This is a two-part post about my days in medical school. Part 2 next week.
The summer before I started medical school, I lived in my car, a ‘59 Chevy Impala. I was back at Laurence Leathers doing accounting on different floors of the factory. I was drinking hard those days, and it was getting increasingly difficult to get up in the morning. Plus, I was broke most of the time, and paying rent was basically out of the question. So I packed clothes and other essentials in the trunk. After work, I’d party till the wee hours, then I’d just drive to the parking lot and sleep in the front seat. Some of the guys would wake me in the morning. It was the only way I could get to work on time.
Classes started at Jefferson early in September, and I had to find a place to live, locate some loan money, and check out the bars. I wanted to be ready to start school. So the Wednesday before Labor Day weekend, I had an extremely drunken farewell with my friends at the factory, stopped at my cousin’s house where I’d left books and other non-essentials, somehow managed to get all my belongings in the car, and set off down the highway in the cool, early morning darkness. The drive took about seven hours. Somewhere in Connecticut, the engine began producing some ominous noises, and by the time I reached the turnoff to Philadelphia, I was traveling about 40 mph in the breakdown lane. I then managed to take a wrong turn, and the Chevy expired in the heart of North Philly – one of the worst ghettoes on the eastern seaboard. I could hardly find space to coast into the curb because of the piles of trash. I locked the vehicle, said goodbye to all my things and valiantly set out on foot to medical school. I had $30 and a map of the city.
Some of the tourist sites were noted on my map and I passed a few. I remember Betsy Ross’s House and a place not far from Jefferson with a plaque on the wall of a house that said, “Benjamin Franklin flew his kite and discovered electricity on this spot in 17-something.“ A few blocks later, Jefferson Medical College loomed over me. I found the main entrance, went up the stairs lined with famous paintings and found an office on my left called Registrar. I entered.
The reception area was separated from the rest of the office by a waist-high counter. I waited. A middle-aged woman with short, dark hair approached, a little harried and brusque. “Help you?”
“Yes. Hello. I’m a new student at Jefferson. Just got into town. I need to find a place, buy books, get set up. Hope I’m not intruding.”
She stared at something at the floor and sighed. There were 180 in my class, and she seemed as though she’d worked there forever. I could read her thoughts. “Great, another green horn.” Dutifully, she asked my name.
“Robert Widdowson,” I replied trying to say it warmly.
Her head jerked like a mule had just kicked her in the chops. She stared at me with eyes big as saucers. “Robert Redmond Widdowson, Junior?” She spoke the words slowly, spaced out. I nodded, but I was getting uncomfortable. Notorious already?
She said, “Wait right there. Don’t move. Please. I’ll be right back.” Then she spun back to her desk and picked up the phone. She had a whispered conversation with someone, lots of girlish giggles, so I started feeling better. Eventually, she hung up and returned to the counter. She was grinning now. “Would you go up to Room 944 upstairs? Just down the hall is the elevator. Take it to the 9th Floor and turn right when you get off. I’ll see you later on, and we’ll get everything straightened out.”
I followed her directions and soon found myself in front of Room 944; the door was closed. I knocked, and, seconds later, a stunning blond, Scandinavian-looking woman with plump lips, bright eyes, and an attitude that said, “Let’s party” swung the door open. She, Dorcas, had been struck by my name on the in-coming list and began joking with her friend Betty downstairs. They had invented someone to go with such a striking name. So when I showed up downstairs, Betty thought that we should meet. I expressed my sincere delight at this turn of events and asked if she’d like to get to know me to find out how close their virtual boy was to reality. We made a date to start her inquiries at 4PM when she finished work. I returned to Betty.
She set me up. First, she had an emergency loan fund of $150 that she could issue right away but had to be paid back in 2 months. She found a really cheap apartment one block from school. I checked it out, signed up, took a cab to North Philly, picked up my stuff – miraculously intact — and was back in the office in two hours. I told Betty that I needed to work, and she made a phone call. When she came back, the job was just for the weekend, but since it was Labor Day, I would receive double time over the three days. I should report to Frank at the Anatomy Lab at 7 AM Saturday morning.
It was about 3 PM, and I had to get ready for my date with Dorcas. I hightailed it to the nearest Woolworth’s, stopped at the liquor store, and rushed back to Jefferson. She met me in Betty’s office; she was still stunning. I told her that I had only been in Philly once before, for my interview; I had never seen the sights. I told her that Ben Franklin was my favorite Founding Father. Would she escort me to the site where he had flown his kite and discovered electricity.
