Monday, March 31, 2008
Weekend by the Bay
Anyone remember this post? (To save you the trouble, it was about a friendship I made online, with a man who trained where I did about ten years earlier, and who eventually sent me a key to the fabled and loved Chief Resident room in the fabled and loved San Francisco General Hospital, of which I was the last occupier before it was torn down.) We've corresponded for over a year, but until Saturday, we'd never met.
This weekend in San Francisco a "distinguished professorship" in honor of one of the early Chiefs of Surgery at UCSF was celebrated. The professor died many years ago, while I was in training; in fact, I was a pall-bearer at his funeral. The professorship was financed by his daughter and her husband, the former being Dianne Feinstein, US Senator. Hosted by the two of them was a fancy dinner at a fancy hotel, with the attendees mostly surgeons who'd been trained by him, many years before me. There, I was the young guy.
Ordinarily I'd not be attracted to such a gathering; I feel out of place amongst strangers, especially those more glamorous than I (which includes pretty much everyone) and having connections to one another that don't include me. (We trained at the same place, but not at the same time.) But at the urging of JB -- the keymaster -- and with the knowledge that a couple of my old professors, now frail and failing and not likely to reappear, would be there, I took a one day trip to SF. Mostly, I'm glad I did, even though it began with a flight made stressful by that fearsome announcement midway to SFO: "If there is any medical person on board, please turn on your call light."
It wasn't the first time I've responded to such a plea. Stalling for a few seconds to see if any other lights went on, I chimed in with the reluctance that comes from fear of the unknown. A steward came and leaned to me (I'd noted his unusually cool and amusing delivery of the safety speech, and his friendly handling of the delay in takeoff occasioned by the usual SF morning weather.) "We have a lady who looks pretty gray. What sort of medical person are you," he asked. "I'm a physician," I replied. "A surgeon, actually. I could take out her appendix if needed." He smiled and led the way to the back of the plane.
In a seat leaning back as far as they go (meaning pretty much vertical) was a thirty-something woman looking indeed quite peaked, already with flimsy and ineffective-looking oxygen mask on her face but with an adequate albeit quite slow pulse, felt under the skin of a clammy wrist. I asked a few questions, determined that she was in prior fine health, no meds or allergies, no clots, had flown in the past with no problems. Ever notice how in the movies -- or even in televised fights of some kinds -- when a person goes down they sit him up, or even try to get him up walking? Pretty basic: when fainting or otherwise woozy, lie the hell down and stay there! Conveniently, the woman's seat was right across from the galley area. After the stewardess spent a couple minutes trying to remove the arm of the seat before discovering it wasn't designed to come off, I helped the lady (she was cognating marginally but able to supply a little leg work) over the armrest and onto the floor and kneeled down beside her, readjusted her silly mask and took the offered sphygmomanometer and stethoscope. There was, of course, no way to hear a damn thing in that rackety galley, but I checked her pressure by palpation and it was good enough. She'd picked up her pulse rate a little, too, complained that her fingers were tingling. About this time her friend came down the aisle and said they'd been out drinking a lot last night.
I was handed a headset. The crew had been in contact with the ground, connecting with some sort of emergency physician, with whom they wished me to speak. As I had when doing my required flying in Vietnam, sitting in the copilot seat and given control of stick and rudder, mic pressed against my lips properly near as confirmed by the frequent kissing of it (pilots did it, so I did, too, singing out "roger one-five-niner" and "rollout" while taking directions from the spies in the back of the plane), I donned the set and knowingly tucked the phone close to mouth. There was a button to push when talking. It was all so familiar... I gave my assessment, thumbing the button like a veteran, and the doc on earth said "sounds like a vagal thing." I agreed, but added that I thought there was a measure of dehydration, hung-overness, and hyperventilation.
"Think she can just check in with her own doc when she's on the ground?"
"Doubt it. She's better lying there, but I don't think she'll be getting up and out on her own power."
"OK, so you want EMTs there?"
"I think it's best."
After reassuring her that I was sure it wasn't serious, she was in no danger, there wasn't more I could do. Thought about getting her to drink some juice, but figured better to let her lie. I returned to my seat after filling out some forms; came back a couple of times to check on her. Interestingly, and rightly I'd say even though it probably broke some rules, they kept her lying there for the landing. We were held in our seats until the EMTs came aboard, checked her, exited and returned with a gurney/wheelchair hybrid (I felt vindicated at that point) and rolled her out. The stewardess thanked me earnestly, offered me a Starbuck's gift card as a reward. For five bucks.
A few hours later I met JB at my hotel. He was more compact and wiry than I'd have guessed. In his seventies, he bristled with contained energy, had a perfect voice: just grainy enough and quietly powerful, confident, in charge. He'd sat himself down with a couple of ladies in the lobby, unknown to him, and was chatting away when I came down, missing him at first, expecting him to be alone. His baldness was semi-encircled in the grandfatherly way. Obviously fit, wearing cowboy boots to the ball, and a Panama sort of hat sporting service medals and insigniae from his time in Vietnam (where, unlike me, he'd served as a fully trained surgeon, well in the thick of it, the real deal), he'd brought a copy of my book for signing. It was heavily annotated and curled from re-reading, underlined, with lists of questions at the back. I'd planned to tell him of my airborne adventure, but his stories were much better, and I lost mine in the moment. After the night's ceremonies and a detour into the bar for one more round, we parted company in a fully exchanged hug. Worth the trip. I want to spend more time with JB.