In Praise of the Old-Fashioned Doctor

And I don't mean my husband. Though I do think he is an 'old-fashioned doctor.' Anyone who can deliver babies, take out appendices, do colonoscopies, take out tonsils, see peds cases, do nursing home rounds, handle psych medications and even do the odd home visit seems to me to qualify as the sort of all-round physician fast disappearing nowadays. And he's rather good at it. But he's an unusual one these days -- particuarly because he's young and just starting out in practice. He doesn't deliver babies or do surgeries currently -- there are specialists in this area for that sort of thing, though he came out of residency qualified to do such things. But put him down in a tiny one-doctor sort of town, and he would run the show; heck, he'd BE the show. They don't make them much like that anymore.

I thought of this particularly this weekend. Last Tuesday, I randomly and suddenly got a rather severe pain in my right lower side. By the next morning, I was having chills. Scott hied me off to the ER, fairly sure I was probably having appendicitis. I had the usual dr. look at me briefly, poke me a couple times, do some tests, tell me I didn't have a high white count, no fever, cat scan showed nothing, etc. Go home and wait -- your husband can tell if you're dying and you need to come back in.

By Saturday night the pain was worse (and had lingered all week), and I felt like a wet cat at the dog pound. I went back in. Different doctor this time. Mid-70s; spent most of his practice in a very small town, being the whole show as mentioned above. He had the wisest eyes. He came in, sat down next to me, and said, "Tell me what's wrong." Then he proceeded to ask me exhaustive questions, poke and prod extensively, listen to my lungs, look in my ears (the pain's in my side, but you have to be thorough), etc., etc. The ER was extremely busy, but he still stopped to say (twice!), "Is there anything else you want to or can tell me about this? Anything you can think of you didn't remember before? Have I got everything?"

He took blood tests again, got the same result as before. "Well," he said to Scott, "this is not immediately evident. I've been around a long time, and I know sometimes it takes some digging." He did test after test, obviously enjoying the mystery, never making me feel like I was in his way or that he thought I was being over-reactive or silly (by this time, *I* had about decided I was making it up!). He talked with Scott about appendectomies he had done, mused over the cat scan report, and finally said, "My money is on her ovary." "But I don't HAVE an ovary on that side!" I said. (Sorry for the wealth of gynecological information.) "I know," he said, "but your abdomen can do some pretty funny things."

Then he ordered an ultrasound, something no one had thought to do before. That did it. Partially ruptured ovarian cyst on the left side; blood from the rupture collecting on the right side above my appendix, causing pain (internal bleeding always makes your body grumpy). "Well," he said. "NOW we have a diagnosis." He sent me home with medication and an order to see a surgeon for a consult this week.

I guess my point is that, had he told me my problem was my wishbone was infected, I would have believed him. His air of confidence and care-taking, his calm unwillingness to announce he couldn't "find anything," and his obvious experience with everything from ears to toenails, was the most comforting thing in the world. "I've been in this business long enough to know that you can be fooled," he kept telling Scott as he worked.

He was the best kind of old-fashioned doctor.

love, kristin