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Saturday, February 28, 2009

The Chamber of Horrors

Many of you know that I am a medical doctor and have been since 1980. I currently do emergency medicine. I can relate to you from time to time some amusing, sobering, shocking, and at times, unbelievable stories from my experiences as a doctor.

My topic today is the John Gaston Hospital. The Gaston, also known as the "Gashouse", the "Pit", the "Chamber of Horrors" was built in 1936 by a combination of funds from the Gaston inheritance (Gaston was a Memphis entrepreneur), the city of Memphis, Shelby County, the public works administration, and Memphis City Hospital.

I don't know what John Gaston Hospital was like in 1936, but between 1976 and 1980 (my time in the Pit), the Gaston was where you landed if you were indigent and in need of medical attention.

Specifically, I want to talk about the 5th floor orthopedic ward. On the 6th floor was the psych ward and the jail ward (a topic for another post). I don't remember for sure what was on the 4th floor, general surgery I think.

In the Gaston, everything was a ward. The 5th floor was one huge ward that ran the length of the building. I don't remember how many beds were in the ward, but there were a bunch, probably 25 on each side of the ward with the feet of the beds facing each other. Male and female patients both inhabited the ward and were huddled into groups apart from each other and sometimes separated by curtains for "privacy". Many of the beds were surrounded by visitors, many of them crammed into the small spaces between the beds. Sometimes it was hard to tell where the visitors ended and the patients began.

The smell was a mixture of urine, feces, body odor, infected wounds, gangrene (there's nothing quite like the smell of rotting flesh in July), and cigarette smoke (oh, the patients were allowed to smoke in bed). The staff could smoke too. From the plain plaster 12 foot ceilings with peeling paint there were long single stems dangling down to a fixture which resembled 3 concentric rings with no more than a 40 watt light bulb in the center. At night, they turned most of them off for the "comfort of the patients" and gooseneck lamps scattered here and there provided any needed light. In the winter, the Gaston was hot; in the summer, the Gaston was hot. It was always hot in that place, kinda like hell I guess. We would sweat along with the patients, all day and night long, and the constant state of damp during a 24 hour shift would allow us to take the Gaston smell with us when we left.

Nighttime on the 5th floor was creepy. You could enter the 5th floor ward from either end. At night you'd go in to be greeted by the heat and the smell. Looking from one end to the other you could barely see the far wall through the haze of cigarette smoke and dim lighting. It looked somewhat like a dungeon, it did. Often your view would be partially obstructed by a maze of orthopedic devices and suspended limbs hanging in the haze from metal tubes twisting to and fro over the beds. The shadows cast on the ceiling and walls by the appliances and wiggling limbs was downright eerie. Your adventure to the ward was also frequently accented by moans and screams from some of the inhabitants (and probably some of the staff and maybe even a few of us). Some were screaming in post-op pain. Some were screaming in alcohol or drug withdrawal. Once in a while the old man in the center of the ward would be in a psychotic scream as he picked the perceived bugs from his body.

Some patients did better than others. The Gaston was full of patients with the last name of "Grandholm" (I actually have changed the name to protect the guilty and the innocent). Anyone with the last name of Grandholm always did poorly. We were warned in the beginning to beware of Grandholm's. In the beginning none of us believed it. In the end these people haunted all of us. On the 5th floor ward, a Grandholm would always be the one to get a wound infection. A Grandholm would be the one to develop gangrene and lose a limb. A Grandholm would be the one to pitch a pulmonary embolus in the middle of the night and suddenly die. The first person I ever saw crash and burn in the operating room during an "elective" surgery case was a, you guessed it, a Grandholm. We always hated it when we had a Grandholm on our service.

One thing I experienced at John Gaston was "snake rounds". Many of the post-op patients would get pneumonia. This was probably because most of them would lay there, day in and day out and smoke in bed. Nobody bothered to get the post-op folks up and walk them in the halls or do physical therapy with those who could not ambulate. Anyway, long before I came along, someone thought it would be of great therapeutic benefit to visit all smoking patients in the middle of the night and introduce a small suction catheter down one nostril and on down into their tracheas, suctioning out the secretions in the process. This was called "snaking" a patient, and it was done with regularity at the Gaston. I never saw this done anywhere else and in fact I never read anywhere in the literature that "snaking" patients reduced the incidence of post-op pneumonia. If you can relate to strangling on a chunk of food, imagine the sensation of someone jamming a tube down your windpipe while you're fully awake. I heard that one of my classmates got in trouble when she took it upon herself to "snake" some of the private surgery patients at the big Baptist Memorial hospital (also known as the big BM), across the street.

To be fair, we do "snake" patients today from time to time, but these are people in obvious respiratory distress, so full of secretions they cannot otherwise breathe. At the Gaston, "snaking" was done all the time as a "preventative" measure.

Strangely as we spent time at the Gaston, it became like home. We rotated to other places from time to time but always seemed glad to get back to the Pit. They did have some fairly nice quarters for the med students and house staff. The area was quiet, clean, void of smells, and had showers where we could wash away the Gaston smell.

After I left Memphis, they finally tore the old Gaston down and what remained was swallowed up by the Elvis Presley Trauma Center and the MED. I suppose that facility has provisions to take care of the huge indigent population of Memphis, perhaps in a manner somewhat more humane than that of John Gaston. On the other hand, perhaps the Gaston was the best thing that Memphis had at the time. I guess a lot who would have died probably lived because of the Gaston (I vividly remember several). Could more have lived if the Gaston had been better? Maybe, but I'll never know that for sure. I saw and experienced things at John Gaston that I never could have imagined before and have never seen or experienced since.



1 comment:

  1. I walked into Gaston one time, saw what the place looked like, what the patients looked like in the waiting room, ... and I turned around and left, never to return again.

    Debbie Hamilton
    Right Truth