Excerpt from “Doc, What’s Up?”
I never would have chosen “Smalltown, Minnesota” as the place to launch my career in internal medicine. In fact, I’d never heard of it until some shirt tail relations, who lived there, told me that the town was desperate for doctors. So, with only a modest inquiry, I quickly found myself my first job.
I agreed to work on Tuesdays and Thursdays as a pinch hitter for the town’s only doctor in this tiny Southern Minnesota farm community of 750 persons. This gave him time off from his otherwise non-stop duties so that he could follow his passion and fly his small airplane above and beyond all earthly tribulations.
The amicable Dr. John Jacobson was ten years my elder. He was short, pleasantly pudgy and surprisingly openminded. He was genuinely at ease amongst his farmer clientele and it was immediately obvious to me that he’d been raised from the same soil. I was quite the opposite: born and bred in the heart of Brooklyn, fluent in Brooklynese and the brazen product of New York City’s subway system.
Our working arrangement began as a marriage of necessity but, even with our distinctly different styles, it quickly grew into a partnership of mutual respect and admiration. John was thoroughly comfortable with himself as a GP, and didn’t hesitate to seek knowledge and advice when he found himself nonplussed with a patient’s condition. As a result, he often consulted with me on his more perplexing and intricate medical cases.
One of these cases was a six-year-old boy whom, a year and a half earlier, had developed a large disfiguring mass on the right side of his neck. At that time, John had consulted with a visiting surgeon who decided to remove the tumor. The surgeon sent a tissue sample of the tumor to the Mayo Clinic, only a few miles further south through corn country, whose excellent pathology department would determine its nature. The diagnosis came back—unequivocally—the boy had Hodgkin’s disease, cancer of the lymph nodes.
Because this took place a year and a half before I came on board, I could only imagine the shock that the child’s parents experienced when they’d heard such a dire diagnosis, as well as their relief when they were told their son had an excellent chance to be cured.
I didn’t review the boy’s chart until I saw him for his normal six-month check up. Based on a glance at his chart, I assumed that he’d been treated with radiation therapy. After all, he was still alive and doing very well. But when I checked his chart more closely, I saw, to my amazement, that the surgeon had advised that the boy not receive any treatment at all. When I examined him and found no sign of Hodgkin’s disease, I was even more dumfounded.
His parents told me it was a miracle. I thought to myself, either that, or a grave mistake… My investigative instincts were piqued at this point and so I began to search the boy’s records for clues that would reconcile the irreconcilable: a uniformly deadly disease—if left untreated—had disappeared on its own…??
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