Merely the patient

On arriving at the Mayo Clinic I found that, if unaccompanied by a physician, you are required to register and procure a numbered registration envelope, which serves as a sort of passport throughout the whole institution and entitles you to be examined, at their discretionary rates, for everything they can think of, including your income and your sanity. This formality disposed of, I was directed to a certain lettered and numbered desk (there are several floors of tremendous length and breadth, with a great number of such desks on each floor). This particular desk was presided over by a young lady who gave me a numbered slip and automatically directed me to “take a chair.” After waiting nearly three hours I was ushered into the presence of a diagnostician in the department of urology, to whom I briefly stated my case, and said I wanted to find out what sort of treatment they would recommend. Without appearing to have heard anything I said he took out a long questionnaire and began cross-examining me about my habits, my mode of living and other personal matters. He could think of more prying questions than a prosecuting attorney. He was particularly curious about my antecedents—how long they had lived, what they died of, and other long-forgotten data about the fallen branches of my family tree. Having no idea that kidney-stones were hereditary I wondered what all this long catechism had to do with my complaint, in which, by the way, he didn’t seem the least bit concerned.

Then having me strip to the waist he stretched me on a long table and thumped me over pretty much as one would test a watermelon to see if it were ripe. For some reason best known to himself he studiously avoided the kidney corner of my anatomy; which reminded me of a man I once played golf with, who when his ball landed in the bushes or tall grass always looked for it in some adjacent quarter for fear of finding it in an unplayable lie. Needless to say, we had mutually agreed that there should be no penalty for lost balls.

When the doctor had completed his record of all I knew, and also had pommeled me until his solemn visage betokened some momentous conclusion—which he guarded with profound secrecy—his air of mute sobriety was in nowise reassuring. He put the stethoscope to my heart, then shifted it to the left kidney and asked me to breathe deeply—perhaps to see if the two organs were beating in unison. But he shook his head negatively, which I took to mean that something was wrong with one or the other.

“Nothing serious, I hope,” said I, studying his inscrutable face for some hopeful token. For a few moments he seemed lost in meditation, which set me to wondering if he had found something he didn’t dare tell me about. Then without answering, he wrote out and handed me the following prescription: “Four ounces of castor oil and loganberry juice, no supper, to bed at seven o’clock, up at seven A. M., no breakfast, report at desk XY-4 at 7:30 tomorrow.” I suggested that four ounces was rather a generous dose, but he said the conditions warranted it, so I didn’t argue the matter with him. He also gave me several envelopes of assorted colors, directing me to various appointment desks, and informed me with great impressiveness that they contained orders for examinations. Incidentally he told me that when I had finished with these I might go to breakfast, then report back to him.

My first appointment next morning was for an X-ray of the offending kidney, and having finished with this I set out to dispose of the other four envelopes, curiously anxious to learn what the examinations would disclose—heart disease, kidney-stones, gall-stones, cancer or what. It must be something terrible, I thought; otherwise the doctor would not have shown such deep and mystified concern. It is remarkable how one’s imagination can run wild when the physical machinery is upset by some puzzling ailment. One fear begets another and, like bacteria, they multiply, until it becomes possible to alarm one’s self into almost any sort of malady. For example, while at the outset I was satisfied that my only trouble was seated in the left kidney, during the course of the next few days, owing to the variety and severity of the examinations, and the utter lack of information concerning the results of any of them, I fancied myself the victim of no less than half a dozen diseases, most of them fatal.

At the next desk, there being at least fifty people ahead of me, I told the young lady I’d call later. At this point I began to feel a little encouraged, because whatever I had, it seemed to be very prevalent, and the afflicted ones didn’t appear to be much disturbed, except one poor old fellow, who was badly doubled up with what I suspected to be a case of “gravel” pains such as I had often experienced. I asked him if he had kidney trouble.

“No,” he said; “it’s just a nasty hang-over from a castor oil jag last night.”

After waiting an hour at the third desk they sent me into a nearby room to have all my teeth X-rayed. This completed, I plucked up more courage, and taking my fourth envelope I wandered about among the crowd, looking for the specified desk, which I finally located two floors below. The attendant there, like all the others, asked me to “take a chair”—a phrase that one hears repeated everywhere, until eventually it gets on your nerves. After a couple of hours or so I got up and asked the desk girl how much longer she thought I’d have to wait.

“The doctor will see you in your turn. Take a chair, please.”

After a few days you get so that, like a trained monkey, you instinctively look for a chair the moment you approach a desk. You sit and sit—anywhere from an hour to all day. Your chief amusement consists of looking about, wondering what’s the matter with this or that one. The majority of the patients wore a look of calm but determined resignation, and naturally I supposed that most of them had kidney-stones.

