One of my best friends, Cup had interned at a white hospital in Michigan and had come to the “G’s” as a 1st year surgery resident. On his first day on the unit he walked up to the nurses station waiting for the nurses to all stand and ask which charts he wanted like where he interned. The head nurse looked up and said to all within her voice “ I wonder what this big fat mutha fucka wants”. Right then he knew he would have to get on the good side of the nurses at the “G’s”.
They literally ran the hospital and no matter how smart or connected you were, they could cut you down or embarrass you in front of patient and peer alike.
Remember nurses are with patients 24/7 and can call or not call with salient information especially if they don’t respect you. So you have to always be on their good side. If you were a sound sleeper and a nurse called you for an emergency she might keep calling if she liked you, but if you were a prick she would let you sleep and pass the information on to your chief or dept. head thus getting you reprimanded. Many a doctor’s career was ruined because of this.
One time in the operating room, we were well into a difficult case and it was nearing a shift change. The scrub nurse replacement had not shown up and as the chief reached out for an instrument, the nurse said “ baby, I loaded you some suture and stuff on the mayo stand and I’m out of here ‘ cause my man is down in the car waiting. Bye!” All you could do was keep operating until her replacement arrived. You couldn’t report it to anyone because she would have done the same thing to Dr Sinkler or Dr.Smiley.
There was a tacit relationship that existed some of it probably due to their nursing skills and some due to romantic liaisons that precluded any and all discipline. It was just understood that nurses ruled!
Homer G. had a nursing school where a large number of Black nurses got their training and some smaller schools in the south sent student nurses to rotate their, usually for 4 month stints. With a fresh crop of mostly attractive young women coming from places like Baton Rouge or New Orleans, it was like being in nurses heaven.
One night my chief and I took 2 nurses over to East St. Louis to party. Speeding back to the hospital well after their curfew, he knocked down a whole line of traffic cones. The police stopped him and proceed to arrest him for drunken driving. The officer asked what he did and G replied I’m a doctor. The cop replied I don’t like doctors because they didn’t treat my son right in the ER and he almost died. To which G replied I would have let him. I’m in the back of the car knowing that out careers and these student nurses are on the line.
The cop sticks his head in and ask me to follow them to the precinct house, I have quickly sobered up and am trying to comfort two scared young women.
When we get to the station there is a night court judge and they bring G before him. I try to signal him not to say anything but he goes into a rant about how he was driving ok. I asked the judge could I speak to him in private and he beckoned to the bench. I told the judge what the situation was and that we worked at the “G’s” and had just gone out for some R&R and indeed my friend was drunk and wrong; also that these were innocent nursing students that would be expelled from school if this was found out. I don’t know what influenced the judge but he told me to get out and take G and if he ever saw G again he would put him under the jail.
When we got back in the car I told him, “nigga you owe me and good, we all could have been fucked”
We were able to slip the students back into their dorm and no one found out about the incident, but after that I had to cut G loose.
Sunday, September 2, 2007
Nuns and Nurses
There were two private hospitals that Black doctors could put patients in St. Louis, Peoples Hospital and St. Mary’s Infirmary.
St. Mary’s was the one that our staff rotated us through so they would have 24/7 coverage, since private patients could not be admitted to the “G’s”.
The best thing about going to St. Mary’s was it wasn’t that busy and they had great food plus the attending let you do a lot of surgery on their patients. Some were not up on the latest techniques and allowed the resident to sort of teach them!
Many a situation occurred at this hospital, especially since Nuns were in charge, and were scrutinizing everything.
One time a physician admitted a patient for a D&C with the diagnosis of incomplete abortion, the truth being she was really still pregnant and the nurse was looking over his shoulder when he aborted the fetus. She shouted “ what have you done? “ and he bolted out of the OR with the fetus wrapped in a towel and flushed it down the toilet. The nurse ran to get the nun who called up the plumber to check the toilet and drains so she could have a priest baptize the fetus. By the time he got the toilet removed the fetus was probably on it’s way to the Mississippi river.
Another time I was operating with a well respected old surgeon who never ever did total hysterectomies. He was fast because it was his technique to do partial hysterectomies. Since it was the current standard of care to do the longer more complex operation I asked him why he didn’t do it. He said, “ My operation takes less than an hour, but I’ll give you another hour to do your operation. If you can’t get it done in that time, no more suggestions from you!
Dr Smiley would have been proud of me because I was just a 2nd year resident and I whipped the rest of that uterus out in under the hour. After that he let me do all his hysterectomies while I was on that 3 month rotation.
Another perk was that most of the attending had offices in East St. Louis which was right across the river from the hospital, but few made it to their deliveries because they all had huge general practices. So we residents delivered most of their patients and did the circumcisions though the patients never knew since most were put to sleep in those days. The good part for us beside the experience was there would be an envelope with some cash in your mail box the next day and we all needed that extra money.
One of the things I did that annoyed the nurses was that I wore my keys on a chain around my neck and at night I would make rounds and the keys would jingle and I sometimes caught the nurses goofing off or smoking on the unit, thinking I was a nun, because their rosaries made a similar sound. When I appeared they would say “ oh shit, Robbie, we thought you were sister”. One thing that won them over was I always came when they called me and that bond took me a long way with them. Many a complication was diagnosed or avoided by them giving me a heads up.
One time I was assigned to scrub with one of the long time revered surgeons Dr T and the next day I made post op rounds on all his patients as was my habit at 6 am. I had inspected their wounds and put on a fresh dressings. When he came in to round I proudly exclaimed to him what I had done and he looked at me with displeasure. He was a real bullshitter with patients and after telling them in detail how difficult or complex their surgery was he left them all smiles. Once out in the hall he said “ Robinson don’t you ever touch a patient of mine post op, they can’t see what I did inside them but they can see the beautiful bandage I put on them”
I learned a lesson and swore that I would never follow another fucking patient of his post op.
Maybe because of my relationship with the nurses and willingness to work hard several of the attending asked me to moonlight in their offices. These jobs were passed down to a select few since it had to be on the hush because it was forbidden by the Dr Monat.
The moonlight jobs were usually done as 3rd year and chief when we were off but occasionally we would do it on call while one of our fellow junior residents covered the service in house.
Remember this was long before pagers or cell phones and our connection to the hospital was the switchboard operators (ala Ernestine) who if they liked you could do wonders patching calls.
So I could be in an office in East St. Louis moonlighting and staff a case with Monat or other staff who thought I was at the “G’s” on the phone and if on a rare occasion I had to be there my resident could hold the fort until I got there. This protocol was tried and true and passed down year after year and had even been initiated on many occasions for personal use. ( i.e. wives and girl friends).
Another important perk at St. Mary’s Infirmary was the nuns served great food especially compared to the “G”s”.
St. Mary’s was the one that our staff rotated us through so they would have 24/7 coverage, since private patients could not be admitted to the “G’s”.
The best thing about going to St. Mary’s was it wasn’t that busy and they had great food plus the attending let you do a lot of surgery on their patients. Some were not up on the latest techniques and allowed the resident to sort of teach them!
Many a situation occurred at this hospital, especially since Nuns were in charge, and were scrutinizing everything.
One time a physician admitted a patient for a D&C with the diagnosis of incomplete abortion, the truth being she was really still pregnant and the nurse was looking over his shoulder when he aborted the fetus. She shouted “ what have you done? “ and he bolted out of the OR with the fetus wrapped in a towel and flushed it down the toilet. The nurse ran to get the nun who called up the plumber to check the toilet and drains so she could have a priest baptize the fetus. By the time he got the toilet removed the fetus was probably on it’s way to the Mississippi river.
Another time I was operating with a well respected old surgeon who never ever did total hysterectomies. He was fast because it was his technique to do partial hysterectomies. Since it was the current standard of care to do the longer more complex operation I asked him why he didn’t do it. He said, “ My operation takes less than an hour, but I’ll give you another hour to do your operation. If you can’t get it done in that time, no more suggestions from you!
Dr Smiley would have been proud of me because I was just a 2nd year resident and I whipped the rest of that uterus out in under the hour. After that he let me do all his hysterectomies while I was on that 3 month rotation.
