Men are quite interesting in their interpretation of directions. A Mr. Smith came in one day complaining of severe constipation, and when examination revealed nothing severe, I gave him a formula for an enema which is usually effective: one with an ounce of Epsom salts, an ounce of glycerin, and a pint and a half of water. When I saw him later, he said it worked wonderfully, but it tasted horrible. I’ll bet it did, too. I thought afterward that perhaps he didn’t know what an enema was.
Wonders never cease in this practice of medicine. One bright spring day I had to make a house call (that was when house calls were an essential part of medical practice) on a dear little woman with the flu. She was in her early eighties, and I had not seen her previously. I checked the address, stepped up to ring the door bell, and saw a card near the bell reading, “Harold Johnson, Inventor.” A man about fifty came to the door and let me in to see his mother, who was the patient. When I finished my examination and instructed him what to do, he showed me to the door, and I said, “Are you Mr. Johnson?”
“Yes,” was his reply.
“You are the inventor, then.”
“Yes I am.”
“I am interested in inventions. What have you invented?” I asked.
“Well, with mother being sick, and my brother working six days a week as a mechanic, I haven’t had time to invent anything, but I have an idea that will revolutionize the plastic industry.”
His mother died suddenly of a heart condition a year or so later, and still later I had occasion to see his brother, who lived in a different house. There again was the card, “Harold Johnson, Inventor.” He hastened to inform me that just as soon as his brother got well, and his household duties let up some, he was going to invent a machine that would drive cars without gasoline. He couldn’t tell me any more because the oil companies were against his invention. I never did tell his secret.
Another man, about forty-five years of age, always brought his mother into the office to see me. She was a kind old lady, but never have I seen a man so tied to his mother’s apron strings. He was not working, and his entire life was taken up with his mother. He pushed the cart up to the market and back for her and didn’t dare look at another woman. He couldn’t answer a question put to him. He really was a brow-beaten sort of man, and he never went anywhere alone without the mother’s sanction. She really kept him under her thumb. He was healthy, with no physical impairment, and was mentally all right. He was just a subdued individual who would be thoroughly lost and helpless when his mother died. How lucky the girls were that he remained a bachelor.
Men are different in their wants and desires. I’ll never forget the man I operated on for acute appendicitis, who had as his love a small, ordinary kitten. When he began to feel better, on the second day he asked me very confidentially if his wife could smuggle in the kitten during visitor’s hours. As he was in a four-bed ward, I thought it would not be advisable. My advice was to ask the nurse. Whether he asked the nurse or not, the kitten was brought in every evening he was there, from the third evening to the sixth, when he went home.
Mr. Burton was a grandfather who lived with his wife, daughter, and son-in-law. There were lovely children in the home, and the Burtons had their own apartment on the rear of the lot. One day he announced to his wife, “I feel that my time has come. Since I’m only in the way here, I want to die. Everyone over sixty-five ought to be out of the way, and I am seventy.” So he went to bed and in about a month was gone. We could find nothing pathologic about him, except age. His heart was good, his blood pressure excellent, and he would not take any medicine or follow any instructions. He ate very little, complained none at all, and just died. He just voluntarily gave up. Now what does one put on a death certificate as the cause of death in a case like that?
On the contrary, there are men who enjoy and value life to such an extent that they try their best to remain alive. There was a Mr. Hays who illustrated this. He had had rheumatic fever as a child and developed a rheumatic heart, so that he had to sit on the sidelines while the other boys played ball. He grew up, finished high school, and got a desk job where he had a minimum of physical exertion. When I saw him, his heart was decompensating. The heart beat was very rapid, legs were swollen, and he had trouble breathing. With rest and medication, he was able to control his decompensation for awhile, but he gradually reached the point where his heart was so weak he could no longer breathe properly. To get his breath, it was necessary to stand up by the china closet that was just the right height to expand his lungs somewhat. The digitalis had lost its effect, other medicines did not work, and his legs continued to swell (this was long before we had the excellent diuretics we now have). But he said, “Doctor, I don’t want to die yet.” This was in 1940. “There are going to be some of the most wonderful inventions yet to come, and I’d like to live awhile longer.”
It was no use. The poor heart finally gave out and his troubles were over. He was right about the wonderful inventions.
There are many interesting ways of rationalizing about things. Mr. Shackelford tried so hard to quit smoking several times, but always maintained that it made him cough, sneeze, develop a cold, and feel terrible when he tried to give it up. So he would always go back to his smoking, maintaining that he always felt so much better.
