Dr. G

Dr. G was my residency program director. I took a year off to regroup after internship year and applied to his program — and he took a chance and let me in for the second and third year of residency. He didn’t like all his residents — the original Match was and is imprecise — but he did in fact pick me personally and thought I was a decent doctor.

He ran a tight ship and was protective of his residents, but you did not want to cross him. He could make life even more miserable than it already was — and if you really pissed him off, he could continue that misery beyond residency. But he was fair. Behind that massive intellect and dedication to practicing “good medicine” was a generous man.

Dr. G died last week after a sudden but mercifully short deterioration in his underlying disease. I was shocked to hear the news: as with Mom, I had assumed that he would outlive us all. In the end he was in the hospital he loved, surrounded by family and colleagues, his attending a former (and favorite) resident from 25 years ago.

My last encounter with him went something like this:

“Are you practicing?”

“Ummm, well, I am a practicing historian . . . . “


I will miss his presence in the world.


The Three of Us

My medical school preceptors considered me a rather mediocre student; it was not necessarily a wrong assessment.  I kept my head down, I made no waves, I just wanted to be done . . . .  because being lower than whale dung really sucks.  Other students were much more savvy: look eager, ask lots of questions (especially ones you know the answers), flatter the attendings.  Get good evaluations, and you are on your way to the rest of your life.  

The rest of my life did not follow, but it is many years later now, and it is a reunion year.  The alumni reunion coordinator had no volunteers to be our class co-chairs, so I thought, “Why not?”  Why not, indeed.  This is not altruism, it is an experiment on myself:  I have time, I want to know if this could be my personal Creative Morning, and I am curious how my former classmates define success. 

I wrote a reunion letter so inspiring that am tempted to go to the reunion!  And then, the coordinator gets not one, not two, but three more volunteers:

The three of us are willing to be the co-chairs for the upcoming class of ’93 reunion. None of us have a whole lot of time . . .  blah blah blah . . . 


Well gosh.  The Three of Us and Bisy Backson, all in one!  

The coordinator has sent my inspirational reunion letter on to The Three of Us, and is sure that they will “connect” with me.  She is so optimistic — but I suppose she has to be to deal with medical alumni. 

I am back remembering the day I realized that The Three of Us (or rather, The Six of Us, of which The Three of Us was a subset) and I had never been friends.  These women were a clique back then, and they remain a clique now.  And of course, the core truth of a clique is that while you-the-outsider can clearly identify them as the clique, they do not identify you as anything because they never think about you at all.  On that day I remember my truth: “How stupid am I?”

But there is hope yet for my inner Opie: the memories are vivid, but they no longer sting.  And that is very good news indeed because I am, of course, on tenterhooks waiting to see whether I will be noticed by The Three of Us Bisy Backsons!

Tenter_Frames,_Otterburn_Mill,_Northumberland (1)

Tenter frames, Otterburn Mill, Northumberland

When a Historian Meets a Travel Diary

She naturally wants to know who, what, when, where, why.  The who was the difficult one: I had her name on the flyleaf, and what I thought was a timeless commentary (State Insane Asylum) by a teenager about her condition in life.  I should have known that a well-brought-up young lady in late-19th century America would not make that sort of comment.  Mary Campbell Andrews (1875-1962) was the daughter of Judson B. Andrews, M. D. (1834-1894) and Agnes Sinclair Campbell (1840-1931).  Dr. Andrews was the medical superintendent of Buffalo State Hospital from 1880 until his death, so Mary was not being snide, she really did live at the State Insane Asylum in Buffalo (although the official name for the institution was the Buffalo State Hospital).

Dr. J. B. Andrews

Dr. J. B. Andrews, photograph from “North Haven in the Nineteenth Century: A Memorial,” published by the Twentieth Century Committee, 1901.

J. B. Andrews was born in North Haven, Connecticut, in 1834, and graduated from Yale in 1855.  During the Civil War he was a captain of the 77th Regiment, New York Volunteers, and later assistant-surgeon of the 2nd Connecticut Heavy Artillery.  In 1867 he was the 3rd assistant physician at Utica State Hospital, later becoming the 1st assistant.  Dr. Andrews became the superintendent of Buffalo State Hospital, remaining so until his death at the hospital in August 1894.  He was a prominent “alienist,” and was President of the Medico-Psychological Association (now called the American Psychiatric Association) from 1892-93.  He produced monographs such as “Exophthalmic goitre with insanity” (c. 1870) and “Case of excessive hypodermic use of morphia: three hundred needles removed from the body of an insane woman” (c. 1872).  Dr. Andrews married Agnes Sinclair Campbell, and daughter Mary was born in January 1875.

