The first time I glimpsed it, I could scarcely believe my eyes. Yet, there it was in the JAAPA table of contents in big bold print: POEMs. Finally, I thought to myself, a poetry department in our national medical journal! Hurriedly I scoured the issue, searching for the promised pieces. When I found the page at last, I was crestfallen. POEMs, I learned, was merely an acronym for patient-oriented evidence that matters. “Aye, there's the rub!”

Most of my 30-year career in clinical practice as a PA has been spent in pediatrics. Although I certainly can't claim carte blanche childlike innocence, I do have a tendency to look at life through the eyes of a child. When I encountered the written word POEMs, my mind immediately engaged in Piagetian concrete-operational thinking and took the department title at face value.

Don't get me wrong. Certainly there are valuable clinical pearls to be gleaned through patient-oriented evidence that matters. Just that in this instance, I had been primed for something a bit more … well … poetic.

Poetry has fallen out of favor these days, especially in medical journals, where evidence-based outcome reviews and studies have become publishing's gold standard. To paraphrase Bambi's friend Thumper: “If you can't write somethin' clinical, don't write nothin' at all.” Yet 3 decades of practice have taught me that every patient encounter is a poem yearning to be composed and reflected upon.

Recently, I evaluated a 17-year-old girl with complaints of fatigue and malaise for 1 week. She told me that she had practically slept her entire holiday vacation away. She had no energy to do anything. An extensive medical history revealed little in the way of illness. She denied any recent fever, headache, sore throat, cough, or abdominal or joint pain. She denied illicit drug use or sexual activity, stating that she had a normal period 3 weeks prior to this office visit.

As we talked, I noticed the slim, rectangular, black object she held in her hands. When I asked about it, she told me it was an iPhone, the latest and greatest electronic gadget that allows the user access to the Internet, e-mail, chat, and cell phone services. The iPhone was a holiday gift from her grandmother.

I have been this girl's primary care provider from the time she was a toddler. She and her sister were removed from their home when their unmarried parents had a major domestic spat that placed the girls at risk. The mother subsequently entered a halfway house for drug and alcohol treatment. The children were placed in temporary custody with their grandmother, who was eventually awarded full custody of the girls, despite her deteriorating health. When last I saw the grandmother, she was pushing a walker and carrying a portable oxygen tank, wheezing with every step, suffering the ravages of end-stage emphysema caused by a lifetime of cigarette smoking.

This girl was usually quiet during office visits. She rarely made eye contact with me. This day she was modestly dressed in an old woolen coat and faded black jeans. Before proceeding with the physical examination, I gingerly transferred her iPhone to the countertop, where it would be less likely to incur damage from an accidental fall. After completing the physical examination, I returned the iPhone to the girl's eagerly outstretched hands. She cradled it in her lap as though it were a precious treasure of immeasurable worth. I sensed that it was the most expensive gift that she had ever received.

I elected to order some routine laboratory studies to check a few parameters and was not at all surprised when everything came back normal. I telephoned the grandmother at home. I could hear her wheezing over the phone as she thanked me for letting her know the test results promptly.

“I sent her to school today,” the grandmother informed me. “She misses so much school. Last year she barely passed. I don't know what's been wrong with her, but today she seemed better.”

As I hung up the phone, once again I thought of the girl, of this shabbily dressed plain Jane sitting in class at school, perhaps with her fingers secretly curled around the jewel of the iPhone in her pocket, smiling to herself at her recent good fortune. I imagined that this gift might afford my introverted patient some newfound status among her peers or serve as a precious link to life on a grander scale.

Freud said: “Wherever I go, I find that a poet has been there first.” Somehow I had been granted a bit of insight to appreciate the poem that I had been handed that day—a small piece of patient-oriented evidence that mattered. JAAPA

Brian T. Maurer, PA-C, practices pediatrics at Enfield Pediatric Associates, Enfield, Connecticut. He is the author of Patients Are a Virtue and a member of the JAAPA editorial board. Visit the author at http://briantmaurer.wordpress.com.