Country Doctoring: How Everyone Got Access to Medical Care in My Community

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“We’ve got a house call.”

That’s what my Dad would say…usually late at night, sometimes even waking me up. He was a country doctor, among other things. Let me tell you some stories from my childhood about making housecalls with my Dad, who treated everyone the same, and paid a price for it in the Jim Crow South of the 1950’s and 60’s.

He was dead set against “socialized medicine” but he was so close to it I guess he didn’t see that what he was doing was socialized medicine at its purest, primitive form. Everybody got basic to intermediate medical treatment, whatever race, creed, color, income level, or social status.

Please enjoy!

After the wars, my dad left the service and started private practice down in the Deep South before I was born…in a poor sharecropper type area, near a mill town, but not close enough. Evidently times were tight, and getting paid for treating farmer’s injuries and sick kids was often a matter of getting some eggs, a bushel of peaches, or some folk art. What riled people up down there in part was the idea that the whites and the “coloreds” would find themselves sitting in the same waiting room in his 1950’s clinic. After the mailbox got shot up with a dead chicken, a move farther North was in order. But not too far…suffice to say, in our new town he lost his hopsital privileges because he insisted on delivering the babies of the black women in the operating room, the same one where white women delivered. You see, the black women were considered lucky to be able to come in and squat on the gravel and dirt floor of the morgue room to have their babies, and a “colored” nurse would attend. Possibly a white doctor would go in if there were complications. So, my Dad started his own small clinic, and lo and behold, it was swamped with a diverse set of patients. This was not without political ramifications, and there were more than a few torchlight rallies in the woods where he would speak to a thousand black and mixed-race families, standing against Jim Crow…but that gets into his politics, and this is about his medicine.

I guess it helped out his cause with the local white establishment that he was considered a good general practitioner, known for amazing diagnostic ability. This was in the era before the hundreds of possible blood tests, MRIs, CAT scans, and the rest…he had his own little X-ray machine, a little lab in the kitchen area of the clinic house, with a microscope and some simple urinalysis equipment. What set him apart even more was his willingness to work impossible hours, and make housecalls, literally anywhere, in any weather, at any time. Holidays, dead of night, dead of winter, he always went out. I think a big part of it was that he like to drive. His one extravagance was probably having a nice car: a big old Buick, a Mustang, a Caddy. But those cars had some serious miles on them, and more often than not doubled as ambulances to take patients to hospitals. In the old days, doctors usually had a silver cadeuceus on the back of the trunk, so if a policeman pulled up behind a speeding sedan, they might check to see if an escort was needed before pulling them over for a ticket…which I recall happening more than once!

So, the housecalls. The first thing, he would wear a suit and tie, always, Then, there was The Medical Bag. It was alligator, big, heavy, and full of stuff. I bet he could remove an appendix with what was in there. After I would tote it to the car, I would ask him where we were going…and the magical trip would start. Places I didn’t know were there, and never found again, that aren’t on any map. And the calls almost always took us to the homes of the aged, the poor, the very sick, the blacks excluded from white society by Jim Crow. I learned so much on those calls, nothing about medicine, since I was not allowed to go into the patient room, being 8 or 9 or 10 or so, or to know what was wrong with them.) As I got older, I would help out with difficult suturing or holding a light instruments if there was a procedure.) That was how medical privacy was handled in those days. You just weren’t told. Sometimes, the patient would ask to meet me and I would go in and visit. It was very exciting for a young boy, going to people’s houses, and learning about how everyone lived. Mostly I remember how glad everyone was that the doctor had come, and did I want a Coke or something to eat. From the poorest most broken down shack in the woods to the neatest Baptist cottage, people were the same, and that is my deepest lesson. People are almost all the same. Suffering, loving, struggling, kind, intelligent, witty, helpful, hospitable, and whether they were rich or poor or Christian or Hindu or black or white or Philipino or homeless…it did not make a bit of difference. I never saw my father treat anyone differently than with true respect and kindness, but firmness if their circumstance dictated. I didn’t realize at the time that we were probably the only “white” family around where black and mixed and Indian children came over to play. If travelers were passing through town and got sick, they invariably were sent to our door. There were even what my mother called “Gypsies” back then, today called the Roma, would would stop in once a year in large caravans. I guess they trusted my Dad for medical care..even the real old-time hobos would stop by the house for a shower and wound care and shots once a year.

