these losses must not only be recognized but must also be "main-streamed" into our society. We are at the threshold of an era when solace and compassion for the deaths of these our smallest and most vulnerable of patients are being recognized more than ever before. I believe the days when perinatal loss is considered an unspeakable loss are waning. Entry Date:2022-09-29 18:00:03Some thoughts about caring for the Loss of a pregnancy or newborn When the outcomes of our patient's pregnancies end in miscarriage, stillbirth or infant death, we struggle to find the right approach to break the news to them, treat them medically and/or surgically, help them recover physically and emotionally, and console them in their grief. Most of us have not been taught to provide this bereavement care. We learn fast that there are hospital nurses and social workers, bereavement counselors and therapists, support groups and religious ministries to whom we can refer our patients for immediate bereavement care and subsequent follow-up. We can do the D and C and we can attend and assist in the birth of the baby who has experienced an intrauterine death. But then, for many Obstetricians, we refer our patients for bereavement care. When we hold in the palm of our hand an 18 week fetus immediately after our patient miscarried or attend the stillbirth of a term pregnancy, our intellectual knowledge and rational thought fade as we struggle to find the right words to say. Unlike the repetition of performing a surgical procedure, no matter how many times we have experienced a loss with our patients, it does not become easier. Although the stillborn baby which might have been born viable represents the greatest emotional and management challenges, we must recognize any loss in pregnancy as a life-altering event for our patients. The care of the patient experiencing a Pregnancy Loss is a paradigm for what we do as physicians. It tests not only our clinical skills and judgments but stretches the fibers of the human aspect of caring very thin. Although we might ask, "how can we heal when our patients' children are incurable, when they are suffering or when they die or what do we do when the advanced technology that has become a part of our black bag fails", we must understand that we can heal by providing comfort , empathy and hope. As bad as this experience is for our patients, we can make it better. If we remain aware that we are the link between the stillborn baby and the bereaved family, that we were the first to touch and hold their child, albeit their stillborn child, then we can share this with them, remember this with them, and from this point forward, heal with them. The bond we form becomes the unbreakable fiber, which strengthens and indeed cements our role in the doctor-patient relationship. Entry Date:2022-09-29 17:59:29Caring for the well-being and the illnesses of patients and their families is to accept that medical science in all its depth and possibilities is not precise and that the human mind and flesh are perishable. We are today steeped in myriad medical technologies that in themselves bring hope to previously hopeless conditions and pathologies. Yet there remains inexorable suffering which accompanies failures and tribulations not only of these new medical technologies but of pervasive disparities which exist to deny access to and recipient of one standard of care for all, disparities defined by the social determinants of health: the paradox of our societies to both cure and cause pain which is real and evident. We must never abandon the souls of all patients. Entry Date:2022-09-29 17:59:04Anuraga Love insists our hope Hidden in winter's facade. The arduousness of these days Crave creative wonder To seek the shining of Next year’s springtime. Longing, when our reverence and friendships, Like the very soul of art, Will enjoin; never to be lost or diminished As seasons themselves Endure in cascading timelessness To unveil wonders and Gifts of tomorrow. Entry Date:2022-09-29 17:58:49An excerpt from a poem I wrote some time ago and share it with you today with hope and promise for the years to come when we emerge from this pandemic. …For you this is what I long: to breath the air, hear a song walk beneath some sapling pines search a dream, slow the time see truths distant horizons hide float on waves at even-tide. know a softly spoken poem call our earth beloved home… Entry Date:2022-09-29 17:58:28Yesterday, at the invitation of the Medical Ethics Society of the Saint Paul’s Girls’ School in London, I presented and led a discussion entitled “When we cannot cure: Thoughts on the ultimate challenge to the bond of patient with doctor”. Many of the students in the audience are planning careers in the health professions and it was a great honor to be able to discuss with them my thoughts and reflections on humanism, ethics and the privilege of caring, foundations upon which healing takes place, and to paraphrase Hippocrates: “ give a share of such precepts and oral instruction…to pupils who [sic] will sign the covenant”. Entry Date:2022-09-29 17:57:57"There is a need to instill a sense of how important our influence and presence is to our patients when they experience their losses. As physicians, we must formulate an approach which will permit us to provide our patients the comfort and hope they require and should expect from us. I believe we must grasp and understand our own feelings to better serve our patients: we must serve our patients though both science and humanism. By becoming more introspective and more emotionally involved in what we are doing, our compassion will become evident and our patients will benefit. Technology indeed provides better diagnostic and therapeutic medical care, but as more technology is developed and utilized, health professionals may become more reliant on that technology and less on their interpersonal skills. They will have to learn –or relearn- and practice the traditional art of medicine, of listening and talking to patients, holding their hands, being at their bed side, while complementing the use of modern technology and advanced science. We as physicians must assure that the benefits of these technologies are fully realized but that their expanding sphere of influence does not disenfranchise the patient nor de-personalize the physician-patient relationship. Entry