Tales from the Emergency Room (12 page)

An Uneven Count

Each year at the medical center the staff underwent a physical exam given assembly-line style by the staff physicians. The first time I was involved it fell to me to do hernia checks on about 48 men. I didn’t find any hernias. During the discussion afterwards of what abnormalities had been found, I felt it my duty to inform the others that I had had to examine only 95 testicles. To this day I am amazed at the dropped jaws and the time it took these doctors to understand just what my efforts had discovered.

Mumps

It seems that I never had the mumps as a child.

When I was in the service we lived in a small ranch house near the prison hospital. One day at sunset I was in the room that we used as a playroom for the children when my oldest son stood up. He was silhouetted in the west facing window. One look was all it took—I called to my wife to announce that Billy had the mumps. The outline of his swollen parotid glands was clearly visible.

The next day I thought it best to stop in at my Colonel’s office before going up to the medical ward to tell him about my son. After I did so, he told me to go home because it was clear to him that I had the mumps, too. So, home I went to develop enormous swelling of my parotid glands so that my face came to resemble a football. I remember shaving without the usual facial topography. I also remember the pain that would develop in my jaws if I even heard my wife fixing a meal in the kitchen. I called my internist to ask what was to be done, knowing that I would just have to suffer through. His comment was, “Call me back if it ‘goes down’.” I got a lot of that including from my dear friend and neighbor, the prison Protestant Chaplain who kept asking me if it had “gone down yet.” I think he thought this was very funny, but to me it wasn’t. In any case, my groin was unaffected.

Eventually the other two kids came down with the disease. It soon became evident who among our friends had had the mumps and who had not. Many came to visit but there were notable exceptions among the “haven’t hads”. They were taking no chances. I can’t say I enjoyed my sick leave, but we all recovered without sequelae.

The Back Brace

At the medical Center we had small medical conferences in the radiology department. Early on I noticed a back brace hanging on a clothes stand in the corner of our meeting room. It was covered with dust, clearly not having been worn for a very long time. A few months into my first year there, the Cuban missile crisis developed. The night that our troops were being moved about the country, an old friend, an obstetrician at Ft. Hood, Texas, called to say that he was being sent to Georgia for possible deployment. I was shocked. I was not happy about the prospect of that happening to me. The next day I found that my commanding officer had had similar thoughts. Upon entering the X-ray area, I immediately noticed that the back brace was missing. When the Colonel arrived a little later, it was apparent that he was wearing the brace. He had no intention of being sent anywhere. However, he did have to endure some good-natured kidding. Happily, the Cuban problem was resolved without anyone having to go to war. (We never did figure out why an obstetrician would have been needed.)

Christmas with Marianne

While I was in the service, my Colonel and I became very good friends. After I was discharged we began to receive Christmas greetings from him and his wife Marianne. After the Colonel died, we continued to hear from Marianne and still do to this day. Every letter was the opposite of the usual Christmas note. One son is in jail, both grandsons are drinking again and one is in jail, I need gall bladder surgery, we have had to move, etc., etc. These are long letters which invariably left us laughing. They are all the more amusing because they are all true and not at all tongue-in-cheek. In this year’s letter Marianne noted that her family thinks she is an ATM machine! A real regret is that we didn’t save all of the letters. They would have made a wonderful collection for a Christmas gift book. Marianne, with her dry sense of humor and straight face would get a kick out of that.

Gladiolas

Our small rental house in Springfield had an enormous backyard. To one side and a little away from the house was a round patch of ground which never had any grass on it. It seemed to me to be the perfect spot for a small garden so I planted a great many gladiola bulbs there. They bloomed beautifully for two years despite some very cold winter weather. Just before our departure as I was leaving the service I gathered up all the beautiful blossoms and we took them to my Colonel’s house where we had been invited for dinner. The aforementioned Marianne was thrilled to have so many lovely flowers gracing her very large house.

While I was in the yard collecting the glads the neighbor lady noted how pretty they were and what a shame it was to have to cut them down. I commented on how nicely they had survived and flourished. She explained this to me by revealing that the bare spot in the lawn was above the septic tank and was therefore warm all the time. Who knew?

Leaving the Service

Now it had become time for us to move back to New York to resume my residency. We had had very pleasant neighbors while in Missouri and we knew we would be very homesick after leaving. (My wife was in tears half way to St. Louis.) This was a military move and so we expected very little trouble from it. However, the movers did not show up until late in the day. We had to leave that day since we had been renting the house and I was on a tight schedule for getting back to work. It became obvious that there was no way that the van could be loaded before nightfall. So we had the house emptied onto the front lawn, locked the doors, said goodbye to our neighbors, all of whom were assembled on the lawn by then, too, and left. Our friends promised to watch over the move and the movers for us. If everything we owned had not been on the front lawn and we had been happy to be leaving, the whole thing would have been funny. As it was, everything, including us, arrived intact in New York several days later. Two pillows went missing during the move about which we grumbled a bit, only to find them a couple of years later when we moved once again. Our oldest son still remembers this whole operation.

Protection?

I had not been out of the service very long, just getting settled with three small kids, when a letter arrived from an inmate at the prison insisting that I appear in Colombia, South Carolina to testify in his favor about a criminal matter. I knew that was not going to happen before I read any further, but the end of the letter was alarming. The letter writer ended with a wish for the continued good health of my wife and children. That sent a chill down my spine and I immediately called my former Colonel at the prison. He went over the possible threat with me and asked me to forward the letter to him. Finally he said that visible protection in the person of federal government agents would be at my disposal immediately. All I needed to do was to give him the OK. So, I asked his advice. He said that no threats like these had been carried out and he did not think that protection would be necessary. Thankfully, he turned out to be right.

