Tales from the Emergency Room

Copyright © 2009 by William E. Hermance, MD, FAAAAI.

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Contents

Introduction

The Early Years

The El-Hi Years

The College Years

The Medical School Years

The Post-Graduate
Training Years

The Military Years

The Practice Years

In the Office

In the Clinic

The Retirement Years

Miscellaneous

Reflections

Dedication

For
Peggy,

w
ho heard these stories when they first occurred and so
many times since, that she could easily have written them down all by herself!

Special
Appreciation
to:

Patricia Stiller Hermance

George W. Hermance

 
Introduction

In the emergency room where I trained, there were several levels of activity. Slow (rare), busy (normal), hectic (often) and busy-hectic (the worst!). From a visitor’s point of view, “chaotic” would have appeared to be a good choice to describe the scenes. It was never that way for the doctors, nurses and medical/surgical assistants, for every move was purposeful, undertaken to achieve an acceptable medical outcome.

I did my post-medical school training at The Roosevelt Hospital in New York City in Manhattan. It was and still is one of the premier teaching hospitals in the country. It has been affiliated over the years with the finest medical institutions in the world. It is called St. Luke’s-Roosevelt Hospital Center now. I started my practice just as Medicare and Medicaid began. Training after college lasted eight years including medical school, interrupted by two years of Selective Service Duty. During my career, there were great happiness and satisfaction, times of joy and sadness and lots of laughs. I noticed early on that almost everybody enjoyed hearing medical tales. I also learned very quickly, as all medical personnel should, that specific medical facts about patients were not to be shared with anyone not directly involved in the patient’s care. Not in the lunch room, the elevator, the waiting room or any place where casual observers might overhear. But, so many interesting or humorous situations occurred that could be told without giving a clue to a patient’s identity, that repeating them here seems acceptable.

My youngest son is a police officer. I suggested that he keep a journal of the interesting things that happen to him in the course of his work since he does tell wonderful stories about his adventures on the police force. But he, like me, hasn’t done it. So perhaps when he is retired he will decide to record those memories as I am doing here.

I spoke the subtitle above one day in the busy, crowded emergency room. I had to nudge a woman out of my way after indicating out loud that she should move so that I could get to where I was needed. She asked why I had “pushed” her and I said, my voice rising, “I have to push because you won’t get out of the way when I shout.” Those words seemed to me upon later reflection to describe the tone of many medical venues especially on “hectic” days.

Not all of these stories originate out of the emergency room. But it is not difficult to decide from what locale they do come. I have left out names purposely except in a few instances where they are important or I especially wanted to make note of specific people.

Finally, to quote a local Emergency Room doctor, appearing utterly shocked when I asked for directions to the Recovery Room, “Somebody recovered here?!”

 
The Early Years

Vegetable Soup

Of course, I don’t remember when I decided to become a doctor. I think it was a gradual process, but as far as I can remember, that is always what I have wanted to do. One family story, though, has it that I told my grandmother one day while visiting the family farm when I was about five or six years old, that I wanted to raise vegetable soup when I grew up. An ambition that I never realized.

The Chain Letter

In the days before I was born, chain letters were not illegal. My father had entered a letter containing $1.00 in one of these schemes. The cost of my delivery was $300.00 and on the very day that I was born, he received 300 letters in the mail each containing $1.00. I often mention this stroke of good fortune when discussing the cost of medical care!

A Nail-Biter

As a young boy I was a nail-biter. I guess I switched to that after I stopped sucking my thumb! My first and best friend growing up lived next-door to me, but then moved several blocks away. By that time we were riding our bikes all over so we continued to be good buddies. His mother had a dear friend who worked for the local dermatologist with whom I had some dealings (warts), mostly with unpleasant and long-lasting ill effects (but that is another story). Frequently, when I went to my friend’s house, his mother’s lady friend would be there. She would always insist on examining my fingernails and then read me the riot act because I continued to bite them. It got so that if I saw her car I would try to get my buddy’s attention without alerting the ogre. I can’t tell you what anxiety this woman provoked in me. Looking back, I believe that this was a form of abuse. And, of course, I would see her in the doctor’s office when my parents took me there. Naturally, I eventually stopped the nail-biting, but it was not because of the anxiety this woman instilled in me.

College?

It never occurred to me that one could not go to college. I remember playing with some friends when I was about thirteen while they had some older cousins visiting. One of the older boys noted that he was not going to college and another said that he wasn’t either but would be going to work soon, just out of high school. I couldn’t wait to report this to my parents, both college educated, only to find out that, yes, indeed, one did not have to go to college! Who knew?

