Tales from the Emergency Room (10 page)

A Royal Mishap

Back in the day, Roosevelt Hospital maintained an exquisitely furnished suite for VIPs. There were two bedrooms, living room and kitchen. It was all done in pale gray and the walls were carpeted, not wallpapered—the first time I had encountered that. It came my turn to obtain blood from the Duke of Windsor who was staying there with the Duchess for their annual physical exams. In those days, each tube of blood had to be separately attached to the needle already in the vein. One got quite nimble at this after having done “scut work” so often. This time I do not know what happened but half way through this simple procedure, the tube I was using came off of the needle suddenly, spewing the Duke’s blood (very red) all over him, the bed, the floor and the wall. I quickly stopped the flow of blood after removing the needle and bolted for the door. By chance, my resident was nearby and I hastily informed him what had happened and announced that I was not going back in to the Duke under any circumstances. I think he understood, but I really didn’t care, so embarrassed was I. I never heard any more about the episode—I expected furious kidding from my fellow house staff, but that did not occur. Another time, much later I had occasion to be in the suite and took pains to notice that the “bloody mess” had been skillfully cleaned up.

Post-Coronary

Interns, the lowest of the low, are often given the most undesirable jobs.

One of those was getting a person out of bed after recovery from a heart attack. In my early days, a coronary (myocardial infarction) meant six weeks of absolute bed rest in contrast to today’s rapid ambulation. The possibility of complications arising from being in bed so long was always a problem. We would have an IV running and a blood pressure cuff in place. Then we would slowly elevate the patient in bed resting frequently until he was sitting upright. Then we would put his legs over the side of the bed and let him sit there, all the time taking frequent pulse and blood pressure readings as well as inquiring if the patient had any unusual symptoms. Then he would be allowed to stand at the side of the bed, maybe a short walk to a chair. Then the procedure was done in reverse. All of this would take several hours and was quite anxiety provoking. I never had a patient have an adverse event while I was involved though others did. However, I think that all those who survived the initial heart attack eventually got to go home.

The Subway Strike

In 1966, I think, probably in January, the New York City subway workers went on strike. I was driving a little red Volkswagen. We knew that it would be hell-to-pay getting to work and most of the Allergy Department staff commuted on the subway. So I offered to pick up three of them on my way into the City from White Plains. We made careful arrangements about where I would pick them up, etc. It was cold! I got to my first rendezvous successfully. Then it was a very slow drive down through a very congested Manhattan Island. It got colder and colder in the car. I finally picked up all my passengers but it was stop and go traffic and it got even colder in the car. Little did I know that the heater didn’t put out warm air unless the engine was running faster than idle which meant that I had to be moving along a little at least. By the time we got to the hospital we were all frozen. But, we had gotten there. Shortly we would be retracing our trip leaving the City, a bit faster this time. For several more days, we repeated this scenario but we knew what the problem was and we were prepared. Everyone was glad to get to work, and it was warm there so the adventure was worth it.

The License Exam

At the end of my first year of training I traveled to Philadelphia, to Temple University Medical School to complete the last part of the exams required for licensure. I went with my friend Dick and we stayed at his house. At Temple we were met by the examiners who would give us our oral exams. A young attending and I went into the chapel which was empty and sat in the last row of pews. He then presented a case to me which involved the lungs and asked how I would proceed to diagnose and treat the condition.

When I had completed my answer he said that I had done well but that I had failed to mention the most important part of the workup. I was at a loss until he reminded me that this was a pulmonary problem and it suddenly hit me that I had not ordered a chest x-ray! I stammered something about assuming that that had been done. He understood completely he said and I eventually passed the examination. I will still bet however that I was not the first or last to leave out the most obvious step for this problem.

