Carrying the Black Bag: A Neurologist’s Bedside Tales
Author: Tom Hutton MD
Publisher: Texas Tech University Press
Date of Publication: December 7, 2015
# of pages: 240
In his thirty-plus years of practicing medicine, physician and neurologist Tom Hutton discovered that a doctor’s best teachers are often his patients. From these extraordinary individuals, Hutton gained a whole-hearted respect for the resourcefulness, courage, and resilience of the human spirit. Hutton’s patients—and the valuable lessons they taught—served as the inspiration for Carrying the Black Bag.
Carrying the Black Bag invites readers to experience what it’s like to be a doctor’s hands, eyes, and heart. Imagine the joy of witnessing a critically ill five-year-old who, against all odds, claws her way back from a coma and near certain death. Meet a lonely Texas widower with Parkinson’s disease who hosts elaborate pinochle parties for a pack of imaginary canines. Step into the surgical booties of the author when he attempts to deliver his own child amid heart-stopping obstetrical complications—during a paralyzing Minnesota blizzard.
Through real-life patient narratives, Hutton shines light on ordinary people facing extraordinary challenges. Moreover, this captivating tale captures the drama of medicine—its mystery, pathos, heroism, sacrifice, and humor.
PRAISE FOR THE BOOK:
Each story slipped into The Black Bag is a shining jewel, polished to perfection and written with empathy, sensitivity and humor. Hutton brings to life a doctor's unflagging dedication to the human condition as a healer with utmost respect for each patient fortunate enough to be graced by his compassion and commitment. Every tale once begun, entrances.
-Antoinette van Heughten, author of USA Bestseller Saving Max, and The Tulip Eaters
Being a physician is a privilege, in no small part because of the powerful insight it provides into the human condition. Tom Hutton addresses themes of interest to all readers--love, loyalty, family, and mortality, and shows how he could affect a positive outcome, and how he, in turn, was changed by those for whom he cared.
-William L. Henrich, MD, President, University of Texas Health Science Center at San Antonio
How many doctors have you come across who can write this well, especially for the lay reader? He's a natural, that's for sure! Carrying The Black Bag is a must-read for anyone interested in following a wonderful doctor on his rounds.
-Bartee Haile, newspaper columnist and author of Texas Depression-Era Desperadoes, and Murders Most Texan
A wonderful journey through the training, practice, triumphs, and travails of a dedicated physician.
What made you want to share your story and write this book?
One reviewer described Carrying The Black Bag as part memoir and part love story between a doctor and his patients. While unusual, this statement is largely true. The wonderful patients described in my book have by now passed on, making me the last person standing who can share their poignant, humorous, and courageous stories.
The sobering impact of life altering illnesses crystalizes what is most important in our lives, deepens commitment to spouses and families, increases reflection on spiritual lives, or even, in rare instances, as described in the book, leads to revealing hallucinations due to loneliness and illness.
Family caregivers are usually irrevocably changed by intense caregiving and might just discover unknown depths of resolve and determination. Such insights allow intriguing insights into the human condition.
What do you want people to take away from reading this book?
First, I want them to experience a good read. Without reading enjoyment few would continue turning the pages. Secondly, I hope these stories will help others deal with current or future medical problems with greater insight and confidence and be inspired by the patients described.
I also hope readers will develop greater understanding of the importance of good doctor-patient-family communication and how this benefits patient care. The reader should as well enjoy and experience “a behind the curtain peek” at the medical profession.
What is the most important thing you have to do as an author of nonfiction vs. fiction?
Nonfiction must have authenticity as well as be engaging. Whereas fiction can be spun from whole cloth, nonfiction must strive for accuracy, develop context within our life experience, and inform to a much greater extent.
Did you find writing about your life as a physician a difficult or therapeutic process?
Reliving the excitement of a fulfilling medical career was a wonderful experience. Admittedly dredging up the intense challenges, the anxieties of a newly minted physician, and recalling the overwhelming fatigue proved emotionally difficult but overall proved therapeutic and satisfying.
Now that you are retired, what do you say was the most challenging part of your profession?
Doctors along with their families must sacrifice in order for the doctor to be available for patient needs. Illnesses and injuries ignore social calendars. For example, my formally dressed wife on several occasions spent her evenings sitting in a busy emergency room amid feverish people, inebriates, and the injured waiting for her sidetracked husband to finish up. Trudy fortunately was able to accept my demanding schedule. Many doctors were not so fortunate and suffered high divorce rates.
I don’t know if my children realized the effort required to be present for their events, to enjoy a regular family dinner, and make sure family vacations came about. On the other hand, I know I missed events important to them while attending my patients who had first claim on my time. This proved painful for me. Managing these medical versus personal challenges proved the most difficult part of my professional life.
