The Homer G. Phillips Experience

Even today, I think the best times I’ve had in my life were the years I spent at Homer G. Phillips. Every thing about the “G’s” was Black starting with the patients……. the Medical Director, the CEO, the CFO, nurses and all department heads.. As I explained in an earlier chapter the hospital was built and opened for Blacks in 1937 because of racial segregation in St. Louis and their need for medical care. When the hospital became a residency training site it had to ally itself with a University for credentialing and Washington University became that source for the academic teaching staff.
Now this interaction resulted in a paternalistic relationship in which the “Great White Father” didn’t think we or our staff knew as much as they. So a game of one upsmanship was always in play. Little did they know that we could play the game too.
Each specialty during my tenure had a department head that was from the “G’s” and one assigned from Wash U. In OB/GYN there was Dr Smiley and Dr Monat from Wash U. In Surgery there was Dr Sinkler and Dr Moyer.
One time, when I was a 3rd year resident Dr.Monat swore that a patient had a huge ovarian cyst and demanded that she be taken to surgery immediately Dr. Smiley felt it was ascites (fluid in the abdomen)and could be drained at the bed side ( this was long before ultra sound scans). We were ordered to explore her exposing the patient to both operative and anesthesia risk. Well as soon as we opened her abdomen out gushed 10 quarts of fluid to Monat’s chagrin on finding that Smiley was right!
The problem for us was always the dogmatic certainty that Dr Monat pompously displayed. It became a challenge to be ready on any and all the salient things involved in cases he staffed.
He did his private practice at Jewish Hospital where we were not allowed to rotate and staffed at Barnes Hospital ( Washington U teaching hospital) which also allowed us no clinical experience though we were able to take pathology and endocrinology there. When you are considered 2nd class it gives you incentive to excel and we certainly did that; especially in combined grand rounds where our cases were some of the most complexed; since we served poorest and sickest of the population and our exposure to trauma could only be duplicated in a war.
One case comes to mind when I was Chief that stands out as one of the most complicated and in the end rewarding of my medical career. Even today I can recall it in the detail I relate here.
The patient’s name was Alverna and she delivered precipitously on admission a premature infant. She had birthed 10 living children and had received no prenatal care with this pregnancy. She had sustained some lacerations and my 3rd year resident was in the process of sewing her up when I walked past the delivery room and heard a sound like water running from a faucet, as I looked in I saw she was hemorrhaging. We immediately set about what turned out to be one of the most difficult cases I ever cared for. She ended up being operated on 4 times and on the 4th exploration she was still bleeding from everywhere in her abdomen. She had been given 40 plus units of blood, platelets, and coagulation products. The “God figures” from Wash U. had come and gone a given their imput and still she bled. I had been with her for 72 hours straight and had only gone home to get clean clothes and when I returned she was close to death as ever. I called Dr Smiley who was at home and he said take her back to the operating room and he would be right in. He said “ over sew lap packs to the bowel and send to the lab and get a large burette and tubing “. I said, “but she’ll get obstructed” and he answered “ we can take care of that later, otherwise she’ll die” So I did as he directed.
Smiley was a fast decisive surgeon and quickly took charge. The patient’s BP had bottomed out and was being maintained with drugs given by the anesthesiologist. Smiley started scooping blood out of the abdomen and filtering it through some gauze he placed on top of the burette and transfusing it back into the patient with the tubing he had requested. Within a couple of minutes her BP began to rise and the anesthesiologist said he had stopped any of the BP maintenance medications. And all the bleeding throughout the abdomen had stopped. To make a longer story short she survived. And that was the first auto transfusion that we had ever seen. I believe still, Dr Smiley created the procedure on the spot. Alverna lived and I told her on discharge that if she ever needed care I would take care of her free anywhere I lived. I have been witness to some dramatic cases but this is the one that tops them all!
One of the almost unimaginable conditions of my residency was the call schedule. Usual call is every 3rd or 4th night but OB/GYN at the “G’s” had it’s unique call. As an intern we were on call 30 days and nights with a ½ day off for personal business; as a resident it was every other or 2 nights on and one off. Dr Smiley’s belief was if you were going into OB this would prepare you for your future call and if you weren’t you would at least get to experience exposure to a large number of deliveries over 30 days that most rotations wouldn’t give you. Clinical situations in medicine are much more likely to be retained if one is frequently exposed to them.
This environment produced unbelievable stress and to relieve it we left the hospital and headed to our favorite watering hole to drink, dance and party until it was time to go back on call sometimes without ever going home. So no wonder so many marriages did not survive the “G’s” seduction.
There are probably bars now closed in St. Louis and East St. Louis that have our names etched on their walls as a testament to our faithful attendance. St. Louis closed down at midnight but East St. Louis stayed open 24/7 and we would head there to keep on drinking at places like the “Faust Club” the “Blue Note” and the “Manhattan” where Ray Charles, Tiny Grimes, Ike and Tina Turner played all night long. And then go to Lovejoy, Brooklyn or Madison, IL to gamble what little money we had left.
Many a night I have searched the city for the “pig ear or pig snoot man” to eat and sober up before going back for another call at the “G’s” Then do it all over again.
I was indeed a willing victim to the seduction of the jealous mistress called medicine. And remember there were nurses every where we turned who were good to go and we took them on the ride. Relationships came and went as residents came and left and affairs ended some marriages and others survived.
There are tales of escapades that I dare not tell, but here’s one so good that I must relate it.
One of my fellow resident’s and friend (who will remain name less) asked to borrow my car while I was doing an emergency room call from 7pm to 7am one night. I had a black ’57 Ford convertible with Indiana license plates ( very distinctive). His date happened to a married woman.
Now the ER had a police scanner that monitored police action through out the city and about 1am I heard a flurry of calls reporting that a car described like mine was fleeing at a high rate of speed, running stop lights headed East, the car had avoided two roadblocks to apprehend it and could not be located.
About 3am he came in out of breath and handed me my keys. I said did he know the police were chasing him? Yeah, but didn’t know what for. He said that he had pulled in front of the woman’s house and parked to talk a while and a suspicious car pulled behind him. He pulled off and circled the block twice and dropped her off and sped away thinking it was her husband. It turned out to be an unmarked police car. And the chase began. I asked how he had avoided the police, he said he didn’t think they were after him and had cut through a side street and hid in a driveway. For weeks afterwards, I was careful to avoid any police cruiser I saw! Naturally I never revealed the incident to my wife hoping she would not be stopped.