Excerpt from Chapter 3 Training—Internship and Residency

I feel compelled to tell you about a man named Solomon Darby. I have thought about this man many times over the last thirty-five years or so. It was truly a very profound experience for me. Mr. Darby was a patient of mine on the general medicine wards during my training. Solomon was an older, African American with a mouth full of gold teeth. He was a personable man. His smile would light up the room, but he did not smile much. He had been admitted with a large lung mass that was probably cancer, but we needed to find out which one it was so that a treatment regimen could be planned. I was extremely busy, and he was just one of many patients on the ward. Every morning we would round on him and ask how he was doing. He would always reply that he was doing well.

One day, after rounds, it came to my attention that Solomon could not move his legs. Indeed, as it turned out he was paralyzed from the waist down. I was incredulous. I asked him why he had not said something during rounds. He just replied that I had not asked him specifically about his legs.

As we move quickly to address this issue, it became obvious that the lung mass was probably cancer and it was now encroaching on his thoracic spinal cord, causing the paralysis. It is called “cord syndrome”. I had not seen it before. He needed immediate radiation to the tumor in an attempt to shrink it and save the spinal cord. We accomplished this and he responded well, with resumption of motion and feeling in his legs. I was so glad, and began to pay him much more attention at rounds each day.


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