A Baby And A Rolls-Royce

I needed a job. I had run out of fellowships, I had run out of local academic positions that didn't pay anything anyway, I had a new wife, two kids, two step-kids, and I needed a job. I didn't really know how to practice pediatrics, the way a new lawyer doesn't really know how to practice law when he or she starts, but it was something I could do at the beginning well enough not to kill anyone, and I would learn. So I started being a pediatrician.

My two new colleagues in Oakland needed someone to be on-call with them. Nights and weekends needed to be covered, and their third on-call pediatrician was leaving independent practice to join a newly forming group that Peralta Hospital had been persuaded to back, even building a new office building for the group right there on Oakland's so-called Pill Hill, where three hospitals were within a block of each other. In time, of course, the three hospitals would merge into one, then be bought by regional powerhouse Sutter Healthcare, and the new group would fail, and I would move with my new small pediatric group into one of the offices in the new building – but that was ten years in the future. For now, one of my new associates, John, needed someone to occupy the other suite in the small, one story office building that he owned, and he and Bruce, with an office around the corner, needed that third on-call slot filled. They needed me, I needed a job, so we had to strike a deal. Luckily I had some money so I could ease into practice slowly and not worry about loans. My independent means also gave me some class in their eyes, and of course, I always had my swagger, the Big Shot, as my father would say. But really, I had never thought about being in solo practice, and I had no idea what awaited me.

Part of our deal was reduced rent for six months or so, and they would introduce me to their referring doctors so I could start picking up patients. John and Bruce didn't want me to siphon off their private patients, so they made sure to introduce me to the OB's with a lot of Medi-Cal patients, along with some privates. They took me over to the hospital to the doctors' lunch area in the cafeteria and introduced me around. And that's how I met Jim Cadwallader.

Jim and his OB associate Ned Nuddleman weren't partners, but they worked together, assisting each other for C-Sections and splitting call. Bruce and John had enough Medi-Cal patients and could spare those patients that Jim and Ned would refer to them. That was the pattern as you got more successful, let the Medi-cal go and load up on privates if you could. Later on, as I got successful on my own, I changed that pattern and kept my Medi-cal patients, and instead hired associates to help with an enlarging practice, but that's another story.

If Jim's unusual last name seems familiar, you might recognize it from a little throwaway line in The Philadelphia Story, uttered by Cary Grant, in his ultimately winning way. (What an actor, Cary Grant!) His character was top of the heap on the Philadelphia Main Line, old established rich, and he mentions “the Cadwalladers” as others of his ilk. You have to listen hard to hear it, but it's there. The Philadelphia Cadwalladers, poshest of the posh. And right here, on Pill Hill in Oakland, was a verified Cadwallader. Although I soon found out that this Cadwallader – a little above average in height, an attractive round face with dark hair and rather clear light skin, with many a smile but also some lingering insecurity – was definitely not top of the heap at Merritt, and was not from Philadelphia, but from Nebraska. Was he related to the Philadelphia Cadwalladers? Not that we knew, but it's not that common and name, and who knows? Every family has its black sheep, the ones who find their way to, say, Nebraska, whose offspring might get medical degrees and find themselves serving Medi-Cal patients in Oakland, California, don't they? I thought they must.

And Jim definitely qualified as an eccentric sort. He looked good, he dressed well, we hit it off at once – he told me later, “didn't you just feel it?” – and he liked to laugh. But he wasn't married, and he was insecure, that's something you certainly could feel. He tended to look anxiously left and right. Someone who seemed to need a friend. And sure enough, we did become friends, often waiting together with Nuddleman during the night for an OR to open up so that he and Ned could do their C-section and I could catch the baby. We weren't fast and close friends, but he did invite us to parties given by his considerably older girl friend Ethyl, who lived in a huge house in Burlingame, which Ethyl had owned since her rich husband had died some years before. They were an interesting pair, they kind of adopted Ann and me, then newly-married and both much younger than Ethyl, as we sought to establish some kind of social life, as I was establishing a new professional life.

As I look back on it now, it was hairy. I really didn't know what I was doing, just winging it day by day, having a job, although I did think that I had to learn to do this job before I could make it a thriving business with a group of doctors, I hardly even thought of these future doctors as employees, too bold a thought, but it was there. And Ann and I were making our way together, both having divorced our spouses to be together, hoping it would work, because we had bet a lot and hurt other people to live our dream.

