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The Horse and Buggy Doctor: [Excerpts]

Hertzler, Arthur E.

doi: 10.1097/ACM.0b013e31819f6f54
Medicine and the Arts

Reprinted from The Horse and Buggy Doctor by Arthur E. Hertzler by permission of the University of Nebraska Press. Copyright © 1938 by Dr. Irene A. Koeneke. (Lincoln: University of Nebraska Press, 1986 [Original edition: New York: Harper & Brothers, 1938].)

I never refused a call, no matter what the condition, or what the chances of remuneration. When I announced that I wished to study medicine, my father asked me to promise never to refuse to attend a sick person, whether he could or would pay or not. My father, being a farmer, did not realize how exasperating patients can be or how useless some calls. I have kept the faith: that is, almost. I have always refused to attend a drunk with a headache. I figure that he might as well suffer from the present headache as from the one he will acquire as soon as he is relieved. (p. 107)

We learned the palliative measures necessary to make the patient comfortable until the diagnosis was made or, as was perhaps more often the case, until the patient spontaneously recovered…. The saving of life is the chief function of the doctor, let us admit, but it is a function he performs only now and then. It is the relief of pain that chiefly interests the patient, and skill along this line is the big factor in the life of the man in general practice. (p. 52)

The more intimate relations between doctor and patient have never before been discussed in print, but I am going to come nearer to doing so than has yet been done. Only an old doctor who has lived with people knows this relationship…. The more nearly the doctor's experience of life has paralleled the patient's before him, the better he is able to understand that patient. The tragedies of literature are silly things; they must be made simple and obvious or else they will not be understood. Shakespeare wrote tragedies out of his imagination, not from experience. They are foolish, because he had not seen life in the raw. Tragedies cannot be written. They are inarticulate. (p. 279)

Nowadays [in medical school] many small courses are given, too numerous to mention, and too brief to make it possible for the student to learn anything worthwhile about them. I presume these subjects might be called “cultural….” Such superficial courses only detract from the things worthwhile. The latest of these courses is medical sociology. The next course, I predict, will be a course in medical hemstitching or doily making. (p. 45)

To return to the female complaints. One may divide them into two general classes: the female complaints and the male complaints. The former include those due to maladjustments between the biologic and the ethical. Male complaints, on the other hand, are those in which man is the aggravating factor or, maybe, the regressive factor. These are subtle things which only doctors can hope to understand. (p. 138)

© 2009 Association of American Medical Colleges