The patient, a remarkable man who has maintained his employment despite end-stage kidney disease, and end stage liver disease, had finally reached the number two position on the liver-kidney transplant list, and with grit and determination, was waiting for the phone call. He was calling me to tell me that he had been hospitalized, not at his regular hospital, but at one closer to his house, and had been released and that the transplant coordinator at the renowned center in Los Angeles on which he was listed, wanted to speak to me about his condition. With a hepatic encephalopathy on his side, and an "are we going to be late for this 50 year event on my side," communication was sub-optimal. I did get a phone number and with blue tooth I resolved to call en route, and we left, the Turbo packed with our overnighters.
The instructions were very clear and very simple, and very wrong, on the invitation. The I10 East does not run into the I5 North, but GPS fixed that. Unfortunately, it could not fix the traffic, however, only give me detailed information of how I would be traveling in my 198 mph rocket, at 10 mph for 5 or 8 miles, watching the arrival time gradually extend toward the beginning of the reception.
And there was the phone number at the large institution, the courteous operator, the switching to the department of transplantation, the liver office, or whatever with each step accompanied by what seemed like 20 recorded options ranging from language selection, to call 911 if I really was in trouble, and, always lastly, or number 19 on the list, "if you're a doctor, press 7." Eventually, I got to Vesta, coordinator, who was very loquacious, and very concerned about stopping Zovirax for Bell's Palsy, his recent encephalopathy, and his treatment at the hospital which she knew more about than I did, as I had no record from the hospital. As the Porsche turtled forth, and the clock ticked, a series of phone calls established that a blood culture done at the other hospital had been treated with oral levaquin and the patient released. More was certainly needed.
The exact order of the phone calls and the traffic progress is not entirely clear to me, but with GPS assistance, and miraculous clearing of traffic as we reached I10 East, I found the State Street off-ramp and, like time travel in the movies, the Porsche propelled me into the same route, more or less, that my 1957 Volkswagen had followed, day after day, in the 4 years of medical school, to the looming temple, the Los Angeles County Hospital. It is a magnificent building and it is no longer used as the hospital because of earthquake requirements. It remains a historic monument, and its forecourt was the site of the reception and luncheon. We arrived to valet parking only 5 minutes late and well within the time frame of respectability. The valets placed the Turbo last in line, directly in front of the event, the Obama-Beiden sticker announcing that I was some kind of bizarre outlier at a University of Southern California event, a gathering of aged physicians, no less. But we were there.
My pager had an unrecognizable phone number that was definitely Orange County, and I had asked to be paged only for emergencies, so after I shook a few hands and said hello to a former professor who had retired in his eighties, Phil Manning, youthful and vigorous as ever, I excused myself from the line, left Lin at table 5, talking with classmate Colin Hubbard and wife Jackie, whom Lin knows through a good friend, and I called the number in the quietest place I could find. It was the hospitalist who had paced the patient on levaquin and he assured me that the patient had no symptoms, but it was, so far, a gram negative rod, almost never a contaminant, and thus in need of urgent treatment. The sensitivities had not been identified, but we exchanged numbers and he said he would call me. I felt I needed to report this to the transplant coordinator as this would put the transplant on hold. Thus, between handshakes and bites of chicken and salad, I tried to get through the recording maze, dropping opportunities to get directions in Spanish, to the ER, etc.
The ceremonies wore on, as the hospital operator attempted to track down Zesta from the lunchroom to the powder room. In the midst of this desperate search, a lovely young lady, from the dean's office, pressed into service by my anxious wife, found me and pulled me off into the direction of the podium, where one after another, my variously decrepit classmates were being adorned with the crimson and gold, engraved medal that marked us as 50 year survivors, just that much closer to allocating a significant part of our estates to our alma mater.
The distinguished Dean, Carmen A Puliafito, a Harvard man, who has presided over the rapid growth and increasing prestige of the Keck School of Medicine, was the man who slipped the ribbon and medal onto my head, as I related the necessity of holding the transplant until the identity of the organism and its successful treatment could make the use of immunosuppressives, a reasonably safe process. Of course, the reception line had no other roly-poly Santa Claus like figure, carrying on a phone conversation.... remember it takes 5 minutes to find Zesta through the maze of "press 4 to hear the instructions in Swahili....etc" I was not going to let go. So the distinguished dean, through peals of laughter form my classmates and the distinguished assemblage, greeted me, a long lost alum, a potential donor, with "Is this some kind of a joke?" It really was an Oliver Hardy moment. If only the desert had been a whipped cream pie!
But it wasn't! So I said that I was in the middle of a liver kidney transplant and looking after a patient's best interests, and wasn't that what this was really about. Well, actually, I didn't say that, because this was happening in real life and it was an unscripted moment. I had my picture taken with the dean by the official photographer and I can't wait to see where the telephone was.
The luncheon was memorable for this huge distraction, and we sat with Richard Teller and Bob and Audrey Pedrin, heard a recent graduate explain how she would return to serve the Mexican community in family practice, coming from an immigrant, and if I heard correctly, undocumented status. While I was on the phone, my beautiful wife who knows me so well, made a bee line to the young Latina physician, bypassing the distinguished dean, and on my busy behalf, congratulated her for her achievement and intent.
We toured the very impressive campus in a bus, next to a classmate, Bill Arterbury, who was a pathologist who retired to became the leading avocado grower in southern California, and had traded histology for the more profitable agriculture. I did come to the conclusion that I would leave some money to USC, but not to the research that appears to be so well funded, but to training more physicians like the Latina, perhaps UCLA rejects like myself, who wanted to become physicians just to help people, however unfashionable that has become. I really did enjoy the day and the many friends, and this bit of recognition by the medical community.