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July 16, 2009

House Calls

House Calls

by Nancy                                   

I have cracked my tailbone. I would tell you how inconvenient--not to mention damn painful!--it is, except I know such confessions would only unleash rude comments about my butt again.  

It wasn't just my sore behind (if you must know, I was backing up while taking pictures on a lovely, rocky Hawaiian beach when I slipped and went down like a ton of bricks) but also the President's nomination of Dr. Regina Benjamin for surgeon general made me think about the doctors I had growing up in a small town. That, and the fact that now after my manuscript is turned in, I'm finally getting around to seeing all my current doctors---in one week!

Dr. Benjamin, in case you've been lounging around the pool and haven't heard yet, is best known for founding the Bayou La Batra Rural Health Clinic in Alabama, which served a community of people battered by hurricanes and a health system that failed them.  (She was also the head of her state's Medical Association and was the associate dean for rural health at the University of South Alabama's College of Medicine.)  Listen to NPR's old story about her here.  It's a good one. In fact, her efforts to rebuild her clinic earned her one of those McArthur Foundation genius grants.  Good stuff.

                           

In one of her recent Q&As, she said that "public health issues are very personal to me," and mentioned her father's death from diabetes and hyper-tension, her mom's lung cancer and her brother's lost battle with HIV-related illnesses--all preventable diseases.  What better kind of doctor for all of us?

Me, I grew up in a town so small we only had 5 doctors, and they were all brothers.  They were known by their first names.  One was a surgeon, one delivered babies, but Dr. Oscar was the physician who took care of my family.  He had office hours that started at a1pm, and if you needed to see him, you sat in the waiting room--starting at 12:30--until he could fit you in. Sometimes you sat a long time.  But not if you were sick.

Because if you were feeling ill, Dr. Oscar came to your house in the morning or evening. It made a lot of sense. Why should a sick kid be dragged to the doctor's office where if you didn't have chicken pox already, you'd probably catch the germ within a few minutes of touching the door handles or the Highlights magazines. (Remember Goofus and Gallant?  They're still around!  And those puzzles where you have to find the drawings hidden within the drawings?) Why should an elderly person hobble from her cozy home, get hauled across town in a bus, pushed up the wheelchair ramp for her insurance-limited 15-minute appointment before making the whole ordeal in reverse--a day so long her oxygen tank runs out? The doctor is a heck of a lot more mobile than most patients.

At the time, it made perfect sense.  There was nothing so comforting as seeing Dr. Oscar's Cadillac come zooming up our driveway (he never did anything slowly) backwards (he liked to make quick getaways) when somebody had a rash or a high fever.  I loved that the first thing he did when you had a sore throat was take one of your dad's handkerchiefs and tie it around your neck.  It's so soothing!  (I just wish there was a tailbone equivalent.)

Okay, nothing beats amoxicillen now, but back then in the dark ages, you didn't get medicines unless it was life threatening. Considering the proliferation of antibiotic-resistant germs, maybe that's a good thing, too.

And now, of course, if anyone suspects you might need an EKG, they hook you up on the spot and take a look at your heart rhythm---which doesn't budge from normal until you see that one little EKG strip costs $750. If you haven't read this article about health care yet, please do so. It's well-written and entertaining--the spoonful of sugar as the proverbial medicine goes down. Turns out, we don't need a lot of those tests that get ordered.  (And the article is required reading at the White House.)

Of course, Dr. Oscar didn't look you in the eye, as did my ob-gyn yesterday after a rather intimate exam, and say, "So what are you using for a lubricant for sex?"

Uh--duh--uhm--er--gulp.

(She recommended mineral oil, although I don't need it yet, thankyouverymuch.)

Dr. Oscar took care of everything. (OKay, except the sex stuff.) When the term "general practitioner" first came up in our national lexicon, it seemed ridiculous.  Of course you had one doctor who did generally everything!  But so far this week, I've seen the ob-gyn, the dermatologist,  and my Primary Care Physician.  My cardiologist is up next, and I expect to be sent to a back specialist, too.  Yeesh!

Did you have a memorable doctor when you were growing up? 

