Title: A Stead Story, of a Sort
Contributor: Geoffrey Basson
I found my own exposure to the chief to be very useful, but, having come from elsewhere, I could never buy into the mythologic status that Dr. Stead was accorded by the guys who were trained at Duke. For us Pittsburgh guys, Jack Myers was a divinity.
I still remember my internship as the most valuable of my 7 years of postgraduate training. Memories are still vivid of being on a vertical learning curve, being chronically exhausted, and being constantly stimulated by a superlative peer group in a teaching environment of unsurpassed excitement.
Actually, I suppose that entire experience is a 'Stead story' of a sort.
Title: Forty-Year Memories of "The Most Hostile" Stead Intern
Lots of memories come back after almost 40 years! Such as that I'm not in our intern class picture because Joel Temple wouldn't let me leave the screening desk in the clinic and I was too much a "goody-goody" to tell him to get stuffed. It still ticks me off because in those days I was cute and had hair.
Then when Mort Bogdanoff told me I was the most hostile intern he had ever met, which filled me with pride until about 1970 when, in neurology residency, I met Larry Kerson, who interned a couple of years after us and told me Bogdanoff had said the same thing to him. so my record didn't last as long as the Bambino's 60 homers.
Memories of the terrific JAR's who kept me from disastrous errors.
Doing the right thing, rather than the easy thing, because I knew I would have to explain myself to Bruni Herrero in the AM.
Dr. Stead has many talents, but the one that endears him the most (or troubles most people, depending on whether or not you are on the receiving end of it) is his uncanny, almost telepathic ability to see through massive reams of data to expose the core, the kernel of truth that reveals the whole case, that makes it all obvious and simple. Like Sherlock Holmes, examples of this are numerous and breathtaking. Unlike Holmes, Stead's are not fictional; some may be embellished a bit, but nonetheless real and mind-boggling.
Here is my favorite:
In 1971 I returned from a tour with the US Army Medical Corps in Southeast Asia to spend my remaining time in service at Fitzsimons General Hospital in Denver, Colorado. Fitzsimons was on the eastern outskirts of Denver, almost as far out east Colfax as you could go at the time and was a huge and magnificent building/campus complex, occupying dozens of arborealized city blocks.
It was one of five teaching hospitals in the Army Medical Education system. Most of the staff were trainees of some sort, or faculty; medical care delivery activities were punctuated liberally with teaching activities of all sorts, and there were some research activities in evidence, not unlike the Duke I had left a year before. Furthermore, there was a close working/teaching relationship with the University of Colorado in downtown Denver, with a steady flow of med students, house staff, fellows and faculty moving back and forth constantly. Not unlike the situation with Duke and the Durham VA Hospital.
On arriving in September, we were pleased to find ourselves and growing family in comfortable base housing, and I was also pleased to find that my next door neighbor was Harry Thomas, a recently graduated internist, and a very pleasant fellow, also in the middle of his military obligation.
We got to talking and as soon as he found out that I had trained at Duke, out came the inevitable segue, "Oh, then you must know Dr. Stead." I allowed as how I did and asked him how he had heard of the great one. This was his story.
It seems that Dr. Stead had been visiting professor of Medicine at the University of Colorado School of Medicine a few months before, an event which was to the Denverites a big deal, not only because of Dr. Stead's reputation and aura, but because the University of Colorado was gearing up to do its first heart transplant. After the usual series of rounds and conferences, there was scheduled a combined Medical and Surgical Grand Rounds [the Mother of all Grand Rounds], with Dr Stead being the featured speaker.
As Harry related it, the auditorium was packed. The medicine chief resident presented a patient, a middle-aged man who had some sort of refractory cardiomyopathy. The resident told of countless admissions of increasing frequency and duration, each entailing diuresis of gallons of water and loss of dozens of pounds, only to be followed by reaccumulation of more gallons of water, readmission, etc. It had gotten so bad that finally they had admitted the patient continuously to try to keep him dry, which had worked at first, but soon it became apparent that even while hospitalized, the patient had accumulated impressive amounts of fluid which the staff could just barely keep up with.
The surgery chief resident gave the usual technical information, the cath data, reviewed the history of heart transplantation, the relevant immunology, set forth the plans for this patient and pointed out that at that moment, they were just awaiting a suitable donor heart, which might turn up at any time. It wouldn't be too soon, because it seemed that any day now, this patient was going to drown in his edema fluid, despite all their heroic efforts.
It was a cut and dried case that Dr. Stead rose to discuss and onlookers wondered what he could add to the massive, data-filled, erudite presentation which preceded him. The patient was present, possibly at Dr. Stead's insistence. Dr Stead introduced himself and the conversation went something like this: Dr. Stead asked, " Oscar, what is your favorite food?"
"What do you mean?"
"Well, what do you like to eat more than anything else?"
"What I like most of all is potato chips."
"Oh, yeah, tell me about it."
"Gosh I eat several bags of potato chips a day. Used to be, I would go home from the hospital with a powerful hunger and eat 20 or 30 bags of chips. Then they admitted me continuously. At first that cut off my potato chip habit but then I found a stairwell at the end of my ward where I can go down one flight of stairs, go into the soda shop, buy all the bags of potato chips I want, and sit out in the stairwell most of the day and eat them. There is also a water fountain across the hall from the soda shop where I can kill my thirst, and that's how I spend most of my time."
The story goes that Dr. Stead turned to the chief residents, and said, "Instead of a forty thousand-dollar heart transplant, why don't you just get a fifteen-dollar dietetics consult?"
He sat down. Grand Rounds were over twenty minutes early.
I asked Harry how the performance had been received. He said that some people loved it but a lot of people hated it and were mad as hell. Overall it seemed, it would be a long time before Dr. Stead would be invited back as visiting professor. Or, before the next time, they were certain to do their homework a lot better. It seemed that whether a person loved or hated it, it made a deep impression.
I said, "Yeah, I know the feeling."