Reflections on Medicine - March 2008
By George G. Meyer, MD
My father was a physician who claimed that I was the seventh generation of physicians, though this was never documented. Being a holocaust survivor, I have been blessed many times in my life. I was able to go to Johns Hopkins University; then to the University of Chicago Medical School.
I have always felt I had three careers as a doctor. One was as a general physician in the U.S. Public Health Service Division of Indian Health; as such, I lived on reservations in South Dakota and Minnesota and later became a consultant in mental health to the Navajo Nation. During those times, I did what had to be done: I worked to gain the trust of people who claimed not to speak English, so I learned Sioux. I did bronchograms, read all the tuberculosis x-rays, and took out a bunch of tonsils.
I was able to save triplets we delivered. The folk myth then was if a woman had twins, she had slept with another man, and if she had triplets, she had slept with more than one man outside her marriage. The survival rate of multiple births was shockingly low. We had meetings with families and made alliances with medicine men. I did a caesarian section in the middle of one night, when a woman came in with a prolapsed cord and the baby was in distress. The nearest surgeon was 200 miles away, so it was me, the DeLee textbook, and a Native American circulating nurse. I did not cut into the bladder, and all survived.
In those days, we still had deaths from diphtheria, and establishing vaccination programs was a real challenge. We did organize a blood bank, using donors who had to be screened, and we were on call regularly.
My second career was academic, and started at the University of Chicago and ended at the newly organized University of Texas Health Science Center at San Antonio. Those were the days of developing community psychiatry, a dream of reducing state hospital admissions, which was done successfully; however, the plan of having the money and services follow the patient into the community was never funded or fulfilled.
It was publish-or-perish time, and I did that successfully, including being very fortunate to obtain federal grant money, which was still available in the '60s and '70s but dried up in the '80s and '90s. Some of the community health services I started still exist. I was proud to bring the concept of day hospitals to San Antonio, as well as to back the establishment of sleep studies and sleep centers.
The bravest step of those times, however, was to leave my tenured job at the University of Chicago and our "forever house" across the street from the university to join the new medical school in San Antonio, which was still a dream. The big hole in the ground was to become the Bexar County Hospital and is now called the University Hospital.
The problems in those days were to bridge the culture gap and respect other languages. This included requiring new staff of the medical health center to learn Spanish, a new idea in those days. Overcoming the prejudice against mental health and the fear of mental illness remains a major problem. It was getting better when we could hire, train, and supervise people. It has become worse since the money has dried up. Side-effects like lawsuits and tardive dyskinesia have tempered the benefit of new medications. The rise of alcoholism and drug abuse, together with the inability to keep people in the hospital or in treatment, has been frustrating.
After I retired from full-time academia, I went into private practice with my wife, who is a psychiatric social worker, and we have had the same office for 25 years. I became a clinical professor to continue to supervise residents, meet with medical students, and do some examining for specialty boards. This has been the third career, and we proudly continue it three days a week at this time.
Let me say clearly that it has been an honor and a pleasure to practice medicine and psychiatry all these years. It is still both challenging and fun to see patients.
I was fortunate enough to be one of the last professors to enjoy a sabbatical year, which we spent at the University of Edinburg in Scotland. I will not go into details of the multiple committees, task forces, and opportunities to represent the American Psychiatric Association worldwide. This gave us a chance to visit Spain for the World Congress and Australia and New Zealand for the World Mental Health Association. What an honor!
There have been regrets, "too few to mention." The rise of the hassle factor has been the biggest problem, and it includes not only the financial issues, but also the lawyers, the HMOs, the government, and even the patients, where the adversarial nature of the practice of medicine has taken some of the fun out of it.
I remain one of the luckiest people alive. Our three sons have followed us into health care, as have their wives. Bruce Meyer, MD, is vice president for medical affairs, with other titles, including professor of obstetrics and gynecology, at The University of Texas Southwestern Medical Center in Dallas. Brian Meyer, MD, is executive director of The Virginia Treatment Center for Children in Richmond, Va. and associate professor at the Virginia Commonwealth University. Barry Meyer, MD, is a cardiothoracic anesthesiologist, now head of his large group of anesthesiologists, also in Dallas. With all that and our 10 grandchildren, we thank God daily for our good fortune.
Editor's Note: This is the latest in a continuing series of essays by members of the TMA 50-Year Club .
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