Three Case Histories

Almost every American has his personal tale of woe about an encounter with a physician or hospital. Many, of course, also have tales of triumph--and those are usually the people whose lives have been saved by medical skill. Whether an American falls into one or the other category is often a matter of luck. These case histories, gathered from a sampling made this month by TIME reporters, sum up the experiences of three fairly typical patients.

JEWELL WHELAN, now 38, has had as much trouble with her doctors as with her gall bladder over a span of 16 years. Wife of a factory inspector in Compton, Calif., she complained of frequent chest pains in 1953, soon after the birth of her second child. The pains came after meals, but each time they were gone by the time she got to the doctor's. "Indigestion," said he, and prescribed a bland diet. So it went until 1957. Dissatisfied, Jewell Whelan then changed doctors and saw her new practitioner four times a year. All that he prescribed for her pain was the bland diet. Still not satisfied, Mrs. Whelan changed doctors again in 1967 and got the same treatment, or lack of it.

Early last October, Jewell Whelan was in such pain that she demanded a thorough workup. First came an office visit at $7, with a blood count and urinalysis for $9.90. A second office visit included X rays of the upper gastrointestinal tract and gall bladder, for $60.50, and a second gallbladder series cost $22. Of the $106.40 total, her comprehensive John Hancock insurance paid all but $12.88. Mrs. Whelan had put her foot down just in time. The X rays disclosed an inflamed gall bladder with numerous stones.

Lacking confidence in her third doctor, Mrs. Whelan sought a good general surgeon. He could not schedule an examination for two days. During the second night, Mrs. Whelan vomited green bile. The surgeon could not be reached, so James Whelan had to call in the last physician. He sent Jewell Whelan to a proprietary hospital, where she was given a shot to kill her pain and sent home. Next morning, with week-old X rays in hand, she finally saw her surgeon. One look at the films and he rushed her to Long Beach Memorial Hospital.

Next morning, out came her gall bladder, with two large stones and a quantity of floating "gravel," which may have explained her persistent chest pain. "The interns told me mine was the hottest gall bladder they had ever seen," says Jewell Whelan. But after eight days, she went home and is now well. The bill: hospital room and board, $360; TV and phone, $8; other hospital costs (lab fees, X rays, operating room, etc.), $265.90; anesthetist, $115; surgeon's fee, $400; surgeon's assistant, $80; office visits to surgeon, $40. Total, $1,260.90, of which insurance will cover all but $155.

Blood on the Floor

Leah Edwards, 10, daughter of a Houston equipment company manager, began having backaches last summer and found urination painful. Leah was taken to Tidelands General Hospital, where a week of tests showed that over a period of years her kidneys had been deteriorating and one was almost useless. Because of a defect in the ureters, her urine was not being passed out directly through the bladder but was backing up into the kidneys. A specialist recommended palliative medication for an indefinite period at $35 a week as an alternative to surgery.

But Leah's mother Charlene Edwards, who works as a grocery-store checker--when she is not in the hospital herself--decided that the family could not afford such drug bills and opted for surgery. "Leah was in a semiprivate room at old Texas Children's Hospital with two other children," says Mrs. Edwards, "but there was only one chair and no facilities for the children's parents. Blood was often spilled on the floor and left there for days. But the doctors and nurses were kind and attentive, and I guess in a way we've been lucky--that kind of operation has been done for only twelve years."

While Leah is doing well, the Edwards' finances are not. Despite Blue Cross, they have to find $800 for Leah's medical and surgical bills, and they expect a $600 bill for Mrs. Edwards, who had another operation last week.

One Out of Four

Clyde L. Anderson, 51, grew up in Salt Lake City. A spare (125 Ibs.) 5 ft. 7 in., he did well in competitive sports, and carried his competitiveness into business--since 1953 as sales manager for radio station KNAK. "Andy" Anderson smoked three packs a day. Seven years ago, when he was feeling below par but had nothing specific wrong, a friend suggested that he see Dr. Irving Ersh-ler. Half time in the University of Utah's Department of Preventive Medicine, Ershler takes private patients on contract to provide all their physician's (not surgeon's) care for $150 a year.

On the Sunday night of the Labor Day weekend in 1967, Andy was getting ready for bed when a sharp pain struck his left arm. "It was unbelievable pain," he says-"and I knew I was in trouble. I knew Irving was up at his weekend cabin. My wife called him, then drove me to the hospital." At the Latter-Day Saints Hospital, an intern ordered an electrocardiogram. Its evidence of a coronary occlusion was printed out when Ershler arrived, only 20 minutes later.

Anderson had a rough night. Although he was soon given heart-lung resuscitation, his heart stopped four times. Then Ershler and Thoracic Surgeon Russell Nelson took him to the operating room, and there, through a vein in his arm, they put in a pacemaker. Says Ershler: "His heart stopped twice while we were putting the pacemaker in. Once we got it in, we were in control." Anderson made a good recovery in four weeks. When he was leaving the hospital, a nurse wishing him goodbye said: "You were one of four cardiacs they brought in that night, and they thought they would save the others but lose you. Instead, they lost all the others and saved you." Says Anderson: "I haven't been sick a day since." (He no longer smokes.) Anderson was fortunate because he had a personal physician who knew all about him and got to a modern, properly equipped hospital within minutes to care for him.

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