Dude, Where's My Stethoscope? Read online

  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 D
r. 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.