March 11
by Bill Booth

anatomy_lesson

In the spring of 1960, getting out of bed at 4 AM became routine and somehow didn’t even feel unusual.  The clatter of a Big Ben by my bedside startled me daily from deep sleep, and I learned not to use the snooze control. I had a job as an assistant laboratory technician at the newly opened CharityHospital in Lake Charles, Louisiana. Starting my second-semester as a Pre-Vet major at McNeese State College, my early morning responsibility was to collect blood samples for lab tests on all the wards in the Hospital..

Entering the multi-bed wards before daylight, I routinely announced at the doors, “Hello, your morning sunshine is here,” to arouse the patients before I checked names on their arm bracelets. “Time to rise and shine.”

Most of the patients extended an arm reluctantly, and I would apply a rubber tourniquet just above the elbow. Veins swelled with information soon to be revealed in the laboratory. Patients who had been hospitalized long enough to recognize me would sometimes reply, “Hello, Sunshine. How you dis mawnin’?”

“Fine, thanks. How you?”

The patients at Charity were rarely anything but friendly despite my unpleasant role in our encounters. I felt the most empathy for post-ops. Many of them had stomach tubes, urinary catheters, intravenous lines, and various other devices for draining or replacing bodily fluids. Rounds typically ended by 7am, the time required by the lab to get blood for tests.

I actually came to enjoy this rather unusual job. It was far more interesting than the one I had my first semester, working two nights out of three at a small motel as a night clerk. We night clerks were all students at McNeese, and we were allowed to sleep on a roll-away bed behind the telephone switchboard after midnight, available if needed to relay a phone call or check in a late arrival.

In my new position as a lab assistant, I returned to the hospital in the afternoon to sit at a desk from two until eight in the blood bank, available to collect donations in the small station adjacent to the lab. The work load was typically light. This made up for the stress of morning rounds – the worst of which was the pediatric ward and having to stick those poor, screaming kids while a nurse eager to get to the end of her night shift impatiently held them down.

During the semester break, I purchased a road-weary and dented old, white ’47 Chevy coupe and overhauled its engine. Before the piston rings were replaced my “white elephant” burned more oil than gasoline. I took a date to a live zydeco dance one Saturday night and had to add used motor oil three times before getting her back to the dorm.

“Here’s another service station. I’ll just pull in and check the oil again,” I said.

“Again? You’ve already added oil two times tonight!”

“Yeah, but we’ve driven nearly twenty miles since the last time, so we’re probably low again.”

If anyone had looked, they would probably have found a trail of oil down the highway. But the engine made the wheels turn, and that was what I needed. Used oil was only fifteen cents a quart.

After morning rounds, the white elephant faithfully transported me to a local greasy spoon or to the campus cafeteria for breakfast. My first classes never started before eight, so I usually enjoyed a plate of bacon, eggs, and grits with toast and coffee – unless I was running late because of a difficult “stick”.

Sleep deprivation was a topic unknown to me back then, although I definitely suffered from it. I had the unrealistic idea that a person could just go on functioning as long as he could stay awake. I remember one day in a chemistry class when something – I thought it was a board – hit me hard in the forehead.

Wham! My ears rang, and when I opened my eyes, I realized I had fallen asleep and my head had hit my desk! A few curious glances from fellow students kept me awake after that.

Because donors did not crowd the doors at the blood bank, there was slack time during the afternoons. I began my sophomore year and was immersed in first semester organic chemistry and physics, both of which had labs and demanded a lot of study. In addition, I took American Literature, American History, and Military Science or ROTC, which all males were required to take at that time.

More sensible people would have taken naps or studied during that slack afternoon time, but I was afflicted with a new enthusiasm: a fascination with human medicine. I took every opportunity to hang out in an operating room, the emergency room, even the autopsy suite. Everything I saw sparked new interests.

A person’s first autopsy is always a memorable event. Mine was no exception. Autopsies at Charity were performed by a staff pathologist, Dr. Cook, who also supervised the laboratory and blood bank. He knew of my interests and invited me to watch an autopsy one afternoon when he caught me hanging out in the emergency room.

“You might find that there is a world of information waiting to be discovered in the autopsy suite. Come over with me, and we’ll get started.” He didn’t have to ask twice.

The recently deceased had been placed on the autopsy table by a technician before we arrived. The nude body of an elderly black man lay covered with a white sheet which the assistant removed while Dr. Cook attired himself in a thick, rubberized apron and a pair of heavy rubber gloves.

“We use a standard Y-incision for males,” Dr. Cook explained, taking a thick-handled maroon colored scalpel in his hand. He immediately started an incision on the corpse’s left shoulder, extended it deeply along the surface of the rib cage, angling down to the lower sternum then down the midline of the abdomen to the pubis. Another incision began on the right shoulder and connected with the other at the upper midline of the abdomen.