Mary seems to have lived her entire life in upstate New York; she was born in Utica, and died in Utica in 1962.  In between she married Dr. Herman Gustavus Matzinger and had four children.  Dr. Matzinger (1860 – 1931) came to prominence in 1901 as one of the doctors who performed the autopsy on President William McKinley.  McKinely was visiting the Pan-American Exposition of 1901 in Buffalo when he was shot by anarchist Leon Czolgosz.  Unfortunately, he lingered on for another nine days, finally dying of what modern scientists think was pancreatic necrosis (secondary to the abdominal trauma).  Pancreatic necrosis remains a high-mortality condition today.  Dr. Matzinger was variously designated as a bacteriologist (of the Buffalo State Pathological Laboratory) at the time of the McKinley assassination, and later as a Professor of Psychiatry at University of Buffalo.   I love the days of undifferentiated medical practice . . . .

Mom’s Dream

“If you tell her you got in, you are going to medical school,” DH said.

In my life is Mom’s life.  A few months before she became visibly sick, she told me something that had everything to do with why I became a doctor.  “I was so tired of being poor, I looked for a medical student to marry,” she said.  “But medical students or doctors marry into other doctor families, so I knew I was never going to be able to marry one.”  How galling for one with as much brains and ambitions as my mother, to know she could not become a doctor herself and to think she needed someone else to take her out of poverty.  She married Dad (and as a school teacher made more money than he did as a young civil engineer, she pointed out), but never forgot the Doctor Dream.

Not son number one, not son number two.  “My own daughter,” she would tell me at the end as I helped her eat, bathe, change, use the toilet.  I am haunted by the thought that the faith she had in medicine was shattered in her last days.  Mom used to ask me what it was like being a doctor, and I would tell her honestly that frequently we don’t do anything except delay death.  We patch patients up, and hope that they are reasonably comfortable in the time they have left.  She never believed me; the harsh realities of modern medicine did not exist in her world.

“Can’t they cut it out?”

“No medicine for it?”

“No cure?”

And in the end, there was nothing.

She passed away 30 minutes before I got there, and I’ll never know if that was because she didn’t believe in me anymore, or that she was my Mommy, trying to spare me the pain.

Statin in the Drinking Water

A cardiologist told me once that he thought statins should be added to the drinking water.  I think he may have been joking, but most cardiologists will tell you the benefits of statins far outweigh the risks.  I have crappy genes when it comes to lipids: my mother has been on Lipitor for 15 years, and her lipid profile is just acceptable.  Unfortunately, I seem to have inherited her crappy genes.   Too bad I didn’t get Dad’s genes: sedentary, eats whatever he wants, and perfect numbers.  His father ate five eggs a day, and attributed his longevity to that and the occasional pipe.

I had been on Niaspan for close to a decade, and while on it had wonderful numbers, including a HDL of 100.  But, given the recent debate about what exactly niacin does to lipids, I decided to take myself off the drug and see what happens.  The good news is that all that exercise has kept my HDL pretty high at 75, but the rest of the profile has gone to hell.  I have become the perfect candidate for statin therapy.  I can do everything right, but I can’t overcome the menopausal rise in cholesterol, and I can’t overcome genetics.

I have been on simvastatin for almost two weeks now, and it’s not going as “benignly” as I had hoped: I am having palpitations again, and while it is true that I have had them in the past (I blame them on menopause), I also don’t think it’s just coincidence that the arrhythmia has returned since the new medication.  So . . . .  My doctor and I play this waiting game while adjusting the dosage, and hope that we hit exactly the right combination of drug-lifestyle choices.  That Niaspan is looking pretty good right now . . . .

Kendal mint cake

Back in February, I was substitute innkeeper for a father-son hiking/climbing duo from England.  The father was retired and lived in Newcastle, and the son worked in The City when he wasn’t off adventuring, doing things like biking across America without support, or climbing Long’s Peak in the winter.  Anyway, the father swore by Kendal Mint Cakes, and had brought a small supply with him for their winter hiking in Rocky Mountain National Park (along with ice picks, avalanche shovels, and assorted other winter survival gear).  He shared his last bar of the mint cake with me, assuring me that it would come in handy some day when I was out and about.  Some day was last week, on a short hike up to Bible Point — and he was right, it was actually surprisingly good and gave us all a needed boost of energy.  After all, the cake made the summit with Hillary and Tenzing Norgay!

