Page 17 - Volume 69, Number 4
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“rounds” two or three mornings a week and dispense advice. These were not paying patients; they belonged to the house staff and the students. They were our patients; we were their doctors. There were Harvard faculty at the hospital, all experts in their fields, heavily engaged in research, who gave lectures and presided over conferences, but they were rarely involved directly in patient care on the Peabody floors, with the exception, as will be seen, of very special cases.
On Peabody 2
After my first week on Peabody 2, I made the following entry in my journal:
The ward looked a little forbidding at first – a bunch of old ladies whose average age must be about 70 – but as I have gotten to know everyone it has become like a big family – the only way in which an overcrowded, dilapidated ward in a run-down building could be livable.
My first night on call was truly surrealistic. During the course of the evening we had in close succession an acute pulmonary embolus causing ventricular tachycardia (which I was the first to see on the EKG), an uncontrollable woman in DT’s with a fever of 103° on whom we had to do an LP. When we got through my left hand, which had held her legs, was covered with shit; and a lady with dementia aspirated her dinner. It was unreal.
My first patient, Annie, was “a whiny, complaining 82 year-old with CHF not well controlled. There just isn’t much we were going to be able to do for her, though Manny Hellman, the Visit and hot-shot cardiologist, wants to electro-convert her.” She was in the hospital for a week. At the time, there were no loop diuretics. There were no monitored beds (and no monitors). Ethacrynic acid was just coming onto the market; furosemide had not yet been invented. CHF was treated by fluid restriction, rotating tourniquets and morphine.
My second patient is much more fun, a 17-year old girl with FUO, jaundice and pleuritic chest pain - ? Mono. The night I admitted her I got to bed at 3:45 AM – up at 6:45 (for rounds) – groan. I was so tired yesterday I didn’t know which end was up.
Nevertheless, I was responsible for doing her CBC’s (85 polys, 2 bands, 7 lymphs), sed rates, urinalyses, and plating her cultures. She went home a week later, still a mystery. The Infectious Disease consult thought she had leptospiro- sis. Serum was sent to CDC; I never heard the results.
After a week, on my second Monday there, my journal records: “I set some kind of precedent by deciding not to work up the admission that day – to the shock and dismay of the residents. I was tired and confused – had two sick patients already – and a searing, splitting headache, so I decided to exercise my student prerogative: I’m supposed to be learning, not killing myself.” Three days later I admitted a 49 year-old woman with Graves
Volume 69 • Number 4 Washtenaw County Medical Society BULLETIN 17

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