Joseph Epstein

n Joe’s view on the use of the
words ‘consumer’ and ‘client’
in lieu of the word ‘patient’:
Myer and David Jones have
‘consumers’, prostitutes
and lawyers have ‘clients’,
hospitals have ‘patients’.
1When I commenced my ED
term as an intern at Western
General Hospital in 1985, the
only part of Joe’s orientation
talk that I remember was his
advice if you were late for
work. ‘If you’re wandering
around the city at midday
and you suddenly remember
that you’re meant to be at
work, don’t worry. Give us
a call and make your way
in.’ Bear in mind that this
was the pre-mobile phone
era. These days, if you’re 15
minutes late for your shift,
you’ll be called and told to
get to work immediately.
Joe speaks a language
unknown to all other
emergency physicians.
Examples include
‘epistemological arrogance’,
‘adumbrated’, ‘vade mecum’,
‘internecine dispute’,
‘aegis’ and ‘desiderata’.
I witnessed Joe’s surgical
expertise during an
abdomino-perineal
resection (APR) in 1985
during my general surgical
term as an intern.
Whilst Tom Poliness and
my surgical registrar (Peter
Cameron) were doing the ‘top
end’, I was at the ‘bottom end’
with Joe. It was a technically
difficult operation, largely
contributed to by the fact
that the patient had severe
ankylosing spondylitis – he
was one of those so severely
affected that his spine was
permanently flexed at almost
90 degrees. Consequently,
when he was supine it
was almost as if he was
sitting up. This presented a
challenge for Bob Smith, the
anaesthetist, and the scrub
nurse who couldn’t quite
work out how to position
the equipment trays over
and around the patient.
Due to the lack of CT
scanning for most patients,
the diagnosis was made
with a barium enema alone.
Consequently, the extent of
the pelvic infiltration was
unknown. The tumour had
infiltrated the pelvic walls and
become adherent to most
of the pelvic organs. During
the dissection from the top
end, the bladder became
completely detached from the
prostate. When the end of the
Foley catheter with its inflated
balloon became visible in
the perineal wound, I recall
these fateful words from Joe.
‘Tom, we’ve got a problem.’
1Joe kindly offered to host
the 1990 Western Christmas
party at his home in Carlton
North. The ED staff said they’d
arrange all the catering,
including a beast on a spit.
Precisely who decided that
a pig would be cooked
remains obscure. I’m sure Jan
was less than impressed.
The other highlight of that
party was watching John
Coleridge’s young son Patrick
running rampant through
Joe’s newly planted grass.
Andrew Walby | emergency
physician, Melbourne.
Former emergency medicine
registrar and emergency
physician, Western Health
32 | A tribute to Joseph Epstein