What do you say was the most rewarding part of your profession?
Without a doubt, the most rewarding aspect of my medical career was the unique relationship that develops between a doctor and patient. The doctor/patient relationship is like no other in that trust has to exist. Few other relationships involve this degree of intimacy and sharing of personal information. Open communication also becomes vital in order to provide the best of care. The trust and appreciation shown by my patients proved incredibly rewarding.
Practicing neurology also proved extremely satisfying. Neurological diagnosis requires careful history taking and examination. This teasing out of clues is paramount to making a correct diagnosis. In a way in this day of enhanced medical imaging and laboratory evaluations neurology is an anachronism. Due to the amount of medical instruments required for the examination, its practitioners may appear old fashioned as they still carry black medical bags.
What do you think is the biggest challenge facing medical care now and in the future?
The inherent conflict between the need to combat rapidly escalating medical costs and the ongoing desire of people for individualized medical care presents the greatest challenge to medicine today. Drastic limitations on time spent with each patient driven by third party reimbursements, increased record keeping requirements, and cookbook medicine detract from patient-specific needs.
I hope the art of medicine and careful communication between doctor and patient will not be compromised in a headlong pursuit of cost saving nor will the art of medicine give way entirely to technological advancements such as in imaging and laboratory evaluation.
The sharing of electronic medical records has potential for great benefit. A less attractive aspect is the growing diminished face-to-face communication among members of the medical team. Such institutions as the “midnight meal” for interns and residents may become a thing of the past. Nevertheless newer means of exchanging and gaining further information than from chart reviews and fostering collegiality will be needed.
Any other projects planned for the writing world of Tom Hutton MD?
At least two projects interest me. First I would like to write a sequel to Carrying The Black Bag, perhaps titled Retiring The Black Bag. With the tremendous number of baby boomers retiring each year, a continuation interests me including my own personal challenge taking off the stethoscope and becoming, what my wife refers to as a real person. Further I wish to share the unusual/incredible role an amazing Border collie named Bandit had in effecting this challenging transition. Moreover the colorful people involved in this important phase in my life would provide interesting reading and relatable events. It might prove helpful to others anticipating and hopefully planning for their own retirements.
Secondly, I am interested in writing an expanded version of the account of Adolf Hitler and his medical problems. In addition to his neurological disorder, Hitler had serious heart disease and a litany of other medical complaints and disorders. The horrendous impact that der Führer had on the twentieth century continues to fascinate and too little attention has been paid to the impact his poor health had on his decision-making.
AT THE FURROW’S END
Heavy double doors banged behind me. I located the unidentified woman responsible for my stat page. A glance revealed a small body eclipsed by monitors, a wheezing ventilator, and a virtual spaghetti bowl of wires and catheters.
Somewhere across the intensive care unit, a ventilator alarm shrieked, a telephone jingled, and infusion pumps thrummed. Nurses with intent facial expressions scurried about the unit on rubber-soled shoes, providing care for these, the very sickest of the hospital’s sick.
(Her husband arrives and provides a surprisingly poignant description, transforming his wife in my eyes)
“Doc, do everything you can.” His voice cracked and faltered before struggling on. He finally blurted out, “I…I love that old gal.”
After his description I no longer could think of Maggie Croft as a shriveled old woman with failing physiology. She had become an energetic harvester who had struggled through desperate decades tightly bonded to her husband. She had evoked the strongest display of public emotion of which I felt Ned Croft capable.
And struggle to save her life we did. We addressed her brain swelling to eke out precious millimeters of space within her skull to buy time for the blood clot to recede. We tried every management strategy to salvage the life of Maggie Croft—but in the end our efforts came to naught.
I recall Ned’s slow pace as he departed the intensive care unit. He pushed at the swinging doors, opening them a crack. Ned glanced back at his deceased wife’s body, his eyes vacant. Ned Croft with his tattered appearance and pained emotions was abruptly lost from view as the doors slammed shut behind him. The complexity of love has baffled the wisest sages. But for me, Ned’s simple utterance said it best. “Doc, I love that old gal.”
Excerpt from Carrying the Black Bag: A Neurologist’s Bedside Tales (Texas Tech University Press) by Tom Hutton, MD
Tom Hutton, M. D., is an internationally-recognized clinical and research neurologist and educator. The past president of the Texas Neurological Society, Dr. Hutton served as professor and vice chairman of the Department of Medical and Surgical Neurology at the Texas Tech School of Medicine. He now lives on his cattle ranch near Fredericksburg, Texas.
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