Another perk was that most of the attending had offices in East St. Louis which was right across the river from the hospital, but few made it to their deliveries because they all had huge general practices. So we residents delivered most of their patients and did the circumcisions though the patients never knew since most were put to sleep in those days. The good part for us beside the experience was there would be an envelope with some cash in your mail box the next day and we all needed that extra money.
One of the things I did that annoyed the nurses was that I wore my keys on a chain around my neck and at night I would make rounds and the keys would jingle and I sometimes caught the nurses goofing off or smoking on the unit, thinking I was a nun, because their rosaries made a similar sound. When I appeared they would say “ oh shit, Robbie, we thought you were sister”. One thing that won them over was I always came when they called me and that bond took me a long way with them. Many a complication was diagnosed or avoided by them giving me a heads up.
One time I was assigned to scrub with one of the long time revered surgeons Dr T and the next day I made post op rounds on all his patients as was my habit at 6 am. I had inspected their wounds and put on a fresh dressings. When he came in to round I proudly exclaimed to him what I had done and he looked at me with displeasure. He was a real bullshitter with patients and after telling them in detail how difficult or complex their surgery was he left them all smiles. Once out in the hall he said “ Robinson don’t you ever touch a patient of mine post op, they can’t see what I did inside them but they can see the beautiful bandage I put on them”
I learned a lesson and swore that I would never follow another fucking patient of his post op.
Maybe because of my relationship with the nurses and willingness to work hard several of the attending asked me to moonlight in their offices. These jobs were passed down to a select few since it had to be on the hush because it was forbidden by the Dr Monat.
The moonlight jobs were usually done as 3rd year and chief when we were off but occasionally we would do it on call while one of our fellow junior residents covered the service in house.
Remember this was long before pagers or cell phones and our connection to the hospital was the switchboard operators (ala Ernestine) who if they liked you could do wonders patching calls.
So I could be in an office in East St. Louis moonlighting and staff a case with Monat or other staff who thought I was at the “G’s” on the phone and if on a rare occasion I had to be there my resident could hold the fort until I got there. This protocol was tried and true and passed down year after year and had even been initiated on many occasions for personal use. ( i.e. wives and girl friends).
Another important perk at St. Mary’s Infirmary was the nuns served great food especially compared to the “G”s”.
Moonlighting
Moonlighting
Moonlighting is working on the side, sort of part time, while doing your regular full time job. It was strictly against hospital regulations. Most of the moonlighting jobs were connected to the specialty you were in OB’s with OB resident, Surgeons with Surgery resident and Medicine with Medicine resident, etc. All of these specialist did general practice since they would never survive if they expected referrals. The offices of the physicians were over in East St. Louis and several small towns along the river Brooklyn, Lovejoy and Madison whose main source of income was the state funded welfare program.
My first opportunity to work was for a young bachelor named Leon who drove a corvette and was known for his free spending partying ways. He had finished the “G’s” and was currently staffing our cases. He was taking his lady to Mexico and asked me to work his office for the 2 weeks he was gone. My eyes lit up at the opportunity to make some serious money.
I was to work from 7 PM until we saw the last patient which could be midnight and all the cash money I collected was to be mine. I couldn’t wait to get over there; I was literally salivating. The first night I worked was a Friday and I must have seen 100 patients. I couldn’t wait for the book keeper to tally my money so I could head out to one of the clubs and spend some. She handed me an envelope and when I ripped it open there was only 30 dollars in it, I was expecting 300 dollars since he charged 3 dollars/patient. I said “where is the rest of my money”. She said “ that’s all the cash we collected, the rest is welfare billing”. I said “ you better get doc in Mexico right now because we have a problem and I won’t be back”. So she called Leon and we negotiated some realistic terms for a daily sum I could live with.
The other thing that was interesting was that there were two Black pharmacies with direct lines to most all the offices and not knowing at first I would call in a script like this. (There would be 5 kids with strep and I would order a big bottle of antibiotic and divide the dose, the same with a cough syrup or antihistamine. The pharmacist quickly scolded me not to do that but to order a separate scrip for each child of each medication, so 5 became 15 prescriptions and he could charge for each. I know now looking back this was probably the beginning of medical welfare fraud since they were not being compensated fairly up front.
Many a night I pulled up to the office and there would be people sitting on the curb because the waiting room was packed. And I would see every thing from colds to heart failure, pregnancy to thyroid disease on and on until we locked the door.
It is a shame that a Board Certified physician had to do general practice to make a living in this way and a bunch more were doing the same thing.
Dr Sinkler knew what we were doing and ignored it since most of the physicians were either his classmates or he had supervised their training. Dr Monat “ The Great White Father” had no clue we were not in the house but making money on the East side even when on call. But what was one to do with a salary of $70-120 a month with some of us married with kids.
All the jobs weren’t over the river. Some guys made house calls in the city and worked offices too, but it was tricky since an attending might call an office you were working in for something and you could get busted. The one of the best moonlight job I had was when I was a chief . One of the wealthiest Black surgeons, Dr. H, had to go on a medical leave from his practice for several months. His private scrub nurse also gave anesthesia on the side and kind of adopted me as one of her favorite residents.
She asked could I cover for him and could I bring a friend to cover when I couldn’t. My main man ”Cup” was a surgical chief so this was perfect, since it enabled us to alternate coverage. And we were discrete
Dr H had owned a large block of land that the city wanted to redevelop and in the deal they built him a brand new office building right in the middle of the area. Because he had a large farm in the country his office was outfitted with an apartment for the weekdays he spent in the city, it even had a library with a fireplace.
Dr H was the first black surgeon to be Certified by the American Board of Surgery in the United States and was for all intensive purposes filthy rich!
The opportunity we had to work in his office revealed how he achieved this.
His nurse Ms G was also his office manager and confidante and when she asked me to work in his office, I’m certain that she knew I was trustworthy and would treat his patients the same as he.
I arrived promptly at 9 am as I was told and given a crisp white coat and told to relax in the library and they would call me when their first patient was there. Ms G came in to review the chart with me and tell me what I needed to check. The patient was an old Black man dressed in bib overalls, the owner of a coal company who had long standing hypertension and heart failure.
She said she would introduce me and for me to check his BP and listen to his heart as doctor always did. It was always doctor does this or doctor does that.
When I asked him to take off his shirt she whispered don’t bother doctor never does that. I wondered how doctor could hear the heart sounds through his shirt, but I did as directed. After I did my cursory physical, she said that was all I needed to do and they would get some tests. These consisted of a blood count, urinalysis and a chest X-ray. When these were done she informed him they would see him in 4 weeks and he pulled out a big roll of bills and peeled off 5 one hundred dollar bills to pay. My eyes were as big as saucers. Twenty minutes at most and he paid $500, I was seeing why Dr H was rich.
They told me that I had another patient in about an hour so relax, they had made me some hot tea in the library. I saw 2 more patients with nothing really wrong with them and was told to get ready for lunch. It was now about 11am and they served a sit down dinner of baked chops, greens, yams, salad, ice tea and pie. I was in heaven.
They then sent me to my recliner in the library to read or nap until the afternoon patients showed. I saw probably 4 more and was done by 3pm. Ms G gave me 3 one hundred dollar bills and said I had done a superb job.
I was literally flying with joy getting that money for doing nothing. When I got back to the hospital I found “Cup” and said “ Big Boy we have hit the mother lode, you won’t believe what we hummed in on”. In 2 months we made more money than what we would have made at the “G’s” during a year of residency.
Dr H had two children, one in law and one in medicine, and the one in medicine wanted to be a psychiatrist so he had no one to take over his practice. Because Ms G liked us so much she asked if when we finished would we work for doctor. We in good faith didn’t want to have a practice like this after completing the training we had received. It would have been like selling out our values for the money! Sometime I wonder by taking the “ high ground” did we do the right thing since we both never got rich! But I’ll say one thing Dr H knew how to live.
