Promises Kept
A Southern Surgeon's reflections of mid twentieth-century medicine
by
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SUMMER NIGHT 1960 Grady Hospital Emergency Clinic The double doors burst open. “Jesus, what have you got?” I yelled across the clinic. An ambulance cop and an intern pulling a stretcher rushed in. “Got a bad one,” they shouted. “Run over!” “Room One,” I instinctively called out. “What happened?” “Teenagers in Buckhead–out cruising–she fell out of the car.” “Get her on the table,” I shouted, now frantic. She was slender with long blond hair, delicate white skin, now gravel-scraped and ripped–all crimson covered. “Strip her,” I ordered the ER nurse standing nearby. We pulled out our scissors. I slit her crisp white, now soiled, blouse. The nurse cut her tight matador slacks. “Is that a tire track across her chest?” the intern blurted out. “Oh, God, she’s not breathing!” The ambulance driver stepped back against the tile wall of Room One. “She fell out of a convertible and we think the back wheel ran over her.” I hesitated for a moment and took a deep breath. The nurse removed the pile of clothes. “How old is she?” “Her license says sixteen.” Aghast, I muttered, “Just a teenager!” “Open the chest pack and the tracheotomy tray,” I ordered the nurse and intern. “Get Dr. John from the Colored Clinic. We need help!” The intern wrapped her flail right arm with the pressure cuff to get an I.V. started. “She’s got no pressure. I don’t hear a pulse sound,” he murmured. Her body was still warm. She gasped what might well have been a last agonal breath. Though new in the clinic, I was the resident. I was in charge. I grabbed a bottle of iodine from the medicine cabinet and doused it over her left chest and soft breast, spread it with a clean towel, reached for the cardiac knife, opened its bright red holder and pulled out the knife, counted the left ribs and slashed through a mid-rib space, opened the chest cavity and felt the collapsed lung. “Chest retractor,” I shouted. I cranked the retractor open and with my gloved hand reached into the gaping cavity and grasped the girl’s heart. It quivered as I squeezed the purple muscle. It was like a small football. The other resident, incised her throat just above the suprasternal notch, retracted the delicate muscles, opened the trachea with his sharp blade, spread the cartilage and inserted the silver metal tracheotomy tube. He suctioned dark, frothy liquid and began to bag-breathe her. “Got to get oxygen into her lungs.” I could feel the spongy lung inflating and softly touching my arm. “Epinephrine,” I yelled to the nurse, “get me the long needle.” I backed my hand out of the chest long enough to stab the needle and syringe of “Epi” through the heart muscle. “Just a quiver!” We continued squeezing her heart and bag breathing until my hand was numb. I could feel no more. I glanced at the nurse, “Get me more ‘Epi.” She leaned over and wiped the sweat and blood from my face. “John, you pump for a minute.” He began to compress the heart. I could see by his poignant expression; it was over. I felt angry. This girl was mine. Her life belonged to me. How could he dare tell me it was all over? I was the resident; it was my clinic. She can’t die in my clinic! “Move over,” I ordered. Feverishly, I squeezed the still heart. She was somebody’s daughter. I couldn’t give up. “That’s enough!” whispered John as he removed the breathing bag from the tracheotomy-tube and slowly pulled off his gloves. He placed his firm hand on my trembling arm and held it tightly. I attempted to pull away. He stared into my eyes.“You’ve tried. We can’t save everybody.” My own heart cried out, “Don’t stop.” Reluctantly, I withdrew my hand from that girl’s chest. I had done all I knew to do. The crimson-sprayed nurse, trying to hold back her tears, lifted a crisp, white sheet and covered the beautiful girl. My shift ended at 7 am. I shuffled out of the clinic, rode the elevator to the resident quarters, shed my splattered clothes, pulled off my sweaty socks, showered in the steaming water and threw myself across my bunk. Before I slept, I tried to remember when I decided to be a surgeon. That morning I wondered why?
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About the Book
Grady Memorial Hospital, one of America’s major teaching hospitals, opened in 1892 to serve “the underserved of Atlanta.”
The author, a naïve young man arrives at Grady to drive the ambulance before starting medical school. Four years later he begins his surgical training as an intern.
It was a time of dramatic social transformation from the Jim Crow era of the racially segregated 1950s to the Civil Rights movement and the racially integrated 1960s.
As a young surgeon-in-training, he is confronted daily with tragedy and threads of humor and must learn to reconcile the conflicting experiences while providing care for an often forgotten and neglected population.
About the Author
About the author: The author,Jerald Lee Watts, a native Southerner was born in Atlanta Georgia, attended Tulane University, Georgia State University and graduated from Emory School of Medicine in 1959. He interned in general surgery and completed an orthopaedic residency at Atlanta's Grady Hospital. He served in the military as a general and flight surgeon during the early 1960s. He has practiced surgery for over thirty-two years. Now retired, Dr. Watts resides in Peachtree City, GA with his companion Ellen Ulken and his English setter, Luke. About the author: The author, Jerald Lee Watts, a native Southerner was born in Atlanta, Georgia. He was educated in the public secondary schools. Subsequently he attended Tulane University in New Orleans, Georgia State, then known as The Atlanta Division of UGA, and graduated from Emory University School of Medicine fifty years ago. He completed a surgical internship and a year of general surgery residency before serving in the military as a flight surgeon and general surgeon with the rank of captain during the early1960s at the beginning of the Viet Nam War. He returned to Atlanta and completed an orthopaedic surgery residency and practiced surgery for over thirty-two years, twenty-five years in Gainesville, GA, and retired six years after surviving a heart attack and by-pass surgery. Dr. Watts presently lives in Peachtree City, GA with his companion Ellen Hunter Ulken to whom he was engaged over forty-five years ago. He has three children by his deceased former wife, two attorneys and one architect and seven grand children. He has one dog, an English setter named Luke.