"To Lift up my Life a Trifle"
Copyright 1996-2006, by Bruce A. Stafford, DO
I have borrowed a phrase of this essay from E.B. White's beautiful
children's book "
Acknowledgements
First of all this work is dedicated to the memory of Bob Jones, executive director of the Oklahoma Osteopathic Association. Bob suffered a stroke during my third year of medical school and was forced to turn over the active reigns of directorship. I was privileged to attend Bob's funeral in my fourth year as he finally succumb to the devastating insult to his body. Bob, of all people worked the hardest to help me attain my goal of becoming a physician. Bob, your memory will live on in all my patients.
Furthermore, I want to acknowledge the support of my wife Mary. She has
stayed close by and has never wavered in her support of what to some might be
considered simply a manifestation of mid life crisis. She continues to give me
her undying devotion as I seek to attain my calling. She reminded me the other
day that it has been right at 10 years since I got that big envelope inviting
me to come to
The constant support and friendship of my lab partners, now doctors L and B
is also recognized, and these dear doctors remain among my dearest friends to
this day.
I cannot forget Drs L and P, my elbow mates in lecture. All of these dear
ladies were, like me late bloomers.
Preface
This little fellow is about 30 minutes old. This is a picture taken while still in residency. When looking at the big picture I realize that few people have had the chance to deliver a baby. I just wish I could do that today but the lawyers and the smell of money have changed all that.
I know who I am and what I am. I know where I've been, and where I'm going.
Bruce A. Stafford- 1996
What follows is the narrative of my life's journey beginning in early childhood, to moves around the country to find a place to put down roots, to finding that one true calling in life. It is also about much self-doubt and the terrible feeling that what one really wants in life may be just out of reach. It is also the story of how sheer tenacity can break through barriers normally impervious to all but those of the highest intelligence or social standing, or just plain lucky. It is also the story of my interaction with professors, doctors, classmates, and patients during my years of medical school training and into solo practice as a family medicine physician. It is not meant to contain any profound religious revelation, but in fact may seem to be quite secular. It is simply prose from the heart and the truth of what it has taken to get me to where I am in life. I have used this material at times to help me vent frustration and hopefully, to paint a picture for others to use as a guide in their search for a path through life. Beware; there is some underlying cynicism that is generated by encounters with the dregs of society. Hopefully, for my sake, the cynicism will be short lived. The joy of meeting wonderful people in the clinic and in the hospital continues to override any doubt I might have that I am where I truly belong. This story is about why I wanted to become a doctor and how I managed to achieve that goal.
The reader should clearly understand this. Few of the major events that have transpired are the result solely of my own doing. That is, I fully acknowledge the positive force of others in helping me pull off what most people would agree is a pretty exciting life. I also understand that, while the engineer in me yearns for proof of an all-guiding universal force, I will have to concede that the events of my life seem to point to just that, without proof. I also fully acknowledge my many failures and that those failures are my own doing and usually the result of not paying heed to the positive (and sometimes negative) example of others.
Let the reader be aware that buried within this text is a picture of the personalities I have encountered along the way. These personalities are unique, as is mine. I cherish the chance to borrow pieces of those personalities that I feel will benefit me and simply overlook those pieces that won't. After all, isn't this just a part of the process of maturing and gaining wisdom?
With these caveats out of the way begin this story with an open mind.
The Chance to Live a Dream
Somebody said that it couldn't be
done,
But he with a chuckle replied,
That "maybe it couldn't" but he would be one,
Who wouldn't say so till he'd tried.
Edgar Guest
Have you ever dreamed about doing, or being something that you felt was beyond your capability or your "station in life?" I found out much later in life, that what I once thought I could never become because I was not "worthy" was in fact an attainable goal. This is not the story of an over 40 white male in mid-life crisis nor of one who has finally triumphed over overwhelming odds or against some superior force. Nor is it yet another "how to" book. Finally, it is not about one who has suddenly "found religion." In fact, it is the story of an average person who is not particularly religious (though very spiritual) at all, and of how a chance encounter with someone can change one's entire outlook on life and redirect them toward a new goal. It is also the story of how fate can intervene, and provide the impetus for that change. This is the story of how I, instead of retiring like most sane people, decided to become a doctor and realized that goal at the age of 52.
Consider the following true story - a veteran engineer working for a large telecom company (making lots of money I might add) is given the offer of a lifetime. The story goes something like this - "We, the company, will allow you to just turn your back and leave for a large sum of money. We will also award you $10,000 toward a retraining program of your choice. Furthermore, in light of your long and distinguished service (which we will promptly forget once you leave this place), we will put you on a special transition program, which will let you retire when you reach your 50th birthday (unfortunately with a considerable penalty). During this special transition we will pay your health insurance just as though you still worked here." Now I ask you dear reader - would you take the offer just described? This is the dilemma I found myself in during the late fall of 1995. Consider this as well. I had just the month before completed my second medical school interview after 4 years of applications and had received the dreaded "wait list" letter from the school I at which I had recently interviewed, the Oklahoma State University College of Osteopathic Medicine. Now what would you do? Perhaps just as I did - I started writing letters stating my very unique opportunity and pouring out my heart to all who would listen and could influence the outcome of my goal. I even wrote a letter to the provost of the school (so, the most that could happen would be that they would say no!). In my letter I stated that by rejecting me yet again they would just guarantee another application the next year. Bob Jones, then executive director of the Oklahoma Osteopathic Association, had assured me that a decision on my application would arrive forthwith. But in my pressing need to know the outcome of my application I had bugged him to no end. He was gracious and reassured me.
Acceptance
On the 24th of December 1995 my wife and I had gone shopping. When we returned home, waiting for me in the mailbox was a notice that an attempt had been made to deliver a registered envelope from OSU-COM, you know, one of those slips of paper which means something important came but you weren't around to receive it. I just hate it when that happens. I called the post office and they said that the important letter would not arrive back at the substation until the end of the day. The attendant said that the letter carrier was probably somewhere in the neighborhood, so at the insistence of my wife I set out to chase the "postman" down. Now mind you, I looked quite the fool driving around the neighborhood like a madman, stopping at every corner to look up and down each street. I found a mail truck and drove up to find that that particular letter carrier was not the one who normally delivers my mail. She did say, however that the other letter carrier and she were to rendezvous any minute. I looked up the street, and there was Lana, my postman. I drove up toward her postal truck as it took off down the street away from me. I opened my window and waved the delivery notice and she saw it out her rear view window. After she stopped. I could just imagine her thinking - "Now what kind of nut is chasing me waving things out the window!" I ran up to her truck and waved the notice at her. After signing for my big brown envelope (no rejection letter comes in a big brown envelope!) and taking a quick look inside I drove back to the house screaming all the way, with the windows up, of course. I had done it. At the age of 48 I had been accepted into medical school. In looking back on this I realized that had this been 15 or 20 years ago this feat would have been pretty much impossible at my age. As I drove back to the house Mary was getting ready to go back to the store. She saw me drive up waving the large envelope and knew that the real journey was about to begin. Later that same day we went over to my mother's house. I went to sit in the hot tub while my wife faxed the acceptance of the buyout to the corporation which I had signed several days before. She had to do it, as I knew that once gone there would be no turning back. She shared my enthusiasm and had no trouble pushing the send button.
