Those Internship YearsApril 1946-June 1947

Dressed in an all white uniform including white shoes, my firstrotating intern service was pediatrics. This was the pediatric worldwhere I thought I wanted to spend my life, even back, then.This thought never wavered until 1988 when my practice years endedand retirement beckoned. Now, it was that time of life to spend withmy Beloved Mary forever more. What a great blessing this retirementbecame for me.

There were eight of us who manned the ramparts of the UniversityHospital. Before this time, there were no residents in specialty trainingin those days at the University Hospital, except for an amputee inInternal Medicine. Everyone else was in the service or was overwhelmedin private practice trying to care for the civilian population with thedepleted numbers of doctors available.

This med school was geared to produce General Practitioners towork in outstate Nebraska; thus no residency programs until now. Theaftermath of the War changed that philosophy for ever more. Today,there are over one hundred residents in training in different medicalspecialties.

The University Hospital was a teaching hospital and, as such, was aprized internship. One was expected and required to accomplish manydifferent medical procedures and to care for numerous patients with aminimum of supervision.

When a new patient was admitted to one's particular service, it wasa mandatory requirement that a complete medical history and physicalexamination be on the patient's chart the next morning regardlessof what time of the day or night this admission occurred. These tasksincluded performing a complete blood count, urinalysis, taking anynecessary x-rays, and/or doing any needed diagnostic procedures suchas a spinal puncture. There were no x-ray or laboratory techniciansavailable during the bewitching hours of 6:00 pm until 7:00 am; so, oneaccomplished these multiple honors himself in a solo manner.

This entire body of the patient's admission work had to becompleted before the start of the next day regardless of when the patientwas admitted. At times, it was almost an unbearable chore when therewere two admissions to your service at the same time and at night. Thosedays and nights were hard, but so would be life later on in medicine, as Iwas soon to learn.

At that time, there were only two full time Clinical UniversityProfessors at the Medical School. Dr. Gedgoud, my idol and mentor inPediatrics for many years to come, and a Dr. Roy Brown in OB-GYN.Neither of these men was paid by the University, but was paid by StateMaternal and Child Health Funds.

The rest of the medical clinical faculty was composed entirely ofvolunteer physicians. They were available on rotation and on call for theintern to consult according to whatever service he was on. As interns, werotated through the many different medical services, i.e. men's medicine,surgery, pediatrics, etc. This rotation exposed us to the differentramifications of medicine. The rotation helped us to decide our desiredfield of medical endeavors to pursue. Unfortunately, this system nolonger exists. A student goes from the classroom straight into a medicalspecialty position and never appreciates the ramifications of the othermedical entities; a huge loss in my estimation.

Tom Viner was the intern in the Admitting-Emergency Room. Onebright day early in April 1946 I was on the Pediatric Service, he calledand asked me to look at this sick child. Well! You never saw a dirtier,filthier, more miserable little waif than this fifteen month old boy lyingin filth on the examining table under my eyes.

He had a strange grimace to his face {risus sardonicus} and hisabdomen was as rigid as a board. "Could this be a case of Lockjaw, Iasked myself'? My memory was harking back to my senior thesis. Dr.Gedgoud was called. He came and confirmed my suspicions. I suddenlybecame a highly respected intern amongst my colleagues for my astuteobservation and diagnostic acumen. Naturally, my fellow interns neverlet me forget my prowess. Ha!

Now, the party with this child began for me. Because of the rigidabdomen and if this rigidity was not relaxed, this child might go intosevere muscle spasms and death. He had to be fed through a tube placedinto stomach to supply his nutritional needs. He was incapable ofswallowing.

Every three hours day and night, I was called by the nursing staffto check his abdomen for the degree of rigidity present; then, thedecision must be made by me on how much "Avertin" was needed tobe given rectally to this boy. "Avertin" was a relaxing anesthetic typeof medication. Each dose had to be individually calculated. It wasimperative that the rigidity be kept relaxed so the body could heal itself.There were no helpful antibiotics for this disease in those days.

We did not have the luxury of telephones in our rooms in the internquarters. Instead, there was an instrument of the devil in the form of adoorbell type of device high on the wall in each room. This inhumanedevice provided a loud, piercing and annoying noise. This noise couldand would arouse the dead. One would sleepily stumble down thehall to a phone positioned at either end of the corridor. This frequentarousing every three hours created such a conditioned "startle reflex"within me that even today if I am asleep and the phone rings, I jumpwith an annoying startle.

Later on when in practice, this sudden reflex was very bothersometo my Beloved Mary. The phone would frequently ring at night. Thisstartle reflex would automatically occur depending upon the seasonof the year and what epidemics were making the rounds. The bedwould shake. She would be shaken awake causing a major irritatinginterruption of her rest and some rancor within the marriage state.Finally, in desperation and with great reluctance, we shifted to twin beds.We rested much better with this arrangement.

Once again, I shift from my tale. This little boy recovered withoutincident or complications. He went home never to be seen again. Whatan introduction to my chosen field of pediatrics this case became!Obviously, it was never forgotten.

During these internship days, one learned the method of how totap the chest for fluid or pus; how to obtain blood from the internal orexternal carotid veins, the femoral veins, or an infant's anterior fontanel.The ability to perform a "Cut Down" on an ankle vein became animportant ability to acquire in order to administer IV fluids when nosuperficial veins were available. Control of the...