His Work Fills Arms, Classrooms : Doctor Who Served the Poor of Alabama Left a Legacy of Life

The work of Dr. Robert Xavier Williams Jr. fills every playground, every classroom and every mother’s arms for miles around.

Pick any woman and child on any street in Macon or Bullock counties in rural east-central Alabama, and chances are that woman was Williams’ patient and that child was brought into the world by his hands.

In big cities, expectant mothers shop for doctors or midwives and hospitals compete for maternity business. But in rural America, particularly the South and the West, such choices are increasingly rare. Women often must travel for an hour or more for a doctor’s care and a hospital delivery room.

Acute Need for Doctors

For 15 years, Robert Xavier Williams Jr. chose to do what fewer and fewer doctors are willing to do: He delivered babies and cared for women in a piece of America where the need was acute, the population poor and the facilities desperately limited.

He delivered the future here, and his sudden death July 13 at the age of 53 turned that future darker and more uncertain for a generation of babies and their parents.

“They want to know, ‘What do we do now?’ ” Annie Thomas, Williams’ office nurse, said of his patients, at least 100 of whom are pregnant. “I just inform them we don’t have a doctor in the office to see them. And the saddest part of all, we don’t even have a referring physician to send them to.”

In Macon County, where Williams lived, there is not even a hospital since John A. Andrew Community Hospital closed in 1987. Williams kept his office there, the only doctor in a mostly empty building with an overgrown lawn. But every day at dawn, he drove along 25 miles of narrow highway to Bullock County Hospital to do his rounds.

After morning rounds, Williams often performed surgery, then drove back to Tuskegee for office hours six days a week. With the office and the three county clinics where he consulted, he might see 1,500 patients a month and deliver an average of two babies a day.

Talked About Retirement

At night, Williams unwound by reading medical journals. He talked about retiring to a life of travel and golf, but no one who knew him took him seriously.

“He just worked, worked, worked,” Thomas said. “He wouldn’t take time out to take a break or a rest or eat a decent lunch. I think he cared more about his patients than he did himself, I really do.”

Williams’ patients, many already suffering the effects of poor nutrition, high blood pressure or other conditions exacerbated by poverty, needed extra care: 90% were high-risk, requiring special attention and sometimes frequent hospitalization throughout their pregnancies.

Their risk status went hand-in-hand with their economic status: Those with the greatest need often were the least able to pay. Most of them were uninsured or underinsured and could not afford a ride to his office, much less an obstetrician’s bill.

“Try to pay me something, if it’s not but a dollar a month,” he’d tell his patients, and they never were afraid to come to him, no matter how little they had in their pocketbooks. Those who weren’t within walking distance were often ferried to appointments by Williams’ son, Bobby, who started working in his father’s office while in seventh grade.

Daughters Ran Errands

The whole family helped. Wife Rita worked as office manager; Bobby and daughters Sherri, Rita and Catherine ran errands and took patients’ blood pressure and weight. Behind their comfortable split-level house lay another part of Williams’ life they all shared, 10 acres of land where they kept horses, cows and chickens and grew vegetables.

Williams, reared by his farmer grandfather, arrived at Tennessee State University with every intention of returning to the land. Instead, he met and married Rita, took the medical aptitude tests as a lark and did well enough to be admitted to Meharry Medical College in Nashville. Later, he joined the Air Force, serving at bases in Grand Forks, N.D., and Blytheville, Ark., where he became the first black hospital commander.

His career was filled with honors, but he never spoke of them. All his patients knew was that he saved their lives and he saved their babies.

“If it wasn’t for him, I would be dead,” said Pinkie Thornton, whose last three children, and three grandchildren, were delivered by Williams. Her most recent pregnancy was ectopic, a potentially life-threatening condition in which the embryo develops outside the uterus. In rare instances, the pregnancy goes to term; that is what happened to Thornton, whose daughter, Tari, is now 5.

When the operation was over, Williams called in six doctors, she recalled. “He was laughing and smiling. He was kind of happy, because he thought he was going to lose me or something. Every last one of the hospital staff members came in, even the cooks out of the kitchen. I woke up and said, ‘What are y’all doing up here?’

‘Going Down in History’

“He said, ‘Ms. Thornton, you are going down in history.’ ”

It was not just the fact that Williams was there to do what had to be done, his patients say. It was the way he did it.

“When I had my daughter, I had a very hard time,” Gennell Dix said. “I stayed in labor, hard labor, for 26 hours. When it was over, I woke up looking for Dr. Williams. You know how a little child says, when mommy or daddy comes in, it makes it all better? That’s the way it was with him. He came in, full of joy, and a lot of times, he embraced his patients.”

Bullock County Hospital stopped offering obstetrical services with Williams’ death and stopped searching for a replacement on Sept. 15. The task proved impossible, said Don Priori, who heads the hospital board.

Every year, 12% of obstetrician-gynecologists stop delivering babies. Those who continue rarely choose to work in small towns with big problems. Twenty-nine of Alabama’s 67 counties have no OB-GYN.

For help, the hospital looked to a federal program, the National Health Service Corps, which gives scholarships to medical students who agree to serve in needy areas. Under the Reagan Administration, however, the program’s scholarship budget has gone from $60 million in 1978 to $2 million this year, and the number of scholarships is down from more than 3,000 to just 40.

Bullock County, which couldn’t afford to wait even two months, was told to wait another year. The job of finding a replacement was complicated by the fact that Williams literally did the work of two.

“He was on call virtually 24 hours a day, seven days a week,” said Duane Brookhart, Bullock County Hospital administrator. “When an obstetrician looks at the types of need that exist, they’re going to say, ‘I need some backup. I need some days off.’ I think that made it twice as difficult.”

In the week before his death, Williams delivered 10 babies, including two by Caesarean section. The last was a 7-pound, 11-ounce boy named Aaron. His own son, now a third-year medical student at his father’s alma mater, spent the summer working with him, including the last 24 hours.

“On Tuesday, he had a delivery, a D and C (dilation and curettage), and a C-section. Then he did his rounds in surgery. We went to the office, and then he stayed at the hospital until 9 p.m.,” Bobby Williams said.

Final Operation

Williams drove home, and Bobby stayed overnight in the hospital’s on-call room. His father awakened him at 6 the next morning to do rounds before the elder Williams performed a hysterectomy.

“I was in surgery with him,” Bobby said. “He said, ‘I’m dizzy.’ He slumped forward. They started cardiac resuscitation.

“That was one of the worst feelings I have ever had in my life,” he said. “I felt helpless.”

Another doctor, Judy Jehle, was flown in by emergency helicopter from a Montgomery hospital to complete the surgery. Jehle had recently cut obstetrics out of her own practice because of the long hours.

At the funeral, more than 1,000 people crowded into the church. Many more went to the funeral home, their children in tow.

“One lady picked up her baby and said, ‘This is Dr. Williams. This is who delivered you,’ ” Dix said. “She had a picture taken. She didn’t ever want to forget him.”