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Dartmouth Medical School Dartmouth-Hitchcock Medical Center

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Point of View

A giant impact

By Stephen H. Hennigan, M.D.

In 1982, I was working in a produce company warehouse in Shreveport, La.—a place of huge oak trees, humid weather, and mostly genteel culture. I had been in college off and on for the previous five years and had managed never to take a science class. This choice was the result of the painful sting of a C for a messy notebook from my high school chemistry teacher. At the restless age of 23, I remained clueless about my personal future.

Aimless: During one of those days in the warehouse, my assignment was to "run oranges." It was a simple task: remove the rotten oranges from a box that had started to go bad, then re-box the good oranges for distribution and sale. It was a mindless job that lent itself well to pondering the problem of my aimless life. I had considered a career in medicine but had discarded it as too messy, given the required contact with bodily fluids, odors, and so on. The real truth of that decision, as well as many others, was that on a quite visceral level I was afraid—afraid of human beings who were dying, afraid of suffering, afraid of responsibility. These were matters of which I was only vaguely aware but knew were not easy.

The Point of View essay provides a personal perspective on some issue in medicine or science. Hennigan was a resident in internal medicine at Dartmouth-Hitchcock Medical Center from 1988 to 1991. Since completing a fellowship at Vanderbilt in 1994, he has been in private practice in infectious diseases in Fayetteville, Ark. This account of his most memorable patient is shared with the permission of Dr. Louis Matthews's family.

At some point during that day with the rotten oranges, I suddenly realized that, with time, one could become accustomed to unpleasant things—certainly things that were physically unpleasant and, I suspected, even things that were emotionally unpleasant. I made the decision then and there to pursue medical school.

I managed to complete the required premedical courses over the following two years. In 1984, I enrolled in the Class of 1988 at the Louisiana State University School of Medicine in Shreveport. I did quite well in medical school and was elected to membership in the Alpha Omega Alpha honor society during my third year. I remained afraid, however—afraid of being entrusted with the care of people who would be depending on me.

I chose to do my residency in internal medicine at Dartmouth-Hitchcock and arrived in New Hampshire with studded snow tires, warm boots, and a winter coat that weighed almost as much as I did. I quickly found that I enjoyed the more casual New England ambience, the beautiful countryside, and the simple thrill of living somewhere altogether different from where I'd grown up and spent my life till that point. It could not have been a better place to train.