“It’s a Good Thing I like You”

When I began my post-graduate training, we went to live with Peggy’s parents in New Rochelle, my folk’s house being too small to accommodate us and the baby. There was a sunroom with its own bathroom just off the entrance foyer. While the baby slept upstairs, Peggy and I borrowed money from her sister to buy a sofa bed, queen sized. Here is where we lived relatively comfortably. We were able to come and go as we pleased without disturbing anyone and were able to see our friends there as well. One evening, we had three other couples over for a social evening, during which I heard one of the four people crowded together on the sofa say to the person next to him, “It’s a good thing I like you!”

Another time good friends of ours came for the evening and stayed and stayed. Finally, in the wee hours, Peggy became quite anxious for them to leave and so she suggested to them that she would like to show them how nice our new sofa bed was for us. She herded us all into the front hall and opened the bed. There was literally no way three of us could get back into the room and Peggy did not offer to close up the bed. So we stood and talked for a while in the hallway and our friends finally left. Lo these many years later we are all good friends still.

The White Pants Syndrome

Several of my classmates took an extra year in medical school to pursue special interests. Some interns and residents however, seemed never to finish training. This was called “The White Pants Syndrome” in which, it was speculated, the wearer was so anxious about leaving the protected learning environment of training that they put off doing so as long as possible, wearing hospital whites all the time. Not so with me, but being eager to get going on my career led to another complication. About a week before I finished training, my wife asked me what I planned to wear to the office since I had nothing much else than white pants and jackets to wear. I did not have a suit or reputable sport outfit with which to start practice. There wasn’t much money handy either, but I did manage to put a couple of outfits together to open my practice.

As I started my practice at the same time as Medicare/Medicaid began, I never saw any problem with the system. But, we sure did hear about how awful everything would be in the future from our attendings who were used to the old fee-for-service style. They all eventually adjusted!

The Condom

To celebrate the completion of my training, Peggy and I decided to do something special. Since we had about $800.00 in the bank, which would not get us very far for everyday living, and since a cruise to the Bahamas from New York in those days cost about the same amount, we decided to blow our bank account on a cruise.

Also in those days one was allowed to have guests come onto the ship to see one off. And so we entertained some people in our cabin. One of the guests was a resident in Urology.

When we received our table assignments on board, the two couples who joined us each had been give two bottles of wine as had we. And so we arranged to have one bottle each night of the cruise for our table. We had a wonderful time with these people for an entire week. On our last night, the bottle of wine which my urologist friend had given to us was produced along with a card, which did feel a bit thicker than a normal small card would. All unsuspecting, however, I tore open the envelop and watched in shock as a red and white Trojan condom flew across the room! What a stir that caused. On the line the next morning waiting to disembark, one of our tablemates announced that as they were getting ready to leave the ship, they discovered a gross of condoms hidden in a dresser drawer. It had been slipped in there by his boss at their boarding party.

 
The Military Years

Staten Island

It came time for me to undergo a physical exam preparatory to joining the Public Health Service (an arm of the Coast Guard) as part of my Berry Plan obligation for military service. To do this I had to go to Staten Island by ferry to the huge Public Health Hospital there. Everything went along quite well until I was leaving. Loping down the steps behind me calling my name was a hospital aide asking me to stop and waving an x-ray envelope around. I managed to see written on the folder “Do Not Show to Patient”. That was a little scary. I was shown into the radiologist’s office then and we both peered at my chest x-ray. It looked OK to me. The doctor pulled his centimeter ruler out and measured the width of my heart. Then he announced that my heart seemed to be within normal size limits after all and I proceeded on my way home.

Several days later, I got a notice asking me to reappear at the hospital because there were red blood cells in my urine. Immediately, I remembered that I had given the specimen directly after a digital rectal exam, which even I knew might push some red blood cells into my urine. Of course, upon examination of the new specimen the results were normal.

My wife accompanied me on this second trip via the Staten Island Ferry. She suddenly disappeared from my side. I found her on the other side of the ferry peering intently at the Statue of Liberty. I was hardly able to believe that she had never before seen the Statue in person since she grew up just a few miles away in New Rochelle, NY. That was indeed the case, bearing out the idea that one tends to ignore the “local” sights.

