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101 n u Chapter Four u livelihood N In the early afternoon of November 27, 1873, someone in the G. Wilson E√erson household in Springfield, Louisiana, asked neighbor Washington King to carry a message to Dr. George Colmer. Sometime later, probably the same day, Colmer wrote this entry in his daybook: Nov. 27 (Thursday) About 2 p.m. Washington King arrived at my o≈ce with a request to go to E√erson’s house and relieve Mrs. E of an afterbirth. She sent word that she was ‘‘just as she was before,’’ and therefore instead of going out, Rx. Just below this entry, Colmer added: 28—Visit to residence—fetched by E√erson (Wilson’s brother). Started at 10b a.m., got back about 5b p.m. Went in Louis Shenk’s vehicle, drawn by Louis Shenk’s horse, and driven by [Winfield?] Christmas. Removed retained placenta and drew o√ urine with catheter. Child (a boy) born the day before. Removing a retained placenta was a risky procedure, and Colmer charged the E√ersons thirty-five dollars for e√ecting it, a hefty fee. In fact, it may have been a tense scene at the E√ersons’; on top of everything else, Colmer charged Mr. E√erson a dollar for a bottle of ‘‘medicinal whisky’’ prescribed, it seems, for Mr. E√erson himself.∞ George Colmer turned sixty-six years old in 1873, and the E√erson case was typical of how he responded to—and recorded—hundreds of other calls during his thirty-year practice.≤ His daybook notational style, though more detailed than most, is nonetheless typical of the informal, time-driven, heavily peopled 102 u doing medicine notes made by other physicians. Indeed, notes of this kind do not change in any significant way throughout the midcentury years, comprising one of the key texts that made for continuity in a physician’s sense of his work. Meant for his eyes only, daybook notes are terse and minimally reflective. By the same token, however, they are candid and wonderfully unapologetic, imparting a clear view of this chapter’s concerns: the fundamental economic and social realities of southern community medical practice that shaped, and were shaped by, the everyday routines of making a living. Part profession, part business, the physician ’s pursuit of his livelihood sketched with broad strokes his domain as he strove to lead, but also learned to follow, his community in matters of health. Drawing on daybooks, as well as on correspondence and other personal sources, the focus of this chapter is on the basic social and economic conditions of country orthodoxy: the essentials of making a living, the variety of patients and the influence of their views, and the way in which everything a practitioner perceived was shaped by making neighborhood rounds. The aim is to see this framework of everyday practice as having more than its material significance, however. It is to see it as doctors wrote about it, as a dynamic combining economic survival with moral purpose, making the physician into a certain kind of public figure. In this way, practitioners gained a new purchase on the desirable quality they called their ‘‘experience.’’ As his schooling suggested, a man’s sense of his experience was a coveted but problematic thing, richly subjective and personal, and yet something recognized by everyone. Although physicians thought of their experience as something they acquired, here they are seen as subjects shaped by the experience they created in the routines of making a living. And although there is much here that is distinctly southern—especially the social relations of slavery and the continuing reality of a biracial setting for medicine after emancipation—there is much in this wide-angled view, too, that tells us about the livelihood of orthodox doctors elsewhere in rural America.≥ As he recorded his routine in his daybook, a physician steadily wrote himself free from many of his early fears and wishes discussed in Chapter 3. He logged satisfying lists of people seen, recording their prescriptions and fees; he experimented with his eye for detail and context, which he would later develop at greater length in his bedside notes and case narratives. Daybook entries record surprise and happenstance, too, in his shifting personal relations with patients, thus opening up a glimpse of a practitioner’s moral bearings as he compiled what amounted to a rough dossier on the well-being of the families under his care. Consider again George Colmer’s notes...

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