Patients Are People, Too
The Memoirs of Trester Smith Harris, M.D.

Chapter 14
In Closing

Two surgeons were operating, and apparently they were over their heads. They were in such a mess it was obvious they could not extract themselves. Said one, “I think Dr. Brown is in the hospital. Don’t you think we should have him called to get us out of this?”
“Dr. Brown is the type of man who would never allow himself to get into this kind of a fix. I doubt if he could help us.” Anyhow, Dr. Brown was called, and managed to extricate the doctors from their difficulty and the patient made a good recovery. The two “surgeons” learned to recognize their limitations after that.
The nationality of a scientist can pretty well be determined by the following observation. A German scientist always asks, “What does he know about it?” An American asks, “What can he do?” An English scientist asks, “What kind of a fellow is he?” And a Frenchman asks, “What examination has he passed?”

Some of the greatest scientists are the good, old family doctors who plod along, unsung and unhonored, caring for the sick, falling in bed exhausted at night, only to arise tomorrow and do it all over again. But they combined the “art of medicine” with their scientific knowledge, always giving the patient and the family hope, and were a great deal more consoling than the strictly scientific men. Patients appreciate a close feeling of empathy more then anything else. But it is a full and interesting life, one filled with satisfaction that a man is helping his fellow men and expending his energy for a very good cause.

Times are changing, though. There is a real lack of camaraderie among solo doctors, as compared to doctors working in a group. In a group, the fellows have the privilege of talking over their medical problems, seeing each other’s patients, and exchanging ideas as to treatment, diagnosis, etc. There is more a feeling of brotherliness, it is easier to plan for time off, and one can rest assured his patients will be cared for by someone who is interested. One of the difficulties of being a solo doctor is to have the patients cared for during a vacation, sickness, or other cause for being away. Ethically, a doctor is supposed to return a patient to the original doctor, but many do not. In a group practice, the patient will be seen by someone in the group, so a man feels better about being away a few days, to attend medical meetings, vacations, days off and the like. After all, it becomes quite a chore to work all the time, no matter how well one loves his work.

Psychiatrists are coming more to the front now. In the thirties they were not as well known, nor did they make such crackpot decisions as now. Now the courts are accenting their diagnosis of a criminal as being insane at the time of a crime simply because the knowing criminal “puts on a show” in his actions before the psychiatrist during an examination. Many very hardened criminals have been able to get out of punishment because a gullible judge believed a psychiatrist who had been fooled. Many a good psychiatrist should have a better knowledge of psychology.

The tranquilizers have put the psychiatrists far ahead of the psychologists. Psychologists are not allowed to prescribe any form of medication, and there is no doubt that the tranquilizers are very effective. They have been most helpful in developing a sense of serenity in many patients who really need them. In many others, though, they are merely crutches for those who wish to assume no responsibility. There are tons of tranquilizers taken by people who would be far better off without them.

There was a used car salesman who went to his physician because he was so high strung. He was the crack salesmen in the yard, always sold more cars than anyone else, and made more commission than anyone on the lot. But he was so nervous, jittery and excitable that he had some trouble going to sleep at night. His doctor thought he was a good candidate for tranquilizers, so he prescribed a three weeks’ supply. When he was seen three weeks later the doctor asked him how he was and if the tranquilizers had helped.

“Yes. I find that I am no longer under a strain, or at all nervous. I go about my business in a calm, serene manner. But I haven’t sold any cars for three weeks.”

That brings up the subject of drug abuse. I had very few patients of that sort, but there were some. Some of them I felt were stool pigeons for the Internal Revenue Department, to see if I was giving any drugs, but there were some bona fide drug users.

One attractive young woman was a fairly regular patient of mine (and of other doctors, I learned later). She came in one day on crutches, complaining of terrific arthritis pains in the knee and hips. She was in such agony she couldn’t stand to be touched. I couldn’t examine her because it pained her too much. She insisted on a prescription for percodan, a very potent pain reliever, and since I had never had occasion to prescribe it for her before, I prescribed a few for her. This was before percodan was considered a narcotic, requiring special blanks for prescriptions.

This patient was in my office about 11:30 a.m. My office nurse saw her at the shopping center about 12:15. Her cure was miraculous. She had lost her crutches and was walking cheerily, swinging her arms, feeling fine. She received no more percodan prescriptions from me, and I prescribed it very carefully from then on. Since then it has been put on the narcotic list.

Having seen abstract modern paintings in art galleries, and having been given quinine for the treatment of malaria as a boy, with the resultant feeling of falling through space, and the accompanying phantasmagoria, I can’t see why anyone cares to take a hallucinogen; those bad dreams do not appeal to me.

Drug addiction is not new, however. The cultivation and use of marijuana is centuries old, and opium has been used by the Chinese for many years. Liquors have been a part of the history of nations, with every “civilization” finding a way of making its own. (Liquor is a drug, too.) Early in the history of our country, liquor was plentiful.

No boat left the harbor without its supply of rum or other liquor. Babies were given rum to quiet them down. Paregoric, and tincture of opium, which was even stronger, were also used, and many babies were inclined toward drugs. Drugs were unrestricted prior to the Harrison Narcotic Act, and there were thousands of men, especially those Civil War Veterans, who became addicted.. By 1910 there were between 250,000 and 1,000,000 addicts in the U.S.A. but soon the number began to decline after 1920.

