July 12, 2016: The Renaissance Men

I looked through my books the other day and found an old pamphlet that once belonged to my grandfather: a transcription of a lecture Dr. Paul B. Hall delivered at Louisville in 1964 entitled “My Forty Years’ Practice of Medicine in the Hills of Eastern Kentucky.” Skimming over it once again made me marvel how much the healthcare industry has changed, not only here, but all over the country, even since Dr. Hall delivered the lecture, let alone when he began his practice as a junior medical student back in the terrible, death-filled days of the 1919 Spanish influenza epidemic. Nowadays we have millions of drugs, tons of tests, and X-ray procedures enough to diagnose conceivably almost anything. Back in the days of his youth, Dr. Hall noted in the lecture, the drugs physicians could count on could be numbered on the fingers with digits left over, none antibiotics because those hadn’t yet been developed, and he and his colleagues had to make virtually all their diagnoses using only their eyes, hands, and ears besides maybe a stethoscope and blood pressure cuff. So if it’s true that a “Renaissance Man” is one who can boast of being accomplished in many disciplines, like Leonardo da Vinci with painting, sculpture and engineering all, our old-time country doctors were true Renaissance Men—at least from the standpoint of the dozens of subspecialties of medicine.

Besides the several stories about riding horseback through creek beds to reach patients and then later having his wife break the ice off the stirrups frozen to his feet, Dr. Hall recounted tales of surgical experimentation and innovation prompted by on-the-spot emergency decisions that would turn a typical young modern physician into a quivering lump of paralyzed fear. He often acted boldly because he just as often had no other choice. Nor was he the only mountain doctor forced to show audacity on a regular basis: though it’s been a long time since the days of the coal company doctors, one still hears stories of mine accidents patched up almost MASH-style by these men, often fresh out of medical school and a one-year rotating internship and on their first jobs. I’ve already shared one anecdote of Dr. F. M. Picklesimer’s days as Royal Collieries’ physician at Offutt. Later on his partner in Paintsville for a while, Dr. A. D. Slone, diagnosed the first case of Rocky Mountain spotted fever ever reported locally, working from a set of symptoms that had stumped doctors much older than him. And though all had to be competent with a scalpel, arguably the neatest surgeon locally was Dr. E.G. Skaggs: he had a reputation for making the smallest, most precise incisions possible in any operation he performed, and once actually removed the appendix of one of my particularly skinny cousins using local anesthetic. Dr. Skaggs simply slapped a band-aid on top of the few stitches he left, and my cousin hopped off the operating table and walked, with a little assistance, back to his room. And the heroic, often wryly comedic, tales of the tough old doctors go on.

The Renaissance Men’s one great collective failing with their patients is almost understandable, though we’re still paying for it today. Psychiatric disorders carried a terrible social stigma and hardly anyone would even admit to the possibility that they might suffer from such maladies. Even then, almost the only thing yesteryear’s physicians could prescribe for cases of “nerves” was, simply, narcotic “nerve tonic.” Later on pills took the place of the tonic, and over the years overworked doctors increasingly threw them at patients as quick fixes; one thing led to another until we have our present prescription-drug addiction crisis. And for all that, the country doctors of yore left a good, strong legacy of healing, one to which our own lawsuit-ridden modern healthcare profession might aspire. To those of us who work inside the industry, though, indoctrinated daily as we are with a medical philosophy that increasingly and evermore makes its very basis the initials C.Y.O.A.F.—like the Good Book says, he that hath an ear, let him hear; the first three letters stand for “Cover Your Own,” and again to quote the Bible, the last shall be “First”—perhaps we are prone to view the deeds of the Renaissance Men somewhat through rose-colored glasses. The doctors of yesteryear would have given their eyeteeth for a full night’s sleep, let alone the medical conveniences we now take for granted. I just can’t help suspecting, though, if the Renaissance Men might have used them more fearlessly—and probably could have slept better, too.

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