Contributor: Stephen Rostand

I remember one time on Osler when Dr. Stead noted that the student, intern and resident had each documented different fundoscopic exams for the same patient. His comment was, "Only one correct exam can exist and we don't know which one that is." He then asked us to have a drawing of the optic fundi on the chart for the next rounds two days later.

It was 3 AM of the day of rounds that we wakened the patient, dilated her eyes and spent the next hour doing a composite sketch that appeared on the chart, much to his satisfaction.

Title: Have You Examined This Patient?

I remember once on "gallop rounds" on Long Dr. Stead asking Mark Entman, "Have you examined this patient?" He asked this because Mark said in his presentation that the pulses were equal.

Standing at the foot of the bed Dr. Stead challenged that without even touching the patient, because he could see the right radial pulse but not the left.

Title: Bumps on the Jugular

On the same rounds he asked a student what were the little bumps he saw on the external jugular vein. When the student responded that they were most likely valves, Dr. Stead told him they shouldn't be, because venous valves were to prevent blood from flowing backward and that shouldn't occur in the veins draining the head.

He sent the student off to see some autopsies and report back.

Title: Cerebral Edema

One time on Olser, Dr. Stead asked a third year student to name all the causes of non-pitting edema. After lymphedema and myxedema, Stead pushed the student for more.

It was clear the student was getting frustrated and began to perspire a little as Dr. Stead persisted. Then the student smiled, a light bulb had clearly turned on, and with that inspiration he looked Dr. Stead in the eye and said, "cerebral edema."

Dr. Stead looked perplexed since he hadn't expected that answer. He seemed pleased and backed off.

Title: Solution to a Problem

I remember an incident on Osler when I admitted a very ill black lady. We discovered she had a perforated stomach.

Marv Pomerantz, the Chief Surgical Resident, agreed that urgent surgery was needed, but the lady balked and said we weren't her doctors and she wanted to see her doctors, who happened to be Dr. Stead and Dr. Bogdonoff.

This stalemate persisted for a while. I tried to call Mort but was told he was out playing tennis. With much trepidation I called Dr. Stead at home and told him the situation. He said he'd be right over and so would Mort.

They both came, Mort in tennis shorts directly from the courts. They looked over the data and told her she needed to have the surgery and she went.

I apologized to Dr. Stead for calling him at home but he reassured me by saying that it was up to me to solve the problem and it was clear that he and Mort Bogdonoff were the solution.

Title: Wage Negotiations

We all should member the housestaff meeting with Dr. Stead when we wanted to know if he would increase our pay after the successful "sick-ins" at Cornell and LA County hospitals staged by the housestaff.

He replied that what we did was not a job, it was an invaluable learning experience and our salary would be whatever he chose to pay.

Title: How's Gene Stead

In the summer of 1967, I left Duke to go to Boston University to start my nephrology fellowship with Dr. Relman. At the first lab meeting held with the fellows Dr. Relman asked me, "How's Gene Stead?"

I was stunned for I never heard anyone at Duke ever call him that except maybe Mort Bogdonoff and then only out of earshot of Dr. Stead.

After a pause, I looked at Dr. Relman and replied, "Gee, I didn't know Dr. Stead had a first name."

Title: We All Change With Time

In 1976, when I was inducted as a Fellow of the ACP, Dr. Stead was there receiving an award and giving a speech. I sat in the back and heard him lament how hard young housestaff and faculty had to work and how they needed to spend more time with their families and to develop others parts of their brains. I was astounded and wondered why he didn't think like that when we were house officers with our 5/7-night call schedule. I guess we all change with time.

Title: Who Was Smarter

The last time I saw Dr. Stead was in 1997 in Nashville at a celebration of Ike Robinson's retirement as Chancellor of Medical Affairs at Vanderbilt. I sat next to him at dinner. His mind was as sharp and as interesting as ever. He told me he had lately become interested in who was smarter, he or the patients who didn't take his advice, a very probing question that deserves some scholarly investigation.

Title: What This Patient Needs Is an "Old Time Doctor"

Who can forget some of Dr. Stead's famous comments heard on rounds such as, "Your camera and mine are not focused on the same thing." This would sometimes be supplemented by, "What this patient needs is an 'old time' doctor who would send her to a nursing home."

He said this on one occasion, commenting on our excessive work-up and treatment of a patient who was not likely to recover from a terminal problem. She had been in coma but momentarily seemed to be recovering. We desperately 'threw the book' at her, extensive (and expensive) lab tests, IV's - the works.

When we presented her the next day to Dr. Stead, he obviously hadn't altered his opinion. He reiterated, "This patient doesn't need an energetic house staff. What she needs is an 'old time doctor' who will comfort her as best he can and send her to a nursing home."