DR. TOM STOLEE, M.D., CONTRIBUTED THE NEXT FIVE STORIES
Doctor Tom Stolee, M.D., a fellow in the American College of Pathologists, is a decades-long friend and mentor. As he acknowledges, he had the good sense while in medical school in Minneapolis to marry the daughter of a Norwegian fisherman from Minnesota’s North Shore. His own Norse forebears gave approval in unusually flowery language: “Good.” Years of consultation in rural hospitals solidified for Dr. Stolee a respect for the role of a country doctor. In his words, “The most critical part of medicine is primary care. The country doc has the most difficult job in medicine.” Further, “If anyone does not have access to affordable health care, then we have failed as a profession!” These values guided Dr. Stolee’s career. During a stint as president of the Minnesota Medical Association, and as a delegate to the American Medical Association for more than a decade, he championed the cause of rural medicine. He was equally dedicated to improving the quality and availability of health care to minority people, both urban and in Minnesota’s far-flung reservations. He lived what he preached and even in retirement continues to advocate for rural health issues.
Let me introduce Dr. Tom Stolee through a few stories from our common experiences:
Consultants
Medicine’s broad panoply of knowledge expands like the shock wave of an explosion. Specialists... consultants... keep a patient healthy and a country doctor sane. Thank you, good colleagues.
Perhaps the most trying part of being the only doctor for miles in all directions was—being the only doctor for miles in all directions. No one with whom to commune. To state the obvious, medicine, the science and art, is complex. City colleagues have consultants down every corridor. During my years of frontline rural practice, I had in-office colleagues less than half of that time. There is no more lonely a feeling than to arrive at office or hospital emergency room and find some catastrophe for which my experience and training are sketchy at best. There is simply too much to know!
Over the years, two highly specialized kinds of doctors came willingly to visit my remote community, and on a regular basis: A radiologist and a pathologist.
Our visiting radiology consultant spent one day a week in town. He read every x-ray taken during the previous week, a safety net for patient and physician alike. I particularly remember and honor Gib and Fred for all they did for us.
Besides performing autopsies, a pathologist examines tissues removed during surgery. An ultimate diagnosis depends on what a microscope reveals. There is NO place for guesswork in medicine! The discipline of pathology also includes supervision of laboratory procedures, vital quality control. For years, we were thus blessed during twice-a-month visits from a Duluth pathologist. In addition, he provided timely updates on current concepts in medicine, essential to keeping up for an isolated doctor. Thank you, Art and Tom and Dave.
A Frozen Section
A visiting surgeon was due in our North Shore hospital one wintry Wednesday morning. I would assist him in removing a man’s stone-filled gallbladder. A woman had consulted me the day before regarding a lump in one breast. She needed a biopsy to make sure that it was not cancer. Dr. Tom, our visiting pathologist, was also due on the same Wednesday morning. I worked the telephone. Dr. Tom, could you, would you do a frozen section of the lump if Dr. Surgeon would agree? Ever helpful, Dr. Tom agreed that he could bring the equipment necessary to do the test. Next, I called Dr. Surgeon; could you, would you, biopsy and if positive, do the necessary operation? He also agreed.
Dr. Surgeon removed the breast lump and Dr. Tom accepted the specimen at the door of the operating room. Still gowned and gloved, we waited. Ten minutes. Twenty. Dr. Surgeon cocked an eyebrow over the top of his mask. Thirty. Then Dr. Tom reappeared, a grin apparent around his surgical mask.
“All clear, benign.”
He winked and motioned to us to follow him back to the laboratory. “Blasted cryostat sprang a leak of refrigerant,” he said, “wouldn’t freeze the specimen. No repairmen within a hundred miles. So, Ray Critchley (our resident genius of laboratory and x-ray technology) and I wheeled the machine outdoors. Ambient temperature was minus 28 degrees. Cold did its thing, and voila! A frozen specimen.”
North country make-do; mission accomplished.
The Importance of a Pathology Report
At one of our twice-monthly hospital pathology conferences, Dr. Tom waxed eloquent on the topic of studying surgical specimens. His dictum: “If it’s worth removing, it’s worth pathological examination. Period, end of discussion.”
Yes sir.
A couple of days later, Mrs. Adamson came to my office with a complaint of a malodorous vaginal discharge. I examined her and discovered a long-overlooked tampon in her vagina.
I was about to discard the offending artifact, then remembered Dr. Tom’s injunction. I grinned an evil smirk and solemnly packaged up the sodden tampon, sending it off to Duluth.
In due time, I received a formal pathology report. Dr. Tom’s diagnosis: “A clear case of cotton-picking syndrome.”
To Hitch a Ride
Dr. Tom had a 7:30 a.m. date at one of the rural hospitals for which he served as a consultant. He left Duluth, headed east toward Wisconsin, at 5:30 on a brisk January morning. Translate brisk as twenty-five below zero. En route, a horrible noise erupted from a back wheel of the car. It proved to be almost red-hot. He managed to reach a service station and left the wounded vehicle. Traffic had been wintertime light. Finally, a loaded logging truck rounded a bend and Dr. Tom stuck out his thumb. He explains what happened next:
“Where you headed?” asked the driver as he began a series of gearshifts.
