Elsie F. Meyers | Doing the "Not Possible" The Memoirs of Elsie F. Meyers, M.D. | The Indiana Magazine of History, 104.4

Doing the "Not Possible"

The Memoirs of Elsie F. Meyers, M.D.

In the spring of l940, I graduated from Wolcottville High School. Now I was ready for college. My head was full of going out in the world and being a success. I took a scholarship test for Ball State Teacher's College in Muncie, and planned to be a teacher of nurses. I had always been interested in medical matters, since witnessing my baby sister's birth. Since Mama and Grandma had been teachers, I decided that teaching was for me. I won a full-tuition, four -year scholarship to Ball State, and told Papa, "Well, I'm all ready for college!"

"I cannot help you. There are five of you and I can't afford to send you all; therefore, I can't send any of you."

That was that! I was crushed. It was the summer of l940, and I had no contingency plans. It was obvious that I'd have to earn my own money for college. To give up my dreams never occurred to me. I decided that since I wanted to be a nurse, I should get a job working for doctors. So Mama went with me for an interview with Dr. C. in LaGrange. Time went by, and I didn't get the job. A couple of weeks later, I went by myself. Dr. C. told me that he had thought I was a wimp, because I had to have my mother with me, so he wasn't going to hire me. But after my solo interview, I got a job as office girl.

Elsie Meyers in 1942, near the start of her career path. Meyers took her first job
with a medical practice in northeastern Indiana at the age of seventeen.

Courtesy of the author

MY FIRST JOB

I was hired to work half days, from eight a.m. until noon, for six dollars per week—an hourly wage of thirty cents. Since I had no car, I couldn't commute seven miles a day to and from the farm. My 4-H leader, Mrs. Chase, had a daughter, Mrs. Brown, who lived in LaGrange and needed help. So I worked at the Browns' for my room and board. J. S. and Helen Brown, my employers, owned the Rexall Drug Store. They had a daughter of their own, plus a daughter by his first wife, who had died of eclampsia soon after giving birth. Their girls were lovely, ages two and four. Soon after my arrival a third child, Fred, was born. I did my best to help as much as I could. I tended the children, washed clothes and diapers, cleaned house, and did some cooking. The Browns were very nice to me.

In order to obtain the job at the doctors' office, I had to promise to work for them for three years. Dr. C.'s partner, Dr. A., required that I put this pledge in writing, which I did. He also told me that I would never go to college—that once people stopped school, they always quit school. I was a real country bumpkin, naive and trusting. That was the first and last time I ever signed away a chunk of my life. And I had no doubt that I was going to college, somehow.

My total monetary assets were the $10 that I had received in high school graduation gifts. With it, I purchased six white uniforms and a pair of white shoes, leaving me a three dollar balance for my college fund. I worked mornings at the doctors' office and afternoons for the Browns. I was an office girl, sort of a "Jack of all trades." I learned to do simple urinalyses and blood counts, to assist with office procedures, and to act as a receptionist, greeting and signing in patients, obtaining their charts, preparing examining rooms, and escorting patients around the office. I made ledger entries, filed charts, took payments, gave receipts, typed, shoveled coal into the furnace, did simple cleaning chores, unpacked drugs and supplies, and in general tried to make myself useful. My college fund was growing very slowly, but I was learning about medicine.

My employers had a large practice. There were two other girls besides me in the office. One worked days, the other afternoons and evenings. After I had been there about six months, the afternoon-and-evening girl left to care for her ill mother. I then stepped into her place, starting at noon and working until the last patient left at night, usually at nine or ten o'clock. I still worked mornings for room and board.

GRANDMA JOINS ME

One day, I told Grandma Flint Healey that I wished she lived in LaGrange, instead of Wolcottville, so that I could live with her. She was lonely, living all alone after Grandpa Healey died. Grandma made the decision to join me. I needed to save money, and wanted to split expenses with her. And I couldn't keep working so many hours for room and board plus my office duties. So she moved to a tiny apartment in LaGrange. We had one room and a bath. In the corner of our room was a homemade sink covered with zinc, the core of our kitchen. We had a coal heating stove, and we slept on a hide-a-bed that we made into a sofa every morning. But we were happy, warm, and well-fed. We economized on everything so I could save money. Our day-old bread cost five cents a loaf. Grandma kept house and did the washing and ironing for us both. At work, I was taking on more responsibility and learning. My salary improved. More office girls were hired as the practice increased in size.

After we had lived in these small quarters for six months or so, Grandma found a lovely, upstairs apartment in the home of a silver-haired, retired teacher, Mrs. Mable Huey, who lived on the first floor. The apartment had a lovely front bedroom, a living room, a kitchen, a tiny back bedroom, a crude utility room, and for a bathroom, a closet with a toilet in it, but no sink or bathtub. What an improvement!

Grandma slept in the front bedroom, and I in the back. She brought more furniture from storage to amply furnish the apartment. We used to sit on the front porch swing with Mrs. Huey, of whom we were very fond. Her house was old, but the walls had been recently papered and the woodwork painted. It was clean, light, and cheerful. I began to need some clothes, so I bought a sewing machine with some of my savings and sewed for Grandma and me in my time off.

SURPRISING APPENDECTOMY RESULT

One Saturday, I didn't feel well at work, but I got through the day and evening, despite the nausea and tummy ache. But after I went to bed, I became febrile and my abdomen became quite uncomfortable. I knew I had appendicitis, so I called Drs. C. and A.; they performed an emergency appendectomy early the next morning at the Sturgis hospital. The folks took me in the car; every bump on the way hurt my tummy. A general practitioner, Dr. Q., gave me a spinal anesthetic, but it didn't work; then he gave me open-drop ether. He dropped some ether on a mask, put it on my face, and told me to take a big breath. I took one breath and passed out (probably from laryngospasm and hypoxia¹), and woke up later feeling wretched.

This was my first time as a hospital patient. Nurses came, changed my bed, helped me bathe, brought bedpans in and out, brought food trays in and out, took vital signs, and gave me medicine. And they rubbed my back. I don't know what I had expected nurses to do, but I expected more than that. Now I knew that being a nurse was not for me. I wanted more. Now I had to recuperate from my surgery, as well as to try to decide what career I wanted to follow. I was pretty upset to have my big nurse ideal smashed and not to know what I wanted to do, instead.

So at work, I learned as much as I could. I would be an x-ray technician. I learned to make x-ray solutions and to develop and fix the films. I took x-rays with the big machine. Boring. That wasn't it.

Then I considered laboratory technology. I studied books and learned to do a variety of simple lab tests. I learned to make blood smears and to stain and fix them. I could do differential white counts. I struggled with the long foreign words: polymorphonuclear neutrophils, basophils, monocytes, eosinophils, and lymphocytes. Boring. Lab technology wasn't it, either.

One night, after Papa had come to visit Grandma and me at Mrs. Huey's, I walked him to his car. Standing there by Route 20, I told Papa that I didn't know what to do with my life.

"Sometimes I think I should be a doctor!"

"Well, why don't you do it?"

Papa had given me permission.

WORKING AND LEARNING

Papa had given me his permission to do the nearly impossible. I had no science background and very little money. And I had never heard of a female doctor, much less seen one. Only men were doctors. But that was now my secret goal: I wanted to be a doctor! I think that my father's believing in me was what gave me the strength to try. I would never marry, I decided. After observing my parents, I wanted to be an old maid. I would concentrate on my career.

My folks now had one of the finest farms in Johnson Township. They could easily have managed to send me to college, and my siblings, too. But the farm was what was important. And the boys were important, for they were destined to help run the farm and, eventually, to take it over. Girls were insignificant in the grand scheme. We could marry some farmer and live happily ever after somewhere. Little did I realize how lucky I was not to be expected to stay on the farm. I had a few dates and three boys wanted to marry me, but I was not interested in marriage. Not at all. I made that clear on the first date, so as not to mislead them. I had some fun dates. And I was a virgin.

At work, I was learning more and more. I could now identify diseases such as Parkinsonism, rheumatic fever, St. Vitus' Dance, and childhood diseases such as measles, mumps, chicken pox, and whooping cough. I learned what medicine was given for each affliction, how to treat cuts, fractures, burns, ears plugged with wax, etc. And I learned the consequences of what I later discovered had been improper treatment. I became very involved in obstetrical cases, also.

HOME OBSTETRICS

After assisting with a number of deliveries in the home, I was left by myself to stay with the parturient woman, sterilize the instruments, get everything ready for the delivery, then phone the doctor to come and deliver the baby—not too early, and not too late. In the case of the county's many Amish residents, who had no phones, this was a bit of a challenge, for I had to know how far their house was from the nearest phone, and add extra time for horse and buggy transportation to the phone. I learned to perform rectal examinations to determine the degree of cervical dilation and the station of the fetal head. I supported the mother, urged her to push when it was time, gave ether analgesia for the delivery, then gave the baby its eye drops, and washed and dressed it. The doctor delivered the baby and placenta; I gave the pitocin, a drug to cause the uterus to contract, and he tied the baby's cord. Then I made routine post-partum calls.

