Tales from the Emergency Room (5 page)

Another less inspiring incident took place during my psychiatry rotation. Each private room in Wing R had a light next to the door. If it was red it meant that the patient was not to be disturbed. I knew this, but whether the light was on by my patient’s door or I just didn’t notice I cannot say. One afternoon however, I breezed into this female patient’s room with my clipboard intent on interviewing her. The room lights were off as I settled near the head of her bed and was just about to proceed when I realized that something was not quite right. Indeed, there were two people in her bed, both momentarily lying quite still. It was the patient and her husband I came to find out. I don’t remember if I said anything as I made my escape, embarrassment being uppermost in my mind.

The Sigmoidoscopy

When I was rotating through medicine I went to watch a sigmoidoscopy with some classmates. The patient was a woman and the instructor was early in his residency. We were there to observe the technique and no one expected abnormal findings. Just after the procedure began the resident noted an “annular lesion” which we all took turns observing. This was a doughnut-shaped lesion which we all knew was potentially a very serious problem. Of course, a biopsy was taken, further enhancing our training that day. A few days later, the pathology report was returned. The diagnosis? Normal cervix. And so, we learned even more, namely to make sure that the orifice through which an exam is being conducted is the correct one.

Antidiuretic Hormone

One afternoon the class assembled in the main lecture hall per schedule. Earlier in the day I had had a shot, planned, of antidiuretic hormone, but later it never occurred to me to sit somewhere near an exit at our afternoon meeting. So I took my customary place in the middle of the seats. About 15 minutes into the lecture it became obvious that the hormone had worn off. I jumped up, made my way out of the row and out of the lecture hall as fast as I could to the great amusement of my classmates. Even I thought it was funny and we all learned much about antiduretics and how they work that day.

Cloudy Serum

From time to time in medical school it became necessary for us to collect blood samples from each other for later study. One such effort took place when we were juniors and subject to “Third Year Disease”, an affliction in which one thinks one has all the diseases that one has ever studied—or at least the worst ones. After we had drawn blood from one another, the samples were carefully labeled with our names and placed in the walk-in refrigerator for storage. One of my classmates had occasion to go into the refrigerator while the tubes were still there. He casually looked through the rows of tubes and noticed that there was one tube in which the serum was white rather than a clear golden color, the blood cells having settled out during storage. He pulled that tube out of the rack to have a better look and discovered it had his name on it. That was all he needed to see—soon the entire class knew that he had a very serious medical condition. Of course, he didn’t have anything wrong, his finding being a normal variant, quite common and not at all indicative of disease. For a while though, Dwight had a very bad case of Third Year Disease.

Vitamin B12

My dear friend George called me one day after I had started medical school. He had been to see his physician who prescribed a Vitamin B12 shot for sciatica (it worked, I know not why). Would I be able to administer the injection he asked. He would be my orange he said, knowing that we sometimes practiced giving injections on oranges. He came to my garret apartment to have the deed done. Well, how would he know that I had not yet administered an injection to any one? Also, no one had yet told me how painful a Vitamin B12 shot could be. The directions said to administer the injection in the buttock, so that is what I did. I must say that George was very good about not fainting dead away but he knew that something had gone on behind him. His first comment after recovering a bit was, “I’ll bet that was the first shot you ever gave wasn’t it?” I admitted it, George recovered and we remained best friends.

“I’m Having My baby!”

Early in my junior year of medical school, everyone in the class was assigned to follow a newly pregnant woman upon her arrival at the obstetrics clinic. This assignment took precedent over our other activities—we were to be on call to attend her at all times and could be called out of whatever class activities we were engaged in whenever she arrived at the hospital. Naturally, we got to know our ladies very well while we were learning how to properly follow a pregnancy. I knew my patient had had several normal pregnancies. When my patient was near term, I was called because she was in labor and already in a labor room. When I arrived, she said that she had come by taxi to the hospital and had had just two labor pains. (We were to call them “contractions” not pains.) Surely, she was not very far along in labor. I examined her and left to stand just outside the room in case she needed me. I awaited the resident in charge. As I was talking with a passing classmate, I heard my patient call from the labor room, “Doctor, I’m havin’ my baby!” Indeed she was and I proceeded to deliver a fine baby boy. Paying attention only to what I was doing, I tied and cut the umbilical cord and prepared to show a very vocal infant to his mother. When I looked up there stood a bevy of nursing students with their instructor and my resident. The nurses had been passing by and stopped to observe the proceedings. Not until then did I feel even a little nervous. The baby was whisked off to the nursery to be weighed and evaluated. And then I began to feel quite proud of myself. (I still do over this event at least.) Later, the mother said that she had had three contractions, one at home, one in the taxi and the final one in the labor room. This was an excellent lesson in taking a complete history. Later also, the OB-GYN section had a serious discussion at higher levels about how to avoid a similar situation in the future, but I didn’t get in any trouble at all as my classmates confidently predicted I would. Thankfully, my training up until then had been quite thorough and all I really did were things I had seen done before.

A Ruined Coat

One evening in the midst of winter in Rochester, I was hanging out in the OB section of the hospital with no specific assignment to perform. Suddenly, the doors to the anteroom of the delivery room flew open and a lady in labor arrived. Her fur coat, which she was still wearing, was trailing off the back of the gurney. I stood there and watched a very quick delivery. As the baby was rushed off to the delivery room, the new mother turned to me and said, “Damn, I’ve ruined my coat!” I looked closely to see what damage may have been done and then assured her that her coat was undamaged. “Great,” she said, “What’d I have?” She had had a healthy baby boy and was quite happy about that outcome, too.

