Bridgeville: the House and the Practice. Chapter 1.

 

                                                  

                                                    

              They tore down the house yesterday.  (April 17th, 2015) My friend, Ellen, sent me a message on Facebook.  She had driven past the house yesterday morning on the way to the vet’s and all that was still standing was the living room and the stairway.  She says the town bought it, maybe for taxes?  She doesn’t know what they are planning to do with the property.

 

              I first saw the house 35 years ago, in 1980.  It was raining and my first thought about the town and the house was “rural ugly”.   Later, when I saw them both in the sunshine and lived in the house and the town, I realized they were beautiful.  The house was a white, clapboard, Victorian, with a wraparound porch on the front and the south side.  An office was attached to it on the north side.  I never did know what year it was built, but it had been a doctor’s office since 1914.

 

               The doctor before me started his practice there in 1929.  He had a hitching post out front for people who rode horses to his office.  He saw his patients on a “first-come, first-served basis”.  One half of the office was a large waiting room.  People told me they would bring their knitting and their lunch and wait to see him.  The waiting room didn’t have magazines; it had books!  Office visits were $10, and people paid cash.  He closed his practice in 1979.  Friends from the county medical society visited him and told him to expect the Drug Enforcement Agency to show up the next day to investigate some of his prescribing practices.  He walked into the waiting room and announced that he had just retired and people would need to find another doctor.  He had practiced there for 50 years.

 

              I had just finished my internal medicine residency at Temple University Hospital in June 1980.  During my residency, I had been mugged three times.  Well, not exactly mugged.  The first incident was a rock coming through my living room window that hit me.  If it hadn’t hit me on the shoulder, if I’d just come home to find the window broken and the small rock on the living room floor, it might not have bothered me so much.  But when it hit me on the shoulder, and I looked at the rock on the floor, I thought “that could just have easily been a bullet”.  I looked for a new apartment and moved, just 5 blocks away, closer to the medical school, but no longer across the street from two high rise public housing projects. 

 

              The second incident happened at Temple, when a boy came through the window of my on call room.  I awoke when he stepped on the bed next to my head.  He had a knife in his mouth.  When I screamed (I don’t think it was a scream that came out though), he spun around and raised the knife.  Fortunately, Evelyn, another resident was in the other bed.  She thought the shadow she saw was me, having a nightmare, stood up and put her hand on his shoulder.  When her hand hit the leather jacket, she knew it wasn’t me.  The boy looked at both of us, said “I don’t want no trouble” and dived out the window again.  We called security, but the person who took the message didn’t catch the room number, so the officer went through Brown building, where the residents on call slept, knocking on each door, and if a man answered, just said, “Sorry, wrong room” until he found us.  He asked how big the knife was.  Have you ever been lying in bed and looked up to see someone standing over you with a knife?  It looked about 3 feet long!  He took our report and we went back to bed, somewhat nervously.  We got more nervous when we heard footsteps coming up the fire escape, and a voice say “Hey this must be the room; there’s two broads in here”.  Security had called Philadelphia’s finest.  The officers argued that no one could have come in that window.  They were both big men and were trying to get over the rail, which was about one inch away from the building, and through the window.  Finally the larger one realized he had to go under the railing, and came through the window brushing off the knees of his uniform and complaining “I guess that guy didn’t care if he got dirty”.  At that point, we gave up and spent the rest of the night in the emergency room. 

 

              The third incident was a mugging.  It was 5:30 on a September evening, still broad daylight.  I was doing a rotation at Germantown Hospital.  It was payday and I was ready to leave at 5 pm with everyone else but it was raining really hard.  The resident’s lounge in the on call room had a piano and stolen minutes there were the only chance I got to play, so I played piano for ½ hour, walking to the parking lot alone.  There was construction going on, and the field behind the parking lot had been cleared, except for one large tree at the edge of the lot.  As I walked to my car, I saw two men sitting on the ground under that tree, under an umbrella, which I thought was odd.  As I turned aside to go to my car, they got up and went behind the tree.  As I was putting the key in the car door, they came out with stocking masks on their faces and put a gun to the back of my head.  They took the keys out of my hand, my purse and plastic bag of articles for a report I was doing off my arm, my wristwatch off my wrist and went through my pockets.  Then they ran off.  I was surprised that they didn’t take the car.  I had the presence of mind to pull the distributor cap before I went to the hospital to talk to security.   The security guard called the police, and while we were waiting for them, went back to the scene and walked through the field with me.  We found the bag of articles and the wristwatch (apparently Timex wasn’t good enough for them), but not the purse.  They had all my keys, since the extra set was in the purse, and my address.  So after I spoke to the police I had a locksmith come and change the locks on my ar and called my landlord to get the locks changed on the apartment, and stopped the credit card and cancelled the checking account.  I had the hospital cancel my paycheck, which I hadn’t cashed yet, and issue a new one.   Two days later, some children from an orphanage on the next street came to find me.  They had the purse, wallet and credit cards intact.  All they had taken was $6.00 in cash from the wallet. 

 

              From my point of view, it went from a rock to a knife to a gun and I hadn’t been hurt yet.  It seemed to me it was time to leave Philadelphia.  I had grown up in that city, worked in Baltimore for two years between college and medical school, and moved back to Philadelphia to go to the Medical College of Pennsylvania.  I had always wanted to live in the country but wasn’t at all sure I’d like it.  So I applied to the National Health Service Corps (NHSC), which put doctors in underserved rural areas.  I didn’t owe them; they hadn’t paid for my education, but I thought working for them was a safe way to try living in the country, without the expense of setting up my own practice.  I was in a relationship with a man who lived in Baltimore and owned a house outside of Crisfield, Maryland, so I wanted to head down that way.  We had been doing the long distance relationship thing for 7 years and it seemed it was time to get geographically closer. 

