Temple University School of Medicine - Skull Yearbook (Philadelphia, PA)

Page 25 text:

IN-PATIENT CARE The middle of the night, the telephone rings, we answer; blood pressure dropping, urine output dropping, diabetic patient acting strangely. All of a sudden it hits you—“hey. it's up to me. I'm responsible! For the first time, “on call’’ in the evening, we made our rounds, giving perivenous Keflin. subcutaneous Heparin, spreading cheer. We learned the seventeen causes of systolic hypertension for Rounds; those who didn’t know learned to stand unobtrusively in the background. For some of us. this was our first struggle with the terminal patient: fighting the vicious cycles of deranged physiology, trying to counter each new turn of events. If we lost, we and the patient’s family knew we had tried. A less spectacular satisfaction was to get the alcoholic back on his feet, or to get back a non-malignant tissue diagnosis, to stabilize a diabetic, or to start a diseased heart on the road to recovery. We tried to surmount the basic stumbling-blocks to good Medicine; difficult communication, treating symptoms, confusion with psychosomatic disease, mis-reading real symptoms and discouragement. Because the Resident twisted arms, we Seniors filled out the Welfare forms, the discharge summaries. hunted up lab results. Because we had to. we hiked up to the Pavilion to give the Heparins. did the “Pinks and Blues. But our satisfactions outweighed the little jobs. We were given responsibility.

Page 27 text:

IN-PATIENT SURGERY The student’s dream is now reality.The scene is the operating room, at the end of a long cholecystectomy on the usual pachyderm. The student, who has been retracting a gargantuan liver all this time, is weak in the knees—his hand is cyanotic. The Chief is waiting for accolades, asking ‘ Should I have explored the common duct as I did?” The Chief Resident, the Resident, and the Intern agree—it was a good idea. Finally, the Chief asks the Student: Well. Mr. Ashley, or whatever your name is. should I have explored the Common Duct? No. What The operating room is silent. Why not?” Because I've had to hold the damn liver all this time, that's why! By watching our mentors, we learned what a difficult task it is to attain surgical judgment—a mixture of experience, caution, fortitude, and skill. Men like Caswell. Lauby. Tyson. Minehart, and others taught us that Surgery is sometimes knowing when not to operate, and the pre- and post-operative treatment are equally as important as the spectacular techniques involved. We tried to get an understanding of the control of hemorrhage and shock and sepsis. We tried to learn respect for tissue. We dressed burns, changed bandages, worried over intra-venous feedings. arranged suction bottles, and grew to respect the sheer physical endurance of the Surgeon. We can quote the recipe of Guy de Chauliac (1300-1370) for the Surgeon: Let the surgeon be bold in all sure things, and fearful in dangerous things let him avoid all faulty treatments and practices. He ought to be gracious to the sick, considerate to his associates, cautious in his prognostications