I floated through the next few months. My boss asked me to stay beyond the
normal exit date of early January. This gave the company time to find, and time
for me to train a replacement. I would not have been happy to just drop my job
into someone's lap and move on. Burning my bridges is not something I practice
or recommend to anyone. By May 1996 the company had found my replacement, a
former colleague who had moved to a subsidiary in
After leaving the former AT&T, now Lucent Technologies at the end of
June 1996 I took several weeks off and traveled to the mountains of
Within a month of my departure from the rolls of Lucent Technologies the BIG check arrived. This was quickly spirited off to my brokerage account and invested. You see, the stars had arranged at this time for the stock market to be in a period of an unprecedented bull market. This invested money in fact, paid the balance of my tuition, books, and expenses during my time away from home. The retraining check, $10,000 (before taxes of course) went to pay for my first semester of tuition and books. Ultimately that brokerage account enabled me to pay for the full four years of medical school with money left over. I was blessed not to have to become one of the indebted graduates from medical school one hears so much about.
During my second interview I had a gut feeling that things were going to go
my way. At the time of the interview made contact with an apartment complex
right next to the school. I was put on the wait list for a nice apartment
within a short walking distance to school. Life at the
After four years of dealing with the agonizing process of filling out
applications and two years of interviews I finally entered medical school in
August of 1996. During those prior years I became an expert letter writer.
Obviously this took a lot out of me but I can rationalize by saying that
whatever school would take me would first have to be shown how serious I was.
Much of the lessons learned in those years of trying to gain entry were put on
the web at the urging of Dr. Peggie Guthrie, my
premed advisor at the
All this is now moot, but the reader may ask, "So what is the big deal about this guy's experience?" Simply this - mine is the epitome of the non-traditional student profile. How many people do you know that enter medical school at the age of 48?
Victories that are cheap are
cheap.
Those only are worth having which
Come as a result of hard fighting.
Henry Ward Beecher
My 50th birthday was held on October 16th, 1997, amidst fun, fanfare, two birthday cakes and cards and banners proclaiming my, yet, very young status. One of my fondest treasures is the bib given to me and autographed by classmates. I was obliged to wear it to the lunchroom that day - got lots of curious stares from faculty. The joy of going to school where I did is that 5 of my fellow classmates were over forty and all us "old folks" were accepted as one of the gang. Another interesting facet of my life is that over 1/2 of my classmates were younger than my older kid. Because of this I had no problem dispensing fatherly advice and several classmates called me "dad." (I even had the joy of attending the wedding of one of my “kids” early in my third year.) My loyalty is now with OSU. But now let me digress to talk about past history.
The Fateful Encounter
The first day of lecture arrived and my thought as I wait expectantly was -
"I can't believe I am really here", after all the blood, sweat and
tears of applying I had finally "arrived". So how did I really get to
this place? My decision to become a doctor spans many years but finally reached
its climax in 1990 after a trip to
After coming home from
Some may call it mid life crisis - I was 42 years old at the time. I prefer
to call it mid-life reawakening. In about July of 1990, several months after
Where I'm From - the good times and the bad
As I looked back on my life I realized that I had always wanted to be a doctor but had never been taught that I could become one. My family background during my formative years was one of struggle, living in an alcoholic, abusive household. I grew up with a lower caste mentality. I became an engineer simply because, though I was not above average in intelligence, I loved math and science and understood electronics. Because of this I took what seemed to be the natural path to success. I intended to become an electrical engineer. This seemed a worthy goal and was certainly not too exalted a position in life to strive for. I had been introduced to the medical profession through my mother whom, it seems, was in some training program most of my childhood. When shadowing her in the lab and meeting many doctors it never dawned on me that perhaps this was a glimpse of what my life might become.
In order to give my sister and me the best chance of success in life my mom
made the decision to bring us “back” to the
Mother was a medical technologist and used to take me to her place of employment to play with the lab equipment. She even showed me how to perform certain types of tests, which in those days was all done manually. I learned to use a microscope at a very young age. One day while looking at a smear of my own blood I was curious about the large number of a certain type of cell. I asked my mother to take a look and she was horrified to find an abnormally high white cell count. She rushed me to a physician she knew whose office was located down the street from the small hospital where she worked. A diagnosis of lymphocytic leukemia soon followed and I was treated by a physician who relied heavily on homeopathic medicine as adjunct to formal protocols. All I can remember of the experience was lots of needles and a very strange diet full of raw vegetables and raw nuts, especially peanuts. Don' ask me dear reader what this had to do with anything but it apparently worked. Within a few months I began to turn around (I wondered why I had been feeling so tired and rundown for a 13 year old kid). At any rate Dr. Raynould Patzer, MD (deceased) was my hero and I looked upon him and other doctors with a sense of awe (don't people still do that today?). Thus, it was during my early teens that my desire to become a physician was likely formed but lay dormant until much later in my life.
My mother's desire to get ahead in life was an object lesson for me. I can reflect on the times when she could have taken the better path but somehow wound up going down a road that was fraught with struggle and left her two kids feeling like orphans; without a real sense of family or closeness. This sense carries on to this day I look back on those early years with ill feeling and bitterness in the pit of my stomach. Ann and I were basically forced to raise ourselves but I vowed never to let that happen to my children. Many times I have thought about mother’s disastrous second marriage and see that as the key to my bitterness. Her decision to focus attention on Wes, her absolutely useless second husband haunts me to this day. Some of mother’s basic philosophy did, however impact me positively. It was straight forward, and I can remember her admonition about smoking (she was a very heavy smoker). She would say -"When you are ready to smoke just get one of my cigarettes and light it up in front of me, just don't ever do anything behind my back." This, of course took all the intrigue out of such clandestine things as experimenting with things like cigarettes. Consequently, except for an occasional smoke of my pipe I stay away from cigarettes.
