Friday, December 24, 2010

Tales of a German Urologist

Urology is not where one usually turns for wisdom – humor of a certain sort sometimes, but not wisdom. Still, within humor there is often wisdom, and in a package that is easy to accept.

Enter my colleague Bernd Schmidt of Pleasanton. A tall man with a craggy face hidden by a rather sparse beard and ever-ready grin, he has a strong German accent that demands close attention to understand him. I really don’t know him that well, but I thought he introduced himself as “Ban,” so that’s what I call him at the doctors’ lunch table at ValleyCare Hospital, be it nickname, the pronunciation of Bernd, his accent, or my poor hearing.

Each specialty in medicine has its own stereotype, and as with most stereotypes, there is a core of accuracy. I once introduced myself at a party of lawyers in the City as a pediatrician, and was told that “you guys are all alike.” Yup, I could have replied, and so are lawyers, as typified by that remark by you, asshole.

But I digress. Internists are removed, cerebral or pseudo-cerebral, not the warmest buns on the table. Surgeons are cowboys who can’t wait to cut but can’t think well or broadly. Orthopedists are strong as an ox, and twice as smart. Urologists – well, urologists. They have a very down to earth attitude, shall we say. My med school classmates told me to prepare for a unique experience in my one-week Mass General urology rotation. They were right. My residents gloried in making rounds while smoking cigars, inquiring of their patients amid their smoke, “How you doin’?” Actually, It was refreshing not having to deal with the poseurs the MGH was rife with.

One of my classmates was interviewing for a surgery residency in at MGH with George Nardi, who had some post in the department. He waited for a while for Nardi in his hospital office, a converted exam room. Then Nardi burst in, hustled over to the sink, pulled out his penis and pissed right in the sink, with a gasp of relief saying, “Sometimes you just gotta go.” Nardi should have been a urologist.

My colleague Ban has a typical urologist get-rich scheme, inspired by the plastic surgeons. He wants to use Botox injections to take the wrinkles out of the scrotum. “Wouldn’t they be beautiful?” OK, Ban, good. You’re a urologist, all right. Wish you smoked a cigar. Maybe your scheme will work in San Francisco, who knows?

Ban had two stories yesterday at lunch. He related that in Germany you never, ever, marred the bed sheets of a patient. The German passion for order and cleanliness prevailed. So he was shocked when he came to America in training and saw that the urologists on rounds routinely used the bed sheets to write on as they made rounds. My MGH urologists were too busy with their cigars to write on sheets, but it did seem right in character.
But Ban said it didn’t always work out too well. A few weeks into it he was standing at the foot of the bed as the urology staff was gather on each side of the bed, discussing the case over the patients supine body, his head sticking out from under the sheets as he listened. The urologists drew pictures on the sheets, depicting the anatomy underneath. But what they didn’t notice was the patient. As they drew and discussed, “Then we’ll cut here, and then here, then pull this together,” and so on, the patients face became paler and paler, visible only to Ban at the bottom of the bed, as the others were in heated discussion. Finally, as they agreed, “Right, this is just where we’ll cut,” the patient sat up and vomited everything he had all over the bed sheets, the pictures, the pens, their hands, and their cuffs. Urologists.

But on a more serious note, Ban has another side to him, a really lovely and understanding, which is to say, perhaps a non-urological side. I told Ban that I had always been fascinated by Germany, but that as a Jew I had of course ambivalence, to say the least. Still, my father had been one of the first to buy a VW in the United States, on the grounds that it was pretty cheap. So my family heritage enabled me to be somewhat dispassionate. Ban is from the Hamburg area, and I said I had heard that the real rapid anti-Semitism was in the south, and especially in Austria.

Ban agreed. He reflected that as a German medical student he could change schools each semester within the German community, just so long as he passed all his requirements. So one semester he decamped to Vienna, where he rented a room in a house where the only TV was in the landlady’s living room. So he was watching TV with her one evening and there was a documentary of some sort about the holocaust, and Austria’s experiences. His landlady denied that there was much anti-Semitism in Austria. She said, “All that never happened here in Austria. It’s a lie. This movie must have been made by some Jew.”

Ban has remembered this story a long time. Reminds me of how one of my very favorite authors, Alan Furst, has never written about Austria and Vienna. “Just never wanted to do it,” he said at one of his readings I attended. Probably one of the cities I won’t visit, either.

It’s good to eat In the doctors’ dining room. You meet the most interesting people. Even urologists.

Budd Shenkin


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