Off North Road

Ambulance rider

By Russell Hoxsie - January 12, 2006

"Ruth! Ruth!" The lonely, endlessly repeated cries permeated Ward-H, or perhaps it was Ward-L, during the first weeks of July 1952 at the old Rhode Island Hospital in Providence. Within seconds a response from a more distant section of the same ward followed, "Tom! Tom!" The first crier was an old man, confused and afraid; the second was an elderly woman trying to comfort the man pleading for help. She could have been someone he loved, a stranger, possibly his wife long dead; we never knew nor did she, apparently, through her own disorientation and loneliness. Both were restrained in their iron hospital beds and covered with a single sheet in the hot nights of summer. I cannot now remember which letter really, "H" or "L," designated that dimly lit hospital unit in the basement off the emergency department. No one could enter emergency those weeks without hearing the anguished cries for help and the delusional response. The ward was temporary home to the homeless who became ill, alcoholics who suffered the agony of delirium tremens during withdrawal from alcohol, forgotten psychotics who had few reserves to help recovery from surgery. They were often out of control and required separation from the general hospital population. The odor of a commonly used sedative paraldehyde was common to the whole area, ward and emergency department alike. The lungs eliminated the drug on the patient's breath and an evil smell spread over a large area even where only a single patient was dosed with the medication.

I wonder if my poor recollection of the unit's designation stems from those pathetic cries emanating from that basement ward that summoned my image at the time of hell on earth. I had carried my MD degree barely a month and the burden shifted unevenly on my shoulders. Both patients remained in Ward Hell for weeks and I could never dissociate their cries in memory from my first service in the adjacent emergency department.

I suppose my initial experience was a rite of passage for a young doctor, encountering the shocking and morbid alongside the exciting adventures of Medicine. I was exhilarated by new experiences as time went on and the burden of my degree settled evenly except for a few occasions, one of which I recount from here. Interns or resident physicians rode every ambulance call the emergency service received during the 1950s and 60s. As we novices became more seasoned we learned that we were subject to subpoena at criminal court from time to time. Our duty was to give evidence for the particular cases that we had examined during an ambulance run. Not the least attraction was the per diem extra pay received from the court for the service provided. It was not much, but, considering our monthly stipend of $25 plus meals, uniforms and a bed on duty nights, we thought extra cash was a bonanza.

My luck was to testify at a trial for the murder of a woman I had pronounced dead in her home bedroom many months before after one of my first ambulance rides. She had apparently been attacked in her own bed and murdered by strangulation. As I waited for the court summons I found I was more apprehensive than I had expected to be. I approached the courtroom with no advice from fellow interns, who were probably as ignorant as I was, or from my superiors at the hospital. Certainly I had not consulted a lawyer for my own support. Worse, I had hurriedly filled out the emergency room record with few details of my examination of the victim after my return from the ambulance run. Time had effectively erased much of the experience from memory. Honestly, my mind had been on the anticipation of extra pay and that should have been the end of it. It was not. The district attorney was harmless enough, his questions routine. His job was to convince the jury of the guilt of the defendant who sat prominently in front with his lawyer. Harassment of the first junior medical witness could not have been a high priority in the prosecution's strategy. However, I had not anticipated the enthusiasm with which the defense attorney would attack to find his client innocent. He took me over the coals. "How was the victim's body lying in bed? Where were the windows and light in relation to the deceased? What was the state of the room; were the chairs and tables disturbed? Were there marks on the victim's body and what did they appear to be from?" And so on for about 20 minutes. By this time I was close to babbling incoherently. All I could remember was my shock at the victim's condition in bed and my relief on the arrival of police who effectively took command of the crime scene.

By this time, the judge moved forward at the bench and in an even voice sternly said to the obstreperous defense attorney. "Now, Counselor, this young man's only duty at the home of the victim was to establish that life was present or not. Is that so Doctor?" I mumbled, "Yes sir." And he continued, "You found the victim dead, did you not?"

"Yes, sir," I answered and was excused. I bolted from the courtroom, hoping never to make another court appearance ever. Whether I received compensation I haven't the slightest memory and collecting stipends for testifying at any kind of court hearing has become a lifetime avoidance, I am sad to say.