Susquehanna University is a small liberal arts university of about 2000 students, in Selinsgrove, Pennsylvania, on 220 acres of reclaimed farmland. It has fields and farms on several sides of it and is a short walk from the Susquehanna River. During the fall, the smell of the harvest wafts in from the fields anywhere on campus. The university was founded as a Lutheran Missionary College in 1858. One of its claims to fame is that the famous football coach Amos Alanzo Stagg coached there during his run as one of the winningest coaches in history. The football field is called Stagg Field. It also has a wonderful college of music and business. The dorms are spread throughout the campus while the main classroom buildings are in the center.
Dorm life in any university builds a bizarre closeness that is hard to describe if you have not lived it. You learn the bathroom habits of your roommate and many of the other people in the dorm. In all-female dorms, the women’s menstrual cycles will synchronize and a dorm of hundreds of women will all be reaching for the sanitary supplies at the same time.
In a men’s dorm some incredibly immature forms of entertainment can crop up. For example in the men’s dorm I lived in, called Aikens, we invented unit check wrestling. It was basically wrestling, except the goal was not to pin your opponent to the mat but to grab his testicles and force surrender. So this was a homoerotic exercise and entertainment. There were usually jokes about wanting to get checked and the frequent participants would be accused of enjoying it too much. I did not participate, although I would be summoned to attend to injuries that had occurred. I took to keeping a combination first aid kit and training kit in my dorm room because everyone seemed to come to me with illness or injury.
After one interesting unit check match the “winner” was a guy named Myron Briggs who had survived a fairly brutal unit check without surrendering. He ended up winning because his opponent was so focused on inflicting what he thought was an intolerable unit check that he left his own unit unprotected. Seeing an opening, Myron seized the moment (and a very painful unit check) to win when his opponent quickly submitted defeat. After the celebrations, however, Myron came to see me for a quiet word. He had read, he said, that sumo wrestlers would push their testicles back up into them during competition. What he was talking about is that a man’s testicles are connected to the inside of the abdomen. They actually form inside the abdomen near the intestine and descend into the scrotum after birth. The canal that they travel down, called the inguinal canal, is where the sumo wrestlers push their testicles. Myron figured that if he could do that he could win at unit checking. The problem is that if you do not keep the canal open from birth as sumos do, it gets too small for the testicles to travel up and down within. Nonetheless, Myron had forced them back up into himself and when he beat the unit check, they were pushed so far up into him that they hurt a lot and did not want to come back down again.
In sports it is possible for a man to be hit in the groin and the testicles pushed up into the canal a little. Since this is known to occur, there is a treatment for it that athletic trainers all learn. I told Myron I would try to treat him but it might not work. I made it clear that if he wanted my help, he had to promise, should that happen, to go to the ER WITH me immediately—no argument. My concern was that for human testicles to function normally they must be kept cool. This is why they are suspended outside of the body, where they are actually about 4 degrees cooler than the rest of the body. If they stayed in the abdomen, as they were now in Myron, he might be rendered sterile and I did not want that happening to him. In any case, Myron agreed to my terms.
I had Myron sit on a hard floor and gently hold his knees to his chest. Grabbing him under his shoulders as I would an ambulance patient to lift them up off the floor, I told Myron to cough repeatedly. As he continued to cough, I would pick him up a couple of inches and let him fall to the floor on his butt. The goal was to force the testicles out via the pressure of the coughs and the force of the fall. After a couple of coughs and falls Myron announced that one had popped out. Realizing now what we were trying to do, Myron would time his coughs to coincide with the drops. After a couple of well-timed simultaneous drops and coughs Myron announced, “they’re back!” with great joy. Then he swore me to secrecy and I have kept that secret until now.
Greg Barry was a chemistry major in my class when I began my studies at Susquehanna. He had started as a chemistry major with the professed goal of being able to make drugs when he grew up. He claimed he absolutely adored Timothy Leary and wanted to be like him and make the best drugs. Greg had a nickname that he seemed to revel in —“Dingle”— thus he was known as Dingle Barry.
Greg dropped out of chemistry in sophomore year and he was still looking for a major by his junior year, which is a pretty sure sign of someone on the five-year college plan or no-degree plan. Greg’s family paid for his college, so as long as he did not fail out he had a gravy train. Junior year Greg was experimenting with majors and different drugs. He got a hold of some magic mushrooms and was having a pretty bad trip one weekend. He told me he had done some cocaine along with the ‘shrooms. Greg was hallucinating, but was coherent enough to be scared. He asked me what to do. I knew the traditional treatment for ‘shrooms was to induce vomiting, but with cocaine the blood pressure can be increased and vomiting can exacerbate this to dangerous levels. So inducing vomiting was not what I wanted to do now. I was in the process of advising Greg to find a colleague to stay with him to ride out the trip when the school nurse arrived. Someone had called her.