One night about six months later a man who had worked in the x-ray department at the prison with whom I had had a pleasant working relationship and who had recently been paroled showed up at the emergency room in New York City asking for me. For some reason, I remember that he was wearing formal patent leather shoes but was otherwise normally dressed. I gave him the names of some people to see at the hospital about a job. He left into the nighttime city and I never saw him again.

The Jackass

Her parting comment was, “You’ll be receiving a jackass in the mail.”

A physician, Frank and his family whom I met in the service came to live with us in White Plains for about six weeks. He was studying at the previously mentioned Public Health Hospital on Staten Island, and then would be moving on to finish his radiology residency. We were all good friends and our kids loved having more playmates. Frank’s wife Anne had made a set of beautiful bisque manger scene figurines which she gave to us as a thank you for letting them stay with us. However, she had not completed the set and thus her parting words. Not long after, the donkey figurine arrived. We are still using this set 40 years later on our mantel at Christmas, carefully hiding the figure of Baby Jesus until Christmas Day. The kids of course, cannot let me forget the year that I could not remember where I had hidden the figurine!

 
The Practice Years

 
In the Office

Smelling Salts

The floors in the White Plains office were linoleum tiles over concrete. On the rare occasions when a patient would pass out (vaso-vagal syncope), it was obvious that it was going to happen long enough beforehand to get the patient recumbent before he fell. One day, however, as I was beginning skin testing on a pediatric patient, I heard a thud behind me. Mama had passed from the scene. (The patient in the meantime had had his nose in my way trying to watch the shots he was getting.) Out came the smelling salts which were always on the examining table, to help revive the lady. They worked just as they were supposed to and fortunately she did not sustain any injury. After that we kept smelling salts in other places as well, closer to the treatment rooms, just in case.

Losing Count

A lot of counting goes on in an allergy practice. The number and identity of allergens is especially important with skin testing. Once, while my nurse and I were doing passive transfer tests on a patient’s back, a bad thing happened. There were about 30 tests, the sites for them had been prepared and numbered and I was placing the antigen tests in the prepared sites. My nurse, a crackerjack worker not prone to errors, suddenly said the two most dreaded words in medicine, “Oh, oh!”. In this case it was not a dreaded finding but only her reaction to the fact that she had lost count of the tests and therefore, about halfway through, lost the identity of one or two of the antigens. Luckily, we were able to salvage most of the exercise. The patient was none the wiser, his diagnosis and treatment were unaffected, but my nurse was mortified. I never kidded her about the episode, however, because I knew how upset she had been.

Office Finances

Often the last thing the office manager would say as I was on my way out the door on Friday afternoons was either, “You can throw another meatball in the spaghetti tonight.” or “No extra meatballs tonight.” In the first case, the office receipts for the week were good. The second meaning is obvious.

Once, however, a man showed up in the office and announced that he would like to review our telephone records. He would, he said, for a percentage of the refund, be able to get money because the phone company had undoubtedly overcharged us. We agreed and soon had $8000.00 (!) in refund money. About five years later, he showed up again, but this time we only got $5000.00 since the records had not extended over such a long period.

However, other complications arose. We got a letter out of the blue stating that New York City thought that our suburban office was a sham office and that therefore we owed taxes to the City on the basis of the entire income to the practice. It cost us several thousand dollars in lawyer fees to get that straightened out only to have this happen again a few years later. This time inspectors came to see if we really did have a second working office. We used to carry charts back and forth to the New York City office when patients wanted to see us there. So, much to our surprise, the agents asked to see three specific charts. (How they knew these patients were seen in the White Plains office was never clear to us. We began to believe in Big Brother!) As luck would have it, 2 of these charts had been transferred to the NYC office! They duly noted the one chart we did have, and, I guess, saw what was clearly a functioning office, and so this time we incurred no legal expenses. We never heard another word from the tax people again.

When the HMOs started up, we were required to prove that we had offices. I mean, the HMOs weren’t nutty enough already! This was determined by having an inspector come to see the office. The visits were never very long—all they were interested in knowing was whether we had a functioning bathroom!

Gifts

From time to time while I was in training I would hear about the occasional gifts patients would give to doctors. A baby grand piano here, a trip to an exotic locale there. I never really understood that since the fees were all paid as well. However, over the course of my career I have received many gifts, not grand to be sure, but still very pleasing. One man would bring me a beautiful tie and matching handkerchief every few months, far more expensive than I would consider an appropriate price for such things. I still wear some of them. The label on the ties amused my friends—it advertised the New York Heating Company. No fashion label for this patient! I received limited edition prints which I still have in my house, one museum quality modern painting, small statuary, including a beautiful cast iron girl holding high a balloon, really a ping pong ball, and even an original collection of Jewish jokes given to me when I retired, by the collector, the husband of one of my favorite patients. I have even received lovely gifts from patients after I retired, including a set of Tiffany champagne glasses, a coffee table-type gardening book and another all about roses. I still really don’t get it, but it’s nice to know that people feel so well disposed toward me.

On TV

I have even been on TV a few times, the most recent in a story about allergies on local TV in Philadelphia. Once while on a TV call-in medical show, a listener wanted to know if it was OK for him to take an antihistamine before going out drinking since he had a problem with some wines. It was hard for me to keep from spluttering my emphatic “No!” My career in radio and television actually began when I was in high school (I can’t remember why now) but clearly did not evolve into a highly lucrative career.