Once, I called Dr. C. too late. We had been called at about 5 a. m. to deliver an Amish lady pregnant for her fourteenth child. Dr. C. examined her and left, saying that she had made no progress in labor and couldn't possibly deliver before noon. I got everything sterilized and set up for delivery and relaxed my vigil a bit, while watching the feverish activity of about 10 children getting hair combed and braided, lunches packed, and breakfasts eaten. After all, it was over five hours until noon! Suddenly, I heard a loud groan from the bedroom. I had just enough time to give a little ether analgesia, get gloved, and deliver the baby. By the time the doctor arrived, the placenta was delivered, the pitocin given, the cord tied, and the baby cleaned and dressed. I never trusted a grand multipara for a minute, after that.²

I usually had to spend much longer than that with the mother in labor. On nights when there were severe storms with thunder and lightning, labor would always stop. I rode out many a storm trying to catch a little sleep while stretched out on three straight-backed chairs or a bench. After a long night, the grandmother would always offer me breakfast—and what breakfasts! There was sausage, eggs, potatoes, cereal, toast, cake, fruit, pies, milk, coffee, and all sorts of spreads for bread: butter, honey, preserves, jam, and jelly. But I was always too tired to eat more than a few bites.

Dr. A. had a young patient who had, much to the chagrin of her youthful boyfriend's family, gotten pregnant. There was a shotgun type of wedding, after which the young bride was a very unwelcome member of her husband's family, with whom the couple lived. The poor girl went into labor and did not tell her mother-in-law. Her husband came in for supper, just as the baby, a breech presentation, was born. Unfortunately, the head was not delivered. The frantic family called us at the office, describing the situation. That car trip was the fastest, most reckless trip I've ever had. We ran into the house a few minutes later and Dr. A. grabbed the baby's feet, rotated the head, and as the mother screamed with pain from the large laceration that ensued, the head was delivered. The baby's heart was beating, but the baby didn't breathe. We didn't know how to resuscitate properly then. I didn't, anyway, and neither did the doctor. I got basins of warm and cold water, into which he dipped the baby, trying to shock it into breathing. (We treated shock shockingly!) I gave coramine, as per Dr. A.'s orders, but the baby died.³ During this excitement, the tall husband fainted and I tried to catch him, but we both landed in a heap on the floor. The in-laws were beside themselves with guilt and grief. It was a very sad scene. I don't know what happened to the young wife and her marriage, but I doubt that the outcome was happy. We left there with very heavy hearts.

THE "IMPOSSIBLE" DELIVERY

I recall another memorable obstetrical case of Dr. A.'s Mrs. T. was a multipara with perhaps four or five children already. She was married to a tenant farmer; the farm was miles out of town on a muddy, dirt, side road. The family was not very bright. They were too poor to have a phone. Mrs. T. went into labor, but made no progress. Dr. A. and I rushed out there three nights in a row, but labor did not progress. We were working our usual daytime hours , and were becoming very tired. I didn't know enough about obstetrics to realize that warning flags were flying—i.e., that something must be amiss if a multipara makes no progress, after hours and hours of hard labor.

At noon on Saturday, just before the weekly rush of patients was about to inundate the office, Mr. T. called, asking Dr. A. to come at once: his wife was ready to have her baby. Dr. A. was disgusted. We had been out there again in the wee hours of the morning. I had sterilized the instruments and left them sealed in a kettle.

Dr. A. was not about to leave the office on another "wild goose chase." But he sent me. I had to go to Harry Timmis's Ford garage and borrow a car. When I entered the T.'s house, I could tell by Mrs. T.'s loud screams and groans that delivery was imminent. Mr. T. saw me and was livid with rage.

"Where in the Hell is the doctor? Why didn't he come?"

"He wanted to be sure it was time. Please go and call him and tell him I want him here, now." I was frightened of Mr. T. I had work to do and I had to get him out of my way. Obviously, Dr. A. could not get there in time for the delivery. I examined Mrs. T. Through the thin vaginal-rectal wall, I felt a baby's hand. Mrs. T. was screaming wildly and threshing around, but the baby wasn't coming. Her retarded-looking sister-in-law was there; I enlisted her aid, becoming deadly calm.

"Hold this mask over her nose and mouth, and put a drop of this ether onto the mask whenever I say, "Drop." Now, drop ... drop ... drop," I repeated, as I struggled to put on the wet, sterile gloves. "Drop ... drop ..." The screaming subsided. Mrs. T. was getting some pain relief and was becoming able to cooperate with me, without wasting her effort on screaming.

I examined her. There was a compound presentation of the baby's head and shoulder, with the arm prolapsing from the cervix. The baby was stuck. Really stuck. I ran my finger around the shoulder and tried to pull it free.

"Drop, drop, drop. Now, push, please!" I began to sweat. I grasped the head with one hand and the shoulder with the other and pulled gently, but firmly. "Drop, drop. Push again now!" I rotated the shoulder a bit. I pulled, now desperately. "Now, PUSH!" and the baby was born—alive! Mrs. T. was awakened right away by the baby's lusty cries.

"Congratulations! You have a healthy baby girl!" I had aspirated the baby's mouth and throat. The airway was clear. I tied and cut the cord, wrapped the baby in a blanket and gave her to the sister-in-law to hold. Then I massaged the uterus, delivered the placenta, and gave the pitocin.

Dr. A. came soon afterward. He massaged the uterus and talked to the T.'s. I put the drops in the baby's eyes, and bathed and dressed her with shaking hands. I had never seen a compound presentation before—nor have I seen one since! I felt absolutely drained. (I later learned from obstetric textbooks that it is absolutely impossible to deliver a baby with a compound presentation vaginally. According to common wisdom, a Caesarean section must be done. Otherwise, the baby will die.) I had had a terrific struggle, and every muscle in my body ached for several days. Poor Mrs. T. could never have cooperated had she not had the benefit of some analgesia. Her sister-in-law's help had been invaluable. Mrs. T. was a very cooperative patient, and I was just plain lucky.

On arrival in LaGrange, I returned the car to Mr. Timmis and faced the end of the Saturday afternoon melee. Little did I know that the day's excitement was not yet over.

DEATH IN THE BARNYARD

The phone rang at six p.m.

I answered, "Dr. C. and A.'s Office."

"Hello, hello! Send the coroner out to the T.'s house right away!"

My heart sank. I hadn't tied the cord properly. The baby had exsanguinated. Or Mrs. T. had died. It was my fault. I could barely speak; my voice squeaked as I asked,

"What happened?"

'"The hired man shot his brains out!" A wave of relief spread over me, leaving me weak.

"I'll tell the coroner. He will come as soon as he can. Just leave everything at the scene untouched." Dr. C. had run for office of county coroner, and had won. He performed his coroner duties plus his family practice.

I gave Dr. C. directions to the T.'s house. I knew the directions well, having been there so many times in the past few days. But the directions were complicated, and Dr. C. was confused. "Oh, hell, just drive me out there. I'll never find that house. It's in the boondocks!"

On our arrival, Mr. T. directed us to the barnyard. There, behind the remains of the straw stack, was a very dead young man, the top of whose head had been blown off. The shotgun was in his hands, which lay atop his body. I had never seen brains before. Then I looked again. The man was Myles Smith. Myles was a boy, several years older than I, who was retarded. When I was in third grade, our teacher gave me the job of teaching him how to write his name. So he and I spent hours together every day for months working on the task. I would write out his name and ask him to trace over it, which he did willingly.

They searched his pockets. There was a piece of paper on which he had laboriously written his name, just as I had taught him to write it all those years before. I guess maybe Myles was afraid of Mr. T. too. Was Myles the father of the new baby? Had Mr. T. known? Had he shot himself? Or did Mr. T. shoot him? None of those questions will ever be answered, which is probably just as well. (But now, as I write this years later, I realize that had Myles shot himself, the gun would have been jolted from his grasp by the back-fire effect.) Mr. T., it appears, had gotten away with Myles's murder.

DEADLY DISEASES OF THE R.'S

The R. family was on relief. Mr. and Mrs. R. were ill with chronic diseases, including diabetes, heart trouble, and hypertension. They had about eight children who ran around town, dirty and ragged. The R.'s couldn't do anything but menial work. They lived in a run-down house on the edge of town. They frequently had overpowering health problems. They didn't understand anything about nutrition. The children ate ice cream cones and drank sodas from the Browns' Drug Store.

It was in their kitchen that I saw my first case of meningitis. The young daughter had a very stiff back and neck. Her head was tilted backwards. Her temperature was high, and she was unable to cooperate. Dr. A. needed my help to do a spinal tap. I held her on the kitchen table while the doctor got a sample of spinal fluid to be analyzed at Sturgis Hospital. He told me to wear a handkerchief over my face, as a mask, then to take it off and burn it.⁴ I don't remember enough details to know what type of meningitis she had. But she survived, and no one else caught it.

