A Bilious Time

If I had endured the vacation the boys and I took in West Texas for a day or two longer, I would probably have died. The extremely jaundiced condition I presented to the chief of the Gastroenterology division of the Department of Medicine on the morning after I had returned to Houston suggested, I had a high level of bilirubin, a measure of a digestive malady. A test indicated this product was about ten times higher than it should have been. I was on the verge of a ruptured gall bladder, when I was confined to a room in The Methodist Hospital where I had to wait while the bilirubin declined to a point where removal of this inflamed and now useless organ might be possible.

The chief of the Surgery division at TMH finally agreed he would attempt the operation. It went well, but he did give Karen a terrible scare at the time, according to her account of their interaction. She had been waiting for several long hours in the lounge assigned to worried families and friends of patients undergoing surgery. During this time, she had observed surgeons coming out to tell those concerned that the operations had been successful. At last, she was told that my own surgeon would meet with her, but not in the general waiting room. They would talk in a nearby small, private location. She was certain bad news awaited her. As it turned out, he was offering a professional courtesy of meeting with her in private. The surgery had, indeed, been successful; she would see me shortly; and she did.

Given the severity of my condition before the operation, I needed to spend several days in the hospital, before and after the gall bladder removal. Since I had been the Administrator of Internal Medicine for the prior year and knew all of the department chiefs for the multiple divisions within Medicine, I had many professional visitors during this recovery period. The nurses were greatly puzzled by the high number of internal specialists seeking to review the chart hanging on the foot of my bed. Fortunately, none of them billed me for a consultation. Actually, much of the billing was lowered, again, as a professional courtesy.

I should not have been surprised by my own need for this surgery. Many years ago, my maternal grandmother had her gall bladder removed. She had to have a drainage tube attached to her body for a long time afterwards. My own mother was more fortunate. She had no drainage tube when her gall bladder was removed. I expected a similar, improved result.

When I returned home, I was welcomed by a movable hospital bed on the first floor of our house. I was also given the opportunity to hug a pillow for most of the time I spent there to counteract the pain associated with all of the healing stitches.

For surgeries performed currently, the incision for the removal of a gall bladder is very small. But forty years ago, this was not the practice. Since my surgeon had convinced me that my appendix should be removed at the same time as he disemboweled me of my gall bladder, the final incision was at least a foot long. My major problem occurred when Ken and Kip saw the scar shortly afterwards and exclaimed “Shazam” in honor of Captain Marvel’s lightning bolt! My laughter almost caused the stitches to pull apart. However, they did hold, and the boys were instructed to restrict their levity in the future.

I did, on the other hand, learn one very important fact and admonition. Never have elective surgery in the months of June and July. This is the time of the academic-medical year when new residents appear in a teaching-hospital. Although a new surgeon needs to learn how to enter and exit the human body, it is better that they practice on “someone else.” The results of my personal neophyte remain visible to the current day. Every personal physician I have encountered since then has the same initial inquiry: “What happened to you?” I seldom have gone shirtless during the last four decades.

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