High school for me was in
As I have alluded to before, the one thing that had the greatest negative impact on my teenage years was the unfortunate turn of events in my mother's second marriage. Wes, whom I refuse to call a stepfather, was too fond of alcohol. I suspect this was the case when he and mother first married but as I know my mother, she probably lived in denial. I can still recall those terrible words that he used to utter almost every evening "Let's go down to the little store." You see the little store was the corner liquor store a couple miles down the road. Much of his fairly decent earnings as an expert mechanic went to alcohol. Wes’ other very nasty habit was to get very violent when he got drunk, which was more nights a week than not. One night, after tearing up the house, he got particularly physical with my mother. Not knowing what to do, I crawled out the window and went to the garage. I hid in the car the rest of the night. This particular car was supposedly mine but I had to brush the glass off the seat before I could lie down. Wes had smashed the car window in one of his many wrecks while driving intoxicated. That night I pondered my next plan which was to kill him. I had decided to dispatch him forthwith, despite any future consequences. In fact, most of the night spent in the car was in contemplation of what might happen after the deed. My plan - to load my .22 caliber rifle when I got home from school then shoot him when he got home from work. I went to school thinking of nothing else. My plans had not altered and when I got home from school I found my rifle lying in the back yard with the barrel bent in about an 80 degree angle. Wes had come home during the day and taken my rifle and, with his hands on the end of the barrel, brought it down on the edge of the concrete back porch. If ever there was a case for the existence of angels this was it. I would say that his personal angel, or perhaps it was my angel, told him what I was about to do. I had told absolutely no one of my plan! I took the rifle to a neighbor who said he could straighten it fairly well enough to shoot. By that time I decided to call off the plan. As I look back on it all I figure that shooting him with a .22 (that's all I had at the time) would have probably just made him mad. After the fact I told my best friend Ron and he agreed that it was probably best to leave things as they were and abandon Wes to whatever justice there might be in the universe. At that time I resolved to leave home as soon as high school was completed. I had sense enough to understand that a high school diploma was a must. By the spring of 1965 I had already enlisted in the Marine Corps on the 90 day delayed entry program.
After I left home for the military mother finally shed Wes and for the first time in her life she bought her own home. By this time in our lives Ann and I had pretty much gotten used to the idea of raising ourselves and that is the tragedy of our family. I ran into Wes during one of my leaves from the military. He had turned religious fanatic (religion truly is the last refuge of a scoundrel) and he wandered off to other pursuits. I haven’t a clue where Wes landed nor do I care in the least. He had never finished the 3rd grade (a non accomplishment which he glorified) and as I look back on that I see his influence as a contributor to my caste mentality.
Uncle Sam's Misguided Children
At the age of 17, after turbulent teenage years, I entered the Marine Corps out of high school in my quest to set out on my own. I had no false impressions of entering college as I simply was fed up with Wes and academics in general. Besides, where in hell would I get the money to get four years of higher education? My meager pay from the bowling alley where I'd worked since the age of 14 wouldn't get me very far. My mother worked like a slave to stay ahead of the game and besides, it was time for me to get on the stick and become an adult. I did not enter the Marines knowing there was such a thing as GI Bill but simply to get away from home. I had always been a little guy (at the time of my enlistment I weighed 110 pounds soaking wet and my physical exam had to fudged to let me in) and felt that the Marines would boost my self confidence, after all, aren't the Marines the toughest of the tough?
I left
One of the hazards of going into the Marines was that it was 1965 and the
Vietnam War was just gearing up. I simply did not connect with the idea that in
1965 there was a very good chance that I would be bound for
Unlike other conflicts, tours in
After The Corps
For a while I faltered in my approach to what I really wanted to do in life and made the mistake of marrying and starting a family at too young an age. Mind you, the mistake was not in getting married. It was getting married fresh out of the military; not taking the time to readjust to civilian life and getting feet firmly planted on a meaningful path toward financial stability. I joined the Xerox Corporation as a tech rep and became a glorified mechanic of copying machines. Oh, how I hated that job. I nearly fell into the mindset that a career with Xerox wouldn't be so bad if I could just stick it out for 20 to 30 years. It didn't take me long to see this wasn't the way to go. I despised having to wear a business suit and carry around a tool box. I would come home at the end of the day with the sleeves of my white shirts black from toner. After a few months I started to get toner stains on my hands that would not come out with washing. My mind’s eye recalled how Wes would come home covered in grease from working on automobiles all day long. Mind you, I liked working on engines and tinkering with mechanical things but I sure as hell did not want to do it for a living. Incidentally, the only thing I can give Wes credit for is that I can perform many of my own maintenance duties on things around the house.
By early 1970, and while still working for Xerox I had begun part time work
at the University of Oklahoma aiming toward my engineering degree. I had
brought along with me 6 semester hours of English completed while in the
military. I had actually been crazy enough to attempt the dreaded English
21 from OU by correspondence while in
The best part of this period of my life was the birth of my daughters, Tammy and Lisa. While getting married at too young an age was a source of tension in my first marriage my daughters more than made up for that. Both brats are now college graduates with advanced degrees and productive, tax paying citizens. As I write this, my older kid is an inner city school teacher trying to deal with the ever-increasing demands of society on teachers to be not only teachers, but also baby sitters. The younger brat is an attorney. Per her promise, she is on the way toward fixing the system. I wouldn't trade these two for anything.
During the early 70s the economy was like a roller coaster ride and the
demand for telephone central office equipment typically lagged 6 months to a
year behind general economic trends. During one layoff binge I found myself
downgraded and working in one part of the shop as a wireman. Now that was an
experience. Imagine what it was like to be a man (there were several of us)
sitting amidst a bunch of women chattering a whole shift about soap operas,
baby showers, etc. I survived that for several months but was recalled to my
old job when it was realized by management that all but one other person
trained on the equipment I was testing had been laid off. That recall lasted until around May 1975 when
I could no longer duck any more layoffs. I graciously exited my employment with
Western Electric with the bold statement that I would be back as an engineer.
We survived for a month or so with income from my working at the electronics
store but I quickly found regular employment with The University of Oklahoma on
the main campus in
I quit my full time position with the university and began working part time as a remote job entry terminal operator, tending computer terminals around campus. At this time in history we were still using punched cards for data entry and RJE terminal operators were responsible for making sure this equipment worked to satisfaction. I also began my last year of school as a full time student. I finally completed requirements for my BS in Electrical Engineering at the last of July 1977. Another classmate and I celebrated our accomplishment over pizza that day, Friday, and by Monday morning I was back working full time as an engineer for Western Electric Co. You see, I had purposed not to make the mistake of burning any bridges after my layoff in 1975 and kept in contact with old colleagues and by early 1977 had received a job offer to return as a full engineer pending completion of my degree. I started out at about $1500 a month and thought I had all the money in the world.