Date:2022-09-29 17:57:24"Inherent in what defines the physician-patient partnership is an unfaltering responsibility of the physician and an unconditional trust of the physician by the patient. Together these bond the chasm between the vulnerable patient and the knowledge and experience of the physician; a synergy of the need for care and the privilege of caring. I believe the medical professional at all levels must step back from each moment in his/her patient care routine, and reflect on what he or she is doing, why it is being done and what influence it is having on their patient’s lives. This self-reflection is integral to professionalism for it encourages the formation of a philosophy of care and ethic of practice, which in turns fosters self-examination and meaning, empathy and compassion." M.Berman Entry Date:2022-09-29 17:57:02I believe that we as practitioners and guardians of humanity's health, have been granted by oath and by ethic the privilege to examine and treat, to counsel and advise our fellow human beings and we must never abandon the souls of all patients seeking our care. It is my hope that Maternl will propagate and preserve these tenets. Prociedo Going forward (latin) Today are times of much despair Yet times of great hope To affirm our oath As unfiltered reason and purpose Rush in our blood Every pulse a wave Approaching distant shores To leave our prejudice behind To fade into vapors As common as fog And guide us to plant Roots to bond our humanhood and Vines to grow our brotherhood As we go forth into tomorrow. A poem defined by our times, January, 2022. Entry Date:2022-09-29 17:56:06Affirmations You are the dedicated and the dear; Who bravely face the abyss With courage that speaks Your truths To the unfaltering oaths Upon which you swore; A grace of caring Which comes from your Outstretched hands and noble souls and more… Your calling: A strength, To strike and penetrate As coulters1 to shear each morsel Of disease and despair Into infinite shards; To awaken the safely guarded Hopes of humankind’s promise As life’s order is at last restored, Returning to us the dreams To freely breathe the air, To walk hand in hand Upon the byways and the beaches, And travel distant shores, And speak of todays and tomorrows Once again with smiles And even drops of tears; Gleams of gratitude and affirmations, For you, the dedicated and the dear. © 2020 Michael R. Berman, MD Entry Date:2022-09-29 17:55:46Today as Thanksgiving, 2021 approaches, I would like to recognize the mothers and the children, globally, who are starved for food, and the many who give of themselves to aid in their struggle to survive with the pain of hunger. One such person and organization among many is Kate Hudson, World Food Programme ambassador, for the UN organization, World Food Programme recipient of the 2020 Nobel Peace Prize. (http://www.wfp.org). I am dedicating the following excerpt from a poem I wrote to her and the UN World Food Programme organization. Dreaming of Amalthea ..and dream...of those, and thank, Who reach beyond the bar, Whose conscience lives both near and far To hear the cry; hunger's cry, And stand steadfast, aware To know their vision be to share Their harvest with those they've seen To sleep on city streets and upon parched earth, where leaves once lush and green now crack, and lifeless, barren branches fracture ; Where famine be the slayer. Excerpted from the poem, Dreaming of Amalthea, dedicated to those who unselfishly commitment themselves to feed the needy. Amalthea, the horn of the goat that nourished Zeus, is the root origin of the term, "cornucopia or horn" of plenty. Entry Date:2022-09-29 17:54:15The impact of words is universal. Words particularly in the form of poetry can uniquely bridge the chasm of what to say and what is felt at significant times in all of our lives. Through metaphor and allusion, rhyming and meter; for eulogy and celebration; for love, understanding and hope, poetry matters significantly. Poetry enables me to ask why even when we already understand how. It permits me as a Doctor of Medicine, witness to the frailties of our humanity, to abet healing through the very core of what makes us human, our language and our personal emotions. It has been my platform to tell my 'stories', to honor my patients, my friends, my family and indeed, the essence of humanity, the "family of man". We as healthcare professionals have a need and obligation to care for others. Whether in academic, research or clinical practice, laboratory medicine or diagnostic imaging, the healthcare professionals' role is to bring comfort and to heal. From such healing comes self-reward, self- fulfillment and honor. If we are surrounded by despair and inequities and have the opportunity to help with their dissolution, it is our obligation to do so. Such has been my mission as a physician, an obstetrician, through my work and my poetry. If one person, one family, can be helped or can gather hope through the words we write and say, it can bring reward equal to the healing with our hands and minds. Hope is a singular gift we must never destroy in ourselves. Poetry is its instrument whose music can be its enabler. Words we write, words we read, and words we hear can serve as an invaluable source of healing. Words are songs from our hearts and can be "songs of hope, songs for hope" My Poetry is about hope and despair; about celebration and sorrow. But mostly, it is about hope. Forms of expression implicit in symbolic language; poetry and verse, song, prayer and ritual, have served a role in all cultures and societies to dispel the tears and foster the healing of death and human loss, suffering and despair. Why does poetry triumph as a source of enduring inspiration and hope? Entry Date:2022-09-03 13:41:12Amare Forlorn, with tears And cries, am I. To lose you to your death Without but even gasp or sigh, Save a wisp of Angels breath; the darkest sorrow I have known. Yet, Your image burnt in my Soul is my gift, my grace, And always will I see your face Upon the simmer of Placid ponds And in the clouds where Sunbeams hide And raindrops form, And I will speak kind words And write of you And sing in sweet demure, In early morning's dew And in the crown of daffodils Which bloom amidst the storms Swept cross my brow, In every dream In which it seems You come to me. My love forever Do I avow.
