Mimosa 11, pages 40-43. "Tales of Adventure and Medical Live, Part VI" by Sharon Farber

There's no particular theme for this issue, but we do seem to be focusing on stories from fandoms near and remote. This leads us inevitably back to Chattanooga, where we started this fanzine about a decade ago. People sometimes ask us if we miss Chattanooga and southern fandom. The answer is yes, but mainly because we no longer get to see friends like Sharon Farber, except at distracting places like a Worldcon. We're happy to report that Sharon has recently become a home-owner, is still writing and selling first-rate science fiction stories, and somehow still has enough time to send us amusing anecdotal fanzine articles like the following.

title illo by Sharon Farber and Teddy Harvia for 'Tales
of Adventure and Medical Live, Part VI' by Sharon Farber

One of the unique aspects of medical education is the way that it takes middle-class sheltered scholars, and introduces them to the sort of people that most of us only get to see on Cops! and America's Most Wanted.

Yes, I'm talking about those sterling citizens who Arlo Guthrie called "mother rapers, father stabbers, father rapers." Doctors in training call them patients.

Since you were supposed to be polite and friendly to all your patients -- or equally dour and snarly to all your patients -- it was best to greet all news of malefaction with a bland expression. (This is where all those years of watching Star Trek paid off. I do a great Spock eyebrow.) And the drug dealers, prostitutes, and felons at least had one advantage over the more humdrum alcoholics, addicts and loiterers -- they had jobs. Sort of.

After finishing my first two weeks of third year on neurology at City Hospital, I went up to the academic hospital for two weeks of (theoretically) more abstruse, academic, and civilized neurology. That first night, about two a.m., I was writing a history and physical. A nurse sat nearby, charting. We could hear some patient mumbling deliriously in the room across from the nurses' station. As we quietly worked, the words became more distinct.

"I didn't do it. Don't arrest me, officer. I didn't kill that man."

I looked up from my note. The nurse looked up from her chart.

"Johnny did it. I didn't do it. Johnny did."

I looked at the nurse. The nurse looked me. The patient kept talking.

We went back to work.

# # #

I was a bit more experienced but no less jaded three years later. Summer was not a good time to be the neurology resident at City Hospital. Not only was it hot and for the most part not air-conditioned, but it was also the time of the heaviest patient load. Maybe people pass out or fall or commit senseless acts of violence during the winter -- but they must do it indoors, where they can recover or die without the inconvenience of hospitalization.

All night, every night, the emergency room hosted meetings of the Knife and Gun Club, and the prevailing theory amongst E.R. docs seemed to be that anyone hit in the head, no matter how trivially, should have the pleasure of a neurology consultation.

(There was also an actual policy, enforced only by the laziest E.R. moonlighters, that no one could be shipped across the street to the mental hospital until cleared by neuro. I remember stumbling down the stairs at three a.m. one might -- this policy was generally remembered about the time all sane individuals are in Stage IV sleep -- and lurching into a cubicle to stare at a completely healthy young woman who smiled hopefully as I entered.

"Why are you here?" I asked.

"My sister has multiple personalities."

"Well, do you?"

She sighed. "No," she said. Very sadly.

I'm still not sure why she was there -- or why I was there, either. But back to the war zone.)

After a while, you got to be a connoisseur of certain forms of violence. Bricks, for instance. I've never met a victim of a brick who didn't need neurosurgery to raise a depressed skull fracture. Krazy Kat, take notice.

When I inherited the City Hospital service, there was a patient about to go home following neurosurgery for the aftereffects of a brick. As he was thanking the doctors, he kept interjecting, "I'm gonna get me the guy that got me."

After hearing it a half-dozen times, I began to get perturbed. Senseless acts of violence, after all, meant more work for me. "Sir," I said, "we've been pretty good to you here, and I think you owe us something. So if you feel that you absolutely must get the guy that got you, please don't get him in the head. Or if you do, then please do it outside
the city limits."

The interns nodded their approval -- let County hospital suffer for once -- but my chief resident was less than pleased.

(My attitude was not unique. One of the junior attendings told me that there used to be a motorcycle shop across the street from the neuro ICU. One day two rival biker factions decided to have a shootout. This physician, then a first-year resident, claimed that he and his fellows stood at the ICU window, ignoring the hail of bullets and shouting, "Don't aim for the head!")

Baseball bats were a more popular weapon than bricks, but less effective. They infrequently seemed to do substantial permanent neurologic damage, but they could transform a face into a swollen mess that reminded me of an over-ripe plum.

I remember treating an unfortunate woman, so treated by her boyfriend. Then I went to the next E.R. cubicle to check a guy who claimed he'd just walked in the door and said, "Hi honey, I'm home," when his wife, evidently fed up by years of abuse, shot him in the forehead. With the incredible blind dumb luck that will never strike anyone nice, the bullet entered at the forehead, skimmed along the skull, and flew out near the ear, doing no real damage whatsoever.

The boyfriend with the bat wandered by the room, recognized the gunshot victim, and shouted, "Hey, man!" They were brothers.

Obviously a family that knew how to treat women.

