who suggests something to get it to stick . Now the hard part : what pharmacy would fill liquid morphine on Christmas morning ? That ’ s how we got him into Hospice .
At Suburban , there was a lady pregnant with twins , three ancient wisps of old women who had broken their hips and no longer had the sense to regret it , and several chest pains of various stripes . In the days before statins , we always had CCU and TCU patients ; we had more codes , more coronary artery bypass grafts ( CABG ) and more deaths . The pregnant lady was being watched for hypertension . She was grimly determined to deliver today , her “ 4,000th day ” of pregnancy . She was supposed to be on bedrest but was walking around the room and wondering if labor pains started in the back . I said yes and asked where she hurt – it was low down , bilateral and galvanized me into getting the nurse . The nurse had her sit and lean way forward , which helped a bit . I took her blood pressure , congratulated her on starting her labor , and vamoosed .
Our old ladies had properly elderly names : Beulah ( Dr . Curran ’ s specialty in names ), Lindy and Myrtle . They were all in their big fake-leather chairs and they were all glad to share my Christmas cookies . In 1987 , you did not have to discharge people to nursing homes on Christmas Day , just to make Medicare happy . There were still such things as grace and common sense .
The chest pain folks were all on drips , all scheduled for CABG and all in a terrible mood at being confined and scared , both . Their wives sat next to them and sighed and asked a lot of questions , while the men in the bed glowered at me . They were not in a joshing mood . I was glad of the questions ; surely the men shared them but were unwilling to ask . I was uneasy about their exams , all sounding wet
and one with lots of premature ventricular contractions ( PVCs ). I had a feeling that the cardiologists on call would not rest well today .
I didn ’ t think I would , either . Holiday calls hold a premonition of disaster , by definition . I don ’ t remember the rest of that day – no call list to nudge me – except for multiple pages during dinner , because my family enjoyed listening to my side of the conversation ( it was still novel then ). Dr . Shaw ’ s patient wanted refills of three meds , to be filled that day , soonest . I told him to call back only when he had found an open pharmacy and I did not hear from him again . I thanked my lucky stars for my senior partners , who had taught me how to handle the people who call you with ill-timed , ill-thoughtout requests : make them help . Any reckoning must come only in the calmer light of day .
Years later , on ER call , I admitted a woman with flu , a fever of 103 and pneumonia . She looked like hell . I had never met her and was explaining why she had to stay when she suddenly stopped me . She ’ d recognized my name from the morphine bottle her dad had needed . He had lived about three months , she said , and his old dog had held on till after he was gone . She said , “ We couldn ’ t believe he suddenly gave in on the pain meds and we were so thankful to you .” I told her , “ I credit the dog : he was the clincher .”
This holiday , be sure to credit the dogs , the cats and the people you love : they help get us through many things too awful to describe .
Dr . Barry is an internist and Associate Professor of Medicine ( Gratis Faculty ) at the University of Louisville School of Medicine , currently retired and mulling her next moves .
December 2022 25