writing from
Scars Publications

Audio/Video chapbooks cc&d magazine Down in the Dirt magazine books

 

...from “I’ve Got To Write a Book!”
by Ira Wiggins

Doctor’s Days and Nights (part 2)



One afternoon, in the middle of office hours, I was called to make an emergency visit to a near-by farmhouse. The very obese, single, 19-year old daughter was having severe abdominal cramps and the parents feared appendicitis. Examination revealed a full-term pregnancy with the patient in very active labor. Parents and daughter all expressed complete amazement at the diagnosis, but when I delivered the baby in the hospital that evening they seemed convinced. My amusement, Or course, had to be discretely concealed.

*****

Parents of another unmarried teenage daughter, when told the girl was pregnant, said they could in no way understand how this could have happened. On the girl’s second pre-natal visit the mother explained to me that they had finally realized the daughter’s condition had been caused by “that scratching on the back screen door.” The daughter agreed. I hare always regretted not having pushed for a further explanation.

*****

On the other extreme was the lady who visited the office to have her pregnancy cared for. She was very obese, had missed six menstrual periods, had gone through a period of morning nausea and was now feeling daily fetal movement. All very routine. The exam was normal in all respects. The protuberant women was firm and about the size of a six months pregnancy. I was unable to hear any fetal heart tones, but this is not unusual, especially in an obese individual. At subsequent visits I was still unable to detect movement or heart tones, but was reassured by her statement that the baby was “very active”. When she was eight months “pregnant” it finally dawned on me: false pregnancy (pseudocyesis). I had never previously seen a case. Diplomacy seemed in order. She was astounded and disbelieving and I had to produce x-ray evidence in order to convince her. In general practice there is, for sure, “never a dull moment”. I would try not to get caught napping again.

*****

“When will the baby be born, doctor?” I dreaded the question, whether it was asked months before the due date, on the due date, after the due date or while the patient was in labor.

“When the apple is ripe it will fall,” was never truly a very satisfying answer to the expectant parents, however true. I learned by experience to give a date much later than I actually figured, for nothing is more disheartening to the distended mother-to-be than to pass the date and daily be bombarded by friends and neighbors with, “Haven’t you gone in yet?” Made her feel like a slackard or traitor to the cause.

Even when the patient was in active labor, “How much longer will it be?” was seldom easy to answer with any amount of accuracy. My greatest miscalculation was with the patient in the labor room of the hospital whom I informed would not have her baby for another two or three hours. Ten minutes later I was visiting another patient on the floor below when the maternity nurse called on the phone to tell me that my patient had strained mightily and, with one great labor pain, had precipitously expelled a screaming, healthy, normal baby into the bed. I think I omitted sending a bill in that case. Of course it was much more common to spend hour upon hour in the delivery room fully scrubbed, gowned, masked and gloved waiting patiently for a stubborn kid to show its red, wrinkled, mucous-streaked and outraged face to the light of day.

After one such delivery, as I was sewing up the episiotomy under local anesthesia, the mother asked, “By the way, doctor, what do you recommend as the best means of conception?” Oh, how I yearned to reply, “Why, the same old-fashioned way, of course.” But I wasn’t sure she was in the mood for that type of humor, so, after a sly grin at the bemused nurse (she had to know I was grinning under my surgical mask), I gently explained to her some of the available choices for contraception. At that point I was sure she was more interested in means of contraception than in means of conception. I relayed the story to the editor of the Journal of the American Medical Association and it was published under their joke column “Tonics&Sedatives” - the only time I ever had anything of mine published in a medical journal.

*****

Delivering babies can be exciting.

Mrs. K had been under my regular care during her third pregnancy. At 2:00 a.m. her husband made a frantic phone call to me.

“Come out right away, doctor. My wife is on the toilet, in labor and won’t get up. I’m afraid she is going to have the baby in the toilet!”

(Oh, well, no one had ever promised me that life would be easy.)

“Look, you must pick her up bodily, put her in your car and head for the hospital. I’ll start for the hospital and meet you there.”

“I can’t, doctor. The car battery is dead and there is no one to stay here with the kids.”