Just like the man who tried to lose weight. When he got under two hundred pounds, he said, “I just don’t feel well, my nerves are bad, I can’t sleep, and I’m very fidgety. I have to eat snacks all day long to keep going.”
We checked his blood sugar and his metabolism and decided it was all in his head. He just wanted to continue to eat excessively. There is nothing you can do with this kind of patient.
Mr. Raney was fifty-six years old and had no job. He loved his alcohol and volunteered the information: “My mother is on welfare, and I am a dependent. I don’t have to work, and besides, my condition does not permit me to work.”
I never was able to determine what his condition was, for he looked healthy and had nothing we could find wrong with him, except his liking for drink.
Thomas Lawrence was an unusual kind of a chap that is hard to classify. He was about thirty-ish, nice looking, had a good job, a car, and all the necessary accouterments for a young man about town. When I asked him why a desirable young man of his caliber had never gotten married, he answered, “Do you know, I would love to be married and settled down to raise a family, but I hate the thought of the preliminaries. Gee whiz, you have to court a girl, take her candy, be passed on by her parents, and do all sort of unpleasant things before getting hitched. I just don’t feel that I can go through with all that. It seems so useless.”
“You are missing out on a lot of pleasant experiences,” I told him. “Don’t you know that getting there is half the fun? If you just find the right girl, she’ll help you through all the preliminaries.” He eventually did get married to a nice young lady. He told me later that it was easier than he thought. Really, these girls have ways of making it easy.
James Strong was having a tough time making ends meet. He had a wife and three small children. He did pay his bills eventually, but one had to wait until it seemed as if he would be left out. Then an uncle died and left James around two hundred thousand dollars. James continued to be slow, very slow about meeting his bills, so his wife reproached him. “Does your conscience allow you to continue to owe all these small bills, when you have inherited so much money? You haven’t paid Dr. Harris for six months!”
“Oh,” he said, “I am enjoying knowing that I can pay when I want, and knowing these fellows are in my power. They can just do without their pay until I get good and ready. I can sleep like a baby while my creditors lie awake and worry.”
Years ago I was quite surprised to see a man wearing a pair of ladies tearose nylon panties with lace on them. He was a big, husky fellow and said nothing about it. Since then I have found panties on several men. I didn’t press for an explanation and they offered none. I feel that if they want to be dressed that way it is their business. They are probably transvestites. What if they were caught in an accident that way? There must be some weird sense of satisfaction in that form of dress.
Some men are very patient and meek. One I think of in this category was Harold Anderson, who was a peach of a chap. He would do anything to help a fellow. He was always donating to collections, helping various married men to paint, clean up, or mend something, until he married, and then his wife put a stop to all that. She kept him at home, so he took up the study of law in his spare time, in order to better himself.
Harold held a job as a court clerk, so the study of law was a natural for him. Now that he was a married man, with home obligations, and was taking care financially of his mother, he could not devote much time to his study of law. His wife was very demanding, really a spoiled brat. His time was so limited that he attended law school off and on for twenty years before he finally completed it. It was a very happy day for him to see his dream come true. He passed the bar examination and promptly died of a heart attack, so he never had an opportunity to practice law.
The difference in attitude of some men toward medical patients in their family is quite impressive. There was a dear old Scotchman whose wife was dying of cancer. She had been operated on some time before for cancer of the bowel and had reached a point where it was spreading to adjacent organs and causing considerable pain. She preferred to be at home rather than in a hospital, probably because it was so much less expensive. Sandy took personal care of his wife with the greatest tenderness. She was bedridden and helpless and required a shot of morphine or dilaudid three times a day. There were bed pans, meals, cleaning and bathing, all of which he took care of, with real love shining in his eyes. Never have I seen such dedication as that man exhibited. His devotion was beautiful. Always a sweet tone, solicitous as to her comfort and well being. Right up to the very end, he tended her night and day in a manner that evoked admiration from all who knew him.
In contrast to his kindness there was a woman with cancer of the breast who waited until it was widespread before she ever saw a doctor. She was terminal and was hospitalized. She was an older woman, very sweet and cooperative, and her son was responsible for the bill. He was a wealthy young man, with his own business, and well able to pay, as hospital rates were much less in those days than now.
“How much longer is the old lady going to hang on?” he asked me when he called to find out how she was. It was always the same tone, and a couple of times he asked if there wasn’t some way of hurrying her along. Never a word of sympathy or feeling for the dear old soul in suffering. There were several examples of callous disregard for a patient’s well being, but this was the worst I have ever seen exhibited. And I might add that he never paid anything toward her bill and the hospital had to sue for the account.
