The Sick Shriners
Burke replied, "We have an emergency room and a lobby full of sick Shriners. They are trying to be gentlemanly, not make a mess, and some are vomiting into their fezzes as they come through the door because no other receptacles are available. The majority are adult males well over the age of 50. I'm really concerned that a few are going to become seriously dehydrated and go into shock. It appears to be some kind of food poisoning. There are so many of them that some have been diverted to the VA [the Dartmouth-affiliated veterans hospital in nearby White River Junction, Vt.] or to Alice Peck Day [a community hospital in Lebanon, N.H.]."
It turned out that the decision to divert some of the patients had been made by ambulance drivers or friends of the stricken Shriners who were bringing them in using the same vehicles that had been in the parade. It had seemed to the drivers that things were backing up at the MHMH emergency room and main entrance.
So Bird went in to the hospital. The emergency room in those days was a little rabbit warren of rooms and cubicles right off the main lobby, just behind the telephone switchboard. When Bird arrived and peered in, things didn't look too bad. There was only one person in each cubicle. He said, "It looks like you have everything under control." But the nurse on call said, "No, no. Go upstairs to the lounge outside of the recovery room. There's a bunch of them up there. We had to clear the lobby so as not to alarm visitors or other patients coming in with unrelated complaints."
When Bird got up to the second floor, he found Burke, the late Dr. John Milne and Dr. Donald MacKay (both internists), and other staff tending to Shriners spread all over. They were sprawled on sofas and chairs and leaning against the walls by the elevators. "What we were really faced with," says Bird, "was a group of people with violent, projectile vomiting—and at least some had diarrhea—both of an acute onset. None of them had high fevers, which was reassuring. At least we were not dealing with an infectious process, which would have been really
alarming." Still, things were alarming enough. Bird recalls a line of gurneys up and down the hallway, with vomiting Shriners and bedpans, bedpans, and more bedpans.
"Although we had no idea at the time whether or not it was serious," Bird continues, "the quick onset suggested most patients might have a rapid course and recover quickly. What to do was clear—start IVs on the more seriously dehydrated patients and monitor their vital signs."
The anesthesiologists had been called in because back then the technique for inserting intravenous (IV) lines was still pretty old-fashioned. Today's plastic catheters, plastic disposable needles, and fancy connectors were just beginning to come into use but were not yet available at MHMH. The task was complicated by the fact that most of these patients were elderly and already dehydrated, so their veins had collapsed. Although the nurses and interns were doing the best they could, the anesthesiologists of that era had the most experience starting IVs in challenging situations.
Everyone was working furiously. At one point, a doctor who had a reputation for being gruff was heard to mutter under his breath—as a patient who was only mildly affected, if at all, pleaded to be given some medication—"No puke, no pill."
Everyone was working furiously. At one point, Dr. Milne, who had a reputation for being gruff, was heard to mutter under his breath—as a patient who was only mildly affected, if at all, pleaded for some medication—"No puke, no pill."
Patients were still being assisted out of the stadium as the game was drawing to a close, but it was clear that the worst was over. Those who had been seen first were already showing signs of recovery, and the prediction that the illness would have an abrupt course proved correct.
It was difficult to keep track of the numbers because a few patients may have been treated and left the hospital before they were identified. The total number of affected individuals was placed at 91—with 69 of them seen at Hitchcock,