Entry Date:2023-01-31 04:04:37Some brief thoughts about trust and physician-patient relationship I just read and referenced here a powerful review of the “Trust Crisis” in healthcare by Linda Kazar (The Trust Crisis - Proto Magazine). This is subject I have always been interested in-now 56+ years since entering medical school. I will be writing more about this in future posts but as I just read this article for the first time, I wanted to share my thoughts on how I have tried to engender trust, confidence and better caring for my patients. The embryo of trust begins at the first meeting between doctor and patient. When meeting a new patient, be humble and appreciative that that patient has chosen you to care for them. Always remember the privilege that is ours as physicians. Show confidence but not arrogance. Look at the patient as did Maimonides: “…never see in the patient anything but a fellow creature in pain “. Whenever possible, meet the patient dressed a non-clinical consultation room / office. Listen to the patient’s ‘story’ without interruption. Try to learn as much as you can about his / her life. Discuss their concerns, their fears and needs for this visit. If this is an office visit, after the exam, return to the consultation room / office to discuss visit. This is time consuming but important to cementing the initial encounter. Allocate more time for a new patient. Explain to the patient what they can expect from you. The patient should leave your office feeling that they have found not only a doctor but an advocate. You should leave the office feeling uplifted that you have ‘helped’ and contributed to the well-being of another patient. Sometimes, we meet a patient for the first time in an emergency situation like the Emergency Room or Labor and Delivery Floor. The challenge to gain trust is more difficult here as there are almost always time constraints. Here is where words, body language, eye contact and overt demonstration of ‘professionalism’ takes over. We must engage with every patient and engender confidence. Remembering and practicing our privilege to care and treat these “new” and mostly vulnerable patients that we meet in acute situations as we would for any other patient is paramount. Always promote and practice one standard of care for all and teach the same. Immersion. One concept I have always tried to practice is immersing myself in my patient’s care. If complications develop, if outcomes become unexpected, if patients die; do not abandon them or their families. These situations require attention, compassion and indeed test our abilities as physicians. The easier path might be detachment and avoidance, but I believe this is not the best one. Transparency and honestly, apology and continuity of care can be healing for our patients, their families and for us. Trust can and must be attained but it takes effort and attention. When patients come to us for care, they are vulnerable, needy and many times frightened. They are seeking professional, high quality and ‘human caring’. Making them feel comfortable, safe, hopeful and confident with our care, in our care, will begin the trust required for healing.
Entry Date:2023-01-30 14:22:43Some brief thoughts about trust and physician-patient relationship I just read and referenced here a powerful review of the “Trust Crisis” in healthcare by Linda Kazar (The Trust Crisis - Proto Magazine). This is subject I have always been interested in-now 56+ years since entering medical school. I will be writing more about this in future posts but as I just read this article for the first time, I wanted to share my thoughts on how I have tried to engender trust, confidence and better caring for my patients. The embryo of trust begins at the first meeting between doctor and patient. When meeting a new patient, be humble and appreciative that that patient has chosen you to care for them. Always remember the privilege that is ours as physicians. Show confidence but not arrogance. Look at the patient as did Maimonides: “…never see in the patient anything but a fellow creature in pain “. Whenever possible, meet the patient dressed a non-clinical consultation room / office. Listen to the patient’s ‘story’ without interruption. Try to learn as much as you can about his / her life. Discuss their concerns, their fears and needs for this visit. If this is an office visit, after the exam, return to the consultation room / office to discuss visit. This is time consuming but important to cementing the initial encounter. Allocate more time for a new patient. Explain to the patient what they can expect from you. The patient should leave your office feeling that they have found not only a doctor but an advocate. You should leave the office feeling uplifted that you have ‘helped’ and contributed to the well-being of another patient. Sometimes, we meet a patient for the first time in an emergency situation like the Emergency Room or Labor and Delivery Floor. The challenge to gain trust is more difficult here as there are almost always time constraints. Here is where words, body language, eye contact and overt demonstration of ‘professionalism’ takes over. We must engage with every patient and engender confidence. Remembering and practicing our privilege to care and treat these “new” and mostly vulnerable patients that we meet in acute situations as we would for any other patient is paramount. Always promote and practice one standard of care for all and teach the same. Immersion. One concept I have always tried to practice is immersing myself in my patient’s care. If complications develop, if outcomes become unexpected, if patients die; do not abandon them or their families. These situations require attention, compassion and indeed test our abilities as physicians. The easier path might be detachment and avoidance, but I believe this is not the best one. Transparency and honestly, apology and continuity of care can be healing for our patients, their families and for us. Trust can and must be attained but it takes effort and attention. When patients come to us for care, they are vulnerable, needy and many times frightened. They are seeking professional, high quality and ‘human caring’. Making them feel comfortable, safe, hopeful and confident with our care, in our care, will begin the trust required for healing.
