I’ve become addicted to a “new” form of communication: what I call “correspondence by clipping.” Instead of trying to give someone the fullness of something I find important or interesting by talking on the phone, or by typing out a long email, I cut out whole items from my local papers and send them to appropriate recipients by snail mail.
People respond. I find my own mailbox much fuller these days.
So it was a relative who sent me The Dying Art of Doctoring by Dr. Jerald Winakur, clipped from the Tribune-Review of Pittsburgh, my own hometown. I don’t know if the doctor is a Pittsburgher, although I do remember people — Jewish people — by that name from my years in the city, and he did graduate from the University of Pennsylvania medical school. But he has been in Texas ever since, most recently in San Antonio.
No matter. It’s what he says about medicine today that interests me. He doesn’t like it. And neither do I. That’s because my father, a doctor who died before he reached 60, practiced it very differently, in a personal way that has now all but vanished.
Dr. Winakur, at 68 and retired from the active practice of internal medicine and geriatrics, used to do the same. Instead, he’s writing of doctors hired by large groups, hospitals, insurance companies or assembly-line clinics … now insulated from knowing too much about their patients. “It’s all about the technology …” He says that many doctors would like to know their patients, but don’t have the time; that young doctors don’t know how to connect with real people because their training has been with computers and they’ve examined only plastic dummies.
Dr. Winakur calls himself “a dinosaur.” So would my father be, if he could come back today. But if that were possible, he wouldn’t even recognize what is now called “medicine.” He truly believed that no doctor could accurately diagnose and prescribe until seeing patients in person, listening to their hearts with his own stethoscope and looking into their ears with his own otoscope, tools he brought with him in his worn black leather bag, thumping their abdomens, peering into their eyes with his own eyes, touching their skin, asking them questions and listening not just to their answers, but to how the answers were spoken. Personal medicine, as dead now as my father has been for more than 50 years.
That personal care is truly available today only in the new “concierge” practices, which are too expensive for most people. Years ago, my father gave that same care for $2 in his office, $3 when he traveled to the patient’s home. Of course he made house calls! I know all about them, because I often went with him. That was an education I’ve come to treasure.
Doctors have certain affinities. Many are gardeners, especially rose gardeners, as my father was; when they come home, they like to deal with growing, blooming, beautiful entities. And many like to write. Dr. Winakur started with a 2005 article, What Are We Going To Do With Dad?; it appeared first in a health magazine, but was soon running in newspapers all over the country. In 2009, Hyperion published his book, Memory Lessons: A Doctor’s Story. He calls it a “memoir-manifesto” that includes stories of his own life as a practicing physician; some commentary on what’s going on in America with today’s medical care, especially of the aging; and being himself the son of “an old, old man,” he says.
Dr. Winakur retired in 2012 as a clinical professor at the University of Texas Health Science Center in San Antonio, teaching ethics as well as medicine. “Once, I was a primary care attending physician,” he says, rather wistfully.
I wish he’d had a chance to meet my father, and my father had had the chance to meet him. They would have understood and enjoyed one another.