“I’ll be right out,” I said.

They lived on the edge of town and I was there in record time to find the situation exactly as he had described it. The cervix was completely dilated and she was going to have a baby in a hurry. He and I carried her quickly out and laid her in the back seat of my car. It was summer and she was bare except for the thin nightie. She and I took off at a high rate of speed, headed for the hospital in Jonesdale five miles away. Visualizing the prospective mess in the back seat of my car I repeatedly admonished her, “Don’t push! Breath hard! Pant! Hold your legs together!” Fortunately no one was on the main street of Hillsdale in those early morning hours as I sped down it, ignoring stop lights and leaning on the horn. Her bare feet, I noted, were pressed against the rear window. What a sight if anyone should be looking out their window. The hospital personnel heard us coming and, as we pulled up to the back door next to the emergency room, three attendants met us with a stretcher-cart. We all went directly to the delivery room and, without waiting, were presented with a lovely baby girl. Oh, sure, it had the usual wrinkled, florid, mucous-streaked face, but then aren’t all normal babies lovely miracles?

*****

The phone awakened me from a deep sleep. With my one open eye I looked toward the alarm clock: 1:00 a.m. The voice was that of a widow lady living in a small village six miles away,

“Could you please come out to see me, doctor?”

“What seems to be the trouble, Mrs. ————-?”

“I just can’t sleep, doctor.”

“Is there anything special keeping you awake? Pain or discomfort of any kind?”

“No, nothing like that. I just can’t seem to get to sleep.”

I had been awakened and made a home call earlier that night and choked back the desire to retort, “Good Lord, woman, I’m having the same trouble!” She had already tried a warm bath and drinking warn milk without benefit. Perhaps there was something of importance she wasn’t telling me. I went.

There was nothing of significance. All she needed was a mild sedative. This deserves a higher than average fee, I thought, at least something to discourage the frequent repetition of such requests. She must have read my mind, for about that time she sweetly informed me that all of her medical bills were to be sent to the County Welfare Dept. No wonder she did not hesitate to call me in the middle of the night. I suspect she got more sleep the remainder of the night than I did.

I did occasionally decline a home call at night with what I hoped was appropriate advice and “call me back if the situation worsens or if you are still having a problem in the morning.” All too often, however, I found that I would then lie awake waiting for the phone to ring and worrying whether the patient really should have been seen. Suppose they were having early symptoms of appendicitis - stroke - heart-attack? Night can be a fear-filled time for patients. And, yes, for doctors too.

*****

Another great fear, in those days, for both patient and doctor was the dreaded “infantile paralysis” - polio. I’m sure it often did not occur to the patient but you may be sure the dread thought always entered the mind of the physician when he examined a patient with headache, aching and fever. And who, with flu, did not have these symptoms? Polio vaccine was not yet on the horizon and treatment of the illness was notoriously ineffective, despite the well-known Sister Kenny treatment with hot packs, gentle massage and mild exercises. Patients frequently ended up with withered and paralyzed or partially paralyzed limbs. Death is not rare. No one knew why some recovered uneventfully and others were seriously affected. The “iron lung” was used in cases of respiratory paralysis. It was estimated that for every case of polio diagnosed by a doctor there were nine other cases so mild as to go undiagnosed, having been shrugged off by the patient as a cold or mild case of the flu.

One of my polio cases was a 24-year old ex-g.i. who had met and married a full-blooded eskimo girl when he was on army duty in the Aleutians. His wife had been under my care for measles, and, having no natural immunity to the disease, had to be hospitalized with extreme fever, hallucinations and a guarded prognosis. She eventually made a full recovery. Later, when he contracted polio he was immediately admitted to the nearby university hospital for care. Unfortunately his was a severe case with serious paralysis and muscle wasting below the waist.

