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Authors: FAAAAI MD William E. Hermance

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BOOK: Tales from the Emergency Room
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Her best story however, involved a birthday party she was hosting for her brother, an Archbishop then, at the Chancellery. After the party was in full swing for awhile, finding that the Archbishop had not appeared, everyone sat down to dinner. About midway through the meal, the Bishop appeared, thanked everyone for coming and left. In the morning, early, Miss L’s bedside phone rang. She told me that she immediately suspected that it would be her brother. It was and he wanted to know if she had heard the morning news. She had not, but soon did, and learned that her brother had been elevated to Cardinal. The Papal Nuncio, who traditionally delivers this news, had called just before the birthday party to tell Miss L.’s brother, in Latin, the news. The Cardinal asked him to please repeat the message in Italian since he understood so little Latin! The Nuncio also asked him not to tell anyone until he had heard it on the news. The Bishop knew he would not be able to hide his pleasure at the news during the party and so he had elected not to spend much time there. Miss L.’s suspicion was right on though. Indeed her brother was now a Cardinal of the Church.

Car Calls

After I began to practice allergy and immunology exclusively, I stopped making house calls for the most part. However, I did wind up making “car calls”. One patient was a well-known Judge. He was a faithful patient for many years, until he became unable to come into the office. He did tool around New York in a big black limousine however, and, about every two weeks during office hours, he would call to say that he would be parked at the curb downstairs so that I could go down and give him his allergy shots. I was happy to perform this service for him, but, I must say, the first time felt a little weird to me. There I was walking from my building to his limo, balancing my paraphernalia, and being ushered into the interior of the car. The Judge already had his sleeves rolled up for his injections. We had an office visit just as we would have had in the office. I gave him his shots and cheerfully went back upstairs and back to work. I remember that the limo stayed parked for the requisite 20 minutes after the injections. I wondered how to explain my biweekly limo rides, but, since there wasn’t any riding, there was not much for me to tell.

Another long time patient and a favorite one eventually became too ill with neurological disease to come into the White Plains office. Her husband reluctantly asked what arrangements could be made for her treatments. Since he drove her regularly to the office anyway, I suggested that his wife could have her shots without getting out of the car. This worked very well, and was still going on when I retired. The young doctor who worked for me was happy to continue this arrangement, which made one less problem for me to deal with.

“Don’t Tell Me about It!’

Like many allergists, I often saw patients once every three months and provided them with medication (extracts) for other medical people to administer in a medical setting. I was quite strict about who was giving the shots as well as the visit to my office, which was required. A young student who had been a patient for several years eventually went to college. Naturally, I assumed that he was receiving his injections in the college health facility. In reality, his roommate was administering them! Unintentionally or not, he told me about this arrangement. I called his mother. Her response was: “I don’t want to know about it.” Well, I certainly didn’t either and told the young man, after carefully explaining the reasons why he shouldn’t be doing that, “Don’t tell me about it!” He survived college and his allergy shots, thankfully.

Another patient who went on to college arranged with a group of his new friends to all go together to an allergist in town to get their shots. Easier and more fun I suppose than using the college health service.

My Cousin’s Coach

A famous football player and would-be politician arrived in the office one day. As we were chatting, I discovered that he had coached the Army football team at one time. My cousin, the Lt. Colonel, had been a football player at The Point and indeed had been coached by my patient, who remembered him as the finest center that he had ever worked with. Just another example of a small world. (On my mother’s side of the family, the Blake Family considered the Lt. C and the MD to be outstanding members of the tribe!)

A Romanian Husband

One of my favorite patients is a school teacher in New York City, an energetic lady with a wonderful sense of humor. While she was in treatment, she married a man from Romania, long a resident of the States, but whose family was still in Europe. One day I asked her how she managed to communicate with her mother-in-law when she went to visit her husband’s family. It was quite simple, she explained. She had learned forty words in Romanian which could be used to describe her husband in the most complimentary terms and she used them freely whenever his mother brought up the subject of him or his family. Eventually, this couple adopted two beautiful girls from his native country, both of whom have grown into lovely, accomplished young women. I know this because their pictures and an update come to me every year from the family.

Three Generations

As I have mentioned earlier, one of the most appealing attractions of my specialty is the continuity of care which can be afforded patients. It was my privilege to know many people for many years and to watch whole families grow up. As I started in practice, I cared for a diamond merchant who had asthma. Luckily, he was very compliant, and so, even though he still had asthma, he continued to be a patient whose problem was well controlled when I retired 31 years later! I even knew that his daughter’s marriage had failed but that he had kept his ex-son-in-law in the business with him and considered him to be an excellent asset to the business.

Early on I also began seeing a woman who was also a social friend of ours. Her children were very young and very allergic. Eventually, they all became patients. And, I remember well the day that her son brought his oldest son in for treatment, the first third generation patient I saw. Eventually, his wife and his three children became patients—all except one were highly allergic, his daughter having only a little problem now and then. Eventually there were several multigenerational patients in the practice, a very rewarding experience for any doctor.

Dr. P

Dr. P. was the leading allergist in Georgia and perhaps in the South when I first began my practice. One day, a lovely looking slightly older lady with a southern accent arrived in my office for a second opinion consultation. Why she picked me is still a mystery, but I was alarmed when she handed me a three page single-spaced typewritten letter she had received as Dr. P.’s report to her. She told me not to bother with the first two pages but to read the last line of the report. It said, “Mrs. Z, you are the kind of patient who, when she walks in the front door, the doctor wants to run out of the back door!”