Mr. Smith

While rotating through the surgery service, we spent several weeks in urology. We were not on the service all day every day but we did make morning rounds with the attending doctors. There were about half a dozen of us doing this and we were assigned patients in rotation as they were admitted to the hospital. My first patient was a Mr. Smith. I completed his workup and presented his case one morning. Quite by chance, my next patient was named Smith. That, of course, caused amusement among my classmates, but they were positively hysterical when my third urology patient was Mr. Smith, too. Just a wee bit suspicious, I checked the rotation list to find that he had been assigned to me out of turn by the resident who didn’t want to interfere with a good thing. I managed to keep all these Smiths straight, but the favorite question to me each day was, naturally, “How is Mr. Smith doing?”

Legs

Unused as I was to having my legs admired, I was most interested in a classmate’s remark as we were waiting in our skivvies to go into the “hot” room while involuntarily participating in another experiment, this one in physiology. Said he, “You look like you must have been a football player.” Touch football once in a while as a kid but none after that I hastened to inform him. Then we went into the “hot” room to sweat, whirl thermometers around and undertake other interesting activities in the name of science. I have no idea what prompted his remark, but I do have big legs.

Birds, for the

One of my classmates who went on to become a very famous physician-administrator in New York City was married to the daughter of the author of the most widely used pediatric textbook, then and now. She and her sister were hired to do the extensive index to the first edition. It must truly have been a massive job. One understands why the sisters would have been happy to complete it. I’m not sure when they added the entry, but there in the “B” section of the index was the listing, “Birds, for the, pages 1-1413”. I saw it for myself! I’m told their father was not happy but surely he had to be amused. Future editions do not have that reference.

Gypsies

In the southern tier of New York State, south of Rochester, there were and may still be gypsy campgrounds. A gypsy chief arrived at the hospital one day requesting to see a surgeon. It seems there was a sick person in the encampment who needed to have a doctor visit. One of the staff went with the chief to the encampment where he found a young man lying outside of the main tent. The doctor was asked to examine the man, which he did. He announced that there was nothing wrong with the man except that his heart was on the right side of his chest, usually a normal variant. With that, the doctor was escorted into the tent where the truly ill patient lay. The doctor arranged for the patient to be sent to the hospital, now with the approval of the gypsies.

For several days after this event, there were gypsies all over the hospital, but there was never any trouble with them so far as I knew. Eventually, the patient recovered, the visitors were happy and the attending physician was congratulated for his astuteness.

Ardmore Street

After I got married we lived in an apartment in a converted house on Ardmore Street in Rochester. This was not the high rent district. Among my classmates there was an annual competition to see who paid the least rent for their apartments. Peggy and I won each year. But, one day while Peggy was pregnant, the landlord raised our rent. It went from $60.00 per month to $65.00. So, we paid our landlord a visit in his Rochester business office. He was quite pleasant, possibly because of Peggy’s condition and the fact that I was a starving medical student. At any rate, we came to an agreement; I would mow the not very big lawn and shovel the snow off of the short front walk and he would not raise the rent.

A Different Competition

There was another competition in our class, as well. One of my classmate’s wives was pregnant. What was unusual was that her mother was also pregnant, due around the same time as her daughter. We were amused by the stories my classmate’s wife told about the ways in which her mother was in competition with her. Near term for both of them, her mother was in a serious automobile crash. Fortunately both expectant mother and her child survived. My classmate’s wife readily agreed that her mother had won the competition and that she was glad to have that part of her pregnancy over with. We were able to laugh at all this because no tragedy came to either the new or the older mother.

Grass

Just after we moved into our garret apartment we had two snowstorms about a week apart each about three feet deep. It was an exceptionally snowy winter even for Rochester. On a day in April while my wife was looking out the window, she said, “Do you have sidewalks here?” I replied that of course we had sidewalks. Then she said, “I know you don’t have grass!” Luckily the next two winters were not as bad, but unfortunately, given our rental agreement, the grass did reappear each year.

Wann Lassen Sie den andere Schuh Fallen?

There is an old German story about a man who always dropped his first shoe noisily and his other shoe quietly. To listeners this may have given rise to the phrase “waiting for the other shoe to fall”. As newlyweds, our bedroom had one small area of wall behind which was our neighbors’ bedroom closet. Herb and Charlotte, an older couple who eventually became good friends of ours, lived next door. Shortly after our arrival while we were in bed we heard Herb drop his shoe in his closet. However, we never did hear the other one hit the floor. Since it was clear that Herb could plainly hear everything that went on in our bedroom from inside his closet, we decided that he did not want us to know that he was in there. This sent us into gales of laughter and we actually did hear a chuckle from the other side of the partition. When I think of it, I wonder that Peggy and I never gave Herb’s eaves-dropping another thought. Now, however as we look back, we are still waiting to hear the other shoe drop and still laughing about our apartment on Ardmore Street.

We were friendly with our downstairs neighbors, too. Peggy saw them preparing to leave in a taxi and found out then that they were on their way to a famous hospital in Boston. The wife had a serious medical problem and they were going to have it treated. Less than 48 hours they returned. It seems that when the house officer at the Boston hospital came to admit our neighbor, he was astonished to find that they had come from Rochester. He could not understand why they were in Boston instead of at Strong Memorial Hospital in Rochester. He indicated that there wasn’t anything that could be done there that couldn’t be done in Rochester, and so back they came. I remember that our neighbor recovered after being admitted to Strong. I often wonder why patients go from one place with an excellent medical center to another one far away, unless there is clearly no place nearby which could handle the medical problem.

The Halloween Party

George came for supper on Halloween, 1959. Earlier that day Peggy and I drove over a wide, bumpy set of railroad tracks in town. My wife was very pregnant and anxious to get things moving. She managed to produce supper which included peaches in syrup for dessert. Just as I was about to have some, she announced that she thought she might be going into labor. Had the railroad track trip worked? I spilled peaches down the front of my shirt.