Moonlighting is working on the side, sort of part time, while doing your regular full time job. It was strictly against hospital regulations. Most of the moonlighting jobs were connected to the specialty you were in OB’s with OB resident, Surgeons with Surgery resident and Medicine with Medicine resident, etc. All of these specialist did general practice since they would never survive if they expected referrals. The offices of the physicians were over in East St. Louis and several small towns along the river Brooklyn, Lovejoy and Madison whose main source of income was the state funded welfare program.
My first opportunity to work was for a young bachelor named Leon who drove a corvette and was known for his free spending partying ways. He had finished the “G’s” and was currently staffing our cases. He was taking his lady to Mexico and asked me to work his office for the 2 weeks he was gone. My eyes lit up at the opportunity to make some serious money.
I was to work from 7 PM until we saw the last patient which could be midnight and all the cash money I collected was to be mine. I couldn’t wait to get over there; I was literally salivating. The first night I worked was a Friday and I must have seen 100 patients. I couldn’t wait for the book keeper to tally my money so I could head out to one of the clubs and spend some. She handed me an envelope and when I ripped it open there was only 30 dollars in it, I was expecting 300 dollars since he charged 3 dollars/patient. I said “where is the rest of my money”. She said “ that’s all the cash we collected, the rest is welfare billing”. I said “ you better get doc in Mexico right now because we have a problem and I won’t be back”. So she called Leon and we negotiated some realistic terms for a daily sum I could live with.
The other thing that was interesting was that there were two Black pharmacies with direct lines to most all the offices and not knowing at first I would call in a script like this. (There would be 5 kids with strep and I would order a big bottle of antibiotic and divide the dose, the same with a cough syrup or antihistamine. The pharmacist quickly scolded me not to do that but to order a separate scrip for each child of each medication, so 5 became 15 prescriptions and he could charge for each. I know now looking back this was probably the beginning of medical welfare fraud since they were not being compensated fairly up front.
Many a night I pulled up to the office and there would be people sitting on the curb because the waiting room was packed. And I would see every thing from colds to heart failure, pregnancy to thyroid disease on and on until we locked the door.
It is a shame that a Board Certified physician had to do general practice to make a living in this way and a bunch more were doing the same thing.
Dr Sinkler knew what we were doing and ignored it since most of the physicians were either his classmates or he had supervised their training. Dr Monat “ The Great White Father” had no clue we were not in the house but making money on the East side even when on call. But what was one to do with a salary of $70-120 a month with some of us married with kids.
All the jobs weren’t over the river. Some guys made house calls in the city and worked offices too, but it was tricky since an attending might call an office you were working in for something and you could get busted. The one of the best moonlight job I had was when I was a chief . One of the wealthiest Black surgeons, Dr. H, had to go on a medical leave from his practice for several months. His private scrub nurse also gave anesthesia on the side and kind of adopted me as one of her favorite residents.
She asked could I cover for him and could I bring a friend to cover when I couldn’t. My main man ”Cup” was a surgical chief so this was perfect, since it enabled us to alternate coverage. And we were discrete
Dr H had owned a large block of land that the city wanted to redevelop and in the deal they built him a brand new office building right in the middle of the area. Because he had a large farm in the country his office was outfitted with an apartment for the weekdays he spent in the city, it even had a library with a fireplace.
Dr H was the first black surgeon to be Certified by the American Board of Surgery in the United States and was for all intensive purposes filthy rich!
The opportunity we had to work in his office revealed how he achieved this.
His nurse Ms G was also his office manager and confidante and when she asked me to work in his office, I’m certain that she knew I was trustworthy and would treat his patients the same as he.
I arrived promptly at 9 am as I was told and given a crisp white coat and told to relax in the library and they would call me when their first patient was there. Ms G came in to review the chart with me and tell me what I needed to check. The patient was an old Black man dressed in bib overalls, the owner of a coal company who had long standing hypertension and heart failure.
She said she would introduce me and for me to check his BP and listen to his heart as doctor always did. It was always doctor does this or doctor does that.
When I asked him to take off his shirt she whispered don’t bother doctor never does that. I wondered how doctor could hear the heart sounds through his shirt, but I did as directed. After I did my cursory physical, she said that was all I needed to do and they would get some tests. These consisted of a blood count, urinalysis and a chest X-ray. When these were done she informed him they would see him in 4 weeks and he pulled out a big roll of bills and peeled off 5 one hundred dollar bills to pay. My eyes were as big as saucers. Twenty minutes at most and he paid $500, I was seeing why Dr H was rich.
They told me that I had another patient in about an hour so relax, they had made me some hot tea in the library. I saw 2 more patients with nothing really wrong with them and was told to get ready for lunch. It was now about 11am and they served a sit down dinner of baked chops, greens, yams, salad, ice tea and pie. I was in heaven.
They then sent me to my recliner in the library to read or nap until the afternoon patients showed. I saw probably 4 more and was done by 3pm. Ms G gave me 3 one hundred dollar bills and said I had done a superb job.
I was literally flying with joy getting that money for doing nothing. When I got back to the hospital I found “Cup” and said “ Big Boy we have hit the mother lode, you won’t believe what we hummed in on”. In 2 months we made more money than what we would have made at the “G’s” during a year of residency.
Dr H had two children, one in law and one in medicine, and the one in medicine wanted to be a psychiatrist so he had no one to take over his practice. Because Ms G liked us so much she asked if when we finished would we work for doctor. We in good faith didn’t want to have a practice like this after completing the training we had received. It would have been like selling out our values for the money! Sometime I wonder by taking the “ high ground” did we do the right thing since we both never got rich! But I’ll say one thing Dr H knew how to live.
Michigan Trip
Michigan Trip
It was in February 1963 and one of my best buddies asked me to help him drive to Mich. to get his Medical Licenses. His nick-name was “Cup”. We both had to get someone to cover our call two days for the up and back drive.
We left St. Louis at about 6AM and sped up Route 66.
Now “Cup “was by far not the best driver but it was his car and he had the first leg driving. Through Illinois 66 is a four lane limited access highway with flashing lights, at cross roads. I was dozing and he was literally flying. I roused and up ahead I saw a flashing red traffic light. Since he was driving, I really kind of ignored it. As we rapidly approached, I noticed our speed did not diminish. Before I could utter STOP…….ERRRRUUUMMM! Through the intersection we shot. Me, literally soiling my pants. I said hey” big boy” you just ran a red light”, his response, “I thought flashing meant slow down”.
As we continued north it began to snow and there was snow from a previous fall on the road with patches of ice. Approaching the bypass for Springfield there was some road construction and a jog that had been there for a couple of years. (By the way his wife was from Chicago and he had driven this route a dozen or more times). When we approached the jog, I noticed that he nether slowed or appeared to recognize the turn. At the last minute I yelled”there’s your turn”. He hit the brakes and a Semi was approaching from the opposite direction. We did 180 missed the truck running it into a ditch and spun on to the ramp without him either slowing or looking back. I said you damn near killed us. He replied “I’m a drivin mutha-fucka ain’t I” At that point I said “get your ass out from behind the wheel”.
I then drove the remaining way with a stop over in Detroit to spend the night. We checked into a motel and I immediately opened a bottle of Jack Daniels that I had packed and drank damn near the whole bottle to calm my nerves. Cup still bemused by our harrowing experience sipped Jack and reflected on how his cat like reflexes saved us from certain death.
The next morning we drove up to Lansing to complete his licenses requirements and then headed back to St. Louis.
The return leg of our trip was more harrowing then the drive up. There was a blizzard warning for Michigan, Indiana and Illinois. The snow was coming in from Illinois as we set out for our drive home. We planned to use the Indiana Toll Road accessing US 66 in Illinois for our shot down to St. Louis.
Cup drove the Toll Road leg and as we approached the Indiana-Illinois border the snow had increased and was now blowing and the temperature had dropped to about 5 degrees and with the wind visibility was terrible.. The defroster was not keeping the windshield very clear and the washer was spraying icy fluid.
When we stopped to gas up on US 66, we asked the filling station attendant what should we do about the defroster and he suggested putting a piece of cardboard in front of the radiator so it would over heat and blow hotter air.