There have been addictions to elixir terpin hydrate with codeine, and I had a woman from Canada who was addicted to straight codeine. She said she could buy it over the counter there, and her withdrawal symptoms were something to behold.

During the time of the Volstead Act, or prohibition, a number of persons bought Jamaica Ginger, a “tonic” with an alcohol content. It was bought by the case, for it was a “medicine,” and after a few cases of Jamaica Ginger, the patient developed a gait similar to that in tabes dorsalis. A cane was necessary, then two canes, a slapping, stumbling of the feet, and an impaired vision. It progressed to the point where the man (usually a man) was utterly incapacitated. We saw two cases of this affliction in Dad’s home town, where I worked with him.

Now that prohibition has been repealed, the alcoholic drinks are easy to acquire, but in addition, barbiturates, tranquilizers, marijuana and hard narcotics are constituting a big problem. To these might be added the amphetamines, for they have been so easy to obtain, and are very powerful drugs.

At one time a certain amount of strain and tension was an urge to action. It stimulated one to do better in his work. In the age of tranquilizers, it is considered the thing to do to take a pill and, forget it, rather than work the problem out. One tranquilizer leads to another (if not controlled). Then the habit begins and soon one wants something stronger to solve all the problems and decrease inhibitions.

In my work with narcotic (Heroin) addicts I have discovered many things of interest. Some addicts are given their first “fix” at age ten or eleven. Many women start at an early age at prostitution, taught by their mothers, and many develop a habit which costs them $100 a day. Many are forgers, automobile thieves, and shoplifters. I was quite surprised to learn how easy it was for them to carry out electric irons, waffle irons, and other small items under their dresses, in axillae and between their thighs.

There are “schools” where they learn the technique of stealing, forgery, picking pockets etc. It is surprising how much nerve some of these nice looking young women have to do the things they do.

Not many heroin addicts live to a ripe old age, for it is a dangerous life, but I met a few who were sixty or sixty-two years of age. I remember one man age sixty-two who had been on heroin over forty years. At $50 to $100 per day, he figured he had spent over one million dollars, all stolen, of course, and the man could hardly read and write. He figured he had had over 60,000 fixes, and the condition of his veins was atrocious. That is another thing. They use their veins to such an extent that when it becomes necessary to give an intravenous infusion, or a blood transfusion, it is well nigh impossible to enter a vein. Sometimes it must be cut down on; since all veins have been used and all become so scarred, they are almost impossible to enter.

We think of death as being a horrible thing, but sometimes it is really beautiful. After all, it is just as necessary as life, in our domain, but we invariably hate to part with our loved ones. However, that really is, to some extent, greed on our part, and we are often thinking of our missing them.

In the case of a patient who is having to labor hard for every breath for a prolonged period, and is so completely worn out, when there is not a chance in the world of his being able to recover, death is a blessing. In the case of a person who is in the terminal stages of cancer and requires heavier and heavier doses of narcotics to relieve pain, death here, too, is a blessing. I feel that it is most inhuman to keep a patient alive by mechanical means, when there is no chance for recovery. It makes a vegetable of him and only prolongs the agony and the expense. Today, people are beginning to look at death in its proper perspective, and are requesting that these measures not be adopted.

We may be amused at the fellow who puts on his card “Inventor” and has never invented anything. But we all have our dreams and fantasies of doing bigger and better, more important things in the future. We are sometimes able to receive inspirations that enable us to carry on routine things and perhaps there may be one inspiration which will result in a real accomplishment. Let us not forget that every building was once an architect’s dream. Every business, large and small, was once an idea in the head of one individual. There are dreamers and doers, and the dreamers may become doers. The bringing of water via aqueducts from long distances to Los Angeles was once considered a wild dream. So, too, may our Rapid Transit system finally become a fact.

Work in the medical field is extremely serious business, especially when there is prolonged illness with the loss of pay, in the case of a bread winner. Death complicates the issue. There may be an accident requiring long periods of recuperation. Cancers do occur, heart attacks do happen, and the termination can be very saddening. As a doctor, I have always tried to leave my cares and worries about patients at the office, but as a friend of the patient in distress, it has been difficult to do.

A good sense of humor can be a great help to a doctor, or to anyone, for that matter. I have therefore appended a few jokes on the medical men in hope they may give further insight into their lives and work and furnish a chuckle or two.

[Note: My father’s book concluded with a selection of medical jokes that he had gleaned from magazines. I have not included them because of copyright considerations. However, knowing that he wanted these to be a part of his book tells you a little more about him.]

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About the author
Trester Smith Harris, M.D. was born in Konawa, Oklahoma Territory, on October 17, 1903. His father was also a medical doctor. Dr. Harris was in private practice for many years in Los Angeles, then worked for a few years at a the California Rehabilitation Center in Norco, California. After retirement, he wrote these memoirs about 1973. He passed away on September 21, 1975.

Note: This memoir of my father’s experiences and opinions is not intended to constitute medical advice. If you have medical questions, consult qualified medical authorities.

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