Tales from the Emergency Room (22 page)

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Authors: FAAAAI MD William E. Hermance

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Early on I got to know a lovely gentleman from Canada. Though I did not play golf, he and I always ended up chatting at our weekly pre-Elks cocktail party. He developed a cough, diagnosed as bronchitis. The physician told him to go to the hospital if the cough had not improved in thirty-six hours. He brought the x-ray report to the house for me to look at. It was clear that more than bronchitis was going on. I suggested that he go to the hospital right then. Six weeks later he died of asbestosis (mesothelioma) in Canada. I think of him fondly still.

At a party around a friend’s pool, an older gentleman, the Colonel, apparently turned away from the bar too quickly and began to fall over backward. By luck I was standing nearby and I simply stretched out my arm to break his fall and lowered his head gently to the concrete lanai floor. I hardly knew what I had done myself and few others noted the maneuver while the Colonel collected himself and was helped to his feet uninjured except for his dignity. The following morning, he and his wife called to tell me how thankful they were that I was able to “save” the man. I’m sure hitting his head would not have had a good result but my action was totally spontaneous and unworthy of any praise.

One man who was a dear friend long before I retired and still is, Dick Grant, was having trouble with his knees. So, he went to the doctor to see about this problem, telling the doctor about only one knee. This, he informed us all one evening was because he was afraid that the doctor would charge him twice. So, Dick treated both knees the same way which seemed to work for each knee because he went on to become a champion barefoot water skier in his middle 70’s!

Even now, having been away from Florida for five years, I occasionally get a call from one or another of my “old” friends. I am always happy to discuss their medical problems in general terms, give encouragement and suggestions on how to proceed when I can. I carefully avoid any specifics and happily acknowledge my lack of expertise when that is necessary.

The Popcorn Club

By the time we settled in Florida we had met most of our friends’ friends. These people had formed a social group called The Popcorn Club. Originally meant as an evening at the Club for dinner once every two weeks, it soon became obvious that the hostesses were vying with one another to serve the best hors d’oeuvres at increasing expense at the before-dinner cocktail parties. Lots of people ate a lot of these and didn’t go for dinner, defeating the purpose of the Club. So a decree from the founders went forth that only popcorn could be served during cocktail hour. Hence, the name of the Club.

Originally quite exclusive with regard to members, we wondered if we would make the grade for membership in the Club. Our best friends finally had. In late August after we had moved to Plant City in July, a friend asked us to come with her and her husband to Popcorn. We thanked her for the invitation and she informed us that it wasn’t really an invitation since we had already been voted in. I asked who cast that deciding vote and she replied, “I did.” And so began many evenings of fun which gave Peggy and me a way to get to know many other people, an advantage since I do not play golf.

Upon settling into our new house in Delaware, we thought we would give starting a Popcorn Club a try. Five years later it is a huge success. We rotate hosts and everyone brings a heavy hors d’oeuvre. The hosts supply the drinks and there is virtually no cleanup since everyone takes their platters home. There is now a Popcorn golf group, a tennis group, and an occasional cruise. Most of the people involved never would have known each other without The Popcorn Club.

The Podiatrist

When I retired the first time, we moved to Plant City, Florida, named for Henry B. Plant who built the first railroad across the peninsula, and home to The Strawberry Festival, one of the largest festivals in North America. Since we already had friends there and had met many of their friends and were soon into a few activities, we quickly got to know many people. One of them was Marty, a podiatrist who became a very good friend, despite our age difference and who literally kept me on my feet for many years. He had been practicing in town for about 15 years, had a very large following and was very outgoing. One day in his office as he was carving away at my feet, he suddenly asked how it was that I knew so many people in town after such a short time living there. He said that every time he said Dr. Hermance, someone was sure to say, “Oh, you mean Peggy’s husband” and if he mentioned Peggy he would hear, “Oh, you mean Dr. Bill’s wife”. I thought this was very funny given the fact that he actually did know virtually everyone in town. To this day, Peggy and I wonder what some people are doing in their houses, since they do not seem to ever be away from home or have visitors. We are not that way!