CSA Share Week 12:  summer squash, Asian eggplant, onion, baby carrots, green beans, Swiss chard, watermelon, strawberries

Week 12 Recipes:  spicy ratatouille with eggplant, squash, and onion; crustless quiche with Swiss chard, onion, scapes, and feta cheese; watermelon-based fruit salad; green beans with spicy olive tapenade; roasted carrots

Red Chair Reads: Medicine on the Santa Fe Trail

During my last trip to Santa Fe, I found Gunstock Hill Books, bookstore for rare and used 1st editions.  I spent an interesting hour talking to the proprietor, Henry Lewis, bibliophile and retired M.D.  It’s a good thing he made plenty of money before opening a bookstore: it is absolutely an act of foolhardy love.

Old medical texts are always interesting; when I hold one in my hands, I feel this kinship — usually tenuous, but nevertheless present — with the generations of doctors/healers who went before.  This kinship holds even when I read, in appalled fascination, the advice and practices of a bygone era.  So I made an impulse buy:  Medicine on the Santa Fe Trail, by Thomas B. Hall, Jr., M.D.

Dr. Hall may have been a good physician, but he was a lousy writer.  I thought the book might have been a vanity press book (limited edition of 1000 copies, of which I now own #542, signed by author), but it was not.  It was published in 1971 by the Friends of Arrow Rock, an organization dedicated to preserving and telling the story of historic Arrow Rock, Missouri.  The standards for a “local history” book is not usually high, and this book was no exception.  For non-fiction works, I like to know why the author wrote the book.  I read the acknowledgments, the introduction, the 11 pages on Dr. Thomas Bryan Lester, and realized that although Dr. Hall wanted to present a history of disease and trauma on the trail through the eyes of a physician who traveled with army units in 1847-48, he simply could not organize his material into a cogent narrative.  The introduction should have been an overview, but was all about Dr. John Sappington, who became “America’s strongest quinine protagonist and its largest user,” and ends abruptly with a sentence about the importance of buffalo robes on the trail.  The next chapter was on Thomas Bryan Lester . . . .  why?  Why did Dr. Hall choose Dr. Lester as the focal point for the book?

The internet to the rescue!

Dr. Lester (1824-1888) was the brother-in-law of Dr. Matthew Walton Hall, who, as it turned out, was the grandfather of the author.  The lineage itself probably is not all that important, but it was important enough to the author that he constructed his micro history around it, and I wish he had clarified it.  Dr. Hall’s narrative truly was excruciating, but I don’t suppose medical school was/is the place to learn the finer points of grammar, punctuation, and essay writing.  I am guessing either no one edited the book, or no one had the gumption to really go at it with a red pencil.  However, Dr Lester’s diary as well as the various tables and data the author gathered from archival sources were fascinating and would be of special interest for those researching life (and death) on the Santa Fe Trail.  I would love to have known about this book a few years back when I was working on my environmental history project.

The Broadmoor

During residency, my program director required all internal medicine house officers to join ACP (American College of Physicians) as associate members.  I dutifully joined, and even continued as a regular member when I finished residency.  The Colorado chapter meeting is always in February, and always at The Broadmoor in Colorado Springs; doctors have lots of disposable income, right?  I went to my first meeting 14 years ago, and returned for only the third time this year.  In the intervening years the resort has renovated, remodeled, demolished, and expanded, and the work continues.  If a grand hotel could be said to be affordable, the Broadmoor was affordable 14 years ago, albeit only during the off-season.  But now?  I miss the free self-parking, I hate the resort fee for things that should be complimentary (use of fitness center, pools, in-room “complimentary” coffee/tea), and for all that, staff tipping is still not included as part of this daily per person fee.  I remember turning in the comments card after my second visit, and was shocked when the general manager actually wrote back to address my comments.  He told me that the pay parking as well as the resort fee were in keeping with other hotels of the same caliber . . . .  perhaps, but I hate feeling like I’m being nickel and dimed to death.

On the other hand, there is something to be said for holding a conference at the Broadmoor:Broadmoor breakfastLovely bowl of fresh strawberries, blueberries, blackberries, and raspberries from the breakfast buffet!  As many bowls as I wanted!!  With real whipped cream!!!

Oh, and the conference was pretty good too.  I like being a retired physician — I have no pressure on me to actually learn anything, so can just sit back and enjoy the sessions and let something new just gently seep into my brain.  Unlike other medical conferences that emphasize the latest research results, this meeting invites speakers who can translate what those latest research actually mean for real-life practices.

Perhaps next year I will splurge and stay at the Broadmoor again:  If you’ve been here, you know.