When we reached the spot, we sat on a nearby steps, and I cracked open the bottle of wine that I’d brought, poured into plastic cups, and toasted Ben, Philly, her, me, Jefferson and so forth until the bottle was done. At that point, I told her that it was time to emulate Ben Franklin, and I whipped out my purchases from Woolworth’s – a kite and roll of string. Soon we were running down the sidewalk with the kite trailing behind. It would rise a little in the air and then crash, often onto cars who were stuck in rush-hour traffic. The drivers did not seem amused, although a few kindly folks grinned. We raced up and down for a long time, pretending to fly the kite, then I took her to supper and drinks. By 8 PM she was barely able to find her vehicle. We made out passionately draped all over her car, and I begged her not to drive – she should stay with me. She managed both to turn me down and to make it home in one piece. An excellent woman and an excellent start to my life in the city of brotherly love – Philadephia.
Saturday morning I reported to work with Frank at the Anatomy building. This was the oldest building on campus. It was an enormous townhouse on the end of the Pine St. block. It may have been built in the 1800s, and in fact we were the last class to use it. The following year anatomy was shifted to a huge modern building closer to the hospital.
Frank was nearly as old as the building. He’d been the caretaker of the anatomy building for forty years; he’d seen it all. He was waiting for me at the front door. The task for the day was simple; we had to set up the anatomy lab for classes which began on Tuesday. First we went up the creaky stairs to the second floor to the lab itself. It was a huge room filled with big tables, six across and eight deep so 48 stations. Each one had two shelves underneath. The task was to sweep and clean and get them ready which we proceeded to do. It took a long time because we had to work around the tables and the old, wooden floors were stained and had little hard pieces of plastic that had to be scraped off. Frank let me do the bulk of the work. Finally, about 11 AM we finished and we went down to the front entrance and sat on the steps to eat lunch. Betty had told me to pack something, so I munched a few sandwiches and slammed a warm coke sitting there in te warm Philadelphia sunshine.
When we finished, Frank said that we had one more task and that it would take us into tomorrow. When we finished, my job was completed, and he’d give me the vouchers so I could get paid. With that he led me back into the building; this time we took the creaky stairs down. The basement smelled old and moldy, and it was filled with cobwebs that Frank somehow avoided but that managed to slap me in the face at every doorway. The place was dark and labyrinthine and creepy with stone walls and dirt floors. Periodically, Frank would hit an old-fashioned light switch so we could continue. After passing through four rooms, we came to a corridor-looking room that was about eight feet wide with dim exposed lightbulb in the middle of the ceiling. The walls here were covered with a series of small, square doors – two rows of eight doors each.
Frank said OK, here’s what you do, and he pulled the first door open. Inside was a long tray with an enormous white plastic bag laying on it. He pulled the tray out about four feet until it started to bend down. Then he stood next to it with his back to the wall and rolled the bag onto his shoulder. The white bag slowly folded down over his shoulder and he pulled the far end out until it dropped off the tray and slapped him in the back. Then, staggering under the weight, he started slowly walking into the next room; I followed. Two similar rooms beyond was an old freight elevator which had no sides and a wooden floor. Frank walked onto the floor and slumped the white bag off his shoulder onto the elevator which slammed into the floor with a hard thump. By now I could clearly see that he had just transported a dead body. Only 47 more to go.
We went back to the first room, and now it was my turn. I pulled out the next tray, bent my knees, and rolled the head of the body off the tray catching it about the solar plexus. As I stood up the rest of the body slid off the tray and banged into my back, nearly knocking me down. The weight was more than I expected, and my knees started to buckle. Frank (or should I call him Igor) nodded approvingly. I staggered to the elevator and slumped the body down next to Frank’s.
And so it went. He and I each carried five to the elevator. After a while we ended up with a big pile in the middle. The elevator was nearly as old as the building so the limit was ten. When it was time Frank stepped into the only place left to stand and said get in. So I climbed up on top of the pile and found a relatively stable spot to sit; it happened to be directly on somebody’s dead face; I could feel his/her nose. When we reached the second floor, we had to take the bodies from the elevator and place them on the tables. Then it was back downstairs for another set of ten. We finished that one, and Frank told me to come back the next day – Sunday.
