Physicians' Untold Stories Read online

  When I arrived, I joined a well-loved surgeon who had been in Ethiopia for twenty years. I admired his dedication and perseverance. Surprisingly, we resembled each other so strongly that longtime patients thought I was his son. This went a long way toward establishing my credibility with patients. He agreed to mentor me for five years while I learned the language and the culture, but after eight weeks he was reassigned to another private, church-sponsored hospital, and I was on my own. I was the medical and surgical team, hospital administrator, and educator! I even administered and monitored the anesthesia during surgery. I don’t know how I held it together at the beginning, but I had the support of a great nurse and several Ethiopian trainees who were learning to be nurse practitioners.

  A typical day started at dawn with seven or eight surgeries, and then I spent the remainder of the time in the clinic. Sometimes we saw as many as a hundred patients in a day. Emergencies punctuated the schedule so frequently that they almost became the norm. At night, a regular stream of travelers arrived, having started their walking sojourn in the early morning. The entourage typically consisted of the ailing family member on a stretcher and ten to fifteen family members who took turns carrying the stretcher along dirt roads and over rivers and streams, often without bridges.

  A common surgical emergency at night was a pregnant woman, unable to deliver, who ruptured her uterus. They were often unconscious in shock from loss of blood, and since our blood bank consisted of willing donors (our “walking blood bank”), they required three or four liters of IV fluid before I could even consider operating. This made for a long day that was then repeated over and over again, seven days a week.

  After seven months of this I was at my breaking point, and it was then that I offered my desperate prayer for an assistant. I was frankly surprised at the boldness of my request, and I felt guilty, but I knew this would be my last day if I did not get relief. With a tear in my eye and a bowed head, I walked across the street to make rounds, and then scrub for my first surgical case, a patient with a massive goiter (enlarged thyroid) in his neck that extended down behind his breastbone and into his right upper lung. I was familiar with chest surgery, but it was not my specialty, and I wished I had a thoracic (chest) surgeon to help.

  As I started the case, my wishful train of thought was interrupted by an urgent knock on the operating room door. An assistant opened the creaking white door to reveal my wife. She never came to visit me here because she fainted at the sight of blood, but, today she stood there boldly.

  Behind her stood a man with strikingly black hair as unkempt as his wrinkled clothing, but he greeted me with a broad smile that was contagious. When our eyes met, my knees became weak. A sense of spiritual destiny filled the operating room. I knew immediately that this person was God’s emissary, sent to answer my desperate prayer offered just hours before.

  “Harold,” my wife said excitedly, “I want you to meet Dr. Ivan Moskowitz from Brooklyn, New York. Harold, he has come to relieve you!”

  Overcome with emotion, I stood there for several seconds before I could even speak. I wanted to say something profound to express my realization that I had just been touched by a divine hand, but all I could muster was an anticlimactic, “I am very pleased to meet you. If you wouldn’t mind waiting, I will finish my case and show you around.” Things were a blur after our meeting, but I did remember our conversation when I asked about his specialty.

  “Thoracic and cardiovascular surgery,” he replied. “In fact, I saw you completing a thyroid case, and I just published a paper on the care of goiters which extend behind the breastbone and into the chest.”

  It was the very case I had operated on this morning! Now I was beginning to understand the true depth of the miracle unfolding before me.

  “How did you happen to come to relieve me?” I asked.

  “It was just a series of coincidences,” he said. “I always wanted to go on a mission to use my training to help others in need, and when I was nearing the two-year mark of my surgical practice in New York, I awoke one day and knew that this was the time. Not knowing where to go in the third world,” he said with a smile, “I used the scientific method! I spread a map of the world on a table, closed my eyes, turned the map around three times, and put a finger down. You guessed it! Ethiopia! I picked up the phone and arranged for a one-month sabbatical to any hospital in Ethiopia. My flight, several weeks later, was to the capital city of Addis Ababa. From there, I did what every thoracic surgeon with a well-organized itinerary would do; I looked in the phone book. My eyes were drawn to a small entry listing your mission headquarters, and I dialed the number. Your mission director, who answered the phone, was delighted to have help for one of his five hospitals, and he randomly assigned me to work with you. I took the next refurbished DC–10 to your grassy airstrip, and here I am!”

