Peter T. Pugliese / MD Cookie Doctor

An American Physician's Memoir of Life's Obstacles and Miracles
1. Auflage 2014
ISBN: 978-0-9630211-6-8
Verlag: The Topical Agent, LLC
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 135 Seiten

Octogenarian and published scientific expert in the field of anti-aging, textbook author Peter T. Pugliese, MD shares his personal recollections of the rural family practice in PA Dutch country where he began his career in medicine. The patient crises and vivid characters provide a slice of history with a heaping side of faith, in this well-crafted memoir of obstacles and miracles along one gentle country doctor's extraordinary path.

Autoren/Hrsg.

Peter T. Pugliese, MD

MD,

Leseproben

Chapter 1 A Country Doctor There were no patients in the waiting room, none the day before, or the day before that. I could not predict when I would see my first patient that week. The year was 1958. I had started my practice of general medicine in Bernville, Pennsylvania, just four weeks earlier. Bernville was a small, rural town populated mostly by German people, commonly known as the Pennsylvania Dutch. I was sharing office space with the town’s local doctor, who had cared for the citizens of Bernville and the surrounding area for ten years. The equipment I had was sparse: my office desk, the diagnostic instruments I used in medical school, and my books. In the month since moving in, I had seen a young boy with a fractured clavicle and a woman with a sprained ankle. That was a modest beginning. I had fair warning about what to expect. Other more established friends and colleagues had described the trials of waiting for patients to treat. Almost every doctor in private practice has a story of what it is like at the beginning—counting the bricks on the wall of the adjacent building, nodding off, slumped into a chair, or reaching for the ringing phone with high expectations, only to find another insurance salesman on the line. That day, I pulled Practical Techniques in General Practice from the shelf to read while I waited. Within moments, the phone rang, and I picked it up. “Dr. Pugliese.” A soft voice said, “Hello, Doctor, this is Ellen.” “Hello, Ellen, what can I do for you?” I asked. “I am going to throw my children into the well.” Her tone was flat. That is all she said. Nothing in my training prepared me for a call like this. I knew I had to get there as soon as possible. My first thought was for the children. I said the most neutral thing I could, “Ellen, don’t do anything until I get there.” She hung up. Though I did not know this woman’s full name or where she lived, I was now responsible for the lives of her children. I did not know how many. The telephone system in the small town of Bernville, Pennsylvania, in the late fifties was primitive. My phone consisted of a box with a bell, a crank, and a combined head and mouthpiece. I had to crank the phone in order to reach the local operator, who would then connect the party whose number I had given her. Most families shared a “party line,” which allowed for constant monitoring of neighbors’ conversations. Our line, number 5R22, was private, for my office use only. I rang up the operator and asked her who had just called my office. “Oh …” she hesitated, “I wouldn’t know …” The operator fumbled, obviously trying to avoid being accused of listening in. “You must know who that was,” I insisted. “You connected us. Operator, this is a matter of life or death. Please give me the name of that girl and tell me where she lives.” The operator cleared her throat and said with a lowered voice, “Her name is Ellen, Ellen Birch. She lives on the first road right, first farm on the left-hand side. It sits back slightly from the road. The house is white with green trim.” “Thank you, Operator.” Intent on getting to the farm as soon as I could, I grabbed my medical bag, rushed out of the office, jumped into my car, and roared out of town. The turn I needed was no more than five minutes away, and the Birch farm probably less than a half mile up the road. As I drove, I feared that Ellen Birch had already thrown her children into the well. I prayed to God that the children were still alive and that I would get there in time to save them. Hand-dug wells can be anywhere from fifteen to sixty feet deep, typically lined with stones and covered with a wood platform. These covers were made to be easily removed, because a bucket of water had to be pulled up to prime the pump whenever it went dry. I did not have a ladder or ropes with me in the car. As far as I knew, there would be no one else there to help. In the days before cell phones, it was hard to summon help. To my tremendous relief, as I turned into the driveway, I saw a woman holding an infant with a small boy and a girl standing close to her. Ellen was standing about two feet from the well, with a blank expression on her face. The old wooden cover had been pushed to one side. She had slid it to uncover the well. Ellen was a thin, worn