Tales from the Emergency Room (21 page)

In-air
Emergencies

The Broken Leg

The one and only time I ever flew for free was on a flight to Denver, CO, courtesy of a drug company which was hosting a medical meeting to introduce new products. I was seated next to a woman who steadfastly ignored me. Having an aisle seat made it easy for me to get about without having to engage her. Eventually, I made my way to the rear bathroom. While inside, I thought I heard the PA system come on, but all I could make out was “or nurse”. When I came out of the bathroom, I had a view of the entire airplane. No one was moving about or loitering anywhere. I asked the nearest attendant about what I had heard although I was beginning to suspect what it was. Indeed, they were looking for a doctor or nurse and I was just the ticket.

The cabin crew led me to a woman seated with her leg precariously elevated and wrapped in ice. The flight crew had done a creditable job caring for the lady. Her history soon made it clear that she was in big trouble. She had fallen while boarding the plane and by now her leg was hugely swollen and purple. She said she was flying on to Hawaii. This, I knew, was not about to happen this day. I asked the attendants to tell the pilot to be sure there was a wheel-chair to meet the woman in Denver and that she would have to be taken to a hospital. The pilot was not happy about all of this, but he had no choice.

I returned to my seat. My seatmate burst into conversation about who I was and what I had done, which amused me greatly. What did not amuse me was the offer by the attendant to give me a free drink by way of a thank you. There I was on a flight where my drinks were free anyway being offered a free drink! Just my luck, I guess.

The Coronary

So, there we were, traveling with Dr. H., an internist and his wife, flying high over the Atlantic Ocean in the middle of the night on our way to Frankfurt, Germany. My friend, a medical school classmate who had been my best man and his wife were fast asleep. I have never slept a wink on an airplane so I easily heard the request for a doctor. I asked my friend to come with me to see about an older lady who was ill in the next compartment of the 747. It was clear that she was having serious trouble but examining her in the plane was a challenge. We administered oxygen and then communicated to the pilot that we had better land as soon as possible. I will never forget the conversation with him on the upper deck. He was not happy saying that we had probably flown beyond a landing at Shannon, Ireland. But, he would do his best to comply with our wishes. In a short while, we did land at Shannon and an Irish physician in his tweed coat, with two assistants, boarded the plane and removed the patient and her husband who had been on their way to India. My wife and I had bulkhead seats and soon after we began to settle down and were airborne again, an attendant arrived and sat on the fold-down seat in front of us. I asked if anyone had complained about the unscheduled landing and, to my surprise, she said that a man in First Class was irate. I offered to settle his hash for her, but she laughingly declined. Then she revealed that many older people were always on this flight terminating in New Delhi, often already ill and going home to India to die. She was very happy that we had insisted on landing since during a similar incident the week before a doctor and the pilot agreed to fly on to Frankfurt. The patient, a man who was having a coronary, died on the approach to the airport. It was a sad story but increased my confidence that what Dr. H and I had done was the right thing. On the way home, we got to wondering how our patient had done, but we were not able to figure out a way to find out.

 
In the Clinic

The Hallucination

I have been in a lot of places, but, so far as I know, I have only been in one person’s hallucination.

From my office desk in my clinic in the south Bronx, I could see a lady waiting patiently to come in. I called her into the office and asked her where she had been because it had been quite some time since she had last visited the clinic. She replied that she had been in the mental hospital for several months. We talked about that for a while and then she told me that I had been in her hallucination. She told me a little about that, much of which I didn’t understand. We both laughed however when I told her that this was a new experience for me and that I would take being in her hallucination as a compliment. I had the idea that she was much improved mentally and I hoped that she would stay that way.

