Always on Call: Memoirs, Stories and Essays by a Doctor

By Allen B Malnak

Despite all the odds stacked against him - the untimely death of his father, type one diabetes, severe colorblindness and temporal lobe epilepsy-Allen Malnak didn't allow his humble beginnings and shortcomings to hold him back. "We all face obstacles in our life. The difference in our outcomes lies in whether we succumb to them or manage to over

• Language: English
• Publisher: Allen Malnak, M.D.
• Release date: May 22, 2022
• ISBN: 9798986104607

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DEDICATION

I dedicate this book to my deceased brother Lewis whose courage and talent have always inspired me, to my wonderful wife Patricia, who continues to give me her love and encouragement, and to my terrific, loving children Nancy, Wendy, Peter and my late son Scott.

This book contains some minor embellishments and composite characters.

FOREWARD

by Mary Morris

There’s a knock at the door. It is late at night. You can’t sleep. But that knock sets your mind at rest. The doctor has arrived for a house call. You take your first deep breath in what seems like ages and get up to let him in.

If this sounds like a dream, that’s not surprising. House calls from doctors are as common as seersucker suits and straw boaters, horse-drawn carriages, and police officers helping the elderly cross the street. Yes, an artifact. Lost in the contours of time. But something that stirs joy and wonder in the heart. We want to hold on to that past, the glory of it, and not let go.

Allen Malnak is that doctor. He may be retired now. He doesn’t press the cold metal of the stethoscope to your open breast and listen to what’s inside. But I’m sure, after reading his remarkable compilation of memoir, stories and letters to the editor on matters of pressing public health crises, that he dreams of those days when he did. In fact, those dreams live in these pages. He has poured out his heart, and we have reaped the benefit.

Always on Call: Memoirs, Stories and Essays by a Doctor is the work of a board-certified internal medicine physician who does more than make house calls. He sticks around afterward and regales us with stories that we will never forget. He weaves a rich tapestry for us all. His fears, his doubts, his beefs, his triumphs, his shortcomings, his fighting spirit. Everything but his regrets, and in this, one hears the voice and force of Edith Piaf, "Je ne regrette rien," a song that could serve as the book’s ballad (and a nod to Allen’s love of Paris that glows here).

Allen Malnak’s Chicagoland section will stir memories for those – like me – who were born in the Windy City or call it their home. But this is not the speakeasy Chicago of Louis Armstrong and Al Capone that was the stuff of my father’s stories to me, and which I tried to capture in my novel, The Jazz Palace, but of lesser-known bad guys in the more recent past. When Allen says he was your doctor, he means what he says. At a certain point in time that meant being on the health-care front line, taking calls like, Doctor, please come quick. Momma needs you. They shot Daddy to death in our garage.

  Malnak has a taste for the dark side in his fiction, as I do when it comes to stories about crimes of passion. As a doctor, he doesn’t wince or look away from situations in which bad things happen to good people. That’s life, one feels reading his stories, memoirs and reflections. But beneath it all pounds a caring heart. While there is much here in stories of junkies and gamblers and murderous cads, the flame of a redemptive spirit flickers on.

Dr. Allen Malnak has much to teach us about fighting the good fight. About staying the course and living that dream. He does this by beating the odds. Being severely colorblind didn’t stop him. Or the early, heart-rending death of his father. Nor did his modest beginnings in old Chicago hold him back. Allen Malnak lived the noble, inspiring life he was meant to live, and he tells us about it with pride, a sense of wonder, a physician’s precision, and with the soul of a storyteller. And in these poignant tales, he brought this reader home.

PREFACE

The true alchemists do not change lead into gold; they change the world into words.

— William H. Gass

One doesn’t ask of one who suffers: What is your country and what is your religion? One merely says you suffer. That is enough for me. You belong to me, and I shall help you.

— Dr. Louis Pasteur

INTRODUCTION

Allen, you may want to become a doctor, but with your severe colorblindness, you’ll never be able to get through chemistry or bacteriology. Since you were too young to serve in the army during the Second World War, you aren’t eligible for the GI Bill. After the untimely death of your father, you can’t even afford to go to college. Might as well forget it.

