My Big Macher Doctor Describes His Most Interesting Medical Case; How He Narrowly Avoided A Shootout in the Delivery Room…..

Our office at Watertower Place, on the tony Magnificent Mile, across the hall from where Ann Landers got her nails done at Lucille’s, usually went out to lunch once a month or so to connect, discuss interoffice issues and enjoy the generosity of our boss who always happily footed the bill.

We took turn covering the phones, back in the day when you could actually make a call to your doctor and get the response of a real human.  The one left behind always had something brought back from whatever eatery was chosen.

This luncheon focused on Dr. Macher’s courting of a female gynecologist from North Carolina, a graduate of Duke Medical School and I don’t recall where she did her OB residency, but am sure it was somewhere prestigious on the East Coast.   When I say, “courting,” this was not meant to imply that any romantic desires on the part of our brilliant boss were intended, but things could have appeared that way, as doctor wanted this lovely lady to join his practice so badly, I remember him having me call to arrange for Dove Bars, at the time a new rage, developed in the home city, to be shipped, properly packaged frozen, to her home in Durham, with a note on his personal stationary saying that he hoped she would enjoy this taste of Chicago and consider the many benefits of relocating to join his busy and lucrative practice, which he would gratefully welcome.  Doctor Macher may have been rather shy in social situations, but was like Clark Kent changing in the phone booth into Superman (SuperDoc?) in regard to his profession.

Let’s call the target of his recruitment Dr. Leslie Swimmer, the lady put up at doctor’s (or the practice’s for tax purposes) expense at the historic Drake Hotel, that first opened in the roaring 20’s, located nearby.  She joined us for afternoon tea at the Palm Court, (I believe that was the name back then also, but admit I cheated just now and looked it up.)  He really wanted to make her short stay enjoyable and memorable, and made arrangements in advance for  Dr Swimmer to sample the best of the Windy  City, fortunately in lovely Spring time, and had taken great effort in organizing  the aspects of her stay, including reservations and plans for her to experience everything from our famous Second City Improv, to the best jazz clubs,to Chicago stuffed pizza and famous hot dogs, to tickets to a concert by Spyra  Gyra, a hot fusion jazz group  we loved and had seen in Chicago, to the best in ethnic eateries located in their own enclaves, to experimental theater where you walk in and pay like $5.00 off Lincoln Avenue.

I recommended one of my favorite local hot spots for our hoped for recruit, Cafe Ba-Ba-Reba on Halsted.  I recall the first time I went there when a fellow aerobics class member suggested we go to this great, new Tapas Bar.  As I was not familiar with tapas, historically served in Spain, meaning small plates of traditional dishes so patrons could sample many recipes rather than ordering an entree, I thought I heard my exercise companion say, “topless bar.”  I couldn’t imagine why this lady was inviting a group of sweaty women to join her at a topless bar, and I am not the only person who made this mistake, so there.

Their talented chef had morphed this concept into unique and creative menu items, and there was always something new on the chalk board that he had whipped up that day to test via customers whether this would merit the regular menu. Often he walked around proffering samples of his latest, gauging the response as a success or failure.  This establishment is still in business more than 30 years later, so something must have clicked.

The boss had narrowed the candidates to three, and one informed us she recently accepted a position in the much more welcoming climate of California.  I am sure Dr. Swimmer was his top choice as much or even more due to her pleasant demeanor, Southern manners and gentle, sensitive disposition than her stellar resume.

His second or third choice was a Chicago native, so no relocation issue, but she also had a number of offers as female OB/Gyns enjoyed a greater demand than supply.  This doctor had gone to medical school and was friendly with Mauro, an exercise buddy of my then boyfriend, later husband, and we had gone out all together one time.  Doc was all excited,  surmising I knew this candidate well and would have some influence on her decision, but sadly I had to inform him that I barely knew her and there was no romantic involvement between the weight-lifting buddy from Columbia and his former medical school colleague.

A few months prior Dr. Macher discussed with myself and Victoria, our all around street-wise, snarkiest employee (No, I lost this one to her)  his thoughts on adding a female OB/Gyn to the office.  As much as doctor was known for his sensitivity and gentleness, (and this was the 80’s) our boss acknowledged that some women felt more comfortable with a female doctor examing their most private areas as well as discussing said locations, and as his practice was burgeoning beyond what he could even uncomfortably handle, he thought he may as well add the professionals his affluent clientele were seeking.

I recall calling the medical journals, especially the ones in that specialty, to place an ad for a female OB/Gyn to join our practice.  This must have been during the early days of political correctness, as I was informed by the journals that I could not place an ad requesting a female doctor, but the code was to title it, “Wanted Female/Male OB/Gyn for Busy Chicago Practice.”  So, I wrote up the ad, paying heed to current PC standards of the 1980’s, and the office prepared to receive lots of responses.  One problem is that back in those days there were fewer female doctors, and thus fewer females in this specialty, although most women went into pediatrics, OB/Gyn or Dermatology, the so-called, “soft,” specialties more inviting to women in the man’s world of medicine.

