My Blog

"I know where songs are made And where simple words are born. It is in the hearts of dreamers. . ."

For my students: Embrace language.

Do not underestimate the influence of the words you read, write and speak for they are empowering. In a moment they can help; in less time they can hurt. They can bring peace and they can create turmoil. A few simple words, prose or verse, in an appropriate situation can have inordinate influence on you and on others. And if we focus on those words of poetry, I ask that you savor them, for through verse and meter, free of inhibition and full of expression, a poet’s voice can articulate sensitivity, empathy and solemnity and provoke much needed introspection and inner peace. Properly selected words can move the reader or listener to tears and awaken the primal emotions of joy, despair and hope. Hope becomes an essential thematic element in a poem for as human beings, we all have the capacity to bring hope to despair that is uniquely created by our humanity and our human conditions. The universe of poetry is an important sphere for you in your personal and professional lives. I suspect many of you have discovered this already. As a physician I have encountered elation, desperation, birth, life, death, happiness, sorrow, fulfillment, disappointment. Poetry has been and continues to be my refuge when my stethoscope, scalpel and pharmacopeia can no longer heal. Many years of caring for the wellbeing and the illnesses of patients and their families has taught me 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 and scientific technologies that in themselves bring hope to previously hopeless conditions and pathologies. Yet there remains inexorable suffering and disappointment, which may accompany the failures and tribulations of all new technologies. Their benefits may not be realized. Thus, the paradox of new technologies to cure and cause pain is real and evident. Poetry enables us to ask why even when we already understand how. It permits us all, when witness to the frailties of our humanity, to abet healing and resolve through the very core of what makes us human, our language and our personal emotions.


A poem to honor the retirement of a friend and colleague.

We are a constellation.
Our wonders and turmoil
…Of caring:
Grasps science with hope;
…Of understanding:
Grasps analysis with insight.
Caring; understanding;
Beacons of what drives us to do what is best.

We are a constellation.
Compelled by mission.
Consumed with passion.
No one leader;
A team of many;
With many bright stars
But none brighter
Than whom we honor today.
A devoted voice
For the patient;
A just and reasoned voice
For us all.
Our praise cannot be enough
Yet our blessings are abundant.
Seek what you love.
Find what you deserve.
Savor your life.

Antares is the brightest star in its constellation Scorpius, and is often referred to as "the heart"


On Trust

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.



A Poem for a Stillborn Child I Do Not Know

Even strangers from afar know of you
and the aura of your birth,
the darkened hope and hue
of stormy clouds that shadow streaming light,
and know the flawless shards of love
disguised in tear drops crying day and night
one by one, gleaned tears from loving faces
reach towards pinnacles of immortality and
makes us all believe that as the paces
of heart beats breach life itself,
love too ascends, cast heavenly
upon rainbows and shooting stars,
our gifts to comfort for eternity.
And in the longer nights of winters liar,
your beauty can be seen by all
and in the frozen air where bellowed
breaths of hope inspire.
Though today it lives, a chrysalis,
laced in grief and pain,
one day it will awaken
when winters\' snows spur springtime rain,
and fuse sadder thoughts with memories
And distant smiles will bind
eternal love with hope and promise,
even strangers from afar can find.


An Aspect of caring

As physicians, it is the greatest professional privilege to participate in the care of a pregnancy and the birth of a child. Yet, the bar is raised when that child dies. As elation turns to grief, and joy to sorrow; when in a brief moment the expected becomes the unexpected, this privilege becomes sacred. For we are first to see and touch her, we inscribe her image indelibly in our minds, and her death, in paradox, does not sear our bonds of caring but rather seals them. We as health professionals must grasp the importance of our presence, our words and our deeds when our adult and pediatric patients are dying or incurable or families are grieving perinatal, infant, childhood and adult death. Everyone who touches, speaks with and interacts with a patient -both in a primary and a secondary role -should be aware of what their life-long influence on healing for the patient and family can be.


