Chapter 03: A Strong Mother Tells Stories with Impact

Chapter 03: A Strong Mother Tells Stories with Impact

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Description

In this chapter, Dr. Holleman talks about his mother, a strong woman with a strong impact on him. He notes that her very difficult background formed her into a very strong woman who would speak her mind and stand up for what is right. She would also tell Dr. Holleman and his brother stories that captured lessons as they were growing up. He offers three stories that influenced him and that he says had an impact on the work on faculty health that he is doing at MD Anderson.

Identifier

HollemanWL_01_20170412_C03

Publication Date

4-12-2017

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Personal Background; Personal Background; Experiences Related to Gender, Race, Ethnicity; Influences from People and Life Experiences; Character, Values, Beliefs, Talents; Professional Values, Ethics, Purpose; Formative Experiences

Transcript

Warren L. Holleman, PhD:

So this gets into a whole other can of worms, but my mother came from a really challenging family background. And very difficult. She ran away from home when she was 16 years old, and was on her own sort of after that, with some support from family and friends, other family and friends. And so she was a very tough woman. She sort of had to be tough, to do as well as she did. She was—so she was—she had a pretty hard view of life.

Tacey A. Rosolowski, PhD:

And how did the medicine factor in? Did she feel—was it an economic thing about being a doctor? Or what was—what did being a physician represent to her as a strong woman?

Warren L. Holleman, PhD:

I think she loved her career and loved being in healthcare. And it had sort of—the hospitals where she worked sort of became her family. In a sense, a family she didn't really have growing up. And she saw that as a very high calling, and a very successful professional life.

Tacey A. Rosolowski, PhD:

Sure.

Warren L. Holleman, PhD:

And it really rescued her from—as I understand it, she wanted to go to college, and she started there with some money from a brother of hers, but then couldn't continue. And the war came along, World War II. And she was able to go to nursing school for free, because they needed nurses. Then from there she went into nurse anesthesia. And basically, the health professions opened up to her at a time when she couldn’t afford anything else. And it really—and she embraced it. I think that she was the youngest nurse anesthetist ever to graduate, or ever to get a license in North Carolina at the time.

Tacey A. Rosolowski, PhD:

Wow. That's very impressive.

Warren L. Holleman, PhD:

Her friends at the hospital always called her, "baby." And you think baby, is that sort of, like, because she's a woman and a "babe," no. That was because she was so young. She talked her way into the program during the war. Usually a nurse would work as a nurse for several years, and then would go back to school and do this. But she just went straight from nursing school, I think.

Tacey A. Rosolowski, PhD:

So what kind of impact did it have on you growing up, knowing this story about your mom, this strong, independent person who's kind of doing firsts so early?

Warren L. Holleman, PhD:

Yeah.

Tacey A. Rosolowski, PhD:

Yeah.

Warren L. Holleman, PhD:

The joke is that my brother and me, especially me, the younger one, we were raised in the state mental hospital. So my mom worked in all the hospitals in Raleigh. She was—I learned after she died—I was going through her stuff—she was the chair of the Anesthesia Department at Rex Hospital, which was the biggest hospital in Raleigh at one point. I never even knew that. And that was way back in the '50s or early '60s. But the place, by the time I came along, she was working mostly at Dorothea Dix, which was one of the largest psychiatric hospitals in the United States. They had a campus that looked like a college campus. It was probably one or two square mile—I don't know, maybe one square mile in Raleigh, and had two thousand five hundred patients, which at the time were called, quote, "inmates." Not a really good term. But when she couldn't get a babysitter, she would take me with her to work. And that was before HIPAA. And there were no rules. So basically I was free to play in the hallway around in the OR area. And they would put a chair in front of the OR door so I could stand on that and watch my mother in the operating room.

Tacey A. Rosolowski, PhD:

Oh, man!

