Tales From Doctors: How Long Have They Had This Condition?

I get a call in the emergency room. It’s some guy with a Southern accent. He tells me he’s sheriff from somewhere in Texas and that his brother-in-law is coming into the hospital soon. He says his brother-in-law is a deaf-mute and has a painful kidney stone. He tells me he’s had them before, and he asks me to treat him right. He explains that he is calling me because the guy’s wife has just had twins.

“You’ve got to tell him that,” he says.

I said great, and I tell the nurses, and they get all excited that we’re going to give this guy such great news. A few minutes later, in rolls this guy doubled over in pain, moaning and moaning. I ask him if he has a kidney stone, and he nods. And one of the nurses tells him, “Your wife just had twins.” He smiles and looks real happy.

We give him a pain medication, Demerol, and he begins to feel better. Then we tell him we are going to get a pyelogram on him--a test to run a dye through him and see what is going on with his kidneys. He writes out a note that he is allergic to the dye, so we can’t do it. Of course, because this guy is a deaf-mute whose wife has had twins, we can’t do enough for him. We treat him like royalty.

We admit him to the urology service and put him on the ward, but we notice after a little while that every time his pain medication is about due, he orders it right away. This goes on for a couple of days, and we all get very suspicious of this guy. We try to locate his brother-in-law, the sheriff, but we can’t find him. We do some checking and discover our deaf-mute is an escapee from the local mental hospital. He’s also a drug addict. He’d concocted this idea to get into our hospital and get drugs. He also isn’t a deaf-mute. Turns out, he’s the “sheriff.”

I operated on an adolescent boy who had a brain tumor. I was able to get it all out and the operation went well. During his recovery in the hospital, he was a little weak on his right side, so he kept his right arm kind of folded against his chest. And because the tumor was on the left side of the brain, he also had a speech impediment.

He was a kind of bizarre boy to begin with, and he loved walking around the hospital corridor with no head bandage, so his head was shaved like a ball and had this long row of stitches. A weird sight. He would always say to me that he wanted to be a neurosurgeon.

While he was in the hospital, I had another patient come in from a foreign country, a young girl. Her family had come over with her, and on the night they arrived, I went to her room to talk with her and her family. When I got there, I found they’d suddenly fled the hospital. All of them were gone without a trace. I couldn’t figure out what had happened.

I looked around and finally found this young boy. He had on a white (physician’s) coat; a stethoscope was hanging out of one pocket; he had no bandage on his head; and his arm was all bent up. It turned out that he had gone to the foreign girl’s room and told the family he was a neurosurgical resident who’d come to work up their child.

We located the family and persuaded them to come back. I still see that young boy. Every time I do, we laugh about it.

The one thing I kept telling myself was that this was a 70-year-old man with a gunshot wound. I didn’t dwell on the fact that he also happened to be the President of the United States. The emergency room was controlled chaos. It was almost deafening at times. I knew I would have to operate when we couldn’t stop his chest bleeding, and I could tell by the rich, red color of the blood seeping out of his chest that it came from an artery. I knew that if we kept waiting, he’d bleed to death.

I told him I’d have to operate, and he said for me to do whatever I had to do. We wheeled him up to the operating room. As we were ready to put him to sleep, he made his famous remark, “I hope all you guys are Republicans.” It was another surgeon, a liberal Democrat, who said, “Today we’re all Republicans, Mr. President.”

After we opened him up, I kept probing around in his left lung for the bullet. It wasn’t that I had to take it out for any medical reason. In fact, we seldom ever remove a bullet from a chest wound because it isn’t necessary. But I knew the whole world was watching, and if I didn’t get that bullet out, there would be a million questions and headlines saying the President’s doctors left the bullet in the President. Also, none of us knew at that time what had happened. I thought the bullet might be needed for evidence, and I wasn’t about to leave it in there and then have to go back in later and take it out.

I kept squeezing his lung tissue, but I couldn’t locate it. I had to order another chest X-ray. We did it with a portable machine right there in the operating room. The film came back a few minutes later, and I could see the bullet in the shadow of his heart, not more than an inch from his aorta. It was that close.

I began looking in the lung near where the X-ray told me it would be. President Reagan’s lung felt like that of a much younger man. As I kept looking, I wondered if I would find it. Then I finally put my fingers on something hard; it was the bullet. It had been flattened like a dime from where it had glanced off the limousine before entering the President’s chest.

I squeezed it out with my fingers, and there was a Secret Service man right there with an envelope. He took the bullet and sealed it and wrote something on the envelope. That was a real good moment.

A patient came for an office visit, a middle-aged man whose daughter had a fatal form of cancer. He told me he felt a lump on himself that was similar to the one his daughter had noticed on herself when she had discovered her cancer.

Feeling this lump really heightened the anxiety and depression the man was already feeling. I examined him and knew the lump was benign, but I also knew that the man was feeling all of these terrible emotions. I really felt that I should take some time with him and talk things through.

But I also had other patients waiting to see me.

A lot of nasty things are said about doctors because we are always late--that we’re rude and arrogant because we keep patients waiting. I’m very sensitive to that and try to run on time, but it’s not always possible. Sometimes I see a patient like this man for what I think is going to be a routine call, and I find out it isn’t routine. Am I supposed to tell him his time is up when I know he’s suffering and wants to talk? If I did that, I’d be called uncaring and insensitive to his needs.

So I did talk with him because I thought I could help him, and maybe the patients who had to wait awhile were angry with me.

After their baby was born, the wife didn’t want the boy circumcised but the husband did. Unless people have religious convictions about it, we don’t recommend circumcisions for babies anymore, so I spoke to the husband about it once when I got him alone.

“Why do you want your son circumcised?” I asked.

He said, “Isn’t it true that circumcised men are more intelligent than uncircumcised men?”

I couldn’t laugh out loud, because he was serious. So I said, “No, that’s not true. How could a little piece of skin on the end of the penis have anything to do with intelligence?”

“I read it somewhere,” he said.

I asked him where.

“In the National Enquirer,” he said.

From the book: MD: Doctors Talk About Themselves by John Pekkanen. Copyright 1988 by John Pekkanen. Reprinted by permission of the publisher, Delacorte Press.