SYRACUSE!

SYRACUSE!

"Change is not made without inconvenience, even from worse to better."
                           Quoted by Johnson, as from Richard Hooker (1554-1600), in the Preface to the 
                            "English Dictionary"

Syracuse, NY

     Speaking of change, among the most important stressors are changing location and professional status.  While not even close to the scale of death of a loved one, divorce, or emotional problems, they are up there on most lists.  The year 1974 was a sea-change for me, suddenly becoming a "professional", as well as the culture shock of returning to the US after 8 years away.  That being said, there were events we missed (family weddings, famous rock groups and music, social upheaval and rioting in the streets, protests on America's campuses, etc.)  Even today, while many of our peers speak of their admiration for groups like "The Grateful Dead" and "The Eagles" among others, Suzanne and I just scratch our heads with quizzical regard, as though we were inflicted with a Rip Van Winkle syndrome.

     We would go wild in the super market, buying items that didn't exist abroad such as peanut butter. We would also shake hands firmly with people who we met, both old friends and new acquaintances, receiving puzzling looks. Firm handshakes are, after all, an established and required Belgian social more.  We had real television, in English, and listened to top twenty hits that were unknown abroad.  In a way, it was like putting on an old sweater or riding a bike again, familiar but somewhat alien to us.  We could also pick up the telephone any old time and call our families who would actually be in the same time zone!

Which peanut butter should we buy?!!!

     Suddenly being addressed as "Doctor" and the heavy responsibility and cachet that accompanied the title took some getting used to.  My mother, extremely proud of me, wanted me to get "MD" license plates for my car but I quickly demurred.  Being a physician was for me, a calling, not a calling card... I was humbled to be one.

Not for me!

 I did have a nice surprise, however, from my family's pride in my accomplishment.  One night, in St. Joseph's Hospital Health Center, while on call, I heard my name being paged on the overhead:  "Dr. Mayer, Dr. Mayer, please call the operator".  When I dialed 0,  I was patched through to an in-hospital phone where I heard the familiar voices of my Uncle Sy and Aunt Bernice!  They had driven all the way up to Syracuse from Long Island to surprise us and..."to hear your name paged as a doctor!"  They were quite excited and spent a couple of days visiting us.

Aunt Bernice and Uncle Sy

     St. Joe's was a wonderful place to do a rotating internship.  They had a university-based Family Practice residency and were particularly known for their cardiac care unit, led by Dr. Goffredo Gensini, the inventor of the Gensini cardiac catheter and a pioneer in cardiac angiography.  I had done a 2 month rotation there as a med student during my last year of medical school so I knew the place and felt comfortable there.  I was one of only a very few foreign medical graduates among a large group of American medical graduates so I felt I had to prove myself.  I made many friendships that year, some that have lasted until now.  My program required that I do Pediatrics, Surgery, OB-Gyn, Internal Medicine, and Emergency Medicine rotations over the course of the whole year.  My first one was Pediatrics which, I must say, I was particularly taken with.  My first attending there was a bright young pediatrician, Dr. Stuart Trust (great name for a doctor!) and he and I spent many hours together trying to save a young boy with renal disease from lupus.

St. Joseph's Hospital Health Center, Syracuse, NY

     Surgery and Ob-Gyn were probably my least favorites due to the lack of sleep each incurred!  The chief surgeon, Dr. Bernie Piskor, who smoked like a chimney, would require the interns to do rounds early in the morning before he arrived.  If we arrived at 6am, he would then get there at 5:45, which would then obligate us to arrive at 5:30...and on it went until we were getting there at 4:30am!  He was a tough guy and, if we weren't moving fast enough, he would address us as "lightning".  One morning, in the OR, I had the "honor" of being his first assistant in removing a patient's gall bladder.  As we were finishing up, I heard him start to breathe heavily and sweat.  He was having a run of cardiac tachycardia and had to leave the operating table, leaving me ALONE to close up the skin!  Several years later, I heard he had died in the locker room from a heart attack.  Another memorable experience was assisting Dr. Vercillo in a hernia repair.  He looked across to me from above his surgical mask and said "You've seen enough of these so you do it today!"  He guided me through all the necessary maneuvers of the surgery.  As I was closing up, tying a knot, one of them slipped and I uttered "Oops!" aloud.  He proceeded to whack my knuckles with a hemostat and motioned with his head toward the end of the table.  I took a quick peak and realized the patient had spinal anesthesia and was wide awake!  These are all stories that you probably don't want to hear about the next time you enter a hospital.

     Ob-gyn was another story. Back then, they did not allow the fathers into the delivery room and the first indication of a successful birthing they had was when the nurse walked over to the glass window with the wrapped up infant and mouthed, "It's a girl/boy".  The young house staff being activists, rebelled and we all agreed we would not monitor and deliver the attending's patients unless they allowed the fathers to come in and be there for their child's birth.  We won and things changed for the best.  One time, I was delivering a baby under an attending's supervision, and the father had set up lights and cameras behind me to record the great event.  I suddenly heard a loud crash and, turning around, saw our dad flat on his back, having fainted with all the fallen lights and cameras surrounding him.

The bad old days

Today!

     Emergency medicine taught me how to think on my feet (as well as how to become expert in taking a ten-minute restorative nap, a skill that remains with me today.)  My suturing skills improved as well.  Internal Medicine made me realize that I did not enjoy caring for adults, particularly the elderly.  Many would have charts as thick as several New York City phonebooks and piecing together their medical histories was challenging.  I kept returning to Pediatrics and even spent a few weeks working in their newborn intensive care unit under Dr. Margaret Williams who was a pioneer in that specialty.  Things were pretty primitive back then and I remember attaching glass tubing together and marking the water levels with white adhesive tape to create positive pressure for the infants to breathe better.  This was the first CPAP machine we were developing!  Now, half the people in the world go to sleep with one of the reiterations of what we were trying to do.

Our first CPAP machine! A real Rube Goldberg contraption.

     My second month of Pediatrics was very special as the attending was the Chair of Pediatrics from Upstate Medical School, the eminent Frank Oski.  He was a tough inquisitor on bedside rounds and had an encyclopedic knowledge of Pediatrics as shown by his authorship of many of our textbooks.  The young doctors would try to outfox him but never succeeded.  One day, my colleagues on the service decided I would present the patient to Oski but to do it in FRENCH!  It took some courage as he induced fear into all of us.  As I rattled off the presentation in French, he looked at me with a deadpan face.  There was absolute silence.  Either I would be terminated as an intern for being a wise guy or he would just ignore me.  His response was a reply to my presentation in fluent French!  Another victory for Dr. Oski.  But he did offer me some good advice along with one of his neonatologists, Dr. Roger Schott, a good old boy from Kentucky.  They both approached me and said they noticed I seemed to really enjoy Pediatrics and that I should consider that as a career path.  I never looked back.  It was late in the year and Dr. Schott suggested I apply to a Pediatric training program in Ohio.

Dr. Frank Oski who encouraged me to be a pediatrician

Next: Friendships