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quarters, an amazingly decrepit firetrap (with) rooms (that) open onto a central airshaft rather than to the outside. It reminded me very much of some of the older (prep school) dorms.
I had forgotten again what being on duty does for one’s sense of time and orientation and I came home Thursday evening in a bitchy mood. I played guitar and sang with Dick Eastman (one of the first year students in V. H.) for most of that evening.
Friday was my day in Neuro OPD clinic and I was given “what we thought would be an interesting patient for you,” a slough if ever there was one: 32
y/o S. Columbian female, speaking little English, referred from medical clinic where among her diffuse and poorly defined complaints were headaches
and episodic vertigo without hearing loss. I did a compulsive job, turned up some new history, watched the visit prescribe a diuretic for her menstrual “fluid shift” and went away convinced again that most people just don’t practice what they preach to students.
Friday night was the eve of the 1st year class’s
first exam: Biochem, for which they were all characteristically psyched up. For a while I was afraid the 2nd year boys weren’t going to come through with the annual pre-exam loosener but finally I saw John Whiffen and Fred Hashimoto sneaking about. They went over to Building C and replaced the amino acid charts with Playmates. Later, a prerecorded tape blared into the courtyard a wonderfully funny take-off on Biochem, “brought to you by Sephadex columns ~ Sephadex really pours it on!”
Saturday Bryan Arling and I again had lunch at Durgin-Park and then because no admissions had come in I rode the MTA up to Cambridge to do some shopping. Back at (the) White II (Bldg.), I read the references on low tension glaucoma and then watched the finals of women’s gymnastics and the men’s high platform diving at the Olympics. Vera Caslavska of Czechoslovakia won 4 gold medals, the last a tie with a Russian girl, and as the Russian national anthem was played she stood with eyes cast aside and down in silent protest. [The Yugoslavs likewise rejoiced greatly when they beat the Russians by 1 point in the basketball semifinals.]
Dobhoff tubes and other forms of nasoenteric feeding tube had not yet been invented, nor had percutaneous gastrostomy, which meant that if you were a patient who couldn’t swallow because of neurogenic dysphagia, feeding could be a difficult problem.
About 8 PM we got an admission and Steve went down to the EW to work her up, leaving the floor to me. About 30 minutes later I was informed that Mrs. N’s feeding tube wasn’t working. Mrs. N is a severe myasthenic and always on the brink of distress. She
had a Penrose drain (held down) with a Mercury bag (as a form of feeding tube), which was indeed not working. I pulled it (out), but the mercury bag broke
off and is still (I presume) in her stomach. Undaunted,
I tried to pass an Argyle plastic (nasogastric) tube and soon learned that when a patient can neither cough nor swallow, it’s hard to know where your tube is going. After an hour and three tries (she had to rest with an 0xygen mask after each go) I got it into her esophagus and on down into her stomach.
I had to stop and reflect at that point on the contrast between book learning and ward experiential learning. I guess I have been doing mostly the latter and not enough of the former. On this one day, nevertheless, the contrast was clear.
Needless to say, I preferred experiential, on the job learning.
Down at midnight supper, (where the day’s cafeteria left-overs were available for free), horror stories about the surgical program at Columbia-Presbyterian were circulating, and the tale was recounted by eyewitnesses of the night the murdered Malcolm X was brought to the EW.
When I finally got to my admission (I was doctor#4) it was 10:30. She is a 20 y/o M(arried) W(hite) mother of 2, a bilateral facial palsies, weakness of (facial nerve) V, paresthesias, and dysesthesias of the face an neck, and bilateral extensor plantar responses (when I routinely checked and saw her toes go up I really did a double- take.) She has been on PCN, has increased CSF protein and 39 lymphs therein. Interesting case. I was the first one to learn that 4 months ago she had had all her teeth pulled because of bad caries, the first to suggest she had probably been on PCN, and the first to suggest partially treated meningitis. Actually, no one has any real good idea exactly what is going on. I got to bed about 3 AM, or rather 2, since we switched back over to EST last night.
Touch football this morning on a beautiful, crisp day. I got kicked in the left shin rather badly by [classmate) Don Vickery, (who was wearing) cleats.
Election day was approaching, colored by political uncertainties and wishful thinking about the wisdom of American voters.
As the election draws near Humphrey appears to
be gaining on Nixon, with Wallace fading slightly. I guess Wallace may get as much as 15% of the votes. Preferences are not running according to stereotype as they did in 1964. It’s hard to predict just who will vote for whom. Hubie is making much hay out of (or should I say, at the expense of) Agnew, who might just be Nixon’s albatross. I don’t particularly care for any of them except perhaps Muskie, who has turned out to
Volume 72 • Number 1 Washtenaw County Medical Society BULLETIN 13

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