(click on picture for perspective)"WE MAY BE SMALLER BUT WE TRY HARDER"
Avis
The first outpatient I saw on my first day of work on Maui was a fourteen year-old boy, and it was then I first learned just how different our languages were.
After introductions and pleasantries I asked him, “What’s the problem?”
“Miiyeneecumsoah.”
"Excuse me?”
“Miiyeneecumsoah.”
“A li-i-i-i-itle slower, son.”
“Meye nee cum soah.”
“O-o-kay….” I opened the exam room door and called for my nurse, a local from Kauai.
“You tell her what you told me,” I instructed the boy.
“Miiyeneecumsoah.”
I turned to the nurse. “Translation, please?”
“His knee hurts.”
“Huh?”
“He said, ‘My knee come sore’,” she explained.
“Ohhhhh.” Clearly, my ability to speak French would be of little use on Maui.
My second patient was a darling little girl who, as soon as she figured out I was a doctor, took a dim view to being examined. After the initial struggle I tactfully moved away. Then she screamed: “All Pow! All Pow! All Pow!”
In the early seventies, the nursery on Maui was different from the one where I had trained at Boston City Hospital. Flowers. Not only did the mothers receive more flowers (Maui is a floral paradise), but the flowers--because of the Japanese influence--were so artistically arranged that you could not remove a single one (say, for example, to take home to your wife) without ruining the display, either in color coordination or shaping. Still I felt uneasy around cut flowers.
Flowers in the wild don’t bother me, but cut flowers do. When I was an eleven year-old at the “Crippled Children’s Home” in Toledo I learned that all the flowers which decorated the rehab hospital were funeral discards. I've never liked cut flowers since then.
“My kid hit me right in da eye!”
“Dat’s nothin’, my kid pissed right ovah my shouldah!”
“Ehhh, you t’ink dat’s somethin’? My boy pissed ovah my shouldah and hit da wall, da li’l buggah!”
I made a point of telling each new father that his baby looked “just like” him. After all, we were certain who the mother was, but…. The fathers beamed at the compliment even if the baby was as homely as a booby prize winner in a baby gargoyle contest. Meanwhile, I became the most popular doc in the nursery.
Another big difference between Maui and Boston was what constituted an emergency, at least in the first few years of my practice. Because I was only one of a few pediatricians on the island, a lot of kids were referred to me by all sorts of physicians. There was no place else to turn. I was it.
One night I received a panicked call from a surgeon from "Lahania", a town on the other side of the island.
“John, I’m sending a seven year old girl to the hospital in Wailuku because she’s in a serious way with one hell of a cough and severe abdominal pain and she's probably at the hospital as we speak and you’d better get your ass over there in one hell of a hurry if ‘we’ are gonna save her.”
While the surgeon's firing off his message in one breath impressed me, the content of the message was alarming. And though my heart froze, my feet did not fail me. I raced (okay, lurched rapidly with my cane) to my car. On the way to the hospital my brain worked in hyper-drive reviewing the differential diagnosis of deadly coughs. I set a speed record getting to Maui Memorial Hospital in my old Mustang.
Waving my cane in font of me like a wand.... "outta my way”..... I stumped to the pediatric unit. Ready to perform CPR, I swung the door to the girl's room open and entered. Inside , a girl sat on the edge of a large bed while her mother sat calmly in an armchair. The girl recognized me.
“Hi, Doc!” she chirped, swinging her legs back and forth as if pumping a swing at recess. She was sipping the Coke her parents picked up at Burger King on the way to the hospital.
This was the emergency? After listening to her parents and examining the girl, I knew that something else was happening. The girl's abdominal pain was from the lung irritating her diaphragm and thus her abdomen. Yes, it was pneumonia....but not a pneumonia that required hospitalization. She could go home, as long as she was stable and could drink fluids.
I phoned the surgeon. “Thank God you phoned me in time!”
“How is she?” he demanded, wheezing with anxiety.
I paused. Diplomacy. “It's penumonia. She wants to go home. But what the heck, we'll keep her tonight. I’ll send her home tomorrow. She'll be fine on antibiotics.”