There was a woman who required a house call frequently for insignificant conditions, or even no conditions at all, over a period of years. she continuously harped on her husband to have a check up, but he felt all right and did not want one. “I’m ready to go any time and don’t want my time prolonged any more than necessary,” he said. “Besidess,s I fell fine as can be.”
So she continued to get the medical care for the family over a period of several months. Then, suddenly he died of a heart attack, and his widow lived on and still was complaining of trivialities.
Some individuals are so honest that they think over their conversations with the doctor and feel that they have given some wrong information. Then they must call and correct it. I recall now that one of my preacher friends was in with a cough and a bad cold. In the course of questioning him, I asked him, “Do you raise anything when you cough?”
“No,” he answered. The examination continued and I prescribed whatever I felt would do the most good. That night, about eleven o’clock, as I was going to bed, the phone rang. It was he.
“Do you remember this afternoon you asked me if I raised anything when I coughed?” he inquired.
“Yes, I remember,” I replied.
“Well, I have noticed since coming home that every time I cough, I raise my right leg a little bit. I hadn’t noticed it before and thought you should know.”
Compensationitis is a medical condition that is not as infrequent as one might suppose. Sometimes, following a slight injury at work, a conflict between self-sufficiency and the desire to return to a more or less childhood status begins, and there is a desire to be served, waited upon, and sympathized with.
Some people so easily develop a feeling of dependency that on the slightest excuse they become manipulative and helpless in their attitude. This is especially true of heart attack victims, even though the attack may have been very mild. These people develop a cardiac neurosis which goes on and on. They take to bed or to a rocker and become rather demanding. One such patient of mine kept saying, “You know, I just might die any time. I must be very careful.” They become invalids when a bit of exercise would be wonderful for them, but they won’t be told.
It is said that if you wish to make someone love you, have them serve you. These dependent ones quickly learn that pity is akin to love, and the two frequently go hand in hand, to a certain point.
There are those who solve their most complex problems by being ill, or while being incapacitated following an injury. It is so easy to lie around in an utterly helpless manner, knowing full well that life will go on, things will be capably cared for, the household will be made to go forward, and the poor “victim” can bask in the comfort of being waited upon, sympathized with, and being babied for the duration.
These people make special demands upon friends and relatives who are stuck with the expense and work, and the worry of treating, consoling, and hearing the complaints of these invalids.
Some of the victims of illness are genuinely ill and deserve attention and care, but I’m talking about those who do not. Some become helpless and manipulative in their attitude toward those who serve them. Sometimes they become more and more demanding, more helpless, and more dependent when, if the truth were known, they are more physically able than they admit, especially if there is a compensation insurance involved. The disabilities become bigger, until eventually a real psychosis develops.
Usually these are the less mature individuals who prefer to have others make decisions. Many have had trouble cutting loose from Mother’s apron strings earlier and easily revert to a dependency status. A clinging-vine type of man is really deplorable. We expect this in women, but we have been truly amazed how capable and strong willed a woman can be when the necessity arises.
Frequently we’ve seen a man who, rather than marry and settle down to establish a home of his own, has chosen to stay single. Sometimes he stays with his father, or with his mother because of the greater security it affords. Friends have said, “Poor Fred. He has given up his happiness in order to take care of his poor mother. Isn’t Fred a hero?” When in reality poor Fred isn’t a hero at all. He just didn’t have the guts to get away from the security of his mother’s home and accept the responsibility of a home of his own. Thus poor Fred goes through life enjoying the false heroism accorded him, and he doesn’t plan ahead to see how lonely his life will be when his mother is gone.
One patient of mine brings this home to me very emphatically. He was a fine fellow, nice looking, neat in his dress, with a good job. He paid some attention to a lovely school teacher, and I thought it would terminate in a happy marriage, but he used his mother as an excuse (in his own mind) and let the teacher get away.
Len Barnes was a rather peculiar sort of a fellow. He came in to see me over a period of several months, always with a mentally inclined problem. There was nothing organically wrong that I could determine in several examinations, but he always had a peculiar attitude and made very peculiar remarks.
“Len, I’d like to have Dr. Brown to evaluate you,” I told him.
“Who is Dr. Brown?” Len wanted to know.
“He is a first class psychiatrist down here close, and I believe his opinion would be a valuable one.”
“Well, listen, Doc,” he hastened to state, “I’m not crazy and I have the papers to prove it.” Some doctor had discovered his peculiarities before and had him seen by a psychiatrist.
