 Well, the theme for this issue seems to be
Fan History Through the Years. Given that, you might think we've got our work cut out
for us in attempting to even tenuously connect the latest installment of Sharon
Farber's 'Medical Life' series with that theme, but never fear -- we're up to it!
Actually, the connection is a pretty easy one -- the history of fandom is literally
filled with many, many stories of and by fan humorists. There are a lot of
currently-active fan humorists whose exploits will someday fill pages of fanhistories
yet to be written. The writer of the following is one of those fan humorists who we
think will be remembered.
 Every week, the Journal of the
American Medical Association publishes a brief vignette by some unknown, unsung
doctor. These pages usually feature heartwarming accounts of patients who find love,
or satori, or just some bittersweet meaning in tragedy. Every week I read these and
every week, as I wipe a tear from my eye (but hey, I cry easy. Sneak up on me at a
con some day, say "Lassie, you came home!" and watch me snuffle.) -- every week I
wonder, "Hey, why don't I write one of these? Why don't I
get my fifteen minutes of fame?"Well, because I just don't have any
stories like that -- when one of my patients dies, it's either fast and unexpected,
with no chance for reconciliation or meaningful dialogue. Or else it is very very
slow, first stripping away the patient's dignity bit by bit, while the family watches
the deterioration and suffers its consequences.And as for heart-warming -- well, the
warmest my patients' hearts get is after cardiac bypass, when the surgeon brings them
back up to body temperature.But if I were to try for one of those
vignettes, here are my tales that come closest to their requirements -- only, I think
they all fall a little short. Like maybe a mile.I. THE GRATEFUL PATIENT Some doctors have patients who bring
them produce or home-baked goods; not me. (Of course, I'm not in primary care; my mom
had a large population of folks from Chinatown whom she had cured of tuberculosis.
They never failed to bring tasty treats on their yearly check-ups. I miss the pork
buns, but I can do without the seaweed cookies, thank you.)During my residency I saved a guy's
life -- well, okay, I only diagnosed his heart attack, then hustled him off to the
cardiac care unit for the cardiologists to save his life. The man was a raspberry
farmer, and despite it being harvest season, and despite the none-too-subtle way I
kept saying how much I love raspberries, I didn't even get a thank you when he left
the hospital. Patients tended to thank the attendings who came by once a day and
signed the chart, not the residents who sat up all night sweating blood over them.When I was a fourth-year medical
student on my medicine subinternship, I did have a grateful patient. She had been
admitted with myxedema -- severe hypothyroidism, with her body just about shut down.
Her past history suggested she had a problem with depression, but we didn't know she
was actually a manic depressive until we brought her metabolism back into the normal
range, precipitating a manic episode.I made the unfortunate discovery one
morning when I came into her room. "I'm so glad to see you," she said, "you've been
so good to me. Here is a chocolate bar for you."She handed me a Snickers, and then
held out a piece of lined paper covered with childish handwriting."..and here's a letter for you from
God."God said lots of nice things about me.
But I was surprised by how rotten he spelled.II. THE HAPPY DEMISE I guess I've had one patient die
happily. It was during my internship. I'd just finished my rotation in the intensive
care unit and two of my patients there, who had been hanging on for no apparent reason
for weeks, died a couple days after I transferred to the wards. Then when this old
man died too, so that I had, in a way, lost three in one day, people started calling
me the Angel of Death.That's the sort of nickname that can
really make your day.Anyway, we admitted an ancient man with
pneumonia and bacteremia -- bacteria in the blood. That carried an 85% mortality in
his age group, and as I was leaving the next evening, having been up the usual 36
hours or so, I heard the operator announce a code (cardiac arrest/resuscitation). "I
bet that's my guy," I thought, and scurried back to his room. Big mistake.The resident running the code had just
taken the Advanced Life Support course, and was anxious to try out his new
accreditation. He ran through the asystole (no heartbeat, as opposed to V-fig -- bad
heartbeat) protocol several times, until they ran out of calcium and epinephrine on
the crash cart. So he told them to go get another crash cart. (Which reminds me of
the unfortunate time, a year later at City Hospital, that I was running my second code
in as many days. "Epi," I said. "There is none," said the nurse accusatorially.
"You used it up yesterday!" I had seen her going through the crash cart after the
previous day's code and, silly me, had thought she might have been restocking it.)
Because the resident was having such
fun, the code went on for at least an hour, although it was apparent to the rest of us
that it was pretty useless. I felt I ought to stick around, so someone who the family
knew could give them the news. At long last, while there was still some calcium left
somewhere in the hospital, the resident gave up and declared the code over. I went to
the waiting room to tell the relatives how sorry I was."Oh, don't worry about it," they said,
and told me how the code had begun. It seemed that the old man had been sleeping
quietly, when suddenly he sat bolt upright in bed and stared off into space."I'm satisfied," he said. "I'm
satisfied. I'M SAT-IS-FIED!" And promptly dropped dead.And if he was satisfied, well, so were
they.III. LOVE WINS OUT 
This happened to one of my roommates
during her third-year rotation as the medical student on cardiothoracic surgery. She
was caring for a woman with rheumatic heart disease, in for a valve job. The husband
was in the room constantly, and a more concerned, loving spouse one seldom saw. The
couple had six children -- surprisingly, she had got through the pregnancies and
deliveries without the complications one would have expected from her severe heart
disease. Thus my friend was a bit surprised when she discovered they the couple were
not actually married."Wait a minute," said my friend. "You
two have lived together for fifteen years, you have kids, you clearly love each other.
Why don't you get married?"They both looked sad. "Well, you see,"
answered the patient, "when I got the rheumatic fever as a little girl, my doctor took
me aside and said, 'Honey, you can never get married.'"When my friend explained that the
doctor had really just meant that she should not have children, and that there was
absolutely no reason they could not marry, there was joy all around.IV. THE FAMILY REUNION During my stint as chief resident at
Regional Hospital (the successor to City Hospital, which was shut down), an elderly
alcoholic was admitted to my service, after being found semiconscious on the sidewalk
outside a bar. He had alcoholic dementia, old strokes, and new pneumonia. He could
tell us his name -- let's call him John Jones -- but no other information. There are
an awful lot of Joneses in the St. Louis phone book.In desperation, I finally called the
only address we had on the chart: the bar he'd been found outside. To my surprise,
they knew him well -- in fact, he lived in their back room, but they didn't want him
back.He recovered from the pneumonia
quickly, but he had no family, no money, and the city nursing home had got in some
kind of government trouble, and was no longer accepting patients. It looked like we
would be stuck with him indefinitely. This depressed us, as the whole ward was
filling up with similar unplaceable patients.(In fact, if an intern managed to place
a patient in a nursing home or otherwise discharge someone, he was awarded my official
Superman pen, to use until the next intern or student earned it. After a prodigious
feat of servicedom, the entire team would start chanting "The pen! The pen!" until I
took it from the pocket of the last hero, and presented it formally to the new one.
But then, I also used to round wearing a button reading 'Doom Patrol'. We were a bit
loose there.)Anyway, it looked as if Mr. Jones would
be another permanent fixture in the neuro ward. Then, one night, my resident admitted
another man named Jones, with alcohol withdrawal seizures. The only empty bed was in
the elderly Jones' room, and despite the sensible policy against two patients with the
same name occupying the same room, my resident had no choice.As the stretcher entered the room, the
young drunk looked over at the old drunk."Daddy!" he cried.He refused to take him home
too. All illustrations by Jeanne Gomoll |
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