Reports from the Society of Anesthesiologists, and Humboldt-Del Norte, Alameda, San Joaquin, Kern, and San Joaquin Counties.

Stephen H Jackson, MD, editor of the California Society of Anesthesiologists Bulletin, commented on the passing of Charles Schulz. His kind-hearted stories and human commentaries ran in 2,600 newspapers in 75 countries, making him the most widely read of all human beings. Schulz gave us Charlie Brown who resonated the feeling of the underdog, a role that our patients, and many of us, have experienced with increased frequency and intensity during this past decade.

There seems to be an endless line of legislators and regulators who degrade and denigrate the medical profession, treat us as commodities and empower those who want to practice medicine without having a medical degree. Jackson sees Charlie Brown as a role model who should strengthen our resolve to protect the sick, the infirm and the vulnerable in our society, and doggedly (like Snoopy) serve as their last line of advocates and protectors.

George Ingraham, MD, President of the Humboldt-Del Norte County Medical Society, describes the rewards of inefficiency. He saw a glossy flyer from a “chap” in the Midwest who had hired an efficiency consultant (three-piece suit, blow-dry haircut).

He was struck by the final paragraph in which the doc in question—proudly, mind you—announced that he is now able to spend just five minutes with each patient. He accomplishes this by having many exam rooms, someone taking notes, a portable phone, and never sitting down unless absolutely necessary (this inefficiency breaks the flow).

Dr. Ingraham likens this routine to a starving, methamphetamine-crazed honeybee in a florist shop. He concludes that his Midwestern colleague doesn’t realize that the folks behind the Redwood Curtain are trying to establish a relationship with patients, something that can’t be done in five minutes standing up, except maybe in a singles bar if you’re really good.

It may be inefficient to sit and get to know the patient, but isn’t it worth it? That feeling of being trusted, sometimes liked, gives you that marvelous personal high. And you realize you would not trade places with anyone on this whole wretched planet.

The ACCMA Bulletin, monthly Journal of the Alameda-Contra Costa Medical Association, has a series on “Reflections.” The anonymous author cites his experience on starting his OBG residency: “My first patient had stage IV carcinoma of the cervix. After rounds I noted dehydration, hypokalemia, and anemia. I felt you couldn’t get into heaven with electrolyte imbalance and so started an infusion, corrected her potassium, and transfused blood.

“The next morning she was alert and went home two days later. Hattie returned a month later. Laying comatose, she was surrounded by nine people dressed in clean sharecroppers clothes. One women introduced me. As they came by to shake my hand, Hattie’s daughter said, ’Doctor, you don’t have to do anything more. My momma had four real good weeks and now she’s ready to go. We all said goodbye.’

“During those weeks Hattie seemed happier than anyone could remember. The family had a reunion. A brother whom Hattie hadn’t seen since 1943 attended. The woman then said, ‘Doctor, the time with my momma that you gave me and my family we can never repay.’ She handed me a box from her battered purse. I unwrapped a watch fob engraved with my initials and the date. Hattie died the following morning.

“I Remember You, Hattie. . . and when I do, I cry.”

The San Joaquin Physician pays tribute to Dr Richard Nickerson, a remarkable doctor-lawyer. He decided to take up law in the 1960s and passed the bar in 1969. From 1970 to 1975, he juggled his life as a practicing lawyer and a surgeon.

After 1975, he realized that being a physician was ;more fulfilling and he decided to stop his law practice. His advice to new physicians is, “Be a people person. Be devoted to patient care, and have great compassion for human suffering.”

Elsa P Ang, MD, president of the Kern County Medical Society, addresses professionalism in her monthly column in the Bulletin. She lists the components as knowledge, learning pursuit, service to your patient, and conscientious adherence to the Medical Code of Ethics.

She discusses psychologists who want to prescribe, optometrists who want to operate, physician assistants who want to play “doctor,” as well as professional ball players arrested for gambling as lacking professionalism. She hopes never to be addressed “Professional Physician.” “Just Call me DOCTOR,” she says.

San Joaquin Medical Society member Moris Senegor, MD, shares “Medical Anecdotes from Music History” in the feature story of the San Joaquin Physician. Dr Senegor became interested in the medical conditions, ailments and deaths of the great composers and other colorful characters.

For instance, there was Jean Baptiste Lully (1632-1687) an opera pioneer, who was known to break players’ violins over their backs. He stabbed his big toe with a billiard cue while trying to beat time for his 150 performers. He refused to have his infected and gangrenous toes amputated and died. He was considered the first case of music related death.

Wolfgang Amadeus Mozart (1756-1791) was a child prodigy whose early talent was recognized and cultivated by his father, Leopold. He began composing by the age of six, and wrote his first opera at the age of 11. He was a sickly man with upper respiratory infections, body lesions, toxemia, typhoid, rheumatism, small pox, yellow jaundice, dental abscess and various other ailments. His premature death at age 36 was officially given as “heated military fever,” an 18th century euphemism for “we don’t know.”.

Felix Mendelssohn (1809-1847) who wrote the popular “Midsummer Night’s Dream,” had a stroke shortly after his sister did and died at age 38. Franz Schubert (1797-1828) led a Bohemian lifestyle, contracted syphilis at a young age, suffered through its various flare-ups and died of typhoid fever at the age of 31.

Frederick Chopin (1810-1849) met an early death at 39 of tuberculosis.

Johann Sebastian Bach (1685-1750) a church organist, and George Frideric Handel (1685-1759), who composed operas and oratorios (Messiah and others), were both killed by the same surgeon. Chevalier John Taylor performed the same cataract operation on both composers, nine years apart, which resulted in their deaths. He earned a place in music history as a most infamous surgeon. Dr. Senegor states that this is just the tip of the iceberg and gives an excellent bibliography of books and lectures in which to indulge.