I took the wheel for the final leg home about 300 miles and 5-6 hours in ideal condition.
What was ahead was hardly ideal. About 50 miles down 66, the road was covered with an icy slush and snow was blowing across the highway making patches of white out. There were hardly any traffic and no trucks. We had to get back to St Louis and being young and fool hardy we decided to press on. There were times when we wanted to pull off to scrape the windshield but could not see the breakdown lane, so I drove on.
The wind was rocking the car but luckily the snow was icey fine and not accumulating, just affecting visibility.
When I negotiated the infamous jog at Springfield we were about 80 miles from home.
Then the condition got even worse, the road started to get slick and darkness was starting to fall. It was about 5 PM and this was February, so we would soon be out of any light.
Cup said what should we do, since there was no where to pull over and we still had those 80 miles to go. So “ I said lets press on, I’m going drive thru this mutha fucker as fast as I can in this shit and if the Lord lets me get back across the Veterans Bridge, the only time I’m going to drive is to an airport..... definitely never in a blizzard ”
And we just flew down the highway for home. I wouldn’t be writing this if things had turned out differently.
You may wonder why we would risk our lives in this situation. We were both Chief Residents at Homer G. Phillips Hospital where time off was restricted and we had taken time off with coverage but none of the staff knew we were gone, so we had to get back to relieve our friends and keep our asses from being A.W.O.L.
It was in February 1963 and one of my best buddies asked me to help him drive to Mich. to get his Medical Licenses. His nick-name was “Cup”. We both had to get someone to cover our call two days for the up and back drive.
We left St. Louis at about 6AM and sped up Route 66.
Now “Cup “was by far not the best driver but it was his car and he had the first leg driving. Through Illinois 66 is a four lane limited access highway with flashing lights, at cross roads. I was dozing and he was literally flying. I roused and up ahead I saw a flashing red traffic light. Since he was driving, I really kind of ignored it. As we rapidly approached, I noticed our speed did not diminish. Before I could utter STOP…….ERRRRUUUMMM! Through the intersection we shot. Me, literally soiling my pants. I said hey” big boy” you just ran a red light”, his response, “I thought flashing meant slow down”.
As we continued north it began to snow and there was snow from a previous fall on the road with patches of ice. Approaching the bypass for Springfield there was some road construction and a jog that had been there for a couple of years. (By the way his wife was from Chicago and he had driven this route a dozen or more times). When we approached the jog, I noticed that he nether slowed or appeared to recognize the turn. At the last minute I yelled”there’s your turn”. He hit the brakes and a Semi was approaching from the opposite direction. We did 180 missed the truck running it into a ditch and spun on to the ramp without him either slowing or looking back. I said you damn near killed us. He replied “I’m a drivin mutha-fucka ain’t I” At that point I said “get your ass out from behind the wheel”.
I then drove the remaining way with a stop over in Detroit to spend the night. We checked into a motel and I immediately opened a bottle of Jack Daniels that I had packed and drank damn near the whole bottle to calm my nerves. Cup still bemused by our harrowing experience sipped Jack and reflected on how his cat like reflexes saved us from certain death.
The next morning we drove up to Lansing to complete his licenses requirements and then headed back to St. Louis.
The return leg of our trip was more harrowing then the drive up. There was a blizzard warning for Michigan, Indiana and Illinois. The snow was coming in from Illinois as we set out for our drive home. We planned to use the Indiana Toll Road accessing US 66 in Illinois for our shot down to St. Louis.
Cup drove the Toll Road leg and as we approached the Indiana-Illinois border the snow had increased and was now blowing and the temperature had dropped to about 5 degrees and with the wind visibility was terrible.. The defroster was not keeping the windshield very clear and the washer was spraying icy fluid.
When we stopped to gas up on US 66, we asked the filling station attendant what should we do about the defroster and he suggested putting a piece of cardboard in front of the radiator so it would over heat and blow hotter air.
I took the wheel for the final leg home about 300 miles and 5-6 hours in ideal condition.
What was ahead was hardly ideal. About 50 miles down 66, the road was covered with an icy slush and snow was blowing across the highway making patches of white out. There were hardly any traffic and no trucks. We had to get back to St Louis and being young and fool hardy we decided to press on. There were times when we wanted to pull off to scrape the windshield but could not see the breakdown lane, so I drove on.
The wind was rocking the car but luckily the snow was icey fine and not accumulating, just affecting visibility.
When I negotiated the infamous jog at Springfield we were about 80 miles from home.
Then the condition got even worse, the road started to get slick and darkness was starting to fall. It was about 5 PM and this was February, so we would soon be out of any light.
Cup said what should we do, since there was no where to pull over and we still had those 80 miles to go. So “ I said lets press on, I’m going drive thru this mutha fucker as fast as I can in this shit and if the Lord lets me get back across the Veterans Bridge, the only time I’m going to drive is to an airport..... definitely never in a blizzard ”
And we just flew down the highway for home. I wouldn’t be writing this if things had turned out differently.
You may wonder why we would risk our lives in this situation. We were both Chief Residents at Homer G. Phillips Hospital where time off was restricted and we had taken time off with coverage but none of the staff knew we were gone, so we had to get back to relieve our friends and keep our asses from being A.W.O.L.
ResidentYear 4 (Chief)
The 4th year as chief was divided into 3 rotations of 4 months each. I chose OB, Gyn and Tumor/ Endocrinology in that order to get the hard stuff out of the way first and coast the last 4 months. Since there were 3 of us, we were on call every 3rd night but could get called in if the chief in house was chicken shit and didn’t want to supervise the 3rd year under him, naturally one of them was and being single he always called you in.
I knew how treacherous Ob could be from my days of acting chief so I made sure I was in the house on my call night.
I also had a rule for my team of residents (my Indians) under me when it came to presenting cases in staffing conference.
Rule #1 When presenting you can give all the information you want; but when I get up to discuss the case you don’t interject anything to dispute what I say.
Rule # 2 If the outcome is bad the chart can some how end up missing!
Rule 3# I will never bail out on you, all cases live and die with me.
My resident’s were loyal to me for always having their back and in the end I will relate how this almost cost me my career.
Some of my most interesting and complicated OB cases occurred in my chief year.
There are 4 or 5 complications that are so horrible that one hopes they never encounter them in their career, 1. Abdominal pregnancy 2. Double footling breech at term 3. Shoulder dystocia
4. Ruptured uterus 5. Complete placenta previa. maybe you don’t want to read about this but these things happened in my training and I feel compelled to share this with the reader. Unfortunately these situations do present themselves and every one I know wishes that they could magically punt the case to someone else. Every one of these cases occurred on my watch in my chief year.
There is a minor point I want to address before I forget; about how OB was managed at IU and at the “G’s”. The regimen for Eclampsia at IU were giving barbiturates for the convulsions and when I got to the “G’s” I was balled out for not knowing that Magnesium sulfate was the preferred treatment. The other thing was patients in labor were followed at IU with rectal exams but at the “G’s “ we routinely did vaginal exams. Once I realized that the IU’s OB department was seriously behind the times in management of patients, I really felt empowered with this new knowledge that trumped my Medical School training.
Since this is a chronicle of my life, I don’t want to dwell on this too much, but you are what you’ve been taught and to realize that the teaching was woefully wrong makes you wonder what other things you were taught weren’t written in stone. And after 5 years in St. Louis I returned to Indianapolis and found they were still routinely doing rectal exams on patients in labor to my astonishment.
One of my horrible cases was an abdominal pregnancy (the baby develops outside the uterus) that was almost at term and went into spontaneous labor. We suspected the problem and were ready with lots of blood and help. Usually the placenta is left in place after the baby is delivered and no attempt is made to remove it. But in her case it started to detach itself from the root of the major intestinal blood supply and blood filled the abdomen immediately. I had my assistant put his hand on the aorta and compress it and I called for Dr Smiley who was on the golf course and in those day no pagers, they could only send some one to bring him to the phone. He was pissed I had called him and said put in some big sponges and towels and over sew them to the bowel and close her up. This we did and she survived and later required about six follow up surgeries for bowel obstruction.
