Archive for the ‘med school days’ category

The Country Doc Rule Number Two- 16 Seconds Won’t Cut the Gig

July 15, 2009

        “Sixteen seconds won’t cut the gig.”  There’s  a song in there somewhere.

         I think it was Dr. Groopman who quoted the study.  On a routine encounter Docs let their patient talk sixteen seconds before they interrupt them, make a diagnosis, and reach for a script pad.   

          Wow.  I hope I am not that bad.  If I am, me and Julius are gonna go to the River and get baptized and rededicate ourselves to our profession.  Sixteen seconds is unacceptable.

        There is an old saying in medicine, and like many cliches it is true.  “If you let the patient talk they will tell you what is wrong with them.”   And I have found it only takes them a little while to do it.

        It is time well invested.  I have been told I have a reputation as a good diagnostician.  If I am I’m humbly grateful for that and hope to never take that blessing for granted.  Today though I must tell you this reputation is because I have good patients. 

        My standard routine is to ask the patient, “Hey Ms. Smith, what’s troubling you today?” and then let them talk until they have finished telling me.  95% of the time they have done so in five minutes.  At what it costs to go to the Doc these days, it doesn’t seem like much to ask for to me.

         Some of this works because most of my people have been seeing me for decades and I know them inside out.  What I can’t figure out has been sorted through by the best army of specialists on the East Coast this old boy could assemble.  I know which ones are reliable (and most of the Docs out there) and I count on them to help me out.  The few who proved indifferent were cast aside long ago.  I don’t give a $@^^ if they send me a country ham ever Christmas till Hades freezes over, they ain’t gonna see my people.  

        Here is a technique I recommend.  If we have anything close to a slow day, and sometimes we do mid summer, Julius and I will go into a room and I’ll issue my standard greeting.  Then I’ll sit down, prop my feet up and say,  “Look.  We’re having a good old lazy summer day, and I had a cancellation.  We got time for you to tell me anything you want.”

        The only problem is often folks are so shocked they can’t remember why they came to to the Doctor.  Then I’ll say, “That’s O.K.  Everyone has the same reaction.  It is a sign I haven’t been giving you enough time.”  Then they relax again and we get serious about the issue at hand.

         I wish I could tell you I am perfect, and do it right every time.  I don’t.  But when I fail I am sorry for it.  I remember one day when everything was going wrong.  I was rushed and distracted.  Late that morning, one fellow called me back.

        “Doc, I know you were having a bad day, but you cut me short.  I didn’t get to tell you what was wrong with me.”

          Dang it.  “Tell you what, Joe.  You come back over here at 12:30 and we’ll sit down and eat lunch together.  I’ll hear out anything you need to tell me.  We go back a long way, and if I get run over by a truck tomorrow I don’t want your last memory of me to be that I let you down.”

          He is still my patient.  In fact I am proud to say my last chart transfer other than someone moving has been a long time.  If we have someone leave, I’ll call ’em and ask why.  That what I did with the last one and  think it was three years ago.

         16 seconds.  Man, I am not sure how I am gonna be remembered, but I want it to be better than that.  I believe Julius does too, so I think I will make the 16 second rule my next lesson for him.

Dr. B

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Our Monday Medical Lesson

July 14, 2009

         Julius and I are gonna try to post one lesson a day.  (We may save them up and do a few at a time)

        Yesterday we saw a man with some vague chest discomfort.

         “Son, what is your number one priority here?”

        “Country Doc rule number two.   Make sure to think of anything that might kill them before you get a chance to see ’em again.”

        “Correct,  A+.”

        I am pleased to tell you the patient passed his treadmill today.  Their gallbladder ultrasound is tomorrow.  We think it might be positive; they had some nausea after meals.  We’re gonna get a cup of coffee and relax.  It ain’t gonna do ’em in before morning.

Dr. B

Med Student Julius Comes to Harvey County

July 13, 2009

        Y’all the Internet is a miracle.  A West Virginia med student named Julius got to reading my blog, and we began to exchange ideas. The next thing I know he asked if he could do a rotation in Harvey County.  We have had a number of med students from my old alma mater, Sandhills U., so I told him if his school would approve the elective, we’d be glad to take him on.  

         Here’s a synopsis of the proposal I sent the University.  (And they still said yes!)