                         

My own children had pediatricians who suited their personalities very well. My older daughter liked the avuncular gentleman from "Persia" who was quick to tell her mind-bending riddles.  My younger daughter went to an athletic young woman who asked blunt questions and may very well have helped her young patient decide to enter the medical field.

So, yeah, health care has improved in many ways.  But I sometimes I feel so rotten I wish the doctor would come knocking on my bedroom door with the little black bag in one hand and a thermometer in the other. 

My point is that I'm glad Dr. Benjamin may be our next surgeon general.  I was surprised when Sanjay Gupta declined the job--I think he's a great communicator and would have been excellent. But Dr. Benjamin has that small town touch. She gives the impression she wants to help us all get healthier. I just wish she'd make a house call now and then. And had a miracle cure for my butt.

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Comments

Allow me to send my respectful blessing and best wishes to your butt, Nancy.

What??? It couldn't hurt.

No great M.D. stories, sorry. But we had a dentist who was a bit of a character . . . in a good way.

Dr. Henry Mitchell was our pediatrician growing up. He always wore a bow tie, which makes total sense when you think about it.

But the family favorite was my younger brother's pediatrician: Dr. Frank Weiner. Dr. Wiener was the king of prescriptions and 'just to be on the safe side' medicine, which is how the following happened.

I was a sophomore in college, and got sick. Didn't realize how sick until I called home one Friday afternoon. The sound of my voice did two things:
1. Put my Mom on immediate Mother ESP alert; and
2. Put my Dad in the Lincoln with a bed made up in the back. He made record time. In part because he was that kind of Dad and in part because the drive from Indiana, PA to Grove City, PA has lots of places to open up the Lincoln.

Went straight to the hospital, because by the time we got home, I was having trouble breathing. My Grandparents were already there. How this happened with no cell phones is a mystery, but I digress.

My Mom had called Dr. Frank Weiner. He took one look at me, listened to my chest and decide to admit me. To the hospital. In an oxygen tent, on IV meds, in the PEDIATRIC wing. I was 19 years old. At least I was short enough to fit in the beds.

But here is the thing about the Pediatric Dept - no one sleeps. There were actually Big Wheels racing up and down the halls. There was a pregnant 15-year-old sharing my room. (She was from Blairsville and she was very chatty.)

Turns out it was the right call. I had pneumonia that had progressed really quickly and had I spent the weekend any where else, it would have been really, really bad.

Needless to say, Dr. Frank Weiner is a legend. Plus I got some nice hand-knit slippers from the Peds Nurses that fit my little feet.

Thank you, Tom. I appreciate the respect. (Insert annoyed foot tapping here.)

Kathy, since I know all the people (and locations!) involved, I could picture everything you related--including those little slippers.

At the rehab center where my mother and aunt both went after hip replacements, they give you a knitted mini blanket to put around your shoulders to take the chill off. Nice to know some places still have those little touches!

Nancy, I hope your butt gets better soon. I can sympathize. I bruised my tailbone when I was younger by hitting the boat seat at just the wrong angle. It's sooo uncomfortable with everything you do.

When I was in high school, my Mom switched me from my pediatrician to the local general doctor. I don't remember the switch - it's just something that happened. One cranky old man to another. The new doc was at least relate-able as he was member of our church with a large family. He was a very small-town doctor in a not-so-small town.

I will never forget a few visits with this guy. I can see and smell the waiting room. I was a varsity swimmer and got very sick at the start of the season. He gave me an Rx, and sent me for a mono test. (Mono? I was the LAST person on earth who could get mono, wasn't I?) It came back negative, but a week later, I was worse. I went back to him, and he told me to have the test again. He said he would bet his practice that it was mono. I walked out of his exam room, in such a state because I could NOT swim for the season. This was devastating news for someone who grew up in a pool.

But the worst part of it was the humiliation to come. One of my coaches was in the waiting room, and witnessed my meltdown. I think he thought I was dying at the time. But at least he was one of the few people who could understand my disappointment - after it was explained.

Anyway, the old doc was correct. I went to him until he retired...And I still cringe when I see this coach, who remembers me decades later, no doubt for the same reason.