The next case was a previa where the placenta covers the cervix and is in front of the baby and we had to do a C-section in about 10 minutes than take out the uterus in a 20 year old to stop the bleeding.
The last case was a young woman with a shoulder dystocia ( the shoulder won’t come through the birth canal) and in attempting to dislodge it the uterus was ruptured. She subsequently died and because it was being managed by a 3rd year resident, I presented it at the mandatory maternal death conference to discuss the errors due to his inexperience and not intervening sooner.
Let me go back and put this in perspective, the case that I presented was on my watch because the 2 other chiefs asked to be released from their contracts early. One was going to California to practice and the other was going into the military and I was covering OB, GYN and the Tumor/Endo service I was assigned to. I had allowed the 3rd year to manage the OB’s since he would be chief in about 6 weeks, and here is what transpired.
A young married woman with her first pregnancy came in with no prenatal care in active labor. It was determined that she had a large baby and the head was not well down in the pelvis. The resident ordered an x-ray (pelvimetry) which was read as her having adequate space to deliver. After 24 hrs she made little progress and was rested a while and it was felt that she should have pitocin to augment her contractions. What indeed happened is she pushed the baby’s head out and the shoulders got stuck and at that point I was called. In maneuvering to dislodge the shoulders her uterus ruptured and she bled to death before the hemorrhage could be controlled plus we loss the baby.
I presented the case exactly as above. And Dr Monat “ the Great White Father “ said to me in a conference filled with nurses, staff and my fellow residents “who gave you the authority to have Dr B manage the case” and I responded “ you and Dr Smiley when you made me a chief”. Why I am presenting this is to show that even though Dr B will be a chief in 6 weeks his lack of experience may have led to him not intervening with a C-section earlier and I was honest enough to present it in conference.” “ And if you and Dr Smiley allowed me to be chief for 2 years and think now I am incapable of allowing a resident to learn than I quit” and added “ fuck you both” and walked out and went home. My wife was surprised to see me at this early hour since I had just left for the hospital a couple of hours before and she asked why? and I replied “I quit”. She said “ What! Have you lost your mind?” “Probably, but I’m not going to take anymore of Monat’s shit and Smiley didn’t stand up for me”
Now the situation escalated because there were no chiefs to run the service and Smiley and Monat would have to do the chief’s work for about 6 weeks. After about a week of them trying to cover 3 services, I got a call from Frankie saying that Smiley wanted me to come back in and I said not unless he and Monat apologized. The story ends with that apology and I finished my residency at Homer G. Phillips Hospital on that note. I will say that when I needed references both wrote glowing letters on my behalf so things did not end on a bitter note.
Just like in medical school, I was not about to compromise my character, loyalty and values.
I knew how treacherous Ob could be from my days of acting chief so I made sure I was in the house on my call night.
I also had a rule for my team of residents (my Indians) under me when it came to presenting cases in staffing conference.
Rule #1 When presenting you can give all the information you want; but when I get up to discuss the case you don’t interject anything to dispute what I say.
Rule # 2 If the outcome is bad the chart can some how end up missing!
Rule 3# I will never bail out on you, all cases live and die with me.
My resident’s were loyal to me for always having their back and in the end I will relate how this almost cost me my career.
Some of my most interesting and complicated OB cases occurred in my chief year.
There are 4 or 5 complications that are so horrible that one hopes they never encounter them in their career, 1. Abdominal pregnancy 2. Double footling breech at term 3. Shoulder dystocia
4. Ruptured uterus 5. Complete placenta previa. maybe you don’t want to read about this but these things happened in my training and I feel compelled to share this with the reader. Unfortunately these situations do present themselves and every one I know wishes that they could magically punt the case to someone else. Every one of these cases occurred on my watch in my chief year.
There is a minor point I want to address before I forget; about how OB was managed at IU and at the “G’s”. The regimen for Eclampsia at IU were giving barbiturates for the convulsions and when I got to the “G’s” I was balled out for not knowing that Magnesium sulfate was the preferred treatment. The other thing was patients in labor were followed at IU with rectal exams but at the “G’s “ we routinely did vaginal exams. Once I realized that the IU’s OB department was seriously behind the times in management of patients, I really felt empowered with this new knowledge that trumped my Medical School training.
Since this is a chronicle of my life, I don’t want to dwell on this too much, but you are what you’ve been taught and to realize that the teaching was woefully wrong makes you wonder what other things you were taught weren’t written in stone. And after 5 years in St. Louis I returned to Indianapolis and found they were still routinely doing rectal exams on patients in labor to my astonishment.
One of my horrible cases was an abdominal pregnancy (the baby develops outside the uterus) that was almost at term and went into spontaneous labor. We suspected the problem and were ready with lots of blood and help. Usually the placenta is left in place after the baby is delivered and no attempt is made to remove it. But in her case it started to detach itself from the root of the major intestinal blood supply and blood filled the abdomen immediately. I had my assistant put his hand on the aorta and compress it and I called for Dr Smiley who was on the golf course and in those day no pagers, they could only send some one to bring him to the phone. He was pissed I had called him and said put in some big sponges and towels and over sew them to the bowel and close her up. This we did and she survived and later required about six follow up surgeries for bowel obstruction.
The next case was a previa where the placenta covers the cervix and is in front of the baby and we had to do a C-section in about 10 minutes than take out the uterus in a 20 year old to stop the bleeding.
The last case was a young woman with a shoulder dystocia ( the shoulder won’t come through the birth canal) and in attempting to dislodge it the uterus was ruptured. She subsequently died and because it was being managed by a 3rd year resident, I presented it at the mandatory maternal death conference to discuss the errors due to his inexperience and not intervening sooner.
Let me go back and put this in perspective, the case that I presented was on my watch because the 2 other chiefs asked to be released from their contracts early. One was going to California to practice and the other was going into the military and I was covering OB, GYN and the Tumor/Endo service I was assigned to. I had allowed the 3rd year to manage the OB’s since he would be chief in about 6 weeks, and here is what transpired.
A young married woman with her first pregnancy came in with no prenatal care in active labor. It was determined that she had a large baby and the head was not well down in the pelvis. The resident ordered an x-ray (pelvimetry) which was read as her having adequate space to deliver. After 24 hrs she made little progress and was rested a while and it was felt that she should have pitocin to augment her contractions. What indeed happened is she pushed the baby’s head out and the shoulders got stuck and at that point I was called. In maneuvering to dislodge the shoulders her uterus ruptured and she bled to death before the hemorrhage could be controlled plus we loss the baby.
I presented the case exactly as above. And Dr Monat “ the Great White Father “ said to me in a conference filled with nurses, staff and my fellow residents “who gave you the authority to have Dr B manage the case” and I responded “ you and Dr Smiley when you made me a chief”. Why I am presenting this is to show that even though Dr B will be a chief in 6 weeks his lack of experience may have led to him not intervening with a C-section earlier and I was honest enough to present it in conference.” “ And if you and Dr Smiley allowed me to be chief for 2 years and think now I am incapable of allowing a resident to learn than I quit” and added “ fuck you both” and walked out and went home. My wife was surprised to see me at this early hour since I had just left for the hospital a couple of hours before and she asked why? and I replied “I quit”. She said “ What! Have you lost your mind?” “Probably, but I’m not going to take anymore of Monat’s shit and Smiley didn’t stand up for me”
Now the situation escalated because there were no chiefs to run the service and Smiley and Monat would have to do the chief’s work for about 6 weeks. After about a week of them trying to cover 3 services, I got a call from Frankie saying that Smiley wanted me to come back in and I said not unless he and Monat apologized. The story ends with that apology and I finished my residency at Homer G. Phillips Hospital on that note. I will say that when I needed references both wrote glowing letters on my behalf so things did not end on a bitter note.
Just like in medical school, I was not about to compromise my character, loyalty and values.
Resident Year 3
As a 3rd year resident, I was also acting chief rotating with the solo chief. My duties besides making up the night call schedule was doing lots of surgery, running Gyn clinic and taking care of complicated Ob cases.
