Текст книги "Dude, Where's my Stethoscope?"
Автор книги: Donovan Gray
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Dude, Where’s My Stethoscope?
and other stories from the ER
By Donovan Gray, M.D.
Copyright © 2012 by Dr. Donovan Gray
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the author.
Printed in Canada
For information about permission to reproduce sections of this book, write to Dr. Donovan Gray:
5grays Publishing
P.O. Box 21106 Charleswood
Winnipeg, MB
R3R 3R2
DISCLAIMER
This narrative is based on real-life events; however, names, ages, genders, diseases, locations and/or dates have been changed in order to protect the privacy of the patients described.
ISBN 9781492818571
Design by Angel Guerra/Archetype
Author photograph by Ruth Bonneville
Illustrations by Dave Whamond
Kudos? Rotten eggs? [email protected]
www.dudewheresmystethoscope.ca
For my four Muses:
Janet (Sustenance)
Ellen (Benevolence)
Kristen (Radiance)
Alanna (Exuberance)
Acknowledgments
I would like to thank all the people who have encouraged and helped me with this project:
Birdielyn Gray, Ólöf & Ken Hardy, Joan Hardy & Tim Edginton, Doug & Michelle Chorney, the Sud family, Joanne Mayer, David & Kathy Lanthier, Colin Leslie, Joe McAllister, Dave Whamond, Prakashen & Jenisa Govender, Gregg & Lana Maidment, Theresa & Jerry Cianflone, Danny & Kelly Murray, Sonny Cochrane & Ardelle Kipling, Jillian Horton, Carol-Ann Veenkamp, Angel Guerra, Simon Burns, Sharon Butala, Brian Goldman and Dave Williamson.
A particular thank-you goes to Arnold Gosewich, without whose expertise and guidance this book would never have successfully navigated the convoluted corridors of the publishing world and made its way into your hands.
And, of course, the biggest thanks of all goes to my wife, Janet, for putting up with my impossible work schedules and off-kilter sense of humour for all these years.
Table of Contents
INTRODUCTION
So What Exactly Made You Want to Become a Doctor?
PART ONE
Learning the Ropes: Med School and the First Urban ER Year
Welcome to the Machine
The Peds Ortho Blues
Even the Cool Kids Can Fall
Dude, Where’s My Stethoscope?
Fear and Loathing at 3,000 Feet
Elementary Questions
Life During Wartime
The Cleanest Boy Ever
The Drug Seeker
Two-for-One Special in the ER
PART TWO
Ma and Pa Kettle: The Rural Years
Ch-ch-ch-ch-changes
Devolution
The Big Smoke
On-Call Gall
It’s Got to Be in Here Somewhere
Semantics
Rocky II (The Sequel)
Alanna’s Birth
Snip, Snip
Last Call
Drug Charades!
Haute Cuisine
“I swear, he wasn’t breathing!”
Rollover Rob (The Adamantium Man)
Drinking Problem
Blood
Paralyzed
Rick’s Tears
Parenting 101
Adventures in Paralysis (The Ventilator Blues)
Koyaanisqatsi (Life Out of Balance)
I, Carnival Duck (Apologies to I, Claudius)
The Simple Math of Medical Errors
Humble Pie
Every Breath You Take
Thank You
Snap!
Tough Call
So Sue Me
3:00 a.m.
Carpool Conundrum
Chiaroscuro (Light and Dark)
Lost in Translation
Patients Say the Darndest Things!
Let’s Get Physicals
Survey Says… .
Prescription for Parenting Skills
Introspect/Apologia
Pssst…Want to Buy Some Medical Products?
Sahara Mouth
Beginner’s Luck
Out-bluffing the Kids
Legerdemain (Sleight of Hand)
Sometimes the Voices Are Real… .
Status Interrupticus
The Call of the Wild (Sorry, Jack!)
Tabula Rasa
Some Patients Are Never Ready
Shotgun Bubba
Disneyfied
Slippage
My Organic Patient
The Wonderful World of Golf
Oops!
Cancer
Betcha Can’t Eat Just One
Curious George
Cerumen
For Better or Worse
Prima Donna
Running the Supermarket Gauntlet
Rust Ring
655: Dead, But Dreaming (Trapped on Jacob’s Ladder)
Time Flies When You’re Having Fun!
PART THREE:
There and Back Again: Return to the Big City
Should I Stay or Should I Go?
“We Put the K in Kwality!”
Where’s Waldo?
