The Hospital Page #3

We reduced it,

and we gave him a small cast.

But did you give him a sling?

You must've taken x-rays.

How am I supposed

to make out the charges?

- Are you Mitgang?

- I'm Mitgang.

Do you carry Blue Cross Blue Shield,

if you don't mind?

Do you have your card with you?

Do you know your number?

You are not leaving this room

until I have this information.

Do you mind if I at least

ask this gentleman to fill out his chart?

May I have your AHS policy number, sir?

Do you carry Blue Cross Blue Shield?

Dr. Spezio!

I think one of your patients in here is dead.

Why do you say that, Mrs. Cushing?

Because he wouldn't give me

his Blue Cross number.

Christ!

How long has this man been lying here?

Isn't he the doctor that came in

around 9:
00?

"Pete's sake," I said, "This is a hospital.

One of our feed lines just blew."

We were lucky to trace it in time.

Have we covered everything?

Dr. Kish has been driving me nuts

about the OR schedule.

He's supposed to see me about that.

This is the Emergency Room.

One of the doctors died of a heart attack.

- One of our staff?

- I think so.

Tom, you want to go down

to the Emergency Room?

- One of our doctors just died.

- Another one?

See what that's about.

I'll be on Holly 8, and I'll be right back.

It's no longer pilferage.

It's reached the point of piracy.

- That's the third microscope this month.

- Let's get together on this later today.

- How about 1:
00?

- 1:
00 will be fine.

Your brother's in his room.

- What one is it?

- 806.

You're gonna be in the hospital

for two lousy days.

- What's the fuss about?

- You're supposed to be a big wheel here.

The private rooms are full.

If they brought in Jesus Christ

fresh off the cross, I couldn't get him one.

- I'm not staying in a room with a dying man.

- He's not dying.

They'll screen him off.

You won't even know he's here.

If you want a private room, go home.

I'll call you when one comes up.

But you phoned me, in a panic.

You're going on vacation.

They'll cut this polyp out tomorrow.

You'll be home Thursday, in Miami Friday.

- Will you talk some sense into this lunatic?

- You said it. He's a lunatic.

Big wheel! Can't even get me a private room.

I'll get you a tranquilizer.

"Five. A full...

"abdomen..."

contrasted with wasting elsewhere.

"Six. Ascites..."

with a protein content above 4 grams.

Unexplained anemia, leukopenia.

Unexplained elevation

of the serum gamma globulin level.

Especially abnormal flocculation tests,

and of course, a positive PPD.

All of these findings

assume special significance in Negroes.

This has been a very commendable workup.

It's as commendable a workup of an FUO

as I can remember.

The staff on this floor is to be applauded.

All right, let's go take a look at the girl.

It's a reportable case, Brubaker.

I'd write it up.

Nurse...

who's the senior resident on this floor?

That would be Dr. Brubaker.

But he's at Chief-of-Service rounds, now.

That's this way?

I wonder if there's some correlation between

hepatic tuberculosis and drug addiction.

Presumably, there was an early

consideration of SBE?

Yes, sir. We discounted it

after repeated blood cultures were negative.

- You, Ambler. Is that right, "Ambler"?

- Yes, sir.

What else do you look for

in Bacterial Endocarditis?

Dr. Brubaker, can I see you

for a minute, please?

Still a little icteric.

Who's got an ophthalmoscope?

Did anyone note Roth spots?

Don't worry about it. There aren't any.

Ambler, you're our big man on SBE.

- What was the latex fixation?

- It wasn't done, sir.

Don't you think that's an important test

to differentiate SBE from miliary TB?

Not you, Biegelman. Ambler.

There's about a 70 percent incidence

of false-positive latex in SBE.

You have been reading up.

If the diagnosis were SBE...

would a positive latex

indicate anything in the therapy?

- We'd expect the latex to become negative.

- Lf...

If the antibiotic therapy were successful.

- Are you applying for your internship here?

- I'm not sure.

Come and see me.

Would you sit up, please, miss?

We've got a little thing here, Doctor.

The girl over there

is the daughter of the patient in 806.

He is at the moment comatose,

and requires intravenous feeding and meds.

The daughter wants to take the father

out of the hospital...

and back to Mexico, where they live.

The patient's name is Drummond.

He's apparently a Methodist missionary.

They run some kind of religious mission

among the Apache Indians.

The daughter says she's a licensed nurse...

so she can give

the necessary IVs and treatment.

I don't think he should be let out

of the hospital.

The attending,

the guy in brown over there, concurs.

Wait, let me have all that again.

As a matter of fact,

this is Dr. Biegelmars case.

Never mind the professional ethics.

What happened?

I don't know why I'm covering up

for that son of a b*tch in Farkis Pavilion.

The patient, a man of 56,

was admitted to the hospital 10 days ago...

in good health, for a checkup.

No visible distress.

We did the mandatory workup on him.

Blood cultures, stool, LE preps, chest EKG.

All negative. However, there was

some evidence of protein in his urine.

I don't know how that guy

in Farkis Pavilion found out.

Maybe he had a deal

with one of the girls in the lab.

He turned up the next day...

conned the patient into signing

an authorization for a biopsy.

- What guy in Farkis Pavilion?

- Some postgrad fellow named Ives.

Elroy Ives. I never met him. He's on

one of the immunology research programs.

Some postgrad came up here,

did a biopsy on the patient?

Yes, sir. He conned Biegelman

with that story...

Protein in the urine?

- And he biopsied the man?

- And he nicked a vessel.

They woke up Biegelman at 2:00

in the morning, as the patient was in shock.

Biegelman called the kidney people

for a consult.

But what was there to see?

The patient was sour and bleeding.

Spoke to this fellow, Sutcliff.

He referred us to a surgeon named Welbeck.

- That barber?

- You ain't heard nothing yet.

We finally got Welbeck

around 4:
00 in the morning.

He said go ahead.

So they laid the surgery for 8:00.

Welbeck turned up half-stoned,

orders an IVP, clears him for allergies...

Without actually testing,

and the patient went into shock.

And tubular necrosis.

They lopped out the bleeding kidney...

ran him back to the room,

we waited for urine.

Fever began spiking like hell, uremia,

vomiting. So we arranged hemodialysis.

He's putting out good water now...

but some nurse goofed on his last

treatment. A shunt separated, something.

Blood pressure plunged.

They ran him up to ICU...

gave him two units of whole blood.

Vital signs are normal, but he's comatose.

- That was two days ago.

- In short...

a man comes into this hospital

in perfect health...

and in the space of one week,

we chop out one kidney...

damage another, reduce him to coma,

and damn near kill him.

Yes, sir.

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