Life stories begin in disparate places. Mine started in a spare high school guidance office in Chicago, Illinois. The words above were spoken to me by a school counselor who had every reason to guide me in the way that she did. Suffice to say, I didn’t take her advice, and this book bears witness to that fateful decision, one that in a long life of over nine decades I do not regret.

We all face obstacles in our life. The difference in our outcomes lies in whether we succumb to them or we manage to overcome them. In my case, I was able to realize my dream of becoming a doctor despite being severely colorblind and, later in life, being diagnosed with type one diabetes with all its complications and temporal lobe epilepsy. Through these memoirs, stories, letters and commentaries, follow me as I fight to overcome these physical and emotional barriers to become a successful physician.

Like most colorblind people, I relied on coping strategies during my working years to keep my disability a secret from everyone except my closest family members. Perhaps color confusion is a more accurate description than color blindness since I do see some colors. Still, I often mix them up or confuse them, which is why, I’m sure, as a teenager, I was counseled against a career in medicine where such mix-ups could have terrible consequences. Another related situation involves color ignorance. Words like magenta and turquoise have no meaning for me. Sometimes when I hear a word like magenta, I will ask, If you need to mix paints to make that color, what primary colors would you use? Seldom do I receive a satisfactory answer to that question.

I feel blessed that after each of these heartbreaking setbacks, including the death of my father when I was still in high school, I felt steeled–rather than derailed–in working to accomplish my goals.

Whenever a medical student, an intern or a hospital resident asked me what it takes to become an excellent physician, I usually quoted an old saying we call the three A's of medicine. They are in order of importance availability, affability and ability.

But I don’t understand, they often say. How can you put ability last?

My answer would be, Let’s say a patient has the three best Mayo Clinic trained doctors a block away, but they cannot get an appointment in a timely fashion. Or when the patient sees the physician, the doctor has the personality of a wastebasket. Just not interested in the problems bothering the sick patient. Focuses more on typing a few sentences into a computer to ensure payment.

Most young docs catch on right away that no matter how smart that type of clinician is, they won’t give patients the care they require.

As a writer, I got my start decades after that fateful day in the high school guidance counsel office. Upon my retirement, my wife and I moved to Florida, where one day, I noticed an article in the Naples Daily News that described a fiction writing course being held at the Naples Philharmonic. The teacher was Hollis Alpert, a well-known novelist, biographer, short story editor as well as a movie critic. Before working with Hollis, my writing was limited to nonfiction involving professional medical material. I took Hollis’s instruction to heart and learned the craft of short story writing. He would critique each story and, at the next weekly session, read some of them to the class. That’s how I learned to write short stories. I followed the mantra of write—rewrite—get it right. The training also helped in the 2011 publication of the historical thriller Hitler’s Silver Box.

As to my fascination for crime fiction, which makes up for a large part of the stories in this book, I didn’t pick that up in medical school. Maybe a lifetime of being a doctor in Chicago played a role in that passion. For that, I owe a debt of gratitude to Kojak.

Doc, I’ll bet you’re always looking at people trying to figure out what’s wrong with them. As for me, I’m sure they already have or are going to commit some crime. That quote came from the mouth of D. Joseph (Joe) DiLeonardi, my brother Lewis’s brother-in-law and Chicago’s ultimate cop. Over the many years he served and protected the citizens of that great city, he went from a patrolman to citywide homicide commander to acting superintendent of police. Later, he was a Federal Marshal. Always a dapper dresser and totally honest, it’s claimed Joe was the role model for the TV detective series Kojak.

Joe and I had many conversations about crime. He brought me up to date from the little I knew from reading those dime true crime magazines during my youth, and that interest undoubtedly led me to write several noir crime short stories—the best of which appear in this volume. Once, when a schizophrenic patient threatened to kill me, Joe volunteered to come to my office on the two nights a week I had late office hours. He simply sat in my waiting room armed and fully alert until the lady was apprehended and confined to a mental institution. When I think of my crime fiction, I remember those dark nights when Kojak came to protect and serve.

