The Country Doctor and the Specialist—Excerpts

THE COUNTRY DOCTOR AND THE SPECIALIS ?—EXCERPTS* FRED LYMAN ADAIR, M.D. Editor's IntroductoryNote.—Anyone interested in thedevelopment in America of the modern specialities of obstetrics and gynecology out of the general practice of the horse-and-buggy doctor should be fascinated by the autobiography of Dr. Fred Adair, son ofa country doctor. We thank the author for permission to publish the following excerpts. On a wet, muddy day in May 1870, a young doctor arrived in the town ofAnamosa, Iowa, to open a practice. He had come about thirty miles, over dirt roads that were not easy to travel in any weather. About ten days earlier, during an otherwise pleasant trip for a first look at the town, he had got stuck in a slough so badly that the horse lost its footing, and there was no remedy but to "unhitch and draw the buggy out by hand." On the second trip things were a good deal less pleasant. He explained in a letterto the girlhehoped to marry, "Icouldnotwriteyouyesterdayafternoon , was too tired and wet and had too much to attend to. I had a miserable bad time coming through." He went on more cheerfully, "I am in my office, nicely rigged and have secured a place to board and have nothing to do now except to wait for the first victim." The young doctor was my father, LymanJoseph Adair; the girl, Sarah Jennings Porter, later became his wife and my mother. In the meantime my father had completed a course of study at Rush Medical College in Chicago. ... at that time there was a student body of about three hundred; the tuition fees up until 1879 were about seventy dollars annually. There was a regular faculty oftwelve professors, which * Published by and available through the Adair Award Fund, Box 6$, Maitland, Florida 32751. 63I during the spring term was augmented by as many more. I especially recall hearing my father speak o£Moses Gunn, a surgeon who had recently come from Ann Arbor, and ofE. Fletcher Ingalls andJames H. Etheridge. Dr. Ingalls was still active when I became a student at Rush Medical Collegejust over thirty years later. During myjunior year ofmedical school I decided to transfer for my final year to Rush Medical College in Chicago, where I received my degree in 1901. The reason for my decision was threefold: first of all, my father had received his M.D. degree there in 1870; second, there were larger clinics and better clinical teachers—Fenger, Senn, Hyde, Montgomery , Billings, Herrick, and many others associated with the Presbyterian and Cook County hospitals; and finally, Chicago offered better opportunities for an internship. In the meantime, my father and Ihad begun to discuss plans for opening a practice together. But those plans were never to be fulfilled. . . . the future was clouded by sadness and uncertainty, now that my father's medical career had ended before my own had quite begun. Those were still horse-and-buggy days. # * * When I moved to Minneapolis, I took with me for my mother's and my use a standard-bred mare, Lady, whom I had cared for as a colt. For home delivery calls, a horse and buggy were not always the most convenient form oftransportation, and I usually took the streetcar. Here the disadvantage was that on most ofthe lines the service ended at midnight . I recall one occasion when I fell asleep and woke up only at the end of the line, where there was nothing to do but wait for the final return trip. In the process ofbuilding up the home delivery service I began to develop a specialty, but without limiting my still meager private practice to that field. 632 Fred Lyman Adair · The Country Doctor and the Specialist Perspectives in Biology and Medicine · Summer 1969 The year abroad came to an end, my research was completed, and my money was running out. We returned to Minneapolis, and it was then that I decided to practice as a specialist. At that time there were no doctors in Minneapolis who limited their work to obstetrics and gynecology. So, in the fall of 1929, 1 wound up my professional and business affairs as...