WHOEVER SAVES ONE LIFE . . . by Dr. Arnold Katz
Try as I might I couldn’t memorize the names of all those nerves, arteries and veins, and whether they passed above or below their neighboring structures. I studied every minute which wasn’t already occupied with attending lectures, eating, or sleeping. I made two compromises: I would go to sleep no later than 11:30 each night, and I would “let go” from 5:00 PM Saturday until 2:00 PM Sunday, the time the medical library re-opened.
Arnie Katz – First day in whites
Some subjects came naturally to me such as statistics and clinical diagnosis. It was not hard for me to remember that there were only a few real medical emergencies, including establishment of an airway and assuring that enough oxygen and glucose were delivered to the brain. Once brain tissue was lost, it was gone forever.I was filled with fear of failure. It surprised me that some of my classmates were also terrified, but their concern was that they might not be elected to Alpha Omega Alpha, the Medical Honor Society. This society was usually the province of those with the highest academic rankings. After discovering that students rarely flunked out of medical school; but rather, were required to repeat a year or a subject, I tried to relax and just learn as much as I could.
After I performed very poorly on a rotation under Dr Gerald Perkoff at St Louis City Hospital, questions were raised as to whether or not I should be allowed to continue in medical school. Dr Carl V. Moore, the most highly respected professor in the school, requested that I be given the opportunity to prove myself on his service, Ward Medicine at Barnes Hospital. He had been told that I worked tirelessly and cared deeply about my patients. The hours were long, the St. Louis heat stifling, the work never ending; but I was prepared to do whatever it took to become a physician.
Arnie Katz in medical school
Hey, Katz. There’s a black guy just admitted through the ER. His wife says he became weak on his right side this morning and then went into coma. His breathing is pretty irregular, and he probably won’t make through the night. Do the H and P now; I’ll give you credit for it. You’ll have one less patient to follow.
We were required to perform extensive history and physicals (H and P’s) on three new patients a week, and then be responsible for all the scut work on those patients, as well as others we had previously been assigned by the intern. One afternoon, near the close of the day, my intern yelled out my name:
I raced down to the emergency room and spoke to Mrs. Smith. As soon as she told me her husband, Frank, was diabetic, I remembered that low blood sugar could cause coma; but there really wasn’t any time to waste. I immediately sent a blood sample to the laboratory to measure his glucose level. Without waiting for the results, I ran to the nurses’ cart, grabbed a 50 cc glass vial of 50% dextrose, snapped off the top, drew up the sugar solution into a 50 cc syringe, and injected it into a vein in his left arm. Nothing happened. I repeated the procedure, again with no results. I really should have known it wouldn’t work because before Mr. Smith had lost consciousness, he demonstrated weakness on one side of his body, a very common sign of impending stroke, not a typical sign of low blood sugar.
I told Mrs. Smith that I was required to attend the afternoon conference; and even though the intern would be in charge, I would return as soon as possible. As I approached Mr. Smith’s bed after the conference, the intern told me that the laboratory reported that Mr. Smith’s blood sugar level was dangerously low. I stood transfixed when I saw Mr. Smith sitting on the side of his bed joking with another patient. I actually had saved a life. I really did save Mr. Smith’s life. I couldn’t wait to be praised by Dr. Moore on professor’s rounds.
It was only after Mr. Smith was out of danger that his wife told me that the night before he was admitted to the hospital, she had discovered a half eaten box of candy bars hidden under his bed. She confiscated the candy bars, but injected her husband with his normal dose of insulin, with disastrous results.
On Friday morning on professor’s rounds, my intern presented Mr. Smith to Dr. Moore. He explained that even though the most likely diagnosis was terminal stroke, he had instructed me to draw the blood and inject the sugar solution. I heard those words in disbelief. I wanted to cry out that the intern was lying. It was I who had prevented Mr. Smith’s unnecessary death. In the 1960’s medical students were commonly the object of intimidation, harassment, and even retaliation by interns. Besides, who could possibly believe the word of a medical student, who was barely passing, against the word of an intern, who had been awarded a position in one of the most prestigious training programs in the country, and who probably was a member of Alpha Omega Alpha?
Dr Moore explained that the reason Mr. Smith initially showed signs of weakness on the right side, was because he had narrowing of the blood vessels to that part of the brain; and therefore, the symptoms of hypoglycemia developed first on the side with the narrowest blood vessels. Dr. Moore never learned that the intern had robbed me of my opportunity to please the only professor who had stood by me.
Arnie (center) on Graduation day – Made it at last
Dr Moore was also unaware that on March 19, 2004 (forty years later) I was to receive the following letter: e (center) Graduation day – Made it at last
Dear Dr Katz:
It is our pleasure to inform you that you have been selected for membership in the Medical Honor Society, Alpha Omega Alpha. This selection is recognition for your contribution to medical students’ education and is a testament of their high regard for you. You now join a most select group of physicians, scientists, and educators whose performance places them in the highest category of excellence. We join the students and other faculty members in offering our most sincere congratulations upon your selection for this honor.”
Dr. Moore died many years ago, but I only wish that he had known that his faith in me had not been misplaced. Maybe he did.
Whoever saves one life, it is as if he saved the entire world.(Mishna Sanhedrin 4:5)