Medicine For People!

June 2017: General Medical Practice

Doctor and Patient 1927
By Seattle Municipal Archives from Seattle, WA [CC BY 2.0], via Wikimedia Commons

General Medical Practice

A 1948 photograph (not the image to the right) appeared in Life magazine. The man wore a white smock and had a white cap on his head. He leaned against the kitchen counter and smoked a cigarette. The caption identified him as a physician, resting after a late-night surgery. To me he looked terribly romantic. This image helped affirm my childhood decision to become a doctor.

You can read the story of the doctor in the photograph, Dr. Earnest Ceriani, here.

He practiced in a remote area of Colorado in a time when general practice physicians routinely performed general surgery and often, as in his case, worked long hours with little time off. Apart from my training years, I couldn’t so much as hold his coat when it comes to hours worked, trauma surgery, and physical stamina.

In the summer of 1984, I substituted for a general surgeon/general practice doc on Wrangell Island in Alaska. The situation called for skills at which I was, in my view, barely competent. But as a nurse once told me, “God looks after fools and doctors,” and I acquitted myself respectably. Communities like those on Wrangell Island and in remote Kremmling, Colorado, especially in years past, appreciated what a doctor does more than they do in the city and in these days of easy access to all the gadgetry of modern medicine. There was more respect for the person in the arena and less of the sometimes unrealistic and unnecessarily legalistic oversight present today.

Life magazine paints a heroic picture. Yet you can see the man’s face sunk in despair that he couldn’t save a child’s eye after it had been destroyed by a horse’s hoof. Had they covered that in a lecture in medical school? Was he napping at the time? He remembered that child, I’m sure, far more than his many successes.

Many of his patients came not for some heroic intervention but for permission. “Can I safely put off this elective surgery to remove a painful neuroma in my foot?” “Yes.”

They came for education. “Why does Grandmother eat more and still lose weight?” “Let me explain to you how diabetes works.”

They shared confidences he could never betray. “Well, actually, I had a child before marriage and gave it up for adoption. But my husband doesn’t know.”

He tried to help people solve difficult problems. “I don’t know where I got this STD. You see, I have two boyfriends.” Sometimes he felt like a priest. “Suzy and I like to do things to each other in bed that the minister says is wrong. What do you think?”

Sometimes all his medical training came down to putting on a rubber glove and using his finger to pull impacted feces out of a very constipated elderly patient’s rectum. Or trimming that same patient’s horn-like toenails.

Not long ago, someone I’ve known for a long time was going over a few health issues in my examination room. At one point she said, “Please give me some knee exercises.” (Pause) “Not that I’ll do them.” She gave me a funny look as she said this, then laughed at herself. I did what I think Dr. Ceriani would have done. I laughed too, and gave her the exercises.

The doc in the picture does not appear to be a sentimental guy. His outfit is rumpled, he isn’t smiling at the camera, he isn’t trying to sell anything. But I’m pretty sure he was surprised, as I have been, by the closeness you can feel to the people who come to you for help.

It was just a picture I saw in a magazine. I was heading for a life in medicine anyway. Maybe I’m totally wrong about what the guy’s life was like.

But I don’t think so.

Thanks to Jody Bower for editorial improvements.



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