This next chapter is kind of a hodgepodge of little stories about things that have occurred over the many years that I have been in private practice. First I would like to start with the people that I have worked most closely with and that is the nurses on labor and delivery. Believe me when I say I have spent more time with them than my family. We have developed a close relationship through the many hours we shared together both caring for patients and just sitting around talking to while away the hours. I know many of them like my own family. We know each other’s spouses, children and personal satisfactions and sufferings. We have lived together through weddings, divorces, births, deaths and God knows how many other personal events in our lives. Yet somehow we are all professional enough to know caring for a patient comes first despite all of our other personal relationships. I have known some of these people for almost my entire professional career and I value their friendships and tremendous dedication to the profession very much. They are some of the most unique people I have been exposed to in my career and I have learned a lot from them. Several of them I have had the privilege to care for as patients and I truly consider that to be such an honor, that after working closely with me, they have chosen to have me as their physician. There are countless stories and incidents we have lived through together and at our reunions now we are able to laugh and relive many of these interesting, sad, funny or challenging incidents. One of the amusing stories I would like to relate is how the labor nurses would call home when there was a particularly loud, I really mean a screamer, patient in labor. I am told they hoped that their daughters would listen to these patients and then maybe think twice about the consequences of having sex without some form of contraception. Now certainly not all patients scream during labor but they used the few that did to try and teach a lesson. I am told that the message got across very well in most instances. As the father of four boys, I always found it quite amusing, but I also understood where they were coming from in trying to impart some first-hand knowledge to their children. Of course I did consider it my duty to preach to my sons about this subject also. Nevertheless, I would always get a good laugh out of it when it occurred. I want each and every one of them to know that I have enjoyed their friendship and respect so highly the work that they do.
Of course there were some difficult cases that we shared caring for that we also would enjoy reliving. Some were very sad and painful, but many we enjoyed reliving knowing that we had helped someone who was in need and that is a wonderful thing to share over and over. It is also the reason that we all chose this profession. I always found it amazing how detailed their memories were of those incidents, like they had just happened and, many times, I would hear little side stories about them that I had never heard before. So to the dear ladies of labor and delivery thank you from the bottom of my heart for your friendship and for all the work you do to bring new life into the world. I could have never done my job to the level I wanted without their support and help. At our reunions, I like to remind them that they are truly the real “guardians of the next generation”. I will miss them all very, very much when I retire.
Naturally over the years I have received some interesting phone calls when I was on call. One night about 3 AM I received a phone call from a very nervous husband who proceeded to tell me that he was sure his wife was in labor with their first baby and he was going to rush her to the hospital immediately and then hung up. He didn’t give his name or phone number, nothing. So what do I do? Do I stay home and wait until she arrives at the hospital or do I go in and wait for them to arrive? Well, being the conservative person I am and besides the fact that I was now wide awake at 3 AM, I decided to go to the hospital right away. When I got there and told the nurses the story, one of them laughed and said “I bet she doesn’t show up doctor”. And how right she was! I waited over two hours and she never showed. And without a name or phone number, I could not even call to find out what happened to her. Was she ok? Did they go to another hospital? Were they in an accident? What had happened? We even called the other hospitals in the area to see if she was there. Needless to say I did not get any further sleep that night. Well, a few days later, I was seeing a patient in the office and she told me what happened. She apologized for the phone call and said her husband got so nervous he thought she said her pains were five minutes apart when in fact they were only five hours apart. Nonetheless, I told her next time make sure he gives us a name and phone number.
Another interesting-but-annoying call I received at 5 AM one morning was from a pregnant patient who was going to see her dentist at 9 AM and she wanted to know what medications he could give her for her toothache. I had just fallen asleep after being up all night with a lady in labor and my temper was a little short, to say the least. I asked her if she knew what time it was and she said “well, what difference does that make? I have an important question for you.” I informed her it was 5 AM and her question was not important and to tell her dentist to call me after he sees her, which I’m sure he would do anyway, and hung up. I fumed for hours after and was unable to go back to sleep.
Another really-annoying-but-predictable phone call on weekends is from young patients to refill their birth control pills. Most women on pills are on Sunday start cycles, which means they start a new package on a Sunday. So, invariably on Sunday morning, they wake up and discover they are out of pills so it’s now time to call the doctor. We have an office policy that we don’t refill prescription medications on weekends for many good reasons. We probably don’t know the patient we are talking to and they often don’t know the medication they are taking and have thrown away the bottle already. We also have had several patients who always call on weekends to extend their prescriptions because they don’t want to come in for a check-up. Usually after telling the patient we don’t refill medications on weekends, the next phone call is from her mother with 5 excuses why little Mary forgot to call during the week. This is sometimes followed by “you don’t want her to get pregnant, do you?” How tempting it is to tell her maybe Mary should not have sex then. Or the best one was “well, how could she call she was on a cruise all week?” Sometimes I just bite my tongue to keep from going ballistic. Other more clever ones will have their pharmacist call and plead their case. I am amazed at how ingenious they are after they forgot to call before their prescription runs out. I am sure other doctors who are reading this are having a good laugh right now, but I can assure you it is annoying as heck.
