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Lessons from the Morgue

 
It is interesting, to say the least, how knowledge begets power, and how power breeds arrogance in the many brilliant minds of our time. It unfortunately happens all too often in the field of medicine, especially since one must acquire seemingly endless knowledge to competently handle the individualized care of a sick patient. It is the overwhelming responsibility which accompanies such brilliance that sometimes becomes too much for its carrier, and subsequently, his or her continuing education is nullified by the untamed beast known as "arrogance." Such a defense mechanism is commonly constructed for the purpose of concealing one's own incompetency that abounds beneath the disguise of omnipotence. Thus was the case one month before my expected graduation from medical school. Figuring to know all, and that nothing else could befall my medically sound mind, my ego and my beast were annihilated only after the supernatural experience of which I now tell.
As was customary with any new patient admitted to our service, the initial presentation of the patient was always preceded by the introduction of each team member. Dr. Kendrick had shown up early to speak with the new admit, which was rather unusual for him since he rarely made it to eight o'clock rounds by eight-thirty. The two were sitting upon the bed chatting about the joys of retirement and laughing at each other's golf scores when our group arrived.
"Good," Dr. Kendrick proclaimed as we filtered into the dimly-lit room, "I want you all to meet our newest patient and my former colleague, Dr. Hugh Evans. Dr. Evans, " he continued, "spent close to twenty years of his life in this hospital delivering babies, repairing broken bones, stitching up wounds, healing the sick, raising the dead...you name it, he did it. Unfortunately for me, he retired the year after I arrived, some fifteen years ago, and the place has gone to hell ever since." My first, albeit cynical thought, was that of another old and decrepit doctor who once practiced medicine in the Medieval ages by giving the sick a good bleeding; who now, was being praised in a feeble attempt to restore some self-confidence and esteem in the final days of his life by another "golden oldie" who was on the way out the door himself. Both patient and doctor continued to chuckle softly as we began the introductions, their minds returning slowly from whatever "glory days" of medical prowess they once shared.
Upon introducing myself and uttering the enchanting words "medical student," the old man turned his attention away from Dr. Kendrick, as he had maintained through the previous introductions, and said in a low, ominous voice, "Medical student, eh? I'll teach you all you'll ever need to know." He stared at me with a cold, glazed, emotionless expression for what seemed to be an eternity before roiling his haunting eyes away from mine and focusing once again on his friend. For some reason, his words continued to ring in my head as clear as the twelfth chime of Big Ben until the silence was broken by Dr. Kendrick's closing remarks. Still somewhat shaken by the entire scene, I nodded my head, and shuffled toward the exit in a quicker fashion than normal.
Our senior resident, on call for the third straight night, had forgotten to bring with her the medical chart, as was her usual procedure, and thus we left the patient's room without any type of formal presentation, although she related that the early morning account of the patient's admission was contained therein. Dr. Kendrick emerged from the room moments later to assign me the daunting task of tending to this old man's ailments which, at that point, had to be senile dementia brought on by constipation or something like that. "Fitzpatrick, this is your patient! I'm leaving his care completely in your hands, so get to know him, cure him, and most important of all, learn from what the man has to say because he knows a hell of a lot about medicine. In fact, don't bother even going on rounds today with the rest of us because I want a full report of his condition when I get back!" Dr. Kendrick ordered.
As the group preceded down the long corridor of the hospital, I stood and stared at the sign on the door that read "Evans: 2311." The sinister sounding words of Dr. Evans echoed in my brain, and I cringed upon remembering those dark, penetrating eyes that seared through my body like a laser. I soon realized that I indeed had to spend time with the man, and actually become familiar with his stare. I shook my head once or twice, and by doing so, relieved my over-worked and tense mind of any superstitions, visions, or images usually associated with a bad horror flick. "I refuse to learn anything from a senile old man, even if he is a doctor," I mumbled to myself in a disparaging tone, and drudgingly headed towards the nurses' desk.
After briefly sitting down to peruse the old man's records, a nurse grabbed my forearm and shrieked in a frantic manner, "It's Evans in 2311, come quickly!" I snatched the chart from the counter and rushed down the hall, chasing the nurse and other accompanying personnel. I quickly glanced at the records, and had only time to notice that the patient, who had been admitted that morning by my resident, had no diagnosis as to why he was here. I thought that very peculiar, since I have in the past paid particular attention to her thorough notes concerning patient admission procedures and diagnoses. In fact, that page was missing altogether.
Dropping the chart as I swept into the patient's quarters, I was startled to find that the old man had become unconscious. This, after not more than thirty minutes earlier, his conversation with Dr. Kendrick revolved around the pleasures of life, and life in general, after retirement. Over the next hour, every appropriate measure was taken by myself and the other staff present to revive the patient, but to no avail. Dr. Evans had mysteriously slipped into a coma, and somewhat to my relief, was unable to open his eyes or say anything.
For the next seven days, I worked furiously to stabilize the old man. Although unconscious, and seemingly dead, Dr. Evans managed to keep me chasing problem after problem. Once I would correct a drop in blood pressure, his respiratory rate would rise for no apparent reason. After relieving the tachypnea, one or more of his electrolytes would become abnormal; and upon reversing the particular imbalance, an infection would arise that would complicate matters completely. This pathological drama persisted for approximately one week until finally, Dr. Evans, although still in a coma, presented me with no more problems.
