Self Examination: What You Will Never Know About Your Physician

By Thomas Arno MD FACC

Dr. Tom Arno will tell you without reservation that Marcus Welby is an inaccurate portrayal of the American physicians demeanorgrossly inaccurate.

Understandably, in the sixties, we wanted to think doctors were calm and self-assured, but Welby never showed himself emotionally. He was milquetoast-toast, a shoe salesman wearing a white coat. Ben Casey was considerably more believable if only because Vince Edwards, who played the title role, was intense and brooding, lending him an air of professional pique and borderline arrogance.

Truth be told, ole Bens character is pretty close to the real thing with internship and residency when competition fierce and everyones jockeying for position with the higher-ups. Come to think of it, maybe Ben was cranky from fatigue, an occupational hazard, especially during training years.

That is the truth, and I know because I lived through it. The American people need to be informed about the reality of medical school and beyond and how doctors are affected spiritually and physically, personally, and professionally. No one sails through it unscathed; no one is immune.

• Language: English
• Publisher: WestBow Press
• Release date: Oct 18, 2016
• ISBN: 9781512755596

Thomas Arno MD FACC

My book is about what you will never hear or read about physicians. What does it take to train a doctor? What are the strains on his or her family? What are the issues doctors face in and outside their practice? Most importantly, how these problems are solved may very well determine the success or failure of that physician. I graduated from medical school in 1978 and finished my cardiology fellowship in 1983. I am board certified in both internal medicine and cardiology and board eligible for critical care medicine. I took my training and moved to where I was needed the most—in a small town where no cardiologist was within thirty miles. Because of the sensitive nature of much of this book, all names and towns are fictitious.

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Copyright © 2016 Thomas Arno MD FACC.

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ISBN: 978-1-5127-5560-2 (sc)

ISBN: 978-1-5127-5561-9 (hc)

ISBN: 978-1-5127-5559-6 (e)

Library of Congress Control Number: 2016914459

WestBow Press rev. date: 10/14/2016

CONTENTS

Prologue

Dedications

Chapter 1: My Son, The Doctor

Chapter 2: Medical school; my dream comes to fruition

Chapter 3: Residency fellowship and real life

Chapter 4: Fellowship

Chapter 5: Shingle Up

Chapter 6: Time for a Change, Like It Or Not

Chapter 7: Rehabilitation-Would you like a drink?

Chapter 8: Near Death Experience

Chapter 9: Redemption

Epilogue

Acknowledgements

PROLOGUE

N ow retired I can look back, reflect on growing up to become a physician, I loved medical school, residency, and my practice. I became a husband, a father, and a dozen other things. Was I perfect, not even close as you will read. I always tried my best with every patient or project. I learned, perhaps because of a rare disease I contracted, it’s the smaller things in life which make a huge difference in day to day life. Negative thinking is a trap I fell into and it was a very deep hole ending me in drug and alcohol rehabilitation. I learned after retiring, and rehab, that self pity, anger, resentments, all hurt you from the inside out, literally eating you alive. I learned the why after 28 years of medicine, 25 directing an ICU, how and why I ended up years later on alcohol and drugs. Resentments can be overpowering. They were for me!

Today, I harbor no resentments or grudges. I cannot afford to and there is no need to.

Remember St. Paul when he wrote this was a prisoner in Rome giving thanks to the Christians at Philippi for the money to take care of his needs. Paraphrasing him don’t worry about your problems, pray for what you need. It sums up what have learned through much of my life from a precocious 9 year old to a 64 year old wiser man. I say this every day, for I truly believe it is the truth.

DEDICATIONS

T his book is dedicated to my loving wife who stood by me in good and extremely difficult times. She bore three fantastic children, one becoming a physician; who has a PhD in neuroscience, one an outstanding ultrasound technician, and one graduating nursing school. I love them more than words can co nvey.

My wife, however, obtains most of the credit. She watched me prosper, cry, complain and work to the extreme, nearly destroy our marriage. She watched me go through an extremely rare disease, and an end of life experience. Without her support and love, I would not be here today.

CHAPTER ONE

MY SON, THE DOCTOR

A s hard as it to understand, I have known what I wanted to do my with life since the age of eight. I had a love of science that was apparent to both my parents even before I went to school Growing up, my two great loves were medicine and meteorology. As an aside fact, I dreamed about being the guy doing the weather on TV in the 50’s and early 60’s. As it turned out, (apparently), I had a heart murmur as a child. In the 50’s the diagnostic equipment went around the neck, we called it a stethoscope. How quaint! No 2,000 dollar echocardiogram (ultra sound of the heart), the doctors relied on theirs ears, knowledge, and maybe a Chest X-ray. The specialty of cardiology was just in its infancy. My cousin was a cardiologist. At age 9, off we went to see him. When I saw him, I was in awe. I knew what I wanted to do! I really wanted to be a doctor. Many will scoff because at this age, (stop right there), I am stating categorically I wanted to be a physician. Who knew 50 years later, ironically would be both a retired cardiologist, and an operational and broadcast meteorologist.

My parents were supportive of my interest in the sciences, and I read everything I could get my hands on. Most Christmas gifts were geared to the sciences; a telescope, a chemistry set, microscopes and my pride and joy, my very own weather station, primitive to what I use now, but was mine and measured temperature. I learned from reading (no internet or computers then, the net was the library) about clouds, fronts, air masses, humidity and dew points. I learned how to interpret weather maps printed in newspapers I still can remember my first grade teacher telling my parents during the usual parent-teacher meetings that I was destined to be a scientist or weatherman. She noted, in her 30 years of teaching, she never had someone my age that knew more than some teachers about meteorology! My love for the sciences continued and expanded into astronomy, chemistry, electronics, radio, physics, biology and yes, physiology; how did the human body work? I was bored to death with English, literature, languages, music, penmanship (well, I am an MD) and many of the arts. Oddly enough, I enjoyed Civics, American and World history and my test scores reflected it. The science scores (1-10 scales apparently used then in 5th and 6th grades). I scored 10/10 on math and science, 4/10 on non science courses. More on this in a moment.