       To the Dean,

        Yes sir, we would be more than happy to take on Julius for his fourth year Community Medicine rotation.  I am an adjunct Professor at Sandhills University, so we have a well established curriculum.  I feel I must outline my expectations before the rotation starts.  Julius has written me several times, and I am confident he will have no problem with compliance, but I want to be sure future students understand the Harvey County Doctor Gig Rule Book before they apply.

        1.  All students must treat my patients with respect and dignity without fail.  This is the number one rule and they can not break it and expect to pass the rotation.

        2.  The student must never forget Temple’s Law numer one.  (A woman is pregnant until proved otherwise.)  To date, I have never x-rayed a pregnant woman and we aren’t gonna start now.  (Thanks Dr. Peter Temple)

       3.  The student must follow me every where I go.  You can teach them about rhabdomyolysis as well as I can, but I hope to show them how to survive in a country town for many decades and stay out of trouble.  If I go to the office, they must go there also.  If I read, they read; if I sleep they can sleep.  (The only complaint I ever got was there was no rest for the weary.) 

        If I play music at the Nursing Home they must help haul sound equipment.  If they sing at all we’d love for them to join in.  I believe music is good for a Doctor’s soul.  When I eat breakfast at Harvey Billiard and Bowl they must join me.  The liver mush and egg sandwich is excellent. 

        We will eat lunch at Chang’s Chinese every Friday at least if there is not an emergency.  Meals will be covered by the ‘Starving Medical Student Foundation.’  We will provide a complimentary lipid profile at the end of the rotation.  However, in spite of the country diet, so far I’ve run all of them so hard no one has turned up with dyslipidemia.

        4.  The student is allowed two fine Cuban cigars per week.  Beyond that I don’t want to know.

        5.   Julius will be here in July, and must attend the office picnic.  It will be held at ‘Six Flags Over Harvey County,’ our local amusement park.  We will have hamburgers, hot dogs, watermelon, sweet tea, and ice cold Co-Colas.   He must concede Dr. B is but a large child, and play one round of Putt-Putt and ride in the bumper boats and shoot water pistols at the other children.  (and take extra care not to aim at their eyes)   

        (An aside here.  The man who started Putt-Putt was gonna call it Putt-Hut but got in a long line at the bank.  While he waited on his loan officer he changed his mind.  The rest is a franchise history.)

        The student will split a large bucket of range balls with Dr. B.  The go-carts are optional, and he must not make fun of Doc for no longer getting in the batting cage.  My eye surgery went fine, but a 95 mph fastball is too much for this over grown boy.  It might dislodge my cataract implant and I don’t want to upset my surgeon.  He did some great work, and I wouldn’t hurt his feelings for anything.

        6.  The student must at least pretend to like bluegrass music and must attend a minimum of one session at the Bomb Shelter to get an “A+”

       7.  The student must understand sudden death is against office policy, and agree to abide by said written policy.  Every case of indigestion is a heart attack waiting to happen until we prove it ain’t, then we can get out the Tums.  So far no one has been pronounced well and then dropped dead in my parking lot.  I know it could happen  tomorrow, and when it does it’ll break my heart, but we will pray hard for it not to be this month.  (or any other time)

       8.  We will be nice to all patients, even the few who are mean to us.  After all, they are on the wrong end of the stethoscope for the day, and our problems ain’t as bad as what they are going through.  

        9.  We will tip well when we are out to eat.  I might be a ‘low end provider’ (trust me, I am the Family Dollar Store of Medicine) but I still make more than what I’m worth.  A lot of those kids waiting tables for us are my patients.  Many of them are single moms trying to survive.  They are a lot worse off than me.

        10.  The student must agree to accompany me to out of town shows which my wife is unable to attend.  He will agree to split any road trip driving time after midnight with me 50/50 so my Marfar won’t worry.  If she can go he must sit in the back seat, or better yet he can drive and we’ll sit in the back.  (She’s gonna get after me if I write any more than that.) 

       11.  I will pray hard for no hits, no runs, no errors, and be humbly sorry if I hit a foul ball by mistake.  In exchange, God has promised me a nice spot in Heaven where I can hear waterfalls every day and have a perfect view of all the rainbows.  My mandolin will stay in tune for eternity, and with no sickness there I can hang up my stethoscope and retire for all time.  I’m too close now to not make good on my reservation.

        On other words, while he is here in Rome all he’s gotta do is act like a Roman.  It shouldn’t be hard; after all his name is Julius.  I’ve got a feeling he’ll be able to live with the rules.  We’re gonna have a good time of it.  Call me if you have any concerns.

