I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.
With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.
Late one Friday night, I got
I was midway through my internal medicine internship when elderly Mrs. Armstrong was transferred to our service for treatment of a pulmonary embolus (aka PE–a blood clot in the lungs) after a knee fracture repair. I remember thinking, disparagingly, “Surgeons should be able to treat a PE!”
The following morning, our team rounded on our patients and hurriedly wrote orders and notes because Susan, my senior resident, and I would be in clinic all afternoon.
Tired from the long drive, I thought back on my years of marriage. Back pain was the first problem, I think. Then GERD, then migraines, dizziness, TMJ, panic attacks, fibromyalgia. They were all tough, serious problems.
It was a grim night. A man had stumbled, drunk, into the street and been hit by a car. The car drove off, but bystanders called 911. The man was strapped to a bright yellow gurney and brought to the emergency department in an immaculately clean ambulance. He himself, however, was disheveled, soiled and violently combative. He fought. He yelled. He spat. He smelled. He was disgusting.
Everyone deserves good care, thought I. My evaluation found him
Despair tastes sour and rotten on my quivering lips. Dishonor feels heavy and tight on my heaving chest. Dejection means hearing only my own sobs through my covered ears. Disgrace sees only my mistakes, and with blurry, red eyes. Depression smells like sweat and fear, even through a clogged nose.
I was lying in the preop area, waiting to be taken in for abdominal surgery, when a nurse came along with a bag of liquid and hung it from my IV pole.
“What’s that?” I asked.
“It’s an antibiotic,” she replied.
“I’m not scheduled to get an antibiotic,” I said.
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