In addition, women weren’t treated so kindly or respectfully in the male-dominated worlds of medical school and residency programs, so many of these ladies had developed a tough, hard exterior to deal with the pressures and even harassment, and while perhaps this was already an aspect of their nature, I can’t say.  But it was clear this practice would not find such a candidate suitable, as the last thing our gentle, sensitive doctor needed for his patients who preferred to be treated by a physician of their own gender, would be a tough, hard-as-nails, pushy, insensitive, gynecologist who focused on efficiently treating body parts rather than persons. In other words, you don’t hire a woman, who for whatever reason, carries the worst of male traits.

As the responses came in we forwarded them all to the boss.  His top pick was Leslie by a mile.  Not only were her credentials and recommendations impeccable, Leslie, with her sweet, easy-going, extraordinarily polite Southern manner was the perfect person to service our patients and fit into the close-knit, friendly if occasionally harried, office culture.

We engaged in friendly banter, asking Leslie questions about her life in Durham, hoping to connect and present ourselves as staff she would be happy to work with. As the social chit chat continued, Leslie asked Dr. Macher, “What was the most unusual case you have had?”  Now, at around 45, doctor received his training in the military and had been in practice nearly 20 years, and his sub-specialty was infertility, then a cutting-edge area of medical care and not often easily available.  Doctor wanted to train a younger partner to take over more of his practice as he looked toward retirement, although not in the immediate future, but he did seek more time to spend with family and vacation in Hawaii and other exotic locales, although I think doctor was a bit of a workaholic, happiest when busily engaged in the most challenging case.

I expected our boss to bring up the lady with a sort of double uterus, who he offered to treat at no cost as she had no insurance, due to the uniquely rare presentation of this congenital situation.  For those of you not familiar with the lives of medical professionals, their daily lives are not so exciting and they live for some rare and fascinating case.

Years ago I had a friend whose husband was a dentist. She complained to him how it was often boring being a homemaker, as she did the same tasks every day, the same cleaning, cooking, shopping and carting the kids around.  To her surprise, her husband replied that it was boring being a dentist, although his practice was doing well and it more than paid the bills, as he did the same procedures day in and day out.  In fact, a homemaker likely has more opportunity for flexibility, creativity and choice, as Roberta could decide what to make for dinner, or choose to order pizza instead, and schedule her household duties as she desired and hire someone to help her with her more unpleasant tasks, although she was of the old school that wanted to do everything herself as no one else could do things to her satisfaction.

Andy the dentist didn’t have that luxury, to choose to do fillings in colors to match his mood rather than the patient’s enamel, or decide that today he was going to take the kids to the beach rather than do teeth whitenings for trophy wives from Rancho Santa Fe or less wealthy, yet still spoiled and demanding Del Mar homemakers.  He couldn’t hire someone to take over his cosmetic dentistry cases, the most lucrative, yet the biggest pain in his rear as he explained to us, as a result of unrealistic expectations on the part of clients, although he did his best to make the expected results clear.

Back to Dr. Macher’s most interesting case, and I certainly wasn’t expecting the answer he provided but assumed in all his years of practice, including the military, he would bring up a case that was medically unusual, and so interesting, not one that could have been written by some tv scriptwriter out to create a suspenseful medical-themed drama.

Doctor thought for a moment and then related, “Well, there was the time during an uncomplicated, vaginal delivery resulting in healthy baby and momma, that I wasn’t sure I was going to make it home for dinner alive or in one piece.”  This case occurred during my time with the practice about six months prior, and although the staff, including myself, had met the patient in question, we were never privy to all the lurid details, even though there was no such thing as HIPPA in those days.

Mary O’Mallery* – her name was something like that, suitably Irish to match her blazing red hair, sparkling green eyes, and stereotypical Irish temper.  Both she and her husband were Chicago police officers, and I think hubby was some big shot detective, while she worked juvenile division.  Mary and her husband Patrick were infertility patients of the practice.  I recall Mary telling us how when she learned she was ovulating while at the office for a check, she called her husband’s supervisor at work and told him to make sure Patrick didn’t leave as she had something critical to tell him.

So, Mary arrives, speeding the short distance, (of course police officers in Chicago speed with impunity) to the macho environment of her husband’s profession and hands him a paper bag containing a plastic, specimen cup.  “Pat,” she breathed excitedly, “I’m ovulating right now. Just take your five fingers and go in the bathroom and bring me back a good sperm sample.  I want to get it back to the office before they go to lunch, so hurry up.”  No pressure here, of course.  Now Pat wasn’t happy to mesh their infertility issues with his job, but both of them had been trying to have a baby for a couple years, and the latest drugs and procedures available in the 1980’s appeared to have been successful for them.

A few weeks later, when Mary’s pregnancy test was positive, and when the hormone levels remained high, indicating the pregnancy was going to continue, the couple were thrilled.  I recall Mary coming in for her regular check-ups, and her pregnancy, if difficult to begin, moved along smoothly with no glitches, compared with other infertility cases.  I don’t know about doctor, but the office wasn’t aware that as the pregnancy progressed, the couple began having marital troubles related to Mary’s discovery that big shot detective was having an affair with a young receptionist at the precinct during her pregnancy.  Now many of you are aware that pregnancy seems to heighten emotions and a need for security and stability, and while I never met the husband (s0me of the other staff had, briefly) I knew Mary wasn’t the type to take this revelation calmly, as she never took anything calmly, whether it was good or bad news.

