In Remembrance of P&S
I have been given the opportunity to say a few words about my experience at the College of Physicians and Surgeons. This covers the dates of September 1957 to June 1961. The events during that period totally changed my life. To put this in perspective, up to that time I had lived my life in rural Minnesota. I had lived in a town of about 7,000 people and had always been in the majority. In that town, there had been two families of Jewish ancestry and no people of color. I was a WASP, i.e. White-Anglo-Saxon-Protestant. My college experience at Carleton had been somewhat different but not much. I was married a week before heading out for medical school and New York City. That marriage has thrived for more than 59 years. I like to tell people that I do not know whether I learned more from New York City or from medical school. Both were EXCITING!
Once my wife and I had arrived in NYC, we were looking for an apartment. This process taught me early on that I was now part of the minority. We weren’t even second but third. This was one of the most valuable lessons I thoroughly learned in those four years. Working with African-Americans, Puerto Ricans in the various NYC hospitals, especially Bellevue, certainly changed how I would work with patients in the minority once I returned to Minnesota.
The first Saturday in my medical experience was mind boggling! I attended my first Clinical Pathological Conference. I still remember the case. The patient had reportedly been part of a family that had a history of hereditary hemorrhagic telangiectasia in some of its members. The patient had presented coughing up large amounts of blood. He was deteriorating rapidly and developed a cardiac arrest. At that point, the professor/physician taking care of him medically performed mouth-to-mouth resuscitation but to no avail and the patient expired. I do not recall what the professor discussing the case gave as the most likely diagnosis, but I do remember that the pathological diagnosis was cavitary tuberculosis. That was the source of the hemorrhage. Fortunately, there was adequate treatment for tuberculosis at that time.
Another case taught us the importance of the careful recording of an accurate history. This involved a young mother who had brought her infant to Babies Hospital. The diagnosis of scurvy was quickly made. However, it was not obvious why the infant had this condition. The mother and her child were living in a nice apartment in the back of Carnegie Hall. She also reported giving the child orange juice almost daily. Not until the fourth medical student questioned her did we learn that the mother, to be certain that the orange juice was sterile, boiled the juice before giving it to her infant.
Throughout the last two years at P&S, I had the privilege of spending several months at Bellevue. The place was incredibly bad in terms of bricks and mortar. There was almost total lack of privacy with the huge wards and only sheets hung like curtains between the beds. It was not unusual for patients to die during the night, only to be discovered when they didn’t sit up and eat their breakfast. However, the teaching that took place at Bellevue made it all worthwhile. Drs. Cournand and Richards were amazing. They had won their Nobel Prize in 1956 having been the first to successfully catheterize the heart. However, the most impressive thing for me was when their patients would come to the Bellevue clinic to allow medical students to listen to their damaged heart valves. They came because Dr. Cournand or Richards had asked them to come. I still remember the comment made by Dr. Richards who stated that the most important part of the examination by a stethoscope was the fact that it got the doctor within 12 inches of the patient. I still recall many of the cases I saw at Bellevue 57 years ago.
We had some outstanding professors who were very interested in teaching. Several examples stood me in good stead years later. I don’t recall the name of the orthopedic surgical professor who told us about a patient he had had who was playing handball and crashed into the wall, causing a hip fracture. However, the two ends of the fractured bone had wedged together and the patient had walked into his office with a broken hip. I had use for that knowledge more than once in the future, making the diagnosis of a hip fracture in a patient able to walk into my office.
While I could go on with other stories involving patients and what they taught me, I think the point has been made. However, there is still the life-changing experience of living in NYC. We were there when Nikita Khrushchev attended a session at the United Nations and pounded his shoe on his desk in exasperation. Why would he do this? Apparently, he had expected to be able to announce that Russia had a man in space, but instead the so-called astronaut had landed in the ocean off the coast of Vladivostok. Another memorable event was during the last quarter of my medical school experience when I was on the obstetric rotation. We medical students were in competition for delivering babies with the mid-wives who were also in training. I stepped out on to the south-facing porch looking down the Hudson River. At the end of the Hudson there were many fireboats spewing their firehoses into the air. Many other boats were running their sirens full-blast and any boat that would get out from the docks was doing so to welcome Sir Winston Churchill who was arriving on the Onassis yacht.