Warren L. Holleman, PhD:

They even gave us, let us, my brother and me go up to the observation room, or deck, or whatever it was called, and watch the surgeries from there. I don't really remember that. That was because my brother was older, and once he started going, that was probably when I was three or four or five years old. There's a funny story that I don't remember, but my mom enjoyed telling, that one day we went up to watch the surgery. And it was a rather unpleasant visual experience. They were removing someone's eyeball. And they said my brother got kind of nauseated. They said I was banging on the glass saying, "Take the other one out! Take the other one out!" (laughter)

Tacey A. Rosolowski, PhD:

So you can decide whether you want to believe that or not, right?

Warren L. Holleman, PhD:

Yeah. Yeah. But when my mother died in 2010, I believe, or was it 2011? Ouch. My brother and me decided that at the memorial service we would tell some of the stories that she had told us, or her colleagues had told us about her from her work in the 1940s and '50s and '60s, and mostly in the psychiatric hospital. And it really—well, those in attendance really enjoyed them. Many hearing them for the first time, older ones reminiscing. But most of her colleagues had died by then. But it really gave them a window into her personality. But also, I realized these stories really were formative for me. I saw how many of these stories shaped the career that I chose in healthcare.

Tacey A. Rosolowski, PhD:

So tell me about that.

Warren L. Holleman, PhD:

So I didn't become a doctor like my mom wanted, but actually, I really did—you want to hear a couple of the stories?

Tacey A. Rosolowski, PhD:

Absolutely, yeah.

Warren L. Holleman, PhD:

Well, I'll tell—the first one I'll tell is a funny one, but it still has a really serious point. But I also want to tell, at least tell one other that was probably the most related to the work I do now.

Tacey A. Rosolowski, PhD:

Mm-hmm.

Warren L. Holleman, PhD:

So as I told you, my mother grew up in a really difficult home situation. She had a very abusive father and stepmother. She had to really fight to—not just her, her siblings all had to be very tough. Many times she lectured me on, if I showed any sign of weakness or cried or anything, she would say, "If you're weak, you won't survive." She didn't allow crying or tenderness. That was a down side of this. She was not a tender person at all. She wanted you to be tough. So this kind of gives you a little window into her personality. So that era, as I understand it, at least in this area of the country, the nurse anesthetist did the anesthesia. I don't think they had male MD anesthesiologists. And so the OR was surgeons and nurse anesthetists, and then the OR nurses. And so the Duke Medical School used the hospitals in Raleigh to train their medical students and their surgery residents. So she taught them all how to do anesthesia. So there was one surgery resident who was—she was trying to teach him how to do a spinal tap, spinal anesthesia, and it involved sticking a needle in the spine. The patient was a young woman, 15, 16 year old, who was mentally retarded. And she didn't really understand what was going on. And he wasn't doing a good job. And he was inflicting a lot of pain on her. It's painful and scary to start with. But if you're not doing it right, it gets worse. So instead of—and so she was just sort of trying to get through the procedure by, I guess, praying. She's, "Jesus, help me Jesus, help me Jesus, help me Jesus, help me, help me Jesus, help me Jesus!" And instead of sort of backing off, as my mom was trying to get him to do, and let's think this through and start over, he kept just sort of trying harder, and making it worse. And her screaming, "Jesus, help me Jesus!" Like that. Finally, he had had enough. And he said, "Will you please shut up?" At that point, my mother—that went too far. So to that young surgeon with her mask on and everything, she pushed her way between him and the patient, pushed him away from the patient and said through her mask, "I don't believe she was talking to you. She was talking to Jesus, and you think you're God, but you're not!" She made that point. And that was kind of a story that everybody talked about, that kind of told the story of a dynamic of working in a mental hospital. The male-female thing, the power struggle, doctors, nurses, all that.

Tacey A. Rosolowski, PhD:

Yeah. Wow.

Warren L. Holleman, PhD:

But also it showed my mother's toughness. And she wasn't—and there was story after story of her standing up to—

Tacey A. Rosolowski, PhD:

On behalf of the patient.