A poem for hope, for family and for our tomorrows

We summon ancestral voices.
And peel our skins of daily toil,
Moments of banal routine,
And stare beyond reflection
To cherish living’s wondrous elements;
Fusing generation to generation,
Parent to progeny, young to old,
Passions to deeds,
To all...bequeathed today.
Our carapace, now shed
To unfurl life\'s grandeur
Of simply love and caring,
Of giving and sharing,
And gifted time…beyond dismay.


Integrity and Values

"The Existence of virtue
depends entirely upon its use.”

Our Integrity is measured
Not by the expense of time
But by its means:
How we live,
Whom we love,
What we sense and feel.
Fueled by spirit,
Kindled by reason,
We assume a purpose.
Furrows of our palms
Map our travail;
Fingers, its instruments,
Voice its praise.
Traversing age of years,
We are valued by our deeds.
And our prosperity becomes.
The reward of our virtues


A poem to honor and memorialize a teacher, mentor, colleague and friend, Dr. Ernest Kohorn. Obstetrics, Gynecology and Reproductive Science Grand Rounds held , March 2, 2023, in his honor at the Yale School of Medicine.


He, the doctor;
plays the theatres of maladies,
thrusts deep into
entwined complexities
of life\'s forces which
penetrate nearly to death...
and to death,
while spectator-less
scenes amass of wretched disease,
spurning wrath of reason,
and frames of frozen helplessness,
turn towards thresholds of despair...
but not crossing.


The healer;
lusts against disease,
at his rostrum, his faculty
to gift preservation,
to imagine suffering
and bring imaginable defeat;
to lift endless torment
with gentle hands of dignity;
to gaze at pain but see life;
to ponder its wonderment
and ironies, peel away its injustice,
and unearth the marbled core of its soul;
to smile, to cry, and now to pause.


The scholar;
who unaccustomed to
senescence, though lighter now
of visible labour, will remain
to till our minds with wisdom and
leave in its furrows, the very families
of humanity he served and bettered;
a shining light, arousing and inspiring,
a never-exhausting actor who compels
an operating theatre of great drama,
of untiring hope…
and amidst the extremes of misery,
of indefatigable compassion.
for it is he who defines



A Thanksgiving Thought

Today as Thanksgiving 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. ( 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.




You are a muse of healing.
Your many hands
Like summer meadows,
Catch silent silhouettes of
Gentle breaths, and caress
Forsaken hearts
To dance about again,
While instruments of
Sunlight stream
On fragile leaves of promise.
...And then in quiet shadows
Of peaceful dreams,
Play duets of hope and affirmation
Uplifting curtains of uncertainty for
All who enter

Hesed. In the discourse of Jewish Mysticism, the human hand becomes analogous to Hesed or "grace" which is symbolic of one who performs a mitzvah




A poem for our health care heroes caring for mothers during the Covid-19 pandemic'

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.


Our Oath

I 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.




Going forward (latin)
A poem defined by our times, January, 2022.


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 thought on the physician-patient partnership

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.



The importance of our 'presence' when our patients experience loss

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.


An excerpt from a poem I wrote some time ago and share it with you today with hope and promise for the yearsto 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



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



Caring 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.


Some 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 an18 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.


Some 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.



Dedicated to students of the healing arts.

To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.
Ralph Waldo Emerson


Fortunate, are those…
whose lives so fragile,
And in just being, so struggle
To feel a sense of freedom
From the pain
Of malaise and hunger,
And the maladies
Which from the formative years
Steal their persona;
Fortunate are those…
Whose lives will be touched by you.
You have learned and witnessed,
Taught and practiced
The tenets of what it means to give,
And live your dream.
And now, with profound kindness…
You will overwhelm the pity
of physical agony,
You will plant seeds of happiness in gardens
Disrupted by blight and sorrow.
You will care when caring seems lost.
You will cry when caring has lost.
You will smile when your
kindness creates peace.

And of tomorrow,
You will see
Through mists of uncertainties
Which veil the newly born and older.
And with passion, skills and fervor,
Pursue cure and order
For afflictions of the blameless.
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 the rest,
A righteous ethic that strives,
Without pretense, to heal, lifelong

Tinos is a sacred Greek Island in the Cyclades and is considered the ancient center for arts and healing.


A New Years Thought

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 soul
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