Plain and Fancy Ladies

In one of my clinics I regularly saw a lady who always dressed in the plainest clothes imaginable. One day I needed to examine her chest and asked her to remove the top of her outfit. I managed to avoid rolling my eyes, unlike my nurse-chaperone, when I discovered that my patient had on very frilly, not to say sexy, undergarments. Later, a similar event occurred except that this time I was dealing with a very stylish, rather sexy woman. To my surprise, this lady was wearing cotton underwear which did nothing to enhance her allure. Afterward, my nurse and I discussed what the reasons between the inner and outer appearances of these two women might be. In future, my nurse would signal to me that there was likely a similar surprise waiting for me with other patients.

I Know I’m Dying . . .

For several years, I also saw a very pleasant middle-aged lady whom I knew to have a very serious disease outside of my specialty. I felt so upset for her when, one day, she said, “I know I’m dying, it’s just that it’s taking so long.” It was a very difficult remark to respond appropriately to.

In White Face

One of my favorite clinic patients was Mrs. D. She dressed entirely in black, I know not why, and used stark white, stage-type makeup on her face. She was a tiny, older lady but quite pleasant. Only in New York, I suppose.

And then there was the lady who showed up in my clinic one day wearing one blue and one brown shoe. How she and I laughed about that. It often came up in our visits, too, and remained a source of good humor.

We are speaking French!

One day my Chief of Medicine at Our Lady of Mercy Hospital called to ask if I would be willing to fill in for a colleague who ran the allergy clinic in the Morrissania area of the Bronx who had become ill and would not be able to work for a while. It was a very poorly paid position. I said that I would be happy to substitute for a few weeks. In the end, I stayed for 15 years at a much better pay rate.

It soon became apparent to me that my lack of knowledge of Spanish was going to be a drawback despite having translators readily available. So I began taking Spanish lessons at night school in White Plains at the high school. About two months into that, I noted during one clinic session that most of the staff was hanging around my office. With my aide/translator at my side I began seeing a young woman and her elderly mother who was the patient. I began the history asking questions of the daughter and waiting for her to translate her mother’s answers. It was slow going. I turned to my aide and said, “It’s a good I am taking Spanish lessons.” Whereupon, the young daughter drew herself up and, quite offended, announced, “We are speaking French!”

Of course, all the people standing nearby burst out laughing, as did I. Even my patient’s daughter smiled. The staff knew exactly what was going to happen when I saw these two ladies. It turned out that they were speaking Creole. I couldn’t help but note that these people must be the last two French-speaking people in the neighborhood.

(Eventually, I learned enough Spanish to eliminate the need for a translator except for those times when the patient or I clearly did not understand what the other was trying to say.)

The Subway

In the course of my travels around the Bronx and Manhattan, my rudimentary knowledge of Spanish did come in handy. When approached with “Cambio, cambio?” I rapidly learned to say, “No tengo!” Even that much of the language would send the solicitors on to other likely looking contributors.

Once I was approached while riding the subway by the son of a clinic patient of mine. To his question, “Doc, what are you doing here?” I replied, “Everybody got to be someplace.” (From an old joke about the lady who found a little old man in her bedroom closet.)

Spanish

It never fails to amuse me that my Spanish-speaking patients always said “Nueva York” and “New Hersey”. That combination could have at least produced “New York”. Often these people would laugh at this, too, but kept right on with their usual pronunciation. Also, the Dominican Republic, I soon learned, was the “DR”.

When I went to Spain, my clinic personnel all laughed and said that no one there would be able to understand my New York City Spanish. Well, I tried it out on the taxi driver from the airport who either understood my version of Spanish or spoke English. I also discovered that, during siesta, the high school kids were often left in charge of things. They had no trouble at all with my Spanish. However, I did have a little problem in an exclusive linen shop in Madrid when my wife tried to buy a bib for a new nephew. No one there knew any English, but I did manage to make myself well enough understood to buy what we wanted.

