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The Art of Medicine

Do you believe in magic?

Maurer, Brian T. PA-C

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Journal of the American Academy of Physician Assistants: June 2018 - Volume 31 - Issue 6 - p 58
doi: 10.1097/01.JAA.0000533663.88073.5c
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What's the end goal for any work of art? The answer is it's not one thing. In almost every work of art there is on one level—and this is the level at which magic is, I think, the most fundamental—at which you must amaze the audience.... That amazement is the bottom line of any work of art.

Teller of Penn and Teller

“His right ear's bothering him,” the mother says. “It's been a couple of days. He hasn't been swimming, but he did lay down in the tub the other night. He might have gotten some water in it.”

The little boy sits on the examination table in summer shorts and a T-shirt. His feet dangle over the side, suspended above the floor. His large brown eyes study my face.

“Any recent cough or congestion?” I ask. “Sore throat? Fever?”

“No. No one's been sick at home.”

The mother holds a toddler in her arms. Another child sits quietly in one of the plastic examination room chairs.

“Did he used to get a lot of middle ear infections when he was a baby?”

“Maybe one or two; not a lot.”

“Let's have a look,” I say, twisting a disposable plastic speculum onto the head of the otoscope.

I peer into the boy's left ear. The canal is clear; there is no wax or fluid. The tympanic membrane glistens in its pearly-gray opaqueness.

“That's not the ear that hurts,” the boy says.

“I know,” I say. “We're running a 2-for-1 special this week.”

The mother smiles. “Two ears for the price of one,” she says to the boy.

I withdraw the speculum and step to the other side of the boy to examine his right ear. A plug of dark reddish-brown ear wax occludes the canal.

“He's chocked full of wax,” I say.

“I thought as much,” the mother says.

“I might be able to snag it with a curette,” I say. “Hold on; I'll be right back.”

I select two clear plastic curettes from the drawer in the laboratory, each with a slightly different shaped loop at the tip. I press the butt end of one of the curettes into the blue plastic base and twist it a quarter turn. Instantly, the entire wand lights up. Satisfied, I disassemble the unit and return to the examination room with the component parts in hand.

When I step through the doorway, the little boy stares wide-eyed at the instruments in my hand. “What are you going to do with them?” he asks.

“Don't worry. It won't hurt. I'm going to use one of these little plastic wands to take the wax out of your ear. Here, touch the tip. See, it's not sharp. I just need you to hold still for me, okay?”

The look on the boy's face tells me that he is not sure about any of this. I decide that a demonstration is in order.

“Do you believe in magic?” I ask him. “Here, I want you to blow softly across the tip of the plastic wand. Go ahead: take a deep breath and blow out slowly.” I bring the tip of the curette a couple of inches in front of his lips.

Slowly, he takes a breath and blows across the tip. At the same moment in one smooth action I push the butt of the curette into the base and twist. The wand lights up in an eerie glow.

The boy's eyes grow wide as saucers.

“Magic,” I say.

I instruct the boy to hold still as I insert the lighted curette into his ear canal. Shortly, a hefty plug of cerumen sits embedded in the loop of the plastic tip.

I show it to the boy.

“Some potato, huh?” I say.

I show it to his mother, then wipe the wax off the plastic loop with a tissue. Once more I present the glowing wand to the boy. “Now, again, one more time: blow.”

As the boy blows across the tip, I disengage the butt from the base, and the light goes out.

“Magic!” I say, smiling.

The little boy smiles, then regards his mother's face. She shifts the toddler in her arms.

“It's just a trick,” she says. “It doesn't have anything to do with the evil kind of magic from the Devil.”

Immediately, an innocence dissipates as the delight on the little boy's face evaporates into the silent recesses of the room.

Copyright © 2018 American Academy of Physician Assistants