Entry Date:2022-12-25 13:49:57Here is a verse I wrote and now redicate to celebrtate and honor the hopes for the New Year, 2023: Secret World gather every morsel of hope, precious gift, and open your eyes to its wonder; common images, earthly sights, hourly routines that maintain the equilibrium of why and how we live. delight in what are your joys and then for just a brief moment let them close and paint upon the canvass of your souls, portraits of secret longings that come alive in these minutes of solitude called dreaming; art forms to dance from the palette as you revel in a secret world of unspoiled vision and immortal promise. Copyright 2022 Michael R. Berman, MD. All rights reserved
Entry Date:2022-11-02 13:31:11Longing for Amalthea A poem for Thanksgiving (Amalthea was the horn of the goat that nourished Zeus) i. Dream... of infinite oceans to nurture infinite life; And rivers too, their flow and rush through time, That nudge the silt and sand, like knives, To furrow banks where thirsty Game and fowl find feed and fuel; While in the lush of groves and pastures, Lavender scents and primrose petals Sweeten the air, and distant vines climb skyward And fruit trees bloom and spring wheat, sown In perfect rows, await the autumn's scythe and sickle. Dear autumn when greens turn umber and the harvest Of the summer’s crop calls before the frost, When cows and deer and lambs Remain to graze on gentle sloping hills As the days of fall are waning and are lost. ii. Dream... To cherish cornucopia; The beautiful; the bountiful; The tasteful flesh and fish, Seeds and nuts, Fruits and gourds; Grains to flour, flour to bread; Morsels to beget the thread Of meals that weave lifelines Into the fabric of our every day; And with every breath and thought, As we taste the meal and feel alive in every way; The meal that makes us, us.
Entry Date:2022-09-29 18:06:14The Din a clamor. louder than the searing noise of jackhammers, trucks, motorcycles and the like, pains my ears: gunshots and sirens, screaming parent’s tears; just children you know, dead now. a disordered, senseless waste of human life and vigor, granted to every person, every child. and yet i ask: of those who escape the leaded missiles from wanton guns; and are not starved of chance to breathe tomorrow, the freshest air of country mornings; of chance to know the youthful joys of endless suns… …of those whose idle deeds and deaf ear bring no reprieve, i ask: "what clamor do you hear?" For those who can see and feel and fear the horror calling at our doorsteps. To those who cannot. © Copyright 2022 Michael R. Berman, MD. All rights reserved
Entry Date:2022-09-29 18:06:11The Harvester I am a planter in the garden of life where seeds and seedlings struggle to dance to songs of the wind and hide tears in rainfalls of the morning yet reach afar to embrace the trellis of humanity and become the harvest of eternal renewal.
Entry Date:2022-09-29 18:05:08Ages For all children world-wide to live and grow and thrive in peace and health. Raindrops fall uncounted and anonymous. Through ages amid floods and famines, quakes and quagmires, hurricanes and holocausts, progenies flourish. Joyful tears fall one drop by one, and imprint in our hearts forever, nurture to our children-and theirs- whose flesh holds the seeds of our contentment: when they grow, we are their source, when they flower, they are our sun. and our tomorrows become a lamplight. All else is nothingness.