Dr. B

Professor Bibey Returns to Country Doctor Life

January 11, 2009

        My med student got an ‘A+’ on his rotation and went back to Sandhills.   When he left, I had to revert back to just Dr. Bibey, country doctor.  No more Professor Bibey, at least for now. 

         This kid was extra special.  Not only did he treat all my people with dignity and respect, but the young man had the good sense to treat me like I had enough wisdom to be worth his time to hang out with me.

        I explained at the onset I couldn’t teach him the finer points of rhabdomyolysis as well as his Professors, or what he could read in Harrison’s Text Of Medicine.  I hoped I could show him how to live in a small town and stay out of trouble; to to be kind to people, how to accept criticism but not tolerate abuse, and how to work and study but still enjoy life full throttle.

        I have a saying I like- “I’ll do all my crying ahead of time.”  It means I’m gonna do all I can for my patient while they are here.  I think about them all the time.  If I can’t figure out what to do, I call on one of my consultants to give me a fresh perspective.  I have built up a lot of social capital over the years, and one of them will help me out.  The funeral is not where I want to think of something else I might have done.

        I hope I taught him about redemption, too.  The only Perfect One died on the cross, and all of us are gonna fall short.  The trick is to do our best, but also accept we are only human.  It is the best we can do.  In the end we are going to lose every patient we have, and it hurts every time.  You have to find some way to carry that burden.  For me it was playing music and writing.  It beats drinking whiskey, although I can see how a Doc could turn to it easy enough.

        We had a time of it.  We saw sick people and heard out the troubles of both young and old.  We ate good and drank a bunch of coffee, picked music with the great Mike Marshall, and talked of books and plans.  He’s just getting started and I’m on the home stretch, but a man’s gotta have his dreams and we both do.  He said he was even gonna consider coming to Harvey County to practice.

        If he does I want for him to look after me when I’m in the Nursing Home or over at Harvey Hospital.  He’ll know when my time has come.  If he has ’em play Bill Monroe in my ear, and then put coffee down my NG tube; well if I don’t come around it’s over sure enough.  I don’t want him to worry; it won’t be his fault, but just a thing- my time to go.

        “But,”  I said.  “Don’t worry about that, we gotta a lot more time to keep on rocking, and not in the chair yet.”  We couldn’t say good-bye.  Instead I’ll say, “See you on the next rotation.  Keep at it pal, you’re one of the good ones.”

Dr. B

Starving Medical Student Foundation

December 19, 2008

       As a follow up to yesterday’s post, I thought I’d tell you about the Starving Medical Student Foundation.  (SMSF)  It has been funded exclusively by Dr. Tommy Bibey for many years.

        There is only one hitch to it.  On Friday, the student must eat at Chang’s Chinese.  I’ve had lunch at Chang’s every Friday, at least if in town (which is usually) and if there is not a life threatening emergency (there usually is not) for the last twenty years.  It is so predictable that when my daughter used to come home from college if it was after 12:30 she didn’t bother to stop at the office, but went straight to Chang’s.

        The SMSF has worked out fine.  Most of the students in debt up to their ears, and welcome a free meal almost as much as a hobo.  And Dr. B gets to choose the venue- they have no choice in that matter.  I get in some great conversations with bright young people I normally would have little access to.  I understand they even text message that for an old guy, Bibey is pretty cool, which is all the reward I need.

        So, we’re off to Chang’s.  Talk to you later.

Dr. B

Professor Bibey

December 18, 2008

        Y’all aren’t gonna believe it, but I’m a med school professor.  Well, not full time, but I’m serve as one of the community medicine preceptors for Sandhills U., my old Alma Mater.  Indie used to do it, and he was the best one there ever was.

        I really like this last kid they send me.  He’s well read, and kind to people.  It didn’t hurt his ’cause any that he’d done a paper on Flatt and Scruggs in college.

        I sat him down the first day and told him what I expected.  “Son,” I said.  “Don’t tell ’em back at the med school, but this might be the easiest ‘A’ you’ll ever make.”

        “How’s that, Doc?”

        “Well, all you have to do is treat my patients with respect.  And when you leave this office, you can’t talk about  ’em.”

        “No problem.”

        “Now.  The State Board Medical Board says we shouldn’t treat friends and family.  After three decades, that’s all I’ve got.   You report me and I’ll do everything I can to see you don’t get a liscense.”