There was a chap who was a carpenter for one of the movie outfits. He worked intermittently and made very good pay. But he had a condition known as Buerger’s disease, or pain in his leg that interfered with his work. He could do work, or walk about half a block when the pain would stop him. After resting awhile he could go on, work some more until the intermittent claudication or pain in the legs returned.
This condition occurs usually in men who smoke, and it is due to sensitivity to tobacco. The arterioles in the muscles of the leg contract, so there is insufficient blood supply to the legs. I explained this and told him the best way to treat him was for him to quit smoking. For a few days he gave up his cigarettes completely and was able to work without pain.
While he was absent from his work with his intermittent claudication, his wife had to make the living at a much lower wage than he received, as a housecleaner. But he could not stay away from the cigarettes (he said), and therefore could not work regularly and was let off from his job. After all, an employer wants someone dependable, so his wife continued her housecleaning while he sat around and smoked. It seems that no matter what one wants to do, or wants to avoid doing, one can find a multitude of excuses.
One of the most unpleasant things in medical practice is the man or woman who comes in and wants insurance papers filled out when you know they were not even sick. There were many of these people who thought nothing of asking me to do this, and I considered them to be the kind of people who would not hesitate to cheat the insurance company because, as they said, “The insurance company has lots of money, and besides, I paid for it.” But when church members, that I knew personally outside the practice, came in for it, I was appalled.
Bill Showers came in my office and laid an insurance form in front of me. “What’s this for?” I asked.
“I went down to San Diego yesterday to see my mother. If you’ll sign my insurance form, I’ll get eighteen dollars. Otherwise, I’ll lose a day’s pay.” He was very nonchalant about it and expected me to comply.
“Were you sick? What shall I put down?”
“Oh, I felt fine all day, but as a friend I thought you’d help me out. I’ll pay you for it.”
“Then you want me to falsify a statement on your insurance form? You come to me and bring your family for treatment because you trust me to be honest and fair with you and yours. If I signed you were sick when you were not, I’d not be honest, and I doubt if you’d ever trust me again. And I wouldn’t blame you. No, I can’t sign it.”
There have even been attorneys call on the phone and request papers to be filled out stating that certain patients did not drink when I knew them to be drunkards. These things always leave me with a cold feeling.
Mr. Steinhofer was a racing enthusiast. When the racetrack was built at Hollywood Park, it was near enough for him to attend. Since he was in business for himself, he could take off without being criticized. But he was a very careful man. He would buy the racing forms, and at night he would sit down and figure the horses’ chances of winning. He used some kind of personal mathematics, and for two or three weeks he hit an average of five winners out of eight. Thinking he had the system pretty well under control, he started attending the races, to put his money on the nags. Somehow, with the races all figured out, it didn’t work true to form when the real bets were involved. He lost almost every time, winning only once in awhile to keep him excited and interested. In practice, he just could not make it work as it did when he put no money up. He had a friend whom he advised, and he also lost. The friend told me about it.
“He gave out more misinformation in fifteen minutes than I had ever heard before in two hours.” His wrong dope on horses spoiled a beautiful friendship.
Mr. Hayward hated the chrysanthemum season. He always had a frequency of urination when he was around them, and the women where he worked always had a bouquet of mums in the office in season. He couldn’t explain to them the effect they had on him, and I have never heard of anyone else with that condition, but I have heard of other allergies definitely affected by the flowers. It created quite a problem for him.
One day while examining a man, during the usual opthalmoscopic examination, I told him to look up at the junction of the ceiling and the wall. I made it specific as to where to look so I would have a good view of his retina. Naturally, I was in front of him peering into his eye, and he said, “Doctor, you’re in my way. I can’t see where I am supposed to look.” I had some difficulty explaining to him that he should look anyway.
Mr. Cobley’s wife was delivering her first baby, and she was in labor quite a long time. It was a difficult delivery, and there was a pronounced molding of the head. There are twenty-two bones in the head, and nature takes care of a baby beautifully by molding and shaping the head for passage through the birth canal. Consequently, the baby’s head was misshapen when the proud father had the first look at his child.
“Good Lord, Doctor, is that thing mine?” he demanded.
But the head shaped up very nicely and he was proud of his little girl after a few days. But he didn’t want to claim her when she was first seen.
Sometimes a patient is capable of completely fooling us. Such was a young fellow I’ll call Donald Lamberson. Don had a small shop, was very steadily on the job, and made a good living at his work. He was dependable, likeable, and always paid his bills. He was in his mid forties and had a very charming wife who had an executive position downtown.