Months later, one night I was alone in the office; Drs. C. and A. were operating at Sturgis Hospital. Mr. R. telephoned, saying, "My boy is sick. Send Dr. A. right away."

"I am sorry that the doctor is operating at the hospital now. I shall give him your message. Please tell me what is wrong."

"He's got a belly ache and he's been uhh pukin' all day. He's sick. How soon can the doctor come?"

"I'll call him right away and find out." I gave him a message in the operating room. He told the nurse to tell me to try to figure out what was going on, and to call him.

I made a kit containing a thermometer, pipettes and equipment for getting a blood count, flashlight, and stethoscope. I followed Mrs. R. up the narrow stairs to a small bed occupied by a small boy, covered by a comforter. He was about eight years old and was extremely ill with a temperature of l04 degrees, dehydration, and a rigid silent abdomen with tenderness, very marked in the right lower quadrant. I thought that he had an acute appendix, which had probably ruptured. His white blood count turned out to be very high—over 40,000.

I gave this information to the operating room nurse. The doctors told her to tell me to get permission of the township trustee for payment and to send the child by ambulance to County Hospital. They would go there directly from Sturgis Hospital. The trustee said that the township would pay. Now I had to get Mr. R.'s permission for surgery. He rocked in his old, squeaky rocking chair as I explained that we thought his son needed immediate surgery, and explained why.

"He ain't gonna have no operation."

I explained again, and he repeated, "I already said he ain't gonna have no operation, and he ain't. And that's that!"

In my deadly calm voice, using measured tones, I told him, "I am quite positive that he has appendicitis and that if the appendix has not already burst, it will very soon. Without surgery, he will die. With surgery, he has a chance to live and be healthy, but he will still be very sick, and there is no guarantee that he will not die."

"I don't care. He ain't gonna have no operation!"

"Mr. R., I hope you will change your mind. If you do not let us help him, you will be responsible for killing him just as surely as if you were to take an ax and strike him in the head. It would be just like murder."

Silence. Rock, rock, went the squeaky chair. And then, "OK, he can have the operation."

In no time, the child was taken by ambulance to County Hospital, where he had an emergency appendectomy for his ruptured appendix. The new drug, Sulfanilamide, was sprinkled into his abdomen and the wound drained⁵. He had a very rocky recovery, but he survived.

MY FIRST SOLO OB CASE

On December 7, 1941, a Sunday, I had the duty at the office. That was the day the Japanese bombed Pearl Harbor. My three-year stint of working for Drs. C. & A. was about half over. Dr. C. told me, "You don't realize what going to war means. Your life will never be the same."

The office was soon inundated with patients, for five of the eight doctors in the county were called to service, leaving only Drs. C. and A., plus an elderly doctor in Howe. I tried my best to help fill the void. There were more and more maternity cases. The office got busier and busier. I took care of some of the emergencies that I could handle, when no doctor was available, such as treating simple wounds by cleaning and suturing them, and giving tetanus antitoxin. I could refill routine prescriptions, give injections ordered by the doctors, and make house calls for routine treatments. I was sent to give an elderly man a diuretic injection, but found that he did not need it, and told the doctors so. I was learning enough to know indications and contraindications of some of the drugs, much to their surprise.

One Saturday afternoon, a lady ran into the office crying and begging, "Please come at once to care for my sister-in-law, Mrs. P. She is about to have a baby!" Mrs. P. had received no prenatal care at our office. Furthermore, she had had three confinements before that, for which she had never paid a cent.

"We are already carrying a very heavy load of patients here. We cannot come."

The sister-in-law begged for help. Finally, it was agreed that I would be sent to care for her. I was not to ask for help unless I got into trouble. I was an eighteen-year-old midwife! Having me was hopefully better than having nobody.

On arriving at the patient's home on the edge of town, I enlisted the aid of the sister-in-law. We put the instruments in a kettle to boil on the old kerosene stove. When I checked to see how they were doing, I found that there had been a small hole in the bottom of the kettle, which had allowed water to drip onto the flame and put it out. A bad beginning!

The sister-in-law borrowed a satisfactory pan from a neighbor. Labor continued for several hours. Finally, it was time for delivery. The sister-in-law gave ether analgesia per my instructions, and the baby girl was born without problems, except that when I held her by the feet to clear her airway, I almost dropped her, for her feet were very slippery and she was an enormous baby, over eleven pounds. The mother was elated. It was the best birthing experience she had ever had. She had felt no pain.

In the late afternoon when I returned to the office, I was extremely tired. Being responsible for two lives all by myself had been a draining experience. The parents wanted to name their daughter after me; I told them they'd best use my middle name, Ellen, since I'd never liked my first name, but I was flattered. Of course, they never paid my employers anything for my services.

NOW I'M A MURDERESS!

One day, an event occurred which would affect the rest of my life. Dr. C. said to me, "We have to amputate Mrs. Y.'s leg. This Amish lady is diabetic and is very sick with her gangrenous leg. Dr. Q. is coming from Sturgis to give her an anesthetic. Would you come to the operating room and help him by checking her blood pressure every few minutes?"

I had never been in an operating room or seen an amputation before. But I did know how to take blood pressures. "Yes, I guess I can handle that," I said somewhat tentatively.

In the operating room, I placed my blood pressure cuff on Mrs. Y.'s left upper arm. I checked and recorded the blood pressure. Then I held Mrs. Y. in the sitting position, while Dr. Q. gave her the spinal anesthetic. "Now, we'll lay her down," he said. I helped. But in the process, the tubing of the blood pressure apparatus was caught beneath the patient's head. I couldn't check her blood pressure.

'Dr. Q., can you please help me get the tubing loose so I can check her pressure?"

"Oh sure. No problem. Here, I'll lift the head up a bit and you can pull the tubing out." This being accomplished, I checked the blood pressure. There was none. Drs. C. & A. had made the incision. The blood looked very dark.

"Oh here, let me check," Dr. Q. said irritably. He checked. He agreed. "She's right. There is no blood pressure!"

I don't know what the standard of care was at that time. But I do know that we had almost no information about the patient. There was no EKG or chest x-ray report to check. We knew nothing about her acid-base balance or her blood chemistries.

Dr. Q. had no intravenous infusion started, nor drugs or oxygen available for resuscitation. The patient was dead! Drs. C. and A. kept operating anyway. When they were finished, the patient's body was covered by a sheet. And in the corner of the operating room was her leg, wrapped in another sheet. Never was the saying more true that "The operation was a success, but the patient died."

I was quite traumatized by this event, but managed to keep myself composed. Afterward, I changed out of operating clothes into my office uniform and joined Dr. C. for the trip back to the office. En route, he asked, "Well, do you know what you did in there?"

"Yes, I checked her blood pressure."

"No, you killed that woman! You raised her head. That made all the anesthetic go to her head and that killed her. You killed her!"

"I did not raise her head. Dr. Q. did. I only retrieved the tubing and checked her pressure."

"No, it is your fault. You killed her!"

I was devastated. I was eighteen years old, and already, I was a murderess. What an awful beginning for my life! I tried to carry out my office duties, but I was fighting back tears. I went off by myself and cried briefly. Then I pulled myself together and thought, "This is ridiculous. Of course I didn't kill her, for I didn't lift her head. I only did what I was told. And I don't think it was right for the surgery to be done on a dead woman!" I tried to get on with the rest of my life and forget about it.

LOSS OF RESPECT

Doctors C. & A. had met while working at a clinic outside of Indiana. They often made reference to their experiences there. I gathered that they felt they'd been taken advantage of and that they had not been adequately paid for their work. So Dr. C. went into practice in LaGrange, needed help, and was joined by Dr. A. They both started families there.

My feelings for medical doctors were extremely respectful. I thought that they lived on a different, higher plane than regular people. They understood how the body worked and knew what to do when something went wrong. I thought that they cared about people and always had their best interests at heart. Doctors could be trusted with one's very life, sort of like a minister could be trusted with one's soul. And doctors were trusted with people's feelings. A great deal of Dr. C. & A.'s work was in treating people who were anxious and upset. But it seemed to me to be a breech of trust to give such a patient a placebo.

Dr. A., a tall, handsome man in his late 30's, was rather aloof and judgmental. He didn't endear himself to people, because of his somewhat stiff demeanor. So his contribution to the practice was rather small. He would spend a great deal of time behind his closed door with the patients that he did see. Dr. C. would probably see six or eight patients to his one.

Dr. C. was a tall, somewhat overweight man in his 40's, about Papa's age. He was friendly and outgoing with his patients and inspired their confidence. So he was very busy, indeed. He did the surgery and Dr. A. was his assistant. He was rather cynical, and did not always do what he should have done. I knew when he did illegal abortions on women who did not want their babies. There would be iodine all over the examining table, after a pelvic exam. Then, within a couple of days, the patient would "miscarry." I guessed that he had placed iodine swabs into the cervix.⁶ One patient hemorrhaged profusely during her "miscarriage" and I had to help him perform a dilation and evacuation of the remnants of conception in the privacy of the patient's bedroom.

