BEER CLINIC:: Doctor Beer or…

by Dr. Carol Westbrook on February 2, 2012

…Beer and the Doctor

Dr. Carol as an Intern Fall 1979

Alcoholic beverages have been a part of our human lives since the beginning of civilization, when we first learned to cultivate grains.  Shortly thereafter we learned how to ferment grain into alcohol. The art of medicine probably began at the same time, when we learned how to care for the sick, providing comfort and relief of pain. Alcohol was undoubtedly one of the first medicines. Since that time, the medical arts and alcohol have been linked, if only because they are an integral part of human existence. Fast forward to the present time.

This is a semi-autobiographical collection of notes about my life as a doctor. Beer or other spirits are a common thread in the stories, sometimes causative, mostly coincidental.  The stories are mostly true, though the names have been changed.

Beer, anyone?

Dad & Bubbly Summer 1976

I grew up in ethnic, Polish Chicago, where beer drinking is a way of life.  Except in our house.  We drank champagne. Not just for special occasions, but any time where a beer would be called for.  It started with my Uncle Rory.  I remember Saturday evenings as a child, when Rory would show up to the house with a couple of six-packs, and he and my folks would drink into the night, talking and laughing. Everyone loved Uncle Rory, but it was common knowledge that he drank too much. One evening he brought a few bottles of cheap champagne. From then on, the Saturday evening parties continued with champagne instead of beer.  Years later I asked my father why the switch from beer to champagne. “That’s because Rory’s doctor said he drank too much beer, and if he didn’t stop it would kill him.  So he switched to champagne.”

A tough place to study

I studied medicine in one of the toughest hospitals in Chicago–Billings Hospital, at the University of Chicago.  Now an elite “Center for Advanced Medicine,” in the 70’s it served as a community hospital for one of the poorest neighborhoods in the city, and one of the toughest.  This was Hyde Park-Kenwood, long before it gentrified and became a suitable home for president Obama and his family.  Crime, drugs, alcoholism, and gunshot wounds were common, even among the hospital employees. One week we had more fatal gunshot wounds among the hospital cafeteria workers than in the emergency department. One was a drug-related shooting in the cafeteria, and in the other instance, a jealous husband shot his wife’s lover in a drunken rage; both worked in the hospital cafeteria.  After that I brought my lunch from home.

Drinking with my cadaver-mates

I didn’t really drink until medical school. Drinking with the other med students is a big part of the bonding experience. Four of us had all been partners on the same cadaver—two on the right side and two on the left—and we would do everything together. In fact, I married my other half on the right side. Typically, we would join the other  med students at Jimmy’s bar to unwind after an exam.  But once we went out for a drink before an exam.   It was the night before Part I of the National Board exams, in our second year of medical school. This was an important test, a “make-or-break” for doctors. “Where shall we study for The Boards?” I asked.  Jeffrey, my left-cadaver partner, said, “Carol, if we don’t know the material by now we’ll never learn it tonight.  Let’s go for a drink instead.”  Who could argue with the logic?  We had a drink at the bar — we were the only med students there.  Then we went to see “The Exorcist,” which had just opened.  We all passed our Boards.

Two guys walk into a bar and end up in the emergency room

Medical students who were on their surgical rotations were encouraged to hang around the emergency room to help out, and possibly get a chance to practice surgery. Weekends were the best time. One Saturday night the cops brought in two men with facial cuts that they got during a bar fight. They both needed to get stitches, and they were very intoxicated. They were put onto adjacent beds in the emergency ward, separated by privacy curtains–we didn’t have individual emergency room beds in those days. I helped the surgeon start the stitching, and then he let me take over on my own. Since they were on adjacent beds I was allowed to do both.   I did a careful job and was very proud of my work, and I threw the curtains back to show it off to the attending surgeon.  At that point, the two patients recognized each other—it turns out they had been fighting each other! They tried to jump out of bed to continue their fight, and I was caught in the middle.  I learned another lesson that night–it’s very easy to subdue a belligerent drunk, since they aren’t coordinated enough to do any harm.  I just used my loudest “mom” voice, scolded them for fighting, and put them back to bed to sleep it off.