Later, when I was working on short stories in Hollis’s class, I found that I also had a knack for warriors of a different type–those in distant battles in distant places. I include three of my favorites here: The Emperor’s Prophet about the battle of Waterloo in 1815 and both The Letter and well as Visit From a Stranger–stories about our Civil War.

Always on Call is divided into four parts: Part One, Beginnings and Hardships; Part Two, At the Hospital; Part Three, More Stories; and Part Four, Letters from the Doc. Stories and memoirs intermingle in the first two parts, with stories in the third. The fourth part is devoted to select letters and commentaries I wrote on medical issues and current affairs that were published on newspaper editorial pages. In all cases, the fiction and memoir material is clearly indicated.

Hopefully, this book holds life lessons for all, but I feel a particular affinity for those readers who suffer from significant disabilities who will see in these pages a pathway to success—whether it’s applying for medical school or chasing a dream that otherwise seems beyond their grasp.

PART ONE

BEGINNINGS

AND HARDSHIPS

Whooping Cough: A Memoir

It came on suddenly in the middle of the night. I couldn’t get my breath. Began to shake with chills. Then the coughing started. Not like anything I’d felt before. I coughed so hard my chest began to hurt.

The sound of my coughing woke my mother, who raced into the room. She felt my head and said, Allen, you’re burning up.

As soon as she heard the high-pitched sound that followed a deep cough, she said, Oh my God, my little boy has whooping cough.

The year was 1934, and I had just turned six. We lived in a small two-bedroom house, so to safeguard my eight-year-old brother Lewis, who shared the bedroom with me, Mom swept him up and moved him onto the living room couch for the night.

Morning was slow to come. Mom hardly left my side. She made me a soft-boiled egg for breakfast, but I couldn’t keep it down. The room quickly took on the unpleasant odor of vomit. After a while, I could no longer smell it, but when Mom came into the room, it obviously bothered her.

She placed cool washcloths on my forehead. When eight o’clock finally came around, I heard her call our family doctor on the party line. Just knowing the good Doctor Clarence Kelly would be coming to help me made me feel better.

After a few hours, I heard a car in our driveway. Since I knew Dad was at work, it could only be Dr. Kelly.

Hi, Buster, he said, smiling at me from my bedside. He tried to place a thermometer under my tongue, but my coughing didn’t let up, so he had to put it under my armpit to get a reading.

After the examination, he wrote out some prescriptions for me and some instructions for Mom. I remember that he suggested that she freeze orange juice in an ice cube holder. She was then to take out the cubes, smash them into bits and spoon-feed them to me.

After he left, even though there were not yet any antibiotics or other effective treatments for whooping cough, I began to feel better. Of course, I was unaware of the power of the placebo effect. Later as a health professional, I often thought back on this experience as a personal example of how effective the placebo effect can be even when dealing with a serious illness.

That afternoon a man came to the front door and put a whooping cough quarantine sign on it. It warned that children could neither enter nor leave the premises.

The following days were a blur. I coughed almost constantly.

It took a number of weeks before I completely recovered from what could be deadly to children in those pre-antibiotic days.

After this bout with a severe illness, I set aside my dreams of becoming a cowboy or a soldier. From that day on, I became determined to practice medicine and help people overcome disease. My hero was Dr. Kelly.

First Love: A Memoir

The sweat trickled down my back. The hot air seemed almost liquid, making it difficult to breathe. We were playing catch, Frank, who lived across the street, and I. Both of us were nearly fourteen, but he was half a head taller and had a more muscular build. I was short, slender, lithe and quick. It was the summer of 1942, and we had been following the details of the European war, plotting troop movements on a large map with colored pins, as the information came over the radio every evening.

I heard my dad’s clunker of a car pull into the driveway before I saw it. The problems of running a failing junkyard in a small southern Illinois town were unsettling, but dad was usually upbeat.

Hi, boys, are you enjoying the sunshine?

We nodded and continued throwing the ball back and forth.