One day, a farmer's wife came to Dr. C. with pelvic inflammatory disease from gonorrhea. He treated her, but took no measures to enlighten her about her problem or how to prevent a recurrence. He just laughed and told me, "Well, the old man gave her the clap!" Maybe there was nothing he should have done. But as far as I was concerned, she had trusted him with her problem, and by giving her no enlightenment, he had betrayed that trust.

To me, Dr. C. was a father figure. He gave me a hug sometimes, but I considered it to be just a fatherly gesture. Actually, I liked it, for I had never had any affection from my father. And then, within the last year of my contract, he raped me. It happened in the small room at the end of the hall where we did diathermy treatments.⁷ It was late at night, after Dr. A and all the patients had left. He weighed about 200 pounds, and was much stronger than I. I was shocked when he unzipped his pants. I cried out, "No, no, let me be. Please let me be. I don't want a baby!" The pain of penetration was intense. I screamed, "No, no, let me be! Stop, stop!" And then it was over. He withdrew before ejaculation and spilled his semen all over my abdomen. I was shattered. And I bled for a couple of weeks. The next day, I brought up the subject of what he had done to me. He replied, "That's not true. You wanted it."

"You know I didn't want it. I told you!"

IS SUICIDE THE ANSWER?

After Dr. C raped me, I had nowhere to turn. Nobody would believe me, should I make a fuss. I knew that. He was an influential, respected doctor, an elected official. I was nobody. And besides, I had signed a paper stating that I would work there three years, and I didn't have enough money for college yet. I had nowhere to turn, no place to go. I went to bed at night in my little room and cried myself to sleep. Nobody ever asked me what was wrong, but I think that Grandma told my parents about the crying.

Dr. C. had sex with me other times after that and I ceased to resist. But I felt awful—betrayed, guilty, dirty, a sinner of the worst order. I began to realize that he was having sex with other girls in the office also. I decided that I would be better off dead.

One day when I was alone in the office, I sat on a stool in the workroom, looking at a big, twenty-milliliter syringe and at the drugs that I could quickly inject to kill myself. Then I tried to think of what effect my death would have. I thought about all the people I knew. But most importantly, I didn't really want to die.

So I pulled myself together and finished my three-year stint as office assistant. I was very happy to leave that den of sin. A short time before I left, Dr. A came behind me and put his hands on my breasts. I took them away, didn't say a word, and walked out. He didn't try it again.

I have never discussed the rape. It is not easy for me to write about it. But it is part of my life, and if this account is to be worthwhile at all, I have to tell it like it was.

OFF TO INDIANA UNIVERSITY

My leaving for college wasn't a very auspicious event. I simply packed two suitcases and stood out in front of the farmhouse and waited for a bus to take me to Ft. Wayne. Then I transferred to a bus for Indianapolis, where I transferred to the bus for Bloomington. The whole trip took about ten hours. I had learned a great deal about life, during my three years in LaGrange, but I was quite anxious about traveling, having had no experience. I took my first taxi ride to my dorm, and went out for my first restaurant meal. I even left an appropriate tip. I had saved my money, and believed that I could get through seven years of college and medical school by economizing and by working summers.

Pre-med was not easy for me, with my lack of math and science background in rural high school. My freshman advisor was Herr Doktor Wooley, my German professor.⁸ He was a very kindly man who looked over my grades and observed that the English literature, composition, and German classes were going well for me, but that I was below average in chemistry. He suggested logically, "Maybe you should switch from pre-med to a different course, since you're not doing well in science."

The author as a pre-medical student, ever-present book in hand.

Courtesy of the author

"No, I will get it. I have worked three years to get here, and I will learn it, somehow!" My problem was that everything was more or less black and white to me. I had trouble imagining protons and neutrons and atoms. My classmates were from big city schools where sciences were taught. The first few months of work were just a review for them. Farm girls like me from small-town schools didn't often go to college, much less study sciences. I continued to struggle and began to improve to just an average grade level. The professor of organic chemistry advised me to not take his course, for with my mediocre grades in inorganic chemistry, he said it would be impossible for me to pass organic. But I did well enough in his classes (including an A in lab work) to get a good recommendation from him for medical school.

The next course I was worried about was Physics. And I had to take the tough physics course, not "Physics for Poets." I got along pretty well there until I got to electricity. The professor had an evening class for students who needed extra help with the problems. So I, with many others, attended these evening classes religiously. One evening, the white-haired professor said to me, "I understand that you come from a farm. I have a farm in Michigan. And I have some pictures of my new tractor. Would you like to see them?"

"Oh, sure," I said, just to be polite.

100

We went to his office, where he motioned for me to sit at his desk, and laid out several tractor photographs for me to see. Then he said, handing me some papers, "And here are the questions for tomorrow's test. The test questions will be taken from this list."

101

"Oh, are they available to all of us?"

102

"Well, ah...... no!"

103

"Then I'd better not look at them. But thank you very much just the same!" And I fled. I was extremely worried that now I would flunk the course, for sure. But to his credit, he gave me no more nor less than I deserved for a grade. (I knew I could have had an A!) I was aware of how some professors required girls to earn good grades.

104

I decided to try to earn a B.A. degree, instead of a B.S., which would have been easier to obtain. I had so many prerequisites for med school that I had to take two summer correspondence courses to fit in all the requirements for my major. I needed to prove myself proficient in a language, also. To Professor Wooley's delight, I passed the proficiency in German after earning only 13 credits in German. I majored in Zoology, and was very lucky to have outstanding teachers. Professor Tracey Sonnenborn taught advanced Zoology and Genetics; I loved working with paramecia. He wanted me to go into research in his field, but I had my sights set on medical school.

105

Then the day came to try to get into Professor Hermann Mueller's genetics laboratory course. Dr. Mueller was a Nobel Prize winner; he had been the first to discover that one could induce mutations in the fruit fly (Drosophila) by irradiating them under an x-ray tube.⁹ Then he had made a road map of the Drosophila's genes. His laboratory space was old and small. There was room for about a dozen students. On the first day of class, the lab was filled by about 50 of us, standing room only.

106

Dr. Mueller was English, a short, rather shy, very polite man. That first day, he turned into a raving tyrant, shouting, "This is a pre-med flunk-out course. I never give any A's. I flunk out almost all of my students. Unless you are a well-versed scientist, and unless you are prepared to work very hard, you have no place in my class! But I never give A's!"

107

It was amazing. At the second class meeting, there were only about a dozen of us left. I loved the work. Dr. Mueller was a very kind, gifted teacher. He answered every question patiently, and never put us down or made us feel stupid. We irradiated Drosophila, bred them, and with his help, figured out a gene map. I even found some brand-new mutations never discovered before, which was very exciting.

108

But, oh, the itching! The fruit flies had lice (one could see them in the microscope). The lice crawled up the microscope and onto my face. One day, I told Dr. Mueller, "I guess I couldn't be a research geneticist. I itch too much!"

109

"Oh yes, you could. You would put sulphur salve all over yourself!"

110

PREPARING FOR MEDICAL SCHOOL

Indiana University is a fine state school. I spent the first three years at the Bloomington campus getting my pre-med prerequisites, plus extra work for my major in Zoology and my B.A. requirements, completed. I loved the woodsy campus with its brick walks and its lovely dogwood and redbud trees. I felt very keenly the competition for getting accepted to medical school. At that time, there were thirteen applicants for each place. Those were war years; the campus walks were filled by marching ROTC students. I had to get off into the mud to let the marchers through. And I always had to stand on the buses, because the seats were filled by soldiers. Students came from everywhere to take crash courses in foreign languages. Housing was at a premium.

111

Although I could not afford the rates for room and board at the university, I was required to live in the dorms the freshman year. At first, I was placed in a room in an old house on Forrest Avenue, near the chemistry building. This I shared with two roommates who brought trunks of clothes and towels, with which they filled all the space. It was a good thing that I had only six hand towels and very few clothes, for the space was taken. We had three beds and three desks in the room. All my roommates did was to talk about their boyfriends and cry. They went to bed early and didn't like it that I studied late. I rigged up a line behind my desk, on which I hung a blanket to protect them from my light so they could sleep. At semester break, I asked to be transferred to a double room, where I roomed with Betty McLeod, a Spanish major. She was a lovely girl who had just graduated from a big high school in Indianapolis.

112

At the end of the first year, I sought cheaper co-op housing. Now I cut down the cost of the room by cleaning it myself and by furnishing my own bed linens. I lived first at the Sigma Pi House (the fraternity men were in the service), then at South Hall, the empty men's dorm. I ate my meals at the Indiana Memorial Union cafeteria, and at nearby restaurants. My meal cost was one dollar per day. My protein consisted mainly of brains and macaroni and cheese at the union. These items were not popular, so the servers gave me large portions. My roommate was a library science major, Marietta Metcalf, from Gary. Her father was a steel worker and she had to economize, too. In our junior year, we moved to a room near the campus in the home of an elderly doctor, Dr. Green, and his wife. There, we were asked to economize on toilet paper, because they were having to buy too much. The rule was not to use more than two sheets at a time. I still feel guilty if I use more! Marietta was a lovely girl; she graduated and left at the end of my junior year.

