The Art of the Matter

It had been a long day for Jack Maypole, MD, director of the Comprehensive Care Program in Boston Medical Center’s Department of Pediatrics. BMC was in the throes of the COVID-19 surge and had swiftly converted into a dedicated COVID hospital. Like many health care workers during the spring of 2020, he was performing duties outside those of his workday responsibilities, and even outside his typical scope of practice as a pediatrician.

After finishing the first part of his day where he cared for pediatric patients and their families through telehealth and the newly-established pediatric mobile unit, he spent the next eight hours in BMC’s Emergency Department (ED). There, he took off his figurative hat as a pediatrician and put on an entirely different one: physician on the Palliative Care Extender Team. The group—consisting of volunteer physicians, advanced practice providers and psychosocial professionals—was established after emergency medicine and palliative care identified the need for more support, such as end-of-life discussions and planning, in response to the increased volume of critically-ill COVID patients arriving to the ED.

Maypole, like so many of his colleagues, did not hesitate to help care for BMC’s patient population, which had been particularly hard-hit by the virus. “We all suspected, based on stories from Italy and from Wuhan, that we’d have to think far beyond the box in terms of how we were going to be working, including practicing outside the scope of our normal practice,” he explains. “There was a top-down call to action and everyone took it very seriously. We all had a drive to contribute and put ourselves out there—without necessarily knowing what the details would be—and each person said, ‘Count me in.’”

Maypole was struck by some images and thoughts as he left work that evening. “After working as part of the Palliative Care Extender Team until 10pm, I was just drinking it all in. It was all washing over me,” he recalls. “I was feeling 50 million things—sad, frustrated, exhausted, exalted and impressed by the work of my colleagues.” As he walked through the lobby of the Menino Building he found it transformed from its daytime hustle and bustle. “It was softly lit in a way that was rare, that you just don’t see,” he recounts. “After the ED, the stillness was profound, as if I caught the hospital between breaths. I just paused, looked back and let that image sink in.”

That moment of reflection stayed with him as he drove home. Pride, exhaustion and gratitude he felt for BMC’s response to the pandemic coalesced, as it usually does for Maypole, into a form of creative expression. Inspired by the bedtime story beloved by his patients, he redrafted the words to Goodnight Moon, and dedicated it to his colleagues:

Good night, Hospital
(with apologies to that moon book)

In the medical center academic
there was a surging pandemic
And a COVID team
And an ER that is a happening scene.
And there were six long weeks till the virus peaks
And two guards, live, handing out N95s
And a little nasal swab for a diagnostic job.
And a donated coffee and a wrap
And plenty of free snacks
And an insistent overhead code page that was urging, “Rush!”
Good night, hospital. Good night, pandemic.
Good night, you fab COVID team.
Good night, ER that is a happening scene.
Good night, weeks. Good night, peaks.
Good night, guards, live. Good night, N95s.
Good night, swabs. Good night, diagnostic jobs.
Good night, coffee. Good night, wrap.
And a bunch of those snacks.
Good luck, somebody for whom they said, “Rush.”
Good night, rock stars. Good night, my colleagues fair.
Good night, noises everywhere.

Note: ER is an abbreviation for Emergency Room.

This wasn’t the first time Maypole made sense of the world by putting pen to paper. He’s best known for cartooning, which has been somewhat of a lifelong passion and form of expression. “My mom was an amateur cartoonist and I grew up imitating her,” he explains. “Over the years, cartooning has been a great way to break the ice with new people. It provides a unique tool to sometimes distract, relieve stress or help people understand complicated or weighty ideas in a lighthearted way. It uses humor to reach people.”

And reach people he does—whether it’s patients, colleagues, fellow parents or strangers, cartooning has been a vital bridge for conveying thoughts and ideas. Maypole often shares his art on Twitter, which became especially therapeutic during the pandemic. “It brought into stark relief the need to sometimes communicate the complexity and the fast-changing nature of COVID from a number of angles—taboos, new expectations and evidence, new practices as well as the political and cultural conflicts that arise around those things. For me, it’s grist for the mill,” he notes. “Sometimes I cartoon to make sense of it. Sometimes it’s to instruct or to convey a point of view. I try to capture and convey ideas in a way that I hope is engaging to make people think and other times it’s just simply to make people laugh when things are grim and hard.” Sometimes, it’s a combination of all the elements he describes, as portrayed in his series of Shakespeare-themed cartoons with a COVID twist.

Thankfully, COVID cases are dwindling and the hospital is in the process of returning to normal operations—something Maypole is anxiously anticipating. “We’re gleefully reconnecting with patients and seeing a growing volume of in-person visits over the next few weeks,” Maypole notes. “It’s a hopeful and helpful dimension to our journey.”

The transition to normalcy means it won’t be long before Maypole is back to cartooning in arguably the most rewarding manner of all, which is to build and deepen relationships with his young patients. Whether it’s drawing with a patient to ease their nerves or using the activity to have a conversation geared towards revealing key information about developmental stage and things of the like, one thing is for certain: art is an invaluable window into understanding people. “A piece of paper and a pencil are welcomed and familiar,” he concludes. “And they can make sense of a time when we’re all feeling outside of our comfort zone.”