Entry Date:2022-09-29 18:04:37Some thoughts about Social Justice from the REPUBLICAN President Gen. James A. Garfield in his presidential campaign Speech 1880 " …They went in the spirit of the soldiers of Henry at Agincourt, of whom he said: "For he today that sheds his blood with me, Shall be my brother; be he ne'er so vile, This day shall gentle his condition." And it did gentle the condition and elevate the heart of every worthy soldier who fought for the Union, [Applause]and he shall be our brother forevermore. Another thing we will remember: we will remember our allies who fought with us. Soon after the great struggle began, we looked behind the army of white rebels, and saw 4,000,000 of black people condemned to toil as slaves for our enemies; and we found that the hearts of these 4,000,000 were God-inspired with the spirit of Liberty, and that they were all our friends. [Applause.] We have seen the white men betray the flag and fight to kill the Union; but in all that long, dreary war we never saw a traitor in a black skin. [Great cheers.] Our comrades escaping from the starvation of prison, fleeing to our lines by the light of the North star, never feared to enter the black man's cabin and ask for bread. ["Good, good," "That's so," and loud cheers.] In all that period of suffering and danger, no Union soldier was ever betrayed by a black man or woman. [Applause.] And now that we have made them free, so long as we live we will stand by these black allies. [Renewed applause.] We will stand by them until the sun of liberty, fixed in the firmament of our Constitution, shall shine with equal ray upon every man, black or white, throughout the Union. [Cheers.] Fellow-citizens, fellow- soldiers, in this there is the beneficence of eternal justice, and by it we will stand forever. [Great applause.] A poet has said that in individual life we rise, "On stepping-stones of our dead selves to higher things," and the Republic rises on the glorious achievements of its dead and living heroes to a higher and nobler national life. [Applause.] We must stand guard over our past as soldiers, and over our country as the common heritage of all. [Applause.]" From From <https://www.pbs.org/wgbh/americanexperience/features/garfield-campaign-speech/>
Entry Date:2022-09-29 18:04:15“Sadness moistens my brow like mist, while silent tears coalesce upon my cheeks…” An excerpt from my poem, The Mist —————————- We who practice our honorable and privileged profession with an ethic to place our patients’ care above all else; we understand the covenant of trust we must uphold, and know the importance of the confidentiality required to achieve this trust. We have taken the oath of Hippocrates -centuries old-containing this passage or similar words: “…And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets…” ( Hippocrates of Cos (1923). "The Oath". Loeb Classical Library. 147: 298–299.) We are sworn to uphold our patient’s privacy enshrined in these words. How alarming that we now are forced by some laws to violate the inviolate oath we took. From where will come reason? Yes, “sadness moistens my brow…”
Entry Date:2022-09-29 18:03:59Andira In memory of all children who have died and are dying from the ugliness of starvation. Beneath their feet the parched leaves crack. Lifeless, fallen branches fracture. To mend the pains of endless thirst. A mother cradles to her chest, The newborn child upon her breast, And while gazing towards the cloudless sky. Asks why to be born if now to die? Wasted by their arid land, Children beg with outstretched hand Their feeble voices impotent, To cry; A Death-Watch all too silent. Yes, hunger cries but finds no ears, None to help their doleful tears. Impoverished people bearing sorrow. Starved today; Entombed tomorrow. Andira is a genus of tropical tree found in Africa known as a "rain tree".
Entry Date:2022-09-29 18:03:30 Read my letter to the editor in the New York Times regarding maternal deaths and access to abortion
Entry Date:2022-09-29 18:02:44Below is my tribute to Earth Day, 2022 In Search of Manu "The earth we abuse and the living things we kill will, in the end, take their revenge, for in exploiting their presence we are diminishing our future." Marya Mannes, 1958 "The Earth does not belong to man; man belongs to the earth." Seattle, Chief of the Suquamish Indian Tribe, 1851. i. I fear for my cherished land, With a sorrow in my heart, As I witness our modernity Tear the fragile earth apart. I look above, the chromatic skies Where hawks and eagles soar, And tremble silent with my thoughts: They'll be safe-harbors nevermore. In pain I bare witness as Emerald columns of evergreen, Majestic redwood, oak, and elm, Vanish from our forests' scene. And of our noble canyons Where the mighty rivers roar, Weakened by the will of time, They collapse upon their shores. Yes, I fear for my cherished land, With a sorrow in my heart, As I witness our modernity Tear the fragile earth apart. ii. I cry for my nation's living, Nature's children who must endure Imminent peril of extinction, Man and beast, rich and poor. Ancient species' sacred homes, Vanquished by iron plow; A necropolis of whooping cranes, Condors, wolves, and spotted owls. Habitats of graceful beauty, Perfumed flowers, and plumage, Fragmented, isolated, wasted By our civilization's pillage. Nor are spared the vibrant seas, Where fish and whale and dolphin’s swim; Struggle to survive a refuge Ravaged and polluted: humankind's destruction. Yes, I cry for my nation's living, Nature's children who must endure The imminent peril of extinction, Man and beast, rich and poor. iii. I'll be father to my land, The earth is my estate. I'll be teacher to its children. So shall be my mandate: I'll not hand industry license To effuse waste in our precious waters, Which destroy the ancient ecosystem: Tantamount to mass slaughter. Through treaty, vow, and summit, My pledge to global neighbor: Deter cataclysmic collapse; So our survivors be our inheritors. Through my sovereignty I will affirm That mankind and earth are entwined. Flora and fauna and each human being, Cohabit one home; pray we thwart its decline. Yes, I'll be father to my land, The earth is my estate. I'll be teacher to its children. So shall be my mandate. A poem to celebrate Earth Day, 2022 © Copyright 2022 Michael R. Berman, MD. All rights reserved
Entry Date:2022-09-29 18:01:48Today, more than ever, health professionals must recognize, appreciate and cherish the meaning in their work. “Meaning is the antecedent of commitment, and the original meaning of our work is service. Service is not a relationship between an expert and a problem; it is a human relationship, a work of the heart and the soul.” Rachel Naomi Remen, MD Recapturing the soul of medicine West J Med. 2001 Jan; 174(1): 4–5. doi: 10.1136/ewjm.174.1.4 PMCID: PMC1071213 PMID: 11154646
Entry Date:2022-09-29 18:01:29The following poem is a poem about the wonder of birth and childhood. Elyssium Our first born cries. A golden dream with Expectations as promising as The expansive petals of the Sunflower....and hope, To learn the provinces Of a virtuous world: Kindness compassion, Benevolence, caring, Integrity, tolerance, delight In sharing... as she emerges From her veil of childhood to Bathe in the joys of her Life; Elysium in Greek Mythology is the abode of the blessed; the paradise or happy land.