I enjoyed the comfort of a decent salary and things seemed to be going my way but by late 1981 my marriage had ended. Per my earlier life’s vow I never let my daughters become pawns in the breakup of my first marriage and all during their formative years I paid my child support, not because it was my obligation, but because it was my pleasure to be contributing to their welfare. I traveled about 150 miles twice a month to pick them up for the weekend. For that effort I am very close to my daughters and, indeed, my former wife and her husband are close and dear friends to this day.
It seems that fate never intended for me to be alone long and I soon met my
wife Mary at work. Mary likes to tell friends how we eventually got together.
It seems that I had caught her eye at work but she did not know about my
feelings, I having recently divorced. Anyway, I was getting ready to go
off to Army Reserve summer camp when I left work one day to go out to my car.
It was hot and the window was slightly rolled down. When I got in there was
this very nice card lying on the seat. She had gotten the courage to slip the
card into the car, taking the chance that it did indeed belong to me. The card
left no doubt in my mind that she was interested in this newly free guy of 33.
We were married several years later and wasted no time in planning for our
dream home in the country. By 1985 we had our beautiful home on 15 acres
complete with small lake and my beloved horses and of course our cats. Within 5
years this was all to change. During the time we lived in
Our life was happy and by 1990 and with my wife's undying support I had gone
on to take graduate hours in computer science, and complete a master's degree
in business management at Southern Nazarene University. I had worked several stints
at Bell Labs in
1990 was the year of revelation for me. After seeking some initially
positive indications from the folks at the OU medical school about whether a
42-year-old man could hope to go to medical school I started a self directed pre-med.
program by taking an animal biology course at UCO in
I did complete the zoology course successfully and went on to take other physical science courses like organic chemistry, biochemistry, genetics, and microbiology. As an under grad engineering major I had not had the luxury of taking these kinds of courses. Besides, I had not looked that far ahead to this point in my life. Soon after starting my second premed course, organic chemistry I took the dreaded MCAT and scored decently enough (mind you, I had been out of under grad school for over 15 years so didn't exactly expect to smoke the MCAT). I also began the, quite literally, agonizing process of trying to gain entrance, eventually focusing on OSU after determining that OU had no interest in me.
I will acknowledge that much of my premed success came from the universal
acceptance of my desire by all the instructors and professors (several of whom
wrote recommendation letters for me) at the
My greatest encouragement came from my wife who
accepted and understood the change in my focus. She accepted the notion to sell
our beautiful dream home that we had contracted to build on our 15 acre
"spread" in 1985. By 1990 the place was really shaping up but after
the trip to
No story of my life will ever be complete without mention of Booboo the cat.
Little boo was a tiny black barn cat among many at the barn where we
boarded our horses before the Piedmont place was built. Boo was very sickly and
when we'd visit the barn she would be sitting quietly while the other cats
licked her and comforted her fever. The tip of her tail had apparently frozen
and fallen off and so it was shorter than the rest of the cats. She would
barely eat and when she caught Mary's eye it was all over. We took little Boo
to the vet who said there was not much hope of saving her and that she should
be put to sleep. Mary would hear none of that so we were given medicine to give
her and took her home. Since we had another cat we asked a friend to take Booboo
in while she got better, which we knew she would. The pills we gave her each
day made her mouth foam up with green foam like she was rabid and she looked so
funny. One day soon after returning from the vet visit she passed an enormous
tape worm and she began to improve markedly. Boo was so affectionate and when
we would go over to the friends place to feed her she would insist on being
patted before she would eat. She would walk toward you then just plop down on
the floor so hard she would emit a little squeak and roll around waiting for
attention. We took Booboo out to the ranch with us and she had free reign to
roam around our spread. One evening she got stranded on the other side of the
pond after dark and Mary went out to look for her. She stood at the back of the
house and could hear this tiny cry coming from somewhere. She grabbed a strong
flashlight and shinned it around and saw two tiny eyes flashing down at the far
end of the pond. Mary waded across the muddy shallows and picked up the little
black cat and took her home. One of Boo's favorite places to get was the top of
my closet. She would climb up and lay on the towels I had placed up there. She
would roll over on her back, purr loudly and wait for me to show up to rub her
tummy, which I always did. In the winter Booboo would occasionally insist on
accompanying me to the barn to feed the big kids. I would bundle her up in my
overalls so only her face could be seen and we would go to the barn. While I
fed she would check out the barn for any mice. When feeding was over I would
carry her back to the house in my overalls. We showered all our attention on
that silly cat as she was truly our child. You animal lovers know what that is
like. Booboo was my cat and she slept on me at night when I was home. We
brought Booboo to
First Day of Lecture
Read the following text as you would diary entries. Some are after the fact, some are running narrative.
Past history is now caught up and at this point it is fall 1996 and the
first lecture of my first day of medical school. Gruff looking Dr. K begins his
lecture in anatomy at precisely 0900 and literally doesn't stop talking until
0955. I thought I had been run over by a truck! Sanity took over when I
realized that all he had said was in the notes, a fact of which he constantly
reminded us during lecture. Oh yes, notes. At
Dr. K is famous for cornering first years and, on occasion a second year, and saying "Come on, lets look at some films", or "Tell me about...." I remember one time in the library when some colleagues and I were studying neuro in second semester of first year when Dr. K. walked thru. I tried to avoid eye contact but it was too late. He walked over and asked me point blank "Bruce, tell me about the neural pathway for the consensual light reflex." I could hardly contain my excitement as, and I didn't tell him this of course, I had just finished studying that very subject. He was suitably impressed with my explanation of the neuro pathway associated with this important reflex. I figure my batting average was 75-80% with Dr. K's impromptu pimp sessions.
What about anatomy lab? - do you really have to memorize all those
bones? (Isn’t that what you dreaded as a kid, learning about what
future doctors would have to do in medical school?) Well, actually no. In all
the exams in anatomy we never had to name one bone. That would have been far
too trivial in light of the hundreds of nerves, arteries, veins, muscles, and
assorted other structures we had to learn. You just sort of learn bones by
default and the professors knew that. I would like to say another thing about
anatomy lab. At our school the class is broken down into two sections, an A and
a B lab section, with times alternating during the week. Each section gets half
of a cadaver with three people per body per section. This is a perfect number
and my lab partners Leslie and Benita were wonderful (still are for that
matter). I was fortunate in that both these women were more mature and we
freely bantered (not loudly of course) and laughed to each other. My favorite
trick was to catch someone who didn't know about my right hand. I would put on
a surgical glove and exclaim-"Hey, this glove has too many fingers."
