Off North Road

House call to the doctor

By Russell Hoxsie - January 26, 2006

The startling confrontation that follows is true although names and details have been changed to preserve confidentiality.

Medical Practice is nothing without a few shocking surprises thrown in. I had been settled into my practice on William Street in Vineyard Haven for about a decade. Working in the side garden at the office gate had become less a relief from boredom and lack of patients than a job neglected because of the pace of work inside. My wife Mary Ann took on many of those outside chores in addition to her total immersion in raising a family, which in time would count five children. About ten in the evening of a late spring day the hospital emergency room nurse called to say I had a patient with severe abdominal pain waiting to be seen. "Come right away," she said. Ten minutes later I was examining Lars Swenson, a sometime patient, who had just returned that day from Florida. He and his wife Gertrude, both in their 60s, worked year-round as driver-handy-man and housekeeper for an elderly retired gentleman in Vineyard Haven. I remembered right away the story their employer, Harry Chadwick, had told me on my last home visit to him. I had asked about the boxer chained out in back of the garage, "Great dog," he'd replied. "Darned if he hadn't nearly torn the arm off my doctor in Florida when he came to the house. Good watch dog. We live in an out-of-the-way place down there." I remembered the story because I had tucked it away quite near the front of my brain.

In the emergency room Lars presented a very tender belly and at certain times cried out with sharp pain, especially when I touched him or when he tried turning over. "I can't figure it," he said between bursts of pain when he seemed quite comfortable. "Had my appendix out just three days ago in Florida and the doc said I was doing famous for my age. I could go back up north anytime I wanted. Was OK till we got near New York. I been in agony ever since. Gotta find out what's ailing me, can't stand this." As he touched his belly again he let out a great moan.

By this time the technician had returned from the X-ray unit with films of his abdomen and beckoned me quietly into the room with a view box. She didn't have to say a word as she put up the films and I looked in horror to see a large eight-inch steel surgical instrument called a Kelly clamp. It's blunt curved tip protruded

forward to the inside front lining of the abdomen; I cringed with the thought of Lars's pain.

A Kelly clamp is used for snagging the ends of bleeding arteries to stop the flow of blood while the surgeon ties a knot of silk or cotton around its tip before unlocking the clamp and removing it from the abdominal site. The law of all operating rooms is immutable: nurses count all instruments before an operation begins and immediately as it ends. The surgeon cannot close the case until he receives the result of the instrument count. Any deficiency must be corrected before he sews the surgical incision closed. Many a minute has been spent in many operating rooms searching for a "lost clamp" to make the count correct.

Our immediate action was obvious. Lars must have another operation to remove the "lost" clamp. Our surgeon removed it without mishap. Lars awoke free of pain and remained so without infection or other complication. I told him what we had found, that we had removed the Kelly, and his appendix operation would continue to heal normally.

For a year or more I heard nothing from either of the Swensons or Mr. Chadwick. Our daughter Debby says she must have been about 10 years old when she had been startled while watching TV on a Saturday morning. She looked up to find an elderly woman had let herself in to the living room without making a sound and was standing beside her. The woman demanded to see the doctor. "Where is he? He must be your father; where is he; I must see him." Non-plussed, our 10-year-old headed for the kitchen following the woman as she made her way briskly through the house. The other children, drawn by the angry voice, now almost ran from upstairs to see this latter-day Peter Pan.

"Do you know that your father killed my husband? "Do you know your father killed my husband?" she asked our open-mouthed 8-year-old.?" By the time Deb, Steve, Rusty, and Pam burst into the kitchen where I had been doing the early morning dish routine, I turned in amazement having heard nothing of the ruckus before that minute.

"Gertrude ... Mrs. Swenson," I blurted out. "What is going on?" No more than a few seconds passed before I could tell what was going on even though it was unbelievable.

"You remember Lars Swenson, don't you?" she demanded without waiting for a reply. "You know that operation you gave him last April was unnecessary and it killed him. He's dead now and you are responsible. Do your children know that you go about killing people?"

I had never seen or heard Mrs. Swenson like this before. I thought she must be in the midst of a nervous breakdown and suffering from paranoia. I had heard in town that Lars suffered a series of strokes in recent weeks and died. A year or more had passed since his unfortunate need for a second operation but there seemed to be no reason to think the two incidents were connected. With her latest outburst all I could think was that I must remove the kids from this scene. It must be confusing and frightening for them. "OK, kids, back to the living room or upstairs. Watch TV and I'll be in as soon as this lady leaves."

They beat a hasty retreat. Debby by now looked pale and I could hear her shepherding the younger ones out of ear shot. Mrs. Swenson persisted for a few more moments in her angry outbursts. "Mrs. Swenson. You must leave my house. I can't have the children listening to your accusations. I don't understand why you make them. They are totally false. Please leave before I call the police." And she left. I saw her only rarely as the months went by. Once in a while we would approach each other on Main Street and one of us would turn or go into a store to avoid direct contact. Both Swensons are now gone, so too Harry Chadwick.

I never heard from the doctor in Florida.