Straight Talk

by A. E. Miller, M.D.

This column's subject is not a current presidential candidate

When people described my father, the country doctor, as a “plain spoken man,” it was generally meant as a compliment. Not so with a few folks, however, who considered him blunt, tactless and a little too handy with cusswords.

This could happen sometimes after the Queen’s proper English failed to register, or other times when people refused to listen to things they didn’t want to hear. One way or the other, nobody walked out the door wondering exactly what he’d told them or doubting what he thought.

Dad once told Bessie Turnbull, the banker’s wife, that she had an incurable attitude; there wasn’t a doctor on earth who could make her well as long as she believed her own bullshit. Bessie stomped out the door in a huff, and proceeded to bad-mouth him to anyone in town who would listen.

The following Friday, when Dad carried the deposit to the bank, Clarence Turnbull was waiting by the entrance. With a silent nod of his head Clarence ushered Dad into his private office and closed the door behind them. From the cabinet behind his desk he produced two fresh glasses and a bottle of Jim Beam. “I’d like to shake your hand and buy you a drink,” he said. “You’re the only doctor in town who understands that damned woman of mine.” For Dad and Clarence that was the beginning of a 30-year friendship. Several people took Bessie’s bad-mouthing as a first-class recommendation and started coming to Dad as new patients. Dad said later that Bessie was the best “practice builder” any new, young doctor could hope to find.

As my father saw it, the only thing he had to sell was his honest, professional opinion. If that meant passing judgment, or even meddling, so be it. He would say things like: “You made that baby, so now, by God, you’ll damn well pay the rent.” Or “Don’t kid me you’re not boozing ... or smoking … or screwing around.” Or “It’s time you got off your lazy ass and went back to work.”

Most of Dad’s office visits were filled with animated chatter, punctuated by laughter or an occasional tear. The cuss word sessions were a last resort. People occasionally went away mad, and a few left by invitation. “Don’t waste your money or my time,” he’d say, “If you’re not going to do what I tell you, then you go find yourself another doctor.” The amazing thing was how many people wandered back – months, years, or even decades later – to apologiz

On rare occasions even harsh words didn’t suffice. After hours of grueling labor the superintendent’s wife was finally far enough along to be delivered. Just as Dad opened the forceps pack, hysteria took command. With a loud holler she started shaking and wriggling, and kicked over the Mayo stand and Dad caught the forceps in midair. (Such things happened before the pleasantries of modern anesthesia.) Thwack! With his free open hand Dad landed a loud slap on the bared skin at the side of her fanny. “Damn it, Katie!” he bellowed, “If you’d fought half this hard nine months ago you wouldn’t be here now.” Through the years they both retold this story and laughed about it a hundred times; and by the way, the baby born that day is still a friend of mine.

Now skip ahead sixty years and picture the fate of a physician who resorted to harsh words – or even physical violence – to be certain he was understood? In our brave new era of patient autonomy, how many doctors withhold their frank, personal, best advice, because they know that their advice might later prove to be faulty? And how often nowadays is plain truth buried beneath ten-dollar words, or sugar-coated beyond recognition?

My father would be appalled by the seven-minute, no-talk, no-touch office call: no chatting, no laughter, no stories, no repeating one’s self – several times, if necessary –simply to drive home a point. Whatever happened, he would ask, to the probing history? Or the physical exam where people took all their clothes off? Or the open-ended question – the one that kills a doctor’s lunch hour: is everything else okay?


Editor's Note: The author of this article, A. E. (Bud) Miller was a classmate of mine in medical school. While engaged in dissecting our shared cadaver, he was unable to display his obvious creative talent with the written word. He has written extensively for the Idaho Medical Association newsletter and has served as its editor.