Gyne Stretcher at Midnight
Lost Soul
The Cost of Letting Go
Doctor Lockout
I Sure Do Love Ol’ What’s Her Name!
Is There a Doctor on Board?
Fit for Duty
Ode to a Carrot Juice Enema
When Your Compassion Runs Out
Guilt
Time to Go
Piece of Cake
Skunked
For This I Went to Med School? (Quiet, Sméagol!)
So There You Have It, Folks
Biography
INTRODUCTION
So What Exactly Made You Want to Become a Doctor?
When I was seven I wanted to be a major league baseball player when I grew up. Either that or an astronaut. Doctor was nowhere to be found on my list of potential occupations. The following year my latent allergy genes manifested big-time. Almost overnight I became the undisputed poster boy for atopic disease. After a month or two of watching me scratch, sniffle and wheeze, my mother went out and found us a family physician.
Dr. Grenier was a lanky, middle-aged fellow with curly brown hair and an unruly moustache. He seemed to enjoy making house calls. Every Saturday morning he’d visit our modest little home in Chambly, Québec to give me an allergy shot. Although I wasn’t crazy about the injections, I didn’t put up much of a fuss because when he was finished he’d always wink and toss me the empty plastic syringe. If he wasn’t running too far behind schedule he’d accept my mother’s offer of a cup of coffee. While he drank it, he and my dad would sit at the kitchen table and have a spirited debate about whether Rusty Staub and the Montreal Expos would ever manage to climb out of the cellar in the National League East. When the coffee and conversation were finished he’d pack up his mysterious black bag, tell me to be un bon garçon, and zoom off in his neon-yellow Citroën.
As I filled the syringe with cherry Kool-Aid and chased my terrified little brother around the house (time for your needle, Robin! Bwa-ha-ha-ha!), sometimes I’d concede that although being a baseball player or an astronaut would be amazing, being a doctor might be kind of okay, too.
*
The year I turned 11 my father accepted a job offer from the Ministry of Education in Jamaica. That summer our family packed up and moved from Chambly to a suburb just outside of Kingston. Once the initial culture shock subsided I began exploring my new environment. One good thing about the move was that it allowed me the opportunity to finally meet several family friends and relatives whom I had previously only spoken to on the telephone or seen in photographs. My godfather Maurison was one such person. He was my dad’s best friend from back in the Precambrian era when they were both bachelors. Their paths had separated when Maurison immigrated to Germany to study medicine. Upon completion of his studies he returned to Kingston to start a general practice. He could easily have opened his office in an affluent neighbourhood and grown wealthy over time, but that career trajectory held no appeal for him. Instead he set up shop in a desperately poor, underserviced and slightly dangerous part of the city. He worked long hours, coordinated public health outreach programs and allowed his patients to pay whatever they could afford. He didn’t get rich, but he loved his work and the community adored him.
Maurison looked after my various allergy-related afflictions, so over the next few years I ended up spending a lot of time in his office. Since I was his godson, no part of the building was considered out of bounds to me. I’d leaf through his illustrated medical textbooks, count the bones in the artificial skeleton hanging in the storage room, marvel at the distorted cortical homunculus figurine and puzzle over arcane pieces of medical equipment in the various cupboards and drawers. The one I liked best was a device similar to an egg timer that he often carried in one of his lab coat pockets. As far as I could tell, its only function was to ring loudly 30 minutes after it was switched on. One day I asked him what it was for.
“Oh that,” he grinned. “If I’m running late and I’m about to see a patient who tends to ramble, I turn it on before I go in. When it starts ringing I exit under the pretense of having to take an urgent call from the hospital. It’s not exactly kosher, but sometimes that’s the only way I can escape from an examination room!”
“Wow,” I thought, as I left his office that day, “Life-saving work. Cool gear. A dash of subterfuge. Aside from the lousy hours, medicine’s not such a bad gig after all… .”
*
When I was 19 my family moved from Jamaica back to Canada. We arrived in Winnipeg a few weeks before I was scheduled to enter university. My grades were excellent, but I had no clue as to what I wanted to study. Education? English literature? Law? In the midst of my tortuous deliberations I got a letter from Paul, a good friend from my high school in Jamaica. He informed me that my old flame was dating a medical student. What?! That did it. In the blink of an eye my decision was made – I’d take the prerequisite two years of health sciences courses and then apply to the Faculty of Medicine.
The following essays and anecdotes chronicle some of the experiences I’ve had over the course of my medical career. It’s been a fantastic adventure, and it is still unfolding.
