Kenneth B. Kay

A Navy veteran of the tumultuous Vietnam and Nixon years, he served his country from inside that chaotic White House. I cannot sing his praises enough! As a writer and a brother, a mentor and a friend, this man has had a life-long effect on me and so many others. Enjoy the spell he weaves with his mastery of prose and attention to detail that only his style surpasses.

DOC

Kenneth B. Kay

06/06/02

Respect and trust are the bricks and mortar of all human relationships. It does not matter if a relationship is established to meet a specific circumstance, accomplish a common goal or purpose, or simply fill an emotional void. The relationship cannot be successful, effective or last for very long unless there is a constant unending supply of respect and trust from all parties.

To say our family respected and trusted our family doctor is an understatement. My mother absolutely adored the man. Any of his instructions or pronouncements carried the full weight of Holy Writ in her eyes. My father had known Doc since early adulthood. They used to hunt, fish and chase girls together. As for my sister and me, we held him in the highest regard because our parents did. Doc would also bribe us with hard candy he always kept in his little black bag.

We knew Doc for what he was – a tool in the hand of God to ease pain and suffering, to put the roses back in a child’s cheeks, to usher new life into the world sharing in the joy and wonder, and finally to see the old and infirm off to their reward in as much comfort and with as much dignity as possible. Doc treated families not just their sick members. He always tried as best he could to calm fears and lessen the anxiety or grief of all of the family members, especially the children.

Doc was a big man, over six feet and heavy set. His head seemed larger and out of proportion with the rest of his body maybe because he was balding or because his eyes were close set and framed with thick horn rimmed glasses. He smelled of a combination of cigar smoke, rubbing alcohol, and bay rum.

He was an imposing figure especially to children but his professional manner was gentle and straightforward. He always told you exactly what he was going to do when he examined or treated you and he always did what he said and nothing more. When he had to give you a shot he would try not to let you see the needle. After rubbing the spot with alcohol, he would pinch or softly slap the flesh in the area so that you hardly felt the needle go in. He never dallied about it either completing the whole process as quickly as possible. Besides that piece of hard candy was always ready and waiting.

Doc’s patients were both blacks and whites and if anybody didn’t like; it well there were plenty of other doctors in our small Alabama town. He did have an office downtown but he never refused to come to one of his regular patient’s home. He would even see you in his home if you called him first. There was no pretense about the man. He really served his patients and the schedule he kept day in and day out would exhaust men half his age.

Doc’s family was well off. He owned a farm and usually drove a new car every other year. If his fee was a couple of paydays late he never sent a bill or refused to come when called emergency or not. If he knew times were really hard, he would waive any payment at all or accept fresh produce, prepared foods, or any other useful item even labor helping out on his farm. Most of the time we settled his bill on the spot, but more than once the last thing he said leaving our house was “ Just pay me if and when you can.”

The last time I remember seeing Doc was a few years after he retired. Our family had stopped by his farm for a visit and to deliver one of my mother’s blackberry cobblers that Doc was more than partial to. We were getting ready to leave and he was dancing with his daughter to some new music called Rock and Roll. That is my most lasting memory of him because it fit his personality to a tee. Doc embraced new things and had almost no fear of change.

Although he retired in the early 60’s and passed away only a few years later, I wonder what he would think of our health care system today. I am sure he would enthusiastically applaud the technological advances such as medicines, diagnostic tools, and the new treatments and techniques. Progress was important to him where treating the sick or injured was concerned.

There are a few things I am sure he would not like such as malpractice insurance, assisted suicide, abortion, and the extensive involvement of “bean counters” and lawyers in today’s so called health care delivery system. He would take a dim view of anyone or anything that tried to dictate to him how to relate to or treat one of his patients.

I think he would also question the basic education of new doctors as well. I am sure he would take issue for example with the notion of teaching them to eliminate emotion from dealing with their patients. Respect and trust are emotion based. If emotions are eliminated or inhibited the doctor/patient relationship suffers and so does the chance for success of any treatment.

Call it “bedside manner”, “patient interface”, or anything else you like; it is still just plain old people skills; nothing more, nothing less. Doc was a master at it because he made himself aware of the patient’s emotions as well as his own. He inherently knew that to get what he wanted – a patient’s respect and trust – he had to give what he wanted without reservation. He had to calm fear, uncertainty, and sometimes-silly superstitions. To complete the paradox he had to not do anything that would induce or increase those emotions not only in the patient but himself as well. It takes emotion to know how to deal with emotion.

The one thing he would hate the most would be the fact that so few physicians make house calls. The way Doc practiced medicine was more like a ministry. He brought his skills where they were needed, when they were needed, and used them the best he knew how on the front lines of life – in the family home.

Of course Doc had “privileges” at the local hospitals. He couldn’t fit x-ray machines and operating rooms in his black bag and he could not supply the patient with constant 24 hour a day care for long. If the circumstances called for it Doc didn’t hesitate to use the resources of the hospital and he always made himself available to ease any fear or anxiety of his patient or their family. In more than one instance he paid a down and out patient’s hospital bill. I can just imagine what sort of confrontation Doc would have with a present day hospital administrator over admitting one of his poorer patients with no insurance. There would have been more fireworks than the Fourth of July. Doc was an impassioned man where his patients were concerned and known for his short temper.

Have we really made as much progress in health care as we thought? From a technical standpoint, unquestionably; however in terms of real human-to-human relationships the cost of that progress may have been the loss of innocence and the ability to respect and trust one another.

In today’s climate the doctor/patient relationship starts from almost an adversarial beginning. We always hear the horror stories about how someone experienced negative results from treatment for their health problem and never get the positive ones; or for that matter the full story of why the negative ones really happened. Our choice of a doctor is dictated if not by circumstance by our insurance carrier or “health plan”.

Even if we do have what could be considered a family doctor, medicine has become so complex and compartmentalized that no one man can competently “practice” it all. So we get handed off to this or that specialist each time having to establish a new relationship on which our health, well-being, and indeed life might depend. That’s a lot of stress and a situation tailor made for misunderstandings, conflict, and negative results.

I think knowing Doc has actually given me a personal advantage in such situations. All I do is remember Doc and transfer that respect and trust to the doctor treating me. Sure I risk getting disappointed or betrayed; but I have yet to have it happen. Most true health care professionals who have day-to-day patient contact are genuinely caring people who got into medicine to help others. I have found that they respond to respect and trust just like the rest of us.

Am I saying that all doctors are to be respected or trusted? Absolutely not! There are charlatans, fakers and just plain incompetents in any field of human endeavor but they tend to quickly weed themselves out of the mainstream in medicine. You can’t “fake it until you make it” in medicine. The stakes are just too high.

The brave new and evolving world of medicine has developed a lot of titles that are supposed to define and clarify the roles of doctors for us poor uninitiated patients. Such terms portray doctors as “healthcare professionals”, “care givers”, “general practitioners “ and other specialty designations.

Doc might have been fond of “professional care giver” but he always said, “ You can call me anything you like as long as it not late to supper.” I think his favorite title was the one he spent his life responding to – DOC.

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Little Sisters – by Kenneth B. Kay – “I was her foil and scapegoat . . .”