Trials and tortures

Thursday, August 4, 2005

The recent History Channel series, "Last Days of World War II," reminded me, with a bit of a shock, that it was just 60 years ago I made my epochal pilgrimage to the Mayo Clinic. We arrived on Flag Day.

They were having a parade, all World War I old-timers, the young being overseas. The trip took two full days in our 1937 Pontiac coupe. Rationing still being in force, my mother had had to con the ration board out of extra gas, and we had two flats on the way.

Recalling my slightly-built father struggling with the lug-bolts, the thought of the tortures of the damned (physical, emotional, financial) those two noble souls underwent, all on my behalf, is more than I can bear with dry eyes. My own torments pale by comparison.

All the good doctors being in the Army, we had "doctored" for two years with the Nevada fogeys and quacks. Doctors in those days were reluctant to "refer" patients to specialists. But at last we were referred to a series of Kansas City fogeys and quacks. One well-meaning medic, Dr. Clark Sealey, did his best. I was diagnosed with undulant fever; yet no more had we come home than he called and said his wife (his lab technician) had found a malaria bug in my blood. I took atabrine (the wartime quinine substitute) till I turned yellow, but I showed no improvement. The doctor wanted to send me to a fever clinic in Memphis. But my mother put her foot down. "The devil with that," she said. "We're going to the Mayo Clinic."

My consultant there was Dr. Hermann Helmholtz, grandson of the famed Helmholtz, who invented the stethoscope and formulated the law of the conservation of energy. My trouble (then called ileocolitis, now called Crohn's disease) was diagnosed in three weeks, using the very same fluoroscopic tests that had been fruitlessly done in Nevada and Kansas City.

So for two more years I swallowed every variety of sulfa, which is still the only treatment. My mother and I went back for checkups, on the old Chicago Great Western, a kind of long-size Toonerville Trolley, that seemed to go backward more than forward, at 20 mph.

No improvement. So down from the stellar regions was summoned Dr. J. A. Bargen, "the gastrointestinal specialist of the world." This dour, icy, studious Prussian pondered my chart and X-rays, and growled, "I think we ought to operate!" I was years forgiving Dr. Bargen.

That was in late '46. New cars were still scarce, and Nevada's bigshot dealer lied that he simply had none, when everybody knew he had them for customers who'd pay a "lug." Charley Loving, however, had lost a daughter to illness. "I know just what you're going through," he told my father. "I've got a new Chevy coming in, for another man, but I'll talk him out of it." It cost $1,250, if memory serves, for Loving didn't "lug" his cars like others.

We reached Rochester over perilously icy highways, and the operation was performed on Jan. 4, 1947. The surgeon, a Kansas native named Dr. Black, said when he got in, things proved much worse than the X-rays had shown. He hardly knew what to do. The result was termed an ileosigmoidostomy, meaning that all the colon and half the small bowel were "excluded" or "bypassed." (Unlike some, Mayo preferred not to "remove" anything.) The miracle is, I instantly throve like the green bay tree! First day out of hospital, I ate a turkey dinner, then went across the street to a hamburger joint and ate two. Previously, I'd been unable to eat much because sight of food brought intense abdominal cramps.

My awareness of world affairs is inextricably tied to personal events. When the A-bomb fell on Hiroshima I'd read about it in bed, taking sulfa.

And having read up on nuclear physics, and fancied I'd like to be a nuclear physicist, my reaction was, "Oh, darn, they've beat me to it!" Then in 1950, I was returned to Mayo in a state of collapse. X-rays revealed nothing. Dr. Black did an exploratory and found that the intestine had kinked at the anastomosis (surgical joining), which he rectified with "sutures."

When I awoke, I said something about war with Communists being likely. My mother said, "We're already at war with them, in Korea."

The kink recurred, less critically, in 1959. Dr. Black said the problem was, the anastomosis had shrunk. He proposed to make a new one, and also return the lower half of my colon into use. It was still in good shape, he said, while the more diseased parts had shrunk to the size of a lead pencil. The new surgery was an ileotransverse colostomy (internal colostomy). It's almost a jejuneo-colostomy (the jejunum being the upper 2/5ths of the small intestine), most of the ileum (the lower 3/5ths) still today being excluded or bypassed.

Again, I prospered. But in the 1960s I began to suffer from deficiencies due to the short bowel: tonic (rigid) spasms from low blood calcium, clonic (thrashing) spasms from low blood magnesium, paralysis from low blood potassium. (More recently a K.C. quack said I had "peripheral neuropathy" which would soon put me in a wheel chair. Terrified, I fled to Mayo, where no peripheral neuropathy was found. I merely needed IM Vitamin B- 12!)

Mayo tried every modern miracle to combat the deficiencies. Finally, in July, 1969, Dr. A.D. Newcomer said, "I'm going to try an old-timer: Tincture of opium." Talk about miracles! In three months my weight went from 89 to 117, and the electrolyte deficiencies have never recurred. I've drunk gallons and big bucks' worth of opium in 36 years, and must be the happiest junky in the world. More power, say I, to those Afghan opium farmers, and to the devil with the U.S. regulatory hoops that make it so expensive! Raw opium (not to be confused with its manmade derivatives, morphine and heroin) is relatively benign. It contains some 40 alkaloids (including even loperamide hydrochloride, sold as Imodium), some of still unknown benefits, since laws stifle further research. The "depraved opium addict" is a fiction. Or at least I've never been accused of behaving like one.

But in medicine, one thing leads to another. In the 1980s my kidneys began to fail, and Mayo believed the process began in the '60s, due likely to those electrolytes deficiencies. I had a transplant in 1989, a rousing success. But alas, prednisone (one of the immunosuppressants) is a cause of osteoporosis. So last year, in a very undramatic fall, I broke an arm. What next? The irony is, I seem to be outliving my classmates, one by one.

While living through all these "tortures of the damned," I took them very much in stride. I saw myself as normal, even refused a "handicapped" license plate when offered one.

It's only now, in looking back, that I'm staggered by such a dismal-sounding history!