One day I was sitting at the nurses station reviewing charts and the unit secretary Frankie said 2 police detectives would like to speak to me. I went out from around the counter and they were standing there holding something wrapped in newspaper. They told me that a 15 yr old young girl’s grandmother said “she birthed a baby and throwed it in the trash pit to burn it up”. And they wanted me to check the girl and examine the burned up baby they had recovered from the ashes.
I had the nurse put the girl in a room for a pelvic exam and found that not only had she not been pregnant she was a virgin. I then went out and got the package that they had brought so I could check it before I sent it to the pathologist for an autopsy. Lo and behold the charred body was a burned up rubber monkey. Laughing, I took it to show the detectives who were totally embarrassed at their error. I went back in to question the girl and she stated that her grandmother who was raising her was always accusing her of having sex so she pretended to be pregnant. And since her grandmother was so nosy she threw the monkey in the fire pretending it was a baby and she knew that she would try to find out what was there. She fished out what she thought was a baby and then called the police.
One of the classic stories about Dr Smiley was that he was absent minded when focused on something important and he never wore underwear when he operated so as not to get them soiled with blood, especially during a C-section which happened frequently.
I was again sitting at the desk when Smiley came out of the operating room and approached the nursing station counter which was about waist high. Frankie nudged me to look and I stood up and Smiley had on his long white lab coat and had shed his soiled scrubs and not put on a clean pair and was butt ball naked underneath. He turned and went in his office unaware or his nudity and she and I rolled on the floor with laughter.
Another time we were doing a C-Section and the anesthesiologist who was a little slow asked…… ready? And he meant was Smiley ready for the patient to go to sleep and Smiley thought he meant for him to cut. And cut he did as the patient’s who was strapped down was still able to grab his hand when the scalpel slashed her open. By that time she was asleep and the baby was practically out and Smiley was whistling his usual operatic musical passages.
To see him operate was a thing of beauty, no wasted motion and I learned a technique that no one I ever saw before use. He used a hemostat as a forceps and his reason was……. You always had a clamp at the ready for bleeders. I made that technique a part of how I operated and I would have surgeons criticizing me that it crushed the tissue; but after observing how gentle I could do it they accepted it. And if any one were to see it done they would know that it was something he passed down to me and I passed on to my students.
Of all the specialties in medicine OB is probably the most stressful because you are dealing with two lives in situations than there are long hours of boredom and suddenly moments of sheer panic. Every woman that has a baby bleeds. It can be a few ounces or literally by the bucketful. And if this doesn’t tighten your sphincter nothing will. Decision have to be made instantly and death is always in the room. There are times when you have delivered a baby and stabilized the mother and as you leave the room the nurse says “Doctor I think she’s still bleeding” and before you can regown the patient is in shock. These are times that try your soul and I thrived on the ability to handle these crisis’s, but later in my career the rush was gone and I gave up OB.
You may have heard the phrase “white is right ”which I don’t ascribe to yet this story goes a long way unfortunately in their perception. We had a young girl about 17 who had eclampsia (convulsions in the 3rd trimester of pregnancy) and it was important to know her due date in order to induce her for delivery before further complications killed her or her baby. The only way to judge due date and maturity of the baby back then was by measuring the uterine size and knowing the last menstrual period.
Though this was not precise it gave us a rough idea about survival based on weight at delivery for the baby. The nurses, the intern and 3 or 4 residents had asked her repeatedly if she remembered when she had her last menstrual period. Finally I spent time with her trying to establish roughly when the period was. I asked her was it before Thanksgiving or around Christmas, nothing triggered any date that we could use. We were having staffing rounds and Dr Monat “ The Great White Father “ was conducting them and said we weren’t asking the right way! Then in his imperial way he asked “ young lady when was your last normal menstrual period” to which she replied “ November 20th doctor”. I could have kicked her ass right then for giving the white man an answer that made us look like fools. Once we were out in the hall Monat proceeded to go on and on to us about not knowing how to elicit reliable information which thoroughly pissed me off.
Every year there was always a classic incident that occurred with a wife trying to catch a husband in an affair. One of the Ob residents who was on call was caught at a nurses house by a fellow resident who was trying to date her. He called the wife who was at a party with some other wives and she rushed to the hospital to confront him. When she asked the switchboard operator to page him they called him. He told them to tell her he was in surgery and wait in the lobby, then rushed back to the hospital entering by the back and going up to OB. There he put on a scrub suit and splatter it with blood and went down to the lobby, There he asked what she was doing there before she could explain he chastised her for calling him out of C-section and sent her home. Quick thinking and a friendly switchboard operator saved his ass. It ended up costing him a 6 pack of beer for the operator, well worth it.
The 3rd year was ending and having been acting chief already, I was set for my last year.
One day I was sitting at the nurses station reviewing charts and the unit secretary Frankie said 2 police detectives would like to speak to me. I went out from around the counter and they were standing there holding something wrapped in newspaper. They told me that a 15 yr old young girl’s grandmother said “she birthed a baby and throwed it in the trash pit to burn it up”. And they wanted me to check the girl and examine the burned up baby they had recovered from the ashes.
I had the nurse put the girl in a room for a pelvic exam and found that not only had she not been pregnant she was a virgin. I then went out and got the package that they had brought so I could check it before I sent it to the pathologist for an autopsy. Lo and behold the charred body was a burned up rubber monkey. Laughing, I took it to show the detectives who were totally embarrassed at their error. I went back in to question the girl and she stated that her grandmother who was raising her was always accusing her of having sex so she pretended to be pregnant. And since her grandmother was so nosy she threw the monkey in the fire pretending it was a baby and she knew that she would try to find out what was there. She fished out what she thought was a baby and then called the police.
One of the classic stories about Dr Smiley was that he was absent minded when focused on something important and he never wore underwear when he operated so as not to get them soiled with blood, especially during a C-section which happened frequently.
I was again sitting at the desk when Smiley came out of the operating room and approached the nursing station counter which was about waist high. Frankie nudged me to look and I stood up and Smiley had on his long white lab coat and had shed his soiled scrubs and not put on a clean pair and was butt ball naked underneath. He turned and went in his office unaware or his nudity and she and I rolled on the floor with laughter.
Another time we were doing a C-Section and the anesthesiologist who was a little slow asked…… ready? And he meant was Smiley ready for the patient to go to sleep and Smiley thought he meant for him to cut. And cut he did as the patient’s who was strapped down was still able to grab his hand when the scalpel slashed her open. By that time she was asleep and the baby was practically out and Smiley was whistling his usual operatic musical passages.
To see him operate was a thing of beauty, no wasted motion and I learned a technique that no one I ever saw before use. He used a hemostat as a forceps and his reason was……. You always had a clamp at the ready for bleeders. I made that technique a part of how I operated and I would have surgeons criticizing me that it crushed the tissue; but after observing how gentle I could do it they accepted it. And if any one were to see it done they would know that it was something he passed down to me and I passed on to my students.
Of all the specialties in medicine OB is probably the most stressful because you are dealing with two lives in situations than there are long hours of boredom and suddenly moments of sheer panic. Every woman that has a baby bleeds. It can be a few ounces or literally by the bucketful. And if this doesn’t tighten your sphincter nothing will. Decision have to be made instantly and death is always in the room. There are times when you have delivered a baby and stabilized the mother and as you leave the room the nurse says “Doctor I think she’s still bleeding” and before you can regown the patient is in shock. These are times that try your soul and I thrived on the ability to handle these crisis’s, but later in my career the rush was gone and I gave up OB.
You may have heard the phrase “white is right ”which I don’t ascribe to yet this story goes a long way unfortunately in their perception. We had a young girl about 17 who had eclampsia (convulsions in the 3rd trimester of pregnancy) and it was important to know her due date in order to induce her for delivery before further complications killed her or her baby. The only way to judge due date and maturity of the baby back then was by measuring the uterine size and knowing the last menstrual period.
