Contributor: Emile Gebel

My first personal conversation with Dr. Stead was in his office. I needed to tell him two things. First, I had signed up to man a display at the International Physiology meeting in Leiden, Germany during two weeks of my proposed internship in September. I considered that would be considered "company time," and he agreed. He also agreed that I could dovetail my two weeks of vacation to travel in Europe at the same time, but the most important consent would be to accept me although I had already been OK'd for a residency in opthalmology.

"Well," he said. "I guess you do not want to be a "168 day-a-week doc!"

I was accepted and found that my medical internship stood me well. Those were the best of times!

Title: Dr. Stead Has Mellowed

My internship started on a Sunday on Osler. My predecessor waltzed me by my share of the 30 or so ward patients and, in passing, mentioned that there was a new "off-ward" admission with pneumonia.

I worked all day and night learning about my patients in preparation for rounds on Monday with Dr. Stead, being aware of his reputation for being tough on new interns.

On Monday rounds, after I had presented the new patient in a somewhat discombobulated fashion, Dr. Stead nodded and allowed, "Well, despite Dr. Gebel's convoluted presentation, it is clear this patient has pneumonia and proper treatment is underway."

I breathed a sigh of relief.

Clearly, I thought, Dr. Stead has mellowed.

Title: Your Charge Is To Make This Patient Comfortable

During my second Osler rotation a "Stead-Resident" patient with metastatic carcinoma and nodules beneath her skin was assigned to me. Dr. Stead appeared once, about five PM on the day of her admission.

"Dr. Gebel, your charge is to make this patient comfortable. She will not leave the hospital alive. Your major task will be to deal with the family.

Of course, he was correct.

It seemed that during better times family members had been unkind to this patient, but now they demanded a cure. One, however, objected to this and even questioned the single transfusion I gave to make her more comfortable. The nursing staff got upset when her morphine dose went to 200 milligrams per day.

I pacified the nurses, dealt with the difficult family and followed Dr. Stead's charge to make his patient as comfortable as possible -- which I did -- and hope, if I someday find myself in that situation, someone will do the same for me.

Title: A Screener in the Medical Clinic

When I was a screener in the Medical Clinic, a patient I knew, Dancy Sumner, presented one day, bouncing in in a highback wheelchair with a note from his outside physician in hand which read "Admit. Has pneumonia and gout."

Well, I knew he had a history of asthma and rheumatoid arthritis with rheumatoid nodules, no gout or pneumonia. I hooked up an IV, got a rheumatology consult, wrote my findings and sent him out with a bag of medicine.

The following morning I was called to Dr. Stead's office. He read Dr. Stanley's note then mine. "Yet again Dr. Stanley was called to the home of Dancy Sumner, this time at two yesterday morning!"

"Yes, Dr. Stead."

"But your note tells me one thing and Dr. Stanley's quite another."

"Yes, sir." I just stood there blinking, not knowing what was coming next.

Dr. Stead continued, "The point is, Dr. Gebel, Dr. Stanley is unhappy, so I want you to get this patient into this hospital PDQ."

So I did.

Title: A Cold, Wintry Sunday

It was a cold, wintry Sunday when a divinity student, bleeding from somewhere in his gut, was admitted to me on the private ward. I started two IV's and two units of blood, inserted a nasogastric tube and waited for Dr. Ruffin to arrive.

Soon he came marching down the hall, followed by a large assortment of students and fellows. I presented the patient, who was by then fairly stable. Dr. Ruffin examined the patient then said, "Here we have another divinity student bleeding from who-knows-where. Just last month we treated one with 27 units of blood. He got hepatitis."

Dr. Ruffin called for a vote. "Do we treat him medically or call Dr. Peete?" Dr. Peete was a surgeon.

The vote was a tie. Because I didn't vote, he turned to me and said, "Dr. Gebel, you vote and break the tie. But be aware that that if you opt for medical treatment you will probably be up all night. You will have to watch him with care!" I voted for medical care, since the patient was then stable and actually remained so well into the night.

About two AM the nurse called me in Baker House and reported bright red blood in the nasogastric tube. I came over and checked the patient, finding a significant drop in his hemoglobin. Then, without hesitation or consulting Dr. Ruffin or his fellows, I changed my vote and called Dr. Peete, who immediately came over, took the patient to the OR and commenced an exploration. A bleeding ulcer was the problem, which was corrected.

The patient is now a Methodist minister.

Title: Oh! I Get It

It would be a total understatement to say that my medical internship experience under Dr. Stead was not the foundation of my private practice in opthalmology. I recall numerous very exciting experiences, not all involving Dr. Stead, who because of his extraordinary memory likely will recall these that follow.

When I was opthalmology chief resident we had no interns, although the other surgical services did. The chief resident on surgery came to me and asked me to approach Dr. Gardner about eliminating "scut work" for surgical interns. He selected me because, since we had no interns, I had no axe to grind.

I met Dr. Gardner for lunch. You may recall he was a large man with very large hands, with which he talked. After presenting my request and pointing out that Dr. Stead had eliminated "scut work" for medical service interns, Dr. Gardner went into a long speech about how it was when he was in training, all the time waving his hands in my face.

I simply did not know how to get into the conversation, or what to say if I did, but finally I got him stopped and said, "Dr. Gardner, I suppose you know that Roentgen took his own X-rays, too."

Dr. Gardner leaned back, smiled and replied, "Oh, I get it! We'll stop "scut work" forthwith!" (Which he did, to the relief of surgical interns.)