The next vignette revolves around delivering a set of triplets. I was on call one night and had just gone to bed after another delivery about 4am when the nurse called to tell me that the lady we had in the hospital with triplets was having contractions. This patient had been in the hospital because of high blood pressure. Almost all sets of triplets are delivered electively by cesarean section but there I was in the middle of the night all alone with the possibility of having to deliver them vaginally because they were coming so quickly. I took a deep breath and thought to myself what one of my old professors had said. “Don’t ever worry if they're coming that quickly you probably don't even need to be there.” But just in case phone calls were quickly made to my partners, anesthesiologists and pediatricians to come in and assist. Before anyone could arrive, the first baby was born spontaneously and because the second baby was breech I quickly grabbed it’s foot and delivered that baby without any difficulty. But then when I reached up inside the uterus, I could not feel the third baby at first. I could feel my heart skip a beat. Where was the third baby? Well, it happened to be in a very unusual position, sideways, which left me with nothing to grab onto to help deliver the baby. Both its arms and legs were extended up and away from me. By then everyone had arrived and one of my partners whispered to me that delivering two out of three was no good and I had better get the other one out quickly. This did nothing to increase my confidence level. So immediately we set up for a cesarean section and the third baby was born without difficulty. What a night that was but that is what obstetrics is all about. One minute all is quiet and the next all hell is breaking loose. I am reminded of that delivery yearly as that woman is still a patient of mine and she kindly brings me a picture of the triplets every year for me to see how they have grown. Afterwards, my partner tried to explain what he was saying was that two for three was okay for a baseball player but not in our business. Unfortunately, I did not see the humor in it at the time. That is another former patient that I get chills when I see her remembering our experience together.
The next patient I would like to discuss is a woman I admire tremendously. She is a lawyer by profession who unfortunately carries a chromosome mutation which leads to frequent miscarriages. After several miscarriages a detailed workup revealed the chromosome abnormality. She continued to become pregnant and finally delivered her first child successfully. I was so happy for her. She was so persistent in wanting a child so badly she was willing to undergo a lot of heartbreak and had finally achieved her goal. Miscarriages, although common, range between 15 to 20% all pregnancies and can be quite traumatic. Multiple ones to the same patient are even more devastating. I admire that patient tremendously for her fortitude and perseverance in going through all that she did. She never complained once. She always said “well, we will just have to try again.” She is another good example of how patients teach doctors lessons in courage and strength of spirit. Patients like her have given me so much more than I have been able to give them and I have been fortunate to know several such inspiring women over my career.
Some of the most interesting stories about private practice occurred in my office. One day I was seeing a patient in one of the exam rooms with my nurse and, as I concluded my exam, the nurse left the room while I discussed the patient's problem with her. When I was done, I began to walk towards the door and the patient said "wait a minute doctor, I have another problem." She began to explain that she had been having a problem with one of her breasts and she wanted me to check. She was a particularly attractive woman and suddenly she removed her blouse over her head. She did not have a bra on and she was sitting on the exam table now completely nude. I said okay and quickly went to the door to switch on the light outside the room for the nurse to come back in. I prayed she would come back in quickly. It was only a minute before she arrived, but it seemed like an hour to me. As I turned to give the patient a sheet to cover herself, the nurse came back in. There I was standing next to this very attractive woman who was completely nude and she is holding her breast up towards me while saying “here it is”. My face must have been as red as an apple and I could see the nurse was quite amused. She had a slight grin on her face as she helped the patient cover herself while I tried to look elsewhere for a minute. After I checked the patient, the nurse and I walked out of the room together. As we got outside the room, she turned and said “gee doctor, I can't leave you alone for one minute can I?" It was one of the most embarrassing moments I have ever had with a patient. I don't know whether she was trying to be provocative or she just whipped her blouse off as a matter of fact. The nurse, however, will never let me live that incident down and reminded me of it for years afterwards. It is a fact that, very occasionally, patients seem to come on to their doctors and especially gynecologists have to be extremely careful that they always have a nurse attendant with them during exams. Especially if it's a male doctor.
