Assume the Position: Memoirs of an Obstetrician Gynecologist (5 page)

It was easy to avoid them during day time but at night, when walking around in the pitch blackness as everyone did without street lights anywhere, the dogs couldn’t be seen and often were sleeping or laying in piles in the middle of the streets.  I love dogs, but was deathly afraid of stepping on and into one of these piles of wild dogs at night.  Everything else was easy!  The folks at AJWS, and its financial supporters, are true angels!

     A Cesarean section is the removal of a child from the uterus through an abdominal incision.  The origin of the term itself has given rise to many a discussion.  It has generally been asserted that Julius Caesar (100-44 B.C.) was brought into the world by this means.  Likely this explanation is not correct since his mother, Julia, lived many years after her son’s birth.  The following view may be more plausible.  In the Roman law codified by Numa Pompilius (762-715 B.C.) it was ordered that the operation should be performed upon women dying in the last few weeks of pregnancy in the hope of saving the child.  In fact, the earliest Cesarean sections were usually performed on women who had already died in an attempt to save the fetus.

     Born by a Cesarean Section because my brother before me was breech, and born in the days when the dictum “once a Cesarean, always a Cesarean” held true because it was then thought that a vaginal delivery after Cesarean section was too risky for the mother due to potential scar rupture in the uterus, I was fully expected to be a girl named Ruth.  For that reason I suppose I may have been a disappointment at birth.  Most people who have a son would prefer their second child to be a girl.  Of course I never saw it that way, but then I expect in some way it did lead to development of my gentler, softer side.

    (Black’s Hospital, Lewistown, Pennsylvania, where I was born in 1949)

My Dad was a small town lawyer in Lewistown, Pennsylvania, known really for nothing special other than its proximity to State College, home of Penn State.

(The courthouse in Monument Square, Lewistown, Pennsylvania, with my Dad’s former law office adjacent.)

He graduated from high school in an even smaller town in Central Pennsylvania, Mount Union, a brick mill town.  His mother died during childbirth.  Raised in a patriarchal family by their father, a shoe storeowner, Dad and his three siblings never got to know their mother. They developed a strong family support system, as is often the case in large families missing one parent, and an even stronger work ethic.  He was Lithuanian by heritage, from an eastern European Jewish family, some of whom emigrated to the United States and some to South Africa.  Like my grandfather, many of these immigrants were small town merchants throughout the Eastern United States.  Tall and handsome, my Dad excelled in high school and graduated at the age of 16 after a successful high school basketball career.    In the early part of the 20
th
Century one didn’t need to go to college first to become a lawyer. When he graduated law school at age 19 he was too young to be admitted to the Pennsylvania Bar Association.   He had little choice but then to attend college where he was again a top basketball player.  His first job after law school was as a law clerk for a Federal Judge, followed by several years of law practice before he enlisted in the army during World War II in the Judge Advocate Division (JAG). He rose to the rank of Captain and became a rifle instructor, an excellent marksmen for a lefty converted to a righty, felt to be the correct thing to do in those days.  He moved to my hometown of 12,000 people in Central Pennsylvania and practiced law for the next 50 years before retiring to Arizona where he died three years later.   He was a kind, ethical, gentle spirit who rarely had flashes of anger, although when they flashed it was always memorable.  I once made fun of his elderly sisters, who while visiting us couldn’t turn off one of the ‘modern’ sink faucets in the upstairs bathroom.   They called for help when it was too late after the sink overflowed, dripping water onto and through the floor and ceiling into the lower level. I deserved the slap in the face that I got for making fun of them. It was an impressive sight for a young kid to finally see what angered Dad, and even more interesting to watch how my parents seemed to suggest that it was not a big deal.

     My Mom was born in the coal country of Northeast Pennsylvania, Scranton.   She was raised in an orthodox Jewish matriarchal family with five siblings.   Her father, who was a local constable, died when she was a young teenager.  The family didn’t have much money and all pulled together to help out.  My Mom went to a State Teacher’s College in Pennsylvania. She later joined the Women’s Army Corp (WAC’s) during World War II, had basic training at Fort Oglethorpe in Georgia, and worked in Washington D.C. during the war.  She was from the penmanship era, often writing long, beautiful letters to family in her very distinct handwriting. Although considered the Belle of the Ball, and a prized catch, Mom was ‘picky’ when it came to men.  She held out for years until the right one came along.   My parents met through a mutual friend just at the end of World War II while both were still in the Army, then married shortly thereafter at the ages of 37 and 35.  My brother was born one year later, a breech, delivered by Cesarean section, and I arrived 21 months after.

     For Mom, loyalty and stubbornness were close cousins, usually but not always ending up in a positive way. When Mom was on your side, she remained a loyal friend forever.  But cross her for whatever reason, and one might as well not exist after that.  Although family loyalty was a wonderful thing to witness, and she herself never exhibited the tendency not to speak to her siblings, there was a streak in that family that at times caused siblings not to speak for years over events that were hard for a kid to understand, and frankly even harder for me as an adult to understand.  Stubbornness played a huge part in almost any major decision that needed to be made, often affecting me, rightly or wrongly.  If I disagreed I was always wrong.   I remember an episode years later after my Dad died. Mom was in her 80’s at the time, and lived near my family in Arizona.  We were out for a ‘country drive’ on a steep, winding, narrow back road from Flagstaff to Wickenburg, Arizona on our way back to Sun City, where she lived.  She was in the back seat, my wife and I in the front.  All I heard was ‘bitchin’ about how I was speeding on the winding roads, which I was, as she was tossed from side to side in the back.  It was a fun road for me to drive, always a speed demon, but not for Mom.  Of course I got pulled over by a cop.   As he approached the car, and before I could say a word, she said;  “ What’s the problem, officer?  My son certainly wasn’t speeding.”  It was the only time out of many in my lifetime that I was stopped by a cop who didn’t give me a ticket. I just looked at her in the rear view mirror and smiled.  Her son could do no wrong at that point in life!  Even though years earlier, during my college days, we didn’t speak for over a year, not a word, because she didn’t approve of who I was dating at the time. 

