We were all terrified, of course.
It was a usual Saturday morning in the winter of 1975. The LSU medical
students sat nervously in "The Pit," the stepped amphitheater on the twelfth
floor of Charity Hospital where the Department of General Surgery discussed
cases from the week before. Two or three students were assigned to
present a case, after which the head of the department--the Chairman-- would
quickly decide whether to decimate the presenter or challenge, point blank,
the attentive med students who were the audience. If he liked the presentation--if
it was a logical reporting of symptoms, signs, findings, diagnosis, and treatment--his
finger would swing around and zero in with a question to a random casualty
in the seats above that surrounded him. If he didn't like the presentation,
if the student hadn't prepared that well or was sleepy, The Pit became the
teaching experience from Hell. The other students could then relax
because all the barbs and verbal entrapments would be going elsewhere.
The presenting student got only one
sentence out before he was stopped.
"You all heard him," the Chairman
said with a smile on his face that fooled no one. "He stated that this
is a case about right lower quadrant pain." He paused. "Ahhh,"
he said, slowly extending the index finger of his right hand. "Dr.,
um, DiLeo," he snapped (even though I wasn't a doctor yet), his hand and
finger locked and loaded.
"Yes, sir?"
"Dr. DiLeo, what would you do?"
"I would get a careful history from
the patient," I answered. Somehow I knew this wasn't going to satisfy
my debt to The Pit.
"You were going to get a history,
were you not?" he swung around to ask the presenter.
"Yes, sir, and after that I was--"
He was stopped dead by the finger
waving negatively. This finger was running the show now on this Saturday
morning.
"We'll let Dr. DiLeo tell us what's
next, right, Dr. DiLeo?"
Well this wasn't fair at all.
True, I hadn't had my turn to present at one of these Saturday kangaroo courts,
but that was no reason to make me present the case I was hearing about for
the very first time. Now no one relaxed, because others realized that
finger could jump track to any one of them instead of me.
"I would do a careful physical exam,"
I explained.
"Oh, I expect it would be a careful
one, Dr. DiLeo," he assured me. Of course I chuckled along with him
which seemed the respectful response to his wit. "But first, before
the physical exam, what about the history? What do you want to know
about the history?"
"Well," I stammered, "I didn't hear
it yet."
"Of course," he agreed, turning to
the presenter. "Let's hear a bit of the history, shall we?"
"Mr. Temple was a 21 year old black
gentleman--" the presenter got out before silenced again.
"Dr. DiLeo," the Chairman asked,
"what can you tell me now?"
"Uh," the stammering continued, "that
he was 21..."
"And?"
"And he was black..."
"And?"
"And...uh...I didn't hear anymore,"
I responded.
"And?" he asked again, raising his
voice.
"And...uh...um...that he was a gentleman?"
"No! No, Dr. DiLeo!"
"You mean he wasn't a gentleman?"
I asked, flustered in the brain. The department head thrived on flustering.
The rest of the students laughed. I was a dead man. Mercifully,
he turned back to the presenter.
"Dr. DiLeo has made a value judgement
about Mr. Temple. So what can you tell me so far based on what you've
said?" he asked him.
The presenter, like me, had simply
run out of gas. His mouth opened as if to begin to answer. The
department head raised his eyebrows in excited anticipation, but no words
issued forth from the presenting student. He snapped around.
I braced myself, but he fired his finger at the student to my left.
"I don't think we can say anything
else about Mr. Temple until we do a physical exam," the student answered,
suspecting a trick question, because there were always trick questions.
"You!" he shouted to the next student
in line, but she wasn't fast enough, and his finger skipped on down the line,
student by student. "And you? And you? How about you?
Surely you know?" He troubled himself to put on obvious expressions
of disbelief. This went on and on until--and I don't know why--I slowly
raised my hand.
"Doctorrrrr DiLeo," he said with glee. "Dr. DiLeo--unless
he has to go to the bathroom, has had an epiphany. Please, Dr. DiLeo,
share it with us."
"Well..." I began.
"Yes," he blurted, smiling at how
he knew he was sucking me in.
"Well...Mr. Temple is a 21 year old
black gentleman."
"Yes, Dr. DiLeo--your insight, please."
"Mr. Temple is not a 21 year old
black lady," I continued.
"No, Dr. DiLeo, that would make him
‘Miss" Temple, wouldn't it? And your point is?"
"I know that Mr. Temple has right
lower quadrant pain and he's a man, so I know his pain isn't from a right
ovarian cyst. Right?"
The head of the Department of Surgery
stood silent for a long moment, then finally rewarded my insight.
"Dr. DiLeo," he said with a most
sympathetic tone, "you need to be a gynecologist, not a general surgeon.
He was so right.
Epilogue:
Twenty-three years later, I was touched
to see this man at the funeral of my father, a retired general surgeon who
died at the age of 84. He knew I was a gynecologist, but this irony
was lost on him, because although I remembered him so well, he probably didn't
remember me or this episode.