Entry Date:2022-09-29 18:01:07Façade Love insists our hope Hidden in winter’s façade. A child. An image. A memory. A promise. Yet, We shall unveil its wonder; …The gift of tomorrow, And why we love, today.
Entry Date:2022-09-29 18:00:45Trophós Dedicated to nursing colleagues, world-wide Fortunate are those Whose lives are touched by you. You overwhelm the pity of physical agony, You care when caring seems lost. You cry when caring has lost. You smile when your kindness creates peace. As no greater worth is there Than for you to share what Rests inherent in your heart: Your art, your soul, your sense Of right and wrong. And above all, A righteous ethic that strives, Without pretense, to heal, lifelong. Trophós from the Greek: “a care-giver, sustaining someone by nourishing and giving tender care like a nurse”
Entry Date:2022-09-29 18:00:25Some words I spoke at a memorial service for pregnancy and neonatal loss: I am honored to be able to participate in this service tonight as my heart reaches out to all here tonight who have experienced the loss of a child. While the death of a baby is a catastrophe and a tragedy which shatters good, secure and confident lives in a matter of moments, the sharing of feelings of such profound loss with one another at a service such as this and beyond can actually beget a healing experience. One bereaved mother has put this in another way: : “Strangers we may be, but we are all connected by the loss of a child, and that makes us all soul mates.” Like yourselves, countless mothers and fathers and those close to them silently grieve with little resolution over the loss of their pregnancies, newborns and children. Seeking reprieve from their sorrow, they cry and yearn for solace and hope, many times for years following their loss; cries that are but a muted weeping of despair as a child so longed for is not born, or is not born alive, or cannot be conceived. Pained by these losses, their lives seem devoid of hope. Yet they-you- prevail, for within each of us is a timeless, enduring spark of divine hope, a uniquely human greatness that permits us to challenge adversity and courageously face the unexplainable suffering of our souls and bodies. To realize the existence of this divine hope is a most cherished purpose, for with it our lives have promise and reason. Infertility, pregnancy loss, neonatal illness and subsequent death are among the most painful losses we can experience, for they deny us a family and leave sightless our vision for immortality through generations of the future. Moreover, a child not born is likewise denied the delight to revel in the simple beauty and endless wonder of this divine hope. Memorial services such as this, ceremonies and tangible items of remembrance are vital for healing after the untimely death of the child, born or yet to be born. They give us permission to remember and cry publicly as well as privately. Memories are what remain of our lost children, invisible bonds between mother father and child, everlasting. Remembering and praising our lost children can make darkness, visible. Perinatal loss entails a "unique bereavement" and is an "exceptional" type of loss, for a child is not expected to die before his or her parents. Across all cultures, the parent-child relationship is and has been the most enduring and significant. The natural processes of birth, life and death should follow in an orderly and rational sequence and through one’s lifetime. Any death but death from "old-age" after a "rich" and fulfilling life is premature. Yet when parents like yourself see their child die, or carry the burden of an unborn demise, they live with this disruption of said natural order forever. There has not been nor is there now one common and standard way to manage the recovery from such grief, for it’s shadow has been and will be indelibly imprinted in the minds and souls of these parents. Bonding between mother and father and child or expectant child occurs and must be recognized. Death tears this apart. The issues of mourning, of lost promises, of sadness and above all, of maintaining faith must be addressed. The impact of these losses must not only be recognized but must also be "main-streamed" into our society. We are at the threshold of an era when solace and compassion for the deaths of these our smallest and most vulnerable of patients are being recognized more than ever before. I believe the days when perinatal loss is considered an unspeakable loss are waning.