Looking at me, he said, I have to drive over to Pinkeneville this afternoon to look at some iron and metal at the Johnson farm. Would you like to go with me?

  A jolt of excitement surged through me. Even though I had only seen Ruth Johnson once and was certain she wouldn’t even recognize me, I desperately wanted to see her. Not to talk to her; I didn’t have that much nerve. She had long blonde hair, big eyes and a perpetual grin. Naturally, she was taller than me—already fourteen and almost had an adult woman’s figure. Living in towns about twelve miles apart, we had no friends in common, but I had heard stories about her, suggesting that she was popular and fast.

That afternoon it was hard to eat lunch; my stomach was full, feeling like a fist was stuck inside. Finally, we were on our way, passing the many farms as well as several of the seven bituminous mines that surrounded our town. The Johnson farm was isolated, and we had to traverse a mile-long dirt road. The dust was thick.

When we arrived, I said, It looks like a large shack. I don’t see how anyone can live there.

They don’t have electricity or gas, Dad replied, but they’re proud, decent people. Pretend the state of their home isn’t important to you.

We were greeted loudly by Shep, their German Shepherd, who joyously jumped on me, licking my face and shaking me up more than I already was. Mr. and Mr. Johnson came out, but there was no sign of Ruth. The porch had so many loose boards that I walked carefully, my head down, tracing each step. Once inside, there was no relief from the heat. The smell of kerosene,

which we called coal oil, was overwhelming.

Take the load offen your feet and have a glass of lemonade, the lady of the house said.

We sat at a creaky kitchen table and drank a pitcher full of delicious, fresh lemonade. I noticed the new, bright yellow curtains on the windows, in contrast to everything else, which was old, faded but clean.

Mr. Johnson had a ruddy complexion, was tall and muscular, and spoke with a slight Southern drawl. His eyes were bloodshot, and I noticed a lot of broken blood vessels on his nose, which seemed a little swollen. His wife was slight, pale and in constant motion. Both were neatly dressed. Still, no sign of Ruth, as we made small talk, then went out to inspect and haggle over the junk, which was piled up in the yard. There were several large pieces of various types of old farm equipment, plows, a decrepit tractor, an old truck and car, as well as various shaped, rusty tools and implements that I didn’t recognize.

As soon as the men were finished with their business, Dad was ready to leave, but I stalled in every way possible. Couldn’t we have another glass of that lemonade or at least some cold well water?

Actually, the latter had a strong sulfur taste, but I would gladly have drunk the well dry to gain time in order to catch a glimpse of Ruth Johnson.

Wait, Dad, I have to go to the bathroom, which meant the smelly outhouse.

As we were saying our final goodbyes, standing on the rickety porch, Ruth suddenly appeared.

That moment remains like a slow-motion movie in my mind. Ruth was wearing a short, pink dress, kind of frilly, with a blue bow on her left shoulder. Reams of blondE hair reflected the light of the fading sun and made her lovely face glow. But what gave me the greatest and longest-lasting impression were her shoes—no, rather, they were beautiful, mid-calf white calf-leather boots. Despite it being one of the hottest days of the year, on her, they did not look out of place but were the perfect complement to her long, sexy legs.

Surprisingly, she greeted me by name. Jack, it’s good seeing you again! It’s been a long time.

She turned on a smile that would be in my daydreams for a long time. I had read about stage fright, but up to then hadn’t experienced it. Now my legs got weak, my heart raced, my hands trembled. I barely groaned out, Hello. And the next thing I remember is pulling into our driveway back home in town.

I didn’t sleep much in the following days. All my energy was directed at overcoming the great distance that separated us—twelve miles of highway. There were no buses or trains that connected us. None of my friends drove. Hitchhiking was considered a capital offense in our home, even though I had gotten away with it a few times.

But a little over a week later, my luck changed. Dad was sending a truck to pick up the junk from the Johnsons. Overhearing him talk about it, I said, Dad, I’d like to go along with Tom when he goes to the Johnsons tomorrow. Would that be okay?

