The Grand Old Men Of Medicine

by Lucky Garvin

I attended a medical conference a while back, and was agreeably surprised to hear a younger physician speak of ‘bedside manner,’ and the old ways of medicine.

It took me back to the ‘grand old men,’ as I respectfully remember them, who patiently, and despite my many fumblings, passed on to me the art and the practice of medicine: Jim Robinson, Paul Forth, John Boyd, who have crossed over, Graham Stevens and Hayden Hollingsworth gratefully, still among us. These were formidable practitioners who had to do it all; there were far fewer specialists in those days. Peri-tonsillar abscess? ENT referral? Nope. GP. They could predict to a certainty if an abdomen needed surgery [without CT Scan] or if a bone was broken [without x-rays.]

Yet, they were wise to their limitations. Johnny Boyd taught me that one day when I, a raw, unintentionally homicidal intern came to report a severe case of the flu. He went in, saw the patient, came back and said, “Lucky, we can’t cure the flu.” [We still aren’t much good at that.] “But when you can’t cure, you comfort.” I watched him, half in fear, half  in admiration of this man. I remember his face, his teeth worn into that pattern peculiar of inveterate pipe-smokers. [In those days, it was not at all amiss to see a patient with a pipe or cigar in your mouth. In fact, back then, when a patient couldn’t remember my name, he would identify me to the nurse by saying, “He’s the Doc with the pipe.”

John mixed a ‘cocktail’ of Demerol, Phenergan and eucalyptus. Eucalyptus has since been disallowed as an injection, although you can still buy ‘Vicks”; same stuff. John gave the patient a “…deep intra-muscular injection.” John never gave a ‘shot,’ such was his devotion and his respect for proper medical terminology, and thus, to his profession; and I don’t mean by this that John, or my other many mentors, felt themselves as ‘big-shot doctors’; it was more they were sensitive to the privilege of being part of the sacrament of healing.

This he also taught me; not by word, but by deed. In John’s mind, there was no such thing as a ‘cheek’; it was a ‘malar eminence.” I loved it. He gave this shot, and before the needle had been removed, not only the patient, but I could smell the healing scent of eucalyptus; soon would come the relief of pain and the delicious drowsiness. “When you can’t cure, you comfort,” was John’s terse summary. This was part of the lore and science of medicine taught to me by these last-generation practitioners.

Some years back, I visited a Smithsonian Exhibit on the history of flying. Grainy black and white films of early attempts and efforts to conquer the air were shown one after the other; all of them ending in failure. The audience laughed. Then came the final clip of a moon-shot successfully negotiating a flight far beyond the bounds of Earth. Suddenly, the crowds’ snickering stopped as we realized the point of the film: Try and fail, try and fail, try and succeed; from this point, we try and we will learn more, although, yes, not without additional failures.

Such is medicine, from the times when healers clad in animal skins bent urgently over their patients, desperately fingering their beads and shaking their rattles trying to make whole a life in peril. How much like the history of flight are the annals of medicine; the passing from the old generation to the next, the best they had learned; ludicrous beliefs lead to those of progressive refinement and insight. I have no doubt that future healers will look back on our efforts. I hope they will suppress the tendency to smirk and to understand that despite early efforts – perhaps laughable – it is in this way, with halting steps, necessary steps, that finally we come to excellence.

One day,  in the patient working of time,  the symbols of our diagnostic competence, CT’s, MRI’s and the like, will sit consigned and forgotten in the dustbin of history beside the  incantations, the beads, the potions and the poultices which were once the curative stand-bys of our forebears – the ancient healers. It’s easy, in hindsight, to mock their naiveté, but never their devotion to voluntarily participate in a ritual and practice they could but rarely win. But then, as now, the old ones were willing to pass on to the newcomers the best of their wisdom, hard-won after years of contending with illness and injury. Yet, threaded through their counsel was the reality that this is a contest often lost. But even if you cannot cure, you can always care, you can always try.

So it is with that humility born of the knowledge that we are not, we cannot be, the final representation of medical art, that we are but one link in a chain that passes beyond sight into the misted past, and impossibly ahead of our time, that I thank these fine men and others, who, undoubtly frustrated by my ineptitude, nevertheless strove to pass on to me the method and the patrimony of medicine with all the thoroughness and patience it had been passed on to them.

Look for Lucky’s books locally and on-line: The Oath of Hippocrates; The Cotillian; A Journey Long Delayed.

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