Gray’s Anatomy

One of the best things about living in Delaware is being able to see our youngest grandchildren frequently. They are as at home with us as they are at their own house around the corner.

I was sitting on the floor in my library while my granddaughter and I were looking up some things for a class project of hers. My old medical school books are assigned to shelves near the floor where the shelves are larger to accommodate the tomes. While we were doing our research, Caroline suddenly said to me, “Oh! You have Gray’s Anatomy! That is one of my mother’s favorite programs!” How times change and spellings, too. The program is Grey’s Anatomy.

Everyone Around Here Is Sick

While my grandson’s other grandfather was in the hospital, Grandma had a bad episode with her diabetes, and Grammy, my wife, had just had a knee replaced. I was still on my feet which were in as bad shape as ever, when I noted in my granddaughter Caroline’s presence that I had to go see my doctor (podiatrist). I realized my mistake when said granddaughter complained loudly that “everybody around here is sick!” She sounded quite annoyed.

A Medical Demonstration

Caroline’s brother Blake, age three, gave us all a demonstration of what was a new medical problem for Grandpa, a coronary requiring bypass surgery. Apparently Blake had heard a lot about this and knew that Grandpa’s chest was somehow involved. Most of the family was assembled one day while Grandpa was still hospitalized when Blake announced that he knew what was wrong with Grandpa. With that, he proceeded to lift up his shirt, grab his nipples and, while pulling them up and down none too gently said, “These things aren’t working right.” Trying not to seem too amused, we assured him that he definitely had the right idea.

Amnesia

When Caroline was about six years old, Grandpa had an episode of global amnesia, similar to one described previously in one of my patients. Fortunately, it cleared rapidly without any residual effects, but Caroline heard a lot about how he had lost his memory for a while. I was still living in Florida and so I wasn’t in on much of this. One day about a year later as I was driving Caroline home from school along our usual route, she said from the back seat that this was not the right way home. I assured her that it was, only to have her protest about it again. I said, “You must have amnesia.” Then, thinking that that was a pretty big word I asked if she knew what amnesia was. To my astonishment, she replied, “That would be short-term memory loss.” This from a first grader. Apparently the reason for this medical knowledge was left over from her Grandpa’s memory problem.

Shanghaied

After I had been enjoying retirement for about 7 years, and after we had settled down in Delaware, my daughter-in-law asked me one day if I would have a look at Caroline who had not been feeling well. I examined her as I had done before on occasion and said, “I don’t see much here. If you want Dr. K. to see her tomorrow, that would be fine with me.” Caroline’s mother took Caroline to see Dr. K. the next day. After looking her over, Dr. K. said to Tricia, “I don’t see much here.” “That’s what my father-in-law said,” Tricia remarked. “Is your father-in-law a physician?” Dr. K. inquired. Tricia told her I was an allergist and thought nothing more of it.

While we were having pizza the following Sunday evening with the kids at their house, Dr. K. called, presumably about Caroline who, by this time, was fine. A very odd conversation ensued to which I paid little attention but which puzzled my son, given that he could not figure out what Dr. K. was saying. At length, Tricia said that yes, I was right there and could come to the phone. It was Dr. K. and her husband Dr. K. (Mr. K. in the office, Babu to me) who wanted to know if I could come to talk to them about working part time. As a Board Certified allergist, they were interested in having me in their practice. After an excellent offer, I went to work for four hours twice weekly. (This left me with five day weekends.) So I was happy to find a fully functional allergy clinic being run by a classically trained allergist. My colleague has left, my work time increased to 12 hours weekly and I have an office and two dedicated treatment rooms and lots of help when I need it. I even do a little pediatrics when needed (more malpractice expense) but I draw the line at itty bitty babies. I tell everyone that I was shanghaied but really I love being back at work with no business or on-call responsibilities for a change. My patients are just as rewarding to work with as before and I have already begun adding some of my experiences to these Tales. The office is entirely internally computerized and this is no longer the challenge for me that it was at first.