  I learned later that our mission director was unaware of my desperate situation, since our communication was marginal at best, so his decision to send Dr. Moskowitz to me was truly “random.” Yet this “coincidental doctor” went on to heal not only my thyroid patient whom I had worried about that morning, but hundreds of other native Ethiopians.

  Dr. Moskowitz provided coverage for me while I went on a one-month rest at one of Africa’s lake resorts where I recovered my strength and was able to continue my dream for what turned out to be another forty-two years. After my initial experience, however, I determined to take an automatic one-month break for every five months of work.

  Several years later on one of my trips to raise money in the United States, I visited Dr. Moskowitz at his New York hospital. The subway system in New York was confusing to a transplanted African used to navigating jungle roads using the sun and stars. My wife and I with our two children were totally lost when an unusually tall young man approached us—so tall he looked like he could have played for a professional basketball team.

  “Do you know where you’re going?” he said in a kind, caring voice.

  We shook our heads and shared our destination with him.

  “If you follow me,” he said, “I will take you there.”

  I’m not sure why he took such an interest in our dilemma, but he became our guide through an underground labyrinth, transferring us from train to train until we came to our destination station, where we all exited. Standing at the long stairway going up to the street level, our guide instructed us to go two blocks straight ahead and then two blocks to the left. Relieved, I started running up the stairs, until I realized I had not thanked our stranger. I turned around to wave and say thanks, but he was gone! There was no exit from the stairway except to the street in front of us or onto a train, and no trains had come in that brief interval. I bowed my head in thanks for God’s servant who showed us the way.

  My experiences with Dr. Moskowitz represent a very special time in my life. I now know that when I struggled the most, I was the closest to my Creator. When I felt I could not take another step on the grueling Ethiopian path or find my way on a busy New York subway, He was there, and He carried me. Now that I am older and no longer able to continue a mission in Africa, I know that He continues to guide my path, and, when I finally complete my journey, He will be there to carry me home.

  CHAPTER 3

  MUSIC IN THE EMERGENCY DEPARTMENT

  ROBIN MRAZ, MD

  “THERE’S BLOOD EVERYWHERE FROM AN arm wound that’s still hemorrhaging,” radioed the paramedics who were at Cleveland Manning’s home. “He’s unresponsive and in shock, and we are ten minutes away.”

  Cleveland Manning was a kind and hardworking man who lived with his wife in a modest home in the Chicago suburbs. His children were grown and out of the house, and he was now a well-loved grandfather. The minor surgery performed two days before on his left arm was to make a connection between two blood vessels. It is usually a routine procedure, but, in Cleveland’s case, a suture came loose, and his artery started spurting blood so rapidly that he was unconscious from the loss of blood within minutes
. When his wife found him unresponsive on the living room floor, she ran to call 911.

  The paramedics arrived on the scene within minutes and radioed his condition to our emergency department (ED). I was the doctor on duty that day, and when I overheard the message, I hoped they could get him to us before he died. I also hoped I could stabilize the patients who were already here before everything was put on hold to take care of our newest arrival. Things in the ED are not always fair. The first to arrive may be the last seen, depending upon the urgency of the problem. And Cleveland’s arrival would certainly trump every other patient waiting for our attention that night.

  He would need multiple units of blood, which we normally crossmatch for each individual, but, in absolute emergencies, we use the “universal donor,” which is O negative. This was one of those occasions. I called to our charge nurse, Cindy Conte, to send someone to the blood bank to pick up two units of O negative and make sure there were at least two more available. Then I hurried back to my last two patients to do as much as I could in the eight minutes now remaining.