Entry Date:2022-09-29 18:00:03Some thoughts about caring for the Loss of a pregnancy or newborn When the outcomes of our patient's pregnancies end in miscarriage, stillbirth or infant death, we struggle to find the right approach to break the news to them, treat them medically and/or surgically, help them recover physically and emotionally, and console them in their grief. Most of us have not been taught to provide this bereavement care. We learn fast that there are hospital nurses and social workers, bereavement counselors and therapists, support groups and religious ministries to whom we can refer our patients for immediate bereavement care and subsequent follow-up. We can do the D and C and we can attend and assist in the birth of the baby who has experienced an intrauterine death. But then, for many Obstetricians, we refer our patients for bereavement care. When we hold in the palm of our hand an 18 week fetus immediately after our patient miscarried or attend the stillbirth of a term pregnancy, our intellectual knowledge and rational thought fade as we struggle to find the right words to say. Unlike the repetition of performing a surgical procedure, no matter how many times we have experienced a loss with our patients, it does not become easier. Although the stillborn baby which might have been born viable represents the greatest emotional and management challenges, we must recognize any loss in pregnancy as a life-altering event for our patients. The care of the patient experiencing a Pregnancy Loss is a paradigm for what we do as physicians. It tests not only our clinical skills and judgments but stretches the fibers of the human aspect of caring very thin. Although we might ask, "how can we heal when our patients' children are incurable, when they are suffering or when they die or what do we do when the advanced technology that has become a part of our black bag fails", we must understand that we can heal by providing comfort , empathy and hope. As bad as this experience is for our patients, we can make it better. If we remain aware that we are the link between the stillborn baby and the bereaved family, that we were the first to touch and hold their child, albeit their stillborn child, then we can share this with them, remember this with them, and from this point forward, heal with them. The bond we form becomes the unbreakable fiber, which strengthens and indeed cements our role in the doctor-patient relationship.
Entry Date:2022-09-29 17:59:29Caring for the well-being and the illnesses of patients and their families is to accept that medical science in all its depth and possibilities is not precise and that the human mind and flesh are perishable. We are today steeped in myriad medical technologies that in themselves bring hope to previously hopeless conditions and pathologies. Yet there remains inexorable suffering which accompanies failures and tribulations not only of these new medical technologies but of pervasive disparities which exist to deny access to and recipient of one standard of care for all, disparities defined by the social determinants of health: the paradox of our societies to both cure and cause pain which is real and evident. We must never abandon the souls of all patients.
Entry Date:2022-09-29 17:59:04Anuraga Love insists our hope Hidden in winter's facade. The arduousness of these days Crave creative wonder To seek the shining of Next year’s springtime. Longing, when our reverence and friendships, Like the very soul of art, Will enjoin; never to be lost or diminished As seasons themselves Endure in cascading timelessness To unveil wonders and Gifts of tomorrow.
Entry Date:2022-09-29 17:58:49An excerpt from a poem I wrote some time ago and share it with you today with hope and promise for the years to come when we emerge from this pandemic. …For you this is what I long: to breath the air, hear a song walk beneath some sapling pines search a dream, slow the time see truths distant horizons hide float on waves at even-tide. know a softly spoken poem call our earth beloved home…
Entry Date:2022-09-29 17:58:28Yesterday, at the invitation of the Medical Ethics Society of the Saint Paul’s Girls’ School in London, I presented and led a discussion entitled “When we cannot cure: Thoughts on the ultimate challenge to the bond of patient with doctor”. Many of the students in the audience are planning careers in the health professions and it was a great honor to be able to discuss with them my thoughts and reflections on humanism, ethics and the privilege of caring, foundations upon which healing takes place, and to paraphrase Hippocrates: “ give a share of such precepts and oral instruction…to pupils who [sic] will sign the covenant”.
Entry Date:2022-09-29 17:57:57"There is a need to instill a sense of how important our influence and presence is to our patients when they experience their losses. As physicians, we must formulate an approach which will permit us to provide our patients the comfort and hope they require and should expect from us. I believe we must grasp and understand our own feelings to better serve our patients: we must serve our patients though both science and humanism. By becoming more introspective and more emotionally involved in what we are doing, our compassion will become evident and our patients will benefit. Technology indeed provides better diagnostic and therapeutic medical care, but as more technology is developed and utilized, health professionals may become more reliant on that technology and less on their interpersonal skills. They will have to learn –or relearn- and practice the traditional art of medicine, of listening and talking to patients, holding their hands, being at their bed side, while complementing the use of modern technology and advanced science. We as physicians must assure that the benefits of these technologies are fully realized but that their expanding sphere of influence does not disenfranchise the patient nor de-personalize the physician-patient relationship.
