Read Tales from the Emergency Room Online
Authors: FAAAAI MD William E. Hermance
The Mellon Sisters
A physician who cared for many wealthy people and who sent us a lot of work used to encourage us to charge certain of his patients more than our normal fees. (We never did.) So one Saturday morning I was surprised by a phone call from him asking me to meet him at Westchester County Airport. We would be flying to Martha’s Vineyard because “one of the Mellon sisters” had been stung by a jellyfish. Since I was not about to fly anywhere with him, I asked how long ago that had happened and was the woman still living. It had been several hours, maybe a day, and she was still with us. I pointed out that, in that case, he had no need of my services, nor did his patient. He was a bit disappointed I think because mainly he wanted company on the trip. But, he took it gracefully, knowing full well that I was right, and continued to send work my way, including, eventually, his wife.
The Parrot Lady
An older woman, about 75 years old came into the office one day because she needed to be tested for feathers. This seemed strange since she did not have a history of allergies. She explained that she was about to inherit a parrot which had been in the family for most of her life, and since it would live to be about 125 years old (and she probably would not) that meant she would be exposed to feathers for the rest of her life. She was a stately woman with a wonderful sense of humor, who, thankfully, tested negative to feathers. She left, happy in the knowledge that she would have a permanent companion without complications. The main problem then was to whom to leave the bird next, over which she and I had a hearty laugh!
R2D2
Several years ago I attended the national meeting of the American Academy of Allergy, Asthma and Immunology in San Antonio, Texas. Normally, I opted to attend sessions which were clinically oriented, but this day I went to a complex scientifically oriented meeting. Leukotrienes (chemicals involved in the immune inflammatory response) were just beginning to be studied and the subject would become important eventually in my daily practice. I noticed immediately that the physicians in attendance seemed quite young, and I realized that they were there so as not miss any new ideas which might crop up on their Board Certification exams. The presenter worked largely from slides, while the audience took notes copiously and furiously. Leukotrienes have names like leukotriene B, leukotriene C4, and leukotriene D4, and many of the slides were covered with corresponding notations. Suddenly, in the middle of the lecture, while everyone was jotting down his last remarks, the presenter flashed a picture of R2D2, a robot hero of Star Wars, onto the screen. This was labeled R2D2. I actually laughed when I saw virtually everyone, most of whom had grown up with Star Wars, immediately began to take notes on this hitherto unknown chemical! All soon realized what had happened and the room erupted in laughs and chuckles. The tense atmosphere lifted and I felt that the presenter had done just the right thing for his overzealous audience.
Her Last Breath
For several years I took care of a little girl with very severe, chronic asthma. It was in the days before all the new inhaled drugs that are able to control most cases so well were in use. She came to me with her mother every Tuesday, got her allergy shots and had her medicines revised if needed. One day, I was called to the hospital to see her after she had been admitted for breathing difficulties. Her pediatrician, the Chief of Pediatrics, arrived shortly after I did. Everything we could think of was done for this child. We were standing at her bedside and she was in obviously severe respiratory distress, when her pediatrician said, “Her next breath will be her last.” So, we waited, and she breathed once more. We two doctors were beside ourselves with frustration over our inability to do more to help her. And then, she took another breath and another, still severely labored, but continuing to breathe. The medications were beginning to work. Eventually, she began to breathe more normally, and, several days later, she went home. To my knowledge, she never had such severe trouble again.
The postscript to the story: During July and August, every year, my office was closed on Thursday afternoons. This was posted from early April on every year. The girl’s mother knew this quite well, her daughter having been a patient over several years. The first Thursday after the hospital incident, in July, the patient arrived with her mother, to find the office closed. Shortly thereafter, I was informed by letter that, henceforth, the little girl would be seeing another allergist, since I had had the audacity to change my office schedule without proper notice!
A Mid-day Drink
I had a friend who was a businessman in Manhattan during my training and thereafter. He was doing quite well for himself and knew how business got done in the City. I was totally unacquainted with the “business lunch”. I had been out of training for just a matter of weeks when he said, “Let’s do lunch.” At the time, I was working in my soon to be partner’s office in Manhattan several days a week. On Fridays, I worked in the morning, was off for several hours and then worked for two more hours in the afternoon. So, my friend and I arranged to have lunch on a Friday. Nothing would do but that I have a martini with my lunch. And, of course, another one. Lunch was lavish—he must have been paying!—and, so by the time I got back to the office, I felt just fine. Actually, I was horrified that I had to see patients after having those two drinks. I told my nurse, quite emphatically, that she was to keep an eye on me the rest of the day, which she did, following me everywhere and being present when I was seeing patients. Finally about an hour before the office closed, she burst out laughing. I asked what was so funny. She told me that she had never seen anybody being as careful about anything in her life as I had been during the afternoon, and, of course, by that time, there couldn’t have been much alcohol in me anyway to cloud my judgment. I had to laugh, too, but never again did I see patients after having a drink.
Mistaken Identity
I began my internship at the same time as a tall, nice-looking fellow, Charles. For reasons which were unknown to me at the time and still are, people often confused the two of us. During training, which we did together, I got blamed for some revelry that I had not participated in, for instance. We both were quite used to this. We both began our medical practices in the same community. I often covered for another older doctor, for the first years I was in practice. One day in my second year of practice, I decided to take a weekend off. I really needed a break by then. On Saturday morning the older man called me, furious because I had not responded to a call from a patient of his. “I asked you to cover for me on the steps of the hospital yesterday!” No, I replied, he had got that wrong. There was a long silence, and then he said, “Well, whom did I ask?” “That would be Charles,” I replied. And sure enough, it turned out to be another case of mistaken identity. All three of us laughed about it eventually, by the time the older man had cooled down. Charles was said to be the finest resident ever to train at St. Luke’s-Roosevelt Hospital. He was our family’s medical doctor for many years and saw our children after they reached adulthood. It was an honor to be confused with him!
