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2014 Andrew Koch, Conner McConnell, Jack Koch, Doc, Marissa McConnell., Kate Fassler, Julia Fassler, Margot McConnell

These are my grandchildren. This website is primarily for them. I want them to know more of Marianne and me than I knew of my grandparents. It also is a creative outlet for my love of writing, photography, art, and history.

Content

The Cases pages are patient stories, including, for example, Trouble in Vicksburg, in which I testified in an abortion case in the 1963 trial of a Black woman before an all-male, all-white jury in Vicksburg, Mississippi.

The Stories pages are non-medical stories. Burying JFK tells of my participation as a US Army physician in a few Presidential events before the assassination and afterward in ceremonies at the White House, the Capitol, and Arlington National Cemetery.

The Images pages are devoted to my art collection and photography.

The Opinion pages are essays, letters, and similar. On Manners and Murder will give you a taste of the content.

The Questions Worth An Answer page is my answers to questions posed by my family. Tell Us One of the Best Days You Can Remember is an example.

Marianne

I am the author of the content and a participant in much of it. The focus is on me, but make no mistake, little of what you read is solely mine. The sustaining force of my life was Marianne, to whom I was married for 50 years.  She loved me. It was wonderful.

Marianne, 2006

My life seems a series of miracles: at every nodal moment, when fate teetered, events turned in my favor.

The first miracle of my life was the death of my opiate-addicted father during my sophomore year (Three and Out: How Not to Go to College). The boil being lanced, I was transformed from a back-of-the-pack student into a Dean’s List honoree in the course of a semester. The second miracle was Marianne. Her effect was slow, an inexorable glacial molding of my terrain to her worldview. Arguing was not her way, it was mine. Hers was persistence and pleasant goodwill.

I made a music CD for her that included All I Need Is A Miracle by Mike + The Mechanics.  The opening line is All I need is a miracle; all I need is you. Another line is It’s always the same old story, you never know what you’ve got ‘til it’s gone. It is impossible to fully appreciate anything until you know it by its absence. If I am at sea, she was my anchor; if directionless, she was my pole star; if listless, she energized me; if sad, she was the source of my happiness; and to the extent that I feel less than whole, she completed my life.

She was careful in thought and action, never rash. What sometimes seemed timidity, was prudence informed by the right values and an intuitive feel for larger issues. She was fair-minded and generous, always willing to contribute to the common good, and forever on guard against selfishness and mean-spirited views. She was courageous in the best sense—always doing the right thing.

She was not given to excess. Yes, we enjoyed some economic success, and she liked beautiful things, but she studiously avoided indulgence or display. I have yet to know anyone who came closer to living out the Biblical imperative to “Love thy neighbor as thyself.”

My Story

In the Beginning

Early evening, Monday, October 25, 1937, Parkland Hospital, Dallas, Texas.  Worried about Hitler, the French raced to extend the Maginot Line, while half a world away the Japanese butchered and raped their way across China.

Nearer to home, storms of the Great Dust Bowl dimmed day into dusk across Kansas, Oklahoma, and the Texas panhandle—dust, fine as flour, smothered crops, strangled hope, and scarred the lungs of Unemployment stood at 15%, a popular mail order item featured a dozen day-old baby chickens shipped in meshwork cartons (“Why pay the grocer? Live delivery guaranteed!”), Disney’s new cartoon movie Snow White and the Seven Dwarfs was a runaway hit, Roosevelt’s new Social Security program began taking 1% of paychecks, and… 

I didn’t get off to an auspicious start—seventeen agonizing minutes ticked away before I drew a breath.  Had I been born in Sulphur Springs, a burg of a few thousand souls in East Texas, I wouldn’t have survived, but Dad was a physician, Mother a nurse, so they came back to Dallas for my birthing in the hands of an obstetrician at Parkland, the Dallas County Hospital, where they had met. The OB wisely left the placenta attached inside of Mom’s uterus, providing me a supply of oxygenated blood, and ordered a nurse to gas me with carbon dioxide by mask—it is high blood CO2, not low oxygen, that stimulates breathing. It worked.

Growing Up (1937–1955) In East Texas

Dad, about 1947

Then it was back to Sulphur Springs for my upbringing, which was undistinguished by some measures, remarkable by others.  Dad was hopelessly addicted to intravenous opiates, he preferred morphine, and he smoked incessantly, there is scarcely a picture of him without a cigarette.  He was forty-one when he had his first heart attack, and died of cardiac arrest when he was forty-seven. I was nineteen. Mother kept us together with the help of Helen, one of her six sisters, and Blanche, our Black housekeeper. Mother drilled into younger brother Jim and me the importance of the Golden Rule, and added a maxim of her own: Always do right. She arranged art and piano lessons for me, neither of which could resist a teenage tsunami of testosterone, a combination that stimulated, among other things, a lasting appreciation of women, athletics, and art.

Blanche and Mom, about 1947

Given the distractions, my high school academic record was only somewhat better than mediocre.  Even as a high school senior I didn’t think much about college—the assumption was that I would go, but I don’t recall discussing it with my parents.  I was prodded into thinking about college by a challenge from my best friend, a very smart guy (and Marianne’s first cousin), who bragged he was applying to Rice University—notoriously picky because everyone admitted got a full academic scholarship—and I probably couldn’t make the cut. That did it. My application and interviews were after the deadline. I never learned my SAT score. I was admitted; he wasn’t.  Go figure.

