Medical school is full of many surprises for all the students, from the lowly freshman to the “sophisticated and highly trained” senior. Some of the surprises are not very pleasant or comfortable, while others are delightful, especially when remembering them years later. Some of the most interesting and wonderful training experiences happened for me when I was serving in the Preceptor program during the summer between my sophomore and junior years.
The University of Arkansas School for Medical Sciences instituted the Preceptor program in an effort to give medical students practical experience with family practitioners in small communities throughout the state. The students spent 6 weeks shadowing their appointed preceptors, while learning first-hand what it was like to treat patients. Up to this point in our training, we had spent most of our time in the class rooms, and very little time with patients. Even though my dad and brother were doctors, and I had spent a lot of time in their offices, I was excited to get this different practice perspective. I was assigned to Drs. Eldon and Julian Fairley, two brothers in Osceola, Arkansas who had been in practice together for over 15 years. Osceola lies in the heart of cotton-growing country in Northeast Arkansas, and the cultural and agricultural environment are totally different from my home in the timberlands of South Arkansas, where oil production and refining are a way of life.
Their practice was unique for many reasons. Dr. Eldon was a bachelor who was totally dedicated to his medical practice. His office hours were from 8 to 5 every day, including Saturdays and Sundays! The only time he took a break from the practice was to attend Sunday school and church. Dr. Julian was married, so his hours in the office did not include Saturday afternoons or Sundays. Both men made house calls and admitted patients to the hospital, so they had to balance their office hours accordingly. Their patient population included a large number of Black-Americans, because of the demographics of the area. These were the years of racial segregation in the South, and they had “Whites Only” and “Colored Only” waiting rooms. Since many people who lived in Mississippi County had incomes below the national poverty guidelines, the office fees of the Fairley Clinic were extremely low compared to other areas in the state. They charged $3 for an office visit, and if an injection was given, the total charge was $5. Another interesting element of their practice was they delivered babies in their clinic. They had a special room designated for clinic deliveries, and they would deliver as many as 10 babies per month. The charge for a mid-wife delivery in the area was $25, and the Fairley’s thought their services justified a higher charge since they were doctors; so their fee for a clinic delivery was $35. The day I arrived I was told that I would be in charge of clinic deliveries which both excited and terrified me. I didn’t have extensive experience delivering babies; in fact I had only delivered one baby at the medical center, and it was an uncomplicated delivery. The Fairley’s assured me they would be within a few feet of the delivery room to give encouragement and help if needed.
It was about 4 pm on this particular Sunday, and the clinic staff, including Dr. Eldon had left for the day, since there were no more patients in the waiting rooms. I was alone in the library reading, when I looked out of the window and saw a woman walking by herself toward the clinic backdoor. As I walked toward the door, I heard her knock. As I opened the door, there stood a Black-American in her mid-30’s, obviously pregnant and appearing in a hurry. She said, “Is you the doctor?” “Yes mam,” I responded. “You better hurry!” I didn’t have time to call Dr. Fairley for assistance.
I quickly took her into the delivery room, which was next to the back door and helped her onto the table. As I was getting her prepped for the delivery, I asked her how many babies she had delivered, to which she responded, “This will make number 8.” When I had the sterile drape in place and took my seat on the exam stool, she asked the important question; “Is you ready?” When I answered, “Yes mam,” I noticed that she held her breath and pushed down as hard as she could. Her 8th delivery proceeded very quickly and could not have been any easier, both for her and for her young “doctor.” As I was tending to the healthy baby, the mother asked if she could go to the rest room. I helped her get there, holding onto her with my right hand while holding the baby in the other arm. I went back to the delivery room and got the baby cleaned and powdered, while he calmed down from his initial crying. He was beginning to get used to his new environment and needed some rest from the ordeal he had just endured. I filled out his birth certificate and walked to the rest room door, where I asked the mother for his name to add to the certificate. “I’m calling him James, she said, “and would you mind calling me a cab?” I assisted her back to the delivery room where she held James for the first time, and they immediately bonded. I had her sign the birth certificate, and she paid me $35, thus completing the business side of this whole transaction.The cab arrived and I helped her into it with James, and they left for their home to be greeted by seven excited siblings. I happened to look at my watch, and the entire process from the initial back door meeting to the awaiting cab took 45 minutes!
For some strange reason, I felt I had done a full day’s work in that 45 minutes, while at the same time had experienced something few other doctors had. I was extremely glad I was training to become a doctor and delighted they had assigned me to Dr. Fairley’s clinic for this once in a life-time experience. Since that unusual experience in Osceola I have always sought to “be ready!”