Cat Allergy
Early on in our relationship it became clear that my wife was very sensitive to cats. So much so that she would sneeze and itch if someone visited us who had cats at home. Naturally, she is not fond of cats, but they seem attracted to her. One evening while visiting another home, she asked me where the cat was. I had not seen one, nor had she. However, a cat had just settled down behind her chair and Peggy was beginning to have symptoms.
As soon as the new cat treatment extract became available, Peggy began immunotherapy. It was easy to do since she was working regularly in the office by then. But, boy! Did we have to be careful giving her allergy shots. Large local reactions and occasional hives guided her dosages. Soon, she began to tolerate cats much better, and eventually became “immune” to the exposure. After about 5 years of treatment, the shots were discontinued and she continues to do well these many years later. She still avoids cats as much as possible, the children have gotten rid of their cats and the people we visit try to keep her exposure to their cats to a minimum. The antihistamines are always in readiness.
Mrs. Purse
On the way home from the office, my wife, carrying the office envelope and her purse, was mugged at knife point. We had often worried that this would happen in the City, but no, it took place at high noon on the main road into White Plains. She knew there was trouble when she saw a man going in the opposite direction on foot, turn around, cross the street and begin to follow her. She did not turn into the entrance to the residential park where we lived and where she probably would not have been seen, but instead continued on down the main sidewalk. The mugger soon displayed a large knife and grabbed her purse. (The office envelope had more money in it.) She screamed, the mugging was witnessed from an apartment nearby where the observers dialed 911. A man in a van who also saw it, managed to corner the mugger up against a wall with his truck. Luckily for him, he did not injure the perp, who then threw the knife down a storm drain. The police arrived, arrested the mugger and retrieved the knife. About then a colleague came upon the scene in his well-known white Cadillac, and was horrified to see Peggy sitting in the back of the squad car. He stopped to see what that was all about. Eventually, Peggy wound up at the police station where I eventually found her.
When the case came to the grand jury, Peggy was on hand. One of our best friends was senior assistant DA in Westchester. He called Peggy into his office to await her turn in court. He also told the young DA on the case, to be sure not to make any mistakes. When she was called, our friend went into the jury room as well, onto the balcony. When the young DA spotted his boss, he became so flustered that he began his questioning of my wife by saying, “Now then, Mrs. Purse . . .” A slightly embarrassing but humorous error in the courtroom. The mugger eventually served over two years in jail. This was his first and only offence on record. We hope it was a lesson well learned.
The Crossing Guard
For several years, a neighbor rode with me on Monday mornings into Manhattan. We usually took the same route which included getting to Martin Luther King Jr. Boulevard in Harlem on the cross street at 136th Street. At that corner, there was always the same crossing guard when we arrived. The first time we saw her it was raining and she was wearing a full length bright yellow raincoat and rain hat. She looked for all the world like a huge banana! Whenever we saw her in this outfit we always had a laugh. Eventually, she began to notice us on our regular schedule and we would all wave at each other. Then we began to stop and chat if she was not busy shepherding children across the busy intersection. We never learned each others’ names, but our association put a bright spot in our Monday morning trip to work even if it was raining.
My Son George
One day a lovely lady came to see me. After we were face to face across my desk, she remarked that she knew my son George. Being in practice in my hometown where my father had been quite well known, I was used to people saying to me that they knew my father. I guess I looked a little bewildered as we proceeded with the interview. At the end, I commented about my initial reaction since I usually heard a different remark. It turned out that this lady was my George’s nursery school teacher, and that she had not known my father. We both had a good laugh over this and would comment on it from time to time over the years while she was a patient.
The Subway to Queens
For about two years, I would take the subway to Grand Central Station and the train to Scarsdale to pick up my car and drive home. This happened on Wednesdays when I would leave the office at about 5:30 PM. One night, after I got on the subway, I realized that the trip was taking far too long even though we were speeding along, and that there were no stations. So, I guessed that I had gotten on the train to Queens and was traveling under the East River. This added at least 40 minutes to my trip and did not make me happy. I thought no more about it other than to be a little annoyed at myself, when, the following week I did the exact same thing. By now I am wondering what is going on in my head, and I resolved not to make this mistake again, and I never did. My wife was thoroughly amused at the time, and it does seem amusing to me now.
The Smithsonian
There was an allergist in a neighboring town who was a very old man. He still continued to see patients—they would bring their treatment solutions from the kitchen refrigerator upstairs to his bedroom where he would administer the shots. Eventually, a family member asked me if I would be willing to see his remaining patients and I readily agreed. (Some were still patients by the time I retired!) When he died, his daughter was in a quandary about what to do with his 1929 style office which had long been unused. Inspired, she called the Smithsonian Institution to ask if they had need of such an office. To her utter surprise, they sent a team to inspect the office and, even more surprising, took the whole office, lock, stock and stethoscope to be set up as an exhibit in Washington. To my knowledge, it remains there to this day.
His Nickname
I was seeing a young man once whose mother insisted that I call him by his nickname. It was “John”. His given name was, of course, “Jack”. Jack was written on his chart and so I often called him Jack before I got my brain around his nickname being John. After his mother reprimanded me for doing this several times, I couldn’t help but explain to her that her son was the only person in the English speaking world to be nicknamed John and that she would just have to be patient with me. I have wondered what Jack’s nickname became after he got off to school and out of the house.
A Cancellation