Medicine For People!
It is the mid-1950s and I am an 11-year-old Navy kid. I am sitting in a laboratory down the street from our quarters watching a Navy medic prepare an enormous needle. The medic extracts the all-metal re-usable newly sharpened and sterilized needle from its test tube, fastens it onto the glass syringe, and tells me he is going to stick it in my arm. Zowie! That gets your attention. But my mother, standing beside me, says everything will be OK. I look at the other side of the room as commanded and concentrate on my arm as hard as I can. I can feel the needle enter my arm. I can stand it. It isn’t as bad as I had imagined. Eureka! I am tough! I will grow up to be a doctor!
It is important to 11-year-old me to be tough, because all my life I have been a shrimp. I’m not growing like I should. Something’s wrong with me and they don’t know what it is. I have too few red blood cells, but why? I don’t weigh much above fifty pounds, and it’s not for lack of trying. I eat everything in sight. My supper consists of several helpings, after which I walk over to the stove, pull off the pans one by one, and finish up what’s left.
My Dad’s a Navy man and we move to a new base every two years. In each new station the doctors have been stumped. Now we are at the Naval Gun Factory in Washington, DC and the Navy doctors are finally getting serious about finding out what is wrong. They put me in the Bethesda Naval Hospital, the children’s ward. It’s July, and ten or twenty children share an un-air-conditioned pediatric pavilion, a sun-drenched room on the tenth floor. Those with severe eczema have their arms splinted at the elbow to prevent them from clawing their skin off. (Topical steroids were just in the process of development, and had reached only the stage of the hydrocortisone creams you can buy today in the drug store without a prescription. Such creams do little for severe eczema.) The two and three year olds have netting stretched over the crib to keep them from climbing out and wandering around the hospital. An occasional child lies in the mist of an oxygen tent. Some of us stick our heads in the tent, too, to visit and enjoy the coolness. I stay six weeks in the hospital. My days are punctuated by innumerable needle punctures, doctors gathering around the bed in a bunch, and hours in the lower-floor hallways on a gurney, looking at the ceiling tiles, waiting my turn for some new kind of x-ray or diagnostic procedure. It is a new world, but I know I will become a doctor. That helps me be more curious that scared.
My mother has perfect faith in the doctors. When the doctors ask her to take me to the National Institutes of Health (NIH) for a confirmatory test and they tell my mother they want to withdraw a large syringe of blood from me, make it radioactive, and put it back in, she says, “Great! When can you start?” Many repeat tests, to see how quickly the radioactivity decays, reveal that my red blood cells are disappearing too quickly from circulation. Usually red blood cells live about 110 days before the spleen removes them for recycling, but mine are disappearing in 30.
Finally a diagnosis – spherocytosis. With this unusual form of anemia, the spleen becomes enlarged and over-enthusiastic about cleaning out old and weary red blood cells, starting in on the fresh ones as well. Today any competent hematologist would require only a few office visits (and no irradiated blood) to figure this out.
Back at Bethesda Naval Hospital, it is time for surgery. My surgeon’s name is Dr Turnipseed, which is hilarious and pleasing to my 11-year-old self. Dr Turnipseed occasionally brings students around to feel my spleen – it is six times normal size. When my parents ask if my condition is serious, Dr Turnipseed replies “Any time I put a scalpel to the skin, it’s serious.” Somehow my parents find this reassuring, and give their blessing for him to wield the knife.
The night before surgery, I sleep like a baby. My folks reassure me I’ve nothing to worry about. Depend upon it, they worry if they have to, and they share it with me. When my brother talks back, they worry he will grow to a life of crime and end up in the penitentiary. If I forget to do a chore, they worry that this will become a habit, one which will destroy my ability make a livelihood in the world, leading to starvation under a bridge somewhere.
The next morning, lying on the gurney, IV needles safely in place, looking at the ceiling tiles outside the surgery, my chief emotion is curiosity. Once through the doors, I come to a stop beneath the largest light I’d ever seen. A kind doctor tells me he’s going to put a mask over my face, and he needs me to count backwards from 100. This I am confident I can do, and start off – 100,99... I see the Lone Ranger gallop across the light and I think that’s pretty funny. The next thing I know, our Episcopal priest is helping several other adults get me off the gurney back into bed, and me with barely any clothes, and I know that’s not right, but nobody seems to mind.
I’m in another pediatric area to recover, one holding four children in a separate sunny room at the end of a surgical ward. My spleen is gone, but I don’t mind. My abdomen is wrapped up like a mummy, and it really doesn’t hurt unless I laugh. Except the slightest thing seems funny, and my family is just a barrel of laughs, trying to cheer me up. Ouch. Don’t even say the name, Dr Turnipseed. Ouch. Ouch.
This isn’t the end of my youthful medical adventures. A couple of weeks later I get a stomach ache that has me writhing in pain, and rushed to the ER and operated on for a bowel obstruction. A few days after surgery Dr Turnipseed comes into my room with a tube, a limp rubber balloon quivering at one end. He explains that the balloon contains mercury to weigh the tube down and drag it through my intestines so they won’t close up again. A military kid, I ask no questions. Dr Turnipseed pushes the balloon through my nose and down my throat. It turns out it isn’t too hard to eat and live with a tube in your nose, just so you know. Believe it or not, a few months later I develop another bowel obstruction, but my mother and I now know the drill, as does the hospital, and I even get my same bed back. I have been cut and poked and prodded. I’ll be among the smallest kids in my school, (and college, and medical school!), but my strength returns and I am whole.
I grow up. I get to medical school. When I arrive, I bring with me a cigar-box full of surgical tools, including a scalpel and blades, that one of the Navy nurses, Mrs Vaughan, gave to me for my future medical career. They are prized possessions and soon I use them on the cadaver I share with three other students.
Most people reach medical school without the kind of experience I had. I am thankful I had that reservoir of understanding when I arrived. I’d experienced first-hand how vulnerable we feel when we are the patient, the one on the sharp end of the needle. I’d experienced the saving comfort of trusting those who cared for me. I’d found strength in patience and acceptance, so I knew that the toughest trials could be borne. Today, we possess technologies that Dr Turnipseed, Nurse Vaughan, and their contemporaries could only dream of. But we can never better their compassion.
As we move into December, we at the clinic wish you and your families a wonderful holiday season.
- Time to review the current recommendations for osteoporosis.
- Multiple Vitamins – Myth or Miracle?
Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.