MORE DOCTOR TRIVIA

House calls in those days (1950-60) were a way of life, as was 24hr. availability. The phone was by my bedside and even in deep sleep I became conditioned to picked it up on the first ring. Often my wife never knew that I had left the house during the night.

One night I had to make a house call on Hoes Lane in Piscataway , a very rural area in the 50s. I was given the location of a house and told that I should go to the rear. When I arrived, I saw a lantern light in the window of a building about 100 feet in the fields behind the house. I walked down the path with my bag and got close to the building when I heard a cow moo. It was a barn. The house had two apartments. They meant by” the rear” was that the entrance to their apartment on the second floor was by outside stairs in the back.

Another time, I was awakened by a patient’s phone call who said” I have bitten my husband. It is an emergency; and would I come immediately”. I dressed and was part way over there when I started to laugh, for the first time it dawned upon me what she had said. When I arrived, she met me at the door and repeated her comment. They were having a fight, and she had bitten him. It was not serious and certainly not worth my loosing sleep.

Of course there was the alcoholic who called about 2am and said;" Doc I can't sleep". I was rude and replied, " Now I too can't sleep". End of conversation but not that patient.

I first began administering obstetrical anesthesia about 1948 for $5.00 a case. Blue Shield would pay that much. When I was on call at night, the delivery room nurse would call when a birth was immanent, so that we could get to the hospital in time. Usually we could get home for more sleep, occasionally there were several cases in active labor so the night was spent in the deli9very room suite.

Ultimately we were receiving $15.00 a case, a substantial source of income. It represented almost 1/3 of my earnings for almost 15 years and I was reluctant to give it up. However, within a year my practice had more than made up that loss.

The techniques used then were either open drop ether onto a cone over the patients mouth and nose. We preferred using the Heidbrink machine, which employed a semi-closed system by passing oxygen and nitrogen oxide over an ether bottle. There was a single re-breathing bag before the mask. If the bag became too full the surplus vapors escaped into the air. With either system, the anesthesiologist often breathed a substantial amount of ether. His clothes would smell of it.

The Heidbrink machine held two tanks each of Nitrous Oxide or Oxygen in a bank on each side of a yoke. Unfortunately, the nipples were of the same size. Therefore, there was always a danger of having a tank on the wrong side, and the patient receiving only NO2, which could be fatal.

NO2 is known as "laughing gas" as was often used by dentist for temporary anaesthesia in their office. In the late 19th century , people used to have laughing gas parties.

The delivery room nurses were superb and would keep the physician, who may have been having “office hours”, informed about the labor’s progress. Sometimes, if the baby was coming too fast, we would have to start the anesthesia and deliver the baby ourselves before the obstetrician arrived. Picture us, putting the patient asleep, slipping on sterile gloves and gown and running to the other end of the table to delivery the baby. That was better than having a nurse hold back the head until the doctor, who was rushing in, arrived.

One General Practitioner had almost complete major surgical privileges in addition to one of the largest post war practices. He would often wait to the last moment to arrive in the delivery room; The nurse had a rubber apron ready for him to put over his clothes, before donning his scrub suit, and delivering the baby. About 33 % of the time, the baby’s head was either emerging or already delivered by the time he arrived. However, his patients adored him.

Unknown to his patients, this physician’s greatest attribute was his willingness to recognize his limitations. He would either ask for a consultation or transfer the patient to a specialist at the slightest indication of a problem.