113

It was during my junior year that I completed my application for medical school. I applied only to IU, for I could not have afforded the tuition of a private or out-of-state school. Finally, the day of my interview arrived. By this time I had heard hair-raising tales of how awful the interviews were. I was told that a large part of the interview would be about my views of the war. That would be a problem, for due to my dislike of anything historical, and to my wish not to get into controversial political issues, I was not going to discuss the war. No way.

114

I was ushered into the interview room, where I was to be interviewed by Dr. Edwin Kime, Chairman of Anatomy, and Dr. James O. Ritchey, Chairman of Medicine. I tried to be calm and composed. "Well, what do you think of the latest war campaign?"

115

"I'm sorry, I know very little about it. I have been busy with my courses and I'm afraid I'm not well versed at all on the war." They asked me a few questions, then Dr. Ritchey inquired, "What books do you like to read?"

116

"The last two books I have read were Great Expectations, by Dickens, and Tess of the D'Urbervilles, by Hardy." Then, with Dr. Kime listening, Dr. Ritchey and I discussed what we thought of the character, Tess.

117

"What will you do if you don't go to medical school?"

118

"I don't have any other plans. There is nothing else I want to do."

119

"But what would you do?"

120

"I don't know. I honestly don't know."

121

"Your folks would foot the bill, right?"

122

"No, I will do it myself."

123

"That's impossible. It is very expensive. Tuition will be costly. Books and equipment will be very expensive. You don't realize how expensive medical school is!"

124

"I think I have a good idea. I have studied the cost estimates in the catalog. I have worked three years before I started college and have saved my money. I have paid for my first three years of college, myself. I have saved enough money for the first three years of medical school. By working summers, I'll be able to earn the money I need for the final year. I can do it. I have it all figured out."

125

That's about all I remember of the interview. It was over. I hadn't lost my cool or stuttered and blown it. I was satisfied.

126

Finally, the letter came from the I.U. School of Medicine. I was afraid to open it. The results of the last six years of work hung in the balance. I sat on the sofa in the parlor of Dr. Green's house, and, with shaking fingers, opened the letter. I was accepted!

127

STARTING THE FRESHMAN YEAR

That fall, I settled down into a private room in Dr. Green's house and started my first year of medical school in Bloomington, the last year that it was taught there. After that, all four years were taught at the Medical Center in Indianapolis.¹⁰

128

The new class assembled in the amphitheater on the first floor. There was a blackboard across the front of the room. There were 120 of us, fifteen of whom were women. Dr. Kime grabbed a piece of chalk and scrawled across the blackboards in huge printing: CONFORM OR PERISH. One male student got up, went out the door, and never returned. Medical school had begun!

129

"Now boys, you need to choose anatomy partners. There will be four of you at each cadaver."

130

A friend from pre-med and I saw each other. We each said, in unison, "Will you be my partner?" And so it was decided. We teamed up with another twosome and were a good group.

131

This friend and I went back a long way. We had been in many of the pre-med classes together. We had sat beside each other in Dr. Mueller's genetics lab. After he had failed his English proficiency examination several times, he was down to his last chance. I knew he would make a fine doctor, so I helped him. I wrote a theme for him and told him to practice writing it until he got the spelling and punctuation exactly as I had it. That time, he passed. He and his wife were very relieved.

132

The first year consisted of Anatomy lectures and lab, Physiology lectures and lab, Histology and lab, and Neuro-anatomy. The amount of material that we had thrown at us was awesome. The girls in the class were completely ignored. The class was addressed as "You men" or "You boys." Dr. Kime told raunchy jokes, most of which I didn't understand. Then everyone would look at us girls to observe our reaction. It's hard to know what to do, when one doesn't understand the joke in the first place. So I watched Dr. Kime's assistant, "Ma Strong," and I did what she did. If she laughed, I laughed. And if she didn't, I didn't. But the whole thing was getting to be too much for some of the girls. We lost eight of the fifteen women that first year. And we lost twenty-two men. It was brutal—one fourth of our original class gone in one year! I became quite anxious about flunking out, and wasted time worrying when I should have been studying.

133

Dr. Paul Harmon, the Physiology professor, didn't like us at all. It was said that he blamed doctors because his son was retarded. But I got along with him OK. One day he asked me a question and I got the answer all wrong. So he told me to look it up. At the next class, before he started his lecture, I held up my hand and said, "I want to say that everything I said yesterday was wrong!"

134

"Well, that's the first time I ever heard a woman admit that she was wrong," he said. We all laughed. I gave the correct explanation of the problem, and Dr. Harmon and I were friends.

135

Anatomy lab wasn't too bad when one got used to the awful phenol odor of the cadavers.¹¹ We all reeked of phenol. Meals lost some of their appeal when one would raise his fork to his mouth and get an overpowering whiff of phenol. There was no washing the odor away! One Saturday morning, I needed to catch up on a dissection, so I went to the anatomy lab alone. There I was, with thirty cadavers in the room. I felt creepy. I had never been able to whistle, but I learned, then and there. The sound gave me some comfort.

136

A couple of weeks before the Christmas break, one of the students at a neighboring anatomy table told me that he was suffering from infectious mononucleosis. A week or so later, I began to cough uncontrollably and had to leave class. I had infectious mononucleosis with pneumonia! I had contracted the kissing disease without a single kiss! I stayed in the infirmary for several days until it closed for the holidays, and then went home to the farm to bed. I took all my books, but was too sick to study at all. Finally, the vacation was over, and it was time to return to medical school. My temperature was 102 degrees; the nodes in my neck were all swollen up, and my throat was red and raw, except where it was covered by a white membrane. I felt rotten. But I got up and dressed.

137

"Where do you think you're going?" Papa asked.

138

"I'm going to school!"

139

"But you're too sick!"

140

"I know. But if I don't go, that will be the end. They'll never let me back in medical school again."

141

"But you're so sick, you may die!"

142

"True, but I have to try. I'll either make it or die in the attempt."

143

"Then I'll take you." So Papa drove all the way to Bloomington on icy roads. South of Indianapolis, the fog was so thick that he had to stick his head out the window to see the edge of the road. I lay in the back seat, wrapped in comforters.

144

Finally, late at night, we arrived at my rooming house. "If you like, I'll help you get your things, and I'll take you home," Papa said.

145

I wasn't very well off, for I had missed several examinations during my absence before the vacation. I had to keep up with the work that was pouring in, plus make up the missed exams. I was pretty weak. I could get up the stairs by pulling on the banister. But getting down was a problem, for when I bent my knees to go down a step, they'd shake so that I had to hold the banister to keep from falling.

146

Every day, for four days, the same thing happened. I went to Dr. Kime's second floor office and said, "Dr. Kime, I wish to make arrangements to make up my missed exams."

147

"Get the Hell out of here! There is no place here for panty-waists! Get out!"

148

On the fifth day, I returned and repeated, "Dr. Kime, I want to take my missed exams!"

149

He looked at me. "How do you feel?"

150

"I feel fine!" (I lied.)

151

"Does your neck hurt?" And so saying, he took his forefinger and jabbed roughly at my swollen neck glands. It hurt awfully, but I didn't flinch.

152

"Nah," I lied.

153

"OK, you may take the exams. But you know, it's just amazing how well you're doing. My son had infectious mono and he missed a whole year of school."

154

"That's too bad!" I declared. And I stalked out of his office.

155

Dr. Schuman, at the school infirmary, was giving me liver shots a couple of times a week; they made me quite ill each time, but they were supposed to help me get well. I slept five hours a night. The rest of the time, I spent going to school and studying. But if my work wasn't done, I'd go to bed, anyway, to sleep for five hours.

156

Dr. Kime gave us reams of anatomy questions for which we were responsible. I remember working on one question concerning an injury to one part of the brain. Symptoms arose from that area, but also from a distal area. I finally deduced that the greater superficial petrosal nerve had sustained an injury, but my time was up before I could figure out what happened distally to cause another set of symptoms. I had to get my five hours of sleep.

157

The next morning, Dr. Kime called on one man after another. At least a dozen guys didn't know what had been injured initially. Then he called on me and leered, "And now, Miss Flint, what is the problem?"

158

"I believe that the patient has sustained an injury to the greater superficial petrosal nerve."

159

"That is correct. Now, men, you have let little Miss Flint get ahead of you. How is it that she got the answer and you stupid men did not?" He yelled at the guys for about ten minutes, then turned back to me. "And now, Miss Flint," he leered in his most awful voice, "What went wrong distally?"

160

"I'm sorry, Dr. Kime. I couldn't figure that out."

