The older you get the more important the past becomes. It brings up unforgettable events of your life, and records highlights of your  life. I recall famous people whom I remember for their fame, although I quickly learned they are just like the rest of us. Likewise, I remember dramatic medical events that made a deep impression that I will never forget. In Medical School at UCLA, one event that stands out was in my junior year, when I was on the anesthesia service, which meant I watched the resident administer anesthesia and had no real function, except in one instance. The patient had a brain tumor and was being operated on by the Chief of Neurosurgery, Professor Eugene Stern. His last name describes his stature and demeanor very well. The patient was in a sitting position with his head held up by a metal ring affixed to the skull by a series of metal screws extending from the metal circle and partially penetrating the skull. The anesthesia resident was increasingly agitated and finally told me he had food poisoning and had to go to the bathroom desperately. Everything was on autopilot with the case. He said the only thing I needed to watch for was an air embolus. “What is that?” I asked. The resident explained that because the patient is in a sitting position and the venous circulation is open to the air by opening the venous blood channels in the open cranial bones, air can enter the circulation, which is usually controlled by plugging the venous sinuses with bone wax to prevent air from entering the circulation.  “But don’t worry, it is very rare,” he said, in fact, he had never seen one. “So how can I tell?” I asked. It sounds like crunching eggshells when listening to the heart. No sooner had he left, when I heard eggshells crunching. At first, I could not believe it but it got louder and was quite evident. I did not know exactly what I should do, hoping the resident would come back. Finally, I got my courage up and addressed Dr. Stern. “I believe the patient has an air embolus,” I said. Dr. Stern turned to look at me sternly and asked, “Who the hell are you, and where is the resident.” I explained that he had to go to the bathroom. He then asked as to why I think the patient had an air embolus. I put my stethoscope on his ears so he could hear the crunching eggshells. He immediately went into action, and the room became a scene of chaos as the resident returned. Dr. Stern fired him on the spot. The patient survived, and I got an A for my anesthesia rotation. 

One other very memorable event, not very pleasant, also happened on the surgical service of Professor Longmire, Chief of Surgery. I was assisting him with a child undergoing a complex heart operation. Dr. Longmire was not a fast surgeon, but very careful, thoughtful, and methodical. Also, a very good teacher by word and deed. As the procedure went on, suddenly my glasses fell from my face directly into the child’s chest. Dr. Longmire never looked up. He did say, “Get out! And take you damn glasses with you.” I did just that and avoided Dr. Longmire for several months thereafter. Nothing happened to the child, no infection, no complications… Thank God!

During my internship, I took care of a Mass Murderer. He was said to have killed close to 20 people with insulin overdoses. He had become very wealthy by collecting life insurance on all those he had murdered. He was brought to LA County USC Medical Center while I was on the jail service. He was undergoing his trial for only three of those murders as they had the best evidence for those three cases, when he became pale while clutching his chest. The trial was not going well for him. He was seen taking a handful of pills just before. I was on call for new admissions, and he became my patient with an alleged heart attack. All his tests turned out negative, however. After learning that he had taken a lot of nitroglycerine right before his episode, I concluded that his heart attack was staged.  This would have made his blood pressure drop and made him look pale and ashen. He hired the most prominent cardiologist in Los Angeles, who also examined him and all his tests and declared that he had a heart attack. They took his word rather than the lowly intern, me. In 1967, the treatment for a heart attack was 6 weeks of bed rest. That is what he wanted, as he would get a new trial.  I almost achieved justice when I discovered he had a positive test for syphilis. I decided that he would require a spinal tap to investigate if he had neurosyphilis. He refused it. The alternative was just to treat him with high-dose penicillin. No one knew he was highly allergic to penicillin. The first shot I administered put him into cardiac arrest. He was dead! I did all those things you do, including an intracardiac (into the heart) injection of adrenaline. And lo and behold, he made a complete recovery. That alone was sufficient evidence for me that he did not have a heart attack. Nevertheless, he spent 6 weeks on my service in the jail ward. I got to know him quite well. He even drew cartoons for me (see above). He was a self-educated, very smart person, but nevertheless a serial killer. He was convicted (sentenced, a correction added by the Honorable Judge Steve Stone) to death at his second trial. But at that time, State Supreme Court Justice, Rose Bird reversed his convictions and others who were convicted to die because “it was just not fair,” she said. He died after nine years in prison in 1977, of pneumonia.