On the morning one week after his initial admission, I discovered from the nursing supervisor that Dr. Evans had passed away sometime the night before. I stood, in disbelief at first, in front of the young woman as she continued to relay the entire story of his passing, none of which I heard after hearing her opening statement, "Dr. Evans died last night." I turned my eyes away from her, hoping that something else about the station would catch my eye, something upon which I could fixate while my mind worked through its doubts, worries, and frustrations. But I saw nothing. I removed my lab coat, dropping it carelessly onto the floor, and leaned against the counter behind me. All I could think about was how much time, effort, and work I expended on this one patient, and all for nothing. My medical career for one week had been wasted on a senile, washed-up doctor, all because my attending thought I should listen to what he had to say about medicine. "The joke's on him," I thought as I dusted off my coat, "because I never got to talk to the old bastard."
The next three nights I was on call, in addition to rounding every morning with my team. By the third evening, I could barely stay awake long enough to interview the new admission at three o'clock in the morning who had a chief complaint of muscle pain. Upon the completion of my less-than-detailed questioning, my beeper alarmed, and I arose to return the page at the nurses' desk where I could lay my head down while I talked. The number "2311" appeared within the viewing screen, and I nonchalantly dialed the number. No one answered as I held the phone and continued to let it ring. I must have fallen asleep at the nurses desk with the phone still in my hand, for I was awakened by the alarm of my pager a second time. The same four numbers appeared. I hung up the phone and called again, taking precaution this time to dial the correct number. Again, there was no answer. Frustrated, I called the operator and asked to which extension within the hospital I was being paged. "Let's see," she said as she searched to match the number with its origination, "it seems as though someone in the morgue is trying to reach you, Mr. Fitzpatrick."
"The morgue?" I said to myself as I hung up the phone. "There's not supposed to be anyone there at this hour." I decided to investigate further, feeling that I could use a brisk walk to revive my senses. Since the Pepsi machine was close by, I could also replenish my caffeine stores to help me through the rest of the long, arduous night that lay ahead.
Stepping off the third-floor elevator, I headed for the morgue at the far end of the darkened, deserted hall. I slowly opened the gigantic metal door, after punching in my entrance code on the digital keypad outside of the room quaintly referred to as "the icebox." "Hello? Is anyone there?" I said as the vapors from my warm breath dissipated in front of my face. No one answered my call. I beckoned again upon reaching the end of the entrance that lead to the steel vaults wherein the dead were kept, but I neither heard nor saw a living soul.
As my eyes searched about the rectangular room, they immediately fell on the vault marked "11." Its door, blocked by the opaque flesh from the skull of its resident, had remained slightly ajar. Seeing no other attendant present, I resolved to close that particular vault to match the appearance of the others. I struggled to force the body deeper into the frigid chamber, but the bench upon which the carcass lay did not budge. I decided, therefore, to pull the tray from the vault, since I supposed that one of the corpse's limbs had become hung on an interior lever. With the entire body now exposed, I stepped beside it to obtain a stronger hold on the cold metal slab underneath. I began to return the cadaver to its temporary resting place, and glanced downward long enough to notice a pair of chilling, jet black eyes roll beneath my chin. My heart froze, and my frazzled mind quickly scrambled to recount the instance were I had viewed those same wretched pupils before.
"Dr. Evans!" I gasped, frantically trying to retain my hold on the bench. His eyes, which were open for some reason, seemed to gaze directly through mine, similar to the manner of our initial introduction, as I pulled the body once again out of the vault. I immediately closed his glazed, fixed stare, since it had nearly cleared my bowels of any material whatsoever, and then began to inspect the rest of his pale, leathery skin for any unnoticed abnormalities that might solve the mystery of his demise. After surveying the deceased, I returned my sight to his, which was once again peering deeply into my own. I quickly jumped away from the vault, and watched in amazement from the porcelain floor as the corpse sat upright, dangling its legs over the edge of the steel bench.
"So, you thought you couldn't learn from an old doc like me, huh?" he said in a sly voice. "You know, that's what gets me about you young docs. You think you know everything, and refuse to listen to your mentors who have years of experience over you." I continued to stare in awe at the talking corpse, fixating on his piercing leer, as I climbed to my feet. "Listen, don't be afraid. I told you before that I was here to teach you, and believe it or not, I already have," he said. "For the past week or so, I threw you every medical curve I knew, didn't I? Once you corrected one thing, something else went wrong, right? I really kept you on your toes, and I bet if you look back now, I'll bet you learned a ton...without me saying a thing."
I paused, still reeling from the whole experience, and nodded my head in agreement. I realized suddenly, that I had indeed handled several medical quirks, the trivial kind that served only to frustrate physicians and their patients' status. I also felt that I somehow had a greater understanding of the processes of many common medical abnormalities, those which are often overlooked in the earnest of finding something bigger, more worthwhile, or more educational. I approached the doctor ever so cautiously, and said in a meager voice, "Now that I think about it, I wish that I had gotten a chance to listen and learn from you."
"Well," he replied, "I'll tell you what. I've got nothing but time, so let's sit down and discuss why I died. By the time we're through, son, you'll have learned more in the past few days than you ever did in medical school." I nodded and helped the doctor to the desk in the corner of the room, where we proceeded through text after text, chart after chart, and diagram after diagram. My former patient, now a dead corpse and professor-for-the-moment, recounted his numerous medical experiences and expounded upon his extensive knowledge of the human body, occasionally using his own body for dissection and exploration in pointing out the more difficult facets of pathology and disease. And for the next several uninterrupted hours, the lessons from the morgue continued.

Jason C. Cooper

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