161

Well, Dr. Kime spent the last half hour raking me over the coals in front of the class. I was the lowest form of low life, an idiot who just memorized stuff and didn't know or understand anything. I sat there fuming. After this diatribe was over, I went to the library to study. I'd look at the books, but I was so angry that I couldn't concentrate. Finally, I slammed the books shut, threw them on a pile, and said to my companions, "That does it. I'm too angry to study. I'm going to go and have it out with Dr. Kime!"

162

"Oh my God! Don't do that! He'll flunk you!"

163

"Well, if I can't study, I'll flunk anyway, so I have nothing to lose, do I?"

164

Dr. Kime answered my knock at his door. "Oh, Miss. Flint, do come in! And please sit down!" He motioned grandly to a chair. I sat on the edge.

165

"Dr. Kime, I think there are a few things that you and I need to get straightened out! I'm sorry that I missed the second half of the question. It was news to me that blood from a hemorrhage could travel so far along the nerve! But you didn't need to castigate me in front of the whole class for thirty minutes!"

166

"Oh, it was nothing personal, Miss Flint."

167

"I took it very personally!"

168

"Oh, no, I was just teaching the fellows. Believe me, it was nothing personal."

169

I said that it was hard not to take it personally, and left. And he never picked on me again. One has to stand up to a bully.

170

Every afternoon, as I walked to my room from school, I sang softly to the tune of "Clementine,"

"Dreadful awful, dreadful awful,
Dreadful awful Dr. Kime.
He'll make a fine cadaver,
And he'll be one, in good time!"

171

One day, I got one of his tests back, marked with checks and X's. I looked up the answers to all the questions marked X, thinking they were wrong. They were all correct. So I went to Dr. Kime for an explanation.

172

"Don't you know anything? X means correct and check means wrong!"

173

"That's amazing!" I answered. "All during grade school, junior high school, senior high school, and college, X meant wrong and check meant correct!' Dr. Kime never used that strange method of grading, after that. But he made many of my classmates so upset that they could not learn. He was a very sadistic man. I understand that the administration cracked down on him after our class, and that no class after ours had such a high attrition rate.

174

Meanwhile, my classes in histology and neuro-anatomy, taught by a Dr. Frank Forry, went well for me, for I was not anxious, and could study them properly.¹² Finally, the year ended. The names of the class members were posted according to class standing. I approached the bulletin board with fear and trembling, and finally found my name halfway down the list. I had made it. But my grades were just average, and I was ashamed of them. There were thirty names missing at the bottom of the list; those students had flunked out.

175

SOPHOMORE YEAR OF MED SCHOOL

At the end of freshman year, I was still not feeling well. I didn't even go to my graduation to pick up my B.A. degree. I just asked that it be mailed to me. I was concerned that I might have trouble with Biochemistry in sophomore year, so I decided to go to summer school and complete Pharmacology. Then during the winter term, I would have more time to concentrate on Biochemistry. About two dozen of us had the same idea. But that would mean that I would have no income that summer. I went to Marion County Hospital, which was located about two blocks from the medical school, and got a job filing records, in return for room and board. I shared a room over the garbage and refuse area with Etervina Figueroa, a classmate. The malodorous refuse and the roar of the garbage trucks and clanking of garbage cans in the wee morning hours became a way of life for us.

176

The Pharmacology course was a delight. I enjoyed learning about all the types of drugs and their actions. The laboratory part of the course I wasn't too fond of, though. I hated giving drugs to the dogs, as I felt sorry for them. But I did get good at making smoked paper for the drums and making recordings of physiological responses.¹³ By the end of the summer, I felt well again, like my old self.

177

One Friday, after class, I got a chance to earn ten dollars by spending the next day in the Eli Lilly laboratory, being tested with a brand new, synthetic narcotic drug, Demerol. A number of us, after a preliminary breathing test, received an injection of the drug; then about every half-hour, we breathed into a machine to test the amount of resulting respiratory depression. We all felt fine and had fun lounging about and visiting. At the end of the afternoon, I collected my ten dollars and headed for my room over the garbage heap. It was then that the retching and vomiting began. It went on for about thirty-six hours. Most of us in the study had the same experience, which we all reported.

178

Later, I was interested to study the Demerol drug insert and to note under "side effects" a mention of "occasional minimal nausea and vomiting." This was a meaningful experience for me, for it taught me to take what drug companies had to say with a grain of salt. And I decided that my days of being a human guinea pig were over, forever. I passed up all lucrative offers for drug testing after that.

179

Clinical studies were very easy for me. I would start to read about a disease, and suddenly there would come to mind a patient I had observed in LaGrange, who had suffered from the malady. One day, the Medicine instructor asked me to demonstrate for the class how a patient suffering from Parkinsonism looks and walks. I easily mimicked the expressionless face with mouth agape, the posture with the shoulders hunched, the torso bent forward, the arms held with elbows bent, the pill rolling tremor, and the short steps with shuffling gait. Now medical school was fun and exciting. I was working very hard, but I was no longer afraid of flunking, and I could learn.

180

LAB AND CLINICAL WORK

Pathology was particularly interesting to me. It seemed to pull together everything we knew about a disease. One could look at a specimen and figure out what symptoms would have been suffered. I got a job for one dollar per hour in my senior year, grading pathology lab quiz papers. I was encouraged to be a pathologist, but I wanted to deal with live people, rather than with tissues and corpses.

181

I enjoyed Parasitology and liked identifying the parasites and their ova under the microscope. The professor knew that I was doing well in his course. One day, we had a lab quiz in which about two dozen microscopes were set up, each to show a slide containing a different parasite. Each student had a piece of paper, on which to write the answer for each slide. When the test was completed, the professor saw on the table beside the microscopes clear indentations of the written answers. He went berserk, ranting and raving that we had cheated. I found my own writing very clearly visible, next to one microscope. He knew I did not need to cheat.

182

"Look, Doctor, here is my writing," I pointed out. "Don't you see, the impression has come through the paper onto the newly waxed linoleum table top? I did not cheat, and neither did anyone else." Thank God, he accepted my explanation and settled down. Cheaters were expelled.

183

While I was assigned to Pediatrics, there was a polio epidemic. I had already seen cases of polio in LaGrange. And when I was in fifth grade, a boy a year ahead of me had polio. After he was over the acute phase, he was brought to school in a wheelchair. He had a decided limp ever after. Now, dozens of children of all ages with high fevers and acute illnesses were being admitted. We were performing spinal taps on them all. In the middle of the night, I ran many times through the dark, abandoned tunnels from Riley Children's Hospital to the lab in Long Hospital, with samples of spinal fluid and blood to be analyzed. They were very scary trips, but they had to be made. I was nervous, because not too long before, a nurse had been murdered at the Medical Center. I felt very vulnerable, all alone in the tunnels. But I felt safer there than outside.

184

Even worse was having to talk to the terrified parents and to give them the diagnosis, which all too often proved fatal. Today, now that we have polio vaccine and the disease is almost eradicated, it would be difficult for a medical student to imagine the dread, terror, and devastation caused by polio.

185

On Saturday mornings for months, we had classes at the State Hospital for the Criminally Insane. We saw thousands of slides of brain pathology shown in conjunction with slides of patients and their case histories. Those were the days before the psychotropic drugs that we have now. I can remember vividly one case history of a woman who had become psychotic and brutally murdered a child. For the next thirty years, she had been a model patient in the hospital, so it was decided to release her. A week after her release, she murdered another child with an ax. The finale of the course was a visit to the wards, where we saw the patients sitting around in their hopeless, mindless states. Very depressing!

186

Obstetrics was an interesting rotation, particularly in the light of my previous experiences in LaGrange. One night, I was on call with an intern who considered all medical students to be dirt under his feet. There was a patient in labor who was making rapid progress. I asked the nurse to call him, but he refused to come, thinking that the medical student didn't know anything, and that he knew everything. The nurse and I got her to the delivery room and I sent another message: "Doctor, are you coming? If not, shall I deliver the baby?" This time, he came, arriving in the nick of time.

187

SENIOR OUTDOOR OB

In the Senior year, we had a rotation on "Outdoor OB" at City Hospital. Healthy multiparas who had been cared for in the prenatal clinic were delivered at home by medical students, in teams of two. The hospital furnished a car. We took turns delivering the baby and caring for the newborn. Most of the patients lived in the city's poorest neighborhoods.

188

Our first case was very traumatic. Our knock at the door was answered by a nude man, who motioned for us to go up the stairs. With some trepidation, we went, to find a lady in advanced labor. She had not gone to the prenatal clinic, so we took a good history and gave her a complete examination. She seemed healthy.

189

"How many children have you had?"

190

"Two."

191

"Were they all right?"

192

"Yes."

193

"Tell us about your labors and deliveries."

194

"No problem, short labors, normal deliveries."

195

"How long have you been in labor now?"

196

"Four hours."

197

"Has the water broken?"

198

"No."