One of the best house calls I remember, we went to see a very ill, very old black man on a Sunday afternoon. He lived in a shack that was very broken down. It was so bad, I had to wait in the car, which rarely happened. There was an old car upon blocks, and underneath it, a viciously growling dog with a very thick chain around his neck. This dog sounded like it wanted to break off that chain, break into the car, and rip me apart. My Dad came out onto the porch with the old man, and I got out to get his bag. The dog went berzerk. At this, my Dad said “How much for that fine fine hound dog there?” I was mortified! My father reached into his suit coat pocket and pulled out a large wad of $20s…like taking out a wad of $100s today…and the nice old man said “Oh he’s not for sale, not for sale…he’s special, he’s a blue tick, finest huntin’ dog there it, no suh he is not for sale.” And my Dad keeps peeling off $20s…at least $400, or more. Finally the price was right, and I was told to get in the front of the car. The dog was unchained, and was howling and snapping viciously as my father moved him into the car. This dog was savage, and he was going into the car! I was scared to death….then, suddenly the dog went quiet, layed down and wagged his tail and laid his ears down, and didn’t move…amazing!

We took that dog home, and he was my dog for many years after, and he was the finest hunting dog there ever was. Faster than a greyhound, smart, loyal…but he would never come in the house, ever. My dad said he had been cowed; I realized many years later that my dad rescued that animal from an abusive situation, and gave that poor old sick man some money for food and rent. That was how it was.

I’m sure my father’s practice was not unusual at that time. How did this kind of medical practice sustain itself? I think it went something like this. For medicines, the doctor would get free samples from the pharmaceutical salesman, while looking at a medical office space for rent. That is how the house calls always ended with my dad handing out the free packages of antibiotics and “heart pills”. Then, my dad had plenty of patients (40-50 per day in his clinic) who were able to pay the whole bill, or some of it. The prices were set high enough so that the net revenue covered everyone who couldn’t pay, and kept our family fed and clothed, and my Dad in a new suit and a fast car…like I said, his one extravagance. Even so, long after he passed away too young, I found box after box of unpaid bills…literally hundreds of thousands of dollars. This kind of localized medical resource allocation and economics even applied to simple operations like tonsillectomies, appendectomies, and broken legs and arms. Pay what you can, bill the insurance if there is any, and the system held together. In those days, malpractice insurance was not such a huge expense, and malpractice suits were much fewer and farther between. Back then, people gave doctor’s a great deal of respect for their service, and medicine was more of a mystery to people. And people gave consideration to the doctors who were there in the middle of the night, at the scene of a higway accident. Even to this day, 40 years later, when I travel through that region, more often than not someone will read my credit card at a store and say “Are you related to Dr. So and So? My granddaddy used to talk about him.”

You might be thinking, “So did you become a doctor?” Well, you have to know that being a doctor is a very difficult and painful thing. I realized that I would not make a good doctor, because I could not emotionally detach from the patient, and did not have the personality to withstand the trauma of seeing suffering and death and tragedy day after day after day. It is hard to explain…I feel like I might go into a second career of medicine, and maybe that might happen, I just don’t know.

I hope you enjoyed this essay, I just sat down and wrote it straight through, and apologies for its lack of polish, and if my using some of the old-time vocabulary like “colored” for racial classification is disconcerting. One other thing that is very important to note: I never, not once, ever…ever, heard the N-word in my family. It was considered the most base and offensive word. Today, I see a Human Race, and that is really about it.

Maybe the next time you see your health care professional, remember how hard it is for them, and how important they are to our communities.