One day, many years ago, I was sitting in front of the television when an emergency news bulletin broke in. There was a major water leak on Broadway and 34th Street in New York City, not far from where our family lived. The leak was snarling rush hour traffic and threatening the water supply of everyone south of 34th Street. The news cameras centered on Mayor Lindsay with maps spread over the hood of a city water truck. At his side were the Chief of the Fire Department, Chief of Police and Chief Engineers, all arrayed in suits, ties and dress uniforms. They discussed contingent emergency plans to reroute traffic, pump out water, get an emergency water supply to residents, make sure emergency vehicles could get through, etc...
The camera faded to a big hole in the street with water gushing out of it. There was the usual crew of nine men looking idly on, but in the hole, there was one man digging frantically. His head bobbed up and down, shovels of mud flew through the air. The worker disappeared into the hole. I did not see him for a full minute and wondered if he had drowned. Suddenly the leak stopped. The worker climbed out of the hole and walked straight towards the camera.
Noticing the absence of roaring water, the Mayor and chiefs turned around and their jaws dropped open. The man carrying a shovel walked towards them. He was covered head to toe in mud; his sleeveless T-shirt tattered and soaked. Without hesitation, the man looked at the Mayor and nonchalantly states, “Boss, you can go home now. The leak is fixed.”
That man was my Grandfather, a man who taught me more about how to be an emergency physician than any book, class or lecture ever could.
He never went to medical school. Unless you count all the times he unclogged sewers at New York City Universities, he never even went to college. He dropped out of school in the seventh grade to support his family.
As a teenager, Grandpa worked as a day laborer. He stood out front of labor halls waiting to be called for a day’s assignment of hard labor. This was a time when there was great prejudice against his Italian Heritage. Grandpa stood right in front of the sign that read, “No Whops Need Apply”. Routinely he was the last one assigned for the jobs no one else wanted, cleaning out sewage and digging holes. This taught me humility.
Grandpa worked twice as hard as everyone else did. He would be asked back to do the same work again. This taught me hard work does pay off; do good work and you will be asked back.
Grandpa taught me the importance of exercise. He would brag how he used every muscle in his body as he dug holes all day. He would work his ‘pushing muscles’ to get the shovel down deep into the dirt and then his ‘throwing muscles’ to toss the dirt over his head and out of the hole. “Legs, arms and back”, he said. At age 73, he was still able to dig trenches. ‘No fitness center necessary’, he would say. He got paid to exercise. This taught me the importance of always having a positive attitude, and that staying in good physical and mental shape makes any job easier.
Grandpa was offered a job as superintendent of an apartment building. Free rent and a regular salary! He still had to shovel coal throughout the day and night for the old coal furnaces. He thought this was fortunate. Whatever broke, he fixed; plumbing, electrical, carpentry, glass windows, doors, tile, etc... He knew the importance of knowing a little about everything. Grandpa was proud of being a ‘Jack of all trades’. Like an emergency physician, he was ready for anything. He dealt with tenants’ complaints, calmed family fights and kept everyone generally happy. Grandpa would shout, “I can fix anything, even broken hearts!”
As a young boy, I thought Grandpa’s skills were almost magical. This was not a time when you would buy a window unit and install it. Grandpa had a room full of raw materials, lumber, glass, metal, screws and nails. No fancy machinery; a hammer, handsaw, glass cutter, chisels, screwdriver and pliers. He would cut the glass, make the frame and put it all together. He could make almost anything out of almost nothing. Like any emergency physician worth their salt, he knew how to get the job done without relying on fancy equipment. Give me a spoon and a flashlight to intubate. Skill, not toys.
Grandpa finally got a real job with the New York City Water Department. As a ‘sewer rat’, Grandpa had to inspect the sewers and pipes that ran under New York City. He would take me to work with him and we would inspect the pipes. The pipes were big enough to walk through, with trap doors entering them. We would shut off valves diverting the flow and walk through the pipes looking for cracks, leaks and potential clogs. Preventive medicine – or maintenance – helped the city avoid the need for major repairs.
The pipe rooms were typically brick block buildings surrounded by chain link fences with barbed wire. Pipes would enter at various angles and go deep into the underground. These buildings were unsightly and were hidden from public view in the poor, indigent neighborhoods. Through it all, Grandpa taught me to work without fear. Any hour of the night, all alone, Grandpa would have to inspect and repair the pipes. Often, he would have to chase away the homeless and vagrants hiding in the pipe rooms. If you wanted running water or flushing toilets, you did not mess with him. I still think of his fearlessness when I am faced with the specters of lawsuits, lawyers, administrators or screaming patients.
He taught me to do what is right, regardless of who is watching. If there were nine workers standing by, my Grandpa would be the one man working. Why? So that he would be able to go to sleep at night with a clear conscience and wake in the morning proud of what he saw in the mirror.
He taught me the value in shift work. Like medical emergencies, toilets flush and water runs 24/7/365. Grandpa worked 36 hours on and 36 hours off. He loved his shift work. He saw the lights of New York City when most were sleeping. He played with his grandchildren during the day. He saw the positive in a schedule others would have found grueling.
He taught me that I was never too important to get someone a blanket, cup of water or wipe up some vomit. Being a low-level maintenance worker, Grandpa worked with many ethnic groups. Italian, white, Hispanic, black; it did not matter to him. He respected and treated everyone equally as long as you did your work. If you thought you were too good to jump into the sludge and start shoveling, Grandpa had no use for you.
As paramedics are ambulance drivers, as nurses are waitresses, emergency physicians are maintenance workers. Be proud to jump in the trenches and get dirty.
Dr. Joe DeLucia is standing in for Dr. Mark Plaster while he is on vacation.