I briefed nurse Mary Peterson on Greg’s status. She proudly said to me, “I have the ipecac.” Ipecac is a liquid that induces vomiting.
“But that might spike his BP (blood pressure). He is already coming down and he did the ‘shrooms and coke nearly 4 hours ago,” I said to her, trying to convince her not to make Greg vomit.
“The treatment is ipecac and he has earned it,” she said.
I fully understood that concept of teaching someone a lesson, which is what she meant by saying he earned the ipecac. I vividly recalled when I worked in the ER in years past “pumping the stomach” of teenagers who got drunk. We would have a tube down their nose and one in their rectum to completely purge their whole system of the alcohol. The truth was that the alcohol was almost never in the intestine at this point and already in the bloodstream, but the stomach-pumping treatment was a punishment to teach them a lesson.
However, I truly believed that cocaine and vomiting could produce a deadly increase in blood pressure and pleaded with Mary not to do it. But I was just a dumb student and she knew better. Greg got the ipecac. He vomited in the dorm toilet and I stayed with him, hoping that his blood pressure would not cause some weak spot in his arteries to rupture. Greg vomited hard and long. There was a lot of fluid because we made him drink a lot to help give his stomach something to flush.
Greg and I both seemed to know when he was done vomiting. I gave him some towels to wipe his face and he looked at me as if he were asking me, why did I do that to him? I looked at him closely and there were multiple little hemorrhages in his cheeks, nose and even the whites of his eyes. The term for multiple little hemorrhages is petechial hemorrhaging, and it can occur with high blood pressures such as while vomiting under the influence of cocaine. I was glad that many small non-lethal hemorrhages had occurred as opposed one big bad bleed that could kill.
I tried to get Mary to acknowledge that the petechial hemorrhaging was indicative of the blood pressure elevation I had talked about, but she dismissed it as unimportant.
Greg’s roommate Paige agreed to monitor him during the night to ensure no more vomiting, drugging, or drinking, and a continuous presence of breathing. I was mildly concerned that Greg might vomit again and inhale the vomit. Aspirated vomit is lethal and has killed the likes of Jim Morrison, Curt Kobain and Jimi Hendrix. I checked on Greg first thing the next morning and he was happily breathing and snoring away.
The next afternoon I discovered that Mary Peterson had complained to my bosses in the athletic training staff that I had undermined her authority in front of “her patient.” I pleaded my case, explaining my coke and blood pressure concerns about Greg, but was duly reprimanded.
Greg became a kind of fan of mine after that. Anytime there was a medical anything at school he wanted to tell me about it. He would brief me on any drug overdoses that occurred on campus and what the other people did about them and did I think it was right? While Greg did not do less drugs after his little episode, he did restrict his experimentation to one thing at a time. He seemed to be very proud of his decision to only do one drug at a time like it was a step towards being a grownup. (This, of course, assumes that alcohol is not a drug, again Greg logic.) Greg reminded me of many of the people I had to deal with on the ambulance in some ways, because of this rationalization of destructive behavior.
It was interesting how my college studies, athletic training and paramedical experiences sometimes collided. This was demonstrated to me late one Saturday night I was studying physical chemistry. I was learning the Schrödinger equations that are used to characterize wave mechanics. This is a fundamental principle in all of physics and chemistry because it mathematically describes all waves. The Schrödinger equation can be used to describe ocean waves, the colors of the rainbow, radio waves talking to satellites, cell phones, magnetism, and how to tune a piano. However, just because it is useful and widespread does not mean it is easy. Understanding it is actually pretty hard. So I was diligently studying with headphones on to drown out the drunken noise of the dorm when Greg Dingle Barry came running in.
“Somebody just fell down the stairs on the north side of Aikens and they’re not moving.”
I was out the door like a shot. Aikens was a two-story dorm with four sets of stairs but only one main set of north side steps that I headed to from my dorm room on the south side. Aikens north was the female wing and Aikens south was the male wing. The wings were about the same size and shape, separated by a common room. So to get from my room to the Aikens north stairs, I had to go through the common room, which was unusually empty for a Saturday night. As I ran through the common room it seemed quieter than my dorm room. How strange, I thought, perhaps I should be studying here. I ran up to the fire door that separated the common room from the north wing, a door I had passed through a hundred times. Because it was a fire door it was always shut. The door had a large glass window with wire mesh in the glass. I pushed on the door and much to my surprise it flew open at great speed. It swung wide and smashed against the opposite wall with a tremendous crash, spider-webbing the glass on the door. As I paused to make sure there was no glass on the floor, I noticed that the spring that closed the door was broken, leaving the door open.
I continued to the steps and found no one. Greg, who was following behind me, pointed to a spot on the floor and said, ‘‘She was right there.’’
‘‘I understand. Ok, we need to go get the RA on duty.’’