Healing Touch of an Old-Time Doctor : Medicine: General practitioner retires after a lifetime of service. He epitomizes an old-school ethos of helping others.
Just the doctor, the patient and the little black bag. Boy, was that the life.
Sure, it was a pain when patients called Dr. Herbert Archibald at home at 2 a.m., and the ring of the phone jarred him awake while his wife rolled over and went back to sleep. He’d tiptoe to the bathroom, pull his pants over his pajama bottoms, throw on a sweater and grab his bag.
That little black bag got Archibald through 44 years of house calls, at a time when there were no MRIs or CAT scans, certainly no sheaves of insurance papers. Dr. Archie, as his patients call him, sometimes got paid in crates of apricots or live chickens or a pruning of his back-yard trees.
Archibald, 75, went into semi-retirement nine years ago after practicing in Northern California and the Pomona area. This month, he went into full retirement.
Throughout his career, he held firm to his philosophy of practicing medicine with a human touch, of treating each patient as a friend. “You have to see the whole person. His body and soul,” said Archibald, an easy-going man with a kind face and gentle voice. “Not just seeing his eyes or his ears or his throat. Realizing the importance of his family situation, social problems, financial, if there’s a problem at work.”
But during the span of Archibald’s career, the ethos of the old-school general practitioner largely has been usurped. In 1931, 87% of doctors were in general practice. By 1962, however, specialists outnumbered general practitioners. And by 1990, only 33% of doctors were in general medicine.
The trend toward specialization has resulted in some dramatic advances in medical science, with obvious benefits to patients. But as doctors like Archibald fade from the scene, there is a renewed appreciation for what is being lost.
Today’s doctors often are too busy to listen, studies suggest. A 1991 UC Irvine study concluded that physicians typically interrupt their patients 15 to 30 seconds after they start talking. What’s more, the study said, doctors use a “high-control style” of soliciting medical information and then cut off further conversation.
For these and other reasons, some health care reform experts want more general practitioners, arguing that they are in a better position to practice the type of preventive medicine that means healthier patients and lower costs.
In line with this view, a presidential task force headed by First Lady Hillary Rodham Clinton reportedly is considering recommendations to offer low-interest loans and bonuses or scholarships to medical students who choose general practice over more lucrative and glamorous specialties. (Generalists earn an average of $100,000 a year, while the average specialist makes $220,000, according to the American Academy of Family Physicians.)
Archibald, reflecting on the bygone era in which he first started practicing medicine, said, “It was the golden times. I don’t think people expected us to be miracle workers. The new generations have been brought up with TV and newspapers and all the glorious advances of technology in medicine. Certainly, they’re marvelous, but for everything there is a cost.”
He’s not saying he has a cure for what ails health care. Archibald sighed, shook his head, took off his glasses and rubbed his eyes.
“I’ve thought about that a long time,” he said. Pausing for a few seconds, he added: “It’s sort of an insolvable situation.”
The old ways worked just fine for Archibald. He got by with his leather bag, solid and worn like an old family Bible, a stethoscope, thermometer, lollipops and other essentials jumbled up inside. Reeking of eye-popping smelling salts and a cold remedy’s soothing camphor-eucalyptus vapor. Brimming with the simplest of things, like a kitchen spoon for dissolving morphine pills in sterile water over an alcohol lamp.
If his little black bag failed him, he’d call for an ambulance, or carefully carry the patient to his car for the drive to the hospital.
“It was simple,” Archibald said wistfully. “It was lots of fun.”
The only child of Methodist missionaries, Archibald grew up in Calcutta, India, a city with narrow roads teeming with oxcarts, rickshaws, and horse-and-buggy drivers. An incident he vividly remembers from his childhood started him on a path toward medicine.
When he was 6, he saw a new couple attending service at his parents’ old stone church. A week later, the young couple were dead of smallpox. He was so struck by the untimely deaths that nearly 70 years later, he recalls that Sunday service, and how the couple had joined the congregation in singing, “I Come to the Garden Alone,” accompanied by the church’s pipe organ.
As he grew up, Archibald thought about the incident and became interested in medicine, reading books such books as “Microbe Hunters.” He decided to become a doctor. He graduated from USC and then attended medical school at Creighton University in Omaha, Neb.
In December, 1944, he began an internship at Hollywood Presbyterian Hospital. During his first week, a young woman was flushed with a 106-degree fever. Her husband was in the military, and she was alone.
Someone from the American Red Cross heard of the young woman’s plight and was moved enough to call the White House for help. First Lady Eleanor Roosevelt intervened, and a new medicine available only in special cases was delivered to the hospital. It was called penicillin.
The ailing woman’s fever plummeted.
“We just cried,” Archibald said. “It was such a miracle.”
