Places, Everyone!

Recently, I had the pleasure of attending a play at my kids’ school. They were sitting next to me because, well, they refused to play a part in the production. I turned to the right and spoke in hushed tones to my middle child, “You know, Matthew, you should be up there.” He popped a couple of Skittles in his mouth and silently shook his head back and forth. I turned left to speak to my oldest daughter (let’s just call her the Queen of Tween) and found myself staring at an empty seat. She found a friend on the other side of the auditorium and escaped without a sound while I was looking the other way. I was annoyed and became determined to find someone who could pay the emotional bill I was quickly running up that evening, so I turned back to Matthew and continued my one-sided conversation with him. “Why don’t you want to join the Drama Club?” My question perturbed him enough that the Skittle he just tossed hit him square in the cheek and rattled through the chair into the abyss of the auditorium floor. He shrugged his shoulders, closed his mouth and pretended to chew on an imaginary candy. Going along with his charade, I continued, “You know, I was in plays when I was your age and I had a great time. In fact, I remember the first time I acted on stage ...”

The year was 1976, the Bicentennial year of our great nation. Disco didn’t suck yet and my entire wardrobe was red, white, blue, and loud plaid. I had leisure suits, but didn’t even know what the word “leisure” meant. I was in the second grade and my teacher informed us that we would be performing the Revolutionary War play, “Sam the Minuteman”, for the entire school. She read us the book, and then handed out the parts. I closed my eyes and prayed, “Please don’t call me. Please don’t call me.” But then Mrs. Scheim was up to the lead role. “... and Sam will be played by Billy Reisacher!” The blood drained from my head, making me look even paler than usual. I was still in shock as I strode to the front of the class to accept the script, which was damp with pungent, blue ink. She must have sensed my apprehension as I took the pages because she leaned down and whispered in my ear, “Don’t worry sweetheart, you’ll do fine.”

When I arrived home that afternoon, I grabbed my pillow and went to lie down on the couch, my only place of refuge when the world was caving in on me. My mother immediately knew something was wrong, but I think I gave it away by watching a TV set that was not turned on. “Billy, what’s wrong?” she said in a soft, soothing voice as she stroked my light blonde hair. I explained the entire predicament to her and, as usual, she had the solution in her back pocket and instantly put my mind at ease. “But Mom, what if I forget my lines?” She picked up the script that I tossed on the carpet next to the couch. “Don’t worry, Billy, we’ll practice every day.”

The night of the play finally arrived and I was as prepared as I possibly could be. I knew my lines backwards and forwards. I was dressed in classic Revolutionary-style clothing, but was most proud of my hat, which was my Dad’s when he was a child. I saw my friend, Marcia, backstage and asked her how she was doing. “I don’t feel so good. I’m really nervous and my Mom is sick at home.” She was a member of the chorus, which sang in the background on stage. I wanted to calm her down, so I tried in vain to make her laugh. “Places, everyone!” Mrs. Scheim frantically called as we assembled in the wings and watched the lights dim. The curtain rose and the spotlight followed me to the center of the stage as the narrator began, “This is Sam ...”

The play was going perfectly. Everyone in the cast was hitting their lines, and the audience was loving it all. At one point in the story, I was supposed to lie down on a cot before waking to hear Paul Revere deliver his famous warning. On my mark, I placed my hat behind the cot and pretended to go to sleep. I had only closed my eyes for a few seconds when a horrible sound emanated from the chorus. It was a guttural, retching noise accompanied by the sound of water pouring from a large pipe. I felt a small splash reach my face and I opened my eyes. To my horror, Marcia had just become violently ill, but my concern for her shifted when I realized that my hat was the sole victim of her stomach malady.

Mrs. Scheim rushed onto the stage and escorted Marcia out of the auditorium. We were now without a director, and both the audience and cast were frozen in stunned silence. I knew that this was my defining moment. I could either rise to the occasion and become bigger than anything the second grade has ever seen, or shrink away forever into the lonely shadows of mediocrity. I stood up and faced the crowd. Staring back at me with wide eyes and open mouths were my parents, sister, friends, teachers, the PTA. Slowly, I looked down at my hat, soiled and deflated on the wooden stage as I thought, “We’re going to need a lot of Ajax for this.” I realized that, just like the foolish ways of childhood, my father’s hat was of no use to me anymore. So I picked it up, carefully balanced it like a bowl of punch as the crowd gasped, and I carried it offstage. Returning to the stage, I took a deep breath and delivered my next line.