Another embarrassing incident happened to me one day as I was preparing to deliver a baby. We had just moved the labor and delivery area from Point Pleasant to Brick Hospital. We had brand-new labor rooms where we did the deliveries also. The bed the patient labored on quickly could convert to a delivery table so that the mother would not have to be moved into another room at the last minute for the delivery. Well, as you can imagine, there were a few bugs that needed to be worked out. As I prepared to deliver that lady’s baby, I scrubbed my hands and put on a surgical gown and gloves. I checked the patient and the baby was not quite ready to be born so I attempted to sit down on a stool to wait. In the previous hospital, those stools did not have wheels on the bottom and I presumed the same was true in the new hospital. Wrong! The stool, to my surprise, had wheels on the bottom and, as I went to sit down, it went flying away and I proceeded to fall to the floor and hit my head against the wall. Fortunately, I was not hurt but my pride was damaged immensely. There I was, all neatly gowned and gloved lying on the floor with two nurses standing over me laughing their heads off. My thoughts, however, were for my patient. There she was ready to deliver and her doctor who was about to handle her precious new baby can't even do a simple thing like sit down on a chair without falling. I wondered momentarily if she thought I was drunk. I bet she thought “do I really want this guy to handle my child?" I quickly got up like nothing had happened and went about delivering her baby uneventfully, but it sure was another embarrassing moment for me.
Sometimes, with the advent of natural childbirth, couples and, especially some husbands, tended to carry things too far. It is fine to limit the amount of medication that a mother uses in labor through various breathing techniques. But, occasionally, some of the husbands who were not in labor or having any pain themselves would decide for their wives when and if they needed pain medication. Well, one day I was with a couple and I could see the mother was having a very difficult and painful labor. I tried to suggest to them that I thought a small amount of pain medication at that time would be very helpful and not hurt the baby. Her husband would have no part of it and informed me that she was doing fine. I wondered for a minute where his wealth of experience had come from seeing this was their first child. It always used to annoy me that when I talked to a patient the husband would answer for her. But I said fine and I would return in a little while. About an hour later as I returned to check her again, I could hear her screaming all the way out at the nurses station down the hall from her room. All the nurses were rolling their eyes about how unreasonable her husband was being. They also had tried to get him to let her have some medication but to no avail. I walked into the room and examined the patient and told them that she still had quite a while before the baby would be born and I really thought she should have some medication to relax a bit. Again the husband chimed in and said “no, she is doing fine." By then I was really irritated with him and told him what I was going to do. I told him I didn't think it was fair to his wife that she suffer and that I didn't think he understood how painful labor can be. But I said let's try this: every time your wife has a labor pain, I'm going to hit your hand with a hammer and you tell me when you need pain medicine and I’ll give it to her instead. I was just joking, of course, but he got the picture and finally let us give his wife medication and she relaxed and went ahead and delivered a nice healthy baby a few hours later. It is great for husbands to participate in their wife’s labor and delivery process but, sometimes, they think they know it all from taking a few classes and refuse to let professionals help. I think that young man learned his lesson and after his wife had delivered he came to me and apologized and said “I understand what you were trying to do and thank you.”
And finally, I would be terribly remiss if I did not discuss the important role my office staff has played over my time in private practice. My office manager, Barbara Rose, who warmly welcomed me when I joined the practice, has been my right hand over these many years. She has made my life so much easier by the competent way in which she has handled the financial and mundane tasks necessary to keep our practice functioning. Thanks BR for all your hard work, loyalty and friendship. Our other office manager Janet is a woman I brought from the hospital because of her hard work ethic. A tremendous nurse, she organized the nursing staff and single-handedly does all the follow-up of patients with problems in what we call the “tickle file”. It was one of the best decisions that I ever made and I will miss her very much after she retires. Thanks Janet for your hard work these many years. To the girls in the front office who make appointments, answer the phones, and take messages, you are the face of Pinelands and a big part of why our practice has been so successful. Thank you Denise, Carol, Pat, Jodi and Nicole for your dedication and hard work. Many of those women have been with us for over 20 years and our patients have come to rely on them to convey their problems to the physicians. They are such an integral part of our practice and many of our patients have complimented them on how helpful they are compared to other offices. And finally to the nurses who have assisted us in taking care of our patients. Jeanette, Nicole, Suzanne and Kathy thanks for making my job so much easier. All of those women are what I refer to as the Pinelands’ Girls. They are more than employees, they are my best friends and I can't thank them enough for their hard work, dedication and friendship. Lastly it was not always easy to be the only male in the office with 12 women, but they have done their best to help me understand the female side of life. I have occasionally shared their hot flashes, irritability, mood swings and cattiness and have as a result come to understand probably more than most other men what the female gender is all about. I have learned that under these circumstances even men can have menstrual cycles lol! Thank you all from the bottom of my heart for all you have done for me over these many years.
During my years in private practice I was fortunate enough to take care of a few very important people, well really celebrities. The first was the wife of Mookie Wilson, the talented center fielder for the New York Mets in the 1980s. Rosa Wilson was one of the nicest patients and most grateful that I have ever taken care of. She was a very down-to-earth person and never demanded anything extra because of her celebrity husband. I happened to be on call the night she went into labor and assisted in the delivery of their first daughter. Mookie was a very attentive husband and an excellent coach for his wife in labor. I was a little nervous to say the least to care for this couple but they did their best to put me at ease. Their new daughter was perfectly healthy at birth and I felt very relieved that all had gone well.