Shingles

The day before we left on our trip to Spain, my wife noticed a slight rash on my back. I had had some achiness there following a long session in the garden getting things settled before our trip. By the time we got to Spain it was clear that I had Shingles. At one point, as I was coming out of the shower my wife took one look and called our friend Dr. H. with whom we were again travelling to come ASAP to have a look. He announced that that was the worst case of Herpes Zoster he had ever seen! Since I did all the driving, I needed to be alert and so I decided to try to get some pain medicine that wouldn’t knock me out. To everyone’s surprise, in Spanish, I eventually talked the hotel doctor into writing me a prescription. He sent us to real pharmacy, after hours, where we found two ladies waiting to escort me into the shop. The prescription had already been filled and so then I had a tour of the lovely little place, all dark wood, multiple levels of drawers and extremely clean preparation areas. All this time I was conversing, sort of, in Spanish. Eventually the medicine did help a bit, but I toured Spain holding my shirt away from my chest whenever I wasn’t driving.

Limpio

I frequently wore a white shirt to the office and clinic. The Spanish ladies would have a look at the way I was dressed and would comment, “Muy limpio!” referring to the fact that I was dressed in suit and tie and looked clean and neat. Milagros was one of the great Spanish ladies who helped me with my language skills and was a fan of the way I dressed. She certainly couldn’t afford the gifts she gave me, and I suspect that her children and grandchildren, who were very attentive to her, got talked into buying small things for me.

One day, on my way to the clinic I was driving on the Grand Concourse in the Bronx. At one of the huge intersections, I came to a red light. There was a green van in front of me. The light changed but the van didn’t move. Why I didn’t honk at it I will never know. However, I didn’t and suddenly the van swerved quickly to the left across the intersection and was T-boned by a car coming in the opposite direction. The van tipped over and the driver clambered out of his window. I pulled to the side, got out and carefully locked my car to go and see what the condition of the other driver was. In this short period of time, it seemed like hundreds of people were in, on or approaching the wrecked car. It occurred to me later that I was probably the only person in suit and tie for blocks around. The crowd parted as a result of my being “limpio” I suppose and I looked into the car. It was plain that the driver was dead, his blood dripping onto the roadway.

I gave a statement to the police and over the next few weeks had to fill out numerous forms for them. I have always been thankful that I didn’t toot at the green van since then I would have felt responsible for this fatal accident.

The Shower

I took care of a lovely Spanish lady whose daughter was also a patient. I commented once that my daughter and her three sisters-in-law loved to sit around the kitchen table “doing” their nails. I also commented on the number of showers they took. She laughed and told me that in her house, an apartment with one bathroom, the shower was always running—24/7. She had six daughters all of whom lived at home and took, she thought, an average of three showers per day. With hair washing as well. After that I never complained about how the bathroom was used in my house.

 
The Retirement Years

Once a Doctor, Always a Doctor

I hadn’t been retired in Florida very long before a lovely, talented lady of my acquaintance called to ask if she could come to speak to me about a medical problem. I had already decided that if this sort of thing happened I would be available but I would limit my advice to just talking, not diagnosing or treating. She arrived bearing a lab report and told me that one doctor had said that she had arthritis and another that she had multiple myeloma. There is a world of difference between these two diagnoses, the former not usually fatal and with many treatment options, the latter almost always fatal and with few good treatments. Naturally, she wanted to have arthritis at this point. However, the lab report she produced was absolutely diagnostic of myeloma. (I can’t imagine what the first doctor was thinking.) My advice was for her to obtain a third opinion. She did, was treated expertly only to die about three years later from her disease.

One of the biggest problems for me was knowing what was going on medically with individuals in our group of friends, when no one knew that I was privy to the facts. I managed to field some pretty prying and sometimes insightful questions, even including the occasional comment to the effect that I had known all along, hadn’t I?

Another friend came to me one day to discuss what he should do about his prostate cancer. We reviewed the options and he finally decided with my blessing to have brachiotherapy somewhere on the west coast. I really didn’t understand why he needed to travel so far, but in the end he did well.