(I had lost a portion of my right hand in
During lab sessions, the cadaver is dissected and structures are inspected per the manual. When there is a problem identifying a structure or with the dissection the instructors are glad to come over and assist. This takes several forms. Dr. T liked to serenade the girls while he dissects. He had a damned good voice. Dr. J instructs and quips as he dissects. Dr. K dissects and meticulously instructs, sometimes far after lab is over. No one minds detailed instruction from any instructor because on occasion you may pick up something that should be tucked away for future reference - that is it might show up on an exam. I can say this much, there sure as hell is no complaint from me about any instructor in the anatomy lab. They all love to teach and they love seeing students work hard to make the grade. Furthermore they know how tough it is and do all they can to help us get through. Quirks in any of their personalities are just so much dust on the floor to me. This does bring up a point. For those of you who are contemplating medicine and taking the path I took consider this. Do not take premed anatomy. Medical school anatomy is totally different and the premed anatomy course I took had no bearing on medical school anatomy.
No narrative about medical school would be complete without words about the cadaver you learn on in anatomy. Mr. T (for teacher) was in his late 70s when he died of cancer. His lungs were riddled with tumor and he obviously was a smoker. He also had the largest set of axillary nerves in the lab. Mr. T. also had one very unusual structure, which became the subject of conversation early. It was interesting to get a classmate over to the table and ask them, ”What do you think that is?" "It is a kidney, of course" was the usual reply. This was a mistake if one did not take time to put a gloved hand down into Mr. T's thorax on the left side to find a small kidney pushed down and posteriorly. You see, Mr. T. had a very large adrenal tumor, which had grown to the point of displacing the left kidney posterior, inferiorly. It even had a large "renal artery" (typical example of angiogenesis) growing out to further confuse you. Mr. T. also had some digital amputations. All in all he was a great guy and fully cooperative with our ham handedness. Thank you Mr. T. for allowing us to learn from you. Your anatomy was just different enough to make our learning process interesting.
The basic course schedule for first year, first semester consists of
anatomy, histology, clinical skills, and biochemistry. Second semester takes up
with neuro-anatomy (using brains from the cadavers of
first semester), microbiology, and physiology, as well as clinical skills and
medical information systems. In all seriousness I did not enjoy first semester
nearly so much as the second, despite fewer hours. I suppose it must have been
shell shock. Several lecturers were a joy. I loved Dr. M's physiology lectures.
Unfortunately Dr. M has retired to his ranch in Big Cabin,
Some might ask, what is the toughest course of first year? Actually, I figure it is a tossup between anatomy and histology. Good ole Dr. M's histo course simply ate my lunch. Yes it was a hard course but many of my colleagues did much better than I. Anatomy was difficult as well but not as difficult as histo. After a while I simply got tired of looking through that microscope. Interestingly enough, I actually did retain quite a bit of histology and find the subject matter quite valuable to this day.
From the first day it was rush, rush, and rush. My gpa the first semester was disappointing but decent. The second semester was, for me easier. Some colleagues said their second semester was more difficult, so go figure. I actually enjoyed Dr. K's neuro-anatomy course and did well. My semester gpa was up a whole letter grade to boot. As with every semester there is one class for which you typically get few hours credit but which takes up most of your time. Neuro was that way but I still loved the class - thanks Dr. K. I learned a lot from you and your love of teaching is infectious.
At this point it is appropriate for me to mention my advisor, Dr. F. He and I used to have conversations in his office about a lot of things and we shared a love of classical music. After buying a new CD it was my habit to lend it to him for a while. On a number of occasions he would go out and order the same CD. We had similar tastes in a number of things but music was our real common bond. He deeply appreciated my difficult situation and reminded me on many occasions that my class standing would ultimately be of no importance, that is to say I would probably never have a patient come into my office and ask me - "Dr. Stafford, what was your class ranking?" Thanks Dr. F., you were right. All the patients I have had never asked what my my class standing was.
Osteopathic clinical skills (aka OCS) did not get really interesting until we started learning the techniques of physical exam in the second semester of first year. That is not to say that learning osteopathic manipulative techniques was not interesting. It just seemed that the course had more meaning when we began to learn to use the hardware of our trade. Physiology was a good course as well. I find I still refer back to the "Guyton" (did you know that guy has 10 kids, all doctors?) to dig up basic information, as pathology requires us to know body systems in depth.
Speaking of osteopathic school, what is the difference? Now that the
allopathic community (read that the AMA) has officially recognized the
equivocal status of osteopathic physicians, the pure medical difference is
indiscernible. Osteopathy is more a treatment philosophy than a treatment
modality. During our pure medicine courses, we use textbooks written by M.D.s, which are supplemented by our course instructors.
Interestingly enough, three of the professors at our school are M.D.s, one of whom, Dr. M - nice lady, has embraced the
techniques of osteopathic manipulation and uses it in her practice as a
pediatrician. Furthermore she is done research into the use of cranial
osteopathy as a treatment modality in kids with otitis.
Dr. M. taught several sections of our osteopathic manipulative medicine course.
Another, Dr. G, is an author and passionate teacher of pathology. He constantly
reminded us of our duty to understand our patients totally, and to treat them osteopathically. In school we are taught, indeed it is
pounded into us, to look at the whole patient. We constantly hear
"Everything is connected to everything else." Looking at the whole
patient means everything - nutrition, environment, everything. When patients
present with a pain in the lower back we are taught to evaluate and treat the
acute distress but also to look at things like posture, gait, anatomy (does
this patient have an anatomical/physiological short leg?), etc. Sure we will
give them an immediate course of soft tissue, counterstrain,
or muscle energy and an antispasmodic. However, after the spasm has subsided we
might do a posture study to look for a pelvic tilt, take a foot impression for orthodics, or simply treat an underlying torsion then tell
the patient how to do some exercises to minimize their exposure to further
injury. We also look at the unseen patient, the spiritual and emotional
component as well. Our clinical skills course includes instruction in the
physical, emotional and spiritual elements of healing. I can tell you this much.