woman who could not have been more than twenty-five years old. Her uncombed black hair hung around her gaunt face. She was dressed in a shapeless, dingy blue housedress and a gray sweater, torn at the shoulder and with missing buttons. Her shoes were mannish, what we called oxfords. She was looking down, with her head turned to the right. Her eyes were sunken. Observing her made me realize I was dealing with a postpartum psychosis. She appeared to be at the end of her rope. The first thing I had to do was to get Ellen and the children away from the well. I placed myself between the well and the children and said, “Hi, Ellen, I am Dr. Pugliese. How are you?” “I’m not so good, Doctor,” she responded. “I haven’t been sleeping much lately, and I am very tired. I just had a baby, and she keeps me up late.” “Ellen, let me take the baby from you,” I suggested, “and why don’t you and the children sit in my car?” I asked the names of the children and found the older child was a boy named Paul, after his father. His little sister, Sarah, was not yet two, a year younger than Paul. The baby appeared to be about three months old. As we moved toward the car, I remembered we had no diapers or milk for the baby. I asked Ellen if she could go back to the house to get them. “Yes, Doctor,” she said. The children stayed quietly next to me, as I watched Ellen walk to her porch and into the farmhouse. Her gait was as slow and deliberate as a soldier walking through a minefield. Ellen, it appeared, had already stepped on a mine. She came out carrying a diaper bag and a couple of baby bottles with formula. I opened the car door, and she helped the two children into the backseat first, and then she got into the front. “Ellen, can you hold the baby while I drive the car?” I asked once she was settled. “Yes, give her to me,” she said and took the baby from my arms. As I slid behind the wheel, I thanked God that the children were alive. I had no idea what to do with a psychotic woman and three children. The boy and girl were very quiet and docile, almost like two little mannequins. As I backed up the car to turn around, I got a really good look at the well. Had Ellen thrown these children into that well, they surely would be dead. I needed to get Ellen into the psychiatric ward of our local hospital as soon as possible. I was unfamiliar with the legal papers required to have her admitted. I did know her husband had the first legal responsibility for her. I had to reach him and notify the hospital that we would be arriving. I drove back to the office to get to a telephone. I often drove my Ford Economy station wagon over the rugged dirt lanes and uneven back roads that cut through the landscape and connected a spread-out community of farms to the center of town. I had chosen the car because it was roomy and comfortable. The station wagon served as an ambulance more than once when a patient needed to get to the hospital. As I drove, I kept an eye on Ellen next to me and glanced at the children in the rearview mirror. “Doctor?” Ellen wanted to know where we were going. I told her we were headed to my office so that I could get some medication for her. She nodded her head, accepting our destination. When we got to the office, I took the baby again and carried her. We moved toward the door, the small children following quietly. I needed to find someone to care for them while I admitted Ellen to the hospital. When I asked Ellen about relatives, I learned that her young family lived with her mother on the farm. Her mother was working in the clothing factory. Ellen did not know the number. With the baby in one arm, I called the operator, who connected me to the factory. I asked to speak to Ellen’s mother. My request was refused, because the company did not allow workers to talk on the phone. I explained the situation to the manager, but he did not seem to care. I hung up, defeated. “Ellen, how about your grandmother?” I asked. “Does she live close to you?” “Not far,” she replied. She said she could show me how to get there. Without taking the time to call ahead to let the grandmother know we were coming, I got everyone back into the car. We drove about four miles down the highway. Ellen gestured to turn at a driveway to a small, tidy house with well-tended flowerbeds and wind chimes on the porch. A slight, gray-haired woman answered my knock. She was surprised and confused by what she saw. She stood there, eyes darting from me to Ellen and then to the children and back again. I explained who I was. “Mrs. Oak, I am the new doctor in Bernville. Ellen called me this morning with a medical problem, and she needs some help. I was unable to reach her mother at work, so I am bringing the children here to stay with you while I take Ellen to the hospital. Would that be all right?” An angry voice came from the darkened living room, an elderly man’s gravelly rasp. “Who is it, Mary? What the hell do they want?” I assumed it was her husband. When he came to the door and stood next to...