The Dentist

Even though I have several friends who are dentists, one of whom was my dentist for many years, I have always looked forward with dread to a dentist appointment. A possible reason for this was the dentist my parents and my friends’ parents sent us to. I was there frequently since I had awful teeth as did my friends. (Fluoridation hadn’t been invented yet.) It turned out that this man never used local anesthesia with us kids although he did with our parents. I can remember vividly being treated by him as can some of my long-time friends. One of these and I still cringe even while we are laughing about our early dental encounters.

 
The El-Hi Years

Gover(n)ment

In the sixth grade, my teacher asked me to stay behind after school one day. I knew this lady very well since she and her husband were my parents’ best friends. My father was by then involved in the politics of education as was my teacher. It seems that I had misspelled “government” on my most recent spelling test. In a note to my teacher my father had made the same mistake. Exasperated, she had me write “government” 100 times on the blackboard. It took a long time but I did it, and, just as this teacher knew, never again did I misspell that word. I never heard about it from my father either though I am sure he was not unaware of the episode.

Sometime later because of an attitude the same sixth grade teacher thought I was developing, she again asked me to stay after school. This time she made a prediction, self-fulfilling or not I don’t know. She allowed that I was at the head of my class, but that when I got to high school (10
th
grade in those days) I would find that the academic competition was greater and I would not be at the very top of things. Then she said that in college I would encounter the same problem. And then the prediction: Billy would graduate in the middle of his class in medical school. How she knew all this was a mystery to me then as now, but her prediction turned out to be exactly right.

Handwriting

My mother and father were both school teachers. One day I handed my father an assignment which I had done for school. The work was fine, he said but he had some advice for me. My handwriting, though legible enough, was very small. His idea was for me to practice writing larger and in that way I would fill up more space on assignments. So, I practiced making my script larger. In school in the future, I would sometimes think how much more impressive the amount of writing I produced looked when written large.

Then there was the teaching assistant in my college physics course who was charged with evaluating everyone’s lab reports. By that time, my penmanship had also improved to the point where it looked quite nice, but was sometimes difficult to read because of its regular quality. My TA called me aside one day and asked if he could prevail upon me to type my reports. He said that he had to leave my reports till last because he got seasick reading them. In the hope that he wouldn’t read them at all, I continued to write the papers in longhand.

Seventh Grade Revisited

Our history teacher in 7
th
grade social studies was very strict and gave enormous amounts of homework. Because of this, I was prevailed upon by my classmates to lead a delegation to the principal to register our complaint. It never crossed my mind that my father, well-known in the school system, would find out about this almost instantaneously. I had not mentioned our efforts at home. Thinking back, I don’t remember any serious consequences either for the teacher or for us students, but I do remember another teacher whom I knew personally saying to me that with regard to homework in high school and college I hadn’t seen anything yet.

About 25 years later I received a phone call in my office from this lady. I had no trouble remembering who she was. She had come upon bad times with regard to her health and possibly her income, and, having kept track of my career, called to see if I could be of assistance. I was able to help her in a small way by sending her to one of the leading internists in town, who, at my request agreed to care for her with no fee and to guide her to some social assistance. (He had been in 7
th
grade when I was, but in a different elementary school in town.) I was happy to be able to assuage my conscience somewhat since I had always felt rather badly about the way I and the rest of my class had treated her.

I Love My Job

My very first job was with an old gentleman civil engineer. He was a bachelor and lived in a very old and dingy house. This is where I worked when I was not out in the field with him. He wasn’t unkind to me but my working conditions were abysmal. When I decided to quit, it was with some trepidation since a friend of my father’s had been instrumental in finding the work for me. I also decided that I would never have another job that I didn’t want to wake up to every morning even if that meant going on public assistance. My father was not nearly as put out as I thought he would be when I quit. I never worked at a job I didn’t love again. I was always happy to get to the office in the morning because I knew my day would be filled with interesting people and interesting problems. Even now, back working in my specialty, I love what I am doing.

Dr. Nash

For three years in high school and college I worked in one of our town’s leading pharmacies. The proprietor, tall and good-looking, decided every year when it came time for me to go back to school, that I was the cause of him losing a lot of money. (I wasn’t of course and he kept rehiring me in the summers.) His wife became pregnant for the first time and went into labor. As she was going up in the elevator at the hospital, the nun asked her if this was her first baby. Her reply? “No, my last!” She subsequently did have another baby.