Contributor: “Dr. J”
Dr. J offers his irreverent, slightly irrelevant, but possibly useful opinions on health and fitness. A Florida surgeon and fitness freak with a black belt in karate, he runs 50 miles a week and flies a Cherokee Arrow 200.

Early in my career as a surgeon, I happened upon the book The House Of God.

It is a semi-fictitious, possibly comical, satirical story of a medical intern finding his way through the initial gauntlet of the working doctor’s hospital experience. He comes into this eclectic environment, poorly armed with the rules and knowledge he learned in medical school, only to be taken under the tutelage of the amply named senior resident “The Fat Man,” who really teaches him what being a doctor means. The Fat Man has his own set of 13 rules, “The Laws of the House of God,” which are quite unusual to say the least.

Strangely enough, as my career progressed, those seemingly bizarre rules, if anything, added to my navigation of the world of medicine.

I had an experience very recently that brought back memories of those laws, and reading that book.

“At a cardiac arrest, the first procedure is to take your own pulse!”

I figure that rule applies to all emergencies.

I had an emergency at the hospital! The good news was, the patient fully recovered from the emergency. The bad new was, I was the patient!

I was in to see my buddy the ENT doctor to have my plugged ears cleaned. He assigned a very nice nurse assistant to take care of me. It was all going quite well, as she flushed out my left ear, and it felt so good to hear at 100 percent again.

The right ear proved to be a bit troublesome as I had had an infection as a teenager that caused some scarring of the internal ear. After some serious curetting and continuous washing, it finally gave up all the bad stuff and cleared.

All of a sudden, the wonderful medical illustrations that decorated the walls of the operatory started gyrating and moving back and forth like windshield wipers, and the room was doing barrel rolls. The problem was caused by the length of the procedure and the too-cool temperature of the irrigation fluid. My whole vestibular apparatus was shook up worse than spinning and looping the Arrow.

In charge of your own emergency

I told the personnel of my distress, and one started yelling Emergency!

“Don’t call an emergency,” I said. “I’ll be all right.“ I had visions of the code blue team coming like the kickoff at a football game.

“I have to Dr. J, or I’ll get in trouble,” she said.

“OK.” At that point she ran out the door yelling the E word! I told the remaining observer (a volunteer high school student) to lean my chair back and started taking my own pulse.

“Not up, back!”

“Oh, sorry!”

“That’s better.” I explained what was happening. “Caloric induced vertigo.”

Well at this point, the room was still spinning, but my pulse was all right, and I wasn’t any worse, which I figured was progress. I had known this is a possible complication when your ears are worked on, so intellectually I was reassured, but the feelings are very disorienting.

By now, more people had shown up. One even had a white coat on with a stethoscope around her neck, a physician’s assistant. She took my hand off my radial wrist pulse, and began taking it herself. I was hoping that she had already taken her own pulse on the way there.

The observer said: “You’ll be OK, now we have someone with a white coat.” Good sense of humor, that boy.
“I have a whole closet full of white coats!” was my reply.

“None of you are doctors, are you?”

“No!”

Someone put a damp cloth on my forehead at this point. The cloth felt wet and hot. I don’t think it is on the list of rules for treating my problem. I took it off. Well, I figured my closet full of white coats outranked their one, so I just stayed in charge until I felt better. After all, there was no way of knowing if any of them had read the book.

About this time, my buddy the ENT doctor showed up. I told him about the vertigo and that I was OK now and he said he had a meeting to go to and left.

Perhaps a new law can be added to the list. ”If you are the only qualified doctor at an emergency, take immediate charge of the situation!”

Really, of the 13 laws, my favorite from The House of God is “The delivery of good medical care is to do as much nothing as possible.”

I hope all your medical care providers follow that law! Mine did!

(Send your questions for Dr. J to calorielab@gmail.com or leave a comment. If your question is used by Dr. J, CalorieLab will send you a $25 Dining Dough restaurant certificate — limited to U.S. residents. More Dr. J posts can be read in our archives.)

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This entry was posted on Saturday, June 27th, 2009 and is filed under Dr. J will see you now. You can skip to the end and leave a response. Pinging is currently not allowed. Permalink.