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The worst illness this physician ever had

Ronald Halweil, MD
Conditions
January 7, 2023
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An excerpt from Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic.

Our favorite internist and chairman of the internal medicine department was lecturing us on sensitivity to patients’ suffering when they have a serious illness. He stressed that our sensitivity would increase as we got older and had more life experiences. Then he added a wish that every one of us should have a serious illness from which we would have a complete recovery.

I thought that was a strange thing to wish on us and quickly forgot it.

We were scheduled to begin our pediatric rotation with a visit to the pediatric infectious disease ward at King’s County Hospital. The pediatrician attending told us to call our moms and check to see if we had all the childhood diseases, like chickenpox, mumps, measles and German measles.

I called my mom that evening. She laughed and was emphatic that I had everything. I also remembered my childhood suffering with them, especially the chickenpox I had when I was 6, which caused me to miss three weeks of first grade.

The pediatric infectious ward at Kings County was full of crying children, and bad smells as our attending took us around to see the various different diseases.

She stopped at one crib, picked up a crying child, and asked if we knew what this child had. I said measles when I saw the rash, and she handed me the baby and asked me to pass her around, so we all had the experience of holding a feverish and crying infant. Then we saw other cases of infectious diseases. We were all relieved to finally exit this awful-smelling ward of crying children.

Remember, this was an era before routine vaccinations for these “childhood” diseases were available.

The lectures on pediatric illnesses were conducted in the usual conference rooms. We did our note-taking and studying as usual because we would be tested at the end of the pediatric rotation.

About a week later, I woke up with a headache, something I rarely get, and I felt chilled as well, but I quickly got dressed as I usually do and went to the lecture hall with my friends to start our daily education.

My headaches and chills continued. I told my friends, who said it was probably a cold, although I was not sneezing or coughing. I took aspirin to relieve my symptoms, but it didn’t help much except to reduce my temperature.

When I continued to feel sick with a headache and chills the next day, I decided to go to the student health doctor for an exam and possible treatment.

He didn’t find anything wrong with me except for a fever and said we would have to wait to see if this got worse. He recommended that I return to see him in a day or two if my symptoms persisted.

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As a medical student, I was already thinking of the worst things this illness could be. My friends were also thinking of a differential diagnosis, like leukemia or Hodgkin’s disease. My close friends cared, but things didn’t stand still in medical school. We continued to attend our classes as usual.

Finally, I noticed spots on my throat while brushing my teeth. That made me think I had caught something from the children’s infectious ward. I returned to the student health physician, who told me I had measles. I was relieved that I could forget about leukemia as a diagnosis.

He then asked me if I wanted to be admitted to the children’s ward at Kings County. I thought he was joking and said, “Of course not.” He told me that I would become very ill and would need lots of help through the illness. I said my wife and mom would be able to help me at home.

My wife was working to support us and would be away during the day, but my mom could take care of my grandmother, me, and my closest aunt, and they worked out a schedule.

I soon found out why all the babies were crying.

Within a day of the diagnosis, my fever increased, and I developed alternating diarrhea and vomiting. My mom put a large bowl on the bed for me to vomit into because I had become too weak to keep running to the toilet. She would clean the bowl every time I threw up and help me to the toilet when I had diarrhea. I also had a bad sore throat, a runny nose, a cough, and an earache and my headache never let up.

I understood that the measles virus was multiplying and affecting every part of my body. My immune system was producing antibodies as quickly as possible but not fast enough to end my misery.

I had no appetite, but I was always thirsty. Though swallowing was painful, I drank as much ginger ale without bubbles as possible so that I wouldn’t get dehydrated and needed to go to the pediatric ward at Kings County for intravenous hydration.

I was very grateful for the work of the four women who cared for me day and night.

Over the next two weeks, I started to improve. My diarrhea and vomiting left, then my fever broke, and my headaches ceased.

I had more strength and could walk around the apartment, and my grandmother and aunt no longer needed to take care of me, and I was able to eat the food left by my wife and mom.

But there was one more discomfort that the measles had for me: severe itching all over my body that lasted for several days.

Finally, I was well enough to go outside and consider a trip to medical school to restart my studies.

My home scale showed that I had lost 20 pounds in these two and a half weeks, something I suspected when my pants fell unless I would really tighten my belt.

I went to the pediatrics dept office to talk about my long absence, and the same doctor who handed me the measles baby was there to greet me and ask how I was feeling. I gave her a little synopsis of weeks of misery and pointed to my loose pants.

Then she told me that I had missed too much of the pediatric rotation and would need to do it over again.

At that point, I told her that after what I went through, I could not conceive of doing this, and I might die from another infection. In any case, I should get honors for my in-depth personal instruction in childhood diseases.

She reluctantly accepted this. I would not have to repeat the course, but she did not give me honors for the experience I had.

I was still curious as to why I had no immunity to measles if I had every disease, as my mom said.

I contacted my old family doctor, who was my mom’s obstetrician, our family’s general practitioner, and my pediatrician. He did have records from that period of my life.

Apparently, when I was exposed to measles as a young child, a new medical innovation to prevent measles had gained some popularity in pediatric practice. This involved an injection of gamma globulin, a mixed blood immune cell product that would grant limited immunity to many infectious diseases.

In that era, and even today, measles could cause severe permanent health problems and even death, so any way to avoid this disease was considered worthwhile.

That explained why I had no immunity 20 years later to that little measles baby.

My medical school friends were happy to see me and were amazed at my weight loss.

So apparently, I was the only student to take the advice of the chief of internal medicine and have a serious and painful disease and get a full recovery.

To this day, that was the worst illness I have ever had.

Ronald Halweil is an otolaryngologist and author of Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic.

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The worst illness this physician ever had
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