We had Dr. Beeler, who managed to make me laugh while he stitched up my thumb. And then Dr. Burnstein who made house calls too--and I agree, when I was sick with an ear infection it was so comforting to have him come to my house.

And speaking of knitted booties and blankets, just last month when I had to get my gall bladder out, every patient in the recovery room got a little handmade pillow to hold against our stomachs when we did the all-important coughing.

Sorry about your tailbone, Nancy!

Oh yes! I remember Dr Oscar and Dr Randon and Dr Mark. Do you remember Dr Means? My sister and I loved him. He and she shared the same birthday so she got special treatment. I was sure that the Norman Rockwell print in his office was a picture of him. After he retired I discovered Dr Shick. I had the biggest crush on his son Chris when I was 5 in afternoon kindergarten at Northside.

Marybeth! I lost your email address! I'm so delighted to see you here! Email me! nmartin at nancymartinmysteries.com

Let's not tell-all about Chris Shick, okay? My mother reads this blog. ;-)

Janet, I could have guessed you were a swimmer, too.

Just so you know, in high school, Marybeth and I did an interpretive dance of the Titanic sinking. I can't believe our gym teacher kept a straight face.

Thanks for the sympathy, Judy. Right back at you for your gall bladder! (It's hell getting old, huh?)

Ouch! That's as original as I can get this morning...coincidentally I'm on my way to my doctor for a follow up on a leg issue (no DVT but cramps that hurt like crazy and keep me up at night) and bemoaning the fact that he's relocated to the west end of Urbana...brand new building and free parking, but still...
I remember my family doctor and the house calls...seems like he'd get there in no time, even though he had a busy practice. Seeing him come through the bedroom door was always cool...suit, tie, little black bag, and those ever-present red lollipops we got for being "good little soldiers". Dr. Parrilli...his regular practice was on the lower floor of his house(which I really wanted to live in...it was huge!), and we went there for the routine things, like school physicals and shots. His wife was his receptionist-nurse, and much scarier than he was :o)since she was the one wielding the needle!
When I broke my wrist, he not only did the initial exam but followed us to the hospital, checked the X-ray, and put the cast on! Time didn't matter as much as taking care of the patient...something I may just discuss during my "five minutes quality time" with my current physician :o)
Hope the tail bone feels better soon, Nancy...just remember to claim the cushiest seats wherever you go from now on!

Maryann, I think doctors don't get enough credit for paying attention to you when you really need it. When I'm stuck waiting in an uncomfortable waiting room, I think about the person who needs the doctor enough to take up so much time. Some day that person will be me! Or you--putting on your cast.

Nancy, hope your current problem has a happy ending.
My favorite doctor was Dr. Maguire, an old-style pediatrician who gave me a sucker after every visit. (I don't think they do that any more.) I still remember the white porcelain cabinets in his office and the glass containers of cotton balls and wooden tongue depressors.
Elaine Viets

First, let me say that my mother is German (read: doesn't spend money, and her take on the matter of sick kids was to "get over it." So, in spite of the fact that our house was directly across the street from the doctor's office (one horse town, one doctor), I can count on one hand the number of times this chicken crossed the road.

So riddle me this, Batman: if there was one sick kid in town, even children we weren't allowed to play with, we were dragged to their homes and told to "drink after them." Which we were not otherwise permitted to do if we were well. Hey, I don't get it either, but it seems she wanted me and my sister to have the chicken pox, measles, mumps, etc. at the same time to cut down on the work, so that meant scheduling illnesses out of convenience. Did that entail going to the doctor's? Noooooooooooooooo.

As a child, I played rough (yes, I know it's supposed to be roughly, but this is a colloquialism where I come from). So when I limped indoors screaming that I had stepped on a nail (it was driven through my foot), my mother told me to stop whining and got the pliers. I screamed all the way through this extraction while she mentioned something about Jesus having one of these...I don't know, maybe I hallucinated that part. But you get the idea. No whiners. The only reason I got taken to the doctor's on that one was because my grandmother (a saint of a woman who was English/Scottish) ranted about tetanus and lockjaw until she was able to bully my mother into dragging me across the street. Did I mention I had a nail in my foot?