When he was discharged from the hospital a few weeks later his lower limbs were essentially useless and he was told frankly that he would never be able to use them. He would require help getting in and out of bed and, in short, would be an invalid the rest of his life. Frank had other ideas. He set out to be self-sufficient. One day when I called to see him I found him in their tiny apartment practicing getting in and out of bed without help. They had out the mattress on the floor and, with great effort, he was able to get in and out of that low bed with no help. Over a period of weeks he persisted until he was able to do the same with a somewhat higher bed and finally he could single-handedly scale the dizzying heights of a standard size bed. He was innovative in strategically placing chairs where they were most useful to him in his efforts.

Meanwhile he had been able to get in and out of his wheelchair only by the direct lifting efforts of his watchful, patient, loving wife. He made this his next goal - to get in and out of the wheelchair without assistance. By now he had improved the functioning of his legs and had been able to tease a little motion out of the few remaining, wasted muscles. He thrilled with each new ability and spent hours in practicing. His wife was now working in order to sustain the family and he felt he must be able to care for his own needs in her absence.

On his follow-up visits to the University hospital the doctors there were interested in trying to determine what muscles he was using to obtain leg movements. The usual ones were useless.

Two years after the onset of his illness he obtained employment in a factory in Jonesville doing hand work while seated in his wheelchair. A great achievement? You bet! I suspect that most men in his situation would have surrendered to the official prognosis, entered a state of inanimate depression and spent the rest of their lives as public wards, reading, watching TV and justly receiving the sympathy of all. My hat is off to Frank and I feel sorry for those in a similar situation who have not been blessed with his supply of spunk.

*****

We had purchased a new car and were justly proud of it. Prior to making the three-hour trip for a week-end visit to Betty’s parents she and I spent half a day washing and simonizing it. A truly gleaming marvel. As we drove we were smug, happy and self-satisfied. The practice was getting well-established and all was well with the world. The last three miles was on gravel road and it was just past dark, Betty was driving. Simultaneously struck by the urge, Betty and I leaned toward each other and sweetly kissed on the lips. As if to say, “Hey, snap out of it, you two,” an overhanging branch from a bush on the right side of the road slapped sharply on the windshield. As we snapped to attention we appeared to be heading for the ditch on the right side of the road. Fortunately we were going only about 33 miles per hour. Betty reflexly jerked the wheel to the left. The rear wheels tried to pass the car on the right as we side-slipped on the gravel surface and headed for the opposite ditch. She turned the wheel to the right and the car pointed down the road but its movement was still toward the ditch, we struck a ridge at the top of the slope and started over sideways. The slope was less than 45 degrees and the adjacent field was only about six feet below the level of the road, The car made crunching sounds; some glass canning jars and my house-call bag in the rear seat (in case my in-laws needed any attention) made a loud clatter as we rolled completely over and came to rest on the wheels.

“Wow! Are you alright?”

“Yes. Are you?”

“I think so. Help me find my glasses.”

“Wait. Let’s check ourselves first.”

“I’m all okay.”

“Me too. Just sore in spots is all.”

“What a kiss!”

The car was dented, scratched and with cracked windows but after be straightened a fender away from the tire it was obviously in driveable condition.

The slope was too steep to drive back up. In the darkness we could see a farm house about 200 yards back from the road on the same side. Thinking to find a gate we drove toward the house but were stopped by a fence. Following the fence away from the road we soon came to a lane which led into an old orchard behind the farmer’s house. Once in the orchard we could not find the exit to the road. There were lights in the house so I climbed the fence and knocked on the back door. The elderly man who answered the door appeared a bit feeble and apparently lived alone.

“Yes?”

“I’m sorry to bother you but we have our car in your orchard and don’t know how to get it out and back to the road.”

He appeared a bit confused - as if in a dream.

“Welllllll... The gate is right there at the south-east corner.”

“Thank you, sir.” I strode rapidly back to the car before he could recover, found the gate and drove back on the road.

I wonder if the man ever found out how we got into his orchard.

The next day we were stiff and sore and had a few bruises. We have washed and waxed our cars many times since then, but never again have we ever simonized one. - makes ‘em too slippery.

*****



Scars Publications


Copyright of written pieces remain with the author, who has allowed it to be shown through Scars Publications and Design.Web site © Scars Publications and Design. All rights reserved. No material may be reprinted without express permission from the author.




Problems with this page? Then deal with it...