Archibald began his practice in the San Joaquin Valley, then moved his office to Upland in 1951. After being diagnosed with congestive heart failure, he went into semi-retirement in 1984 to take care of his health. (He and his wife, Naomi, have four children and five grandchildren).
But he still saw patients and served as medical director of the Visiting Nurse Assn. of Pomona-San Bernardino, a group that provides home health care. As medical director, he made free house calls. The association gave him a retirement party on May 5 to thank him for his service.
No charts, no sophisticated tests will tell a doctor as much about a patient’s psyche as a home visit, Archibald said.
“I still feel that everyone should have a general practitioner’s knowledge or experience so you know how it feels to be out in the home or somewhere when someone is having a heart attack or acute respiratory distress or having a mental breakdown,” he said. “How do you handle that? How do you talk someone out of killing themselves?”
He did that one New Year’s Eve about 15 years ago, when a young man called and said his wife had been drinking and waving a gun. Archibald got to their house about 11 p.m. and called police. He talked to the woman and calmed her. Why don’t you just put that down, he said gently. Let’s give it to the police for a week or so.
There were other times when an office visit left Archibald with nagging questions. Like the time he couldn’t pinpoint what was troubling a high school boy with a rheumatic heart ailment. The boy was pale, his mother seemed frightened.
Eventually, the mother confided that her husband was abusive. I think he’s crazy, she told Archibald. He has a whole bunch of guns. Archibald urged her to seek help.
One night the mother called him at home. Her stomach hurt, and she was vomiting.
The mother was in the upstairs bedroom of an old farmhouse. She warned the doctor to be careful about touching her, because if her husband came upstairs and saw him, there could be trouble.
Later, Archibald sent over a social worker. Police later raided the house for guns, and the husband was committed to a mental institution.
As a general practitioner, Archibald was part-doctor, part-confidante. He told a joke or two to relax patients, and then he listened, not just to their words, but to their body language and facial expression. Maybe a patient’s mother had died of breast cancer, and she didn’t quite want to own up to that lump in her breast. If there was worry, Archibald would find it.
A few months ago, Archibald made a house call to the cramped trailer of a retired waitress in La Verne. The 75-year-old woman lived alone, with her cat. She had a brain tumor, and she was in pain, but not just from her disease.
After a while, she confided in Archibald. Could you do me a favor, she asked him. Could you check and see if my cat could be cremated with me? They talked awhile about the cat and then she decided:
“I’m not going to put him to sleep,” she said. “Maybe he’ll make someone else happy.”
On a recent afternoon, Archibald made one of his last rounds of old-time patients at Shea Convalescent Hospital in Upland. He had a hug for each nurse or administrator passing by. He slung his stethoscope behind his neck the way a prizefighter does with a towel. He bent down to smooth the thin gray hair of Mary Martin, a 68-year-old cancer patient. She was on morphine, which left her weak, expressionless and unable to talk.
“Mary, how are you doing, honey?” Archibald asked quietly, taking her hand. “Are you hurting?”
He murmured to her for several minutes before moving on.
His patients say he has always found time to listen. Archibald treated Edwina Smothers’ mother for years, until she died at 87 of a rare tissue disease. He rushed to her Upland house whenever she called, Smothers recalled.
“She put him right up there under God,” she said.
Archibald took care of Corynne Hanzlik, her husband and three children for nearly 40 years. He also took care of her mother, who had heart problems, brought on by stress.
Several years after her mother had a heart attack, Hanzlik began having chest pains during a stressful period at work.
If you don’t want to end up like your mother, Archibald told her, you should retire. Eventually, Hanzlik retired from her job as a librarian and the pains went away.
“As it is now, you go to see what you think is your family doctor,” said Hanzlik, 75, of Rancho Cucamonga. “He says, ‘I think it’s your heart. You should see a heart specialist.’ He says, ‘It seems to be a rattle in your chest. Go see a lung specialist.’ And you keep going and you get very upset.”
Archibald is retiring to the comfort of his Rancho Cucamonga home, where he can spend time with his wife and their two dogs, a Pomeranian named Henry VIII and a sheltie named Patty.
The Archibalds’ ranch-style, four-bedroom house sits under giant oaks and alder. Family pictures hang on the walls, lacy curtains on the windows. Archibald’s handmade hooked rugs rest on the living room floor and his wife’s embroidered seat cushions on the dining room chairs. The bookshelves are piled with boxed Beethoven record sets, a Norman Rockwell art book, and issues of National Geographic and Reader’s Digest.
Around the back-yard pool, the garden is lush with rose bushes, fig trees and delicate cymbidium orchids. The back yard alone is enough to keep Archibald busy in retirement. Take that pesky custard apple tree, for instance, which requires hand-pollination with a camel-hair brush.
But Archibald will keep his black bag around for speeches to schoolchildren or emergency visits to neighbors. A couple of years ago, he showed his bag to junior high school students at his church.
What’s it for, they clamored. Is it for traveling?
