DR. ROBERT NELSON, M.D., CONTRIBUTED THE NEXT STORY

Dr. Robert Nelson, M.D., began his practice in Benson, Minnesota, before moving to his present home in St. Peter, Minnesota. This true story from Dr. Nelson’s practice allows you a sense of the man and his patients (as told to Dr. MacDonald):

Swedish Ingenuity

A major imponderable of medical practice is: How to get a patient to follow the prescriptions of his or her physician?

Exercise?

“Been meaning to, Doc.”

Diet?

“Good Lord, Doc, you can’t be serious, meals that small?”

Certainly a doctor can depend on a patient taking medications as ordered, for does not the perpetual dieter clamor for a magic pill?

Not so fast.

Mrs. J. lost my prescription on her way home and decided it didn’t matter that much anyway. Mr. K. decided the drugs were too expensive and tore up his prescription. Miss A. decided that an herb recommended by her neighbor would do as well, while crotchety Old Man J. told anyone who would listen that, “He’d be danged if any young squirt of a doc could tell HIM what to do.”

When his patient returns later, no better, even worse, the physician is left to wonder whether the medicine prescribed had lost its punch, or if he needs to try another drug, or whether the patient has developed an allergy to it, or...

Adults are difficult enough when it comes to what doctors call patient compliance. Consider, then, the realm of pediatrics. Oh those many years ago, my basic attitude toward news that baby “Whosis” refused the medication I had prescribed could be summed up by, “Mother, who is in charge?” Raising children of my own, and doling out scores of doses to them over the years, effectively disposed of that flight of fancy.

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Dr. Bob is as Swedish as any resident of Stockholm. He practiced in an enclave of fellow Swedes in southern Minnesota. In his broad Scandinavian drawl, he recounts this story:

Mrs. Yontson arrived at his office with her baby, six-month-old little Olga. The lass seemed healthy except for a noticeable pallor. A blood test confirmed his impression, a moderate iron-deficiency anemia, not uncommon when a child has subsisted on condensed-milk formula, a regular practice years ago. The treatment is straightforward, a liquid form of iron by mouth. The only problem is that, because of its taste, the stuff could gag a scavenger who dined on road kills.

Dr. Bob sighed, wrote out the prescription, and asked the baby’s mother to return in thirty days to monitor the results.

A month later, little Olga had pinked up and her hemoglobin was well on its way toward normal. Pleased, even if bemused, Dr. Bob said, “I’m glad to see how well she has done. To be honest, I’m a little surprised, given how bad the medicine tastes. How did you get her to take it?”

“It vas simple, Doc-tor, ve yust put it in her cof-fee.”

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