*
P.S. Several years after I graduated from med school I discovered my friend got the story all wrong – the fellow my ex had dated had been studying aviation, not medicine. I’m glad Paul didn’t get his facts straight, otherwise right now I’d probably be somewhere up in the stratosphere piloting a 747. And I really hate flying.
PART ONE
Learning the Ropes: Med School
and the First Urban ER Year
Welcome to the Machine
There is nothing more exciting than opening your mailbox and finding a big, fat envelope from the medical school you applied to. Skinny envelope – not so good. Those contain cachectic little one-pagers that may as well begin, “Dear John… .” A bulging envelope, on the other hand, means you’re in like Flynn. I got mine back in the spring of 1983. At the time my parents were both teaching up in northern Manitoba and my brother had already left for school, so I had to do the Snoopy Dance by myself. Didn’t matter. I was still the happiest guy in the world.
Nowadays when I reflect on how cavalierly I approached the entire med school application process I shake my head in disbelief. Not only did I not bother to take any MCAT prep courses, I only left myself enough time to write it once before the application deadline. I elected to apply to a single medical school rather than to the customary five or six. Lastly, I refused to wear a suit to the all-important interview (those were my fractious motorcycling days, and at the time I felt suits were definitely not cool). Despite my best passive-aggressive attempts to sabotage myself, I got in. Then the real fun began.
My first inkling I wasn’t in Kansas anymore came on the first day of term when each of our seven lecturers assigned us roughly 25 pages of reading homework. 175 pages wouldn’t have been that difficult had we been granted a few days to slog through the material, but they all seemed to expect we’d have everything memorized by the next morning. On day two another 100-plus pages were piled on. And so on. By the end of the first week we were drowning in paperwork. But med school was just getting warmed up… .
During the second week we began working in the cadaver dissection lab, or Gross Lab as it was affectionately referred to by our preceptors. I had never even seen a human corpse before, never mind taken a scalpel to one. I was so wigged out by the concept that the night before our first trip to the lab I had a nightmare about working down there alone and turning around to find a cadaver sitting up and staring at me. It was like something straight out of The X-Files. I woke up in a pool of cold sweat.
The next morning 99 nervous newbie first-year medical students filed silently into the lab. As we answered the alphabetical roll call we were assigned six to a body; three down the cadaver’s left side and three down the right. Once we were all in our proper places we were given the order to unzip our respective body bags. When I peeled open our bag, the distasteful tang of formaldehyde leapt into the air. Although no one keeled over and face-planted like those poor saps in the opening credits of Quincy, I have to admit we did all take an involuntary half-step backwards before pausing to inspect our cadaver. Approximately 60, male, tall, thin, left forearm anchor tattoo. Dead. A few seconds passed and no one in our group moved forward. After another several seconds I realized what was going on – no one wanted to be the first to touch the body. We eyed each other nervously. Then the fellow next to me leaned over and raised the cadaver’s wrist. He furrowed his brows and pantomimed checking for a radial pulse.
“So tell me, Mr. Jones,” he said in his deepest baritone, “how long have you been feeling this way?”
We all burst out laughing, picked up our scalpels and got to work.
The Peds Ortho Blues
In the winter of 1985 my classmates and I were turned loose on the unsuspecting wards. At the time we were “baby clerks,” fresh out of two years of sitting in our medical school’s darkened lecture theatres and still struggling to make sense of the countless thousands of pages of physiological facts floating around in our heads. My own clerkship rotation schedule kicked off with a one-month stint on the notoriously busy pediatric orthopedics service. I wasn’t the least bit worried. In fact, I was confident I’d be making more saves than Hippocrates and Grant Fuhr combined.
On the first morning of the rotation I arrived on the ward at 8:30 sharp. A quick search of the area failed to reveal any doctors, so I made inquiries at the nursing station. A harried-looking ward clerk stopped stamping requisitions long enough to inform me the team had finished rounds an hour ago. Since then the house staff had gone down to the ER to see some consults and the surgeon had headed off to the outpatient clinic. I decided to check out the latter.
When I got there I was surprised to find the waiting room already full. Inside there were four rooms. The orthopod saw patients in three of them while the plaster technician applied casts in the fourth. One of the examining room doors was closed. I could hear muffled voices behind it. I walked over to it and was poised to knock when the door suddenly banged open. I was nearly bowled over by a short, 40-ish, balding fellow with thick glasses. He was wearing greens, a lab coat and purple clogs. He thrust his right arm out, shook my hand briskly and said: “Hi, I’m Dr. Stone. You must be my new clerk. Glad to have you aboard! You can just follow me around for now.”
