The Patient Was…

The patient was an elderly man whose first words to me, on the telephone before we even met, were, “I’m hemorrhaging to death. Can you please see me after you finish your dinner.”

I was on holiday in France and, having rented a car on arrival at Charles de Gaulle Airport, my wife and I headed east with no planned itinerary. As the daylight faded, we found ourselves in the tiny hill town of Vezelay, famous for its abbey, about 225 kilometers from Paris. It was Spring, but the temperature was quite cold and the room we found in one of the two little hotels in the town was freezing. When asked about getting a heater, the hotel owner/manager replied, “Non! C’est impossible!” She insisted that winter was over, and no heaters were available despite it being really cold. There seemed to be nothing we could do. 

A while later, my wife and I were enjoying a fine dinner in the hotel restaurant when the owner entered the dining room and announced, “Telephone call for Doctor Solomon.” My wife and I looked at each other in surprise. Nobody could have known we were in the Hotel de la Poste et du Lion D’or; after all, we had randomly chosen it just a couple of hours earlier. Amused at the coincidence of another Doctor Solomon being in this little hotel, we looked around to see who responded. Nobody did.

A few minutes later, the hotel owner returned to the dining room and made the same announcement. My wife looked at me and said, “It has to be you.” I knew she was right, but it was unnerving. Who could have traced us there, and why?  (A VIP patient once had a physician, whose practice I was covering, traced by the FBI to Massachusetts).

I went to the reservation desk in the small lobby and the hotel owner handed me the telephone. “This is Dr. solomon,” I said, warily. 

“I’m hemorrhaging to death,” said a man’s tremulous voice. “Can you please see me after you finish your dinner.”

“Who are you?” I yelled into the phone. “Where are you?”

“I’m in room #2, at the top of the stairs.”

“I’m coming right up,” I said, slamming the phone down and racing for the stairs. Room #2 was right at the top, and I banged on the door as I barged in. Despite the medical urgency, my first thought was: Wow, it’s warm in here.

Sitting on the bed were an elderly couple, husband and wife, I presumed. The woman was sobbing and holding tightly to her husband’s arm. He looked worried, but there was no blood anywhere, and he didn’t seem to be in any real distress. I gently pried his wife’s arm from his and proceeded to examine him, finding no evidence of active bleeding. He did, however, have a large, purplish discoloration of his left buttock.

As he and his wife told their story, it seemed that they had arrived in France a couple of days earlier, and had arrived in Vezelay shortly before my wife and I did. They were absolutely positive that the husband had not fallen or sustained any injury or trauma to explain the bruise on his buttock. Because it was so cold since their arrival in France, they had not undressed in the past couple of days, so neither patient nor wife had seen his bare buttock.  Now, in a warm room, they had, and panic set in.

I was puzzled as they were by the discoloration, which was clearly old blood, but suddenly I had a brainstorm.  “Did you see your doctor before your trip?” I asked. They had, in fact, seen their doctor. “And did he give you a gamma globulin shot?” Indeed, he had.

Gamma globulin is a type of protein found in animal and human blood. Also known as immunoglobulin, it contains antibodies and has an important role in the immune system, helping to prevent and fight against infections and diseases. The antibodies attach themselves to agents that are foreign to the body, and either neutralize their harmful effects or allow other parts of the immune system to do so.  It was fairly common practice to give gamma globulin injections into the buttocks of people who were going to travel abroad, to provide them this protection against illness.

Clearly, what had happened was that the injection needle had pierced a vein deep in the muscle of the patient’s buttock, allowing blood to seep out of the blood vessel and into the surrounding tissues. Slowly, the blood had made its way to the surface, appearing finally as the deep purple discoloration of his buttock.

“Is there anything we can do for you?” the patient asked, after he and his wife were reassured by the explanation of what had happened.

“First, tell me how you knew I was here,” I said.  

“I was standing near the desk when you checked in. I saw your passport said ‘Physician’.”

“Okay,” I said. “Now tell me how you got a warm room.”

They said they had initially been assigned a room as cold as ours. Having been refused a heater as we were, they insisted that as an elderly couple they were at risk of getting seriously ill, and that would have devastating consequences for the hotel. The owner relented at the threat and had gotten them a heater.

When I left them and returned to the lobby, the hotel owner was waiting anxiously. Was everything all right she wanted to know. Was it serious? Were there to be consequences?

When I assured her that I had taken care of everything and there would be no problems, she took my hands in hers, bending over and practically kissing them, thanking me profusely for saving her hotel. And was there anything more she could do to show her gratitude?

“Yes,” I said. “Get me a heater for my room.”

Straightening up, she said, “C’est impossible! It is no longer winter!”

“Look,” I said, heatedly. “I have just saved your hotel from a terrible situation. You are in my debt. I want a heater!” And I strode back into the dining room to rejoin my wife and finish dinner. Later, when we got up to our room, there was the tiniest heater you could imagine, which produced no appreciable warmth at all. We slept in our clothes.

The next morning, we left Vezelay for the rest of a wonderfully uneventful holiday.

About two months later, a messenger arrived at my office, delivering a flat, rectangular box. Inside was a beautiful silk necktie. The enclosed card read: It took a while to locate the right Doctor Solomon. With gratitude, from the Purple Backside of Vezelay.