College (1955–1958): Drowning In A Rice Paddy

I hated my time at Rice. Worrying about Dad’s addiction muscled aside every other concern (The Death and Life of the Father and the Son).  On the first physics test, my blue book had “21” scrawled in red on the front.  It had to be a mistake; it was—my correct grade was “11.”  I floundered—three semesters of C’s, a few B’s, and one D.  It was the darkest period of my life—it was an act of will to get out of bed, study, and mix with others.  All I wanted to do was to be alone with my thoughts. I must have been depressed. I had no choice but to plow ahead—counseling and coddling of students in the current fashion were unknown.  Callous though it sounds, it is true that Dad’s death in my sophomore year was my salvation. My grades shot up, I made the Dean’s List, and after my junior year, despite Rice’s strenuous objection, I applied to UT Southwestern Medical School and was accepted (Three and Out: How Not to Go to College).

Medical School (1958–1962): On A Roll

With best friend Don Payne in freshman anatomy lab

Medical school was easy and fun.  But it didn’t start propitiously. After the first pop quiz in anatomy, I felt in over my head again. Trying to lower expectations, I protested to anyone who would listen that I was having a hard time.  Then came the first major exam, in neuroanatomy, a very difficult course. I complained loud and long about how poorly I thought my grade would be.  This time, however, emblazoned in red on my blue book was “98.”  It was surreal.  And good grades continued to fall into my lap like ripe fruit. I couldn’t understand why I was doing so well when my internal experience shouted the opposite.  To this day it seems otherworldly.

Mississippi Intern (1962–1963): In the Belly of the Beast

With our VW bug at U. Mississippi Medical Center, 1962. Marianne photo.

I interned at the U. of Mississippi Medical Center in Jackson, the state capital, during a period of bloody racial unrest in the 1960s—during my time there federal troops occupied Jackson and Oxford to ensure James Meredith’s admission to “Ole Miss.”  It was a remarkable experience in ways too numerous to mention here but detailed elsewhere on this website and in the memoir I published in 2011 (Dead Wrong).  The social tension was extreme—everyone had a gun in their car or their pocket.  Medgar Evers was assassinated during my ER rotation, and I had a series of case experiences so memorable that I have written vignettes of most of them.  The details are too lengthy to repeat here, but among the more memorable cases were two criminal abortions gone bad, A Death in Jackson and Trouble in Vicksburg

US Army (1963–1965): Jump Doc

Jump ready under the wing of a C-130

After finishing my internship I joined the Army.  I had a wife and infant daughter and bills I couldn’t pay and the military draft in those days ensured every doctor would go sooner or later; so I chose sooner.  I was posted to the Pentagon and found myself going to several important functions involving JFK in case anyone needed minor first aid.  As circumstance would have it, I was Medical Officer of the Day on November 22, 1963, and was swept into the JFK funeral (Burying JFK).  I found myself at the White House with orders to follow the casket to provide medical assistance in case some dignitary needed care.  I had three days of military-escorted rides to and from the Pentagon, White House, Capitol, and Arlington National Cemetery.

Despite the thrill of involvement in important affairs, I did not like Pentagon duty. It was boring and I had to ride the bus to work.  The surest ticket out was to volunteer for parachute and ranger training, which I did immediately.  Two months later I was in jump school at Fort Benning, GA. Afterward, I was posted to Fort Campbell, KY as Battalion Surgeon for the 501st Parachute Infantry Regiment in the 101st Airborne Division.  I loved the military and made a lot of jumps (Jumping for Joy) with my medical platoon, aid station, and ambulance falling from the sky with me.

I am no exception to the rule that military service inspires a lot of tales. One of my best is about the one-and-only adult circumcision (Paratrooper Circumcision) I performed in my otherwise honorable medical career.

 Residency (1965–1969): Becoming A Pathologist

After two years of military service, I returned to Dallas for pathology training at UT Southwestern and Parkland Hospital.  For the most part, it was plain vanilla stuff except that I watched the autopsy of Jack Ruby. He died of an uncommon variety of lung cancer.  I autopsied Lee Harvey Oswald’s housekeeper. She was not assassinated by the CIA—she died of heart disease.

Practice (1969–1991): Searching and Finding 

In my lab office

After residency, I bounced around from one small Texas hospital to another as a staff pathologist, never lasting very long because of my impatience to do things differently, which brought me into conflict with partners and hospital administrators.  After a few years of this, I found myself in El Paso in a dream job at a new hospital with a good friend as a partner.

But within months I was again frustrated and for the first time admitted I was not cut out for institutional practice and needed to work for myself.  I asked a former pathology professor if he would have me in his small, independent laboratory practice, and he took me in.  I took an income cut of 70% and went into business for myself.

My time in the commercial lab business was financially rewarding but more important, it offered what I had to have, a space of my own where my peculiar brand of poison ivy could flourish without giving anyone else a rash.  It was fun but harrowing, and I was constantly reminded of the truth of entrepreneurship—the good news and the bad news are the same—you get to keep what’s left over.  All in all, yes, I’d do it again, but I wouldn’t look forward to the corrosively competitive nature of the lab game as it was played in those years.

I bought out my partner in 1980.  The lab grew rapidly and was sold to a publicly traded competitor in 1991, leaving me with enough resources to retire when I was 54.

Retirement, Teaching, and Writing: Discovering Freedom to Be

After selling the lab I served on some corporate boards and did some consulting work, but it was unfulfilling.  In 1997, I was invited to join the faculty at UT Southwestern and teach basic pathology to students in the Allied Health Sciences School.  It was invigoratingly creative and I enjoyed teaching.

However, I could not find a pathology textbook that I thought was appropriate, so I wrote an outline and submitted it to publishers.  Lippincott was interested and in 2007 The Nature of Disease was published (the second edition was published in 2014).  The success of TNOD prompted Lippincott to ask me to be a co-author of a textbook of anatomy and physiology, Human Form, Human Function, which was published in 2011. Later in 2011, I published a memoir, Dead Wrong

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