So anyway, Jim and I became friends and he referred patients to me and I did a better and better job with them. But in practice, you never know what will happen, and sure enough, a couple of years into it, one bright morning in the office I got a call from him. He sounded excited and challenged. He had gotten a call from someone, probably his patient, who had a daughter who lived at home and who was a college student at Cal. What had happened was, that morning her daughter had gone into the bathroom and had a baby. Jim's patient and her husband didn't even know that their live at home daughter was pregnant, so it was more than a surprise. They didn't know what to do, so they called Jim. He said that he was going to get the new mother into the office and examine her to make sure she was all right, and would I examine the baby? Sure I would.

So, next thing I knew, just maybe a half hour later, Jim was driving into our parking lot with the new mother, the new grandfather, and the new baby. Oh, yes, I forgot to say, one of Jim's eccentricities was that he liked to drive nice cars. His car was a Rolls-Royce. So he rolls into our parking lot in his Rolls and they all pile into my little office. What a scene! The baby's grandfather was Chinese with a rather thick accent, clearly an immigrant. The new mother was an attractive young college student, and as I examined that baby girl, I discovered that she was a normal newborn, a healthy and beautiful newborn. What should we do? I said to Jim, well, the baby's normal, they could go home. Nope, said Jim. Born at home, non-sterile conditions, let's admit them both to the hospital and watch for a while, which we did. Back up to Merritt, our home base, into our OB ward and the nursery, and we were all comfortable.

But then Jim said, what should we do with the baby? We didn't know what their plans were, and as it had all come as a sudden surprise, we figured that they didn't have any plans. So, here's the amazing thing. Just a couple of months previously, one of our hospital colleagues, Revels was his name, an internist with a specialty in pulmonology, had approached me. Revels was an operator, always with an angle and always well and even nattily dressed, a light skinned black man with origins in Mississippi and a civil rights family background, with a beautiful and classy Chinese-American wife. Revels had asked me a question that I had never been asked before and would never be asked again. He asked me if I sometimes came across babies who needed to be adopted. He and his wife could not have babies and they had decided to adopt. I had told him that I would look out for him, but that's it's not something that usually comes up for me.

So, when Jim asked me what do we do with the baby, I naturally thought of Revels and his wife. What a set up! An asian baby for a half-asian couple, a college student mother so the baby would probably be intelligent, and no waiting time on a list of prospective adoptive couples. The hand of God, I would think if I believed in God. We approached the family, Jim and I, and they seemed receptive to the adoption idea, so I put in the word for Revels. Revels was beside himself at the find, told me of course I would be his pediatrician of choice (strange that he would say that, I thought, but I figured that I was not top of the heap in pediatrics at Merritt – yet – and it was a concession to me on his part) and the deal was made. Adoption is not a final decision in California until six months had passed, and such was Revels anxiety that he was after me repeatedly during that six months period, was the mother wavering? Of course I wasn't seeing the mother, but I still reassured Revels, I can understand your anxiety, but I think it's going through. Which indeed it did, and Jim and I counted ourselves heroes in this excellent adventure.

I never got a chance to check on the Chinese family, wondering what happened to them. From our point of view, Jim and me and Revels, it had gone great. I don't know about the mother. When mothers give babies up for adoption there are always little or bigger scars, second thoughts for a long time, no matter how much they know it's the right thing to do. I never saw her again, so I don't know.

Then there's the father of the new mother, the grandfather. What a day he had! He was a tender man with a heavy Chinese accent, clearly an immigrant who seemed to have made a wonderful transition to America with an achieving daughter, despite this misadventure. After all the commotion that had ended with both mother and baby at Merritt Hospital for a few days for observation, we drove away in Jim's Rolls with me in the passenger seat and the new grandfather in the back seat. He looked around and summed it up for us. “What a day!” he said. “First my daughter has a baby and I didn't even know she was pregnant, and then I get to ride in a Rolls-Royce!” Jim and I looked at each other and kind of chuckled.

You just don't know what you're going to find, when you go into practice in the community, you just never know. You make friends, you meet all kinds of people, you share in life's adventures. I did get to see what happened to the baby. She grew up to be a lovely and accomplished young woman whose parents doted on her. When she got into the school years, Revels and his wife switched her away to my colleague Bruce for pediatric care. Bruce had higher prestige around the hospital, but that's the way it goes. Revels was an operator.

Budd Shenkin