Country Doctor, 1950

Even in the age of specialization in medicine, three-fourths of the people in the U.S. are born, live and die under the care of a general practitioner, their family doctor. In country districts the proportion is far higher. There, the relationship between the ailing and their doctors has not changed much since homesteading days. But there has been a great change in country doctors themselves.

Last week, the change was evident in the tiny (pop. approx. 1,000) crossroads town of Arnold, in the rolling sandhill country of western Nebraska. Dr. E. (for Elmer) Howard Reeves and his partner,

Dr. Robert A. McShane, received 300 patients in their office, made 40 house calls, delivered four babies, performed two operations. All the babies were born and both the operations were performed in Arnold's ten-bed private hospital. None of the cases was medically unusual, but this kind of service was the reason for the doctors' being. At 30, Dr. Reeves is the senior member of a two-man medical team which is responsible for the health of about 5,000 people scattered within 45 miles of Arnold.

Crowded Hours. Outwardly, the routine of Arnold's doctors is much like that of the traditional horse-and-buggy doctor. Up every day of the year by 7:30, Dr. Reeves takes time for a good breakfast with his pretty brunette wife Jean and their children, Steven, 5, and Pamela, 3. By 9 o'clock he is off to the partners' office on Highway 92, half a block from Main Street, where blonde Mrs. Audleye Nelson, receptionist and bookkeeper, gives him a list of the day's first house calls. These, with morning hospital calls, afternoon office hours and after-dinner calls, keep him busy until 11 p.m. And nearly every night he has to get up and dress to go to a patient's home or the hospital.

Also like the oldtimers' is Dr. Reeves's relationship with his patients. He knows most of them by their first names. (Nobody, not even his wife, now calls him anything but "Doc.") Born & raised on a farm near Madison in eastern Nebraska, Doc Reeves can talk with his patients about stock and crops, fodder and weather. In his office or at the hospital he can hear the shrill yipping of cowboys as they drive a herd of red Herefords through the middle of town to a feed lot. Many of his cases are cowboys with broken bones or farm boys with mangled hands.

Big Business. Where Dr. Reeves and his partner, roly-poly Dr. McShane, 26, differ from oldtime physicians is in their methods. They carry few pills in their black bags, and rarely dispense medicine. (Their patients give the local drugstore $12,000 in prescription business a year.) In two years Dr. Reeves has never delivered a baby at home, nor performed surgery outside the little yellow stucco hospital on the edge of town.

As he sees it, the days of appendectomies on farmhouse kitchen tables are gone, and good riddance. "You can train the public to plan in advance and get to the hospital," says Dr. Reeves. "It's better for the patient and better for the doctor. In this day & age, there isn't much point in practicing under pioneer conditions."

To get farther away from pioneer conditions, Dr. Reeves has lent the hospital an electrocardiograph. Last week the partners installed a $5,000, hospital-sized X-ray machine to replace a portable model they had been using. Come spring, they will start building an office of their own to replace their present rented quarters (which replaced a wooden shack where Dr. Reeves had to practice at first). It will be big enough to serve as an outpatient clinic. In it will be still more modern equipment, notably diathermy and basal metabolism machines. ("With those," says Dr. Reeves, "we'll have all the essentials.") Finally, there will be facilities for a skilled laboratory technician to make the countless tests demanded by modern diagnostic methods.

Dr. Reeves's objective is clear: "We want to be able to practice medicine in such a way that fewer & fewer people will go to Omaha or the Mayo Clinic in Rochester. I want everyone in the community to have the advantages now limited to those who have the money to go to some distant clinic."

For the Team. Husky Doc Reeves looks what he is: an ex-football player. Just short of six feet, he still has a lithe, athletic bearing, no trace of waistline bulge. A broken neck (compression of the fourth cervical vertebra), suffered in the last quarter of his last game as a guard at Midland College at Fremont, still bothers him occasionally and he gets Mrs. Reeves to massage it. To encourage high-school athletics, Dr. Reeves serves (without fee) as physician for the football and basketball teams.

Graduated in 1946 from the University of Nebraska's College of Medicine in Omaha, Dr. Reeves served a year's internship at Southern Baptist Hospital in New Orleans, then cast about for a place to settle where he would feel at home. An advertisement in the Journal of the American Medical Association took him to Callaway, Neb., as assistant to a general practitioner. The young doctor had to make several calls in nearby Arnold, where a doctor had recently died. He liked the place, and within a few weeks moved in.

Winter Harvest. The first months were even busier than Dr. Reeves had expected. Before a year had passed, he called in Dr. McShane, just graduated from his own old school, and made him a partner.

Dr. Reeves hoped that a partner would cut down his 16-hour day, seven days a week. It helped, but he still has few chances to get away to the irrigation spillways to cast for bass, or onto the prairie to hunt for quail, or to the hills for antelope. Grinning, he sees a connection between last winter's blizzards (when he had to make farm calls by horse team or "weasel" tractor) and the heavy obstetrical practice in the last weeks of 1949: "The blizzards kept most people home, and we're just reaping the benefits now."

Materially, country doctors are far better off than they used to be. Though their fees are moderate ($50 for a delivery, an average of $125 for an appendectomy), Drs. Reeves and McShane are estimated to gross more than $20,000 a year each. And still, like oldtimers, they give onefifth of their service to those who cannot afford to pay.

Dr. Reeves believes that he could never be happy out of general practice. "I don't think a doctor should be a scientific automaton," says he. "He has to be a warmblooded human being, capable of sympathy and understanding." And Arnold's general practitioner is resigned to the long hours: "A doctor ought to be busy; he can't be happy or proficient otherwise. But of course there is that matter of fishing. A man can go stale from too much work, so everybody ought to go fishing now & then."

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