Once again he met me at the front door. We dove straight into the creepy basement, and by noon we were loading up the last set of corpses. When we got upstairs, Frank asked me what my last name was. He went over behind the instructor’s desk at the front of the lab and pulled out a clipboard. With my name starting with ‘W’, I would be working on table #48. Frank told me that big, muscular bodies were the easiest to work on, so we found a 48-year-old man who had been about six feet two inches and really buff. We moved that body to Table #48. Later that week, after we’d had a few lab sessions and I told the three other student with whom I shared the body, they couldn’t stop thanking me. Oh, and those little piecew of plastic suck to the floor? Human flesh well dried.
I kept in touch with Dorcas, and over the next few weeks we went out twice. I’d managed to get my car back on the road with my money from Frank, and both dates were fantastic. At the same time, Betty in the office was still taking care of me. She had helped me arrange a student loan that would pay my tuition with enough left over to cover living expenses for a few months. When I got the check, I managed to pay Jefferson what I needed, but then the rest of the cash started burning a hole in my pocket.
So one day, I called Dorcas and told her that I had a favorite restaurant that I wanted to take her to. I’d pick her up on Sunday at 5 PM. On the appointed time, I picked her up and drove to the airport. We got on a flight to Logan Airport in Boston. We took a cab to Durgin Park where we had a fantastic meal. Then we got back on a plane and flew back to Philly; I had her home by 9 PM.
About half the student body at Jefferson Medical School joined fraternities in those days. The Nu Sigma house was centrally located, had a great cook, and most appealing, they were well known as the party animals. It only took one or two parties for me to realize that I could excel as a Nu Sig. My class of freshman had 15 guys, and they were extraordinary. They could party like animals; they could drink with me. But they were also brilliant and disciplined. At graduation, 3 of the top 5 came from my class, and 5 of the top 10 in the school. We had the student body president, the captain of the rugby team, and every other position of distinction at the school. I’m sure those guys have gone on to greatness in medicine. They knew how to work hard and play hard. Unlike me.
I fell into the same self-esteem trap with these guys. Why would they want to hang around with me? Plus, their humor revolved around teasing one another which I hated. My nickname quickly became Crazy Bob – Craze as in, “Hey, Craze. You ever get directions to anatomy classroom? You haven’t found the place yet, and we’re halfway through the semester.”
Somehow, I couldn’t force myself to study. I’d start, dutifully carry my books to the library or a lab in the science building or to the dining room at Nu Sigma. Within an hour, I’d be so restless that I couldn’t even sit in the chair. I’d pace, I’d sit back down, I’d pace, and then I’d zip out the door to Dirty Frank’s or to one of the stripper bars. I’d find my way home and collapse in bed, often keeping one foot on the floor to control the spins so I wouldn’t vomit all over my poor roommate. In the morning, I couldn’t think, often skipped class. When I did show up I stunk of drink. I knew it was wrong; I didn’t like it, but I couldn’t stop myself. I had the same out-of-control feeling I’d had at Bowdoin: Something was wrong with me. I was impaired.
We played basketball in the afternoons after class. I stayed in pretty good shape. I had no technical skills, but I was enthusiastic, running around like a madman and rattling people enough so they would sometimes make mistakes. One afternoon, I went up for a rebound, landed wrong, and ripped out my ankle. In the emergency room they put a cast on it and put me on crutches for at least 6 weeks. But the big dance was coming up, a formal affair called the Black & Blue Ball.
I invited Hawley even though my leg was in a cast and I hadn’t seen her for about two years. I’d borrowed my friend Bob Waterhouse’s apartment for the occasion. We spent most of the next five days in bed together. Although we weren’t having sex at that point, we were fooling around a bit. Mostly, we talked and giggled and snuggled – as always, we created our own little world for the moment with little recurring jokes, heavy conversation, lots of lying in each other’s arms. We did go to the dance, and I put on an excellent performance. Hawley painted my cast to resemble a high-button shoe which I wore with tartan plaid shorts, a tuxedo jacket, ruffled shirt, and black tie. Dancing on my cast – I remember a spirited Charleston with the Dean’s wife – I stole the show. Poor Hawley. I don’t remember if we stayed in touch after she left. I don’t think so.
Class was similar to Bowdoin, only more difficult. It was a little more cut-throat too. My old roommate Doug was at Hahnemann Medical School, and he turned me on to an excellent Anatomy text called Pansky & House that we didn’t have at Jefferson. Three times I bought it, and three times it was stolen within 48 hours. I gave up.