 

              So I interviewed in Harrington, Delaware for an NHSC site, but I would have been sharing an office with a family doctor who refused to be involved in the interview process because he didn’t think the town needed another doctor.  I knew that one wasn’t going to work.  I then interviewed with two NHSC doctors in Chincoteague.  One was finished with his service time and was leaving, the other loved it and was staying.  I agreed to take the position.  However, after I went back to Philadelphia, that doctor decided to buy out the practice and solo it.  However, the office manager for NHSC decided then that they would put a clinic at Oak Hall, a one street town at the intersection of Route 13, the major north-south road, and the road to Chincoteague.  They bought some land and someone donated a building.  I went down when they moved the building, and went again for a health fair in Onley, Virginia.  I did free pelvic exams and talked to lots of people and found a place to live.  I was psyched!  I was rotating on infectious disease then and did a presentation on zoonoses (diseases people can catch from animals) in the Delmarva Peninsula.  I threw a map out on the table, explaining the peninsula as looking like a muskrat swimming north, with his feet paddling in the Chesapeake and his tail the 80 mile Virginia portion and showed everyone where I would be practicing.  Then, three weeks before my residency ended, Nixon cut the NHSC funding and I was told the clinic wouldn’t be able to open. 

 

              My mother lived in Germany then, working for the US Army Corps of Engineers as a contracting agent.  I had planned to visit her for three weeks when my residency ended.  In the three weeks before I went to Europe, I took the national hospital directory and wrote to all the hospitals on the Delmarva Peninsula, and a few on the western shore of the Chesapeake, and a couple in central Pennsylvania, just in case.  I got my first response as a phone call the next day, from Ed Hancock, the CEO of Nanticoke Hospital in Seaford, Delaware.  His hospital had just decided on a physician recruitment program, looking at what they thought they would need in the next 5 years, and then my letter came.  But I was going to Europe and when I came back, he was going away.  So it would be mid-August before we could meet. 

 

              So I went to Germany.  It’s cheap to go to Europe when your mother lives there, and I pulled my usual “Oh, Mom, I left my wallet on the kitchen table” routine.  When I came back, I worked the emergency room at Germantown hospital (yes, the same place I’d been mugged with the gun), and set up interviews at the hospitals that had responded.  I interviewed at Crisfield, a little 40 bed hospital, where it seemed I would be very alone; Salisbury, Maryland, a large regional hospital, where it seemed I would just be a referral source for the specialists; Kent county, where the administration was very encouraging but hadn’t asked the staff if they thought the area needed another internist (I found an internist to talk to who actually took me home to dinner and said he thought the area could use another internist, but I was put off by the lack of communication between administration and staff); Milford hospital, where the doctor’s had a very formal tea and talked about planes and farms and how much money they were making.  I talked to a doctor in Maryland who was looking for a partner.  He was at another small hospital without much coverage and was working all the time and had no life.  I went to York, Pa. and St. Mary’s on the western shore.  My tenth interview was at Nanticoke Hospital in Seaford. 

 

              I stayed at Ed Hancock’s house, with his wife and children.  I still remember the dinner the night I arrived: chicken divan and zucchini bread.  I still use Barbara’s recipes.  They wanted to put a doctor in Bridgeville, a town 7 miles to the north.  The doctor who had been there before admitted to Milford hospital, 16 miles to the north east, and Nanticoke wanted to capture the business from Bridgeville.  Bridgeville had had 3 doctors for years, and the area had always had a woman.  There had been a woman doctor in the Bridgeville area in the late 1800s.  She graduated from Women’s Medical College in Philadelphia, which became Medical College of Pennsylvania when it went coed, about 9 years before I started school there.  Then there was Annie Shipley, who practiced in Seaford in 1910, followed by Kitty Gray, M.D. who also graduated from my alma mater.  She had retired in 1974 and died two years before I moved there.  So I wouldn’t face one of the challenges of rural practice anyway; the area was used to women doctors. 

 

              So Ed showed me 3 possible office locations in Bridgeville, including the one that had been vacated a year and a half earlier, and had the house attached.  He had plans and an estimate for the renovations he thought would be needed in the office.  I had lunch with the medical staff.  They talked about medicine and almost came to blows in an argument about whether there was a place for peritoneal lavage in hemorrhagic pancreatitis!  What a difference from the "farms and planes" conversation just up the road in Milford.  Then Charlotte Cannon, one of the hospital board members who lived in Bridgeville, had a cocktail party for me. Smart lady!  She invited 1/3 people connected to the hospital, 1/3 people from Bridgeville who hadn’t had a doctor since the previous one left, and 1/3 people in their 30’s, so I would know I could find friends.   

 

              So I accepted the offer.  The financial arrangement was interesting.  Remember, this was 1980!  They advanced me $7,000.00 to buy what I needed for the office.  Then, when the office was open, they would guarantee an income of $4,000/ month.  If I made less than that, they would give me the difference.  If I made more than that, I would start paying them back, as a no interest loan.  I went back to Philadelphia, gave my notice at Germantown hospital, looked at catalogs and ordered supplies, including an electric typewriter, an EKG machine, otoscope, ophthalmoscope, suturing and dressing materials, instruments, incubator, small refrigerator, exam tables, file cabinets, patient charts, urine dipsticks, blood sugar machine, blood pressure cuffs, thermometers, everything I could think of or see in the catalogs that I thought I would need.  A friend gave me an old chemclave to sterilize instruments.  My grandparents and friends helped me to move the 100 miles south to the house.  The doctor who had left offered to rent it with an option to buy in two years, agreeing to accept the rent as the down payment.  

            The signs on either end of Bridgeville, as you approached on rte 13, read "Bridgeville: If you lived here, you'd be home now.  I was ready to come home.