I told the man my destination, Dr. Tom said.
“Do you live there?”
“No, I live in Duluth.”
“Oh, do you work out here?”
“Sometimes, like today.” I dreaded the obvious next question; here it came.
He asked, “What do you do?”
“I’m a doctor.”
He cocked an eyebrow. “Do you always hitchhike over here?”
“Well, you know, Medicare payments are really bad.”
The man nodded. “Yah, I understand. The government will screw you every time.”
We had a good, if kidney-jostling trip. Arrived in town, I told the man I could get out on the highway. He looked around, said, “I don’t see any hospital.”
It was several blocks away, I explained.
“Doc, it’s too cold to walk. Hang on.”
He swung that big rig and trailer around a narrow corner. When he chugged into the hospital driveway, he nearly clipped off part of the entrance canopy. He bade me a cheery goodbye and drove away to snarls from shifting gears and the hiss of airbrakes. I trudged into the hospital. A friend stood in the entrance, attracted by the growls a loaded logging truck makes. He rolled his eyes.
“You! What next?”
To Save a Soul
To understand my Norwegian friends and relatives, keep in mind that godliness is secondary only to stoicism. Words are suspect, for do they not sometimes bed down with... emotion?
A privilege of a country doctor is to know neighbors so well. I am minded of Olaf and Fredrick Anfinson, bachelor brothers from the “alt country.” Norwegian fishermen.
Doctor Tom was the conveyor of this true tale about mutual friends.
Back in the 1940s, a church of uncertain denomination hatched a flock of zealous missionaries. A number of them undertook the onerous task of improving the spiritual life of those tough Lake Superior fishermen.
The Right Reverend Jimmy Bob Surely was a wooly bear of a man. He drove all the way up from Duluth one August day. He always wore a broad-rimmed hat. He carried a tattered Bible in one hand and a cane in the other.
The house which Olaf and Fredrick called home had been built by a fisherman from an earlier generation. Rough-hewn boards, rolled green roofing material for siding, squinty windows designed more for keeping cold outside than letting in light. Floors bounced underfoot. A hand pump set into the kitchen sink provided water with full modern convenience. No more hauling it up a bucketful at a time from The Lake.
It was about 2 p.m. on the day when Missionary Surely knocked at the screen door to Anfinson’s house. A series of rattling thumps. Fredrick levered himself out of the armchair where he had been involved in a nap. He peered through rusty screen at the imposing figure on his doorstep. The big man took off his hat.
“Ja?” Fredrick said.
“Good afternoon, sir. I hope the day finds you well.”
“Ja.”
“Warm out here.”
“Ja?”
“I wonder if I might have a few minutes of your time.”
“Vell, I had in mind—”
“Of course, sir. Still, some things are so important that I dare cross the boundaries of constraint.”
“Huh?”
“If I might come in?”
“Vell—”
“It’s awkward speaking through this screen, especially about as important a topic as one’s immortal soul.”
“Your soul got trouble?”
Hearty chuckles shook the broad abdomen contained by the Right Reverend Jimmy Bob’s trousers. “No, no, sir. Mine is accounted... that is, I had in mind one more important to you.”
“Ja?”
“Yours, sir. If you might just unlatch the hook of your screen door.”
“Vell—”
“Thank you, sir.” The Right Reverend wrung Fredrick’s hand and glanced around. “What an... interesting place.”
“Oh, so?”
“May we be seated? Thank you. I hope I didn’t steal your favorite chair.”
“You did.”
“Oh? Oh! I’ll just sit over... tell me, what is your name?”
“Fredrick.”
“And mine is the Right Reverend... uh, just call me Brother Jimmy Bob. What is your occupation?” The Right Reverend sniffed. “Well, fish do leave their... I can guess. And your denomination?’
Fredrick cocked an eyebrow. “I be a fella.”
Brother Jimmy Bob grinned and waved his hands. “I meant your faith allegiance.”
“Norvegian.”
“No, no, what is your church affiliation?”
“Ohhh. Lut’ern.”
“Of course, one of those. Which congregation do you belong to?”
Fredrick scratched his head. “Ve never choosed up sides.”
“But you are Lutheran?”
“In general.”
“Have you considered the state of your immortal soul?”
“State? Vell, ve vas from Tofte, alt country, but over here ve’re Minnesota.”
“No, no, I mean your spiritual state.”
“Oh, ja, that probably be the same.”
“I don’t believe I’m making myself clear.”
“You be right dere.”
Brother Jimmy Bob waved his Bible with enough vigor to flutter its pages. He roared like Moses on the mount, “Do you know Jesus Christ?”
“Noooo. You need go down to the fish house and talk to my brother, Olaf. He knows everybody on the whole North Shore.”
—————
Time caught up with Olaf Anfinson, hardening of the arteries and heart disease, diabetes. He was brought to the hospital one day, in heart failure and declining kidney function. He expired within the week.
A friend saw Fredrick a few days later and said, “I understand you buried Olaf last week.”
Fredrick replied, “Had to. Died.”
• • •