Contributor: Herb Kaplan

I remember only two occasions (there may have been more) when I was the object of the famous line: "What this patient needs is a". And He was right both times.

An old patient friend of Dr. Stead's with bad scleroderma was admitted at 3 A.M, very anemic. As the junior resident, I asked the intern to give her some blood. About an hour later, she reported no success after numerous venepunctures. I fared no better.

On rounds next morning, her friend, Dr. Stead, making teaching rounds and seeing the now macerated forearm, uttered the WORDS, aimed at me, the guilty resident. But a bit of advice followed: "Next time try a bit of local anesthetic at the proposed entry site."

On a morning when I had planned to ask Dr. Stead to write a letter to Dr. Beeson recommending me for a senior resident position, on teaching rounds we found a young lady out on the porch of Osler Ward, dressed and all packed for home, sitting on the bed awaiting her family. Dr. Stead asked her what her problem was.

"Colitis" the patient replied.

"Have the doctors told you what to expect in the future regarding your disease?" "No," was the reply.

And then he uttered the WORDS, aimed at you-know-who.

P.S. Dr. Stead did write the letter (which I requested on a later date). And this, too, was a mistake on my part. The program at Yale in no way compared to my two years at Duke.

Title: Working Too Hard as an Intern

During morning report, some brave (dumb) soul must have inferred that he was working too hard as an intern.

He survived, but only after being told that the intern year was the "mechanical year." Habits formed then would stay with you for the rest of your life. I hope my colleague learned as much as I did that morning-and, of course, that year. Other than my parents, no one other than Dr. Stead has had more influence as to what kind of a doctor I have been since.

Title: People Who Don't Do What I Say

A patient with a fortunately mild CVA, after having the aneurysm spotted on the angiogram, refused my repeated pleas to have it surgically repaired. But I was sure that she might agree after Dr. Stead supported my advice.

After also being refused on teaching rounds, Dr. Stead turned to me with memorable advice: "Herb, I learn more from people who don't do what I say than from people who do what I say." How many times since then have I used that advice in my teaching and in my practice!

Title: You Can Tell Them As Much As I Can

As a junior assistant resident, I thought the patient with malignant hypertension, heart and renal failure and loads of abnormal physical findings would present a wonderful teaching opportunity for the Professor.

The intern's presentation was flawless.

We all awaited the sure-to-come pearls. But Dr. Stead turned to me and said, "Herb, you can tell them as much as I can about this lady."

He then spent the remainder of the hour listening to, holding the hand of and asking to breathe deeply and fast, a patient with anxiety and diffuse aches and pains.

Let's forget about the lost nickels.