FYI- This refusal to seek medical attention for the children was not a religious issue. It was a cheapskate issue.

And my sister and I used to fight like animals. This led to one of the major rules in our house, which was if you broke your sister's arm (leg, etc.) that you would have to pay for the doctor/hospital visit out of your allowance. Never mind we got fifty cents a week.

I remember the night my parents threw a dinner party and the doctor and his wife were invited. The kids were kept in the back room, but my sister somehow managed to run into the doc in the hall. He took one look at her and scolded our mother, went across the street for his black bag, and returned to treat her for strep throat.

Naturally, doctors make me gun shy. But what can I say, being the product of a woman who just received 27 bee stings last week, and never said anything about it for five days?

Laurie - I don't know whether to laugh or cry. Good grief.

I thought my family was crazy, but not even they would've invoked Jesus to get out of a trip to the docs. Thank heaven for your grandma!

Nancy, an interpretive dance of the Titanic sinking in the pool? Your creative side showed itself early on, huh? (BTW I've always been facinated with the Titanic.)

Laurie: Loved the description of your mom. My mom is almost as anti-doctor as yours, but I don't have any good stories about nails! I'm lucky I made it to the doctors after my first week of mono...

Our town was so small we had to go to the NEXT small town, where there was one doctor.

When I was growing up, the whole family went to the same doctor--whose office was across the street from a large cemetery. What was the message there? Nice guy, though--he didn't make too much fun of me when during one check-up he noticed my belly-button was red and I had to admit I had painted it with mercurochrome. What can I say? I was bored in the bathroom one day.

I'm more troubled by my sister's current hometown, population 50,000+, where for a time they had only one ob/gyn accepting new patients. Is that some kind of birth control?

I shan't make any remarks about Nancy's butt because... well, because she might hit me.

BUT... I will relate the following. This week, the Infamous Sinus Infection returned, with a screaming vengeance. I'd been taking antibiotics for bronchitis, and it was decided the AB would handle both. Okay, went away for a few days, came back Tuesday to the point my left eye watered to an extreme, giving me the appearance of crying. Yesterday was massively busy, called this morning to see the doc. We've been through this before, know what's needed; Omnicef (strong AB) and Vicoprofen (for the pain; it kills the pain but does not make me goofy).

Called this morning for appointment. No dice today, booked solid. I asked about tomorrow morning. Nope. The office closes on Fridays now.

A DOCTOR'S OFFICE CLOSES ON FRIDAY??!?!?!?!?!?!?!

No chance of a phone-in. Office policy mandates a visit. SO.... it's Motrin for me all weekend long.

But yes, Nancy, I remember the days when a doctor made house calls. Or genuinely cared about his/her patients.....

William!!!! That what Doc in the Box is for. Call you can even get a semi appointment. Go! Now! jodi

As an aside, my town (pop. 3200) had no hospital. By the time I was in high school, a second doctor appeared out of nowhere, set up shop, and started a clinic that treated minorities, poor people, and illegal aliens. One Sunday afternoon, he got into an altercation with the police and was shot dead. Riots ensued. It was a horrible, scary time because it divided the town.

Later, the doctor who lived across the street from me died at a fairly young age, and for a long time, people had to travel 36 miles to get medical attention or die trying.

Today, there's a free clinic named in honor of the doctor who was killed. Weird, the memories Nancy's column conjured up. Just saying.

Yes, we had a family doctor, Dr. Wright, who made house calls. His nurse's name was - sit back - Miss Nightengale. But the twist in this story is that my Gram was also the neighborhood midwife and "go-to" lady: a tiny Polish woman with a heart of gold who spoke little English but always got her point across.

Gram would be called first and then, whether it was a birth or a broken arm, Dr. Wright would be called in. If he ever resented this, he never let on.

I remember a particular incident. My mother fell and began bleeding profusely We children called Gram immediately. In her efficient way, she calmed us and settled my mom and then the usual call was made to Dr. Wright. I can still hear him saying to Gram, "Damn good job, Mary, damn good."

my doctor growing up, Dr. Heller, volunteered in Vietnam during the war and was a peace activist. His one patient room contained a lot of black leather covered by white butcher paper. He was smart and down to earth and chain smoked like hell, even when he was doing checkups.