I get a great deal of satisfaction when I can treat a fellow classmate's
headache or tight neck or back restriction without pills of any kind or be able
to sit quietly and just listen to daily problems. Most would agree that that is
true medicine. I will leave that to you. It should come as no surprise that
osteopathic schools' traditionally put out the largest percentage number of
family practice/primary care docs. In fact our school was specifically
chartered to supply family care doctors to rural
Aside from classes we also had our share of clubs to belong to. I specifically liked the radiology club. We met generally every Friday after class ended at noon to hear discussion on radiographic technique and diagnosis by Dr. K I learned a lot about reading x-rays from those sessions. We also had the chance to participate in off campus clinics for giving physicals. This allowed us to hone our hands-on skill with patients.
So, what did I do for recreation during my first two years in
During my first year Mary and I exchanged trips back and forth between OKC
and
End of First Year
First year ended with a big bang at the ole Steam Roller bar in
Yes, we had several folks drop out for assorted reasons, but for the most part there were 80+ very happy, now MS-IIs talking about the tough times in gross and neuro anatomy, histology, about professors, and all the stuff veterans talk about. We had only heard about the next year but were soon to experience it.
I began my summer with great expectation. First things first - I slept, literally, for almost the entire first week of my summer break. I cannot remember being out of bed for more than a few hours. I had no clue I was so mentally and physically drained. What was so interesting was that while in school I never slept through the night without waking up because of the stress. My first day home from school I went to bed at 2000 and slept like a rock until 0700 the next morning. That's 11 hours folks! I had gotten so used to going to bed at 2000 and getting up around 0300 to study that my entire sleep cycle was disrupted and it took time to get back on track.
Summer Medicine
In order to maintain my focus on medicine I elected to do several extracurricular rotations and so chose a couple of docs I know to work with. I spent three weeks working with Dr.M, D.O., and a family doc who runs a walk-in clinic close to home. I worked in the clinic as a colleague practicing all the examination skills I had learned the first year of school. In one instance I was even scolded for doing the job of an M.A., being reminded, "You have patients to see." Mind you, after finishing 1 year of medical school you don't know squat but, in some instances, I was able to diagnose a problem and suggest medication. I also learned that patients present with problems that just don't quite look like the textbook.
During one memorable day at the clinic Dr. M asked me if I had ever done a pelvic exam. I answered no. This lead to the next one - had I ever seen one demonstrated? I said yes. He then stated it was now time to do one - "you recall", he said, "the old adage - see one, do one, teach one? Now get in there!" I did two pelvics that day and this experience alone put me miles ahead of any of my classmates in the second year of clinical skills. When it came to doing my practical exam in first semester of second year I breezed through the procedure with a live patient model while most classmates were sweating bullets. While working with Dr. M I didn't get to do any OMT (manipulation) on patients but I did it on everyone who worked in the clinic, including doc's wife who had a backache, which I relieved with a simple impulse technique for the lower back.
After a week of rest I spent four weeks working with my lung doc, an M.D. pulmonologist whom I have known for over ten years. Dr. H took me into the office as a colleague as well and allowed me full access to procedures and the hospital rooms where he made rounds morning and evening. He would give me the names of a handful of patients to see and I even got to do physicals and write admission notes. I met a third year student from OU on the floor and she was amazed that I was writing progress notes on a patient. I told her we learned to do that in our first year so it was no big deal. Indeed, before the tour was up I had done my first partial bronchoscopy. This was an amazing accomplishment in light of my novice status. Dr. H had complete confidence in me, which I deeply appreciated. My most memorable experience on his service was when I was given the honor of comforting Mrs. C. as her husband lay dying from complications of cancer surgery. Mr C. was the first patient of mine to die but I understood my obligation, not to him, but to his wife. She later sent me a thank you card for being there. My exposure to patients, the office and hospital, and pathologies gave me an enormous boost to the ego and helped prepare me for the second year of medical school. I learned that my greatest asset is my age and I easily won the confidence of all the patients I saw. Thank you Dr.s M and H.
Second Year
The second year started with about the same size bang as the first. Now Dr. G, as well as others started talking about the real Dr. stuff, pathologies. The amount of material to learn grew, I swear, by an order of magnitude but I found out that I loved pathology and related subjects. My experiences during my first summer helped me immensely to understand various disease processes as I had seen them first hand. In the second year the clinical problem solving course begins, with real clinical scenarios written by Dr. G and requiring lots of outside research (aka learning issues) both in the library and on the web. Oh, I forgot to mention that in early 1997 our school opened a new wing called the center for advanced medical education (CAME) with new lecture halls and breakout rooms. The lecture hall seating provides hookups for laptop computers directly into our local network and each breakout room has a computer tied to network resources and a color printer. It is possible to do a web search during a problem solving session and print out the results for the group.
The clinical problem-solving course involved lectures during the week and two 2-hour sessions in small group moderated by a practicing physician. Having Dr. E as a moderator during first semester was fun; someone always brought cookies or sweet stuff to eat. Dr. E. was good about not giving us too many hints about the disease process that we were investigating, but he didn't let us flounder either. Thanks Dr. E.
Of course, as I have alluded, the second year pivots around one course, pathology. Even problem solving, or CPS as we call it is all pathology and learning to diagnose problems by looking at the clinical scenario, labs, and imaging. We have 5 hours of pathology in our 28 hours of course work but it takes up the majority of study time. We had path quizzes nearly every week and three semester exams. To minimize the trauma, the school does a good job of synchronizing materials in all courses with a core concept in pathology. For instance, if the core concept in is respiratory pathology, all the other courses try to maintain that theme. This goes for pharmacology as well as OCS. This makes going a little easier and is appreciated by the class.
Mid term tests of first semester second year took the wind out of a lot of
sails and brought the stress level to an all time high. I experienced a
genuine, classic panic attack of all things, right before a psychiatry exam!
Several female classmates were on the verge of tears at times, simply worrying
about how they did on exams. What made it tough on us was that one classmate
had a death in the family and didn't take the CPS exam until several days after
the rest of us. Besides the pain of a classmate in distress, this delayed the
processing of grades. Our toughest exam, CPS, brought many to their knees but
things turned out OK in the end. I have only been under stress like that one
other time in my life, during
I suppose one of the biggest problems for me is my general status. I am an
older guy in a class of pups and don't have a core peer group. I cannot pal
around with anyone as all my nearest older classmates are married with
families. I certainly cannot run around, or get to chummy with any younger
females, and so sometimes had a tough time finding anyone to talk to. We have
psychologists at school, who are always ready to lend an ear of support but one
really needs a classmate or two to cry with as it were. I made do, however. I
went to bed early in the evening, say around 2030 and get up between 0200 and
0400 to get a good head start on the day. I have long since given up the idea
of being the top of the class as I have to compete with some very smart
cookies. I am content to do my best with classroom work then kick butt in the
practical application. On occasion I did get together with one of my older
colleagues in the library to discuss mutual interests, mainly how we are doing
under the stress of the course load. This chance to exchange personal thoughts
with someone close to your age is very therapeutic. Along with the
Finals of the first semester of second year are over and my grades, though never good enough are decent. I ran with the pack in pathology, the toughest course of second year. I am grateful for what I have learned thus far and looking forward to next semester with guarded optimism. Second semester will be tougher simply because we have ACLS certification on top of our course work, our pathology course final is comprehensive over both semesters, and of course, there is study for the boards. At our school passage of step one (COMLEX) of the boards is required before we can start rotations.