      Not long after that speeding episode Mom had a severe stroke and was incapable of caring for her self, or speaking for many months.  She was adamant about remaining in her home.  She got her wish, but this required full time live in help.  She managed to fire just about everyone that Phoenix had to offer in the way of in home care.  Often I would get a call in the midst of my busy office hours from her home aide as she was on the way out the door, saying she was leaving and Mom would be alone. ‘The hell with them”, Mom struggled to say. It was her way of exercising what little independence, strength, and spirit she had left in her frail body.   Mom knew I would find someone else. If they weren’t going to be nice to her, or stole some of her possessions, she just let them go even though there was no one else to care for her. She eventually did get her voice back after months of physical and speech therapy.   It was a colossal effort on her part that spoke much of her inner strength and fortitude.  Before she died she apologized to me for those times when we didn’t speak, and said things to me that I wished she had said years earlier but hadn’t.  She was most appreciative of the time, energy, love, and attention I gave to her at the end of her life, and I was forever grateful for those last few months when she struggled to speak, this time from the heart.

     My brother and I were two different human beings in many respects.  He clearly relished the roll of ‘older brother’ and held it over me whenever he could.  We played together, went most places together, and fought together.  For years we had an adjoining closet between our bedrooms, and he would often taunt me with repetitive phrases such as “ Bones, skinny, no muscles” over and over again while I lay crying on my bed.  Although not always aware of it on either of our parts, I suspect we were just two competitive kids, whether it was competing for parental favoritism, competing on the basketball court, or competing in academics. He was the trailblazer, but often chose different trails than me.  As I reflect back on it now, it didn’t always make it easier for me with my parents when I went off in other directions.  But the competition served us both well in our lives.

     With Penn State just 30 minutes away by car, there was no conflict about college loyalties.  This was truly Penn State Nittany Lion country. There was no other team even worth our loyalties.  I can still picture the long line of cars snaking through town on a Saturday morning to State College for ‘The Game’.  I even remember going to games on Saturdays before Joe Paterno was head coach when he was an assistant under Rip Engle.  So one wouldn’t be surprised to know now that after all these years of loyalty to the program, how let down I was, and still am, after the recent cover-up that occurred relating to the pedophilia scandal brought down on the school by one horrendous individual.

     Summers were spent around the local amusement park and public swimming pool, and Boy Scout camp in the mountains that garnered me nature, canoeing, and swimming merit badges.  There were many car trips to visit family.  The highlights for me were many journeys to Atlantic City where I got salt water in my veins, sun on my skin, salt water taffy in my mouth, and the best iced tea in the world made fresh daily by my Aunt. I could play in the ocean waves for hours on end. It was here that I first developed a healthy respect for the power of Mother Nature.  One day I got carried way out past where I should have been for a little kid, and struggled mightily without success against a huge rip tide current.  Scared, panicked, afraid of sharks, gasping for air, heart racing, and exhaustion setting in quickly, I felt like I was well on my way to Europe and/or the bottom of the ocean. Suddenly my feet hit a sand bar.  I was able to stand up, catch my breath, get hold of myself, and figure out a way to get back to the shore. Thank goodness for swimming merit badge, good fortune, and sand bars. But I learned never to challenge Mother Nature beyond its norms, a valuable lesson for a budding Obstetrician and Gynecologist. 

     Law seemed to be in my family genes.  My father and his brother, cousins, and eventually my brother and his wife, were all lawyers.  After one summer in my father’s law office, it was clear to me that it was not in the cards for my future. I was bored beyond belief, and considered myself the ‘black sheep’ of the family, since everyone seemed to go into the Law.  But that was not to be my direction. I just needed to find my own path.  

     I have fond memories of two family physicians both of whom cared for us in our small town.  I sensed the respect and reverence that they received within the community.  I of course didn’t know it at the time that I too would become a physician, but in many small ways they laid the groundwork for me.  I was wide eyed when I was in their office, or when they would make house calls when we were sick as kids. There were always distinct smells that came along with the doctor, and unusual tools and instruments that fascinated me.   As a young kid home from school with a high fever, I can still remember peering through my upstairs bedroom window watching the doctor get out of his car in his black three piece suit, black medical bag in hand, slowly walk up to our front door, knowing full well the routine that would follow; greetings, peering into my mouth with a tongue depressor on the tongue, feeling my neck glands, taking my temperature (often orally, though not always), then drawing up the antibiotic into the syringe and shooting it into my behind.   At the time I had no idea it was chloramphenicol, a potent antibiotic born the same year as me in 1949, now no longer in use due to dangerous side affects on the bone marrow, and of course not effective against viruses anyhow.  All that mattered then was getting better and back to school as quickly as possible.  But that black bag and the doctor were both full of magic, as far as I was concerned.