Warren L. Holleman, PhD:

In this case, on behalf of the patient. Another thing she did that was really remarkable that I learned in her later years, at both the hospitals where—at the two big hospitals where she worked, Rex and Dorothea Dix, so in the 1940s and '50s and early '60s, there was a big problem with narcotics use by doctors. I don't think they realized how bad it was. So she was in charge of the narcotics. And her narcotics, in both hospitals, would disappear. Only about five people had keys, so she knew it was one of those five. And one was at Rex, one was at Dorothea Dix. These were in different time periods, I don't know the details. But in both cases she caught the perpetrator, and they both lost their careers over it. And that—I've heard—that's unusual. But in one case, it was a surgeon, the head of surgery. He lost his medical license and never practiced medicine again. He sold real estate, I think, after that. And she caught him, and she stood up to him. He was her boss, basically. And the other, it was the hospital administrator, who was a more of a business type. So she told me later in life how she caught them. She said, "I sort of figured out who I thought it was," but they say, "Well, you've got to prove it." So she announced to the five or so people who had the keys that there was—she was going to change the keys on the locker, and she would give everybody a new key. So she changed the keys, only gave the key to the person she thought was the thief, and then told the other three just to stay quiet. Or, I don't know what she told the other three, but she did not give them a key yet. And then when the stuff continued to disappear, she had proof.

Tacey A. Rosolowski, PhD:

Yeah. Wow.

Warren L. Holleman, PhD:

So I think she was pretty tough.

Tacey A. Rosolowski, PhD:

Yeah, very tough. And, you know, doing the right thing. Focused on that.

Warren L. Holleman, PhD:

My parents were both into doing the right thing. They were very—that's one of their strengths.

Tacey A. Rosolowski, PhD:

So here you are in this family environment. You obviously admire these aspects of your mom very much. How did your own interests develop independently and (cell phone buzzes)—

Warren L. Holleman, PhD:

Is that mine?

Tacey A. Rosolowski, PhD:

I think that may be yours buzzing. It's okay. I was just trying to take the—do you need to take it?

Warren L. Holleman, PhD:

No, I'm just going to turn it—

Tacey A. Rosolowski, PhD:

Okay.

Warren L. Holleman, PhD:

I thought I had it off, but it vibrates.

Tacey A. Rosolowski, PhD:

Oh, it was just vibrating. I wasn't sure if mine was.

Warren L. Holleman, PhD:

Yeah. So that should be off. Well, and I do—there is one other story—

Tacey A. Rosolowski, PhD:

Oh, sure, tell it if you'd like.

Warren L. Holleman, PhD:

—that really relates to the work I do now. At some point, let's be sure—

Tacey A. Rosolowski, PhD:

If you want to tell it now, go right ahead.

Warren L. Holleman, PhD:

Okay. Because the work I do now is kind of different than what I've done in most of my career. I'm working with trying to help doctors and scientists and other health professionals have better mental health, basically, because we do have a crisis now of both high burnout rates and high suicide rates among physicians. This is a cautionary tale that she told me, at least 10 or 20 times in my life. And I checked in with my brother a couple of months ago. I published this story, actually, and showed it to my brother. He said, "You're right. She told us this story over and over and over." So this story goes back to the 1940s. There was a Duke Medical student, we'll call him "B." I don't think we need to use his name, although I heard his name throughout my life. I think his wife is still alive, his widow, in South Carolina. I've always wanted to follow up with her. So in the 1940s, the Duke Medical School was kind of decimated by the war, because all the faculty headed off into the war effort. And they were short on faculty. There was this student there, we'll call him "B" who, as my mom put it, said he was the best student ever to come to Duke Medical School. And everybody agreed. He was just amazing. He was smart, he had clinical and surgical skills, he was a good teacher, he was a good administrative person, he got things done, and he had the nicest personality. And I got the idea he must have been good looking, because they all just loved him. And because of his skills and his personality, he kind of got recruited into a faculty role, even when he was a student. He would have the role of teaching the younger students, both didactically and clinically. Then when he became an intern and a surgery resident, he continued to—now was working primarily in these hospitals in Raleigh where my mom worked. And he continued to have these multiple roles. He was doing his work, but he was also being a teacher. If the hospital had stuff they needed to get done, they would always ask him, because he would always get it done and he'd do it with a smile, and he was the nicest guy. And my mom said, everybody loved this guy. He was just—they never met anybody like him. And they all wondered, how does he manage to get so much done and do so well and always have a smile on his face, and always be so nice? They just never experienced that before. One day, one morning early, they came into the operating room to prepare for surgery, and they saw the strangest site. The OR had basically been trashed. Somebody had had a rage in there, and the weirdest thing was, the OR table had been cut in half. So this was a steel table. And they thought, how could this have happened? Did a bunch of the patients at the psychiatric hospital get a hacksaw and just take turns sawing all night long? Well, the truth was stranger than that. It was the work of one man, one person, and it wasn't a patient. It was a doctor. And it wasn't any doctor, it was B. Dr. B. So they hospitalized him at Butner, which was the other psychiatric hospital in North Carolina. And a few days later, he was found dead in his room, he had hanged himself. So my mother never forgave the hospital for that. She blamed it—she said if you do a good job, people will keep asking you to do more, until you can't do anything else. So A, you've got to learn how to say, "No." You've got to stand up to these hospital executives, you know, this sort of thing. I think she's projecting her father. Her father was abusive, and she said, "You've got to stand up to these men." That was her point of view. And she said the hospital, that leaders need to learn that when they have a good worker, a good resource, they shouldn't just run it into the ground. The analogy I would—she didn't say it this way, but it's like they've got this fleet of Maseratis, but they drive them like clunkers, and they don't bother to tune them up, oil them, lube them. They just drive them into the ground. And she said, "Whoever your employer is, that's the way they'll treat you if you do good work. And you've got to stand up to them, and tell them what you'll do."

Tacey A. Rosolowski, PhD:

Wow.

Warren L. Holleman, PhD:

And that's sort of the way she was.

Tacey A. Rosolowski, PhD:

That's an amazing story.

Warren L. Holleman, PhD:

Yeah.

Tacey A. Rosolowski, PhD:

Obviously had a huge—sticks in your mind still.

Warren L. Holleman, PhD:

One of my regrets is that I didn't sort of follow up with some of her colleagues when they were still alive, and ask their memory of that. At the time my mother died, right before she died, she said that B's wife at the time had remarried and moved to South Carolina. And I wanted to try to find her. But I don't know if she'd still be alive. But she'd be probably 90 years old now.

Tacey A. Rosolowski, PhD:

Well, that story obviously does have a lot of connection with the work you do now, for sure.

Warren L. Holleman, PhD:

I think about that story all the time.

Tacey A. Rosolowski, PhD:

Yeah. Yeah. Have you ever told it? In a professional context, like here at MD Anderson?

Warren L. Holleman, PhD:

I should. I don't think I've ever told it at MD Anderson. I've told it a couple of other places. It's such a painful story, it's almost too painful, you know?

Tacey A. Rosolowski, PhD:

Mm-hmm. Hmm.

Warren L. Holleman, PhD:

I don't know. You think I should tell it more?

Tacey A. Rosolowski, PhD:

I don't know. I mean, I really don't know. It's, I think people would really connect with it. Whether or not they could handle what comes out when they connect with it is another matter.

Warren L. Holleman, PhD:

Yeah.

Tacey A. Rosolowski, PhD:

You know?

Warren L. Holleman, PhD:

I did put the story in—I published it in a publication called KevinMD. It's a blog for doctors. It's a very—it's a good blog. It's the most widely read social media among doctors. And I got a lot of responses. I sent the link to my brother, because I was thinking, it's been all these years, do I remember this story correctly? Am I projecting something of my own in there?

Tacey A. Rosolowski, PhD:

Sure.

Warren L. Holleman, PhD:

He wrote back and said, "This is exactly the way I remember it. You're right, mom just drilled that in our heads, over and over and over."

Tacey A. Rosolowski, PhD:

Yeah. Very interesting.

Warren L. Holleman, PhD:

That's not a story we told at her memorial service, obviously, because that wasn't really about her. But it was a powerful story. I'd call it a "cautionary tale."

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Chapter 03: A Strong Mother Tells Stories with Impact

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