Death by aerosol

As a medical student I did a 2-week rotation on the inpatient psychiatric ward at Billings hospital. It was a locked ward. Our job was to look after the physical health of our patients, while learning as much as we could about their psychiatric illness. I was assigned to Frank, a pleasant, 50-something man who seemed perfectly normal. Many people with psychiatric illness drink excessively, and Frank was no exception, though he had no trouble stopping when he checked himself into the ward. He was just a regular guy from an ethnic neighborhood in Chicago, a retired factory worker who spent his days at his local bar.  Frank told me there was absolutely nothing wrong with him.  He claimed he had no psychiatric problems, he was just hiding out at the hospital so his brother-in-law couldn’t find him and kill him.  Frank claimed that the brother-in-law had an aerosol can filled with a deadly poison and was following him in close pursuit, trying to spray him to death.  To avoid this, he took 3 different buses, in several different directions, running miles on foot between bus stops, until he reached the hospital and voluntarily signed himself into the locked ward for protection.  Frank had what is called “a fixed paranoid schizophrenic delusion.” Except for this one obsession, everything else about his mental state was normal and coherent.  He was convinced, and convincing.  I was afraid for him to be discharged from the ward — because what if he was correct?

Euphemistically speaking

As interns, it was our job to admit patients to the hospital and manage them during their stay.  We were on call to take new admissions every third day; most of our admissions came in from the emergency room, which was used by most local residents in place of a primary care physician.  Most came in at night.  On those days we’d be up all night, to take new patients, evaluate their medical problems, and start their treatment.  In the morning, bright and early, we would go around with the attending physician and the rest of the doctors to see the patients, who would then assist in their diagnosis and management. The challenge was to discuss the case at the bedside, in front of the patient.  We became adept at using Greek and Latin phrases, and euphemisms to discuss sensitive medical details in front of a patient.  A typical presentation:

“This 60-year old man, a known habitual user of two-carbon fragments, presented to the emergency room with hallucinosis and odor spiritus fermentum. His BAC was .16.  He was started on prophylactic diazepam and IV thiamine, to prevent delerium tremens and Korsakoff’s.  We are monitoring his BAC pending discharge.”

The old drunk would lie in bed smiling, enjoying the attention, impressed and pleased that his doctors were discussing him in Latin, totally oblivious to the true meaning of the discussion.

Translation: “This patient, a known alcoholic, showed up in the emergency room seeing pink elephants, and smelling of alcohol.  He was drunk at twice the legal limit.  We gave him Valium to stop the DT’s, and vitamins to prevent further brain damage. We are letting him sleep it off until his alcohol level drops low enough for discharge. “

The Animal

I was called to the Emergency Room late one night for my next admission, a big brute of a guy with head trauma who had to be admitted for observation.  We interns usually ended up transporting our own patients from the ER to the ward, since the patient transport service was slow and lazy, and patients could die waiting for them (literally).  They handed Tyrone off to me on a gurney, told me his nickname was “The Animal” and that he was ready to go except for a small detail–he had to have head X-rays to make sure he didn’t have a skull fracture. It appears that he fell off a second story balcony, but was so drunk that he didn’t feel a thing.  Apparently this was not the first time it happened.  The Emergency Room staff was unable to get this burly, muscular, 250-lb man to cooperate for his X-rays, as he tried to hit anyone who came near and he was too heavy to lift. So now it was my problem.  Fortunately, his wife showed up, all 300 lbs of her.  She barged into his room, scolded him for giving the doctors trouble, grabbed him by the ear and led him to the X-ray machine.  Cowered, he followed meekly.  Fortunately, his X-rays were normal and we brought him to his room to sleep it off.

