I met Marian Richards in 1972, September 9th to be exact. It was our first day of medical school and we hit it off immediately. Back then we were still attractive, young people. Marian, a striking brunette about five and a half feet tall with olive skin, bright eyes and a figure that other women deny they envy yet diet constantly hoping to achieve. And my cropped white hair was still a shoulder-length dusty blond and the sinewed, athletic build had not yet faded.

Both of us had come from rather modest backgrounds. My parents, Anne and Daniel Watson—my namesake, were hard working, honest and creative. They never made much money, but neither was it an issue with them. They quietly got along with what they had, content with their faith and each other.

Marian’s father, Martin Richards, had been a minor-league baseball player with genuine major league potential until a routine lay up in a pickup basketball game in the winter of 1964. The unexpected midair collision left him square on his back and the family’s comfortable middle-class living seemed to vanish overnight.

Marian spoke often of the sudden transition. Just as she entered junior high school, what should have been some of the most exciting and memorable years of her life became a nightmare of family squabbles and near poverty. By the time she graduated high school, Marian’s parents had been divorced for three years—the last two of which she had not even seen her mother who had left the family for a more able-bodied breadwinner. Marian was a determined student. Determined to succeed. Determined to escape her past.

We had a mutual respect for each other. I admired her enthusiasm, her intelligence and her wit, and she appreciated my philosophical perspective and my honesty. I know this because she often told me. Given another set of circumstances we might have pursued a more intense relationship, but I was a married man—which Marian also respected. From the beginning, ours was purely a platonic relationship and it has remained that way throughout our lives—satisfied simply to count each other as close friends. In time, Marian would also count Suzanne as such a friend.

Suzanne Cline and I had been childhood sweethearts. She was, and still is, a beautiful bookworm: high cheekbones, long curly reddish-blond hair and a statuesque physique that has still not aged. By our sophomore year of college, we could wait no longer and by the time I entered medical school our happy marriage had become a fruitful one. However, Hanna, our first arrival, had limited Suzanne to a part time student status and when Heidi followed two years later, Suzanne’s progression to graduation came to a near standstill.

Marian and I did well in medical school, both graduating in the top ten percent of our class. We also did well as interns—that fraternal hazing that every physician must experience. Although the academic requirements were minimal at best, the pace was nearly unbearable: unnaturally long hours, sleep extremely evasive and the subsequent zombie-like mental confusion that must accompany such deprivation. But we survived and were both invited to stay on as residents at the University Hospital.

As with the previous year of internship, during the next three years of residency, there was seldom an opportunity to wear anything other than scrubs and I believe I saw more of Marian and my other colleagues than I did of Suzanne and the babies. But this was all about to end and each of us, including Suzanne, was looking forward to it.

I have poignant memories of our last day of residency. Not only would it be many years before Marian and I worked together again, but in time, the events of that day would have a significant impact on our lives, especially Marian’s. We had responded to an emergency in pediatrics and Marian had entered the room a couple of steps before me.

"Have you tried to intubate him?" Marian asked the intern standing at the head of the bed.

"No, we haven’t done anything," his tense voice and the fear in his eyes betrayed his confusion.

"You haven’t even given epinephrine?" I asked.

"No."

My question was a deliberate censure and I knew my disgust was evident when I asked if they were planning to just stand by and watch the boy suffocate.

"Give him the epinephrine," I growled, "and get the intubation tray ready!"

When the intern at the foot of the bed explained, "We weren’t sure what to do," I grew even angrier. Not at them so much, but angry at the system that had already conferred the coveted title M.D., upon these, as yet, ignorant apprentices.

"You are graduates of medical school, licensed by the state to practice medicine and you can’t even treat an allergic reaction?" I didn’t wait for an answer. I didn’t want one. They stood petrified, embarrassed—unfortunately, my castigation of the system was at their expense. "Even victims are trained to treat this by themselves." I looked about the room, making eye contact with each intern, "You do know that it is anaphylaxis, don’t you?"

Even before I finished the question I was pondering the possible reality that perhaps they did not know—which, I realized, was even worse. No one dared to answer and I finally let it drop.

Marian had prepared the endotracheal tube and already slipped it into the boy’s trachea. "Pull the tube back about a centimeter," I had my stethoscope on the boy’s chest. I listened again, first to the right side and then to the left, "Okay, get a picture." My unusual burst of anger had settled and I felt a fleeting sense of shame at my outrage.

Marian handed the resuscitation bag to the respiratory therapist and the radiology technician placed the x-ray plate under the young man. A voice sounded from somewhere within the group, "If you don’t want to be zapped, leave now!" Everyone but the therapist and the technician stepped out.

"X-Ray!" the technician warned. After a few moments, the familiar beep sounded and immediately the room filled again with interns, nurses and therapist. After the technician removed the plate I listened to the boy’s lungs again, mechanically felt his pulse, ordered an intravenous fluid and another shot of epinephrine.

Dr. Levitz rushed into the room with a look of shear terror, "What happened here?" He said softly.

The group of interns turned in unison, their expressions still betraying their ignorance. One of them shrugged his shoulders to confirm their bewilderment.

"This is my patient," he repeated so everyone could hear, "what happened?"

"It looks like anaphylaxis," Marian emerged from the crowd.

"Anaphylaxis? How?"

"I don’t know," she answered. "He passed out just as we entered the room. His upper airway is very swollen—extreme stridor, hardly moving any air. We’ve given him epi, I tubed him and we’ve just checked for tube placement. They’re hanging an IV right now."

"He’s seventeen years old, in for a simple knee surgery. He hasn’t even been medicated yet, what could he have reacted to?"

Marian shook her head as she waved her hand toward the boy; "This is how we found him."

Dr. Levitz turned to the nurse, expecting her to answer.

"I don’t know either. We haven’t given him anything. He hasn’t even eaten. When I answered the bell all he could do is grunt... I called the Code."

"He’s breathing’s okay with the tube in," I said, now standing alongside them.

"I was very lucky to get it in," Marian added, "I couldn’t see a thing, too swollen."

"Make certain it doesn’t come out," I looked at the nurse, "we might not get it back in again."

"He’s Dr. Levitz’s patient," Marian nodded her head in his direction.

"Tommy Warren, in for arthroplasty. He isn’t even medicated," Dr. Levitz repeated, still puzzled by the chaos.

"I can’t tell you what happened," I sighed as I signed the orders on the code sheet. "Only that it appears to be anaphylaxis."

"I’ve filled him in on what we’ve done so far," Marian added.

"Thanks for your help," Dr. Levitz said as he turned his attention toward the child, dismissing us from our duty. "When I figure it out, I’ll let you know."

"Yeah, I’m very curious, he’s a lucky boy."

"I’ll say," Marian echoed as we left the room, "lucky he was in here when it happened and lucky I was able to place that tube."

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