Tales from the Emergency Room (8 page)

Penicillin Please?

Late one evening just after I had begun my first rotation through the Emergency Room, two men literally burst through the door without stopping at the desk to register and hauled me off to the minor OR just across the hall. The next thing I knew I was backed up against the wall inside the room behind the large door. I was frightened at first and then, when bodily harm did not seem to be in the offing, indignant. It seems that these nicely dressed men in their thirties had just returned from an out-of-town convention where they both had contracted gonorrhea! And now they were on their way home to their wives. One of them explained to me that his wife would expect to have him busy in bed as soon as he got home. So, they needed penicillin. Well, there was no way they were going to get it from me! (In any case, it would not have worked instantaneously as they thought it would.) They were not happy and so I thought fast and told them the truth. I reminded them that if I treated them for a venereal disease I would, by law, have to report it and the Department of Health would then take steps to contact all of their sex partners who could be found. That was enough for them to hear and off they went, departing in the same manner that they had arrived. I was unharmed but a bit shaken. It was one of those encounters that I have always wanted to know the outcome of.

The German Sailor

In high school I became something of a German scholar. At least that’s what my teacher thought and so I crammed three years of study into two and went on to advanced German in college. But then my other study interests took precedence and between then and post graduate training I had little opportunity to use the language. Except once. There was an accident on board a German ship in New York harbor and an injured sailor who spoke little English arrived in the Emergency Room while I was on duty. I spoke greetings to him in German, much to everyone’s relief including his and I was actually able to remember enough to ease him through the emergency treatment and into the hospital. I knew he would have no trouble on the ward since there always seemed to be someone around who could help out with a foreign language. But I was happy to have been of help. The only other time I used my German was in the subway in Berlin, but that is another story.

Cardiac Resuscitations

There I was one evening during my residency covering the ER and the medical wards simultaneously. The emergency call “doctor, doctor” came over the PA system from the ER so that is where I headed at top speed. Indeed, the staff had already begun resuscitation procedures on a man in cardiac arrest. Things were proceeding normally when a second call came from a medical ward that a cardiac arrest had occurred there. I went as quickly as I could to that scene where a bit more intervention on my part was needed. I finally assigned a nurse to man the phone to the ER and continued with the staff which had assembled to treat the patient and to answer questions from the ER at the same time. It seems unreasonable now but at the time I had no sense at all of being stressed. This was work we had been trained to do and even having two arrests going on at the same time didn’t occur to me as unfair. Sadly, we eventually lost the man in the ER but the patient on the ward recovered. With cardiac arrests, even today that would not be a bad record.

The Stabbing

One evening when I was an intern I was standing on the parapet where the ambulances pulled up to the ER entrance. It was warm and I was chatting with the chief surgical resident. We watched as across 58
th
street two men passed each other walking in opposite directions. One kept on going and the other bent over and then looked directly up at us. By that time, the resident was already beckoning the man to come to us. (It struck me later that we should have gone to his rescue, but truly, I did not even know what had happened.) My resident with the experience of many years knew that the man had been stabbed! We helped him into the ER and loaded him fully clothed onto a gurney. As a crowd of nurses and doctors assembled the last I saw was everyone heading speedily toward the elevators up to the operating rooms. The man had sustained an abdominal stab wound but lived to tell about it. I have no idea what his assailant was thinking. I doubt if he was ever seen again except, it being New York City, the men were probably “friends” and eventually met up again.

Early Problems

Having finally figured out how to cross Ninth Avenue without getting killed, I immediately encountered a couple of other problems. My medical school was bordered by an enormous park and an equally enormous cemetery. It was a very quiet place. When I arrived at Roosevelt Hospital in the Hell’s Kitchen area of Manhattan on the west side, I had no idea how noisy it would be. I literally heard very little through my stethoscope during my first few days as an intern because of all the street noise. The stick ball games in the street outside my dormitory kept me awake. I eventually adjusted.

Then there were strange diseases and measurements: “appendiceetis”, “cholcysteetis”, “sauntameters” (centimeters). I always thought “—itis” meaning inflammation was pronounced “eyetis”, but I was wrong. In Manhattan, it was pronounced “eetis”. It soon became clear to us foreigners that these were affectations of speech and that we had not suddenly encountered diseases that we had never heard of. By the time I had finished my first two years in training the words were being pronounced correctly throughout the medical staff.

Roof Parties

The hospital dormitory had a lovely, flat, tiled roof filling the entire area of the building’s footprint with an open area and a glassed in area. It was a great place to relax, have lunch, even to study and a perfect setting for parties. We were repeatedly warned to “keep it down” so as not to bother patients in the adjacent hospital building, so in the evenings we would mostly stay inside the enclosed area.

One party I remember in particular. My wife was about six days past the delivery of our daughter and still a bit sore, but determined to show up at a rooftop party. And we did. I had a bit more to drink than I should have, but before I could even suggest it, Peggy announced that she was not driving home to New Rochelle. So, very early in the morning we set out for home having first to drop off another partyer at his home on the upper west side. It was easy to drive very slowly and inconspicuously in Manhattan and the Bronx. This was not so on the New England Expressway (I95), however. Made no difference to me since I was not about to have an accident. The trip, normally about 50 minutes, took us nearly two hours. The only time I became a bit anxious was passing under the observation bridge near the start of I95. By that time I was probably sober, but I kept on driving at a snail’s pace in the far right lane expecting to have the observers send a police car to see what I was up to. They didn’t, and we got home without a problem. That was the last time I tried that maneuver. We had had a lot of fun but putting ourselves and others in harm’s way was really not very smart.