My parents, especially my father, a 1st generation American who, like many, went through the Great Depression in the 30’s, did not go to college, but instilled a great work ethic in myself and my older brother. I still remember Be your own boss…get an education, go to college, be somebody; drilling into our young impressionable skulls. I remember my father’s father, who came literally over on ‘the boat’ from Italy. I am 100% of Italian heritage and very proud of it and at age 86 the Dept. of Public Works, made him retire. He was in good health and wanted to work. God love him! I loved him dearly, and distinctly remember seeing him with a hammer in his hand looking at me, and speaking in broken English, you a no work you’re a bum! Looking at me with his loving eyes, he told me you must always work hard for what you want. Then said similar in Italian (Lavorare o sei un barbone - roughly the same phase-work or you are a bum). He died near age 90. I admired my father’s dad. Coming over from Italy, starting a new life, his wife having five male children, and the Great Depression. My father’s mother, a quieter woman told me (when I asked about the depression) opening the ‘icebox’, and seeing it empty, she cried, as she did not know how she was going to feed her family. My father and his brothers worked in both the CCC and WPA, sending money home to help his family. That is a powerful statement. He then joined the Air Force as we approached WW II.

How does this story and work ethic affect me? You want something; you work for it, period. You were not ‘entitled ‘to anything. There were obvious exceptions, but allow me to illustrate. I loved astronomy; I wanted a telescope. I was learning about the planets, and a small reflector telescope would be great.

I looked at the cost and shook my head. Man it was expensive, $33 from Edmund Scientific, 3 inch reflecting telescope. I wanted the 4 ½ inch one, but that was 75$, wow, forget that. I believe the conversation would have gone as such: Mom, dad, could you buy for me…No (note, not ‘nope’, proper grammar was important and inculcated in my household at a young age), maybe next Christmas or birthday. I can hear myself now, ‘’But mooooom’’, speak with your father when he gets home from work. Well, I knew the answer before I asked it, you want it, work for it; chores to do, you know the drill. That was that! I wanted it that badly; I would need to work for it. Later in life I mowed grass, washed cars, repaired even some car engines (in the days before everything in a car was a gigantic computer). I even had my own timing light and tools for gapping spark plugs and points in a distributor. It was basic electronics and mechanics 101. Easy!

All I needed was a book to set the timing when the plug would fire (degrees off TDC-top dead center) the in the cylinder. I earned ‘an allowance’ and extra money by changing oil, oil filters, tuning up car engines. Fun and a piece of cake and I was good at it. (in college a friend of mine and I tore an engine apart to repair a head gasket, and put it back together) The work ethic took, and will answer many questions as why I took on directing a large ICU/CCU for 25 years, despite the load.

The other ethic my parents both taught us was compassion, especially toward the less fortunate. I am indebted to both of my parents for that. A young child growing up in a suburb and middle class area, surrounded by similar and equally comparable people, I had no idea what less fortunate was. That was until I went to Junior high and mixed with all students whose parents had different occupations. Now I understood. And appreciated the difference.

I remember a fight in 8 th grade which I was not involved. Fighting then, as today, physically sickens me, although my dad taught me how to throw a punch, I never wanted to. Once the fighting stopped, one kid was bleeding from his nose. I came over, told him, let me help you, you are bleeding, gave him first aid, as I had read the Red Crosses manual, about first aid,until the school nurse kicked me out of the scene. Later that day, he came over thanked me for ‘coming to his aid’. I was, as you will see, the school nerd, I know how he felt being ‘picked on’ (we now call it bullying). We talked and he had no father, just a mom; mocked and ridiculed for having one parent, which began the fight. We are still in touch on Facebook and am in contact with him to this day.

I was lucky as many teachers saw my potential and always gave me extra material to read on topics I just could not get enough of. By The end of grammar school (6th grade back then) I still remember my teacher laughing and shaking his head when I corrected him on an astronomy error. He stopped and asked in mid lecture if I would like to teach the class. Embarrassed and red faced, I declined. After class, we looked up the answer in the World Book Encyclopedia; I was correct. We bonded, and how about this for Irony. When my 6th grade teacher had a heart attack, I helped take care of him, as a medical resident in the CCU! He remembered me, and I him 20 years after the fact! He looked me, "Tommy, I knew YOU would be a doctor!’ *

As time passed, my love for all the sciences continued to grow, but home issues were distracting. My dad was fine; my mother became ill, mentally ill. She suffered (as later I found out) from bipolar illness. Depression and suicide ran in her side of the family, as my aunt hospitalized and underwent ECT (electroshock therapy) for severe depression in the early 60’s. I loved my mother and her sisters. All smoked like the proverbial chimney, which was until the 1964 Surgeon General’s report came out on smoking. I read it, needing some help understanding the bigger medical terms, which teachers in my school did. I told my mother to quit smoking. I explained the report as best I could, for 12-year-old kid.

Unbelievably something I said must have touched a nerve; she did quit, her sisters did not, and one died of heart disease, one of horrendous metastaic lung cancer. I can still picture her all 60 lbs, just before her death.

As high school progressed so did my knowledge of math and all sciences. In high school, the teachers even let me borrow the school telescope for the weekend, as I was charting sunspot activity for a science project to prove areas of the sun rotated at different speeds. I wanted to go to college and be a doctor to help people.