Silence.
Avis
by John M. Briley, Jr MD
The first outpatient I saw on my first day of work on Maui was a fourteen year-old boy, and it was then I first learned just how different our languages were.
After introductions and pleasantries I asked him, “What’s the problem?”
“Miiyeneecumsoah.”
"Excuse me?”
“Miiyeneecumsoah.”
“A li-i-i-i-itle slower, son.”
“Meye nee cum soah.”
“O-o-kay….” I opened the exam room door and called for my nurse, a local from Kauai.
“You tell her what you told me,” I instructed the boy.
“Miiyeneecumsoah.”
I turned to the nurse. “Translation, please?”
“His knee hurts.”
“Huh?”
“He said, ‘My knee come sore’,” she explained.
“Ohhhhh.” Clearly, my ability to speak French would be of little use on Maui.
The nurse came to administer immunizations. I denied hitting the child (“And you can ask the mother, too!”) Mom and nurse howled till their eyes watered.
“Want to share the joke?” I groused.
“Doctor,” the nurse explained, “she is saying ‘pau’. P … A … U. It’s Hawaiian for ‘finished’.”
In the early seventies, the nursery on Maui was different from the one where I had trained at Boston City Hospital. Flowers. Not only did the mothers receive more flowers (Maui is a floral paradise), but the flowers--because of the Japanese influence--were so artistically arranged that you could not remove a single one (say, for example, to take home to your wife) without ruining the display, either in color coordination or shaping. Still I felt uneasy around cut flowers.Flowers in the wild don’t bother me, but cut flowers do. When I was an eleven year-old at the “Crippled Children’s Home” in Toledo I learned that all the flowers which decorated the rehab hospital were funeral discards. I've never liked cut flowers since then.
“My kid hit me right in da eye!”
“Dat’s nothin’, my kid pissed right ovah my shouldah!”
“Ehhh, you t’ink dat’s somethin’? My boy pissed ovah my shouldah and hit da wall, da li’l buggah!”
I made a point of telling each new father that his baby looked “just like” him. After all, we were certain who the mother was, but…. The fathers beamed at the compliment even if the baby was as homely as a booby prize winner in a baby gargoyle contest. Meanwhile, I became the most popular doc in the nursery.
Another big difference between Maui and Boston was what constituted an emergency, at least in the first few years of my practice. Because I was only one of a few pediatricians on the island, a lot of kids were referred to me by all sorts of physicians. There was no place else to turn. I was it. One night I received a panicked call from a surgeon from "Lahania", a town on the other side of the island.
“John, I’m sending a seven year old girl to the hospital in Wailuku because she’s in a serious way with one hell of a cough and severe abdominal pain and she's probably at the hospital as we speak and you’d better get your ass over there in one hell of a hurry if ‘we’ are gonna save her.”
While the surgeon's firing off his message in one breath impressed me, the content of the message was alarming. And though my heart froze, my feet did not fail me. I raced (okay, lurched rapidly with my cane) to my car. On the way to the hospital my brain worked in hyper-drive reviewing the differential diagnosis of deadly coughs. I set a speed record getting to Maui Memorial Hospital in my old Mustang.
Waving my cane in font of me like a wand.... "outta my way”..... I stumped to the pediatric unit. Ready to perform CPR, I swung the door to the girl's room open and entered. Inside , a girl sat on the edge of a large bed while her mother sat calmly in an armchair. The girl recognized me.
“Hi, Doc!” she chirped, swinging her legs back and forth as if pumping a swing at recess. She was sipping the Coke her parents picked up at Burger King on the way to the hospital.
I phoned the surgeon. “Thank God you phoned me in time!”
“How is she?” he demanded, wheezing with anxiety.
I paused. Diplomacy. “It's penumonia. She wants to go home. But what the heck, we'll keep her tonight. I’ll send her home tomorrow. She'll be fine on antibiotics.”
Silence.
What do surgeon's know about pediatrics? What do I know about surgery? I recalled a wise old professor in college telling me, “Don't always believe what people tell you … even what I am telling you now.” Ah, the life of a doctor.