It was assumed that I would be taking my residency under Steven A Shepard D.O., and until I got my residency diploma, I never knew that he was not certified. Instead the diploma was signed by Cliff Foster D.O. an E.N.T. surgeon. Now this carries a whole lot of suspicion to me, and always has. Like I mentioned in a previous post, I announced early in my internship that I was going to go into a residency in surgery. Recall, I had been doing tonsillectomies since college, and even in med school under the tutelage of Jake Lutz D.O. who was professor of E.N.T., at PCO. He never got to scuba dive and we had long talks about it since it is quite related to his speciality. He allowed me to do one side of a tonsillectomy on occasion. I was definitely a chosen one. So, Cliff Foster D.O. stated that to do tonsillectomies at Bay View, I would have to pay him $6000 and stay for a year after my internship or residency to learn. Richard Shepard D.O. said that for me to get permission to do C-sections I would have to pay that same amount and stay for that period. This was just too fishy for me. As soon as Paul Weiss D.O. a recent graduate from residency at Bay View, found that I was moonlighting, he came to me and said, “Look, I know you are moonlighting, and I know you want to do surgery, so, I’ll tell you what….you find the case, make the diagnosis and admit it under my service, then you can do the surgery but I get to charge for it”. Such a deal. I was in heaven. I did my first appendectomy as an intern, my first ectopic pregnancy, my first D&C for bleeding and my first hernia repair…as an intern. I catheterized my first ureter with a cystoscope, as an intern. I’m sure there were others, but I don’t remember them. I did keep track, I was required to keep a surgical log of every procedure I did, and I did this thru my entire career. One time, I was doing a hernia repair for Paul and he came running into the room after I had made the incision and started the dissection. “Which side are you operating”? The left side, the one you told me. “Ahh….it’s the right side. Close that and do the right side and I’ll tell him he had two hernias”. I only followed orders.
Paul had taken a fellowship course in Japan under a surgeon by the name of Nakayama (sp) and then considered himself an expert in gastric surgery. For all I knew at that time, he may well have been. He told of scrubbing in surgery in Japan and not using gloves in the surgery. Nakayama had invented a clamp for bisecting the stomach. Readers will have to understand that in 1964 ulcers and stomach disorders were much more common than today in 2011. I got plenty of experience in gastric surgery from this. The first gastroscope was a long swordlike instrument that had a light at the end. It was rigid all but the last 8 inches which could be flexed slightly about 15 degrees, and then by rotating and flexing, one could see quite a lot, but not all, of the stomach. At least, one could see the distal stomach where most of the pathology lay. The biggest problem was that the proceedure was done under ether anesthesia. Oi. One can not imagine trying to do endoscopy with ether anesthesia. Much worse was bronchoscopy, where we had a hollow tube with a small…REally small bulb, lit by 2 D cells from a Welch-Allen power supply. No lenses and one could only see the right mainstem bronchus and a very small portion of the left as it went off at an angle. One would have to get his eye right up to the tube (scope) and his nose right into the ether. I’ve seen, and experienced myself, more than one doc heaving mightily and actually vomiting from the effects of the ether. We tried not to do many bronchoscopies.
About a year later Paul came in with the cure all for ulcer disease. I don’t remember much about how it came about but I do remember the device…it was a fairly thick rubber balloon shaped literally like a stomach…and we would pass this into a patients stomach thru the mouth and then hook it up to a machine which caused the balloon to inflate to a size determined by a pressure and then the mucosa of the stomach was frozen. It was left in this manner for a time and then withdrawn. Naturally, it was done under anesthesia. I don’t recall following any patients after this, and I am really sorry for this because my curiosity is still aroused about it and I don’t recall any deaths. We experienced quite a few perforated ulcers which was a fun diagnosis and did quite a few gastrectomies in that time era. The stomach is a marvelous organ.
THEN…comes my hero. I hope I can remember to write about him in “important people in my life”, and certainly more than I’ll write here. Ray Rooney D.O., came onto the staff I believe late in my first year as a resident. He was Irish and young. Brash and coarse. Smoked a cigar and talked like he didn’t have a fear in the world. He became my hero. His chief was Ed LaChance D.O. from Michigan and I’m sorry but I forget Ed’s chief, though I was fortunate enough to meet him and know him briefly. Such a wonderful line of surgeons they were. I was proud to be a part of it. I still am. Ray had taken a year with a neurosurgeon in ?Sweden..Leksell, who had developed a bone rongeur for assistance in laminectomies for ruptured intervertebral discs. Ray was a genius at orthopedics. He could reduce a fracture in less time than it took to occur in the first place. He showed me that an intrafractureline delivery of local anesthesia was so far superior than general anesthesia for a child in a fracture reduction. I can’t begin to say all that I learned from him. It was almost a magical “meant to be” association right from the beginning.
Gerald Haldeman D.O. was senior resident ahead of me and was ex-military. He had very short cropped blonde hair and smoked, and spoke with a raspy voice. He was ok, but he liked to throw his weight around…weight of seniority. Ah, I tolerated it, annoyance that it was. He died of malignancy at too early an age.
4/12/12 Frustrating to not have Charles’ help. 😉 I wrote yesterday of an uncommon experience and now see I’m having to repeat it because of ? Whoknows? Yes, I spelled that right!!
I was an intern at Bay View Hospital in 1963. I slept in the intern quarters on the 4th floor of the old building which was a mansion that was converted into a hospital. It really was quite magnificent, elevator and all. Anyway, my bed in the quarters was right at the top of the stairway from the 3rd floor up and at the bottom it faced the labor room. So, in order to get sleep…I delivered a number of babies. One night I was called down and delivered a baby from a woman who was given Thalidomide for nausea of pregnancy. This was well before sonograms were done. On rare occasion one would need an x-ray pelvimetry to know that the baby was not too big to pass vaginally, but like I said, it was a rare need. The delivery was not unusual but the baby, when I had it in my hands…had polydactyly in both hands and feet. She was a little girl and I almost cried. Trying to imagine what future this child had, much less what the poor parents would have to go thru. I did not follow her after she left the hospital. It was too emotional for me and it was among the first victims of thalidomide that thankfully now is not permitted. I saw just recently where it was being recommended for use, and I obviously have shut that out because I just couldn’t imagine it being accepted for Anything. For the sake of science and perhaps philosophy, I’m attaching an image.