# # #

Relatives of felons who live and die by the sword must not have day jobs, because they tend to call real late at night and ask questions like, "How's he doing?" and "How could this happen to such a nice boy?" The mother of a lad shot in a drug war always called at midnight for a progress report.

"I don't think he's going to get any better, ma'am. There's been a lot of brain damage," I explained, not for the first time.

"Oh," she said. Long silence. "Can he have a transplant?"

"No, sorry."

Another long, disappointed silence. Then, "Why does God allow this to happen?"

I'm not at my best after midnight. Especially when confronted with questions of theology.

# # #

Another patient with relatives who just couldn't understand his bad luck was Floyd (name changed to protect the guilty). "It's just not fair. Why did it happen to him?" an aunt once asked. Floyd taught me a lot, primarily about bad luck (his, not mine), but also about the transformation of a casual comment into legend.

On the neurology service, Floyd was not often called by name. He was usually referred to as "Farber's Folly."

This occurred when I was chief resident at Regional Hospital, the successor to City. They let second-year residents be neurology chief at Regional, on the theory that the incredibly myopic are perfectly capable of leading the blind.

The on-call neurologist was asked to see Floyd, who was in status epilepticus (having continuous seizures) on a surgery ward. His abdominal infection had resulted in brain abscesses. I came by the next day and found him still having seizures. (It turned out they hadn't quite followed our resident's suggestions, and once we did, he was seizure free. Too later for me, though.)

"You have to take him on your service," the surgery chief resident said.

"No way; he's a disaster," I said. Floyd was paraplegic, with every complication of his paralysis that you could imagine. His legs had been amputated because of pressure sores. His bladder was surgically diverted to drain into his intestines, due to kidney damage from frequent urinary tract infections. He had constant infections, this latest one leading to brain damage. He was obviously doomed to be a chronic player, to languish indefinitely -- and troublingly -- on whichever service he landed.

"Please. We can't handle him," replied the surgeon. And then he begged, an awesome sight, as surgeons are, of course, God. "Look," he finally said. "Just take him till he stops seizing, and then we'll take him back."

That sounded logical. He was in status epilepticus, after all, and this way I wouldn't have to walk over to the surgery ward all the time. "You'll take him back?"

"I promise."

So, Floyd came to our ward. A couple days later, when I tried to return him, the surgeon refused. It seemed that the very next day after we made our bargain, surgery chief residents had rotated, and the new chief felt no need to honor his predecessor's promises. If Zeus promises rain, need Odin comply?

At which point I had a sinking feeling, only made worse when my team began to refer to Floyd as "Farber's Folly."

(I must state that I was extremely angry. I had thought chiefs from the same institution should behave honorably toward each other. After all, my treaty with the medicine chief at Regional -- a chief from a different program entirely, and thus with every reason to engage in mutual hostilities and patient dumping -- resulted in a year of relative peace between the medicine and neurology services. Of course, creation of The Farber-Hopkins Treaty Determining Disposition of Alcoholics From the Emergency Room had been facilitated by my possessing an embarrassing Polaroid of the medicine chief in the Ugly Tie Contest during our internship.)

Poor Floyd took root upon our floor. He was now unable to communicate or comprehend but was very skilled at pulling out central lines with his teeth. (Kids, don't try this at home.) He also became famous throughout the hospital for chewing a hole in his flotation bed, something we had not thought possible.

One day we were outside his room, on rounds, when the med rotator spoke up.

"Floyd was my patient two years ago, at City." And he told us the whole sad story.

Floyd had evidently become paraplegic after being shot by the police while committing a felony. When our rotator first met him, before all the complications of poorly managed paralysis set in, Floyd had been vigorous and active.

"In fact, he even tried to rob a drugstore in his wheelchair but got caught."

At which point someone -- and memory is imperfect, but I strongly believe it was me -- said, "Well, maybe we should get him a lawyer. Because if the drugstore'd had proper wheelchair access, he might have succeeded." We snickered a bit and got on with rounds.

Eventually I rotated away and forgot all about Floyd, except that the next neuro chief complained how long it took to get him home.

The next year, as I was sitting on one of the medical wards at Regional, I glanced up at the chart rack and saw a familiar name.

"Floyd?"

A medical intern said, "You know him?" and eagerly filled me in. It seemed that the family had soon given up trying to care for him, and no nursing home would take him, as he was tragic, unpleasant, indigent, and a lot of work. So they dropped Floyd off at the hospital, where he appeared to be a permanent fixture. In order to prevent nurses from quitting, he was rotated to a different medicine ward every six weeks.

"And you know the amazing part of it?" asked the intern, leaning in confidentially. "He got shot by the cops, robbing something, and then went out and tried to rob a grocery store in his wheelchair. And when they caught him, he sued the store for improper wheelchair access!"

The intern beamed as my jaw dropped in astonishment -- not at the story, but because my joke about Floyd had become incorporated into his official medical history, and my wiseass comment would forever after skew his physicians' opinions.

Oops.

I mean, if a joke is going to be that good, shouldn't you at least get paid for it?

Title illustration by Sharon Farber and Teddy Harvia
All other illustrations by Teddy Harvia