        “Yes sir.  You can count on me.”

        “All I can really teach you is how to stay out of trouble.   I’m not gonna teach you the differential diagnosis of hemolytic anemia as well as Dr. Woodley down there will.  But I can help your gestalt.  For example, if anyone here has any complaint from the waist up and they’re over forty- five, you consider it heart ’till you prove it ain’t.  It usually won’t be, but you can’t miss anything that might kill ’em before you get another try at it.”

        “A little scary.”

        “Don’t worry.  I’ll check behind you on everything.  So far, it doesn’t count for you.  I’m just gonna help you to be ready when it does.”

        “And don’ t forget Temple’s Law.  Very important.”

        “Huh?”

        “Temple’s Law number one.  ‘A woman is pregnant till proved otherwise.’  In all these years I’ve never accidentally x-rayed a pregnant woman, and we ain’t gonna start this month.”

          He wrote it down.

         “And speaking of women, don’t chase any around here or I’ll send you packing.  I ain’t got time to run interference for any stupid behavior.”

        “Yes sir.  I’ve got a girlfriend back at Sandhills.  I’m very loyal to her.”

        “Good.  I like loyalty.  I think you might get an “A.”  I’ve never had one get an “A+, though.”

        ‘What do you have to do to get an “A+?”  

        “You have to play bluegrass music.  You don’t have to be a muti-instrumentalist, although there’s nothing wrong with that.  If you are good on one, that’ll do.  And if you can sing tenor it will cut the gig, too.  They’re almost as hard to come by as a good fiddler.”

        “Yes sir, I won’t forget.  Oh, I need to run out to the car.”

        It wasn’t but a minute and he was back toting an old battered case.  “Do you know Jerusalem Ridge?”  He opened it up, pulled out a fiddle, and low and behold rendered is as fine as anyone I’ve heard since Indie went to the Nursing Home.

        “Son, do you do the Cherokee Shuffle?”

        “Sure.”  He bowed it to perfection.

        “Have I ever got somebody who’s gonna want to meet you.  After we finish up, we gotta go over to the Nursing Home.  I’ve got a buddy over there, Dr. Indie Jenkins.  Man, he is gonna dig you.”

        “Sure boss.  Wherever you go, I’ll follow.”

        I knew I liked this kid.  He might be the most well prepared student I’ve ever had.  We’re gonna get along famously.

Dr. B

Patient Speak

April 17, 2008

        At least for a country doctor, it is best to use patient speak, as opposed to doctor speak, when you talk to your patients.  I found this out early in medical school on daily rounds.

        Sometimes the attending would come in the patient’s room with a big entourage, and speak “at” the patient, instead of with them.

         “Mr. Charles has an ejection fraction of twenty-five, but minimal peripheral edema, and no jugular venous distention.  His current respiratory compromise is more likely on the basis of his obstructive pulmonary disease.  I would pursue bronchodilators but not at the expense of diuresis.”  This would go on for a few minutes, and then the attending would wheel around and  walk out the room, his entourage right on his white coat-tails.

        As the lowly med student we were left behind to get our history for the day.  I sat down to listen.

        “Hey, Doc,” said the patient.  (I was just a med student, but even at that stage, I had come to cherish the title and respect the obligation that went with it.)  “What wuz he talking about?”  He handed me a can of Planters.  “Care for some nuts?”    

        “You better leave these with me, man.  That salt’s gonna swell you up.  Makes the water build up in your lungs.”  I sifted through the can for the cashews.

        “Really?” 

        “Yeah, no kidding.”  I handed them back.  “I ain’t gonna take ’em all, but you better go light.  They can go against you.”  You’ve got the head of your bed up, you having much trouble sleeping?”

        “Yup, I can’t lay flat Doc, sure enough.” 

        I checked his chart.  “Looks like you didn’t pee much last night.”

        “Shoot fire, I told that nurse I needed that water pill, they didn’t give me one.  It was right at shift change.  I think she had boyfriend troubles.”

        “Tell you what, let me call the intern and see if I can make sure you get it today.”

        We got him the missed diuretic, and the breathing treatment recommended by the professor on morning rounds.  By that afternoon, the patient was better.  The attending was pleased, and everyone complimented him on his brilliance.  (Rule number one in med school- always make the attending look good if you want to graduate.)

