Several astute readers of this column asked me what happened to my patient in St. Louis who took a shotgun to himself. The answer is limited because most of the patients who are treated in emergency rooms return to their own doctors. I never actually saw this man again after Dr. Ogura’s team took off with him in the night. I did hear snippets of his surgical saga involving months of multiple procedures needed to treat his horribly disfiguring head injury. It is my understanding that he eventually went back to Illinois where he was under the care of his local doctors. As with most of my readers, I am concerned that one morning he may have stood in front of the mirror, looked at what he had done, and decided to take a better aim.
The story of this unfortunate man with an unknown outcome brought back rich memories of my surgical training in St. Louis. Occasionally I crossed paths with legendary doctors, in and out of my own specialty. One of those was Dr. Joseph H. Ogura — who was revered internationally and was one of the crown jewels of the Washington University Medical School. His surgical innovations forever changed the treatment of laryngeal cancer. He traveled around the world so much as a visiting professor, that his wife referred to him as the TWA professor of the year. He was so renowned that his own residents referred to him as the Moses of his specialty — indeed, his teachings were recited like the Ten Commandments. Underlings like me and even his own residents did not actually speak to him unless spoken to. His voice could be politely soft or boom deeply with authoritative annoyance. He could be impatient — even brusque — in his manner. I understand that he also had a soul filled with compassion.
I did not actually meet Dr. Ogura until three years later when I was a chief resident in urology. All the king's horses and all the king's men could not get a catheter into Dr. Ogura’s patient following an eight-hour radical neck procedure for laryngeal cancer. I was covering for my chairman who thought that "he" was the TWA professor of the year. At the patient’s bedside in the Recovery Room, I was pleased to see that Dr. Ogura had stayed to watch me care for his patient. He put me at ease when he thanked me for coming to help and referred to himself as Joe. Uh, huh. I knew better than to call him that. His team stood reverently behind him in total silence. As I worked to gain urethral access, I talked about the development of the fiberglass urethral filaments that I was using. My smooth story appeared to be in contrast to the brisk urethral bleeding that began as I was talking. Dr. Ogura was standing close enough that I could see his eyes widen when he saw large, beefy, clots coming from the narrow urethra. To the unsophisticated, it appeared that I was in real trouble. His eyebrows furrowed as he told me that he couldn’t imagine why I chose to go into a specialty where I had to do this sort of thing to my patients. As the Council-tip catheter quickly slipped into the bladder, the bleeding stopped and 1500 cc of clear urine freely flowed into the down drain. This solved the problem and gave me a moment to explain to Dr. Ogura that in urology, a patient, who has a bladder the size of a basketball and can’t pee after a dramatic radical neck dissection, thinks that the urologist who can help him pass urine is the most important doctor in the world — notwithstanding the fact that a world-class head and neck surgeon had just saved his life by removing half of his larynx and leaving him looking like someone who had just taken a shotgun to the right side of his neck. As I talked, I stayed focused and did not look up at Dr. Ogura or his team — I could tell from the silence that none of them dared laugh at my commentary. However, Dr. Ogura was amused and slowly began to chuckle with a deep “…hum huh huh.” He graciously thanked me and disappeared behind the Recovery Room drapes to complete another 15-hour day.
He never got to retire. Three years after we met, Dr. Ogura died from a myocardial infarction at age 68. By then I was practicing in Idaho Falls and was saddened by the news. Later, I learned the rest of the story. At his funeral, it came out that during his pathology residency, Dr. Ogura and his wife, Ruth, suddenly left California when War Fever struck the West Coast and Japanese-Americans — including some of their relatives — were moved to relocation camps for internment. If he was bitter about how the government had mistreated his friends and relatives, no one ever knew. He completed a pathology and medical residency in Cleveland and, uncomplaining, he turned a miserable situation into a golden opportunity. He went on to train in otolaryngology, launching a stellar surgical career at Washington University in St. Louis.
Ever vigilant,
RT
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