Happy Harry’s

I answered my telephone in the office to hear a woman asking to have a prescription renewed. I brought up the fax form on the computer and asked what she needed. I typed in the prescription and then asked her to which drugstore I should send it. She replied, “Happy Harry’s.” (This is a huge drugstore chain in our area.) So, I asked her which Happy Harry’s. She replied, “The one right here.” How is it possible not to get a kick out dealing with the public?

Sex?

There is a long list of questions which patients must answer when they come for their school/sports physical exams in my office. One concerns what one’s religion is. One of my teenagers who was there with his father ran aground on this question. His father filled in for him. “Soccer”, his father said. Another question asks about sexual activity. The young ones check “no”, the older teens check “yes” or “no”. My favorite answer however, which I see occasionally, is “n/a”. I usually take that for a yes answer.

Two Mommies

Almost unheard of in White Plains, NY and rarely seen in Manhattan while I was in practice were racially mixed parents and same-sex couples. Some say that these two things are prevalent here because of the huge Air Force Base in Dover, DE. The C5 Galaxies fly out of here. I’m not sure that is the reason but, I have had to get used to these life styles as well as an enormous number of separated and divorced couples. The mixed race couples often have quite stable families and well cared for children. I do have trouble hearing a child call an obvious woman “Daddy”, but I try not to roll my eyes. So far, I have not had two men as parents together. The real problems come when one parent gets after another because of their differing child care styles. It can be dangerous as well—one parent’s house is smoke-free for the asthmatic child while in the other people smoke around the child, in their cars and homes, during visitations. Or, one house has a cat which causes symptoms for the child. My policy is to have the parent write letters to the offending parent and, often, to the lawyers and the court. Then I edit them to be sure they are factual and print them on office stationery. That way I can be sure that the pertinent information is accurately communicated.

Ringworm

While in search of the physician’s assistant in the office, I found myself in an examining room with a nurse, two parents, a cute little boy and the assistant. Upon leaving, I patted the little boy on the head. On my way back to my office, I felt an arm go around my shoulder and the quiet voice of the nurse in my ear. “You might want to wash your hands,” she said, “He has ringworm of the scalp.” I veered off to the nearest bathroom to wash up, thinking that my propensity to be sociable did sometimes have a downside.

The Old Guy

After I had begun my part time work I agreed to see some pediatric patients. The busy office had just lost one pediatrician and things were getting too busy for the other doctors. My malpractice insurance for pediatrics was being covered.

My examining room is directly opposite the appointments desk in the clinic. I had finished with a pediatric patient and his father and asked them to come for a revisit in two weeks. I heard the appointments manager ask if the father would like to have the boy’s usual doctor see him next time and I heard the father say, “No, I think we’d like to see the old guy again.” After they left, the appointment lady burst out laughing, asking me to come to the desk so she could repeat what the father said. Having already heard the conversation, I was laughing, too. I figured that I had not yet completely lost my touch.

In the News

Since coming to Delaware, my public silhouette has increased somewhat. I have managed to be profiled on Philadelphia TV about seasonal allergies and featured on the entire front page of our local newspaper health section discussing food allergies. All the press people I have dealt with have been very pleasant and, to my surprise, extremely well prepared as shown by the questions they ask.

 
Miscellaneous

Antihistamines

My partner of many years studied at a medical school where his uncle was a distinguished professor. As a resident, he had expressed an interest in studying Allergy as a specialty. About this time, the first good antihistamine medication came on the market, the first drug to treat hayfever adequately. My partner’s uncle called him into his office one day to explain to him that, with the advent of antihistamines, there would be no need for a specialty in Allergy and that his nephew ought to rethink his interest in this field. Well, my partner shortly decided to continue with his interest and the rest, as we say, is history. I’m glad he did since he asked me to come to work for him out of his residency program in Allergy and Immunology. Shortly thereafter he offered me a partnership arrangement—one that I couldn’t refuse. Thus began a twenty-five year relationship for the good of a great many allergy and asthma sufferers and for us.

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