The View from the Vue (22 page)

In any event, my patient was going into shock from blood loss, so we gave her a transfusion, and zipped her up to the operating room, where we could repair the damage under anesthesia. The woman had severely injured her urethral opening, and we feared for her eventual urinary function, but somebody somewhere liked her, and when her catheter was removed a couple of weeks later, her urine passed strictly on schedule.

During her stay on the ward, I got to know her pretty well. She told me about her seven other children at home, and how difficult it was to take proper care of them on welfare payments, but how she kept forgettin’ to take that li’l pill at the wrooooong time. I assured her that we’d tie her tubes at the termination of her current pregnancy.

Naturally, Dr. Karp was on duty the night she returned, seven months later, to deliver her lovely nine-pound girl. A week after this event, as she prepared to leave the hospital, babe in arms and fallopian tubes in formaldehyde, she flashed me her mile-wide grin and thanked me for my contribution to her care. I told her she was welcome. “Doctor Karp,” she said, “since you wuz so nice to me all long, I want you to help me name mah li’l gal. I’m plum outta names.” She giggled.

I stifled the urge to tell her that I thought Permanganate would be elegant, lovely, and thoroughly appropriate. We settled on Christine.

One Friday afternoon, while I was sitting in the GYN emergency room, I realized that it was quiet: we hadn’t seen a single patient for at least three hours. This was usually a portent of imminent disaster, and when the messenger from the Admitting Office brought in a frail, nervous-looking little lady, I began to get bad vibes. In a few minutes the nurse told me that the patient was ready, so I went in to examine her.

She may have been the most unattractive woman I have ever laid eyes on. The note from admitting said she was thirty-one, but she looked much older. Her hair had apparently started out the day drawn back in a bun; now it was flying all around her head and face, Medusa-style. A combination of acne and blotchy flushing contrasted with the chalky pallor of the rest of her skin. Her eyes looked glazed, and she was shaking all over. I asked her what was wrong. Something was, obviously.

“I’m having a miscarriage,” she whimpered.

I checked her temperature. It was over 102°. “Did you do anything to bring it on?” I asked.

At that point the white parts of the lady’s face turned even whiter. “Are you going to—you won’t—call—you won’t tell—the police?” she stammered. She was shaking so hard from both chills and fear that she dropped her little black pocketbook onto the floor; she pounced on it and clutched it again to her bosom.

I assured her I had no intention of calling the police, but that I simply wanted to know because some techniques of self-induced abortion are particularly hazardous and necessitate special treatment or special precautions.

She began to cry and then started to moan, “I did it. I did it. Oh, Lord, I did it. Will you treat me anyway?”

I told her I would, and asked her how she had done it. She sighed deeply and brushed the snakes to the back of her head. “I’m a…a social worker,” she said. “From Indiana. I tried to have an abortion back home, but…but no one would do it. Then my supervisor found out I was pregnant, and I got fired from my job.” She dabbed at her eyes and went on. “She said I wasn’t any…any better than…our clients.”

“So I took all my money and decided to come to New York. I thought I could certainly get an abortion here. But I was in the city three whole days and I couldn’t get a single doctor to do it. I offered them every cent I had—every single penny—but not one of them would help me.” The pitch of her voice hit the hysterical level, and she shrieked on, “Every cent I own I offered, and it didn’t do any good. Look! Look! I’ll show you.” With this, she flung her little pocketbook open and money burst out. Bills flew around the room. Tens and twenties fluttered to the floor. A hundred settled on top of the speculum on the table. “Twelve hundred dollars,” she screamed, “and no doctor would touch me for less than two thousand.”

I helped her pick up the money and put it back into her purse. Twelve hundred dollars—three months’ salary! I felt absolutely giddy. I wondered what I’d have done if I had lived in Hadleyburg at the time when Mark Twain’s stranger was passing through.

The social worker from Indiana calmed down a bit at that point, and went on with her story. “When I couldn’t find a doctor to help me, I finally got desperate. Last night, I was in my room at the Y and I just couldn’t stand it anymore. So I…I took a…coat hanger, and dipped it in alcohol to clean it, and then I…I stuck it in.”