Ahh, those were the days.

Thanks for the memory..

William!

Get thee a NEW DOCTOR and I mean NOW. That is obscene.

Go to the nearest MedExpress or whatever - most accept major insurance.

I do remember a Dr. appointment when I was 4 or so where this old Dr. screeched at my mother for her poor parenting skills - HUH. I remember being terrified of going to the Dr. after that because my mom might get in trouble.
Or how about the dentist who hit my sister . . .
Or the first optometrist that wanted to have someone sit on me to get eye drops in.
Sheesh I should have a Dr. phobia!
I had Mono in Grade 12 and I remember being in the waiting room and going to sleep on one of the couches and embarrassing my mom.
In 1971 we were living in a very small town with a 1 hour drive to a Doctor's office. My brother got sick and there was a veterinarian in town . . . The vet recommended an immediate drive to a real Dr. Turned out my brother had leukemia.

William Simon, does your pharmacy have a doctor/PH/RH in residence? Try that out - at least they will have your prescription history to know what works.

I know from experience that chronic conditions make it harder to change doctors.

You could also call and ask to speak to the your actual doctor. Sometimes they don't know what kind of hardass they have working on the phones.

If he won't bend, then ask for a referral of another doctor that might have better hours. It might get your point across. I've done this in the office. The practice was so mismanaged that I couldn't deal with it anymore. She had a call-in policy where you call an hour before the appt and ask when they thought they would get to you. When my 4PM appt turned into 9PM appt, I told them to forget it.

Patients tend to forget that we are the consumers and the doctors are the service providers. That annoys me.

Is anyone else thinking that William has a case of Stubborn Man Syndrome? So he'll wait until next week to be treated? I'm thinking a nearby drug store might have a nurse practioner on hand. (I love Med Express! I was in & out with pneumonia one night in 20 minutes--including the chest x-ray!) And your doctor should have somebody "covering" in the evenings who would pick up a phone and call you back! Just saying.

Holy crap, William. That's nuts.

I don't really remember any doctors from my childhood. The one I remember most is the OB/GYN from India who kindly got me through the stress of an "irregular" pap smear when I was 20, which scared the hell out of me. He sat and talked to me, and drew pictures of cells, and described what had to be done. He eventually saw me through my pregnancy at 24.

Nancy, I'm so sorry to hear about your butt. They can be very painful beasts!

Our pediatrician/GP didn't make housecalls, but I don't ever remember there being a problem getting in to see him immediately if one of us was ill or otherwise needed attention. I don't even bother with a primary care doc these days because they're never available when you're sick. Through no fault of their own -- I just spent a few days in Portland with a couple of physician friends, and have gained new sympathy for the crap they have to put up with.

My only good doc story was about the time I had a bicycle accident and needed a tetanus shot. Mom spent the entire drive to the Dr. Johnson's practice telling me that it wouldn't hurt at all. Naturally, the more she talked, the more freaked out I became. I was probably about 6 or 7 at the time.

I remember Dr. Johnson walking into the office with the hypodermic. Then I remember opening my eyes to my mother's horrified face. Seems I had shut my eyes, screamed, and kicked the doctor. I was so embarrassed (and more than a bit scared of what my Mom's response was going to be later)! I apologized profusely and told him he could give me the shot -- but he already had. I never felt a thing. And haven't been afraid of needles since.

A story from my mom, when 4 of 5 of us kids had the measles (#5 not born yet) the Dr. made a housecall, told my mom not to bring us to the hospital as we were all going to die anyways. Nice guy. My mom laid us all on the couch and stayed up for 5 days straight, her and my dad taking shifts to keep us alive. So glad I have no memory of this.

William has found another doctor who can see me today, in about an hour. Everyone relax, it's under control....

Good for you, William! (Although now I'm worried that the sinus infection has you speaking in 3rd person ala Bob Dole)

Hey William,
you could always do the natural sinus infection cure and snort warm salted water up your nose . . .
gross

Gaylin, that's hilariously horrible!

