Thoughts on Veteran’s Day

Thoughts on Veteran’s Day


Dr. Cook reflects on his surgery residency rotation at a VA Hospital and how it had a profound effect on his life. He tells the story of a special veteran who would rather sing the praises of his doctor than himself. The men and women of the armed forces risk their lives in defense of principles. On Veterans Day we should set aside our differences to remember and honor those who’ve put their self-interest aside to defend a higher purpose.

Early in the first year of my surgery residency (what we now call PGY2), my rotation had me assigned to the VA Hospital in Augusta, Georgia.  Although a lot of my colleagues dreaded the VA rotation, I looked forward to it.  I enjoyed it not only because of the abundance of surgical pathology, which made it a great place to learn but also because of the location of the hospital building and all of its surroundings.  You see, in the late 19th and early 20th centuries, Augusta was the Miami of that era.  It was the southernmost city of any size that was reachable by railway, and as a result, it was home to a dozen or so luxury hotels and resorts where the aristocrats of the north would escape from the frigid northern winters.  After the railroads, and eventually airplanes, reached south Florida, the resort industry in Augusta died a slow but unavoidable economic death.  But with the coming of World War II, several of those old, majestic, abandoned buildings were resurrected as hospitals.  

By the time I arrived in Augusta in the mid-1970s the Army had moved its acute care hospital to a gleaming new facility several miles away.  But the VA took possession of the old Forrest Hills Hotel and it became the “new” Veterans Administration Hospital.  So, the physical surroundings were unlike any that I’ve ever experienced in any hospital anywhere.  The grounds were expansive and unspoiled by the clutter of urban buildings.  Magnolias and azaleas were abundant.  The building itself was stunning to behold with its nineteenth-century architectural statement of opulence, now showing its age.  Inside, hand-painted murals echoed the artistic tastes of the late nineteenth century.  A massive ballroom, accented by Corinthian columns, served as a gathering place for our conferences.  And perhaps most fascinating, the walls of the operating rooms were covered with polished marble, I suspect in a space that was formerly a luxurious gourmet restaurant.  The irony of this juxtaposition of modern medicine being practiced within a space that belonged to the past, upon patients with a very special past of their own was not lost on me.  It was amidst these enchanting surroundings that I met a patient who had a profound impact upon me and influenced my attitude toward military veterans and all patients, for the remainder of my professional life. 

Late one evening when I had MOD (medical officer of the day) duty, just after I had turned off the lights in my call room, I got a call from the ER.  They had a patient with lower extremity cellulitis that they thought should be admitted.  At that moment, I wondered why the patient couldn’t be started on oral antibiotics and followed up in the outpatient clinic.  But one never wins this debate over the phone. Begrudged as I was, I made my way to the ER, and immediately it was clear why he would have to be admitted.  Retired U.S. Army Colonel William Alexander (not his real name), indeed needed to be hospitalized.  He not only had severe cellulitis of the left lower extremity, but he was also severely intoxicated, to the point he couldn’t answer even simple questions.  Physical exam was completed, lab work was reviewed, orders were written, IV fluid was started, and “the Colonel” as I came to call him was transferred to a bed on one of my wards.  

The following morning, I found the Colonel awake and alert and in amazingly good humor.  We chatted casually as I examined him and reviewed the night nurse’s charting.  His fever had already started to subside.  The swelling and redness in his leg were visibly better (probably more a response to supine posture than medication) and his white blood cell count was already starting to improve.  My plan was discussed and approved on the chief resident’s rounds.  After a few days, the Colonel was well enough for discharge.  He seemed to have taken a liking to me and he complimented me generously upon his departure.  He assured me that he would be writing a letter to Senator Herman Talmadge (the late Senior Senator from Georgia) to inform him of my superlative work.  I thanked him for his kind words.  Considering the rotation schedule of residency, I felt it was unlikely that I would ever see him again.  

As it turned out, my expectation was off the mark.  The Colonel returned about 2 weeks before the end of my VA rotation.  His clinical presentation was the same as was his management.  He was delighted to see me when he regained his senses.  He assured me that the promised letter to Senator Talmadge had been sent and I would likely hear from him any day.  Again, I thanked him for his kindness and expected this would surely be our last meeting.

A few months passed.  I was now assigned to the burn service at our index hospital, Eugene Talmadge Memorial.  One afternoon as I sifted through my mail, which consisted mostly of advertising matters from pharmaceutical companies, I spotted an envelope emblazoned with “United States Senate” in the upper left corner.  Inside was a letter signed by Sen. Herman Talmadge who was thanking me for my “excellent care of Col. William Alexander” who had contacted him on my behalf.  Of course, I was stunned, and a little embarrassed.  Perhaps I had under-estimated the importance of “the Colonel.”  But the story is not yet done.

Several months later, I was back at the Forrest Hills VA Hospital, and as if scripted, the Colonel appeared in the ER again on a night when I was on call.  The presentation was identical.  Treatment was identical.  And when he emerged from his drunken stupor, the Colonel was thrilled to see me. And I’ll admit, I was glad to see him as well.  I was also very sorry that alcohol was still ruling his life. Nonetheless, he responded promptly to the treatment of his cellulitis and was soon discharged.  This time, he promised that he was going to recommend me for a chief of staff position in the VA system.  He had no concept of the importance (or lack thereof) of a PGY3 surgical resident, but I did not try to dissuade him and thanked him for his kindness.    

Fast forward another 6 months or so.  I received a phone call at home one afternoon.  The voice at the other end identified himself as a representative of the VA.  He explained that they had gotten my phone number through the Department of Surgery at Medical College of Georgia.  He went on to say that I had been nominated to be considered for a Chief of Staff position in the VA hospital system and he wanted to know when I might be available to come to Washington for an interview.  I felt rather badly for him. His embarrassment was apparent when he realized that he was speaking to a third-year surgery resident.  I thanked him for calling and apologized for the misunderstanding.  I never heard from the Colonel again.  He never had visitors when he was hospitalized, and I fear he might have died alone.

I’m offering this story on Veterans Day because it’s central to my pitifully slow understanding of why we observe this holiday.  I was very young when I met the Colonel and in the colossal stupidity of my youth, I didn’t understand the emotional pain and loneliness that made him turn to alcohol for ever-so-brief relief.  He was proud of his service and rightfully so.  From my conversations with him, I know he was present for the invasion of Normandy in WWII.  He also saw action in Korea.  Yet, he never really “tooted his own horn.”  Instead, he heaped an abundance of undeserved praise on me.  Yet it was he who had faced a battle in opposition to fascist dictators.  It was he who risked his life in defense of principles.  It was he who deserved to be recognized and honored.

So, I’m asking that we all set our differences aside today…Veterans Day…to remember and honor those who’ve put their self-interest aside to defend a higher purpose. 

 

To read more of Dr. Randy Cook's blog "The Script Pad" go to https://mymdcoaches.com/blog. Dr. Cook is also the host of MD Coaches, LLC's weekly Rx for Success Podcast found at http://rxforsuccesspodcast.com

MD Coaches, LLC is a company dedicated to developing and empowering physicians to realize greater satisfaction in their roles. Understanding the challenges and operational concerns for both physicians and hospital administrators. MD Coaches utilizes experience and coaching skills to support their physician clients in establishing strategies for positive career progression.

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