tales from an anesthesiologist

HOWARD E. HUDSON, JR., MD

Iam a retired Anesthesiologist from Lehigh Valley Health Network who shared an experience with the Northampton Chapter of the American Wine Society (March 2023). As a beginning Anesthesia resident at the University of Pennsylvania, I attended the national convention in San Francisco in September 1969. The keynote speaker was Robert Dripps, MD. The topic of his speech was “The Importance of Serendipity in Patient Outcomes.” Three years later I would experience how important. In my third year of residency, I was working in a lab with no call, no weekend duty and no holiday call (life was good, I could finally catch up on lost sleep).

I took a 24 hr. call in the emergency room of the Delaware Hospital in Wilmington, Delaware. In early September on a Saturday, I parked in the hospital lot and walked into the emergency room. The clerk of the ER greeted me with “We are getting a child from down state...in “status epilepticus.” I asked the clerk to page the pediatric resident. In minutes the pediatric resident arrived and asked are the parents with the child? Do we have a contact number? He got the parents and a good tentative diagnosis. The parents were from Central America and spoke no English, but the pediatric resident was Spanish. He next called the hospital librarian and requested the most up to date treatment for lead toxicity, both drugs and dosage. Next he called the pharmacist and requested the pediatric size and dose of chelater and diuretic.

The child arrived and was seizing. I gave oxygen and when the seizure stopped, I started the appropriate size jelco. When the next seizure started, the pediatric resident produced a syringe of amital and began to titrate the amital through the IV. The seizure stopped. I asked the resident to count respirations and he replied zero. I gave three breaths and inserted the appropriate size endo-tracheal tube. The assembled group took the child and equipment through the hallway and up the elevator to the pediatric ICU.

When the ER became quiet in the afternoon, I asked the clerk how to get to the pediatric ICU. To my astonishment the little boy, who arrived in “status epilepticus,” was pushing his IV pole, walking to all the other childrens’ beds and handing out toys and huggies, talking up a storm. This little guy invented the job description of Play-Lady decades before smart adults did.

So why were three NC members of the AWS interested ? All three chemists are working on Pennsylvania State safety and health standards for the fifty-thousand PA employees who work with heavy metals daily. In 1969 a group of complete strangers came together to treat acute lead toxicity (in the only hospital available to that child). In 2023 three Northampton chemists are working on safety and health standards to protect the 50,000 PA employees who work with heavy metals daily. Was the Delaware Hospital event part of my “learning curve” or “serendipity”? Let archivists and historians decide!