Though this was not precise it gave us a rough idea about survival based on weight at delivery for the baby. The nurses, the intern and 3 or 4 residents had asked her repeatedly if she remembered when she had her last menstrual period. Finally I spent time with her trying to establish roughly when the period was. I asked her was it before Thanksgiving or around Christmas, nothing triggered any date that we could use. We were having staffing rounds and Dr Monat “ The Great White Father “ was conducting them and said we weren’t asking the right way! Then in his imperial way he asked “ young lady when was your last normal menstrual period” to which she replied “ November 20th doctor”. I could have kicked her ass right then for giving the white man an answer that made us look like fools. Once we were out in the hall Monat proceeded to go on and on to us about not knowing how to elicit reliable information which thoroughly pissed me off.
Every year there was always a classic incident that occurred with a wife trying to catch a husband in an affair. One of the Ob residents who was on call was caught at a nurses house by a fellow resident who was trying to date her. He called the wife who was at a party with some other wives and she rushed to the hospital to confront him. When she asked the switchboard operator to page him they called him. He told them to tell her he was in surgery and wait in the lobby, then rushed back to the hospital entering by the back and going up to OB. There he put on a scrub suit and splatter it with blood and went down to the lobby, There he asked what she was doing there before she could explain he chastised her for calling him out of C-section and sent her home. Quick thinking and a friendly switchboard operator saved his ass. It ended up costing him a 6 pack of beer for the operator, well worth it.
The 3rd year was ending and having been acting chief already, I was set for my last year.
Resident Year 2
The 2nd year was probably the least stressful of the residency, because the year was basically off service rotations with the only clinical work being night call. We had a great rotation in GYN pathology at Wash U and a rotation in anesthesiology that prepared us to cover our OB needs. Later they paid us $15 a case ( max of 4 cases a month) to give anesthesia for emergency cases.
We also were attached to a General Surgery team giving us extensive experience in surgical diagnosis and techniques. But the best part was it gave us a breather from OB which is a killer service with hours of boredom and seconds of sheer panic.
One of our rotations was with the famous authors Masters and Johnson who wrote the seminal work “Human Sexuality.” They
had set up a lab in which prostitutes were wired with electrodes and stimulated to document orgasmic responses. I guess I was fortunate to be at IU where the Kinsey wrote “The Kinsey Report” and Wash U for the above. Both volumes were deemed a break through in understanding human sexuality.
A couple of things happened in this second year that ended up being advantageous to my training, though what occurred was hardly my doing. The first thing was Dr.P a 3rd year had to drop out because he contracted TB as I had in medical school. And the second thing was Dr.F was fired from the program for unprofessional conduct, he punched a nurse in the back of her head! Dr.F was a strange individual, to say the least, who was built like a line backer and carried his books and personal things around in a pillow case. (duh!)
He was unpredictable and had a temper that made everyone scared of him. One day on the elevator a tiny little nurse asked innocently “ Dr F are you married?” and turned to exit. He said “ maybe I am and maybe not, it’s none of your damn business” and hit her in the back of the head with his fist so hard she dropped like a sack of flour. Naturally they had to get rid of this loose canon, and that left the 3rd year level 2 residents short. The chiefs all liked me so they suggested to Smiley and Monat that I rotate with the 3rd year and one of them would back me up. This was great for me but it caused a little jealousy with the other two 2nd year. So I moved my stuff up to the 3rd year call room and did what I was asked.
There is an inside game in medicine in which those who are better than others tend to rise to the top and it kind of gets to be common knowledge around the hospital. There is also a sub group who are klutzes or light as feathers brain wise who are treated like a joke.
We had a standing retort to anyone in this category “ Mr Moke could do that!”
Who was Mr Moke? St. Louis had a world famous zoo and in the 50’s and 60’s Marlin Perkins, before “Wild Kingdom”, was the director of the zoo. One of the things he did to popularize the zoo and increase attendance was do a local Saturday morning TV animal show. And one of the most beloved animals of the children was a chimpanzee named “Mr Moke”, who could dance, skate, play drums, do all kind of human tasks. So we had a saying if one of our colleagues was inept or technically awkward, say they couldn’t tie a particular knot……” Hey, Mr Moke can do that!”
This became a sort of mantra around the hospital.
So by my moving into this unique position as an acting 3rd year among other things, my statue rose among the other residents and I was elected president of the house staff.
During my term, I tried to get our salary increased and hours reduced to no avail. The city was known to write us checks that may not be good on Monday (bounce) when pay day was Friday. So most of us cashed our checks at the Brinks pay truck and then handed over the cash to our wives, keeping what little we had left for cigarettes and to play poker in our on going game in the residents quarters. Missouri had some strange banking laws that there could not be bank branches. So the hospital deposited the hospital’s money from the city into a charter bank called Lindell Trust and because that gave the hospital controller leverage, he became one of the biggest car salesman in St. Louis. I’ll tell his story later.
The entire 2nd year was interesting because of the variety of duties I had and the administrative experience I gained. One bonus was I had a little more time to spend with my family.
But nothing runs as smooth as it seems and one of the problems was a need for more interns. Dr Sinkler died suddenly and my uncle Red became the acting medical director and asked me to visit IU on a recruiting trip. He gave me and another IU graduate $ 100 to go there and bring back some bodies……..we in fact brought back 3.
When the year ended I was now a 3rd year and was formally expected to function with my old buddy ( the drunk arrest guy) as a chief. What made it interesting was that he was single and lived in the hospital right across the hall from my flop room. So when I was on call he was in his room with guests or out moonlighting and when he was on call he was out with guests or moonlighting.
The switch board operators stayed stocked with beer covering his escapades. I in turn just stayed busy covering for him!
We also were attached to a General Surgery team giving us extensive experience in surgical diagnosis and techniques. But the best part was it gave us a breather from OB which is a killer service with hours of boredom and seconds of sheer panic.
One of our rotations was with the famous authors Masters and Johnson who wrote the seminal work “Human Sexuality.” They
had set up a lab in which prostitutes were wired with electrodes and stimulated to document orgasmic responses. I guess I was fortunate to be at IU where the Kinsey wrote “The Kinsey Report” and Wash U for the above. Both volumes were deemed a break through in understanding human sexuality.
A couple of things happened in this second year that ended up being advantageous to my training, though what occurred was hardly my doing. The first thing was Dr.P a 3rd year had to drop out because he contracted TB as I had in medical school. And the second thing was Dr.F was fired from the program for unprofessional conduct, he punched a nurse in the back of her head! Dr.F was a strange individual, to say the least, who was built like a line backer and carried his books and personal things around in a pillow case. (duh!)
He was unpredictable and had a temper that made everyone scared of him. One day on the elevator a tiny little nurse asked innocently “ Dr F are you married?” and turned to exit. He said “ maybe I am and maybe not, it’s none of your damn business” and hit her in the back of the head with his fist so hard she dropped like a sack of flour. Naturally they had to get rid of this loose canon, and that left the 3rd year level 2 residents short. The chiefs all liked me so they suggested to Smiley and Monat that I rotate with the 3rd year and one of them would back me up. This was great for me but it caused a little jealousy with the other two 2nd year. So I moved my stuff up to the 3rd year call room and did what I was asked.
There is an inside game in medicine in which those who are better than others tend to rise to the top and it kind of gets to be common knowledge around the hospital. There is also a sub group who are klutzes or light as feathers brain wise who are treated like a joke.
We had a standing retort to anyone in this category “ Mr Moke could do that!”
Who was Mr Moke? St. Louis had a world famous zoo and in the 50’s and 60’s Marlin Perkins, before “Wild Kingdom”, was the director of the zoo. One of the things he did to popularize the zoo and increase attendance was do a local Saturday morning TV animal show. And one of the most beloved animals of the children was a chimpanzee named “Mr Moke”, who could dance, skate, play drums, do all kind of human tasks. So we had a saying if one of our colleagues was inept or technically awkward, say they couldn’t tie a particular knot……” Hey, Mr Moke can do that!”
This became a sort of mantra around the hospital.
So by my moving into this unique position as an acting 3rd year among other things, my statue rose among the other residents and I was elected president of the house staff.
