OUR STORIES LIVE ON—LONG AFTER WE HAVE ASSUMED ROOM TEMPERATURE
After completing 6:00 a.m. rounds on the first day of my surgical internship in 1975, I was sent to the spanking new neurosurgical wing of Barnes Hospital, in St. Louis. Those suites were more sophisticated than anything I had ever seen. The patient was anesthetized and in the sitting position for a posterior fossa procedure so that the back of his head and neck were the only part exposed under the massive blue drapes and equipment. As I scrubbed in, I was surprised to hear yelling and coarse language coming from the operating room. I thought to myself that these two men yelling at each other would really be in trouble if their words and actions got back to the neurosurgery chairman. I soon learned that one of them WAS the chairman -- Dr. Sidney Goldring, Chairman of the Department of Neurosurgery and world-renowned neurosurgeon. Behind his demanding and rough exterior with the residents was an exceptionally talented man who actually devoted his life to teaching. Nowadays the soft and cuddly types running most hospitals would send him off to anger management and disruptive doctor courses and the medical world would be deprived of his brilliance and some really great stories.
That first month was a particularly brutal rotation in a particularly brutal 12-month internship. I was mostly on call every other day which translated into being at the hospital for 36 hours before going home for 12 hours. When I got home for the first time in two days, I told MK that I had two goals for the year. The first was that I did not want to kill anyone. The second was that I did not want to sleep in my food. The only reason that I was successful with those goals was that whenever MK observed me fading into my plate of food, she quickly moved it away.
Dr. Goldring became an unlikely friend. On Saturday Morning Neurosurgery ICU Rounds with the Chairman, he asked five doctors, from the Chief Resident in Neurosurgery down to the assistant residents to explain Addison’s Disease. When none of them could answer his questions to his satisfaction, he let me have a shot at it, thinking that I would also strike out. I had just studied Addison’s disease and had all the answers—he was particularly impressed that I knew that it afflicted President John F. Kennedy.
During the next posterior fossa procedure, I was assisting when everyone turned their attention back to the Mayo stand to look at a cerebellar tumor that had just been removed. I kept my eye on the patient and was working on keeping the surgical site dry when I saw something flash above me. The scrub nurse had bumped a 7-inch Davis malleable brain spatula off the instrument table three feet directly above. The falling metal retractor had become a projectile and was headed straight down -- on course to skewer the open brain. I reflexly deflected it with my forearm and it glanced off, hitting the tile floor with a ringing metallic clang. Dr. Goldring saw the Davis retractor bouncing across the floor and started yelling at me for causing the problem -- after all, everything that ever went wrong in surgery was the intern’s fault. To her credit, the scrub nurse jumped to my defense and said he was yelling at the only one who had been paying attention to the patient and that I had just saved him from a disastrous, if not fatal accident. He walked right over to me, quietly thanked me, turned, and continued as though nothing had happened. He never forgot that event, nor did I.
Dr. Goldring didn’t even greet his own Chief Residents, but, after the Davis brain spatula event, he always politely greeted me with a nod and said, “Hello, Dr. Tall.” This went on for five years until I left Washington University to come to Idaho Falls. The most memorable of these encounters came in the last year of my residency when I met him and his flock of white flowing lab coats going in the opposite direction in a long hallway that led from Barnes Hospital to St. Louis Children’s Hospital. I was walking with Dr. William Fair, who was the dual Chairman of Surgery and Urology at the time. We were with another group of white flowing lab coats on urology rounds. To say that Dr. Fair’s appointment to a dual chairmanship rankled a few other big egos would be an understatement. As we passed, and without speaking a word to Dr. Fair, or anyone else, Dr. Goldring said, “Good afternoon, Dr. Tall.” I returned his greeting, “Good afternoon, Dr. Goldring.” The two chairmen did not extend greetings and I suspect that their speaking to each other at all would be an anomaly. Dr. Fair wrinkled his eyebrows and quizically asked, “Does he know you?” I told him that we had been friends for about five years. I don’t know if my stock value went up or not with Dr. Fair after that encounter, I just know that you can never have too many friends. Both of these exceptional men have assumed room temperature--but their story lives on.
Ever vigilant,
RT
Below is a photo of an ongoing pone posterior fossa procedure. Our neurosurgical suite was at least twice as big and our scrub nurse was much smaller, prettier, and she stood on a platform three times as high, passing the instruments down to us. The instrument tray was another 18 inches higher than the one pictured. I don't know why that position was popular for several decades, I just know that I cannot find a good picture of a sitting posterior fossa procedure and that it is not used much anymore. Perhaps someone got skewered by a Davis malleable brain spatula.
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