        All this talk about patient speak reminds me of an old story that came out of out of Hawthorne Gray School of Medicine.  It is apocryphal, but makes the point.

       An old country preacher had prostate cancer, and wanted to get his treatment at the medical center.  The attending saw him, and recommended surgery.  “Reverend, in the morning we are going to proceed with an orchiectomy.”

       “Doctor, whatever you say is fine with me. You doctors at Hawthorne Gray are the best doctors in the world.  I trust you, and will do what you  recommend.”

        “Excellent.”  The Professor handed the patient a consent form, and the preacher signed it.

        The resident was not so certain the Preacher got it.  “Preacher, I want to be sure you understand.  In the morning, they are going to remove your testicles.”

         “Whatever you doctors say is fine with me.  You doctors at Hawthorne Gray are the best doctors in the world.  I trust you.”  The preacher handed the signed consent form back to the resident.  “I am ready.”

        The doctors left.  The med student was worried. He was not at all sure the preacher got the message, and decided to speak to him one last time.  He pulled up a chair.

        “Parson, (the med student was a bluegrass boy) I want to be sure you heard them right.  In the morning, they’s gonna cut your balls off.”

         “The Hell they are!”

        In my line, as country doc, I gotta go with patient speak over doctor speak.  I sure don’t want to be misunderstood, especially over such an important issue. 

Dr. B

Power in the Blood

March 25, 2008

        There is an old hymn we do as a bluegrass number called “Power in the Blood.”  Today’s post though, is medical instead of music.  I hope you aren’t disappointed.  (Never know which way ole Dr. B’s gonna go, huh?)

       A family recently asked me some good questions about what you could tell from the blood smear.  The answer is a lot.  Our family can lay claim to an early N.C. pediatric hematologist, so we’ve been talking about blood around the dinner table a long time.  (Aren’t docs weird?)  Anyway, the whole conversation set me to thinking about an old med school story.  It is apocryphal, but still a good one.

        We had an old hematologist at Sandhills U. who claimed he could diagnose anyone in the hospital by a review of the peripheral blood smear.  No history.  No exam.  No chart.  No other data.  Nothing but prick the finger, put the blood on a microscope slide and bring it to him and he’d tell you what was wrong.  There’s Power in the Blood, he’d boom out in a most excellent baritone.  He had a standing bet.  If a group of interns could stump him, he’d buy dinner.  If they lost, it was on them, and he got to choose where.  Everyone knew he liked Kell’s, a local steakhouse out of the price range for the students, and the Professor was good.  He got few takers.

        Of course, every doctor on the planet knows how difficult this feat is.  Near impossible.  We are taught to take a history first, and that it is your most important piece of  information.  If you don’t where you are headed after the history, you are in trouble.  In fact, we had one old Doc who used to say if he didn’t know what was wrong with his patient in the first five minutes, there was a ninety percent chance no one would ever figure it out.  (Bear in mind he had the advantage of knowing years of the patient’s history before hearing the first word on that encounter.)  I wouldn’t go that far, but the idea of diagnosing from a smear alone is an Olympic Dive with a degree of difficulty of twenty.

        One day a group of medical students decided they were going to stump the old Professor, and set out to insure success.  They recruited the number one smart @^^ intern to head up the search team, and off they went.  After a hospital wide hunt, they found their candidate. 

         Their primary criterion was to find a patient with a single medical problem, and one so obscure the hematologist could not make the diagnosis from a blood smear alone.  (I know all this makes you wonder when we find time to practice medicine.)

        They found their man on the orthopedic floor.  The patient was a young male who had fractured his femur in a motor vehicle accident, and was near discharge. 

        Now, one thing med students can do is take a history, and they descended on this poor boy with zeal.  This kid not only had nothing else wrong, but his family history was clean too.  The grandparents were living, his parents and siblings all healthy; there was nothing.  This was a car wreck, and that was it.  They took their smear to the Professor with great confidence, the intern leading the way.  

        The ace intern issued his challenge.  

        “Sir, if you would review this slide.  We believe this patient can not be diagnosed from a peripheral smear alone.”

        The professor placed the slide under the microscope and began a systematic review.  For a long time he did not speak,  The students were confident.

         He began to issue a few pronouncements. 

        “Hm.  The white cells are normal in appearance and number.  I  doubt this patient is suffering from any systemic infection.”

        He continued to peruse.  The intern gloated.  The old Professor seemed stumped.