I was unsure whether to laugh or cry, but Mrs. Z turned out to be a very easy patient to deal with who was satisfied with my care. Several years later, I had dinner with Dr. P. a tall handsome southern gentleman. I managed not to tell on Mrs. Z. and to this day I have no idea what caused the good doctor to pen the “offending” line.

A Height-challenged Boy

After I had been seeing a young man for some time, his mother, slightly round and very short, asked if I would speak to her in my office about a problem with her son. I did so, and during the consultation, I could tell that she was very upset about how short her son was. The more she talked the more I wondered about her husband, and so I finally asked as carefully as I could about how tall the boy’s father was. Well, he was 5'2". Then, again as gently as I could, I explained that her son was not likely to be very tall, but would probably be taller than she and his father, that boys grew until they were in late teens and even early twenties. We discussed human growth hormone which was not in wide use then for height problems in children.

He was an excellent boy, smart, popular by all accounts, extremely outgoing and generally nice to have around. I knew he would find the right girl eventually and that height differences among the sexes were causing fewer problems than in the past. The last time I saw him, he was finished with college and stopped in the office for a social visit. It was plain then that he would be successful in his life despite his height and that he was at ease with his stature (about 5'5" to 5'7", I guessed). He had not had any problem dating, often girls taller than he.

Ill Advised Therapies

Once, in his earlier years, my partner was seeing a patient who was apparently allergic to newspaper print. His suggestion was for the man to dry the paper out thoroughly before reading it. He was to do this by heating it in the oven. You can guess the result!

On rounds one day I came across a young child with severe eczema. It has been said that eczema is an itch in search of a rash. Repeated scratching trauma to the skin results in infection and the chronically abnormal skin of eczema. This child was tied down on his bed by his arms and feet. He certainly couldn’t scratch, but it seemed to me to be a particularly awful form of torture.

A similar thought crossed my mind, when, again on rounds, I came across a man with the most awful case of poison ivy I had ever seen. This, I thought must be the reason for his hospitalization, but, it was not. He had been given the skin disease (contact allergy) on purpose as a counterirritant for his cardiac-related chest pain. Thankfully we have progressed a bit beyond these treatments today.

A Long Island Wedding

My secretary invited us to her wedding. It was held in a well-known wedding establishment on Long Island. The bride wore white—she was lovely, but, her mother wore gold lame and stole the show! I sported a yellow yarmulke. We adjourned to the reception hall which was immense and featured a real stage with an orchestra below. Across the stage was the table for the large wedding party. The servers wore yellow gloves. We were having a wonderful time, when suddenly, there was a terrible crash. I looked toward the stage and there I saw a row of people sitting, sans table. The table had fallen off the stage into the orchestra. All was set well so fast that some people missed the whole thing I think, and no one was hurt. The reception went on as if nothing had happened and a good time was had by all.

Parallel Lines

During the Nixon administration, price fixing was in effect for a period of time. The fee for a regular office visit at that time was $10.00. Physicians were among the last group to be decontrolled, but at one point we were told we could raise our fee 2.5 % to $10.25. The accountant advised us to do so and from then on the office was awash in quarters. People would pay their bills by check or cash and, of course, bookkeeping for them was easier if they just handed over a quarter. For a time thereafter, we found quarters in some very odd places.

Later, we were told that we could raise fees again on the basis of our current fees. Many doctors were unhappy that they had not bothered to raise their fees the first time. In any case, the fee became $11.00 for an office visit. At the very next billing, the calls began to come in. What did the quotation marks on the bills mean? Why were there parallel lines after the dates of office visits? The office staff had fun explaining these mysteries to the patients who, for the most part, accepted them with good humor.

Thoughtful Thieves

On my way to work along 55th Street, I came into contact with another man, sort of a brush up against. A short distance away there was a receptacle for trash. Lying there on the edge was my date book which had lately been residing in the breast pocket of my open suit jacket. Astounded that I had not noticed anything unusual, I was even more amazed at finding my book. I have ever after thought of the other man as “the considerate pickpocket”!

Again near Central Park a man approached and demanded my money. Like an idiot, I took out my wallet, gave about half of the money in it to the thief, announcing that I needed the rest for my day’s expenses. The thief was brandishing a tiny pocket knife at me. Then he noticed the ring I wore and demanded that, exhorting me not to yell. I immediately began to shout but, by the time I had really made any noise the man was gone with about $40.00 of mine but no wallet or ring. Another considerate (?) thief.

The Cadillac

I once owned a beautiful Cadillac, calypso green in color. Usually, on my way to the office, I drove down through the middle of Harlem to the north entrance of Central Park. While the car was brand new, I pulled up to a stop light on Martin Luther King, Jr. Boulevard. Another car came up next to me. The driver, a black man, in a very nice car of his own, rolled down his window indicating that I should do likewise. I did so and we sat through a couple of light changes while he explained that my car may have been the most beautiful car he had ever seen. We both drove off with smiles and I still chuckle when I remember the scene.

And You a Doctor!

In a different car on a dark and stormy night, as Snoopy would say, I was negotiating the complicated exit from the Cross Bronx Expressway to the Bronx River Parkway, northbound. I did this many times before and after, but on this night I gently bumped the car in front of me. It was clear that the other driver, whose car was full of people, wanted to discuss this with me and so we rolled a short distance into an unused, unlit gas station. We both peered at our cars to inspect the damage. Luckily, there was none to either car. He, of course noted my MD license plate. As he stalked off to his car (from which I expected to be attacked any minute) he said, clearly disgusted, “And you a doctor!” Uncharacteristically, I kept my mouth shut and was able to drive off unharmed. By the time I got home, I thought the whole thing was humorous. I didn’t at the time though, and my wife has never thought so. We usually comment on the event when we travel that intersection now.

BOOK: Tales from the Emergency Room
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