199

On and on. All of our questions were answered in this manner. There had never been any problem with anything, ever. Labor progressed very slowly. We couldn't hear fetal heart tones, but thought the problem was due to a combination of our old fetus-scope and our own inexperience using it.¹⁴

200

Finally, with much difficulty, a perfectly dry baby was delivered. Dead!

201

Evidently, the membranes had ruptured long ago and there was not a drop of amniotic fluid to serve as lubrication. The baby was perfectly formed, but dead. We tried everything we could, but could not resuscitate it. I baptized the baby, at the request of the parents.

202

After this dreadful experience, the parents gave us the real history. Their other pregnancies and deliveries had ended in the same tragic manner. I never could figure out why they would not have sought prenatal care. Had they given us a true history, we would have taken her to the hospital, but in that case, it is doubtful that the outcome would have been changed.

203

One night, a lady called us after suffering a miscarriage. The tiny fetus, of about four months gestation, had been born dead. We cared for the mother, then told her and her husband to call the undertaker for the baby.

204

"Oh no, we can't do that!"

205

"Why not?"

206

"We have no money. Undertakers are very expensive. We simply cannot afford one."

207

We did not know what to do. Finally, I used my common sense and told them to place the fetus in a little wooden box, to dig a hole at least two feet deep in the back yard, and bury it. That's what they did. Right or wrong, it seemed to be the best thing to do.

208

One night, my partner was the very charismatic class president. We were called to a very well-kept, clean house of a young couple who were about to have their third child. He was an interior decorator, out of work. Her labor was progressing rapidly. I knew that she would deliver within about two hours. But my partner wanted to leave.

209

"Come on, let's get out of here," he insisted.

210

"We'd better stay. She'll deliver soon."

211

"No, I'm not going to hang around here."

212

"I do not think we can get back in time if we leave. If you want to leave, I cannot stop you, but I will stay."

213

Of course, he couldn't very well leave me behind, so he had to stay. The baby was born soon after and the family thought he was wonderful. So they gave him the honor of signing the family bible. It had been my turn to care for the baby; they asked me to sign the bible, as an after thought.

214

One night, my partner delivered a baby and the grateful family wanted to pay him $l. It was a rule that we were not to accept any money. But he took it gladly, bragged that it was the first dollar that he had earned as a doctor, and that he was going to frame it. I was ashamed for him.

215

Outdoor OB was a rough rotation. At one point, I worked seventy-two hours without sleep. Late one night, we had an emergency call. We went deep into the ghetto. There were guides posted along the last several blocks of the trip, motioning us on: "Hurry, hurry, go that way!"

216

Finally, we entered the front door and were in the living room of the tiny house. In the corner was an emaciated-appearing woman, sitting in the messy overstuffed armchair in which she had given birth to a tiny, premature baby, weighing less than four pounds.

217

It was my turn to care for the baby. It was mid-January; we had to get the baby into the premature nursery quickly. I knew that my biggest challenge at the moment was to avoid a fall in the baby's body temperature. As my partner cut the cord, I took the baby and immediately wrapped her in a small shawl. But I needed a very warm blanket and a source of heat.

218

I headed toward the back of the house and the kitchen, through a small room filled with beds, in which men were sleeping. I threaded through them in a small aisle about six inches wide. In the kitchen, I asked, "Is there hot water? I need hot water and a water bottle for the baby."

219

"We don't have a hot water bottle. But we'll find one in the neighborhood."

220

"Please hurry. I also need a warm blanket, please."

221

"We don't have one. Will this bed spread do?"

222

"Thank you." Then, cuddling the infant, I asked my partner, "Are you almost finished? I'm anxious to get the baby to the hospital."

223

"I have to get the birth certificate information first." Then he asked the mother some questions, finally getting to the information about the father. "What is the father's name, please?"

224

Silence. A long silence.

225

Finally, a young woman in the room spoke up and said, "Mama, if you won't give the name, I will!"

226

Silence.

227

Then the daughter gave us a name and an age. Meanwhile, my scouts returned with a hot water bottle. I was worried as much about burning the baby with it as I was of allowing her to become hypothermic. I carefully incorporated the hot water bottle and the baby into the folds of the old, tattered bed spread, and we sped in the cold night toward City Hospital.

228

On arrival, I walked so fast through the deserted corridors that I was almost running, toward the nursery. Then, "Halt!" It was the security guard. "You are kidnapping that baby!"

229

"Sir, I am a medical student. This premature baby must get to the nursery at once. Let me go!" Moments later, the baby was in a warm incubator. I was vastly relieved that her temperature was normal! The baby thrived, and was eventually discharged to her mother's care in good condition.

230

Meanwhile, my partner told me that caring for the mother had been the worst experience of his life, for she was crawling with lice in her pubic hair.

231

The following day, we made our first post-partum visit. We knocked on the front door and opened it a crack. "Psss-t! Psss-t!" The mother, who was lying on the sofa, beckoned to us. "Quick, before anyone comes! The name that my daughter gave you for the birth certificate is wrong! The name was John S!"

232

"And his age?"

233

"Sixteen."

234

"His occupation?"

235

"He's an usher at the theatre on the corner."

236

"Why didn't you have any prenatal care?"

237

"I didn't know I was pregnant. I knew my belly was getting big, but I thought I had cancer!"

238

We hurried back to the hospital to retrieve the incorrect birth certificate and fill out another, stating the sixteen-year-old father's name. We had been worried that we would fail to find the incorrect certificate before it was sent in to the Bureau of Vital Statistics, but it was no problem.

239

On another emergency call, we came to the home of a family whose house was shabby, but tidy and clean. It was my turn to deliver the baby. The mother was in her thirties and was in hard labor. She had had no prenatal care. "Why didn't you go to the free prenatal clinic?"

240

"I had no money for carfare!"

241

I lifted the bed covers, and there it was! A transverse lie! (The only one I've ever seen.) This was confirmed by palpating, on rectal examination, a baby's hand and foot, both prolapsed into the vagina.

242

"We must get you to the hospital at once! The baby is stuck cross-wise in your pelvis. It cannot be born this way. The baby will have to be turned so that it can be born, either head-first, or feet-first! There is no time to lose!"

243

We called for an ambulance, which arrived a few minutes later. By the time we got to the hospital, the baby had already been turned and delivered as a breech presentation. Fortunately, mother and baby were all right. Transverse lies, like compound presentations, are extremely rare occurrences. I had been very lucky that my two unusual patients and their babies were all right.

244

One night, when it was my partner's turn to perform the delivery, we went to the home of a laboring woman, in which about a half-dozen neighbor women were present. We set everything up for the delivery, placing the mother cross-wise of the bed, draping newspapers underneath her pelvis and at the side of the bed, and putting each foot on a chair by the bedside. Behind my partner, who knelt on the floor beside the bed, was a whole row of women with ring-side seats! We didn't want all those onlookers there, but felt that we must conform to the local customs, and did not ask them to leave.

245

The house was cold. The kitchen door had a three-or-four-inch-wide crack beneath it, through which the icy winds were blowing. It would have been so simple to nail a board on the door to make it longer. But poor people often don't seem to be able to help themselves.

246

I needed a warm place for the baby, so I asked for a table to be put behind the heating stove in the living area. The table was so wobbly that I feared its imminent collapse, but I braced it against the wall and pushed against it to steady it, as I cared for the baby. However, I didn't like being close to the wall, for there was a regular parade of some sort of big bugs skittering up and down. Fortunately, I kept them away from the newborn.

247

It is a shame that people who are least prepared have the most babies!

248

SENIOR CLINICS AND EXAMS

Time went by rapidly in the senior year. We were having lectures and spending a great deal of time in clinics. Many nights, we were on call. One day, I was on the neurosurgery service following a brain surgeon around the wards. He diagnosed a brain tumor and scheduled surgery for its removal. I was going to see delicate brain surgery! The operating room was hushed, as the surgeon incised the scalp and removed a section of calvarium from above the left frontal area. I held my breath, waiting for the painstaking dissection of brain tissue that I expected to follow.

249

Much to my astonishment, the surgeon thrust his forefinger into the brain, dug around with his finger, and after a short interval of time, "delivered" a brain tumor.

250

"It's a meningioma!" he shouted triumphantly, holding up a tumor about the size of a tangerine, for all to see. So much for delicate brain surgery!

251

I was very impressed with his post-operative care of that patient, however. He paid attention to every detail of the man's blood pressure fluctuations, and to every neurological sign. The patient had a full recovery, for his tumor was benign. The surgeon had pinpointed its location exactly and removed it quickly—quite a feat, despite his surprising method of removal. I was also impressed by his painstaking and compassionate explanations to the patient's family, as he appraised them of the good outlook, after the dangerous hurdle of his immediate post-operative period was surmounted.