Addicts, needles and antibiotics

There were many heroin addicts in our neighborhood.  They had no regular medical care, and used the Emergency Room as their primary care physician.  Addicts frequently developed serious medical problems as a result of sharing needles. A blood infection which settles on the heart, bacterial endocarditis, was one of the most dreaded This was in the days before AIDS (which later killed many of them). We had a rule: if an IV drug user showed up with a fever that lasted more than a couple of days, we’d admit them for observation with the presumption that they had bacterial endocarditis. If the diagnosis proved to be correct, then they had to stay the hospital for 4 to 6 weeks to get antibiotics given intravenously, 2 to 3 times each day.  Without this treatment, they would die.

To an addict, 6 weeks in the hospital was like 6 weeks in jail.  You couldn’t leave, couldn’t do what you wanted, and worse yet couldn’t smoke, shoot heroin, or drink. Most of our addicts were put on methadone, and could sneak out to the yard to catch a smoke, but getting a drink was almost impossible. For us interns, getting assigned to an IV drug addict for 6 weeks of antibiotics was no picnic either.   First of all, many of them were in the hospital against their will, and at times we had to forcibly restrain them (yes, you could get away with it in those days, since we were saving their lives, after all). Worse yet, we had to start IV’s in order to treat them.

Back then, all IV’s were started by the interns.  Typically, most addicts have used up all the “easy” veins for his drug habit, so it could easily take an hour for an intern to find a vein and get in an intravenous line.  I recall one frustrating situation with a 30-year-old addict, Leroy, who had no veins left, and didn’t particularly want to be in the hospital. I don’t know how many times I stuck him with a needle without any success. Finally, Leroy got sick of being a pincushion.  He grabbed the needle from me without a word, put a tourniquet around his leg, and proceeded to put the IV into a small vein between his toes.  “There you go, doc. There’s your IV in my favorite vein. Now would you please let me get back to sleep?” I thanked him profusely.

Ed. Part 2 of this fascinating narrative will be coming tomorrow and posted below to avoid symptoms of dizziness and nausea due to disorientation. 

{ 6 comments… read them below or add one }

Susan Garstki McManus February 8, 2012 at 10:14 am

Love the picture of your dad in your back yard. By the way, I remember the champagne “Uncle Rory” would serve — Piper-Heidsieck. You were being compliant with HIPPA — something else that didn’t concern us back in the 70s.

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Richard February 9, 2012 at 4:52 am

Carol, I took a closer look at the champagne bottles in the photo with your father at the grill. The two on the left are Cribari Champagne and the others are Andres. In the mid 1970s, each bottle would cost about $1.79 at the local Chicago Foremost Liquor store. It was also wise for your Dad to keep them near the Weber Kettle because they were very effective for putting out minor barbeque grease fires !

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Carol, the beer doctor February 9, 2012 at 10:30 pm

You are very observant, Richard. Now you can see why they picked champagne instead of beer–it’s a lot cheaper drunk! And yes, it does put out grease fires.

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Richard February 10, 2012 at 3:26 am

Make no mistake about it Carol, Andres Bubbly was always a part of my family’s budget-minded celebrations of the 60’s & 70’s too! When your Dad picked the Cribari, I think he got a tip from his parish priest. The Cribari brand is known for their altar wines. Your father enjoyed it as a religious experience and savored its ecclesiastical approbation, not as a cheaper drunk ! http://www.altarwine.com/

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Richard February 10, 2012 at 3:44 am

This topic brings up a Valentines Day gift suggestion. Loosen up the purse strings and buy one for your favorite Valentine. Please remember to get one for your husband too! It will look great by the grill. http://wineharlots.com/wordpress/2011/12/moet-chandon-dom-perignon-champagne-fire-extinguisher/

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Carol, the beer doctor February 10, 2012 at 2:14 pm

This is hysterical! Dad would have loved it. Thanks for sending the link.

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