‘I Want a Vacation When He Comes Back’

Twelve years ago, Dr. Luther Vance Jr. and his wife, Brenda, started a family-medicine practice in a trailer home, parked on a hospital lot.

They worked hard, she managing the office, then becoming a nurse, he taking on a variety of cases--pediatric, geriatric, jailhouse, even house calls--until they became well-known and well-liked in Perry, a little town of 9,200 and the birthplace of Sen. Sam Nunn (D-Ga.).

A spacious office building with state-of-the-art equipment replaced the trailer. And the number of patients, drawn from miles around, rose to some 13,000, Brenda Vance said recently. Life was good.

Then came the Persian Gulf War. Dr. Vance’s Army National Guard medical unit was activated in November and later sent to Saudi Arabia. With that, life back home turned upside down.

In a town with fewer than 10 doctors, Vance is one of just two or three general practitioners and maintains a rare open-door policy. People around Perry say he cared for a lot of patients other doctors did not want, like those in a nursing home.

Now nurse Vance is working mightily to hold the practice together. She is getting help from a friend of the family, Dr. Charlie Dean, who drives over from Columbus, about 80 miles away, three times a week. But as the war wears on, it takes its toll here too.

“I’m coping,” Brenda Vance told a visitor as she escorted a patient to an examining room. “I’m scared to death. I’m terrified. But I’m coping.”

Part of the terror is, of course, her fear of harm to her husband. But she also knows that if war lasts for many months, her difficult job will become even more so.

Now open only mornings on Mondays, Wednesdays and Fridays, the office, which displays several small U.S. flags, accommodates an average of 25 patients a day, Vance said, adding that “some days we could see twice that many” if a doctor were available all day.

Despite the circumstances, Vance allows humor to intrude once in awhile, answering a question about whether she will be reluctant to relinquish control of the practice once her husband returns: “I want a vacation when he comes back.” And, as only a wife-nurse could, she speaks lovingly and admiringly of his ability to stitch an incision.

For now, patients seem willing to wait for Dr. Vance, believing he is unique in a time when medical care seems dominated by impersonal specialists.

“A lot of people in Perry feel like he’s from the old school of medicine,” said Kathy Norris as she waited to have her blood pressure checked. “He gives unending hours to the community. We fear for him and pray for him and hope everything’s going to work out for him.”

Godfrey Durham, another patient, also wished for Vance’s return “in a reasonable time,” adding: “I wish he hadn’t gone.”

That is the prevailing sentiment around here. Like many small towns across America, Perry is dressed up in yellow ribbons and signs declaring support for the men and women fighting the Gulf, while hoping for their quick return.

Dr. Dean, who keeps none of the fees he earns in Vance’s office, seemed incredulous that the Pentagon would call up a small-town doctor who filled a medical gap by providing care to walk-in patients. Vance’s office, he said, “is about the only place with an open-door policy. When you take that out of the community, it decreases the community’s access to medical care.”

Dean, who believes Vance should have been allowed to stay in “some geographical proximity to his practice,” nevertheless vowed to continue filling in as long as he can keep up the pace of 16-hour days.

And Brenda Vance vows to wear the small flag pin on her blue sweater until her husband returns.

Finishing up another day at the office and preparing to go home and tackle a mountain of business mail, she reflected on the shock of her husband’s leaving. “At our ages, you’re not thinking military,” she said, noting that he is 48 and she is 44. They have been married 26 years.

She said Dr. Vance, never expecting to go to war, had joined the Guard in the late 1970s because a friend asked him to do so in order to conduct physicals. He is now a major.

When he was activated Nov. 15, “We kept saying, ‘This is not real,’ ” she recalls. After training at U.S. Army bases, he left for Saudi Arabia on Jan. 4.

“It was like experiencing a death,” she said. “In my wildest dreams, I could not have imagined this nightmare.”

That said, Vance said her husband is not trying to get out of doing his duty. “He’s needed here,” she said, “but he’s really going to be needed over there once the ground activity starts”--reflecting a widespread belief that allied troops will sustain numerous deaths and injuries in a ground war.

Meanwhile, Brenda Vance is fighting to keep the family practice alive.

“We started from scratch,” she said. “That’s why I’m trying to keep it together.” But if she fails, Dr. Vance will understand. She said that when they talk by telephone, he tells her to “do the very best you can, but if it gets to be too much for you, lock the doors.”