The first year was anatomy, embryology, physiology, and Biochemistry, mainly. I did poorly – 75’s in anatomy and biochemistry. Physiology class should have been interesting, but I didn’t like the way it was presented. Even so I was going to most classes. At the beginning of the second semester, a stunning young woman started attending physiology. We began calling her the Cute Little Dark-Haired Girl or CLDHG. Many, many conversations and many, many jokes were made about CLDHG; she became a phenomenon, but nobody ever spoke to her. After about a month, I finally worked up the nerve to sit next to her one day. Her name was Susie Kincaid, and she was really sweet and pretty cool. She was research associate to a famous physician who had invented something called the ‘crash cart’, a self-contained unit set up to help restart hearts in cardiac arrest. He had suggested that she take the course.
Soon Susie and I were dating, and she became a regular at Nu Sigma parties. About half of my friends had long-term girlfriends, and matrimony was in the air. I was getting desperate to find a way to change my behavior which I recognized was self-destructive even though I didn’t seem able to do anything about it. So I proposed. She wanted to marry a doctor, and even though she must have had questions about my behavior, she accepted.
The next year, my second at Jefferson, she had already signed a teaching contract in a small town in up-state New Jersey. She would still take the job, and at the end of the year, we would marry. She’d look for another teaching job in New Jersey close enough to commute from Philly. We were set.
I don’t think that it had anything to do with Susie, but I failed physiology. That summer, the physiology professor tutored me. Every week, I had to go to his office to discuss all that I’d studied the week before. By this time, I’d discovered most of the seedy bars in the neighborhood including the infamous Dirty Frank’s at 13th & Locust. So at my meetings with the young Professor, I always embarrassed myself.
However, I had a saving grace. I’d managed to get a great job doing research with a cardio vascular surgeon. Dr. Weldon was the star of the department. He was young about 40, and he was doing high tech surgical research with the companies who make heart valves. A valve is normally a flap that helps stop backflow in a hydraulic system. The manufacturers had discovered that when they put plastic valves in hearts that they didn’t fit right; they leaked. Dr. Weldon had pointed out that regular valves work in an immobile system of pipes. The heart is a muscle and when blood is pumped through the valve, everything is moving and the pipe – the artery – changes shape; it flattens. So the valve has to be flexible and stretchy so it can change with the shape of the pipe. So he had designed these springy valves that adjusted shape with the motion of the heart. The patients had many fewer problems. Now he wanted to document just how the valve changed shape. He wanted to film the valve from inside the heart.
The first problem to deal with was light. How can you take pictures inside blood when it’s opaque? You can’t. So Weldon decided to make a sugar solution that had the same viscosity as blood but was of course transparent. So we would sacrifice dogs. We got them from the pound, and they just had to be big so their organs would be big enough. Dogs also have an immune system that’s different from ours. With dogs, you don’t have to worry about infection. So we’d wear gloves, but we didn’t worry about sterile technique and operating room protocol. We opened their chests right in the lab. For our experiments, we needed the heart to remain alive even though sugar water circulates. So Dr. Weldon would expose the poor dog’s heart and expose the arteries. The heart is a muscle and needs a very big supply of blood to keep beating day in and day out. So the arteries that feed the heart are crucial. Indeed, it’s these vessels that get blocked in a heart attack. Anyway, Weldon would slide little tubes into those arteries, and then we’d hook the tubes up to a heart–lung machine that put oxygen into the blood and circulated it back to the dog’s heart. Then we’d replace all their blood with the sugar solution; naturally they died, but their hearts lived on.
Fiber-optics had just been invented, and Dr. Weldon would then make a purse string suture in the base of the heart at the point. Then he’d slice a hole in the tip of the heart, slide a fiber-optic lens inside, and pull the suture tight to seal off the blood. And the heart would keep on beating. We’d film the valve and its complicated motion. We also took electrocardiograms at the same time and recorded the beating of the heart. Then he’d have movies made with all the parameters shown on the screen with the valve opening and closing and the soundtrack blasting. Sometimes, we’d inject fine metal filings that would follow the currents through the sugar solution. As it came through the valve, the filings would swirl and spin in places of turbulence and show where flow was disrupted. This became important later when we operated on the dogs about a month before the footage and replaced a valve in their heart. Then we took pictures of flow through the artificial valves and look for turbulent patches.
I ran the heart-lung machine. I had to keep track of the flow and the oxygenation and I had a bank of meters and dials in front of me. Our operations would often take 7- 10 hours. It was a long time to remain attentive, but I loved it. I read all I could about hearts and valves and learned enough physiology to get by. The main path of my med school career was dismal, but I frequently found myself captured by a project, and for a few months I’d pay attention. In other words, I had a few shining moments in a sea of despair – the story of my life.