Thursday, July 23, 2009

Hungarian Rhapsody No. 2 by Franz Liszt

Last week's pneumonia has now affected 4/5ths of the family. I've recovered, but now my wife has it and both the boys have fever. Apparently we were all infected by the canaries with chlamydia psittacci. Needless to say, the foul fowls have been evicted. Person to person infection is extremely rare so, Trep, you are safe (you ol' germaphobe you!).

As a result I'm not at work. The upside of all this is the "quality" time I'm spending with our youngest child. We are watching lot's of DVD's together. And his (and my) favorites are the Bugs Bunny shorts.

My favorites are the musical cartoons and my all time favorite is "Rhapsody Rabbit" based on Franz Liszt's Hungarian Rhapsody No. 2. The funniest bit is when the phone rings inside the piano and Bugs answers, "Franz Liszt? Never hoid of 'im." I have several versions of the Hungarian Rhapsodies but this was the first one I ever heard and it still makes me laugh. So here it is:

Here are some other versions:

And for the purists:

Tuesday, July 21, 2009

The Gift

A month ago, a 12 year old boy needed ultrasound guided drainage of Perforated Appendicitis with Abscess. This invasive procedure often requires sedation and I was sent to the radiology suite for that purpose.

I talked to the patient and to put him at ease I asked him what movie he would like to watch during the flight. He eagerly wanted to see the latest James Bond movie (I thought 007 was retired!). I told him I'd do my best.

The procedure went well. In recovery the boy was very agitated and complained of abdominal pain. The parents were in tears. I prescribed pain medication and asked the patient to breath slowly and deeply (a great meditation and auto-hypnotic technique) and explained that he would feel less pain.

This was at the end of Thursday and I was eagerly anticipating joining the rest of the family for a long weekend at a hotel near Jerusalem. Before I left the hospital, I went back up to Radiology to see how the boy was. The father seemed more worried than ever. Despite my desire to leave, I answered all his questions to the best of my ability (the surgeon could better answer most of his concerns, however at that point in time I was most available). After about half an hour of discussion, the father seemed somewhat relieved.

When I got to the hotel, I called the hospital. The boy was back in the pediatrics ward and was no longer suffering from pain.

A few days later I again met the father at the local cafe. He was all smiles and said that his son was fine and was being discharged. He thanked me and I went to work.

This week, when I returned to work from sick leave, I was given a package. It was a letter of thanks and gifts. The package included a very portable 3 book set of the Mishna and a silver bookmark. I have never received such beautiful gifts for just doing my job. This gift means quite a lot to me. Among the changes in my life this past year, is an interest in the sacred texts of Judaism, and I have begun (albeit sporadically) to study the Talmud with my local Chabad Rabbi (who, in my humble opinion is a genius).

However, the accompanying letter is very touching. Here is a (very) rough translation:

Dear Dr. L,
On Thursday xx/xx/09, my son was brought to the ED because of abdominal pain. The diagnosis of Acute Appendicitis with Peritoneal Abscess was made in the ED and within an hour Prof. K and Dr. N performed an invasive procedure which saved my son's life. This procedure couldn't have been performed without your dedicated help. Now, having been discharged from the hospital, is the time for giving thanks:
" are charged day and night to remain by the side of a patient in distress at all times and all have been taught to understand the heart and soul of the patient and lift his spirits with understanding and the love of humanity...
So it is written in the Physician's Oath (the Hebrew version. Here is the original with the biblical references. -QL)
At times, in life, events occur which bring into focus the meaning of the word: humanity. So it was in this case.
Deeply stirred, frightened, unable to speak, I watched as the doctors worked calmly with determination to save my son, and again understood the sanctity of your work and especially your humanity.
Thank you from the bottom of my heart for the dedicated treatment and for literally saving the life of my son. Blessed is the man who has known you.
In the tractate Sanhedrin (from the Mishna - QL) it is written:
"He who saves one soul - saves an entire world."
On behalf of the entire family, please accept this humble gift.
I will end with the 8th blessing of the Amidah:
"Heal us Lord, and we will be healed, save us and we will be saved, bring complete healing for all our illnesses, for you are a compassionate healer."

With Infinite Gratitude,
The L. Family

I called the family to thank them for their generous gift. The son answered the phone. When I identified myself he said that I had done a poor job because he didn't see the James Bond movie. I apologized and assured him that it was much more important to be healthy again.

He then passed the phone to his father. I thanked him for the gift. He said it was only a small token of appreciation. I assured him that it was much more than that.

Monday, July 13, 2009

Hypochondria by Proxy

On the cel phone my wife was sobbing, "Thank God!" and she hung up. My temperature must be up again, I'm having an auditory halleucination. My wife is actually thanking God that I have pneumonia. I'm definitely hearing things. "Nurse!" I call out, "get me a psych consult...for me!"

Let me start over. Most people have one Yiddishe Mama, the biological one (Hi Ma!). I have three:
1. My actual mother.
2. My mother-in-law.
3. My wife.

Of the three, my wife is the most accomplished. To be sure, it is genetic, her whole family are master worryworts. And they have taken Hyphochondria by Proxy to completely new levels. Every cough, rash, sneeze, pain, tingle and premonition in a family member is cause to seek expert consultation.

About four months ago I was hit with the ol' one-two punch. I got the common cold and then when I recovered, I got it again. I was pretty worn out. Since then, I've had this cough. Just a dry cough and a constant tickle in my throat. It got to be so routine that I didn't even notice that I was coughing.

Eventually, my wife and mother ganged up on me. "Go to the doctor!" "But I feel fine, besides I'm too busy". Both were true, I felt fine and I was very busy.

But last week, I developed a fever. It started in the middle of a very long operation. The surgeons had the air conditioner on full Siberia mode. And I felt awful. I took a surgical drape and fashioned a balaclava out of it. So, the next day I called in sick and went to my family doctor. "Your lungs are clear, it's probably just a viral infection. No cause for worry." (I've used that line myself many times) "Good, I can finally reassure my wife the hypochondriac by proxy." He laughed.

A few days later, my cough got worse, more productive. I went back to the doctor and this time He heard crepitations in my right lung. "You've got pneumonia." OK, Emergency Dept. here I come. First I went home to drop off the mail and tell my wife. I was met with the patented hypochondriac-by-proxy-gaze. She looked more worried than ever. I tried reassuring her, "It's just to get a chest xray to confirm the diagnosis. I'm fine, really." The gaze became a black cloud.

I went to the ED in the hospital I worked in for ten years and received the royal treatment. I was actually enjoying myself seeing old friends and co-workers. The most senior internist in the ED recognized me and took my chart even though any resident could take my case. A couple hours later, after blood work and a chest xray I was the proud new owner of a right middle lobe pneumonia. See?

Well It is actually hard to see if you're not trained to see it.

Anyway, then transpired the conversation that began this post. I must be insane, my wife is relieved that I have pneumonia? When I got home I was greeted with that "I told you so" look. That too is patented. I swear, I'll have "My wife told me so." engraved on my tomb stone.

It was only today that I asked my wife what she was thinking when she thanked God that I had pneumonia. "Something worse, much much worse."

"You mean cancer?"

"Don't say that word in this house! Besides, your mother must think I'm a loony toon."

"Oh, Oh. Why?"

"Because, when you were in the ED I phoned your mother. She said it was probably pneumonia, and I said "I hope so.""

Just for the record, had I gone to the doctor a month ago, he wouldn't have found anything. I was assymptomatic (except for the cough), my lungs would have been clear on auscultation and the chest film would have been normal.

But "I told you so" just can't be lived down.
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