Dr. Welby and Patient Care

“Simon,” I called in to the living room.  “The taxi is here.”

“Tell him to wait; I’ll be along in about half an hour.”

“How can I get him to wait half an hour?”

“Give him five dollars.”  I did.  The cabbie turned off the motor and relaxed with a cigarette.

I shed my coat and returned to the living room.  Lapius was glued to the tube.  There, Robert Young was impersonating a doctor and Lief Erickson was impersonating another doctor, and people were impersonating nurses, orderlies, receptionists and patients.  “For goodness sake, Simon, we’ll be late.”  He waved me to silence.  “It will be over shortly.”

I went into his study and buried myself in the latest New England Journal of Medicine.  I became lost in an interesting article when Lapius came lumbering in, “Harry,” he called sharply, “stop dawdling, we’re late.”  I suppressed some epithets and struggled back into my coat.

Seated in the back of the cab, crushed between Lapius and the side of the vehicle in a seat that was built for three, I groused.  “What’s the sense of going now?  The lecture will be over.”

“We’ll be in time for the refreshments, Harry.”

“I guess you were a great soap opera buff too.  Always late for dinner.  Couldn’t tear away from ‘John’s Other Wife, or Melody Street!’”

“As a matter of fact, I was.  I always enjoyed these slice of life episodes.  Show me a great novel that deals with the subjects of soap operas.  Oh, once in a while there is a story about tuberculosis, but its tragedy is recessed into a plot.  But the soap operas are about real life.  So is Marcus Welby.  No, Harry.  I believe that the great tragedies, the nitty gritty things, are life and death matters.  What is more dreadful than a member of a family developing a brain tumor?  These catastrophes are so poignant that the great writers haven’t the art to deal with them properly.  Look what happened to poor Erich Segal with ‘Love Story’.  He became the laughing stock of the intelligentsia as being camp, kitsch, maudlin and other unkind descriptions.  Yet the public loved it.  Why?  Because they could identify with the tragedy.”

“But it’s so obvious and unsubtle.”

“Of course.  What is subtle about a kid getting crushed by a truck.  Yet look at the range of emotion it must arouse in his family and friends.  After all, that is what the great novelists try to do, fictionalize some human trait that each of us recognized before.  But the soap operas do it with a sledgehammer.  They don’t probe or dig around the subconscious.  ‘Here’ they say.  ‘What’s worst than this death, or better than this marriage?  Each should evoke an entire spectrum of response in 15 minutes of airtime.’  I think they are pure genius.”  I looked at him to see if he was kidding.  He wasn’t.

“So how does Welby fit into this?”

“It’s the same sort of thing, it’s authentic.  Here’s a mature inside view of real tragedies and problems of life, except that there is hope.  The hope that medical science offers now is unbelievable, compared to even a score of years ago.  You don’t like Welby, I take it.”

“Oh I guess it’s all right.  But I find it funny when Kiley hangs an x-ray upside down or they give a lethal dose of something and the patient sits up in bed smiling.”

“Even real doctors make mistakes on occasion, Harry.  But the fact is that Welby promotes something that may soon disappear in American medicine, if third parties become paramount, if doctors become employees instead of independent practitioners.  That’s the doctor-patient relationship.  Foremost in the mind of Welby is his responsibility to the patient.  He doesn’t let himself be sidetracked by ancillary considerations.  While the patient is in his care he assumes guardianship, and brooks no interference with that responsibility.  I find it touching.  A great act of faith.  A good example to patients and doctors alike.  I’ve seen him fight off administrators, nurses, family, and even other doctors to accomplish what he believes is for the good of his patient.  I learn a lot, even medical things from the program.”  Meanwhile we had arrived at the Medical Society.  I paid the driver while Lapius ambled in.  He returned in a huff.  “There are no more refreshments, Harry.  Next time don’t dawdle so.  We’ll leave the moment Welby is over.”