Entry Date:2022-09-29 17:57:24"Inherent in what defines the physician-patient partnership is an unfaltering responsibility of the physician and an unconditional trust of the physician by the patient. Together these bond the chasm between the vulnerable patient and the knowledge and experience of the physician; a synergy of the need for care and the privilege of caring. I believe the medical professional at all levels must step back from each moment in his/her patient care routine, and reflect on what he or she is doing, why it is being done and what influence it is having on their patient’s lives. This self-reflection is integral to professionalism for it encourages the formation of a philosophy of care and ethic of practice, which in turns fosters self-examination and meaning, empathy and compassion." M.Berman
Entry Date:2022-09-29 17:57:02I believe that we as practitioners and guardians of humanity's health, have been granted by oath and by ethic the privilege to examine and treat, to counsel and advise our fellow human beings and we must never abandon the souls of all patients seeking our care. It is my hope that Maternl will propagate and preserve these tenets. Prociedo Going forward (latin) Today are times of much despair Yet times of great hope To affirm our oath As unfiltered reason and purpose Rush in our blood Every pulse a wave Approaching distant shores To leave our prejudice behind To fade into vapors As common as fog And guide us to plant Roots to bond our humanhood and Vines to grow our brotherhood As we go forth into tomorrow. A poem defined by our times, January, 2022.
Entry Date:2022-09-29 17:56:06Affirmations You are the dedicated and the dear; Who bravely face the abyss With courage that speaks Your truths To the unfaltering oaths Upon which you swore; A grace of caring Which comes from your Outstretched hands and noble souls and more… Your calling: A strength, To strike and penetrate As coulters1 to shear each morsel Of disease and despair Into infinite shards; To awaken the safely guarded Hopes of humankind’s promise As life’s order is at last restored, Returning to us the dreams To freely breathe the air, To walk hand in hand Upon the byways and the beaches, And travel distant shores, And speak of todays and tomorrows Once again with smiles And even drops of tears; Gleams of gratitude and affirmations, For you, the dedicated and the dear. © 2020 Michael R. Berman, MD
Entry Date:2022-09-29 17:55:46Today as Thanksgiving, 2021 approaches, I would like to recognize the mothers and the children, globally, who are starved for food, and the many who give of themselves to aid in their struggle to survive with the pain of hunger. One such person and organization among many is Kate Hudson, World Food Programme ambassador, for the UN organization, World Food Programme recipient of the 2020 Nobel Peace Prize. (http://www.wfp.org). I am dedicating the following excerpt from a poem I wrote to her and the UN World Food Programme organization. Dreaming of Amalthea ..and dream...of those, and thank, Who reach beyond the bar, Whose conscience lives both near and far To hear the cry; hunger's cry, And stand steadfast, aware To know their vision be to share Their harvest with those they've seen To sleep on city streets and upon parched earth, where leaves once lush and green now crack, and lifeless, barren branches fracture ; Where famine be the slayer. Excerpted from the poem, Dreaming of Amalthea, dedicated to those who unselfishly commitment themselves to feed the needy. Amalthea, the horn of the goat that nourished Zeus, is the root origin of the term, "cornucopia or horn" of plenty.
Entry Date:2022-09-29 17:54:15The impact of words is universal. Words particularly in the form of poetry can uniquely bridge the chasm of what to say and what is felt at significant times in all of our lives. Through metaphor and allusion, rhyming and meter; for eulogy and celebration; for love, understanding and hope, poetry matters significantly. Poetry enables me to ask why even when we already understand how. It permits me as a Doctor of Medicine, witness to the frailties of our humanity, to abet healing through the very core of what makes us human, our language and our personal emotions. It has been my platform to tell my 'stories', to honor my patients, my friends, my family and indeed, the essence of humanity, the "family of man". We as healthcare professionals have a need and obligation to care for others. Whether in academic, research or clinical practice, laboratory medicine or diagnostic imaging, the healthcare professionals' role is to bring comfort and to heal. From such healing comes self-reward, self- fulfillment and honor. If we are surrounded by despair and inequities and have the opportunity to help with their dissolution, it is our obligation to do so. Such has been my mission as a physician, an obstetrician, through my work and my poetry. If one person, one family, can be helped or can gather hope through the words we write and say, it can bring reward equal to the healing with our hands and minds. Hope is a singular gift we must never destroy in ourselves. Poetry is its instrument whose music can be its enabler. Words we write, words we read, and words we hear can serve as an invaluable source of healing. Words are songs from our hearts and can be "songs of hope, songs for hope" My Poetry is about hope and despair; about celebration and sorrow. But mostly, it is about hope. Forms of expression implicit in symbolic language; poetry and verse, song, prayer and ritual, have served a role in all cultures and societies to dispel the tears and foster the healing of death and human loss, suffering and despair. Why does poetry triumph as a source of enduring inspiration and hope?
Entry Date:2022-09-03 13:41:12Amare Forlorn, with tears And cries, am I. To lose you to your death Without but even gasp or sigh, Save a wisp of Angels breath; the darkest sorrow I have known. Yet, Your image burnt in my Soul is my gift, my grace, And always will I see your face Upon the simmer of Placid ponds And in the clouds where Sunbeams hide And raindrops form, And I will speak kind words And write of you And sing in sweet demure, In early morning's dew And in the crown of daffodils Which bloom amidst the storms Swept cross my brow, In every dream In which it seems You come to me. My love forever Do I avow.