What I Learned from Ike
Louie,
in the early, to mid-fifties, the United States was preoccupied with Ike. During the Second World War, we had become attached to Ike as our commander, and leader. In 1952 we elected Ike Eisenhower as president and he assumed a position of elder statesman, the leader, the teacher, the revered, and sometimes the maligned ex-president. There was a real love and admiration of the and most of the nation worshiped him in his leadership. I also knew an Ike, not Eisenhower but nevertheless an Ike from whom I learned a valuable lesson.
My friend Ike was a bartender in Hartford where I lived and practiced medicine. He became my patient and my friend. During that era, the practice of medicine was somewhat different than at the present. More solo docs were in practice; there were fewer doctors, more generalists, and more individual effort with fewer referrals. Tragedies were borne by solo physicians to a greater degree. And there were more tragedies, less was expected, and less was obtained. Diagnostic procedures were fewer and less sophisticated; the gain in diagnosis was less and expectations were not as great. Referral hospitals so often did not afford greater diagnostic or therapeutic help. It was the age of change and expectation. There was a sense of impending change in technology. This was appreciated by the younger physicians who awaited newer techniques and procedures. While we waited, while we practiced alone and not often in groups, we bore the worries of patient care and worried. We often sought out a friend to ease our burden of anxiety. To speak with a listener of confidence was a benefit.
I well recall working in the office all day, seeing ten to twelve patients twice daily in the hospital, delivering babies, tending the emergency room during night and day, and often being so very tired.
During the first two years of practice, I was literally never at home. Many nights I would go home after midnight and I would stop at Ike’s for a beef sandwich and a glass of milk. Ike and his assistant bartender made the best beef sandwiches in the county, and around midnight the tavern was near empty. For just a few minutes I was alone; I ate the sandwich, drank the milk, and closed my eyes. Ike was smart and observant. He said nothing until I spoke. Many nights we spoke of the Braves, the Packers, the high school teams, the local politicians, and not much else. After a quarter-hour or so I would go home. We grew to know each other during those weekly stopovers, and we learned to respect each other. I soon began to see him in the office for treatment of his diabetes and hypertension; he learned of my family and I learned of his. He had diabetes, high blood pressure, obesity, and flat feet. He was about 55 years of age, laughed a lot, and weighed in excess of 250 pounds; as mentioned his feet were flat, his belly was round and he laughed like a bowl full of jelly.
It is surprising how much one can learn of another during brief encounters. I learned of his bowling prowess, of his encounters with the law during prohibition, of his family, and of his wife who poorly controlled her type one diabetes. I learned a great deal from him, but the greatest lesson was to begin to recognize the insidious onset of chronic depression, which I later called bartender’s disease.
One night Ike was quiet, he mumbled to himself as he counted the money in the register and reconciled it to the paper printout. I had become aware that this exercise took place each night and it apparently was not an enjoyable exercise. One night I asked him why he mumbled so much as he counted. He looked at me, teared up, sniffled, and said. “Doc, it’s a hell of a life when all you have at the end of the day’s work is a handful of receipts. I say the same things, ask the same questions, listen to the same jokes - day after day. And this is all I have”. He readily admitted that his business was good, but oh how he wanted to study law! He became quiet, he said he was depressed and I left.
We spoke of the problem a few more times, anti-depressants helped, when he remembered to take the meds. He was hospitalized for depression on one occasion, fared better when he took a summer vacation and watched the Cubs in Chicago. In 1958, during a flu epidemic, he took sick with the flu, was hospitalized, developed the smoker’s adult respiratory syndrome, and died. He died on my service and during his stay, he called me into his room one night and said. “Don’t work too hard; take time to develop a hobby, learn to know your wife and kids, and remember, at the end of the day show a product, not just a box full of receipts.”
That’s what I learned from Ike.
Jim