The Pentagon Calling

In my second year of residency, I was all ready to go to my assignment at The Medical Center for Federal Prisoners in Springfield, Missouri, when Peggy announced to me one day at home that the Pentagon was calling. She thought this was hysterical, but I thought there might be a problem. The caller asked if I would be interested in putting off my departure to Springfield for a year at which time I would be assigned to the Federal Prison in Atlanta as Chief of Medicine. I allowed that this was a fine offer (I had no idea about rank at the time) but that I had no money and I had to go into the service right away in order to feed the family. The caller was quite sympathetic and did not press the issue, thankfully.

So, I missed out on that offer, but, soon after I arrived at the hospital in Springfield, my Colonel called me into his office, handed me his own oak leaf clusters from the top drawer of his desk and announced that I was now a Major. It seems that I had been made Chief of Medicine at the Medical Center and that, in order to become a department chief I had to be a Major. So, I was promoted on the spot and, of most interest to me, began earning more money. The irony of the promotion in view of the earlier offer was not lost on anyone!

Missouri Move

When the van driver showed up to load our meager belongings for the move from New Rochelle, NY to Springfield, MO, where I would be putting in my military time, he commented on how glad he was to be going to the Midwest since in all likelihood he would not have to cart furniture up stairs. (This was true in our case.) He left on Thursday afternoon, July 1
st
. We left the next morning with two babies and another on the way. We crossed the Mississippi River in St. Louis on Route 66 in mid-afternoon on Sunday. It was terribly hot and there was no air conditioning in the car and practically no one else on the road. The highway around St. Louis was very wide. We were stopped at a red light when I noticed my wife talking to someone out of her window. And there he was, our van driver. Peggy said that she guessed that he would not have to call us in the morning before unloading for us, but rules were rules and he would have to call. Of course, had we planned this rendezvous it never would have happened. Later that day, we all piled into our motel on the side of a hill overlooking the highway. The kids got out to the pool as fast as they could just in time to wave at the passing moving van. The driver tooted as he flew by on the road.

On Monday, July 4
th
, we had just settled down in bed after an exhausting day finishing moving with two kids when were treated to a loud “Mooo” from the field behind us. We both burst out laughing, deciding that we suburbanites were truly in the country now.

The Stop Sign

When we arrived in Springfield, having driven down Route 66, my car was very dirty. I knew that I would need to obtain Missouri license plates within a short time after my arrival. On my route to the prison there was a stop sign that I negotiated every day. I was always in uniform. It occurred to me that whoever saw me with my New York MD license plates and dirty car would assume I had just come off the highway and would not think that I was a Missouri resident. So, I reasoned, I would just leave the car dirty and I could thereby avoid the license plate hassle. One day, after I had come to a full stop and was proceeding on I saw a police car with lights flashing behind me. Clearly I was the object of pursuit. I pulled over knowing that I had not run the stop sign. The officer walked up to my car and said, “Doc! You are going to have to obtain Missouri license plates.” He then advised me that he had seen me go by many, many times. I and my dirty car had become a source of amusement for him, but, enough was enough.

The story continues. I arrived shortly thereafter at the DMV and stood on a long line. Finally, I got up to the counter whereupon the clerk asked if I had all my papers in order. What papers I wondered. So, I returned home, donned my formal service uniform, hat and all, and reappeared on another long line. A clerk at a station that wasn’t open spied me and beckoned me over to her place. I patted my jacket pocket when asked about my papers. Since it was apparent to her that I had no idea about “papers” she filled them out for me. She asked when I had come into the state to live and when I gave the real date she said, “Oh, no, no. That will never do.” So I gave another date about 3 months later. “Much better,” she said. I was now within the law. I was directed to the eye test area, passed that and left with a new set of Missouri plates.