During my term, I tried to get our salary increased and hours reduced to no avail. The city was known to write us checks that may not be good on Monday (bounce) when pay day was Friday. So most of us cashed our checks at the Brinks pay truck and then handed over the cash to our wives, keeping what little we had left for cigarettes and to play poker in our on going game in the residents quarters. Missouri had some strange banking laws that there could not be bank branches. So the hospital deposited the hospital’s money from the city into a charter bank called Lindell Trust and because that gave the hospital controller leverage, he became one of the biggest car salesman in St. Louis. I’ll tell his story later.
The entire 2nd year was interesting because of the variety of duties I had and the administrative experience I gained. One bonus was I had a little more time to spend with my family.
But nothing runs as smooth as it seems and one of the problems was a need for more interns. Dr Sinkler died suddenly and my uncle Red became the acting medical director and asked me to visit IU on a recruiting trip. He gave me and another IU graduate $ 100 to go there and bring back some bodies……..we in fact brought back 3.
When the year ended I was now a 3rd year and was formally expected to function with my old buddy ( the drunk arrest guy) as a chief. What made it interesting was that he was single and lived in the hospital right across the hall from my flop room. So when I was on call he was in his room with guests or out moonlighting and when he was on call he was out with guests or moonlighting.
The switch board operators stayed stocked with beer covering his escapades. I in turn just stayed busy covering for him!
Resident Year 1
The OB/GYN residency was a prized program sought by many with few accepted. I was both relieved and elated to get in since it gave me a specialty that combined both the medical, obstetrical and surgical challenges I wanted.
The year was divided into 6 months of OB and 6 months of Gyn split into 3 month rotations. The night call was every other night on OB and 2 nights on and 1 off on Gyn. It was a killer year and since we averaged 10 to 15 deliveries a day, you can imagine the number of cases a resident handled, especially complications since we were a high risk center. I figure that I was personally involved in 900 or so deliveries that year and probably 90-100
C-sections. On the Gyn rotation one of the daily duties was being assigned to doing D&C’s on patients that came in the nightly with botched abortions, both criminal or self induced. The chief would round on the patients examining them to be sure they weren’t still pregnant and assign a 1st year resident and an intern to alternately do D&C’s under twilight anesthesia ( Morphine and scopolamine) on the 10 or so patients that were lined up on gurneys every morning like a train waiting in a station. Talk about getting a lot of clinical experience, I did more D&C’s in a month at the “G’s” than some residency programs did in a year. You became proficient over time by the lessons learned in the adage “see one, do one, teach one!”
If nothing else the volume of patients produced clinical material unmatched at other hospitals around the country except for maybe Charity in New Orleans and Cook County in Chicago. Wash U even sent some of their residents to rotate with us though we didn’t reciprocate. And when we had them on our service we busted their sorry asses with work that they weren’t use to.
On Gyn surgery was usually done with a chief paired with a 1st year and the 3rd year paired with the 2nd year and the intern floated between the teams depending on whether there were 1 or 2 interns on the service. By the time your 1st Gyn rotation was over, you pretty much had operated enough that your confidence allowed you to be comfortable making decisions…….because a lot of times the resident above you was no where to be found. (i.e. either moonlighting or in a rendezvous somewhere).
One time I called my chief and told him I had a ruptured ectopic who appeared to be septic and he said he staffed it with Monat and for me to go ahead and explore her. When I opened her up, I immediately knew I had made the wrong diagnosis. There was pus everywhere in the abdomen and it appeared the uterus had been perforated. I was right, she did indeed have an ectopic pregnancy but I had missed the other stuff. I called him back and he was pissed since he would have to give up his motel room and come in.
It was a good thing because we ran into a horrendous case. It turned out that she had an attempt at an abortion and an instrument had passed through her uterus, bowel, liver and diaphragm. This patient eventually died from sepsis through no fault of ours and no one was the wiser since the surgery was done appropriately. What has always stuck in my mind was this young woman had told me a doctor attempted an abortion on her, all be it criminal, he could not be charged when the case went to the district attorney, because what she told me was hearsay on my part when I was questioned by the police.
I had two children and it was really hard trying to have any family life because when I was off I was so tired all I wanted to do was sleep. One time my wife left me baby sitting the two and I fell asleep only to be awaken by what smelled like chili cooking.
What had happened is my two year old had turned on the gas on a stove that had to be lit and gas was escaping into the apartment. Luckily for all of us, the smell awakened me.
Occasionally on weekends we would assemble at some one house or apartment and have an informal party, but I never had to worry about hosting because nobody wanted to come down to the Priitt- Igoe projects.
As I look back, it is really difficult to have a family during a residency because it put a tremendous strain on the relationship.
Your career is paramount and the camaraderie with your fellow residents is a close 2nd and family falls a distant 3rd making it almost impossible to have a successful outcome. Most of the marriages unfortunately did not endure.
The year was divided into 6 months of OB and 6 months of Gyn split into 3 month rotations. The night call was every other night on OB and 2 nights on and 1 off on Gyn. It was a killer year and since we averaged 10 to 15 deliveries a day, you can imagine the number of cases a resident handled, especially complications since we were a high risk center. I figure that I was personally involved in 900 or so deliveries that year and probably 90-100
C-sections. On the Gyn rotation one of the daily duties was being assigned to doing D&C’s on patients that came in the nightly with botched abortions, both criminal or self induced. The chief would round on the patients examining them to be sure they weren’t still pregnant and assign a 1st year resident and an intern to alternately do D&C’s under twilight anesthesia ( Morphine and scopolamine) on the 10 or so patients that were lined up on gurneys every morning like a train waiting in a station. Talk about getting a lot of clinical experience, I did more D&C’s in a month at the “G’s” than some residency programs did in a year. You became proficient over time by the lessons learned in the adage “see one, do one, teach one!”
If nothing else the volume of patients produced clinical material unmatched at other hospitals around the country except for maybe Charity in New Orleans and Cook County in Chicago. Wash U even sent some of their residents to rotate with us though we didn’t reciprocate. And when we had them on our service we busted their sorry asses with work that they weren’t use to.
On Gyn surgery was usually done with a chief paired with a 1st year and the 3rd year paired with the 2nd year and the intern floated between the teams depending on whether there were 1 or 2 interns on the service. By the time your 1st Gyn rotation was over, you pretty much had operated enough that your confidence allowed you to be comfortable making decisions…….because a lot of times the resident above you was no where to be found. (i.e. either moonlighting or in a rendezvous somewhere).
One time I called my chief and told him I had a ruptured ectopic who appeared to be septic and he said he staffed it with Monat and for me to go ahead and explore her. When I opened her up, I immediately knew I had made the wrong diagnosis. There was pus everywhere in the abdomen and it appeared the uterus had been perforated. I was right, she did indeed have an ectopic pregnancy but I had missed the other stuff. I called him back and he was pissed since he would have to give up his motel room and come in.
It was a good thing because we ran into a horrendous case. It turned out that she had an attempt at an abortion and an instrument had passed through her uterus, bowel, liver and diaphragm. This patient eventually died from sepsis through no fault of ours and no one was the wiser since the surgery was done appropriately. What has always stuck in my mind was this young woman had told me a doctor attempted an abortion on her, all be it criminal, he could not be charged when the case went to the district attorney, because what she told me was hearsay on my part when I was questioned by the police.
I had two children and it was really hard trying to have any family life because when I was off I was so tired all I wanted to do was sleep. One time my wife left me baby sitting the two and I fell asleep only to be awaken by what smelled like chili cooking.
What had happened is my two year old had turned on the gas on a stove that had to be lit and gas was escaping into the apartment. Luckily for all of us, the smell awakened me.
Occasionally on weekends we would assemble at some one house or apartment and have an informal party, but I never had to worry about hosting because nobody wanted to come down to the Priitt- Igoe projects.
As I look back, it is really difficult to have a family during a residency because it put a tremendous strain on the relationship.
Your career is paramount and the camaraderie with your fellow residents is a close 2nd and family falls a distant 3rd making it almost impossible to have a successful outcome. Most of the marriages unfortunately did not endure.
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