I guess so, but you’ll have to call and ask if you can stay around the house. I don’t want you getting hurt. Tom’s taking a couple of men with him, and they will be cutting up a lot of the iron with acetylene torches. It’ll take most of the day.

I was more scared than excited about the idea of seeing Ruth. Thoughts raced through my head at a thousand miles an hour. What will I say? Who will I speak to? What if Ruth won’t be home? What if they say no?

Finally, I wrote and rewrote detailed notes to have in front of me in case my mind blanked out.

Mrs. Johnson answered the phone about my desire to visit and said, Why that’s wonderful; maybe I’ll prepare some fried chicken, and you and Ruth can go on a little picnic. I thought I’d burst with relief and happiness.

That day at the Johnson farm, I didn’t mind the dusty dirt road or the humid heat. I didn’t notice the porch or the crumbling house. All my senses were filled with Ruth, who happily wore the same outfit, down to her beautiful white boots. She seemed to sense my shyness immediately, handed me the picnic basket, took my other hand, and led the way to a little grove of pine trees. Her touch sent waves of desire through me as if the acetylene torch was a few inches from my body. We spread an old sheet on the ground and spent the most glorious four hours of my young life. We spoke of our families, our hopes and dreams, our plans.

As long as I can remember, I’ve wanted to be a doctor, I told her. My dad’s business isn’t doing too well, and I don’t know what my future will hold if he goes broke, I confessed.

It was not like me to pour out my innermost thoughts to a stranger, but at that moment, I somehow felt deeply connected to her.

Ruth had similar dreams. I just want to finish high school and get out of this house and this cruddy little town. When I get to Saint Louie, I'll find a job doing something fun. I’ll live in a lovely apartment overlooking the big river. There will be fresh flowers on the table...

We lit up Camels. I had only smoked a little before and had to fight to keep from choking. At the end of the day, as we walked back to the house, Ruth suddenly threw her arms around my neck and without a word, kissed me full on the lips. I almost fainted! I dropped the basket and tried to grab hold of her, but laughing, she ran ahead of me to her porch.

A few weeks later, my dad’s business went under, and we moved to Chicago. I only saw Ruth a few times before the move, but somehow the knowledge that we were leaving, as well as the emotional turmoil our family was suffering, took the magic away. I never wrote back after we arrived in Chicago, although I often thought of Ruth Johnson. For more years than I would like to admit, the mental picture of those white boots, and yes, the awful smell of kerosene, turned me on!

The Intimidating Marchers: A Memoir

Nate, did you watch our little parade goin’ by your house the other night?

Yes, Chief. Kind of scared my boys. We all watched from our bedroom.

Got nothin’ to worry ‘bout. Ain’t enough you Jews to matter none to us. We got them Negros, foreigners and Pope worshippers to think about. On top that, you being a war vet, why we even let you in the American Legion.

Dad frowned. You don’t mind when I lose to you at poker.

Got that right, the chief replied.

Guess you Jews here are lucky. Most of our kind don’t take kindly to Jews. Kinda consider you people as God killers.

Dad locked eyes with the officer. Never understood why you dress up like you do and what you stand for.

Can’t talk about that with someone who’s not a fellow Knight. I can tell you we’re against equality for them sambos, socially and politically, and in favor of a white man’s government in this country. We’re God-fearing Protestants.

The Chief of Police occasionally stopped by Dad’s small junkyard to pick up an old part for one of his teenage son’s cars. This time he was after a carburetor, which Dad found and handed over. No charge for this little item.

As the chief began to walk away, he turned and said, "You know what would make my job easier and keep them others in check?’

What’s that?

If like several close-by towns, ours was a sundown city.

Don’t know what that means.

Simple. Means no colored allowed out of their homes after dark.

But don’t most of them already live on this, what some call the wrong side of the railroad tracks?

True, but they can still come over and even go to the movie pictures on our side. They can only sit in the balcony, but they got a shitty little movie house on their side. Let ‘em use that. Dammit, we don’t even have a hanging tree.

Just before he entered his car, the chief turned around and said, "Just a minute.