Later that year the Mets were playing terrific baseball and entered the playoffs with high hopes of going all the way to the World Series. In the National League Championship series in 1986 the Mets played the Houston Astros. The Mets had had a phenomenal year with a 108-54 won-loss record. So had the Houston Astros and after four games the series was tied at two and two. The next two games were historic with the Mets winning game five 2-1 in 12 innings and they won game six 7-6 in 16 innings. There are many who consider this to be one of the best playoff series ever. So now the Mets were in the World Series facing the Boston Red Sox. Mookie had arranged for me to have box seats behind home plate with the Mets wives for all the home games. Boston won the first two games and the Mets won games three and four. Boston went up three games to two by winning game five. With the Mets facing elimination they entered game six with their backs against the wall. No one was prepared for the miracle of game six. Tied in the bottom of the 10th inning with two outs, Mookie came to bat and hit a ground ball towards first base that slipped under the first baseman Bill Buckner’s glove and the Mets won a real thriller. The Mets went on to win game seven 8-5 in not as thrilling fashion as in game six. Mookie invited me into the locker room of the new World Champion New York Mets and I will never forget that thrilling day. To this day I have a sport jacket that I wore which was doused with champagne which I refuse to have cleaned. Mookie also introduced me to several of the players including their ace pitcher Dwight Gooden. He was known as Dr. K for his numerous strikeouts. When Mookie introduced me to him he said “Dwight, I want you to meet the real Dr. K.” There is also a picture of me with Mookie, Rosa and their new baby that I had delivered in the Mets 1986 yearbook. What an exciting year that had been for me. I had always been an avid Mets fan, but that year was a dream come true for me and all Mets fans.
And now let's talk about the famous Buckner ball. A few weeks after the World Series my wife was running a benefit for our hospital. Mookie was kind enough to accept my wife's invitation for him to be the honored guest. He brought along many World Series memorabilia including bats, shoes, gloves and last but not least the Buckner ball. All of these were auctioned off to the highest bidder and were presented by Mookie himself to the winners. I happened to be the winner of the Buckner ball. I thought twice about keeping it but, in my mind, I thought it was something that Mookie himself should keep so I gave it back to him. Classy move but really dumb in reality. But at the time nobody could realize how valuable that ball would become. In his true unselfish way he gave it away at another auction. Where it is today is unknown to me, but I have heard that at one time it was owned by Kevin Costner, the actor. Besides being a tremendous baseball player, Mookie was a kind man and a beloved New York sports idol. To this day I consider him to be a real friend.
Although many of my patients were not celebrities like Mookie Wilson, some had rather interesting backgrounds. One of my patients was a beautiful young woman who I thought could be a model. She came in on her first visit and asked that she be tested for STDs or sexually transmitted diseases. This was not an unheard of request by patients and I didn't think much of it at the time. When she returned one month later asking for the same testing I became a little suspicious. I asked her if she really wanted to be tested again so soon and she replied “in my business you cannot be too careful doctor.” It was becoming clearer in my naive mind she was not a model by trade. I also informed her that this testing is quite expensive and she replied “don't worry about it doctor, I can afford it.” She went on to explain that she was a call girl in New York City and she would continue to return for regular checkups and she did for the next few years. All the doctors in the office had interesting groups of patients that followed them in their practice. One doctor had a large following of teachers, another one had a group of dwarfs and I had the hookers! By far I think my group was the most interesting.
Some of the most rewarding patients in my practice came from the same family. There were several groups of women in which I cared for grandmother, mother and daughter. I considered it to be such an honor for these families to choose me as their doctor. There were also many patients that I cared for over 30 years. These women became more than patients to me they became true friends. But the most interesting groups that I cared for the ones that I had delivered who subsequently came to me to deliver their child. It also gave me pause to think that maybe it was time for me to retire. In all I delivered four children of women that I had previously delivered. I also had the pleasure of delivering a child who would later become my oldest sons’ wife. The relationships that I had with these women was more than just doctor-patient. They had faith in my ability to care for their families which gave me a great sense of pride. I looked forward to seeing many of these women year after year and watched many grow from mothers to grandmothers and children to adults. I took care of them through their childbearing years, then into menopause and some until the day they died. Whenever a patient of mine passed away I always tried to send a letter of condolences to the family. I tried to tell each family why I had enjoyed caring for their loved one. I hope you can now see in some small ways that I never really considered this to be a job. It was so much more than that for me. They say if you love what you do you will never work a day in your life. How true this has been for me. These are the things I will miss the most when I retire.
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