So, after the end of the first semester of second year who are my favorite professors? They are all good is my answer. Compassion and love of teaching is the common trait. No one is allowed to sink without a lot of bending over backwards to pull things out. Nurturing and mentorship are the hallmarks of my encounters with the faculty at OSU-COM. I understand that professors, just like everyone else have their personality quirks, but that when looking beyond this it is easy to see the goodness in each faculty member I encountered.
Second semester of second year started off in early January 1998 after an
all too short Christmas break. For two weeks I whittled away on my mile long
list of to dos. I actually got some things accomplished though not much
studying. I really don't think I could have studied enough to prepare me for
second semester. It was more of the same, only worse. I did manage to gut my
way through pharmacology, HP/DP, and psychiatry. Pathology, as always was the
fun course. It is extremely hard and took up the majority of the study time
available but I loved it. I did nothing but study second semester. I totally
neglected my bike and the only margin I allowed myself was an occasional
evening at the "Bistro at Brookside", my favorite
Toward the end of the second semester we had to qualify for BLS and ACLS. This added just a bit more stress to the upcoming semester finals. The most fun thing I can report is the happy times spent in class bantering back and forth with notes to my elbow mates in class Laurie and Paulette. Both were old ladies, though quite younger than myself. Jeez, I'll miss you two. At this point there is nothing eventful to report save to say that finals week about 80+ other students and I were physical and mental wrecks. During finals week I never arrived at the school later than 0400 in the morning and one morning came at 0130. I was so keyed up with studying I just could not sleep. The school did a good job of scheduling the hardest to not so hard exams across one week. Friday, May 1, 1998 ended for me at about 1345 with a bang as I totally blew my final exam in psychiatry. At that point I was simply worn out and just wanted to be done with it.
The big party at the Mexicali Border cafe in Tulsa started at about 1500 but
some classmates and I went to the Steamroller for an after psychiatry final
bitch session. After that we had some Mexican food and drinks at the
Speaking of my father in law; one of the biggest inspirations in my life -
Major General John T. Honeycutt, USMA class of 1933 died two weeks after I had
the pleasure of toasting his undying confidence and telling him of my
acceptance into medical school. The general had encouraged me to keep plugging
away as he had done until he met his end. After retiring from the Army he took
up his love of making violins. He became a master violin maker and, though he
did not live long enough to make the 100 he had set out to make, he did produce
over 60 beautiful instruments. He had been stricken with a Staph.
infection which triggered a latent, rare genetic disorder involving the
neuromuscular system. During the last several years while he was pretty much
bedridden he took up the study and review of the calculus to refresh himself
with a subject he had once taught at
So, I'm home now. I left the apartment on Saturday afternoon after finals (and after recovering from one big hangover). Brought home most all of my clothes and books. I will be returning in a few weeks for board reviews then boards. I am so looking forward to that being over. The neat thing about all this is, 1) the older guy did it, and 2) I'm now an MS-III. Yeah!
Boards
After two wonderful weeks at home I traveled back to
Boards began at 0800 of the 2nd of June and ran for two grueling days. Damn, at this point I just hope I passed because it was a killer exam. The pathology part was not bad, as Drs. G and M had prepared us very well. The pharmacology part was a pisser because there are no brand names, just generics. Guess what we had been told all second year about the boards - generic and brand names will be on the exam - WRONG! This was not the fault of the department as they had been led to believe that. The rest of the exam is an unknown though; will know in about 8 weeks, well after starting my first rotation at St. Michaels.
Speaking of rotations - my first two months will be in internal medicine. I
am joyfully looking forward to that experience, as I love internal medicine.
After that comes a month of surgery then a month of
Looking back on two years of medical school - I can honestly say, "Where did the time go?" Some unfortunate things happened to classmates during that time, including the inevitable straining of several marriages, one of which happened to a very close friend. That particular situation will be just fine though, as the woman involved is a strong person, ornery as hell, but a lovely, wonderful lady. I'm through it now and ready for bigger and better things. In all honestly, I had several bouts with self-doubt and questions about whether I would make it this far. Again, thanks to Dr. R for pulling me out of my slumps - you are such a sweet lady. So, that just means even at the age of 50+ I am still human. This is what the first two years boils down to. Learn what you can and if you are lucky you will have retained about 20-25% of what you learned. This might, again if you are lucky, carry you through endless pimping sessions during your last two years. I don't know where those two years went. I endured it, learned something, and even passed part I of the boards. Now the real learning begins
3rd and 4th years - Clinical Rotations
Medicine
It is now the 8th of August 1998 and I've finished my first week of my second internal medicine rotation, Medicine A. I was so damned busy and the hours so long on first rotation that I didn't have time to sit down to write. Medicine B started off on the 1st of July after several weeks of needed rest. Unfortunately it was not enough. Too bad, the day of reckoning waits for no one. After a day of orientation we began our first clinical rotation bright eyed and feeling almost like real doctors. The nurses even call us doctor. It is enough to give one the big head. Reality sets in quick enough when the attending barks at you the first time about why you didn't do such and such, and when you also realize that your continued presence is hinging on having passed the boards, the results of which would not be available until the next rotation.
Medicine B was the toughest rotation of all two clinical years I have been told, and I was right in the middle of it. Dr.s M and D were very good doctors with totally different styles. Dr. M. was extremely hard to read but I enjoyed his instruction. He was also quite abrupt when dealing with patients who just didn't want to do as he wanted. He also had an interesting sense of humor. Dr. D, though more laid back, was also a good teacher. It was always a treat to hear him say "Excellent!" in response to a pimp question. General internal medicine service is the busiest in St. Michael’s and my classmate and I (one of my "kids") were given responsibility for from 6 to 7 patients at a time - this is pretty standard. Most of the time patients were gone in 3 to 4 days but some of the elderly were still around after changing services. The hardest thing for me to get used to is to write orders on patients. When asked early in my rotation by Dr. D why I wasn't writing more orders I simply replied, "Because I'm not ready to kill my first patient yet." This hesitancy was healthy as one realizes that a lot of harm can be done a patient simply by misplacing a decimal point on a dosage.