Unless someone stumbles over your feet, you are rarely disturbed, whether awake or asleep, therefore it is necessary to exercise due caution that you are at the right desk; otherwise you may sit all day till closing time before discovering your error. When your turn comes, if you happen to be asleep from exhaustion you automatically revert to the foot of the line, which is apt to mean the loss of a whole day. But time means absolutely nothing here—to anyone but the patients. If you ask the diagnostician when you’ll be through he answers evasively, “As soon as we have completed your examinations.” There is something contagious about clinical examinations: the first one calls for at least two more, the next two show that you need five or six others, and so on ad infinitum, until you feel like a fellow in the dark, hunting for the last link in an endless chain.

Another stereotyped phrase that one hears on entering most of the examination rooms is, “Strip to the waist.” You are sent to a little undressing booth and furnished with a sort of loose flowing Chinese robe to take the place of your upper garments. On being directed to one of these booths, and finding it already occupied, I sauntered along the hallway and presently found another similar looking room, with the door slightly ajar. Without observing the “For Women” sign overhead, I opened the door and switched on the light, supposing the room to be unoccupied. But a loud shriek from a back corner disclosed my error; and frightened almost out of my senses, I turned about to find myself face to face with a squatty, florid-featured Amazon, whose dishabille indicated that she had rather exceeded the examiner’s customary directions to strip only to the waist. With an impromptu word of apology, I was making a hasty exit, when she snarled, “Can you beat it!”

At the fourth desk I was called at the end of two hours, and they undertook a thorough examination of my eyes, ears, nose, and possibly my throat—I don’t remember. I do remember wondering again what all this wearisome routine had to do with my kidney; also that I was absolutely empty and exhausted. I recollect, too, that it was 2:30 P. M. and I hadn’t had a bite to eat since the morning before; so I pocketed the other envelopes till the following day and went to my hotel next door, where I found the dining room “closed from 2:30 until six o’clock.”

Next morning when I went to dispose of my two remaining envelopes I discovered that the first one called for what is known as the blood urea test—where they jab a needle-pointed syringe into a vein in the arm and draw off quantities of blood. Then, as if they suspect you of holding back on them, they send you into another room where they puncture the lobe of the ear, drain off more blood—if you have any left—and store it away in glass tubes labeled with your name and number.

The young lady at the desk gave me a numbered card—number 6, I recall, for I was early. “Take a chair,” she said as she wrote number 7 on a slip for the man behind me. I sat there an hour or so, studying the faces of the crowd and listening to the monotonous “Take a chair,” when a nurse opened a nearby door and called out numbers one to six. The first six of us filed into a small anteroom where we were requested to remove our coats and roll up the left sleeve. Through the door leading into an adjoining room we could see a number of nurses in uniform, and on a table near the door were several strange looking instruments, glass containers, etc. Extending past the left side of the entrance we could see about eighteen inches of what seemed to be an operating table, and altogether the interior did not look inviting.

Number one, a tall hardy Scotchman, was soon called and as he stretched himself on the table we could see his feet projecting over the end at the doorway. For a moment all eyes and ears were strained, then suddenly a heavy groan issued from within, accompanied by a violent swinging and jerking of the patient’s feet. Presently the legs dropped, and after a few convulsive twitches the feet hung limp over the table end. From what we could see, it looked as if the nurses had won the first fall, and had the victim’s shoulders pinned to the mat. Among the five waiting occupants in the anteroom was a rather pale looking chap who stood for a moment with wide-staring eyes, then suddenly gathering up his hat and coat he exclaimed, “Here’s where I quit!” At which he jerked open the door and disappeared.

At the desk where I had postponed my appointment the day before I spent two hours waiting and another half hour going through some sort of heart test; then for a circulation test they kept me another hour with one foot and leg thrust into a covered vessel of water, which threw me into a state of nervous apprehension by continually bubbling as if it were boiling. This operation was supervised by a vivacious little nurse who kept track of my pulse; and observing my anxiety, she did her best to engage my attention by relating a tragic chapter of the story of her life. She timed the story so that it ended coincidentally with the circulation test; then she lifted the cover, tested the water with a thermometer, and assured me it was cool; also that the flesh on my leg was still intact. I thanked her and said it was the most enjoyable examination I had had.

Following this I hurried through a fifteen minute luncheon, and spent three hours waiting for my doctor.

“I observe you are no less a humorist than a physician,” I said, remembering the loss of my breakfast and luncheon the day before. “You gave me a two days’ job to perform before breakfast.” Aside from provoking a flicker of a smile this did not change the gravity of his countenance in the least. He asked me a number of new questions, about everything except the part that troubled me. Whenever I asked about my kidney he always answered by asking me about something else—on the theory, perhaps, that having the kidney safely quarantined, he was interested solely in exploring for new trouble.

When he inquired about my stomach I was prepared for him, for I had been forewarned as to the rigors of this examination, which consists of swallowing the nozzle end of a rubber hose and forcing a quantity of dry bread crumbs down alongside it, then with the hose dangling from your mouth you take your place in the line and wait for the food to digest. By means of a pumping device on the outer end of the hose they test the contents of your stomach every half hour or so to see how you are getting along. I emphasized the fact that my digestive organs were in perfect working order and would rival the gizzard of an ostrich. Thus after an eloquent protest I escaped the dreadful stomach test.