NOW AND THEN
Familiarity: just what the doctor ordered
By Donald M. Murray, Globe Correspondent, 12/9/2003
I never made an appointment with Dr. Fred Bartlett in the long-ago days before my war. He had regular office hours, and if you wanted to see him, you went to the small waiting room at his home office and waited your turn. No partners, no nurse, no bookkeeper, and no appointment maker. If you couldn't make it to the office, he would drive to your house and shamble up the walk, black magic bag in hand. He'd sit on the edge of the bed, listen to your complaint, and treat it on the spot. He was a homeopathic physician, and there was always a dose of something for your ailment in the small bottles lined up in his bag.
No tests. No consultations. No specialists. He was both physician and psychiatric counselor -- invited or uninvited. If he thought you needed advice he gave it, simple and direct. He changed my life when I was 12 by saying, "Donald, you do not have to be like your parents." He didn't worry about lawsuits or popularity.
Of course, if Dr. Bartlett had remained my doctor after the war, my funeral would have been held at least a couple of decades ago.
Last week I stood in the control room while Minnie Mae had a CAT scan of her brain. I saw 28 pictures on the TV monitor. I think I saw a couple of fried eggs, but the radiologist didn't. Good news: There was no blood clot. Today I will have a sonogram of my kidneys.
I carry a list of our doctors with me at all times. Eighteen specialists who know a part of our bodies intimately and, at the top, Dr. Ira Schwartz, the primary care physician who reads the specialists' reports and puts us together again.
He is as good a listener and uninvited advice giver as Dr. Bartlett. Under his name on my list are six associates, including a nurse practitioner. His office has a receptionist, four appointment makers, nurses, nurse assistants, and a mysterious back room with a bookkeeping staff.
But until today the list did not include the medical counselors I see more often than all our physicians together. Lisa Boesch and Laurie Lacroix are now on the list. They are the pharmacists at Brooks pharmacy in Durham, N.H., who more than once have caught an incorrect prescription or a dangerous conflict between the medicines given to us by our specialists.
No appointments necessary. They are available to suggest treatments for the minor but life-affecting conditions for which we do not want to make an appointment weeks or months ahead.
The great change in medical treatment in our generation consists of the drugs that dominate medical care. They are expensive -- we spent more than $18,000 for drugs last year -- but they work. We are still here, shuffling to the prescription counter to have a word about a new drug with Lisa, Laurie, or their staff of caring, knowledgeable assistants.
I have tried to mail order our drugs, but the computer didn't listen, and I kept going to Lisa or Laurie for explanations of what drug the computer was sending me.
Lisa and Laurie work long, hard shifts and always seem available to listen and explain. Too often we take their training and neighborly familiarity for granted. They know our medical histories and can put a new prescription in the context of our individual ailments and treatments. They are even more available than Dr. Bartlett was, and yet to many of us they seem invisible.
Not anymore. They are on the list.
© Copyright 2003 Globe Newspaper Company.
