It helps to clean your room from time to time ; I found a trove of old call lists ( as well as Christmas present lists I apparently never wrote thank you notes for ) in a shoebox , while looking for an address . I could instantly summon up the people , so I sat in my room and remembered them . Doctors don ’ t forget patients easily : we certainly forget names , but often not clinical presentations or events . We just push “ play ” and watch the mental reel spool onward .
It was a special day , because I ’ d never taken call on Christmas ‘ til my first year in practice , 1987 . Our truly jerky medicine resident when I was an LMC-3 at General Hospital had wanted us to take call . But I thought , “ No way bro , you are getting paid , and I am still a student .” I wanted a Christmas free of duty . At Grady , we had a longstanding deal with the non-Christians versus the rest of us : they wanted New Year ’ s off , so we mostly got at least 48 hours for Christmas , and I was lucky three years running . I could come home to the bosom of my family and lie on my mother ’ s sofa and read to my heart ’ s content .
However , as the newbie that year it was my turn to see all the folks for Drs . Shaw , Curran , Speevack , Henry and myself , at Norton , Suburban , Baptist , Jewish and even Our Lady of Peace , to read EKGs and see the consults . It was cold and rainy and still early , an 0430 start in the CCU at Norton , when the day began to ramp up . The ER had a man in DTs with chest pain with anterior T wave changes that were not responding to nitroglycerin . His mutterings were indecipherable and unhappy . We switched to IV nitro and got him to take some propranolol with what he thought was rum . He had the beginnings of a cold chest sweat and we gave him IV valium and more O2 and his color pinked up ; I wrote orders with
24 LOUISVILLE MEDICINE
A SECOND OPINION
This space is for our physician members to speak their minds freely on both medical or non-medical issues of the day and respond to the opinions of others . The GLMS Editorial Board reserves the right to choose what will be published . Please note that the views expressed in A Second Opinion or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine .
Christmas Calls
by MARY BARRY , MD
generous amounts of valium and left him to the experts . I do not think you ever forget watching someone who was bluish turn pinkish , especially when you are already dreading giving bad news to a family on Christmas .
Everybody else had pneumonia or sepsis , or was postop and fine . The surgeons were rounding , we all waved cheerily . My Amish guy ’ s family was encamped in the waiting room , asleep on the floor . I spoke quietly to them and then tiptoed out , headed to Jewish to see a newly paraplegic young man who had hopes of extubation soon . It curdled my soul to see him so , to imagine his imprisonment in a tennis player ’ s body . I had private nightmares about him getting extubated and then failing , and not being able to call for help . I spoke to the nurses about this worry , but told him , “ You got athletic lungs , even if they do root for UK .” He smirked ; UK had beaten UofL by a single point that month . I taught him about his duty to panic if not breathing well once extubated : panic the only correct answer here . He gave me a thumbs-up and then another finger and we laughed . I thought , he ’ s gonna be ok in his new life .
Next stop was Baptist . They had a great spread normally in the doctors ’ lounge . I stashed a bunch of goodies to distribute and headed up to see a poor old man with bone mets from prostate cancer . He was widowed and lonely and scared of pain medicine . To understand that “ getting hooked ” does not matter if your prognosis is poor , one must first accept that mortality is closer than it used to be : that ’ s the oft-unspoken roadblock . So I told him that if his days were numbered , at least he would get a lot more done in them , if he hurt less . He could see grandkids , watch basketball and get home to his dog . “ Liquid morphine , laxatives and dog bones – that ’ s the recipe – otherwise , you are stuck in the hospital , no dog .” His face cleared when he realized he could simply go home and not have to take shots . Sometimes , you just have to be the third person