The best way to describe my first impression of Charity Hospital is culture shock. I had never experienced anything like it, not even in the VA hospital during medical school. It was overwhelming at first. The demolition derby parking lot (I don’t remember any more why I was advised to leave my radio on at high volume when I got out of the car); the elevators; the huge wards, with about half of the patients at any one time chained to the beds so they wouldn’t escape; the ER, with trauma like I had never imagined. We had a whole ward of just femur fracture patients in traction at various stages of healing, because our chairman refused to let us do open roddings because of the risk of infection. We finally had to get one of the local ortho docs to staff us so we could start doing closed roddings. We operated from 7 AM to 7PM on scheduled cases for a while (I think it was due to some repairs or renovations that cut down the number of OR rooms available). There was such a fight for OR time that we used to schedule fictitious cases just to reserve room time, and then cancel them and replace them with the ER cases that would always come in (we referred to them as space-occupying lesions). Anesthesia was notorious for cancelling cases left and right. One day one of our residents made up a set of anesthesia dice to help them out. This way they could just roll the dice for reasons to cancel. My favorite was “Great-grandmother had thyroid disease and you didn’t order thyroid studies.”
At one time during my tenure the ER made up a troll index to rate the ER patients. Each thing was worth so many points. I can’t remember all but I remember things like “Interrupts seizure to smoke cigarette.” The top rating went to “Crowning and didn’t know she was pregnant.” Maybe that’s too inappropriate to go into the book.
Stories. I don’t know if you can use this because I did not personally witness it, but one day the Neurosurgery Dept had a visiting professor in, (I think it was LSU but I am not sure), and the Chairman wanted to take the VP into Charity for rounds. Unfortunately he forgot his ID badge and the security guard stopped them. The chairman said “Look, I am doctor so-and-so and I am chairman of neurosurgery and I am going in to make rounds.” and he started to head for the elevators. At which time the security guard promptly took him down to the floor. In front of the visiting professor. Maybe someone who was there in the early 80’s can corroborate that story.
I did personally witness one of our patients with a C-spine fracture who was placed in a halo-body jacket. A couple weeks after discharge he walked into clinic and flopped the halo down on the desk and said “here’s your stuff.” Apparently he got tired of the apparatus so he soaked in Lake Pontchartrain to get the body jacket off then took his own halo off. Hey, at least he brought the equipment back.
The clientele at Charity was always interesting. We had a shoulder dislocation in the ER one day that we tried to reduce with the usual Demerol/Valium sedation. After giving him 150 mg of Demerol and 40 mg of Valium and struggling to get it back in, the third-year resident turned to me and said to send him to XRay, at which time the patient hopped up off the table and asked “Where is it?” Obviously his enzyme system had some prior experience with drugs.
The ER was always so busy that for a long time I didn’t even know there were call rooms upstairs for us. I think I saw them twice during my entire stay. One of those days we were only there a short time when we got a call from the ER for a shotgun blast to the hand. OK. The elevator stopped a couple floors down and the urology resident gets in. “Hey, how you doing?” “OK. Got a shotgun wound to the penis.” Hmmmm. How many people using shotguns on the same day? Yes, it was the same patient. He saved his jewels pretty well but didn’t have much of a hand left. (The price he paid for fooling around with another man’s girlfriend.) Just another day at Charity.
It was always a challenge to work at Charity. At one point while I was there Charity ran out of Betadine. At another time we had no 6″ plaster rolls and had to apply adult leg casts with little rolls. Just to be fair, Charity later ran out of 2″ and 3″ rolls and we had to cut 6″ rolls with the cast saw to apply casts to children. But I did learn how to make a shoulder immoblizer out of Stockinette.
I definitely agree that Charity was a great place to train. Besides the fact that fracture work is the area of orthopaedics that I love the most, we actually did the procedures ourselves. I feel quite certain most other programs do not provide the same number of cases. And I personally think that trauma is the best training. If you can do that, you can do elective cases. I really began to appreciate my training after I finished and started private practice. I was very sorry to hear that it was closed. I always thought of it as a timeless institution. The building should at least be turned into a historic landmark. (Yeah, I’m not holding my breath on that one.)
Good luck with the book. I think it is a great idea.