The randomness of life can result in profound influences on our choices of what we do and who we become. Take for instance a Saturday in November during my third year of medical residency when I decided to go bike riding with a physician friend and his wife. I remember it being a nice, sunny California day as we began to ride near Marina Del Rey. And that is the last thing I remember until a couple of days later, when I found myself as a patient at my own hospital, LA County.
The story, as told to me by friends and subsequently by others who interacted with me, was that I was apparently the victim of an accident. When my friends turned around to see where I was, they saw me lying on the ground, my bicycle twisted up next me. I apparently hit my head and my face, knocking some front teeth out in the process. My friend’s wife pulled a handkerchief out of her pocket to try and deal with the bleeding, spilling some coins on the ground next to me. I apparently told her, seeing the coins and my teeth on the pavement, “Look! The tooth fairy has already been here.” The ambulance took me to one of the small near-by emergency rooms, but as I was a County resident, and had no other insurance, they transferred me to County. (I know this because I later received a bill for a very expensive ambulance ride!) They called the ER to let them know they were sending me, along with another man who had been stabbed. Signals somehow got crossed, because when I arrived at County, covered in blood and confused from the concussion, they were expecting a County resident who had been stabbed, with the trauma team rushing to meet me. “Where have you been stabbed?” demanded the trauma resident, who didn’t recognize me with my smashed up face. “I don’t know,” I replied. “What do you mean, you don’t know? What kind of gomer are you?” (Gomer = a derogatory term for “get out of my emergency room.”)
It seems that my worst trauma occurred when I was being transferred from the gurney to the X-ray table and got dropped on my head on the floor because the tech forgot to lock the brakes of the gurney. All this I know only form hearsay. When I finally was able to see my face in the mirror, it was a pretty daunting sight. I had a broken nose pushed to the side of my face, broken and missing front teeth, and part of my upper lip was avulsed, giving me the look of someone who was on the losing side of a boxing match with Mike Tyson. Fortunately for me, the chief ENT resident on the service, who was later to become a top plastic surgeon to the Beverly Hills crowd, used me as a guinea pig for a then new procedure of split layer skin grafts, largely avoiding the use of sutures, to reconstruct my face. I eventually ended up with a barely noticeable scar under my nose and a face which looked acceptably human rather than like Frankenstein’s. I remain grateful to him and his skills. I was in the hospital for almost two weeks, and spent some more time recuperating while being assigned to a cardiology research project with one of the faculty. Freed temporarily from the daily grind of patient care, I had the luxury to attend many of the specialty conferences and grand rounds, which were usually both instructive and interesting. This is how I got to know one of the GI faculty, Dr. Pincus, an elderly, rotund, and not immediately impressive man. I soon discovered that under his slightly disheveled and unimpressive exterior lay a very bright intellect with a vast store of not only medical knowledge and history, but also a deep love of ancient manuscripts, herbals, and medical texts, Over the years, he managed to amass the largest private collection of rare medical texts and illustrations outside of the Huntington Library’s vast collection. He owned not only an original copy of the five hundred year old Vesalius’ Anatomy text, but also one of the three hundred limited prints made from the original woodblocks destroyed during the bombing of Munich. The illustrations, recognizable even to non-medical people, are rendered around locations in the Italian city of Padua. If you visit the city today, you can still recognize the background seen in each illustration, and know where the artist stood when he sketched them. He invited me, along with a couple of other students to his house to share with us his passion. The experience and privilege of being able to touch and read masterpieces, many with illuminated texts, is difficult to describe. He was a very humble man, and lived in relatively modest home, much of which was given over to this amazing library. I later found out that he came from a very wealthy Philadelphia family, and likely never needed to work for financial reasons, but he loved medicine as well as rare books. His influence was the deciding factor in my choosing gastroenterology as a subspecialty.
As I was nearing the end of my County training, he was also the person responsible for sending me to teach internal medicine in Indonesia under the umbrella of an organization called Care-Medico. He went so far as to actually pay my airfare and housing during my stay out of his own pocket for an experience which truly changed my outlook on many aspects of life. The story of my Southeast Asia adventures will have to wait for another blog. For now, and always, I remain grateful for his generosity, kindness and example of how to be a good doctor, as well as arousing in me a lifelong interest in medical history.