WE DID OUR BEST

From The Medicine Men" by Leonard Tushnet, MD

A young man had an acutely inflamed throat. He went to his doctor, who gave him an injection of penicillin. The sore throat quickly got better.

Three days later, the young man began to itch. The itching got worse and he developed hives all over his body. The doctor made the correct diagnosis of an allergic reaction to penicillin. He prescribed antihistamines. The hives disappeared.

The young man, a machine operator, got drowsy from the antihistamines and cut his hand at work. The nurse in the dispensary gave him first aid and put on an anti-bacterial ointment containing penicillin. The hives returned and now the young man had swelling of the eyes and lips. The doctor recognized that a potentially dangerous allergic reaction was present and ordered a course of corticosteroid treatment. Result: the itchiness, the hives, and the swellings disappeared and the patient was well again.

Except that now he had pain in his belly plus heartburn, and he began to show signs of blood in his stools. The correct diagnosis of a peptic ulcer (induced by the corticosteroid) was made. The young man did not do well on medical treatment. He continued to bleed from this ulcer. His doctor, therefore, had a surgeon in consultation. The two doctors agreed that partial gastrectomy was necessary, an operation to remove the ulcer-bearing portion of the stomach. The operation was successful.

But because of the previous bleeding and the unavoidable blood loss at the operation, a transfusion of 1000 milliliters (two pints) of blood was given. Hepaptitis (inflammaton of the liver) followed. The young man became intensely jaundiced. He vomited his food and had to be fed intravenously for a few days. His youth did him in good stead. He recovered from his hepatitis.

At the right ankle, where the intravenous needle and the plastic tube had been inserted into a vein exposed by cutting through the skin, a tender nodule appeared. It became red and inflamed, evidence of infection. Because of the bad experience the patient had had with penicillin, the doctor prescribed tetracycline. The inflammation promptly subsided.

Because of the antibiotic, diarrhea came on and the patient had severe colicky cramps. The doctor ordered a special diet and a new synthetic antispasmodic drug to control the cramps. Diarrhea stopped.

The new drug was in the belladonna class. It relaxed smooth muscle all over the body, and by its action on the iris, it caused dilatation of the pupil.

The young man’s vision was impaired. He drove his car into a tree. Existus young man.

This is a true story.