  I didn’t accomplish much before Cleveland made his spectacular entrance through the double doors of the ambulance bay. I will never forget the scene. He was lying flat on his back on a gurney with a paramedic straddling his body, actively doing CPR while calling out the cadence for the chest compressions. Another paramedic was holding Cleveland’s wrist, attempting to keep the bleeding to a minimum, although not as successfully as I would have expected, since Cleveland was lying in a pool of blood. His face looked like a ghost! He had no pulse, no blood pressure, and was completely unresponsive. He was essentially dead.

  I remembered a similar situation in training when we were able to bring a patient back with multiple transfusions, but Cleveland had been gone for at least twenty minutes. Looking at him, I was not optimistic, but there was a nagging voice in my head telling me to try.

  “Let’s go for it,” I said to my ED team.

  One nurse took over the CPR compressions; another applied pressure to his arm wound, and the IV team started a second IV. I opened the transport box and took out the two units of O negative blood. It comes in plastic bags, which we connected to Cleveland’s IV tubing and squeezed as hard as we could to force the blood into his body as fast as possible. Dr. Franklin, our vascular surgeon on call, was also waiting in the ED. He quickly inspected the wound and decided surgery would be the only way to repair the torn blood vessels, but he doubted Cleveland would survive to go to the OR. After applying another pressure dressing, which temporarily stopped the bleeding, he left for rounds.

  Cleveland was still unresponsive and without a pulse or blood pressure. After the first two units were squeezed in, we hung another two. I then reached for his carotid artery to see if I could feel anything.

  A pulse! I felt a pulse, although it was very weak. It took another two hours before we felt like we were out of the woods. He received more units of blood than I can recall, liters of saline solution, and multiple medications to control his heart rhythm and blood pressure.

  Finally, there was a flicker of his eyelids, and Cleveland opened his eyes. He was dazed and could not talk at first, but, over time, I could see his strength coming back. I was thrilled when he finally spoke.

  “You guys really have beautiful music here,” were his first words. “I want to hear it again. Could you get me back to that room where they play the music? It was so peaceful.”

  I smiled. “Mr. Manning,” I said, “we don’t play music in the ED!”

  Cleveland went on to describe a beautiful white room with quiet music from instruments that were unfamiliar to him. He sat up to look for the room and was upset when we could not move him back.

  My nurse, Cindy, and I had goose bumps when we both realized what had just happened.

  Cleveland soon stabilized enough to go to surgery, where the tear in his artery was successfully repaired. He left the hospital several days later, but I saw him again in nine months when he returned to the ED for an unrelated illness. His color was much better this time. I chatted with his wife, who told me she thought he died the last time he was here but came back to life. Cleveland was still arguing with her about where she brought him after he lost consciousness in his home.

  “Of course I brought you to the hospital,” she said defiantly. “Where else do you think I would bring you?”

  But he was still not totally convinced. I had to agree with Cleveland. He was somewhere else for those three hours, a place that was so beautiful and peaceful he longed to return, a place of purity and comforting music, a place where we all hope to go someday—a place called heaven.

  CHAPTER 4

  THE BURNING BUS

  SCOTT J. KOLBABA, MD

  WE SLOWED DOWN ON THE expressway for a closer look at the dozens of flashing lights from police cars and fire trucks. The object of their attention was an incinerated coach bus parked off a blocked exit ramp. “That’s Luci’s bus!” my wife shouted, gazing at the bus that was still belching great clouds of black smoke. The blood drained from my face as I realized she was right. Our daughter, Luci, had been riding on that bus!

  That memorable day started like most did when our high school show choir had an out-of-state competition. A flurry of activity in the morning, taking hair out of curlers, making sure the costumes were packed with all the fittings, and gathering up the makeup, the snacks, and most importantly the earbuds for music. At 2:45 p.m. as planned, I dropped Luci at her high school to join thirty-nine other chatty girls. There they boarded the ill-fated luxury bus headed for Onalaska, Wisconsin, on the shore of the Mississippi River. My wife, Joan, and I followed an hour later with our GPS programmed for the five hour trip.