Without further fanfare he rushed into the next room, expertly grabbing the file out of the plastic chart rack beside the door as he went by. Upon entry he pulled a small tape recorder out of one of the pockets of his lab coat and proceeded to dictate a note on the child he had just seen. He paused for a second to introduce himself to the new patient’s parents and shake their hands. He then resumed dictating. When he was finished, he slipped the tape recorder back into his pocket and nodded at the parents. Thus cued, they launched into a description of their child’s problem. Every so often Dr. Stone nodded his head and grunted knowingly. When he figured he had enough to go on he scooted over to the examining table where the little girl was sitting and began twisting her left knee in every possible direction.
“No need to worry,” he declared a short while later. “This problem should correct itself as she grows. I don’t think she’ll require surgery. Please bring her back in six months for a recheck.” He fielded a few questions before doing a nimble 180 and blasting out the door, his trusty tape recorder already in hand.
As this pattern was repeated umpteen times over the course of the next two hours, it became excruciatingly clear to me that I knew next to nothing about real-life pediatric orthopedics. Eventually we took a five-minute break while Dr. Stone went down to the operating room to sort out a glitch in his schedule. When he returned he dispatched me to the plaster room to learn some casting skills. The tech was a jovial fellow with a terminal case of verbal diarrhea. He seemed to be hell-bent on giving me the entire two-year cast tech course in an hour and a half. By the time I left the clinic my head was spinning.
After lunch I returned to the ward. There I was introduced to the rest of the peds ortho team: a cranky intern and an even crankier resident. They both looked as though they hadn’t slept in weeks. Apparently the service was chronically short of house staff, and this month wasn’t going to be any different. The resident divided the ward patients between the intern and me and told us to see them, review their charts and write progress notes. The afternoon passed uneventfully.
At 5:00 p.m. we met to do sign-out rounds. When rounds were completed I picked up my knapsack and walked to the door with a relieved smile on my face. Survived my first day on the wards! Piece of cake!
“Where are you going?” asked the resident.
“Home,” I answered.
“You can’t go home – you’re on call tonight. Didn’t you see the schedule?”
My smile evaporated.
“No, I didn’t. Live and learn, I guess. Who’s on call with me?”
“Well, normally we put you newbs on with an intern or a resident, but right now we’re so short you’re going to have to take call by yourself.”
That didn’t sound too enticing.
“Who’s going to be my backup?”
“Dr. Stone.”
“Oh, that’s good.”
“Not necessarily. He takes call from home, and he doesn’t like to be contacted unless it’s for something really big.”
Oh, crap.
About 10 minutes after they left I was paged to the pediatric ER to see a girl with a broken upper arm. I tried to recollect what the chatty plaster technician had told me earlier about casting a fractured humerus. Something about an army-navy sling with sugar tongs. Or was it sugar buns? Whatever. I doped out a reasonable facsimile and went to town. Putting the contraption on was quite a battle – the child was developmentally delayed and she kept swinging her broken arm all over the place. I could feel the bone fragments grinding against one another whenever she moved. I had to keep reminding myself not to wince. The final product was no Michelangelo, but I was pleased nonetheless.
“Bring her to the fracture clinic next week for a recheck,” I said to her guardians in my most impressive doctor voice.
“Why does she need to come back again so soon?”
“Okay, make it a month.”
Half an hour later I was back to see a teenage wall-puncher with fractured knuckles. I wasn’t sure about the angles the various joints were supposed to be cast in, so I perused the bible – Salter’s textbook – and started slathering plaster on. The end result was a hand cast the size of a boxing glove. It was a miracle the guy could lift his arm off the stretcher.
“It’ll get lighter when it dries,” I chirped optimistically. “Come see us in the fracture clinic in a month.”
“That long?” he said dubiously.
“Okay, make it next week.”
An hour later emerg called me to see a 9-year-old with a fractured femur. Geez, isn’t that the biggest bone in the body? I scurried into the plaster room to find a stoic but uncomfortable little boy waiting for me on a stretcher. His father lunged out of his chair and shook my hand like I was the Messiah.
“I’m so glad you’re here! I’m Mr. Singer and this is my son Jake. The emergency room doctors didn’t want to give him anything more for pain until you assessed him.”
