April 1991 |
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Old-Style Family PhysicianCorning's "Doc Mac"1856-1927byRobert F. McNamaraChapter 1, Chapter 2, Act One, Chapter 2, Act Two, Chapter 3Chapter ThreeCompassion, The Sovereign IngredientWhy did the old-time GP achieve such high, and even reverential regard, in the families he served? They respected his scientific expertise, of course; but they also appreciated the compassion with which he applied it. No physician, man or woman, can avoid being drawn into the feelings of an ailing person. He or she automatically becomes a confidant, a parental figure. It seems to me that the difference between the office-hours specialist and the house-calling family doctor is one of degree rather than of substance. Because of his closer domestic associations with his client families, the GP won for himself an even deeper parental esteem. If the physician happened to be impressive himself, gracious in the office or at the bedside, judicious in professional conversation, serious in his commands, the patients would trust him all the more. Doctor Mac was blessed in this respect. When he spoke frankly, his words were those of a man of both skill and conscience. In 1927 the president of Corning Hospital described him as "courteous, considerate, and high-principled." A medical colleague termed him "the personification of honor and trustworthiness." For the editor of The Leader, the doctor had been a sympathetic figure; a calming presence, one who could bring out the best in others. The physician owes it to his patients not to encourage them in self-pity, hypochondria, or malingering. Dad found that a little joshing could often calm the dithers. There were the two long-faced sisters, for example. Other women might make a hobby of collecting teacups or thimbles. This pair hoarded symptoms, and called at the office with some regularity to itemize them. The doctor would kid them so outlandishly that they would finally burst out laughing in spite of themselves. Thus they forgot their complaints, at least for the moment. Then there was Harold Mosher, a stove repairman. Feeling out of sorts one day, he took to bed and might well have begun to goldbrick. Doc Mac, requested to drop in, gave hima thorough examination and concluded that there was nothing really wrong with the repairman. "What do you prescribe, Doctor?" the patient asked. "Well," he replied, "if you'd just put that big toe out from under the covers, you'd be all right." Although he was a little surprised, Mosher did get up, and was soon back at work. In later years he used to tell with a chuckle the story of his instant resurrection. Nothing made the GP seem more a part of his client families than when he brought their children into the world. That intimate service could establish a bond of trust and sharing that extended over three generations. My father was especially fond of the Italian immigrant families in his care. They had little of this world's goods, but their children were treasure enough, and those who showed interest in them could do no wrong. The Lavisanos would remember with gratitude what Doctor Mac did when Mrs. Lavisano gave birth. Her husband was a proud father, but he had budgeted for one child, not twins. "How much do I owe you, Doctor?" he asked, embarrassed and worried. Seeing the nervous look in his eyes, Papa replied, with studied deliberateness, "Why, I usually charge $25 for each delivery. For twins, that would be $50. However, this was really one confinement case, wasn't it? So $25 will do." Lavisano heaved a sigh of grateful relief. Especially on the occasion of a first birth, my father made a personal practice of urging the new parents to take out insurance on the newborn. He himself was a great devotee of life insurance as an investment. "You're young now," he would tell the couple, "and the premium will be low. Take out a policy now, and you'll never regret it." Apparently many followed his advice. His solicitude for their families, beyond the call of professional duty, made him all the more a father-figure in their eyes. One of the occupational hazards of all medics is to be considered infallible by those whom they serve. The more a doctor knows of either general or special medicine, the more aware he or she is of possible inaccuracy in diagnosis and ineffectiveness in therapy. And what if there is no cure at all for the ailment? I do not doubt that many an earnest physician turns, in these baffling moments, to prayer. I know that Dr. McNamara, by nature a devout man, factored prayer into his regular curative measures. In anxious hours he would not hesitate to drop to his knees and pray by the bedside, or pace the floor quietly reciting his rosary, or stop into church for a "consultation." For him the art of medicine was one that the Creator had chosen to share with the medical doctor, and it required frequent conferences. If the doctor found that a cure was beyond the power of science, he still did not consider himself useless. The Hippocratic Oath suggested that he could be of service even in lesser ways. There was also the medical motto coined in medieval times by a wise old French practitioner: "Guerir parfois; soulever souvent; consoler toujours." I venture to translate this modest maxim. "To cure, sometimes; to relieve, often; to comfort, always." Many an old-style general practitioner could probably tell stories of how, even when he failed to heal, or greatly to relieve, he had nevertheless succeeded in consoling dying patients and their families. With regard to my own father, the story of DeLacy Cash provides a good illustration. Charley Cash stopped me on Corning's Market Street to recount it many years ago. The Cashes were Corningites of average means. I believe that they were Protestant; but they had long since chosen Dr. McNamara as their family physician because they respected his professional skill and his acknowledged reliability. By the 1920s, Charley and his father DeLacy Cash were, I believe, the only survivors. DeLacy, becoming more and more infirm with years, was confined increasingly to his bed. The doctor would stop by every now and then, but he recognized that the sands of the old man's life were running out. One day Charles found that his father had somehow swung his legs out of the bed and was sitting stark upright, speechless and staring into space. He sent at once for the physician. When the doctor entered, he simply sat down opposite old Cash and watched him in silence. Finally, Charley asked nervously, "What should I do, Doctor? Make him lie down again?" "No," Papa replied, "Just sit beside him and put your arm around him." The son did as directed. DeLacy died a few minutes later. This event had happened perhaps three decades before, but there were tears in Charles's eyes when he recalled it. "I only hope that when my time comes, I can die as peacefully. "Good old Doc Mac!" © 1991, Robert F. McNamaraPart 1, Part 2, Part 3, Part 4Index to articles by Robert F. McNamaraCLR Blog | Site Map | Contact CLR |