(Part III of a series)
Part 1- The strong survive and succeed
The writings of Dr. Arthur E. Hertzler, a Kansas farm boy turned country physician who earned his living by making house calls in the early 1900s, provide a remarkable glimpse in to the medical care of his day as well as his perception of health care of the future.
With our present-day dialogue regarding the middle class, the following quote jumped off the page of this old book:
“We hear much of the high cost of medical care. The poor may resort to free hospitals, the wealthy are able to go to first-class hospitals. The middle-class people, too proud to avail themselves of the former, are in many instances unable to meet the cost of the latter.
Two difficulties are apparent here. Many people make no provision for a rainy day and when sickness overtakes them they are unprepared to meet the situation. Efforts are being made so that these people may secure something referred to as ‘insurance’ which will provide for these emergencies. There are many who reject even this means of security. People so improvident should not slam the free institutions.”
This man who had struggled to make a fair wage while tirelessly caring for the ill would likely be mortified if he were to see today’s medical world.
He writes, “A major difficulty lies in the high charges of the city hospitals. Palaces are built accessible only for the rich. Lay people and architects play a large part in the building of dream palaces. The chief culprits are the standardizers who though allegedly medical men have no knowledge of the requirements of a hospital.
“I believe the hospitals were the first to suffer from what is generally known as braintrusters. These are the people who are to blame for the high cost of hospital care. What shall we do with these? Nothing. They never learn anything and it is against the law to shoot them.”
Ah, if only this doctor could have wrangled with today’s health insurance companies and our present-day Medicare system! He would have penned a chapter well worth reading, of that I have no doubt.
“It is said that the fates are kind to the beginner. This was most certainly true in my case. I did operations on the road for conditions I would not think of doing even in a hospital now. This was particularly true of goiter operations. I operated on patients I had never seen before, and of course, they had no preparation of any sort.
“I did one very toxic lady who ever had a rise of temperature and was as wild as the proverbial March hare. One lady had a widely dilated heart and was so dropsical she could not lie down, so I operated on her sitting up. Both recovered.”
He tells of brain abscess surgeries, pelvic tumor removal, resection of cysts, breast operations for cancer, and mastoid operations.
“I look back on those days of kitchen surgery with unadulterated pleasure. No doubt about it, I saved many lives, and made many friendships which have endured. I was not afraid then. I would not consider tackling such things under those circumstances now. It is a strange feeling. Many of the trips were terribly arduous, even worse, but these things are soon forgotten after a full meal and a warm fire, and an interesting specimen. Those days are gone forever.
“The coming generation of surgeons will not have a like experience. They will have to accept the word of the old kitchen surgeons that all that is needed for a good operation is a good surgeon and a patient.”
Faith? Time-wisened and tough, Dr. Hertzler’s take on life sometimes seems to border on stark, unfeeling, and void of faith. He closes his life story with this:
“After more than sixty years I can still hear the eloquent prayers that filled the countryside when epidemics of diphtheria appeared. One tube of antitoxin will do more good than all of these. I have seen all of these things. A doctor must think the truth. Perhaps it would be better if he sometimes proclaimed it.”