We helped her up onto the table and I started to examine her. She was pretty well along in the process of aborting, and as I introduced my fingers, I inadvertently broke the bag of waters. Alcohol on coat hangers must have a selective antibacterial effect: it must kill the harmless germs and leave only the real doozies. I won’t even try to describe the odor that spread outward from that examining cubicle, but suffice it to say that, within three minutes, the chief resident was in the room to see what in the name of God had happened. He had been sitting in his office, a hundred yards away, around a corner, and with his door closed.

The woman did survive and went back to her Indiana home. There, she is most likely spending the rest of her days as the exemplary wicked maiden lady whose behavior should serve as a negative model for local damsels.

A woman worthy of mention was one who came to Bellevue for a relatively minor complaint, a nondescript vaginal itch. I was examining her when I noticed that the nurse was making wild gestures in the direction of the floor. She was pointing frantically in the direction of the patient’s knitting bag, which was lying on the floor near the head of the examining table. From where the nurse was standing, she could see into the bag, but I couldn’t. So, after I had finished the examination, I walked up to the head of the table and glanced sideways.

My God, it was right out of Edgar Allen Poe by way of Vincent Price. The bag was chock-full of the lady’s instruments of trade. She had specula, uterine sounds, cervix grabbers, curettes, catheters, you name it. And dirty! The curettes were rusty and bloodstained. The catheters and specula had crud all over them. They looked as though they had never been washed. I thought the engraving on some of them looked familiar, so I bent over and picked out one of the specula, holding it as though it were carrying plague bacilli. Sure enough, it read, C
ITY OF
N
EW
Y
ORK
, D
EPT. OF
H
OSPITALS
.

No wonder I hadn’t been able to find a cause for this woman’s problem as stated. She had been coming in with phony complaints to different GYN facilities, and when she had been left alone to dress or undress, she’d filled her knitting bag with various instruments she could use for abortions. There was a woman who really stuck to her knitting.

She looked at me and I looked at her. I felt calm and prepared for any eventuality. Had she pulled a knife or a gun, I’d have promptly dropped the speculum back into the bag and offered her her choice of our stock of shiny new equipment. But she didn’t say a word—just stared at me. Finally, I came out with, “What do you get for a job?”

She smiled sweetly. “Fifty bucks, Doc,” she said. “And seventy-five or even a hundred if it’s some snotty little college girl who’s too afraid to tell her daddy.”

“At those prices, don’t you think you ought to at least wash your instruments?” I asked.

She stopped smiling and snapped at me, “Sheet, Doc, as long as you bastards won’t do ’em nohow, you ain’t got nuthin’ to say. You hear me—NUTHIN’!” She glared harder. “Long as women want ’em and you won’t do ’era, you’re gonna keep me right in business.” Then her expression relaxed, and she smiled again. “And I’ll tell you, Doc,” she added, “business is mighty, mighty good, too.”

During the past few years, I’ve derived considerable pleasure from thinking of the severe business setback that woman has suffered since the Supreme Court ruling. But meanwhile, the Right to Life campaign to make time march backward continues. And I’m willing to bet more than a little money that I know one person who is eagerly watching that campaign, hoping it will soon bring the day when she’ll once again be able to send the Bellevue gynecologists some of their most challenging cases. I’d also wager that the knitting bag is in her closet, full to overflowing with hardware and ready to go to work at a moment’s notice. I’d even bet she still hasn’t washed those damned instruments.

During the early 1960’s, one of the favorite pastimes of the Bellevue house staff was to get together every week and watch Ben Casey, that old TV show about a neurosurgical resident with all the human virtues of a tortured mongoose. We’d crowd around the set and hoot at the stupidity that the credulous public cheerfully swallowed as reality. The scenes that set off the largest numbers of outraged howls were the ones in which Ben, or one of his colleagues, rode in an ambulance to the scene of a disaster, and then heroically kept the patient alive as the vehicle screamed its way back to the hospital—not a moment too soon.