A New Paging System

About midway through my internship year we were informed that a new paging system was being installed. Eventually we were told to pick up our pagers. They were quite large and could only be transported around if attached to a belt or strap. The hospital extended for one square block and the system would cover that, and with luck, the residence across 58th Street. Now of course one can be paged almost anywhere, but at that time New Jersey was out of the question. We were instructed to have the pager with us at all times. After I spent the first day with my new machine, it came time for me to take a shower before trying to get some sleep. So there I was just ready to get into the shower with my pager in my hand. Then I had to try to find some way to stay in touch so I put it on a ledge in the shower stall. By the time I got back to my room I had fallen out of love with this new devise and never again took a shower with it. Many were the patients however who did not have to listen to the loud speaker paging system any more, and how happy they were!

The Blackout

On November 9, 1965, just as I had one leg in my street pants preparing to go home to White Plains, the lights went out. I used my pocket flashlight to finish dressing and headed for the elevator. The dormitory (which no longer exists) was so old that the elevator was operated by hand by a rope mechanism. No kidding! My car was parked at the corner of 58
th
Street and Tenth Avenue, and so I was able to reach the corner easily. Someone was already in the intersection directing traffic, since the stoplights were not working. I then made it onto the West Side Highway and was driving along when I suddenly realized that I could not see the lights of New Jersey. I found out the scope of the electrical failure quickly enough on the car radio.

When I arrived home, my wife had three children in the kitchen with her with strict instructions not to wander off. A couple of candles and flashlights were providing some illumination. She was thoroughly annoyed that the lights had gone out and was floored to learn that the entire east coast was in the dark. Still, she managed to produce some sort of meal and we put the kids to bed. We sat in candlelight for awhile and then went to bed ourselves since there was little point in staying up in the dark. By morning I think the problem was resolving since I do not remember missing any time at work.

The wife of one of my professors, however, was certain that she had caused the whole thing since the lights went off just as she turned on the oven. There were many similar stories.

The Bath Blanket

Late one evening when I was an intern, my resident paged me so that I could go with him to see an elderly female patient in a single room on the medical ward. The reason probably was so that I would be able to care for her during the night if the need arose and the resident could get some uninterrupted sleep. In any case, when we arrived in the patient’s room, she was sitting up in bed enclosed in an oxygen tent. Her fever was high but not yet in the dangerous range and the nurses wanted to know how this should be dealt with. In those days, bringing the patient’s fever down was of paramount concern and the best way to do that was to soak a cotton bath blanket in rubbing alcohol and cover the patient with that. The evaporating alcohol would draw the heat from the patient’s body. We agreed that that would be the thing to do and the nurses set to work. When I returned early in the morning to check on things, the little lady was still propped up in her bed, saying her rosary and chortling to herself. She was in great high spirits because she was thoroughly drunk. The alcohol wrap had been left partially under the tent so that she had been breathing in a good deal of alcohol. I would not have been surprised if she had never imbibed alcohol before and had certainly never been drunk. The happy ending—her fever was gone never to return and she was discharged several days later!

The Nametag

In training, we all wore our nametags just above the breast pocket of our white coats. (We also wore shirts and ties!) Several times my nametag resulted in interesting conversations. I was seeing an older man on the private ward, collecting his blood for tests. While I was engaged in my work he suddenly said, having studied my nametag, “Do you belong to the Holland Society?” I indicated that I did not. He then said that in all probability I would be welcome there because of my name. He said he had seen it several times in the Society lists. (A member has to be a direct descendant, in the male line, of someone who lived in or was born in New Amsterdam prior to 1625.) So, we talked for a bit while I told him a few of my family’s stories. I really would have been interested had it not been for the $100 fee required to join. That would have been used to verify my qualifications, I suppose. However, at that time I had more important uses for my money. I have looked into the Society from time to time and once even went so far as to obtain membership application forms. The Holland Society is now primarily a philanthropic organization. In the distant past however, one’s social climb would have been enhanced and doors of opportunity would have opened for me.

I also went to draw blood on another patient in a private room at the end of a hall where a loudspeaker used for paging people was mounted on the wall just outside his room. As I bent over to do my work, he examined my name tag and loudly said, “So, you’re Doctor Hermance!” It startled me, but this time I avoided getting blood all over everything. He told me that he listened all day to people being paged but he had decided that he heard my name the most often. I don’t know why that might have been since all of us were pretty busy all the time. Shortly thereafter the new hand-held pager system went into effect.

Mr. Clanfergis

I had occasion to care for an elderly man on the medical ward whom we all referred to as Mr. Clanfergis. He had no relatives that we knew of and he had no visitors from whom we could obtain information. He wore a copper bracelet which, he pointed out to me, had no apparent point of fusion. He said that the bracelet had been fitted onto his wrist when he became the head of the Clan Fergis. He also knew that he would die soon, but not to worry, the Queen of England would pay for his funeral. I saw him daily for many weeks so we became well acquainted.

One day on the ward a nurse came in looking excited and slightly flustered. In fact, she was very nervous because she said she had just mailed a letter to the Queen about Mr. Clanfergis, describing his circumstances as best she could. We all had a good laugh about her action and expected no more to come of it.

A short time later however, the nurse actually received a reply from the Queen’s staff saying that our patient was, indeed, the Head of the Clan Fergis and was related to Queen Elizabeth, something like her cousin 22 times removed. The letter also noted that the Crown would not provide funds for any of our patient’s care or funeral expenses. We were not surprised, but, when Mr. Clanfergis died, the Explorer’s Club in New York City actually did pay for his burial which made us all happy. It turned out that everything our patient had said about himself was true so we were pleased that we had not made fun of any of his claims.