My most memorable patient on medicine B must have been Ms.W,
a 90+ year old belle who had been transferred from a nursing home. Ms. W had
all the problems one can imagine at her age and her peripheral vascular disease
had caused her left foot to develop some gangrenous toes due to poor
circulation. I met Mrs. W at about the time several of her toes had been
amputated. I visited with her most every day, even though skilled nursing
facility patients were not generally seen every day unless problems arose.
Well, a problem did arise in Ms. W. A serious infection began to develop at her
surgical site and despite advice for further surgical intervention she refused
any further amputation. She was treated aggressively with antibiotics and the
infection began to clear up after several tense weeks of treatment. This is not
why I write about Ms. W. I want to remember her because we used to converse at
length about why I wanted to become a doctor, about my family, my horses, and
about my love for
Medicine B, general internal medicine at St. Michael’s I am working in encompasses not just the floor, but also geriatrics, and psych. I could talk about a lot of interesting cases but suffice it to say medicine A, my current rotation, is a lot different. Medicine A involves several specialties, cardiology with Dr. M, being the busiest. I observed a number of special procedures including EGDs and colonoscopies with Dr. H but I seemed to enjoy cardiology more. Of course, there is the ever present history and physical, of which students averaged at least one a day. My record was five in one day. We write progress notes on our patients, and are expected to present diagnosis as well as treatment plans. I have become a fair reader of EKGs since coming on board and plan to get a lot better. The one lasting lession I learned from Dr. M is that when I call him up at O dark thirty in the morning there are only two things he wants to know. In other words, "Dr. M, I'm looking at a PA and lateral chest series on Mr. X, a 65 year old caucasion male c/o chest pain and sob. I detect no active infiltrates, but there does appear to be cardiomegaly using the cardio thoracic ratio criteria."
During my cardiology rotation I learned that my mother had developed breast cancer. She had had a palpable lump for over a year but didn't tell me for fear it would interfere with my schooling. Once the cat was out of the bag she wasted no time in contacting a general surgeon, Dr. A., to have bilateral partial mast done. She was staged IIb and is doing fine and has no regrets about losing unneeded mammaries. Perhaps in sympathy, I don't know, my gall bladder started to really act up at this time. I have had suspicions that there was trouble because I've been hurting for about a year. Dr. M, my PCP obliged my untrained (but correct) diagnosis then sent me for a HIDA scan that confirmed the truth. Midway through my cardiology rotation I took a Friday off to show up at the hospital where Dr. A., by now the family surgeon "whupped it out" laproscopically. I was back to work bright and early Monday morning in scrubs and not moving very quickly. Lap is the greatest thing since sliced bread!
Surgery
By now I am on my second week of surgery rotation, principally a Urology service with some general surgery thrown in. Arriving at St. Michael’s around 0530 to 0545 was normal routine in order to see patients on the floor and be ready for an 0730 surgery. I suppose the most memorable thing to write about, besides all the interesting patients one sees, is that first surgery where you are part of the team. That day came for me when a lady in her 70s who came to St. Michael’s with an acute cholestasis. Her common bile duct was severely dilated and she appeared to have about a 2cm stone in the duct. She went to surgery with the understanding that a laparoscopy would be out of the question with such a large obstruction. I was asked to assist and scrubbed in and took my place as first assist opposite the surgeon Dr. H. After draping the patient and after being joined by the second assistant, an intern, the first cut was made in traditional fashion. After opening the abdomen Dr. H. explored while I manned a couple of retractors (this is the most some students ever get to do in usual surgery rotations). After locating and partially dissecting out the gall bladder from the lower edge of the liver he made his expert extraction. The patient also had a duodenal diverticulum which was repaired incidentally. After assisting with suturing the deeper layers of fascia and muscle I was given the job of final closure which went off without a hitch. All in all the day was very enjoyable and was finished off with a seminar with the urology attending, myself and several interns plus a resident. I was privileged to present about 8 cases involving interpretation of intravenous pyelograms (IVP). Last word I got from the attending as we walked out the door was that I had done an excellent job. He jokingly told me that I had won the grand prize and handed me a box of Viagra samples he had been carrying around. We laughed! This was a good ending to a long day.
My stint on the general surgery service has been interesting as well. The intern on the service had to go out of town to a seminar to present a paper and I volunteered to work a weekend with the internal med service and surgical services both. During this time I declared my first patient. I had just visited Mrs. S - she had been moved from the unit to the general medical floor after a massive infarct. She was not expected to live and was a DNR. At the time of my visit she was expressing agonal breathing. I had made note of what I could and went back to the nurse’s station to write on her when one of the floor nurses asked someone to come in and see Mrs. S. I went to her room and found her no longer breathing. I went through the protocol and declared her dead at 0927 in the morning. Sleep well Mrs. S. I hope you don't mind me looking into your eyes with my opthalmoscope for practice.
One of the things I will never forget on surgery was being able to observe a liver harvest for an organ donation. The donor was taken to the OR in comatose condition and all the usual protocols were followed, including anesthesia. Believe it or not this was a very long procedure. The most profound thing about it was when the liver was lifted out and the ventilator was turned off. Of course the patient was essentially dead on entering the OR but to see the chest moving one minute then not moving the next made me stop to think about life and what it means to be alive.
Last week we had completed an abdominal surgery when the surgeon told the
1st assist, Dr. W., an
Starting
So now it is a week later and I am fully into my
Today is October 9th, 1998 and this morning around 1000 I delivered my first baby. T was born of a hispanic mother who came into labor and delivery (L&D) around 0900 or so after her membrane broke (SROM) at 0700. She was clearly in active labor when she came in through the ER entrance. She was placed in a room and hooked up to a monitor. She was about 5/70%/0 when she appeared. A kid was clearly on the way. When it was time for delivery, Dr. H, the senior resident said "Come on Bruce, this is your kid." Funny thing, I wasn't shaking at all and I knew what to do thanks to Dr. M's and Dr. H's expert teaching a few nights before. After baby T was born baby J's mom went into active labor after an assisted rupture of membrane (AROM). This time it was old hat and baby J shot out like a bullet. I didn't drop her and she was handed to the attendant after clamping then cutting her chord. Placenta was dutifully delivered in about 5 minutes and that was that. You're damn right I'm proud. It has taken me 8 years to get to this point. Why shouldn't I be? I'm on call this weekend so we'll see what happens next.
What happened next is tragedy. I was on weekend call and had left