Milan family oral history relates the story of my maternal grandmother Marie Teresa Scheick Milan, who, following the death of her only son, John, of the Black Measles in 1901, sold their house in Westchester County and with her husband, mother-in-law, and oldest daughter, Marrion, moved from the pestilence of the cities and became a farmer's wife on Poughquag Mountain in Dutchess County, New York State. On The Mountain, as my family has always referred to it, except for the school teacher, she lived as the only literate woman there. And only at her behest would the doctor. The rest he left to her. And there my grandparents raised seven daughters, leaving The Mountain when the youngest, my mother, Roberta E. Milan, was twelve.
Family Medicine in the Mountains of New York in the Early 1900's.
We loved the stories my mother told with themes that touched upon the notion that while the neighbor children were kept at home to help with chores, the Milan girls populated The Mountain's one room school house. Just as we loved the broad stroke description my grandmother as midwife doing as she could-swaddling the healthy and burying in cigar boxes those who were stillborn. And of Adelaide who had a growth on her cheek for whom my grandmother sterilized the razor and white thread and needle in the hot oven, removed the growth with a quick cut or so, and sewed it up with white thread, leaving only a fine line across Adelaide's cheek-nothing compared to the large ugly cyst that had deformed her face.
Family Medicine in the Years of the Great Depression
About the time I was born, coming out of the Great Depression as we were, going to a doctor or a dentist was more than most could afford. As a result, my mom took care of Artie Whalen who lived across the street when he developed blood poison in his knee. Those were in the days before penicillin. How he lived I have no notion, but he did. His parents had to work so days he stayed on our couch with my mom half carrying him back and forth to the bathroom as necessary.
Meantime Margaret, who lived downstairs from us, had five children and an abusive husband and rather than starve the family more than it already was, chose to push the refrigerator back and forth across the floor until she aborted.
Eventually the neighbors scraped together enough money to purchase Margaret and her five children a one way ticket to California and to safety from her husband whom everyone was convinced would soon kill her if she stayed.
No one ever heard from Margaret or her children again and to this day she remains a question mark in my mind.
Family Medicine in the 1940's
Then in the second world war, when my dad worked in the shipyard, he picked up a piece of metal in his finger and developed blood poisoning around the heart. It was summer when he went to the doctor. Hospitals were out of the question. The doctor told my father he would have to be brave so he gave him a swig of whiskey and told him not to move.
My father held his arm above his head and the doctor lanced the sacs that were visible under his arm. They drained for weeks, burning his skin so my mom taped sanitary napkins along his side and somehow he lived. If we sometimes asked him, he would lift his arm to show us the two well-defined scars where the knife had entered. But he lived.
Medicine was different then.
What I have told above is only the tip of the iceberg. There must be twenty more family stories of similar ilk that I could tell-not all, however, with as positive endings. Still I wanted to set the stage for comparing my past family medical encounters with my most recent surgery-done just yesterday-to remove a small bony growth-a bunion-from the top of my right big toe. The sequence went like this.
At my first appointment with the podiatrist, he x-rayed my toe from three directions after which he shared with me the images as we consulted on just how conservative we could cause the operation to be. The doctor, a very ethical man who communicated calmly and directly and was amenable to the notion that in the effort keep the healing period as brief as possible as much as possible he would keep the bone removal only to the outer surfaces of the it. He then instructed me to get some blood work and a medical clearance from my primary physician and left me with a nurse who questioned me
in-depth about my medical history in a pre-surgical interview.
My Primary Doctor
On the day of my visit to my primary there was no waiting. He talked to me, a nurse did the required cardiogram, and the blood was drawn on the floor below the doctor's office in the laboratory and I left. The results came in the mail two days later, well before the date of the procedure.
A day or two prior to my appointment in the same day surgery unit, a nurse from that unit called me with a detailed list of instructions I was to follow that included that I wash my feet with Dial antibacterial soap, remove any toenail polish, and cleanse well between the toes-a direction which brought a smile to my face.
The Procedure (Operation)
On the day of the procedure-yesterday-again I was interviewed, that time by the intake nurse, the anesthesiologist, the podiatrist, and operating room nurse. Each had their own specific and thorough set of questions the result of which was that the decision was confirmed that I would be ‘awake' during the procedure-we no longer referred to it as an operation-as they would be using a type of intravenous anesthesia that was to only depress the central nervous system without requiring intubation or masking.
The event went smoothly. The gentle and pleasant older Indian from India anesthesiologist talked to me occasionally asking how I was and letting me know how much longer the procedure would last. My arms were fixed to the operating table but I lacked any volition to move them-or any part of me for that fact-except when my nose itched-but not to the point of the unbearable. I could feel the doctor moving my foot and ballooning clot-prevention stocking moving up and down-although initially I thought it was the doctor pushing my leg around. Beyond that nothing until they loosened my arm straps and the intravenous feed tube at which point I was asked to scootch over to the trolley that would take me to the recovery room.
I was done.
The Importance of Family
One of my sisters had accompanied me to the hospital when I reported there at 6:30 a.m. for the operation which had been scheduled for 7:30. The time after 7:30 included the physician and nurse interviews and operation. By 9:00 we were done.
My sister had been joined by a second of my sisters so the three of us waited in the recovery area while I drank coffee and juice and chowed down on a few graham crackers.
Around 9:30 we said our goodbyes to the nurses and left, taking with us a cane, a prescription for Vicodin against pain and Keflex to prevent infection as well as several pages of written instructions related to my appropriate post surgical care and some possible red flags for which, should one occur, it was recommended we call one of the doctors whose names and phone numbers had been listed near them.
All in all, neither an uncomfortable nor frightening experience at all. And certainly a far cry from that of my grandmother fleeing the pestilence of the cities and operating with sterilized needles and thread from the oven of a kitchen stove; or my father braving through the lancing of pus sacs with knife but no anesthetic; or Margaret pushing an old refrigerator back and forth across a kitchen floor to abort an unwanted fetus in a family that was already undernourished.