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“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler






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    Saturday, February 19, 2011
     
    Taking Care of Patients: You Do What You Have To

    Today the Food Librarian posted a piece about today being the Day of Remembrance for Japanese-Americans. On this day in 1942 FDR signed Executive Order 9066, authorizing the internment of Japanese-Americans. Her father and his family were interned in camps during the Second World War.

    This post brought to mind a story my father told me many years ago. When he moved to Southern California he got a job in a medical practice in Westminster, in Orange County. The founding member of the practice was named Dr. Johnson. (I vaguely remember him; we were invited to dinner at his house once a year.) Dr. Johnson had founded the practice in, I think, the ninteen-thirties. He was the old-school type who delivered babies at home. There was no hospital in the area until he got a group of doctors together and built one. Sadly, Westminster Hospital now no longer exists.

    At the time the area was largely agricultural and many of the farmers were Japanese-American. Once the Executive Order was signed these farmers knew they'd lose their land. Having nowhere else to go, they went to their doctor - the only Caucasian authority figure they could trust. They sold Dr. Johnson their farmland for a dollar.

    When the farmers were released from internment, they returned home and went to Dr. Johnson to buy back their land. He sold it back to them.

    For a dollar.

    My dad told me this story to teach me something about medicine and about the relationships doctors build with their patients. Those farmers stayed with the practice for decades, even after Dr. Johnson retired; they and their children became my father's patients. The trust they had in him overwhelms me. Would you sell someone everything you had for a dollar and expect to get it back? But then, people entrust their lives to doctors every day and think nothing of it. Nor do I, really. Maybe I should think about it more.

    A favorite philosophical question of medicine is "Is medicine an art or a science?" The answer is it's both: You can't have one without the other. I think that's what this story illustrates. Medicine is changing every day, but the heart of primary care is still the relationship between doctor and patient. I will defend that relationship with everything I have, because when it is gone medicine as we know it will no longer exist.

    Oh and by the way. Dr. Bernard Micke of Madison, Wisconsin? YOU'RE DOING IT WRONG.

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    3 comments

    3 Comments:

    During the Depression, my grandfather did a lot of barter doctoring among the farmers. He got produce and meat; they got medical care. This carried over for a generation after he died too young, with the people he cared for looking after his widow and kids.

    By Blogger Jack, at February 22, 2011 at 2:32:00 AM PST  

    I Love my family doctor and trust her with my life. And, I don't trust people very easily. But, she has proved that she can be trusted and because of that, I trust her. Does that make sense? Now I refer her to my friends, and because they trust me, they know that they can trust her.

    Trust is a something very precious....

    That Dr. Johnson was a very special man. I would have liked to have known him!

    By Blogger A.Marie, at March 13, 2011 at 6:14:00 AM PDT  

    Oh, and I agree...that Doc is definitely doing it wrong!!

    By Blogger A.Marie, at March 13, 2011 at 6:16:00 AM PDT  

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