Resident Class of 1974
For all of the times in the last 15 years when I’ve told myself that I sure could tell those folks in Ann Arbor a thing or two, now that I’m presented with the opportunity, I find myself a little more cautious and introspective than I otherwise thought I would be.
Walking through my house the other day while musing about what I might say, I was distracted by the sound of a video game. One of my children was skillfully playing some Nintendo game where in balls of flame or fiery bombs are dropped on intended victims. The victims scurry to avoid their immolation while the player masterfully tries to do in as many as possible. I suddenly realized that, that’s what I feel like our relationship with our current greatest nemesis Medicare vis a vis HCFA is like. The regulatory bombs keep getting dropped toward us while we try to zig and zag and preserve our “medical” life the private, free-enterprise practice of anesthesiology. I have to acknowledge that for all the positives of my residency at the “U”, there were some negatives or rather some voids. The business aspect of practice was little discussed and politics not at all. I would readily concede that the political climate of today is much different than it was in the early 70’s. So I will include some thoughts on that. But since this is to be shared mostly with those who are members of the fraternity of Michigan Anesthesia Department grads, I can’t resist the invitation for a reminiscence or two.
Looking back, my eight years in Ann Arbor were truly the most carefree and self-indulgent of my life. Everyday was a delicious, wonderful, mind-expanding educational experience. Kids, wives, pension plan and third-party reimbursement could have been planets in another galaxy for all we knew. We worked hard and played hard and what an experience it was.
When I started in the residency in 1972, most of the resident classes were small four or five and most of us had done something else first general practice, surgery, surgical residency. Dr. Sweet was the chief and with his penetrating blue eyes, he could charm you into anything. The ASA meeting was in Boston that fall, and I went to it. I found out there, much to my great surprise, that Dr. Sweet was stepping down. As I recall, he remained chief until I left, however. Dr. Child was chief of surgery. Having been one for two years myself, I was naturally impressed by most of the surgical residents. Some of you may remember Ned Dalton in surgery. He and I have been working together here in Manchester since 1978. Some of you may remember Warren Emley in ENT. He is in Concord just north of me, and he and I are quite active in medical society politics. We still wear our wolverine ties and stump everyone out here as to what critter we’re wearing. Over the years, I’ve seen quite as few fellow residents at meetings and have visited Ann Arbor a few times. I’ve seen quite a bit of that greatest of Kamikazes-Miki Hiraga and have seen more of the new I want to call it St. Joe’s but it’s not the hospital in Ypsilanti. I’ve not yet gotten over to the new “U” and have, unfortunately, not been able to get back for any of the Sweet Conferences, but I will continue to try. Disturbingly, on my infrequent visits to Ann Arbor, I note with deep sadness that some of our favorite watering holes are gone Bimbo’s and Pretzel Bell and where have RFD Boys gone? They must be on Social Security by now!
The educational experience was terrific. I note a few familiar names on the staff but mostly new ones. Mott and Holden were new when I was there. We had some wonderful experiences with Jordy Waldman and Keith Lieding. The county rotation was always worth the ride for the free food and listening to Roger the CRNA talk about investments. I never went driving with him again after that one time however! Georgine is still there, but Anne Hill was a Bruce and a newcomer then. She smoked wonderful English cigarettes, and we all used to “borrow” them. I’ll never forget her listening to my description of a particularly tough, sputum-covered intubation on the wards and then promptly throwing up in her hand. Alena Fabian remembers the night I intubated an esophagus during an arrest and the first cough filled her lab coat pockets and shoes with emesis. Ruined our whole night’s supply of matches and cigarettes. Jay Finch went from the county to respiratory therapy and the respiratory ICU was just getting going. I remember otherwise-healthy young men dying of bizarre pneumonias think they weren’t AIDS? Several of us went to Bill Ford’s for a party one night, and after years of apartment living in Ann Arbor, couldn’t fathom living in a real house like Bill’s. Dr. Zsigmond always sputtered some number more than five but less than fifty thousand when he did an arterial cannulation, this number representing the consecutive, successful punctures he had performed. And his numbered syringes of purported “relaxants” to patients, it made for floppy fingers but somehow always seemed to allow the diaphragm to continue to function vigorously. I can see my Michigan diploma as I sit here typing, and I have to say that it was a pretty terrific experience. I hope the residents now are learning as much and having as much fun, and like me, they’ve stopped or don’t smoke.
It’s a good thing the anesthesia education was so good, because I still feel most confident about my abilities there. With business and politics, it’s another matter entirely. And while I may hope today’s residents are getting some smattering of the political climate out there; some might turn back if they knew all I know. As I have traveled around the state of New Hampshire during the past year as president of the state medical society, I have tried to impress my medical colleagues of the need to wake-up and face head-on the menace before us. I can tell you without hesitation, that the way we will be practicing into the next century will be decided more by laymen in governmental subdepartments in Washington and in state capitals than by medical researchers or professors. DRG’s are already in place have been for more than five years now!…..(The remainder of this article was lost.)
Originally published March, 1989