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Dancing on Air
Medical decisions are often far from clear-cut. A DMS graduate who practices neurology in Pennsylvania writes about an elderly patient who was rushed to the hospital after a stroke. He had to decide whether a powerful drug would save her life . . . or kill her.
By John E. Castaldo, M.D.
The brightly painted Ford truck lumbered into the parking lot of the Allen Family Restaurant. The word "ECNALUBMA" was embossed in red fluorescent letters across the hood so other drivers could identify the vehicle through their rearview mirrors as an ambulance. It was 8:00 a.m., and the August sun was already burning brightly, wrapping the city of Allentown in a plastic bag of heat and humidity.
"I remember when all ambulances were V-8 Cadillacs," reminisced Bill, the driver, as he pulled into an open parking spot. "Now those were the days," he went on. "These tin boxes today are nothing more than glorified pickup trucks."
"True enough," his coworker, Jerry, replied. Young and wiry, he looked more like Bill's son than his peer. "But remember," Jerry added with a sly smile, "the days of long-bed Cadillacs and doing CPR on your knees were before my time, way before. When was that, around 1902?"
"Shut up," Bill shot back amiably. "Let's get something to eat."
The two men had been up most of the night. There had been four emergency calls and then an early-morning transfer from the hospital to a nursing home. Now, finally off duty, Bill and Jerry were weary and hungry. Still dressed in their regulation blue-and-orange jumpsuits, they headed into the restaurant, sat down at their usual table, and picked up the plastic menus.
"I don't know why we even look at this thing," Jerry said dryly, flipping the menu shut. "I always have the French toast with maple syrup, and you always have the farmer's omelet."
Their waitress, Milly, was already pouring their coffee when they noticed a well- dressed, elderly woman get up from her table and head over to the cash register
to pay. "Morning, gentlemen," she said with a smile as she passed their table.
Bill and Jerry nodded hello and turned back to Milly. "Hey, Milly," Bill murmured, "I think I'll have ..."
"... the farmer's omelet, and Jerry will have the French toast," Milly finished. "I placed your order when I saw your ambulance pull in," she said, smiling. "I'll be back with your food in two minutes."
Absently, Bill looked out the window as the woman who had just left the restaurant walked toward her Buick Electra. He turned back to speak to Jerry just as the Buick backed up with a roar. Bill and Jerry watched as the rear wheels spun furiously on the pavement, and then the car exploded backward, slamming into an SUV parked behind it. The Electra's trunk popped up and the car stalled. But the woman behind the wheel quickly restarted it and this time accelerated
forward, jumping the curb and crashing into a tree.
Bill and Jerry stared briefly, open-mouthed, then smacked down their coffee cups and shot out the door.
At age 86, Irene Polosky was healthy, single, and still living life for all it was worth. She volunteered at her church, organized neighborhood picnics, and danced at the local fire hall every Friday night. She had 13 grandchildren, ranging in age from 7 to 21, and she could tell you any detail about each one—often before you asked. She had even mastered the internet and enjoyed e-mailing her far-flung grandchildren and ordering books online. But her handsdown favorite activity was dancing. At the fire-hall dances, she did the tango, waltz, and polka. Because of her Polish heritage she had a special love for the polka, but she danced them all, whirling gracefully a- round the room like someone half her age.
The author of this story is a 1979 graduate of Dartmouth Medical School and also did his internship and residency at Dartmouth. He is now chief of the Division of Neurology and head of the Stroke Center at Lehigh Valley Hospital in Allentown, Pa. In addition, he does neuroscience research; is a professor of clinical medicine (neurology) at Penn State College of Medicine; and is a recipient of the American Heart Association's Cardiovascular/Neurovascular Care Award. The story here is excerpted with permission from The Man with the Iron Tattoo and Other True Tales of Uncommon Wisdom, by Drs. John E. Castaldo and Lawrence P. Levitt; it was published by BenBella Books in 2006.