William, we knew you had the fortitude to get this taken care of today. Very Bondian.

Nancy -

Not to be an alarmist. I too cracked and dislocated my tailbone years ago in a bad fall. Should you want free suggestions on what to do now so it doesn't turn into a nightmare of scar tissue and sciatica years down the road, (like it did for me), please don't hesitate to e-mail me off list.

I'm a chiropractor and have been doing many types of natural therapies for over 25 years.

Best of luck in healing quickly and correctly!

Pamela.DuMond@gmail.com

Yes Nancy, totally horrible and they even sell a weird little pot thing so you can pour water up your nose with ease.

Keri - "They can be very painful beasts!" Carnivalli Animale: There is the painful onager. And then there is the ass, equally painful. Especially in Nancy's case.

And difficult to steer, even when in a bridle. The beast, that is.

As for the salt water sinus lavage . . . yeah, it's one of the less glamourous elements of the classical vocalist's life, when The Show Must Go On.

007 doesn't get sinus infections, Nancy. He also smokes 70 cigarettes a day and can run faster than anyone!

Today was the last straw. Changed doctors officially. Got what I needed, all is well, stand down....:)

Life was simpler with one family doctor -- and house calls. Specializing is ostensibly because medicine is so complicated now, but I've heard it referred to as "profit sharing" by the cynics . .

Best thing I've found for sinus problems http://www.nasopure.com/

oh, oh, sorry about that tailbone!

We had a doctor back in Lincoln, Nebraska, who was so wonderful he made housecalls -- and we lived on a farm in the middle of nowhere -- for 2 weeks so that my mom could recover from pneumonia at home rather than go into the hospital. Our very own Marcus Welby.

Lord, I have so many doctors.

Endocrinologist-hypothyroid

Pulmonologist-asthma

Podiatrist-plantar faciitis & just last week tore a toenail off and he had to work on it.

OB/GYN-he was my favorite of the bunch until he retired 2 years ago (I really hate him for that, too, he's younger than me). He saw me through the hell of my hysterectomy and we could giggle like school girls. My daughter (at age 15 and heavy trouble like her mother) was his first teenager. His replacement is ok; just don't know her very well yet.

Orthopedist-I have my father's crappy knees. Will not wait as long as he did for the replacements.

Internist-great guy. Treats my whole family. Really handles my 75yo mother & 83yo father with kid gloves and takes excellent care of them. He will call something out for us; he knows when we call it is important and he's not just prescribing something not needed.

Dentist-my lord, do I have respect for this guy. He is my 4th dentist within the same practice. My file goes all the way back to when I was 4 years old...that is 50 years ago. Yeeks. But I have terrible teeth and they know me quite well there. Dentist #3 was actually my favorite (he had to retire for health reasons at a very young age). He was doing a root canal and when he finished he told me, "Now you can go home and tell your husband that you have been reamed by the best!" I spit the cotton all the way across the room.

I don't really remember my doctors as a kid. I just remember getting tonsilitis every Christmas. They wouldn't take out my tonsils out because, as the doctor said, they weren't rotten enough. I waited for 6 years at my Lutheran school to join the school chorus to be able to sing and the Christmas pageant. It was the candlelight service and every kid wanted to be in it. But I got another soar throat and the doctor made me stay home. Devastated!

Nancy, my sympathy on your tailbone! My husband laid his motorcycle down last summer and I bruised or broke my tailbone. Went to doctor for advice and he said "We can't set it or do anything-so why x-ray it. Only time will help." I thought it was all healed, but husband took us down a BUMPY road last week and it hurt like hell! Hang in there!

To Tom,
I remember dear Doctor Frank Wiener of Indiana, Pa. He treated all 4 of my girls before he retired. He wasn't one of those assembly line doctors. He took time to do an examine then talked to me to explain what was going on with my children. He had a collection of antique baby bottles in his office, even. He left our area due the health of his own daughter. I pray all went well for him and her. He was a blessing when you needed a friend as well as a doctor to talk to. Thank you for reminding me of my old friend.

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