252

In medicine clinics, I saw patients with diseases of every organ system. One family I shall never forget. The parents, who were in their 30s, had four young children, the eldest a girl of about 13 years. The mother was worried, for her husband was becoming unable to function properly at work. At home, he acted strangely, had uncontrolled jerks of his arms and head, and had made some sexual overtures to his pubescent daughter. According to the history, her husband's father and grandfather had started to act strangely at about the same age; both had "lost their minds," jerked so much that they could not function, and died young. On examination of the patient, the wife's observations were verified. The husband had Huntington's Chorea, a progressive disease for which there was no hope of cure. The gene for this condition is dominant.

253

"And what about my children?" she asked. "Will they get it?"

254

"Each child has a fifty percent chance of getting the disease. According to the law of averages, one would expect two of your children to get it. But it is possible that none of them will get it, or that all four will get it."

255

The mother was devastated. My heart went out to her. "What about them having children? How will they know whether or not they'll be OK?"

256

"They won't! Not until they're past child-bearing age." I've often wondered how that family fared. They were my most tragic case in clinics. We just couldn't be of any real help then. Today, thanks to research, we know much more.

257

We could choose a special elective, so I chose Anesthesiology. It was unfortunate that I had no contact with the chief, Dr. Virgil Stoelting, for he might have been able to help me. I worked with residents, and was given a great deal of responsibility.¹⁵ One day, I asked them about the woman whom I had been accused of killing by reaching under her head after spinal anesthetic. "Tell me, could raising her head have killed her?"

258

"We don't know." Then they said something about hyperbaric and hypobaric and said that there was no way of knowing. It was an unsatisfactory discussion, altogether.

259

The end of senior year was coming. There were examinations galore, including the one for state licensure. But the most important one, as far as I was concerned, was the medicine exam. It would cover the entire enormous textbook of medicine. My classmates went on vacation and saw movies, declaring, "It's impossible to study for that test!"

260

I wondered what type of test I'd give if I were the examiner. We had about six lecturers during the year. I decided that each should be allowed to ask two or three questions. Then I went through my notes and looked for asterisks. Whenever I had felt that a lecturer was trying especially to get a point across, I'd put an asterisk in the margin of my notes.

261

I then formulated questions including all these points. There would probably be ten to twelve essay questions. I wrote about fifteen questions, enabling me to include all the asterisk subjects. Then I studied and tested myself until I was able to answer all my questions thoroughly and automatically, without wasting time thinking. The day of the big test arrived. I took a big breath and opened it. There they were, practically word for word, eight of my questions. The other two that I hadn't anticipated were quite easy. Being a good student takes a lot of hard work!

262

THE INTERNSHIP DECISION

A big decision was coming up as to where I would intern. I had been required to make my four applications before my rotation through City Hospital. I had included Cincinnati General Hospital, but I now knew I didn't want to go to a city hospital, but rather to a teaching hospital. I was accepted there, and turned them down.

263

Dean John Dean Van Nuys told us that if we weren't satisfied with our match, not to worry, for there were always plenty of excellent internships left over, there being more internship slots than doctors to fill them.¹⁶

264

Medical school graduation, 1950. "I had done it. I had
reached my goal of being a doctor. But little did I realize
that my medical education had just begun."

Courtesy of the author

I applied to the University of Michigan in Obstetrics and was turned down. No woman had ever been accepted there in that field. I applied to Henry Ford Hospital in Detroit, but now I wanted a teaching hospital. I was accepted at Indiana University, but I turned them down, thinking that I needed to venture forth from my comfortable school and surroundings, and widen my vistas.

265

Now I was the only member of the class without an internship. At that time, the best internships paid no stipend. I had about 700 dollars left. I could afford a good internship. It turned out that there was an opening at the hospitals of the University of Pennsylvania in Philadelphia. I.S. Ravdin, Chief of Surgery there, phoned Herbert Gaskill, Chief of Psychiatry, who had come to IU from Penn, and asked whether there was an IU graduate available. Dr. Gaskill interviewed me, after which I made application to Penn and was accepted. This internship was one of the finest in the country, though it paid no salary. I was extremely lucky, but also apprehensive. Could I measure up in the East?

266

Toward the end of the senior year, our grades were tallied and I was elected to Alpha Omega Alpha, the medical school honorary society. I felt very pleased to make it, particularly in light of my poor beginning. I had done it: I had reached my goal of being a doctor. But little did I realize that my medical education had just begun.

267

Elsie F. Meyers is a retired anaesthesiologist living in St. Louis, Missouri. This article is excerpted from her self-published full-length memoir of the same title. Some of the people in this excerpt are identified by fictitious initials in order to preserve confidentiality. The editors have added several explanatory footnotes to the original text.

Notes

¹�The National Institutes of Health define hypoxia as a "condition in which there is a decrease of oxygen supply to the brain even though there is adequate blood flow." Among other conditions, "complications of general anesthesia can create conditions that can lead to cerebral hypoxia." (http://www.ninds.nih.gov/disorders/anoxia/anoxia.htm)

²�The term "grand multipara" refers to any woman who has given birth seven or more times.

³�Meyers explains that "coramine, no longer used to my knowledge, was considered to be a heart stimulant. The baby died of hypoxia because he was unable to breathe. Today, after delivery, that baby's airway would immediately be cleared of mucous and blood. Then he'd be given mouth-to-mouth respiration until he began breathing on his own. If his heart stopped beating, compressions of the heart would be added to the respiratory aid. These efforts would persist for awhile before the baby would be pronounced dead. Since this baby lost his life, great strides have been made in resuscitation."

⁴�Meyers writes: "Some types of meningitis are extremely dangerous and easily spread. These days, college students receive vaccinations for protection from meningococcal meningitis, a deadly form. At that time, however, I was at risk. I should have been protected by an adequate mask as well as protective gear—including a large gown and head covering—and antiseptic solutions for my hands."

⁵�"By the 1940s sulfanilamide was a widely used drug," often utilized in "the treatment of open wounds." (http://www.britannica.com/EBchecked/topic/572427/sulfa-drug).

⁶�IMH contributor Alexandra Stern writes that early twentieth-century physicians often induced abortions by one of three methods: 1) administering certain drugs; 2) irritating the cervix, usually with a catheter or other objects; or 3) dilating the cervix with dilators or tampons in order to do a dilation and curettage (D&C) procedure. After one of these resulted in hemorrhaging, the doctor would be able to claim the woman had a miscarriage. Meyers's account suggests that Dr. C. was not using the iodine for its generally intended purposes, but was instead taking advantage of its corrosive/toxic properties in order to induce bleeding or hemorrhaging. For more information about "miscarriages" that were really medically induced abortions, see Leslie J. Reagan, When Abortion was a Crime: Women, Medicine, and Law in the United States, 1867–1973 (Berkeley, Calif., 1997).

⁷�Diathermy is a "deep-tissue heat treatment. The temperature of the injured tissues is raised by high frequency current, ultrasonic waves, or microwave radiation. Like surface heating, deep heat is used to reduce pain, relieve muscle spasm, decrease soft-tissue contractures, resolve inflammation and promote healing." See the University of Iowa Hospitals and Clinics "Health Topics" webpage (http://www.uihealthcare.com/topics/sportsmedicine/spor3327.html).

⁸�Dr. Elmer Otto Wooley graduated from Indiana University in 1907 and received his PhD from IU in 1915. In 1930 he returned to the university as an assistant professor in the German Department. Although he retired from IU in 1954, he continued to tutor students in German until his death in 1964 (http://www.indiana.edu/~liblilly/lilly/mss/html/wooleye.html).

⁹�Hermann Joseph Mueller was awarded the Nobel Prize in Physiology or Medicine in 1946 "for the discovery of the production of mutations by means of X-ray irradiation." He had become a professor of Zoology at IU in the previous year. (http://nobelprize.org/nobel_prizes/medicine/laureates/1946/muller-bio.html).

¹⁰�In the 1979–1980 school year, IU students once again gained the option of taking their first two years of medical school coursework on the Bloomington campus.

¹¹�Phenol was used as part of the liquid solution for preserving the bodies.

¹²�Dr. Frank Forry received his M.D. from IU School of Medicine in 1923, and was a member of its faculty from 1924 through 1956.

¹³�The method of recording physiological records by using smoked drums has become antiquated. If one wished to track the effect of a drug on a dog's respiratory function, for example, he would expose a piece of paper to black smoke, then wrap it around a revolving drum against which a stylus connected to the dog's chest was affixed. As the dog breathed and the drum rotated, a wavy line scratched in the smoked paper by the stylus indicated any changes in the depth and rate of breathing caused by various drugs and manipulations. Similarly, using cannulas, results of heart rate and blood pressure physiology changes could also be recorded.

¹⁴�A fetus-scope is a stethoscope adapted for use in listening to heart sounds of an unborn infant through the mother's abdominal wall.

¹⁵�Dr. Virgil Stoelting received his M.D. in 1936. He was a member of the IU faculty from 1947–1977.

¹⁶�John Dean Van Nuys was the first full-time Dean of the IU School of Medicine, and held that position from 1946 to 1964.

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