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'Wild' nights moonlighting in hospitals

My third child was born when I was in my second year of medical school, so my social life during med school, residency, and fellowship was the best.

I had lively dinner discussions with people I loved. We built some pretty amazing forts and LEGO structures. And I started an awesome book club with Dillon, Greg, and Francesca (my kids) and with Carla, my wife. We worked through “The Lorax,” “Are You My Mother?” and “Where’s Waldo?” Then, “The Lion, the Witch and the Wardrobe,” and ultimately a systematic reading of Harry Potter, from “The Philosopher’s Stone” straight through to “The Deathly Hallows.”

But the greatest literary masterpiece we read, and which still informs my life today, was “Where the Wild Things Are,” the words of which I still have memorized.

In addition to being the book club leader from 7:30 to 8:30 in the evening, I also needed to feed and clothe my book club members. Which meant I often spent more nights of the week moonlighting in various hospitals than I did in my children’s room reading stories.

Moonlighting, unlike formal training, was in many respects where the wild things were. I worked in prisons, psychiatric hospitals, and in hospital jails. Hospice centers and nursing homes. I was flown to South Dakota to work through night and day in a VA Hospital in Sturges during the motorcycle rally, spent nights doing intake in a psychiatric hospital in Sioux Falls, and weekends in Cheyenne, Wyoming. I moonlit in Pueblo, Fort Collins, Colorado Springs and small towns I can’t even remember.

I was usually moonlighting as the sole attending physician on the premises of an isolated hospital.

In residency, I had learned how to treat septic shock, intubate patients with respiratory failure, put in central lines and even temporary pacemakers.

I spent many an all-nighter in the psychiatric wing of a Veteran Affairs Hospital in South Dakota talking with some very manic Vietnam veterans with acute psychosis.

I felt confident that I could handle pretty much any medical emergency — those standard life-or-death situations, but I was not prepared for the scariest wild thing of all, and I remember it clearly, that night in Cheyenne, Wyoming. My heart jumps even now when I think of it.

A bull rider from the rodeo had walked into the ER in the VA Hospital in Cheyenne on a weekend night. He was wiry in his cowboy hat, dirty jeans, dusty pointed boots, pearl-snapped shirt, and enormous, silver belt buckle. But his left shoulder was just wrong. I knew nothing about orthopedics, but this guy’s shoulder was very dislocated.

He had drunk a bottle of Jack on the way to the ER in order to kill the pain and now was yelling: “Just set it. Set it.” I had absolutely no idea what to do.

So I called an orthopedic surgery resident I knew in Denver and screamed: “What the ——-?” into the phone. He calmed me down, walked me through it.

I looked inside an Emergency Medicine textbook that was lying around, left the page open on how to set a dislocated shoulder and gave a shot of 150 mcg of Fentanyl. The nurse held a sheet wrapped around his waist, while I grabbed his arm on the other side. Sweat dripped off my nose. I stared into his yellowish eyes without blinking once, counted to three and yanked hard.

He yelled. His shoulder popped, and bang, he was back to normal, got up, politely said, “Thank you, ma’am, thank you, doctor, Goin’ back to the rodeo,” tipped his hat and walked out, back to the wild rumpus before we could get security to stop him. I was still shaking.

Somewhere in my medical education, I learned how to treat cardiac arrest, talk to a dying patient, treat heart disease and become a cardiologist, but I don’t remember when that happened. Strangely, the only thing I vividly remember from those days was setting that dislocated shoulder. And, of course, that wondrous book by Maurice Sendak, “Where the Wild Things Are.”

I realize now, the morning after I wrote the above column, that whenever I’d moonlight in these hospitals as the only doc, I felt like I was Max, King of All the Wild Things. And by the end of my shift, like Max, I was “lonely and wanted to be where someone loved me best of all.” And so, even though the wild things wanted me to stay and cried “please don’t go, we’ll eat you up we love you so ...” I stepped into my private boat and said goodbye and went into the night of my very own home, where dinner was waiting for me. And it was still hot.

 

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