There was a slightly obese woman, also in her forties, who was living alone, having a hard time making ends meet. So Mrs. Lamberson suggested she come and live with them, help out a bit with the work, and thus pay her part. It was agreed on, and all went smoothly for a period of three to four years. They were comfortable, happy, all getting along very well together, with a very minimum of bickering.
One day Gloria, the wife, came home with a splitting headache and found her husband in bed with the friend. Naturally, they were embarrassed and Gloria was terribly upset. When she found these escapades had been going on for over two years, she almost exploded. The headache was soon forgotten.
“Poor Norma didn’t have anybody, and I felt so sorry for her,” was his explanation. He went on to explain that about three times a week, at noon he had closed his shop for an hour and had come home for their meeting. It was so handy for him, and she seemed to enjoy the break, he told her, so they continued it.
They had a talk and since Don was averse to giving up Norma, Norma had to move out into an apartment furnished by Don, and Don was to see her three nights per week, including weekends. There was some real competition between the women and poor Don was obligated to satisfy both of them.
It was too much for him. He soon began to waver, getting weaker and weaker. Finally he came for medical assistance, and I found his blood pressure to be dangerously high. And this was in the days prior to the excellent antihypertensive help we have today. In spite of all we did, hospitalizing him, low salt, Phenobarbital and all, he died in his sleep one night.
Which goes to prove that no matter how quiet, hard working, and respectful a person might be, he (or she) might be living out some of the fantasies and might be able to fool you, after all.
Some people are extremely and unsuspectedly shy. When we consider them peculiar, selfish, or ungrateful, or even rude, they may just be extremely shy. Some children grow up that way, never getting over it in school. Many children never take advantage of their “Show and Tell,” but grow into adults the same way. They have the type of job that does not require an outgoing personality, and thus they go through life very quietly. But their egos are very delicate. They watch a doctor’s face very carefully, listen to the tone of his voice, and pay close attention to his every detail, to see if he might be trying to deceive them or fail to give a proper importance to their problem.
Communications at times are difficult. Sometimes we have a tendency to say too much, and sometimes silence is to be preferred. One of the chief complaints against doctors is that they do not explain to the patient or to the patient’s family about the condition, or what they can expect. Then too, a doctor has a tendency to speak in technical terms which the patient does not understand. Patients do not like being talked down to, but they do appreciate being told in understandable terms what the condition is. A patient or his family is going to be asked many questions he will wish to be able to answer, so it pays to take the time to explain a bit. If there are questions that can’t be directly answered, tell them so. After all, there are a lot of things in medicine that no one understands. Many of the older ladies actually seem to be psychic and can guess just what one is thinking about at times. Some of the dear old souls are extremely polite, too. Politeness is certainly not limited to the well educated. In fact, some of the educated seem to know enough to make them feel superior and are very impolite. I have noticed many of the poor and poorly educated are most polite and very genteel. I have noticed, too, that those who brag the most, and tell the tallest tales, have the least to brag about.
There are many instances in which an illness happens to follow some specific action that was slightly unusual. I think of a fellow who called me one night, while he was in a terrible bout of pain. He had a kidney stone colic, which is one of the most painful ordeals a man (or woman) can go through. We got him straightened around, and he told me, “I had chili and beans for dinner, and that was what brought it on. I dearly love good chili and beans.”
Now, the chili and beans had nothing to do with the renal colic. In medicine, that is what is called a “post hoc, ergo propter hoc” affair. That means the patient thinks it happened “after that, therefore of because of that.” There are many, many instances where we associate an illness with some occasion, which really had nothing to do with it.
I was amused one day when a chap was in for some medical care, and he could not keep from talking about his belief in herbs. Now, there is no doubt about the efficacy of some herbs, especially in cooking, but we doctors can use only what we have found to be satisfactory, and medicines from the best pharmaceutical companies. This fellow was a firm believer in herbs, but they must have failed him this particular time, for he condescended to come to me. Anyway, as he was leaving, he turned around and gave his final sales talk to me: “There’s some herb that’s good for everybody and for everything, except for them that think they are sick when they ain’t.”
I always made an effort to convince an individual he or she should not smoke, especially when that person had chronic bronchitis, bronchiectasis, heart disease, or just in general. I always rejoiced when I had a modicum of success. One day, a patient told me he had been off cigarettes for nine whole weeks. I congratulated him heartily, and told him he would live much longer.
“Yes,” he said, “at least it will seem much longer.”
With the women, I admit I have had no luck in helping
them quit smoking.
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.