“We’ll examine the abdominal contents first,” he said upon opening the peritoneal cavity. “This is a sixty five year old diabetic with long-standing hypertension who was admitted yesterday with chest pain and shortness of breath. His EKG and initial lab work weren’t diagnostic of anything specific. Blood sugar was a bit high, but he wasn’t in keto-acidosis. EKG showed some non-specific changes. Chest x-ray showed mild enlargement of the heart, compatible with poorly controlled hypertension.”

Dr. Cook methodically removed, weighed, and took tissue samples of various organs while I stood fascinated by his thoroughness and knowledge of anatomy and disease processes as he explained what he did.

“The patient remained stable for several hours after admission but was found dead lying beside he commode in the bathroom this morning.”

We found the cause of death shortly after opening the chest. The patient had suffered a massive pulmonary embolism, or blood clot which broke loose from a large leg vein, traveled through the vena cava to his heart and completely obstructed blood flow out of the heart into the lungs. When Dr. Cook removed the clot and laid it out on the porcelain counter, it formed a perfect cast of the deep veins in the leg. I was so awestruck I almost forgot to eat supper that night.

On another evening I was delighted when a long, black hearse arrived at the back entrance to claim a body as I left the hospital. I walked over to the loading area and asked the attendants if they would be embalming the body that night. They said yes, they would.

“Would you mind if I watched? I’m a pre-vet student at McNeese.”

“Course not! You want to ride with us, or do you have a car?”

“I have a car, so I’ll just follow you,” I replied and walked the short distance to where the white elephant rested between short trips. It came to life reluctantly and belched out some dark smoke after I stepped on the starter button a second time.

The two undertakers enjoyed demonstrating their skill, showing me how to dissect the brachial artery and vein inside the upper arm of the deceased. Then they showed me how to tie in glass connectors, one attached to plastic tubing that ran from a large reservoir of pink fluid and the other to a tube that ran to a drain in the floor. The lesson was accompanied by several cups of black coffee spiked with generous splashes of Old Crow.

When the pink reservoir was opened and fluid flowed into the brachial vein, immediate changes occurred. Moving up into the head and downward from the chest, the body of the recently departed gradually became as firm as a sack of flour and took on a waxy sheen, as though becoming covered in increments by frost when the embalming fluid coursed through the circulatory system.

The process was terminated when blood draining from the artery was replaced by embalming fluid. The large vessels were then tied off and the incision was closed with large, even stitches of heavy string.

Classes the next day were just a blur of noise that kept me from much needed sleep. I had learned to take meticulous notes during lectures without remaining fully alert. These later were invaluable when studying or preparing for exams.

My fascination with the hospital and things related to human medicine grew, and gradually I realized I wanted to go to med school instead of veterinary college. This realization was followed by a move from the roach palace to the “new” men’s dormitory. My new digs consisted of a modern, air-conditioned three story building not far from the army barracks beside the barn and rodeo arena.

However, it soon became apparent that it was impractical to live on campus because I could not eat in the cafeteria during the time it was open thanks to to my bizarre hours. All dormitory residents were required to purchase meal tickets good for three meals a day.

So I found a room to rent in the nearby home of a little old gray-haired widow lady who lived alone. For the most part I came and went during the hours she slept. On Saturday mornings, I would return to my room to study after finishing morning duties at the hospital. When Mrs. Vincent, my landlady, knew I was in my room and awake, she would knock on my door and inquire sweetly, “Would you like a cup of coffee?”

Would I!

Mrs. Vincent made the best coffee I have ever drunk in my entire life! She started the process by pouring boiling water into a French-drip pot over a cloth bag filled with a mixture of dark coffee grounds and chicory. Then she poured the effluent back over the grounds twice more. This resulted in a very concentrated, aromatic brew which would have been excellent as it was. But Mrs. Vincent liked to take it a little further. She saved heavy cream from the top of her un-homogenized milk and added it with cane sugar to our coffee. The final result was the most wonderful, rich, nutty coffee flavor imaginable. She always served me a second cup while we chatted and watched squirrels in the moss-draped live oaks in her back yard, and this fueled me adequately for several subsequent hours with my notes and books.

Living a lifestyle such as this was not healthy. Fortunately it ended when my blood bank and laboratory assistant jobs were dropped from the hospital budget. I found myself without work.

My parents were unable to help me financially due to protracted problems my father developed following an operation for stomach ulcers. His ulcer disease had prevented him from being able to work regularly as an electrician for years, and we all were hopeful he would regain his health after the surgery. The opposite occurred. He developed what is known as a “dumping syndrome” and found that he became intensely nauseated after eating almost any kind of food. My mother kept groceries on the table and paid bills by keeping books and working behind the counter of a local department store. There was no money left for tuition, room and board, or books.

I needed another job if I wanted to stay in school.