1 Boring Old Man

Long ago and far away when I was meandering my way through medical training and had made it to the level of Intern, we weren’t exactly paid for working. I was paid $286.00/month – which wasn’t much even in 1960-something. But in case you ever wondered why they call doctors in training "residents," I  remember the answer. We got free uniforms [white "duck" pants and smocks done by the hospital laundry with enough Argo starch to stand on their own], free meals in the hospital cafeteria [southern fried things], and a free room in the "Pavillion" – an old brick building with peeling paint behind the hospital. It was a time of change and by then most of us were married, in my case supported by my wife’s teacher’s salary [she ate all her meals at the hospital free too]. But I still had a room in the "Pavillion" – for every third night call [a room rarely visited] mainly a place where the starched clothing showed up.

There was an elderly doctor who was just part of the landscape. In medical school, we’d all seen him because he ran the "cast clinics" where we went to put on and take off casts at the charity hospital and the VAH. He was at all the Orthopedic conferences. He was around in some of the Pediatric Clinics where kids with Cerebral Palsy came. Some time later, I encountered him in the Rheumatology Clinics when I was a resident. He was a nice, quiet, very knowledgeable guy with a heavily starched very long white coat. One day, it dawned on me that I’d seen him for years, but had no idea about who or what he was – so I decided to find out. At lunch [southern fried], I sat down at his table and asked something like, "What are you?" And he told me.

He was Boarded in Orthopedic Surgery, Neurology, and Rehabilitation Medicine and had come to Memphis from some prestigious place to direct the "Pavillion" when it opened long ago. He was a Polio Doctor, having dedicated his life to treating the kids who had that affliction. He’d even treated FDR. The "Pavillion," as it turned out, had been a hospital built specifically for that purpose – a Polio Center. He obviously liked being asked and described in some detail the programs they had – orthopedic devices, corrective surgery, physical therapy, "iron lungs." When the vaccines for polio came, the previously afflicted didn’t disappear quickly and he shepherded the gradual wind down of the "Pavillion." By that time, he was along in years, and so he created a new career partitioning his skills to various places where needed. He wasn’t bitter about having his profession and program disappear, saying – "I’d always hoped they’d figure it out." He was well past retirement age when I met him, but he just liked his work and stuck around [unpaid]. I recall him saying something like, "You know, doctoring isn’t just about curing people. It’s about taking care of the ones that can’t get well – doing whatever you can do." After that conversation, we kind of became clinic pals. He knew a gajillion little tricks for helping people with crippling Rheumatoid Arthritis [something else we don’t see so much anymore]. Quite a guy.

I don’t think I really got what he was saying at the time, even though that comment obviously had an impact since it’s still with me nearly 50 years later. But I recall thinking about it a lot a few years after that practicing Internal Medicine – because that’s what it’s often about – doing what you can do to help chronically ill people. With me, it took a different turn. What became interesting to me was not just their physical afflictions, but their lives. Flash forward, by the time I got to psychiatry, I think my view of what doctors do had changed a lot. Unlike some of my colleagues, I was, by that time, not so put off by what couldn’t be done for the mentally ill. I was impressed with what could be done – to me more than my former profession, actually a lot more. I could see that Schizophrenia was a lot bigger than the medications, and so I learned all I could about being Schizophrenic and the little tricks that helped. I never really saw psychotherapy or psychoanalysis as a cure. But I could help some people untie some rigid knots that helped them move more easily in life – sometimes dramatically, sometimes less so. Fine by me.