        The Professor went on.  “And judging from the size, shape, and color of the red cells, I believe this to be a healthy individual.”  Professor Lauton held his cards close and continued his search.

      He scanned the slide again.  The tension was growing.  They had him.  He stopped.

        “Hm.  In this quadrant there is a finding of significance.  Here is a fat globule.  Care to look?”

       Now the intern was less confident.  He peered into the microscope.  “Yes sir, I see.”

        “A fat globule is an indication of fracture, usually of a long bone.  Given we have established this is a young healthy individual, I am going to say this must be trauma of significant force, such as in a motor vehicle accident.”

        The med students rolled their eyes.

         The Professor went on.  “Given this is trauma to a long bone in a young individual, I am going to say this involves risk taking behavior, so it more likely this is a young male rather than a young female patient. ”

       He paused.  “Therefore, I must conclude this is a young male patient who has been involved in a traumatic injury, most likely a car accident.  Given the finding of a fat globule in the peripheral blood smear it had to be a bone fracture that would warrant inpatient orthopedic treatment, so I’ll say he has a fractured femur.

       Not to be outdone, the smart @^^ intern said, “Well that’s great Professor, but which leg?” 

        I don’t know about y’all, but I don’t believe I’d a said that. 

        Gonna turn into a bluegrass mucisian for the weekend, so will report back my findings.  Remember, there’s Power In the Blood.  And don’t forget, whenever someone wants to lay bets on their own game proceed with caution.

Dr. B

Asthma and Pretty Girls

February 14, 2008

        Back in med school we wouldn’t admit it but we were all scared about half to death.  You couldn’t help but be intimidated.  There was so much to learn and most of us were too young to have any idea how to deal with people.  I think the trend nowadays is towards older students who have some life experience.  This is not a bad idea.

        I remember one green third year student asked to examine a young woman with asthma.  As it turned out, this was a quite attractive girl, and those flimsy gowns didn’t do much to hide the fact.

        The boy was quite unaccustomed to being around anyone who looked like that, much less being called on to examine her chest.  He placed his stethoscope with great caution, careful to avoid any notion of impropriety.

       He listened.  “Breathe in, and out,” he counseled in a most professional manner.  He did his best to divert his eyes from the obvious fact that God had been very kind to this young woman.

       The exam went on for a moment, then she asked a question.

        “Sir, aren’t you supposed to put that thing in your ears?”

        The boy was too embarrassed to go on, and left the room.  Someone else had to do the intake on that one.

        I think he went into Radiology.  

Dr. B

Sandhills University School of Medicine

November 25, 2007

        I am a graduate of Sandhills University School of Medicine.  We are very proud of her.  She started out as a sleepy little place, but is now ranked sixth in the country in the proper education of primary care docs.  We did well when we were there too- I guess when they published our Board scores on the front page of the local paper it was a good indication we had outstripped some of our more well-established rivals that year. 

        Sandhills didn’t just turn out country docs like me, though.  We produced some first class specialists, too.  Take a guy like Tony Smitt.  He showed up the first day of med school in a Mercedes car.   His daddy owned a number of furniture factories in western N.C.  Smitty was independently wealthy, and our only classmate to go to school on a trust fund.  We asked him why in the world he would put himself through the grind, and he said he needed a hobby.  Gotta hand it to old Tony, the boy didn’t have to do it, but dedicated himself to his craft, and is now the chief radiologist at a famous institution in the Tobacco Triangle.  Joe DiMaggio said a rich kid never made it to the majors, but Tony proved the Yankee Clipper wrong on that one.

        We had John Quietner, a country boy who made it all the way through med school without uttering a full sentence,  (finished near the top of the class, too)  Tom Bailey, the smartest human being I ever met, Lee Stewart, who went from the farm to being a famous neurosurgeon, and Renaldo Peysoir, the Latin heartthrob dermatologist.  I have to give Renaldo the award for the most integrity- every woman in the Med Center wanted to go out with him, and he remained 100% faithful to his lovely wife.  Others were equally loyal, but some will never know if it was integrity or lack of opportunity!  

        We also had good ole Dr. Bibey.  I reckon he was a little above average, but had one exceptional talent.  He could always spot a special human being, and befriended them at every turn.  Many, many times through the years, that was the gift that saved him.

        I have run out of time tonight, but eventually I will tell you of our exploits at old Sandhills U.  I don’t see how we could have had more fun while getting a first class medical education.

Dr. B