“Oh. Well… .”
“Have you had a chance to look at his x-rays yet? How serious is the break?”
“Er… .”
“Is he going to need surgery? Will you have to operate tonight?”
“Um, well, I’m not actually the surgeon. I’m the medical student.”
His eyes widened and he gasped. He looked horrified.
“When will the surgeon get here?”
“I’m not exactly sure. They tell me he doesn’t come in for every case. How about if I examine your son and then call Dr. Stone to see what he recommends?” Mr. Singer didn’t appear to be too thrilled with that plan. His nostrils flared and his eyebrows began to knit together ominously. “I expect he’ll come in right away for a major case like this, though,” I added hastily.
After the examination I telephoned Dr. Stone. I described the fracture to him and asked if there was anything he wanted me to do before he arrived.
“Oh, I don’t need to come in for that,” he replied. “Just put him in a Thomas splint and admit him to the ward. I’ll look at him in the morning when we do rounds. If you have any trouble with the splint, I’m sure the emerg doc will give you a hand. Good job! See you!”
I returned to the cast room and sheepishly notified Jake’s dad that Dr. Stone would not be coming in after all. He was not the least bit pleased. His displeasure bloomed into near-wrath as he watched me fumble around with the splint, trying to figure out how to apply it correctly. Charlie Chaplin had nothing on me. Eventually the ER doctor noticed my unintentional slapstick and came to my rescue. He also ordered more analgesics for poor Jake.
I hadn’t even started on Jake's admission paperwork when a razor-thin ER nurse with hair an aberrant shade of red stuck her head in the door and yelled in my general direction: “Hey, ortho! You better not go anywhere – an ambulance is coming in Amber Charlie Three with a girl who just jumped out of a third-storey window. They think she might have a broken back!”
A broken back? What am I supposed to do with that?
Sure enough, a minute later the ambulance attendants came bustling in with a teenager on a gurney. They had her trussed up tighter than a Thanksgiving turkey – spine board, cervical collar, sandbags, splints, tape and Velcro. The only part of her that wasn’t immobilized was her mouth, and it worked fine.
“My neck hurts! My left leg is numb! I have to pee!” she squalled at the top of her lungs.
While I was busy wringing my hands and trying not to hyperventilate, the ER doctor examined her in detail. When he was finished he came over to me and said: “She seems to be stable right now. She’s going to need baseline blood work, plus x-rays of her entire spine, pelvis, femurs, ankles and heels. She may also need to go down for a CT scan. Normally I’d look after everything, but I have to do a lumbar puncture on a septic baby and they tell me another ambulance is on its way in with a kid who’s been seizing for 20 minutes. Since this girl’s injuries are primarily orthopedic, I’m going to hand her over to you. Call in your staff guy and maybe even neurosurgery if you need backup.”
If I need backup?
My new acquisition resumed her litany: “My back is sore! My head hurts! Get me off this board!”
I was in the process of trying to decide whether I should have my brain hemorrhage now or later when the Crayola redhead poked her head through the drawn curtains and bellowed: “Hey, ortho! We have two more consults for you! And that teenager you casted earlier is back with his dad – they’re saying his cast is too tight! What the heck kind of cast did you put on his hand, anyway? It looks like a freakin’ beach ball!”
I could feel my eyes starting to bug out. I herky-jerked across the room like a defective marionette, scooped up the nearest telephone receiver and dialled Dr. Stone’s number. He picked up on the third or fourth ring. I could hear some trippy jazz music playing in the background.
“Hello?”
“I NEED HELP NOW!”
He didn’t even ask what the problem was. All he said was, “I’ll be there in 10 minutes.” And he was.
Even the Cool Kids Can Fall
Mark was a crazy friend of mine back in the early years of med school. He was the most chill guy I’d ever met. The ultimate non-conformist, he did whatever he wanted, whenever he wanted to do it.
On the day of med school interviews, Mark was one of the few applicants who chose not to wear a monkey suit. He showed up at the designated time sporting his trademark handlebar moustache, a couple of earrings, a CAT Diesel baseball cap, a leopard-skin muscle T-shirt, jeans and sneakers. He didn’t try to snow the panel with treacle about wanting to save the whales, either. Undoubtedly they found his attitude refreshingly different and he was accepted into medical school.
During our first year Mark continued to be coolness personified. He was a knockout tae kwon do black belt. He dressed like a hard-core punker. He slam-danced to bands like the Dead Kennedys and rode the lightning with Metallica. In addition, he was a bright, energetic and thoroughly likable guy.
