Modern medicine: Who will be the great Chattanooga physicians of the 21st century?

Modern medicine: Who will be the great Chattanooga physicians of the 21st century?

January 20th, 2013 By David Wendt, M.D. in Opinion Columns

The medical community in Chattanooga is undergoing a quiet but seismic shift. Many of the physicians who first brought modern technologies and interventions to the region are retiring or have passed away. These early healers were the pioneers of a scientific process that disseminated new ideas and challenged folk wisdom and local customs. They moved the community away from the vestiges of Civil War medicine and proprietary clinics to the modern hospital of today. We inherit the richness of this tradition and practice they established years ago.

Many of these men and women were a part of the "Greatest Generation" obtaining their medical education while serving in our armed forces. Some belonged to the early handful of women begrudgingly granted admission to medical school.

Some endured the "trial by fire" atmosphere common in programs under medical pioneers like Michael DeBakey in Houston. Others tested their mettle doing a "decade with Dave" Sabiston, then chief of surgery at Duke Medical Center. Having faced these challenges and completed their training, they came to Chattanooga to work in the trenches, caring for men and women in the Tennessee Valley. The illnesses and fears of these patients were now their responsibility.

For many practitioners this was the start of a different kind of study. They assimilated daily observations with an eye to the nuance of signs and symptoms, which often required a reinterpretation of the teachings from medical school. The best physicians learned at their patients' bedside, often at a cost to families, marriages, or even to their own psychological health.

Over time, Chattanooga became comfortable in knowing that Dr. Hicks Corey or Dr. Minnie Vance were here to see a sick child

through a tough illness. They knew Dr. Donald Ross Campbell was a phone call away to assist with a child in crisis. They relied on a Dr. Winston Caine to diagnose and treat leukemia, or Dr. Walt Puckett to treat their heart disease, or Dr. John Evans and Dr. John Boxell to operate on a head and neck malignancy. They knew Dr. Malcolm Daniel would work through the night to repair a leaking aneurysm. These physicians wove the tapestry of Chattanooga's health care system. We who practice today stand upon their shoulders, and continue to bring to bear the most current scientific understanding on the care of each patient.

When a physician leaves a practice, his parking spot and patients are reassigned. The former is perfunctory and the latter occurs only provisionally. When I care for one of these patients I hear stories of the dedication and compassion they were shown and their grateful loyalty to the physician who provided them that early solace is still palpable.

Today patients often enter the health care system during an episode of acute illness. The patient is transported through a maze of hallways and testing areas and sees several specialists and a hospitalist who directs the course of care. Often unfamiliar with any of these doctors, the patient relies on the nursing staff to provide comfort and assurance. Some patients stay briefly at a rehab facility, and are discharged home where a home health nurse, physical therapist, or occupational therapist follows a plan devised by the hospitalist. He visits his primary care physician who reads the summary of the hospital stay, but has not witnessed the furrowed concern on a spouse's face, the grimaces of pain, or look of perplexity as a test result is given.

A fortunate few have families and church homes to support them, but many, who are defined by their role at work, reenter society, expected to seamlessly fulfill pre-illness roles.

In the evenings, they return home to read surprise letters denying coverage for portions of their hospital bills. They watch the evening news with its lead story on the economic and manpower crisis facing the nation's health care system.

Meanwhile they hear the faint strains of fiddle music wafting Nero-like from the halls of Congress.

In today's uncertain medical climate, it is my hope that fragmentation, regulatory scrutiny, and economic realities do not become the weft of our cloth. While each of us has to grapple with present realities, it is, as Times Free Press columnist and physician Clif Cleaveland tells us, within the "sacred space" between physician and patient that the real weaving of health occurs. It is our challenge in honoring those who came before us to ensure that the sanctity of this space remains a part of the tapestry of Chattanooga's health care system.

David Wendt, M.D., is a board-certified cardiologist at the Chattanooga Heart Institute.