Medicine For People!

June 2014

Phone BoothMedicine in These United States: 1949 and 2014

Contents

  • Medical Care in 1949
  • Dr Rienstra Responds
  • The View from Generation X

In last month's newsletter we took a look backward at medical practice in the 1930s. This month we'll begin with reader Joel Leonard's radiant memory of a medical experience from the late 1940s. 

Our very perceptive RN, Karla Theilen follows with her thoughts from the Generation X perspective-but, let's allow the story to unfold! First, Joel Leonard…

Medical Care in 1949

When I was a 12 year old just out of grammar school I was sent on an adventure from Southern California to Florida to spend the summer with a relative. My mode of travel was Greyhound bus. Alone, and with a ticket two feet long that had a coupon for every stop along the way, I left on a Monday morning from the local bus stop in Costa Mesa. Somewhere in Arizona, New Mexico or West Texas-memory fades, it was 1949!-I began to feel sickish. Finally, in East Texas, I told the bus driver that I was sick and had to get off the bus. The next stop was Dayton, Texas, a little town in the middle of nowhere. What I could see as I watched the bus drive off was a drug store with a wide graveled area for the buses. Way out next to the highway stood a lonely phone booth. The scene reminds me now of The Last Picture Show. I put a dime-or was it a nickel?-in the phone slot and asked the operator for the number of the local hospital. She gave it to me, I called the hospital, told them I was at the bus stop at the highway, and would they please come get me. I was alone and had appendicitis. They suggested I wait in the drugstore.

In the drugstore I told the lady behind the counter of my situation and that the ambulance would be there in a few minutes. And it was. It took me to this tiny hospital in the town. I was put in a room, someone examined me, put me in a bed and left. A nurse came and gave me an ice pack. She left. I put the ice pack on my forehead (I'd only ever seen ice packs put on foreheads!). Someone came in in a while and told me the ice pack was to be on my right side, near my hipbone. It was for my appendix!

Next thing I remember was waking up in a room full of flowers with a big bandage on my right side. Seems my diagnosis had been correct and my appendix was about to burst so the local doctor took it out. And put it in a little green jar which I had clenched in my hand. The flowers were from the people of Dayton and I was now a local celebrity. Not much was happening so a little kid coming to town and getting emergency care was news.
I was told that they had found my address and phone in my wallet and my mother was flying out to Texas. In the meantime I was moved to the house of the Mansfields, the people who owned the drugstore on the highway. They gave me my own room and treated me wonderfully.

My mother arrived two days later and told me of the phone call and how she'd given permission to the doctors to operate. Later I learned that they'd already operated-it was an emergency, after all.
After a week or so rehabilitating I got on a train and continued on to Florida.

So.... the doctors did what was necessary for a 12 year old kid on a bus ride cross-country. There were no rules to cover such a situation I guess, so the wonderful town folk adopted me complete with front page coverage in the local paper! Mom paid the hospital bill, the Mansfields became family friends for life and I was put on a train to Florida to save me the rigors of bus travel.
I don't think this could happen today!!!!

Joel Leonard

Dr Rienstra Responds

Dear Joel,

Thanks for your wonderful story. One thing for sure, today we would not hand you your appendix in a green jar. Just think of the liability!

What changes do you see, readers? Do you think our world today is better or worse, more liveable or less, more stable or more brittle?

I posed this question to one of our nurses, who responded with the following:

The View from Generation X

Is this a brittle world we live in? It really is a compelling question. It may seem brittle because so much of what we do (or don't do) is motivated by fear. Might a doctor today hesitate to slice into a boy with just a mere verbal consent over the telephone from a mother, so many states away? Heck, would anyone even put a 12 year old boy on a cross-country bus alone anymore? Surely not. And in a way, how sad! Isn't it true that the often the best, most compassionate, and selfless of human actions come in the face of adversity? I know that for myself, some of the best experiences I have had with other human beings were when I was lost, my car was broken down, or my pocket had been picked in a foreign country. People always came out of the woodwork to cushion my fall, shine a light on my path, and restore my faith in humankind. As in Mr. Leonard's story, the salvation was in the altruistic acts of people like the owners of the drugstore, the doctor who removed the hot appendix, the nurse with the ice pack, and everyone in the story sharing the goal of helping this young and imperiled traveler. Just look at how the townspeople took such pride in the boy's recovery and filled his hospital room with flowers! People feel good when they are united in a noble cause; many people still behave this way. Look at how volunteers flock to Red Cross rescue shelters after floods, how communities rally for house fire victims, and how nurses take vacation time to travel to areas devastated by hurricanes, tornadoes, and earthquakes to volunteer their services.

In nursing school I was trained by one of the "old guard" nurses, a remarkable woman with whom I remain friends to this day. Sally Kelly was, and still is, a fiercely spirited nurse who wouldn't let anything stand in the way of providing care to her patients. Under her tutelage one semester in the hospital, one of our patients left the hospital against medical advice after surgery, inspiring anger, frustration, and fear in many of the hospital staff, especially those with whom the patient had expressed displeasure. Sally, on the other hand, was simply concerned. She wanted to know how the patient felt, and wondered how we could have better met her needs. She thought we really needed to call the patient at home make sure she was recovering all right. Between the two of us we tracked down the patient and reached her on the phone at her sister's house. We found that the real reason she left the hospital was that she felt that no one was listening to her concerns. She couldn't get a good night's rest for all of the beeping machines. Feeling satisfied that contacting this patient was the right and compassionate thing for a nurse to do, I shared the story with my classmates at our post clinical conferences. A young instructor with a freshly earned Master's degree admonished me in front of the group, telling me that what we did was unprofessional, a HIPAA violation, and that Sally should have known better. Master's degree or not, I knew to follow the example of Sally, who volunteered at the free clinic and secretly dropped off Christmas packages on the doorsteps of needy families. She was and is the real professional.

As to the question of whether or not we are living in a brittle world, I would say rather that we live with brittle ideas. It seems we've created a house of cards that we erroneously think provides us shelter from the storm. We are on a razor edge these days, shaky ground. It seems that the more "sophisticated" and technologically advanced we become, the further we are removed from the real world of human hopes, fears, dreams, courage and power. Surely we can outwit this "machine" that threatens to drive us all further and further away from the truth, and closer to total disengaged insanity, can we not?

Karla Theilen, RN

story: 

Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.