Mark would bow to no Moloch. To that end, he quickly worked out a system for not letting medical school take control of his life. This primarily involved studying at home rather than coming to our downtown campus every day for lectures. If he showed up for a lecture and it turned out to be shite he’d usually be able to convince several of us to ditch the class and take off with him. We would invariably end up playing pinball or shooting pool in the student lounge. A couple of times a month our low-life crew would head over to the local watering hole to swill beer and watch strippers. Can you think of a more entertaining way to learn surface anatomy?
Two-thirds of the way into first year, Mark started to run into trouble. His driving became more erratic. His amusing collection of unpaid parking tickets gradually morphed into a serious problem. He found it increasingly difficult to keep up with the demanding med school workload and his grades began to slip. At the end of first year he was told he’d have to write an exam during the summer holidays to determine whether he would need to repeat the year. He hit the books hard and eked out a passing grade.
Unfortunately, things continued to unravel during second year and by the end of it Mark had become visibly disillusioned. He decided to take some time off to travel to the Far East and find himself. The faculty strongly recommended Mark wait until he graduated before embarking upon any long trips, but our turbulent anti-hero had already made up his mind. He bought a backpack and an open-ended ticket and set off for Thailand with high hopes. Nine months later a complete stranger returned.
When Mark got back, the first thing evident was his pierced nose with its diamond stud. But right after that you couldn’t help but notice his eyes. They had become ancient. There was a huge emptiness behind them. When he looked in your direction you got the impression he wasn’t really seeing you, but rather that he was staring right through you into some other world. A bleak, unhappy place.
Who knows what he was seeing? He didn’t talk much, and when he did his voice was toneless and subdued. He would often start a sentence and then stop halfway through it, as though his train of thought had derailed. Occasionally the old spark would briefly reappear and he’d go on a spiel about something in his usual manic fashion, but before long his words would trail off into silence.
What had happened to Mark in Asia? Rumours began to swirl. Had he gotten into some bad drugs? I don’t think so – he had never been into anything heavy prior to the trip. Had mental illness struck? There were whispers of schizophrenia, bipolar disorder, PTSD… . No one but Mark knew the whole story, and he wasn’t telling. Each time we tried to probe deeper to find out what had gone wrong he retreated behind a stony wall of silence.
That September Mark joined the medical class one year behind us to resume his training, but within a few months he had washed out miserably. He took some more time off to regroup and tried again the following year. Things went better that time and he was able to stay afloat long enough to complete the theoretical portion of the curriculum and advance to the dreaded wards.
I don’t know how things are now, but back then the wards of our teaching hospitals were harsh environments where only the strong survived. Every four to eight weeks medical students were tossed into a new subspecialty ward populated with its own unique mixture of complex patients, overworked nurses and terse staff physicians. You had to land on your feet, integrate seamlessly with the new team and quickly learn the ropes. No one was assigned to hold your hand. No one wanted to hear about how sleep-deprived you were. Nobody was even remotely interested in the fact that studying for the mandatory bimonthly exams while working almost every day (in addition to being on call for 24 hours every three days) was nearly impossible. Even well-balanced, mentally healthy students often cracked under the intense pressure. Mark didn’t stand a chance. He went down without a trace.
The last time I saw him was about 20 years ago. I used the phone book to figure out where he was living. It turned out to be his mother’s place in the north end of town. When I telephoned no one picked up, but I really wanted to see him so I took a chance and drove over to the address anyway.
I knocked on the door for nearly five minutes before Mark shambled out. He had gained a lot of weight. His skin was pasty. The cool hair, leather jacket and easy grin were gone, as was his confidence. He looked haunted. It was painfully obvious he was embarrassed about the way things had turned out for him. During the course of the conversation I mentioned the Asia trip a couple of times but it seemed to make him edgy, so I backed off. We sat on his front steps and small-talked about bands, motorcycles and the good old days for awhile.
Needless to say, it was an awkward reunion. I didn’t stay long. On the way home hard tears stung my eyes.
Dude, Where’s My Stethoscope?
By 1989 I had completed my basic four-year MD degree and was more than halfway through an additional three-year residency in family and emergency medicine. That summer I took a break from the crucible of my ER and ICU rotations and travelled to McMaster University in Hamilton, Ontario for a leisurely month of training in dermatology. The specialist to whom I was assigned was a leader in the field, so I got a lot of great hands-on experience.