Mary left Patrick to his extramarital excursions and moved in with her sister’s family.  When Mary went into labor, she swore her entire family to secrecy, but somehow Patrick found out, and perhaps he had been calling the hospital, or some officer was stationed at the hospital and annoyed the staff into revelation, and no family member squealed.

Patrick showed up at the hospital in the middle of Mary’s active labor, with doctor and a nurse attending to her, as his point of view was that this was his child, his son – known via amnio, as ultrasound wasn’t of the same quality back then, and he had paid good money out-of-pocket for some of the treatment, and believed he had a right to see his child come into the world, despite the extenuating circumstances of the tense situation between him and his wife.

Doctor had rushed to the hospital from his suburban home, and said he was stopped and threatened with a ticket – I thought doctors driving to an emergency were exempt from tickets and even provided with a police escort to the hospital, but I guess it depends on the mood of the officer, and things have changed.  But when the officers heard the emerging infant belonged to one of their own, the ticketing officer relented and allowed the good doc to hurry on to his business.

Mary was progressing well, a textbook labor case, but first labors are longer, and it would be several hours before she was ready to push.   Doctor was examining his patient for cervical dilation and effacement, the manner in which an OB gauges the stage of labor and  how soon the delivery phase will occur, which if at night determines how long he can nap before coming back to check his patient, or during daytime hours he may be able to return to office patients before shuttering back to the hospital next door in time for delivery.  He called Crystal, the office manager, to inform her of his projected schedule, and asked her to reschedule afternoon appointments that required his presence, asking the support staff to handle routine weight and urine checks.

Doctor was so focused on what he was doing, as he always is, he didn’t even notice as Patrick opened the door and marched into the room.  Mary began screaming nasty words in English and Gaelic at him, demanding the *%^$# cheater leave immediately.  Mary kept screaming, while Patrick quietly wouldn’t budge, his guns at ready.

With Mary demanding her unfaithful during pregnancy husband leave, doctor considered that this guy was not likely to listen to a request in that vein from himself.  In his mind he imagined a scenario of calling in security, and between some hospital security guard and this big shot, highly trained detective – I think he worked narcotics – I wouldn’t place my bets on the hospital to win this one, or even that stirring up already hot passions was going to be beneficial to either mother or baby.  Mary’s labor slowed due to stress, and her contractions became irregular and weaker.

So, doctor calls in the nurse to attend to and calm Mary and then takes Patrick aside to speak with him.  He tells Patrick that he will need to get washed up and prepared with a gown and other paraphernalia to make sure baby wasn’t contaminated with dad’s bacteria and infective abilities and that his nurse would assist him in doing so.  Doctor then informs his nurse that she is to take as long as possible with this process, spending time educating the detective soon-to-be father of the process of labor and hospital requirements to keep mother and baby medically safe and optimum.

After an extensive delay, with Patrick suitably attired, the nurse knocks at the door and they exchange places, with the nurse attending to Mary, while doc goes outside the room to speak with Patrick, who seemed to have calmed down.  Doctor tells dad he may stay in the room and observe the birth, but he must sit in a chair by the window and not budge, and not say anything, and if Mary’s or the baby’s well-being was threatened by his presence, he would need to agree to leave.  Doc got officer’s promise that he would cooperate, as now he thoroughly understood the stakes at hand.  Doc would periodically come over to Patrick to speak to him and explain what was going on and answer any questions, quietly.

Our boss understood that his patient wanted her husband out of the room, yet both were his patients, so he was in a quandary, and given the tense nature of the conflict, he didn’t want to take the risk that hot tempers might lead to something far worse than a patient upset that her wishes weren’t being exactly followed during the birth of her child.

I know Mary and Patrick’s son, named Sean James after relatives, as Mary said, “no way,” to naming her son after his philandering dad, was a healthy and squalling, nearly eight pound baby, whose length suggested he would be tall like his dad rather than petite like his mom, and there was already a smattering of red hair to accompany his squashed little face.  Mine were born by C-section, so we didn’t have this issue.

I don’t know what happened afterward, and as I wasn’t aware of this aspect of our patient, I never questioned the clinical staff for gossip, although Mary did show up sans Patrick for her follow-up visits with baby Sean, who vigorously nursed in the waiting room prior to mom’s check-in.

We brought Crystal, who missed the excitement as well as lunch, back a small salad, some tea sandwiches and delicious British sherry truffle cake. Chrystal was always on a perpetual diet, so she had been drinking a diet coke and eating cottage cheese while awaiting our return with the goodies. I guess Crystal’s phone watching failed to match the excitement of our lunchtime conversation.  “I was sitting there eating my cottage cheese, and this patient calls and tells me, “I have this discharge.  It looks like cottage cheese.”  Chrystal was unable to finish her lunch for obvious reasons, and gratefully accepted the menu items Palm Court had so beautifully packaged for her.

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