Thus, most people think they know about riding the ambulance: how the intern flies out of the Emergency Room and leaps onto the side of the vehicle. Then, holding the outside rail, his white coat flapping in the breeze, he risks life and limb as they zip through the city traffic. All this is presumably done so that when they reach the victim, the doctor may save one or two seconds getting to him. Such an intern would have to be more than a trifle tetched.

In actual fact, hospital-based ambulance calls have now pretty much gone by the boards. Certainly, interns don’t go on the runs any longer: it’s a dreadful waste of manpower. Besides, there are currently private and civil ambulance services which maintain vehicles stocked with first-class resuscitation equipment and staffed with paramedical attendants whose knowledge of first-aid procedures make the average intern look like a refugee from kindergarten. But back in my own internship days, we still took a turn going out to answer the calls. It was, though, very different from what was seen on Ben Casey.

The truth was, most of our ambulance runs were pretty tame affairs. For one thing, the genuine emergencies were already being attended to by prototype paramedicmobiles. Mostly we went out to get people who simply had no other means of transportation. Some were poverty-stricken elderly citizens who didn’t have fifteen cents to spend on a bus. Others had the fifteen cents, but figured why the hell should they wait fifteen minutes in the rain on a street corner. Other calls were for people who had stopped breathing, whose hearts had stopped beating, and who were no longer moving. Of course, there was nothing anyone could do for them, but the gawkers standing around gnawing off their fingernails needed a specially trained individual in a white coat to tell them that the guy was officially dead. Then they could relax and go home to eat dinner.

Actually, we enjoyed going out on ambulance calls. Since we worked thirty-six hour stretches in the hospital, this was our one chance to get out for a while. Can you imagine that: a bunch of people who opted for breathing the New York City air because they considered it an improvement? That tells you something about what lack of sleep will do for a person’s judgment. Or how thoroughly depressing Bellevue was. Or both.

An ambulance call usually began when someone happened to notify the police. They, in turn, would radio in to the ambulance dispatcher at The Vue. It was this worthy’s job to get a crew together: a driver, an attendant, and the next intern “up.” The three of us would climb into the meat wagon, strap ourselves securely in, and off we’d go to God-knows-what. Usually the essence of the requesting call bore little resemblance to what we’d actually find. But we often did get to meet some very interesting people on these runs.

One day we got a call to a fancy office building on Park Avenue South. As we wheeled up, the cop from the car parked in front of the building waved us to pull in next to him. As we leaped out of the back of the meat wagon, he yelled, “Thirty-second floor, Doc, hurry up.” We ran on into the lobby.

When we got to the thirty-second floor, we encountered hordes of popeyed people, all pointing at and urging us toward one particular suite, whose door was open and from which issued the most piercing wails. We looked at one another. The attendant said, “Lawd, sounds lahka buncha god-damn banshees.” The stretcher-bearer and I shrugged, and we all walked in.

The anteroom we entered was occupied by five or six women who were running about, apparently in random fashion, and periodically emitting the wails that we had heard from the hallway. One of them noticed us and motioned us frantically into the inner office. There we found a gentleman in his mid-forties. He was wearing a gray suit and was sprawled between a desk and a chair. His skin was bluish-gray and his pants were wet. It was obvious that he had been transferred to the Great Corporation in the Sky. I walked back into the anteroom, where I triggered off another burst of wailing. I asked if anyone could tell me what had happened.

The calmest member of the group, a tall, middle-aged woman who had been sitting at the desk dabbing at her eyes, came up to me. “I was taking dictation from him,” she said, “when he just stopped talking and grabbed his chest, and turned gray all over, and slid out of his chair.”

“How long ago did it happen?” I asked.

“About three o’clock,” she answered. I looked at my watch; it was 3:40. At that point, a fat, heavily made-up woman ran over from the periphery where she had been pacing, and grabbed on to my lapels. “He’s dead, isn’t he?” she wailed.

“Well, uh…yes.…”

That set her siren going full blast. “You don’t have to tell me; I just know he’s dead.” She began to cry inconsolably.

I tried to calm her down. Aside from the commotion she was causing, she was on the verge of ripping my coat or choking me. “Was he your boss?” I asked her.