A TOUCHY SUBJECT
Eschar is the medical name for a scab.
I mention this fact because, as most small-town doctors know, patients will frequently use an encounter with the doctor at a local business establishment as an opportunity to “catch up” their case histories or “ask a question or two.” One of the most amusing encounters I ever had involved an eschar.
An elderly couple was sitting at Super Swain Drugs when I walked in with Ken Hicks for lunch. I had seen the woman for a venous stasis ulcer that had been located just above her ankle. Of several potions tried, one of Doc John’s recipes had dramatically reduced the size of the eschar and begun to promote “proud flesh” formation more successfully than any other treatment.
Doc John called it “Betadine-sugar paste.” It was very easy to mix, and I used it off and on for my entire practice career. The paste contained eight parts granulated sugar, one part Betadine ointment, and one part Betadine solution. Additional ointment or solution could be added as necessary to obtain a paste, as Doc John would say, “the consistency of granular peanut butter.”
Ken and I stopped at their booth to say hi. As we turned to go to our booth, the husband remarked to me, “Doc, the dressing you suggested for Ruth’s escargot was wonderful. Her escargot is the best it has ever been!”
Once I realized what he was saying, I chuckled out loud.
As we walked to our booth, Ken seemed rightly confused. “What was that all about?”
During our lunch together, for some reason we got on the topic of specialists—which was, early in my career, a somewhat sore subject with me.
Ken began innocently enough. “Walt, what do you think about the hospital’s desire to bring some specialists into the community?”
“I hadn’t heard about it.”
Ken cocked his head and explained. “I thought you would have known. Anyway, Earl Douthit, the administrator, mentioned to me that they’re thinking of buying the home next to Rick’s house. It’s for sale.”
“What would they do with the home?”
“He says they’ll convert it into an office and have specialists from Sylva come over to see patients here in Bryson City.”
I paused, certain my neck was changing color. “Why would we need them?”
“Well, a lot of people from this town travel to Sylva to see a dermatologist or urologist or pediatrician.”
“I know,” I complained.
“Well, maybe it’d be easier for folks if the specialist came here once or twice a month.”
“Ken, seems to me we already have too many physicians here. In fact, Dr. Mathieson thinks we have t-w-o too many physicians.”
Ken chuckled. “May be true, Walt. But sometimes the specialists in Sylva will tell our people that GPs may not be the best for their care. They say there’s just so much any one person can know.”
Now I was certain the emotion showed in my face. Before I could think, I shot back, “Ken, many subspecialists are academic, ivory-tower types. They usually care only for one gender or for one age group or for one organ system. And they believe there’s so much medical knowledge that no rational person could ever consider becoming a competent generalist physician. Such sentiments are, I believe, hogwash.”
Ken sensed my emotion. “Whoa, Walt! I’m on your side. I’m just telling you what I hear folks saying.”
I took a deep breath and a sip of my soft drink. “Ken, since Sir William Osler’s time at the turn of the century, the discipline of general practice has been an academic discipline with its own curriculum, research base, and peer-reviewed journals, but it’s also the cornerstone of most national health care systems—that is, with the notable exception of the United States. What a GP has to know to be a competent physician is different from but no less demanding than that of any specialist in any university center—much less Sylva!”
Ken looked at me and then said gently, “I can see this is a touchy issue.”
“Well, it really is, Ken. As residency-trained and board-certified family physicians, Rick and I are trained to handle over 95 percent of the problems that come into the office. And we have additional training in maternity care, orthopedics, nursery and child care, and surgery.”
“You know, my friend, I don’t think most people around here know that. I think we need to get you some PR.”
“Ken, if they’d think about it, it would make sense to them.” Then I chuckled.
“What’s so funny?”
“I was just remembering a quote from a fictional character who was the oldest man in the world. His name was Lazarus Long.”
“Oh, I remember him!” exclaimed Ken. “He was in one of Robert Heinlein’s science fiction novels.”
“Yep, that’s him. And he said something like this: ‘A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying. We should be able to take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly. Specialization is for insects!’ ”
Ken laughed. “Okay, okay. I see your point.”
“Of course, Ken, I’d never publicly admit to so deeply enjoying a quote such as this.”
“I understand, my friend. But I still think we need to get you and Rick some PR.”
I let the comment pass. We finished lunch and walked back to our offices. We were both absorbed in our own thoughts. My concern was whether Rick and I would ever be able to fit into this small, closed medical community. In so many ways they wanted us there. Yet in so many ways they did not.
Only time would tell.
TO BE CONTINUED
PAST STORIES FROM BRYSON CITY SEASONS
- Dead Man Standing (Part 1), (Part 2), (Part 3)
- Eyes Wide Open (Part 1), (Part 2)
- Auspicious Accidents (Part 1), (Part 2)
- Answered Prayers (Part 1), (Part 2), (Part 3), (Part 4)
- Rotary Luncheon
- Death by Emotion (Part 1), (Part 2), (Part 3), (Part 4)
- The Invitation (Part 1), (Part 2)
- Barbecue and Bacon (Part 1), (Part 2)
- A Touchy Subject
PAST STORIES FROM BRYSON CITY TALES
- The Murder (Part 1); (Part 2); (Part 3)
- The Arrival (Part 1); (Part 2)
- The Hemlock Inn (Part 1); (Part 2)
- The Grand Tour (Part 1); (Part 2)
- The Interview (Part 1); (Part 2); (Part 3)
- Settling In (Part 1); (Part 2)
- First-Day Jitters (Part 1); (Part 2)
- Emergency (Part 1); (Part 2)
- The Delivery (Part 1); (Part 2)
- The “Expert” (Part 1); (Part 2)
- The Trial (Part 1); (Part 2)
- Shiitake Sam (Part 1); (Part 2)
- Wet Behind the Ears (Part 1); (Part 2); (Part 3)
- Lessons in Daily Practice (Part 1) — Anal Angina; (Part 2); (Part 3); (Part 4)
- White Lies
- The Epiphany (Part 1); (Part 2)
- Becoming Part of the Team (Part 1); (Part 2)
- Monuments (Part 1); (Part 2)
- My First Home Victory (Part 1); (Part 2)
- Fisher of Men (Part 1); (Part 2)
- Fly-Fishing (Part 1); (Part 2)
- Something Fishy (Part 1); (Part 2)
- A Good Day at the Office
- An Evening to Remember
- Another New Doc Comes to Town
- ‘Twas the Night Before Christmas (Part 1); (Part 2)
- A Surprising Gift
- The New Year (Part 1); (Part 2)
- The Home Birth (Part1); (Part 2); (Part 3)
- The Showdown (Part1); (Part 2); (Part 3)
- The Initiation (Part 1); (Part 2); (Part 3)
- Home at Last (Part 1); (Part 2); (Part 3)
© Copyright WLL, INC. 2017. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.