Friday, February 26, 2010

Centenarian's reflection on a life in medicine

I had the pleasure to speak on the phone this morning with David Gale Duncan, M.D., who celebrated his 100th birthday on February 1. Dr. Duncan was kind enough to answer some of my questions about his life and career.

Duncan was born in Litchville, N.D., in 1910. His father owned a grain elevator, one of five in the small town. His mother kept house and raised Duncan and his older brother. Diagnosed with breast cancer, Duncan's mother underwent surgery (performed by a young doctor from the Mayo Clinic) before dying at the age of 42 in 1918.

In 1928, Duncan graduated from high school in Lamberton, MN, and enrolled at the University of Minnesota in the pre-dental program. He was able to pay his way through college in the Depression years by waiting tables at a fraternity and serving as a driver for a wealthy woman in south Minneapolis. He switched out of the dental program, partly because of the high cost of the required tools, and joined the pre-med program. He transferred to Creighton University to finish out his program, largely because they had fewer students and fewer required classes, and then entered the medical school there.

Graduating from Creighton in 1936, Duncan came to Portland on the advice of his cousin. She knew the president of Emanuel Hospital and was able to facilitate Duncan's acceptance to the internship program there. Duncan was one of seven interns that year; at the end of the program in 1937, none of them were immediately able to find work as physicians in Portland. Duncan remembers that three of his fellow interns went out to the hospital in Pendleton. Duncan chose to join the Civilian Conservation Corps, moving around from Bonneville to Woahink Lake and back to Portland.

Duncan was then hired on by Union Pacific to serve as railroad physician in the busy hub of Huntington, OR. He remembers being told that he needed to treat a narcotics addict and a drunkard, and to get out there and set up an office. The only space available at first was a mobile home; after four or five months he was able to move his quarters and his practice into the town's hotel. His brother came out from Omaha, NE, to visit and, since he himself had entered medical school at Creighton, Duncan had him assist on some tonsillectomies. (Tragically, his brother was killed in a car accident in his senior year in medical school.)

In 1939, Duncan was recruited by Dr. Thurston to come out to Council, ID, to join a busy practice. Duncan got his friend, Dr. Gillespie, to take over the Huntington practice and moved off to Council with his new wife Miriam in tow. Their first son was born in Council in October of 1940, in the house that Dr. Thurston had built for the family ("He was very eager to get us!").

The partners maintained three offices in three area towns and maintained their own hospital. The practice was very busy, and Duncan learned a lot. But when the first call came out for military service in the run-up to World War II, Duncan--who had come out of Creighton with a commission as captain in the U.S. Army--was one of the first to go. He was assigned to the 41st Infantry Division out of Fort Lewis, and was there when the attack came on Pearl Harbor in December 1941. He was sent out to the coast to watch for Japanese planes and then was ordered overseas to serve in New Caledonia. There, he had responsibility for 100 soldiers, but "didn't do much medicine" beyond the daily sick call. He was then moved to Guadalcanal, where he served for 6-8 months as chief of a 50-bed ward. Another move took him to a hospital 60 miles north of Manila, where he assisted a neurosurgeon. Duncan doesn't remember that neurosurgeon's name, but thinks that he was the one who got Duncan sent home before the end of the war. Duncan had stopped eating anything but canned fruit, and had dropped to 120 lbs before his arrival back in the States at St. Charles, LA, in 1945.

After about a month, Duncan returned to Portland, where Miriam had purchased a house in the northeast part of the city. Looking for work, Duncan connected with Bernard Brown, M.D.; the two had gotten to know each other during Duncan's internship at Emanuel. Brown had recently suffered a heart attack, and was eager to turn his practice--and his home--over to Duncan. From 1946 to 1989, Duncan practiced general medicine in the Alberta neighborhood, seeing enough patients to do "real well"--despite the fact that he often accepted payments in kind or waived fees for his low-income patients. He delivered a lot of babies (especially in the postwar period) and had admitting privileges at Emanuel, Vanport City, Holladay Park, and Woodland Park hospitals.

He kept up in medicine by spending time with his Emanuel colleagues and participating in activities of the Oregon Medical Association (of which he has been a member since 1936). He never had much use for the medical school, but he never saw it as a competitor either--there always seemed to be plenty of people who needed a doctor.

Looking back over his career, he thinks the biggest change has been that most people used to have "their own doctor"--a general practitioner who would look after them throughout their lives. Now, fewer patients have that continuity, and Duncan sees this as a change for the worse. "Too many young people don't take care of themselves" these days, and without preventive medicine and regular checkups, obesity and other health problems have soared. He's very concerned about the present state of health care in America, but he doesn't have any answers. He's leaving it to a younger generation to work out a solution to this current crisis.

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