Having completed my fellowship in Pulmonary Medicine in 1978 and with my newly conferred credentials tucked tightly beneath my arm, I excitedly and confidently ventured into the world of private practice. I purchased a thriving medical practice from a retiring colleague. He was kind enough to stick around for a month and introduce me to his patients assuring them that I was a knowledgeable and competent practitioner in spite of my obvious youth. Most of them were willing to give me a chance although I wonder if it was as much out of curiosity about the first new doctor to come to town in seven years as it was about trusting in my ability.
So I threw myself into a practice that was primarily Internal Medicine with a subspecialty in Pulmonary Disease. It was a joyful journey in those early years developing relationships that I carried with me until my retirement from office practice 32 years later.
LWRH was a grand elderly lady who would always arrive at my office with a flourish. She always wore a magnificent broad brimmed hat, long white gloves, a string of expensive pearls and, of course, what I presumed to be a mink stole. Her magnificent long white tresses pouring down over shoulders surrounded her well attended makeup so obviously intended to mask her aging face. Her clothing was always impeccable and demonstrated significant wealth. Where she accrued this wealth was unknown to me and I wondered if she was truly affluent as she had been a schoolmarm in her younger days. At any rate, she was quite garrulous chatting on with any and all she encountered in the waiting room. She would regale me with stories about her grade school students and their often difficult parents. She would embellish the stories of how she would require the parents to spend a day in school with misbehaving little ones. She felt that this was quite effective. She was highly critical of the evolving educational system. If she were still alive today, the current changes would prove fatal. Sadly, years later, I found out from an acquaintance of hers that my dear patient was alone in the world, that all of her family and friends had passed on. Coming to my office was a highlight in her life as she had no place else to go. I miss her to this day
DM was a 29 yr old woman who suffered a cardiac arrest in the Intensive care unit. She was experiencing a cocaine overdose and developed a lethal cardiac rhythm disturbance. She actually was not a patient of mine. I was assigned the case on rotation for emergency room backup (each doctor on staff was assigned on rotation to care for patients who came into the ER without a family doctor). She arrived in the intensive care unit unconscious and immediately suffered a cardiac arrest. She appeared so white and fragile she looked almost angelic. CPR was immediately initiated and the crash cart brought to the bedside. A multiplicity of intravenous medications were ordered. Cardiac countershock was administered repetitively without initial success. I ordinarily discontinue resuscitation at around a half hour as brain damage approaches near certainty by that time. However, for some mysterious reason, I couldn’t stop. Although I don’t specifically recall, it may have been due to changing heart rhythms during the attempt. But some inner voice drove me forward for two hours, unusual by any standard. Amazingly, she stabilized and came around at that time. She returned to full normal brain function thereafter and was discharged home without any apparent damage. Interestingly, I ran into her at the Walmart several years later. She appeared robustly healthy, remembered me, without apparent mental deficit, holding down a job and completely normal and drug free. Her husband coincidentally happened to be there as well. He was attributing godlike qualities to me. I assured him that it was the real God he needed to express his thanks to. But it did make my day!
These are only two interesting stories from my practice. I will have more in the future.