The applause were still ringing in my head as I snapped back to the present and realized that the play at my kids’ school was over and the audience was on it’s feet, clapping, screaming and snapping pictures. I jumped up and Matthew reflexively followed, spilling the remainder of his Skittles. He stood up on his seat and spoke to me, but all I could do was read his lips. “Daddy, my stomach hurts.” We stopped off at the bathroom before heading home and conversed through the stall door. “Daddy, maybe I’ll join the Drama Club next year.” I thought about it for a moment and replied, “No need to rush into anything. How about trying the trumpet?”

It's History

I walked up the front steps of City Hospital and navigated my way through the revolving door. I was wearing my short, white jacket and the overstuffed backpack on my right shoulder almost got stuck as I emerged into the crowded lobby. I stopped at the security desk and explained, “I’m a medical student from Mount Sinai. I’m supposed to meet Dr. Goldstein in room 324.” The security guard motioned me towards an elevator bank, “Make a left on the third floor. It’s on your right.”

Across his large, wooden desk, Ronald Goldstein, an internist, was explaining what I was supposed to do for the day. “Learning to take a good history on your patient and perform a complete physical exam are the most important skills that you will learn in medical school. And this is the first time you’ll get to do this on a real patient ...” He was in his 50’s and the chaotic piles of papers and journals on his desk matched perfectly with his wrinkled clothing, disheveled hair and two day old beard. His monotone voice sent me into a daydream, but I returned just in time to catch the critical details. “Mr. Pal will be your patient for the morning. He’s in room 561. Drop off your history and physical in my office when you’re done.”

I took the elevator to 5 South and followed the rooms, 558 ... 560 ... 562. Across the hall, I located Mr. Pal’s room, straightened my white jacket, took a deep breath and knocked. Hearing nothing from inside, I started knocking harder, but once my knuckles began to throb I decided to push the door open. The room had a stale odor and the sheets on the bed had been hastily pushed to the side, but, so far, no sign of my patient. I knocked tentatively on the bathroom door, but instead of a human voice, the response of a five gallon flush thundered through the door, almost throwing me backwards. Mr. Pal burst triumphantly from the bathroom. He seemed startled to see me right in front of him as he quickly closed his robe and smiled politely, “Hello.”

Mr. Pal was a 40 year old Indian male who was admitted to the hospital for pneumonia. I explained my mission and he was delighted. “Go ahead; ask me anything you’d like.” He leaned in a little closer to me and whispered, “You have no idea how boring it can get in here!” Without hesitation, I began to take a history. With each question, I probed deeper into every aspect of his life from his family history to all the medications he ever took. No stone was left unturned and within a short period of time, I felt like I knew him better than I knew myself. He started answering the questions with long-winded answers, but before long, he was able to trim his responses down to one or two words. He had a hard time with a few of the questions. “Well, I’m not exactly sure how much roughage I get in my diet, but I guess I could ... uh, why exactly is that important?”

I was taking my detailed history of Mr. Pal for approximately one hour, and the reason I knew that was because he pointed it out to me. He kept glancing at his watch, so I added that observation to the twelve pages of notes I had already accumulated, “Patient seems to have a nervous demeanor. Consider ... Neurology consultation.” I assured him that I was about to begin the physical examination, but his eyes began to shift from side to side. “I think I have to go for an X-Ray ... or something.” “Don’t worry, Mr. Pal, we should be able to wrap this up within the next hour.”

I opened up my backpack and began choosing the instruments I would need to perform a complete physical exam. With this vast arsenal of tools, which I had accumulated over the first two years of medical school, I could not only uncover any subtle physical finding, but also fix a variety of appliances. “What are you going to do with that”, Mr. Pal inquired as a pulled out a sewing needle. “I’m going to test the sensation on your legs.” Mr. Pal replied, “I don’t think you need to ... OUCH!” We stared at each other in silence for a few seconds before I looked down and scribbled quickly in my notepad, “Nervous system intact.” For the next hour, I probed and explored every space and surface on Mr. Pal’s body that I could reach and took detailed notes on all my findings. He was watching TV and for some reason, settled on the channel that had a clock ticking. Suddenly a nurse entered and informed Mr. Pal that doctors would be coming soon to perform a spinal tap. Fortunately, the only things left for me to do were palpate his liver and spleen. He perked up and said, “Oh, good ... I mean, OK, if you must.”

I sat at the nurses’ station for the next hour, compiling all of the data I had collected during the morning. When it was finished, I was so proud of what I had accomplished. I tried to staple all the pages together, but the staple wouldn’t go all the way through, so I settled for a paper clip. I went back to Dr. Goldstein’s office and placed Mr. Pal’s history and physical on his desk, but as I turned to leave the office, it slid down one of the piles on his desk and landed on the floor.