  The bus ride was uneventful until they were about an hour from Onalaska. Then Luci and some of the girls heard a popping sound near the right rear tire. It was not very loud, and, since nothing seemed to happen immediately, they went back to talking, sleeping, and listening to music. At about 8:00 p.m. the noise became louder, so the bus driver decided to pull onto an exit ramp to investigate. He found a flat rear tire, but the heat generated from it caused him concern, and he went back into the bus for the fire extinguisher. In the meantime, the girls waited impatiently inside the bus for the problem to be resolved. A companion bus that was following also pulled off, and the members of the troop were watching the activity when they noticed something so alarming that they grabbed their phones and sent a series of urgent texts to everyone in the disabled bus.

  “Your bus is on fire! Get out!”

  The flat tire had generated enough friction to cause a fire, and now the flames were visibly licking at the side of the bus. Seeing the flames and smelling the smoke, the girls started to scream, “Get off; get off!” Everyone sprang to their feet and pressed forward toward the congested single front door. The fire progressed quickly, and soon the entire bus filled with such dense clouds of smoke that the girls could not even see their feet. Those who were shoeless felt the heat on the floor as the flames darted along the underside of the bus. Luci and her friends, who were seated in the back, sobbed as they waited at the end of the slow-moving line. Would they ever see their families again?

  The flames were now wrapped around the bus like a deadly blanket while the girls were still far from escaping what could soon become a giant burning coffin.

  Then something amazing happened. It was as if a large hand moved silently over the bus, dampening the flames enough to allow each of the forty girls to escape totally unharmed. Thirty-seven, thirty-eight, thirty-nine, forty! The stunned students in the second bus watched as the last girl leaped to safety just as a roaring wall of flames engulfed the interior, consuming everything—except the girls!

  Luci, now on the crowded number two bus, called us on her cell phone. “I’m safe; I’m safe,” she said over and over, and then silence, punctuated by what sounded like sobs. “There was a little fire on the bus,” she said, obviously minimizing the true situation to spare us anguish, “
but I am safe and everyone is fine. I can’t talk anymore and have to go,” she said, and she hung up.

  Shaken by the news but relieved no one had been hurt, we continued driving. When we finally passed the scene an hour later, we were shocked to see the reality of the disaster and the smoking shell of the gutted bus. We tried to stop, but the police wouldn’t allow us to take the blocked exit, so we drove on to meet our daughter at the hotel in Onalaska. Finally, just after one in the morning, the girls arrived. Luci was too traumatized to talk about what happened and went straight to bed. Relieved to have our little girl alive and unharmed, we let her go.

  Still, we feared for the competition. All of the custom-fitted costumes, shoes, makeup, and undergarments had been completely destroyed. Would the girls still compete, and, if so, would they have to sing in their rumpled, slept-in, day’s-old clothes?

  At close to two that morning, we were unwinding in the hotel lobby with many of the parents when we heard the announcement. “We are going to compete in the morning! We’re not letting this stop us,” said Kelsey Nichols, our young choir director.

  My wife, Joan, who was in charge of the costume committee, was just as surprised as I was. We had no costumes, shoes, makeup, or undergarments, and, even if we did, how could we have them fitted in the nine hours between two and the performance at eleven?

  But Director Nichols’s statement provoked a flurry of activity. While the girls slept, parents and alumni of the show choir who had heard about the disaster brought clothing to the home of Mike Moukheiber, a parent and the president of the organization. Then Diane, his wife, with a contingent of parents and students made a 3:00 a.m. raid on the high school. Fortunately they were accompanied by the principal, Dave Claypool, who coincidently had a girl in the choir and who also had the keys. They rummaged in dusty storage closets until they found twenty-five old sequined costumes, which they loaded onto cars for the trip to Wisconsin. But that was not enough for the troop of forty.