The Quest for Cortisone

Chapter 20. The Amazing Mrs. G.

143 Chapter 20 The Amazing Mrs. G. We also have our diplomatic secrets. —sherLoCK hoLMes, THE ADVENTURE OF THE SECOND STAIN Mrs. G. received her first injection of compound e in the early evening on september 21, 1948. Dr. slocumb provided the 50 milligram injection; he was in charge of Dr. hench’s hospital service, and would be overseeing the day-to-day care of Mrs. G. and the other patients hospitalized with rheumatological disorders.1 Where was hench? As usual, he was preparing for a trip. he’d be leaving in seven days for London, where he would give the prestigious heberden Lecture.2 Coincidentally, hench’s upcoming talk was titled “The Potential reversibility of rheumatoid Arthritis.” As the date of departure approached, hench shifted into hyperkinetic mode; because of his speech impediment, the text and slides had to be perfect. The rheumatologist was both busy and distracted. Mrs. G.’s first dose of compound e was, as noted earlier, the culmination of eighteen years of work for Dr. Kendall and possibly the defining moment of his career. The gravity for hench was not quite as serious. Although he was interested in compound e, in many ways it was just another potential therapy for rheumatoid arthritis, no different than dozens of others he had investigated earlier. The sad truth—compound e was something to try on a problematic patient for whom there was nothing else available. hench wanted it to work, but deep in his heart he knew that it, like all the other therapies he had tried, probably would not. And with the demands of his 144| Chapter 20 upcoming trip pestering him incessantly, there was no way he could make Mrs. G.’s problems his main focus right now. Mrs. G. surely felt differently about her situation. At that time there were an estimated three million patients in the united states with rheumatoid arthritis, but she was certainly one of the most severely afflicted. Young, pretty, and at first glance healthy appearing, the petite woman was completely debilitated by her disease . “The patient could hardly get out of bed; once she tried to walk, it was too painful, so she remained at rest.”3 for Mrs. G., day-to-day living was little more than an intolerable, subhuman existence. september 22 came and went. Mrs. G. noted no effect from her injections . Dr. slocumb did not even bother to make a note on her chart. on september 23 the patient awoke feeling a little better. Amazingly, over the course of the day she seemed to improve even more. Mrs. G. reported feeling less stiff, although on physical examination her joints were still inflamed. Dr. slocumb wondered if this was merely a placebo effect? That evening he discussed the situation with hench, insisting that “you’ve got to see Mrs. G. tomorrow before you leave town and see if she’s still the same.”4 When hench balked at the suggestion, slocumb, not usually one to challenge his boss, dug his heels in and demanded that hench visit saint Marys hospital and lay eyes on the woman. The following morning, september 24, it was apparent that something quite extraordinary was happening at the hospital. According to Kendall, “we found her exercising, raising her hands over her head . . . previously impossible. she visited several patients to demonstrate her changed condition . Painful stiffness was gone.” As the patient herself noted, “My muscles feel stronger, and my appetite is very good.”5 As hard as it is to imagine now, Philip hench was so preoccupied with his impending trip to england that he still found it difficult to make the half-mile trip from his office to the hospital in order to see the ongoing transformation for himself. Perhaps he thought his colleagues were exaggerating Mrs. G.’s improvement. or maybe he was just so focused on his travel preparations that he’d managed to compartmentalize his problematic patient in some far-off mental place where she could not distract him. it was with very great reluctance that hench finally agreed to visit Mrs. G. at 7:30 p.m. on the night of september 24. Dr. hench was in a hurry. The patient was in room 127 at saint Marys hospital, located in a bed next to the window of a double room on the first medical unit. The room was directly off a stairwell, and hench was anxious to get the visit over with. “Dr. hench surprisingly came up the...