The Doctor Will Hear You Now

Dr. Spencer’s medical practice thrived as he met his patients where they were, quite literally. He would drive his Jeep, sometimes accompanied by any of his three children (including my mother), into the back hollows to treat people in need: an elderly man with pneumonia, a woman giving birth. The Licking River often flooded the low-lying areas in Morgan County, so at these times Dr. Spencer would travel by motor boat to reach people. At times he traveled by mule or even horse-drawn sleigh. When the doctoring was done his patients often would feed him—typical Kentucky fare like fried chicken or ham with biscuits. Money was never an obstacle to his providing care, and payment could come in the form of a chicken, or permission to fish on the person’s land.

When I was in elementary school we lived on my grandparents’ land for 2 years. Six days a week cars packed the parking lot of Dr. Spencer’s home office. As a family doctor, he saw everybody—adults, kids, babies. Appointments were typically first-come, first-served, and patients often filled the 20 or so chairs in his waiting room, with others standing. Those who knew him saw his warmth toward his patients, and his fundamental kindness. His humor put sick kids at ease. He knew how to make people relax. His patients loved him.

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Perhaps it’s not surprising that Dr. Spencer took on almost saintly status, both before and after his death in 1999. His path to secular sainthood was well paved in my own mind, and I aspired to follow the credo that defined his actions: Do something that makes a difference in people’s lives.

And yet. There’s something about being a saint that seems like a lonely existence. Can we make someone a saint without stripping them of some of their humanity? I’ve often wondered in my adult years what I missed in my grandfather. What were his faults? His failings? Was he, in fact, as human as the rest of us?

From what I’ve gathered, Dr. Spencer’s flaws were mostly harmless. He confessed to running red lights as a young doctor if there was nobody coming and he didn’t feel like waiting, and would invent stories about “having to get to a patient” if the police pulled him over. He loved playing tricks on people, like surprising his snake-phobic friend with a rubber snake. He was a regular poker player, but had no gambling issues. He drank regularly, but not to excess—although sometimes he would bring his drink in the truck as he drove my brothers and me to local fishing spots. He smoked two packs of Camels every day for most of his adult life, as many doctors of his generation did. And of course he worked as a doctor when it was no longer legal for him to practice.

Once when we were kids my older brother and I happened upon a nighttime meeting at our grandfather’s cabin in the woods. When we saw the parked trucks, we crept through the creek bed to see what was going on in a clearly Adults-Only gathering. The sights and sounds we could make out suggested drinking and revelry. Our young ears were scandalized to hear a “damn” from someone, maybe … our grandfather?? Could there be more to this man than we knew? Having lost our nerve we quickly fled the scene.

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More than wanting to know about a “darker side” I didn’t see, I wish I knew about his internal workings. What drove him? Why didn’t he retire sooner? What were his insecurities, his fears? Did he wrestle with self-doubt? I realized too late that I never knew my grandfather, not really.

As ironic as it may sound, those who knew Alec Spencer well knew that he was a very private man. He came from a generation that believed you shouldn’t wear your emotions on your sleeve. He invested much more energy in fulfilling his duties than in trying to make himself understood.

Dr. Spencer knew that to be effective in his work, he had to understand the person in front of him. Like any healer, his primary tool was his ears. I remember his saying that many of the people he treated wanted most of all for someone to listen to them. Sometimes as patients we feel like our doctors prescribe medication or tell us what to do but don’t really hear us.

Times we truly feel heard tend to stand out, which tells us they probably don’t happen that often. Indeed, all of us fail at times to be fully present for others. We live busy lives and our minds are great at “listening with one ear” (enough to say “uh huh … yeah … right …”) while making mental lists, planning the rest of our day, or trying to remember if we took care of something. Technology presents an additional challenge as our blinking and beeping mobile devices compete for our attention.

So we can imagine how hard it is for physicians—who are among the busiest and most stressed out professionals—to listen attentively to patient after patient. I’m always struck by how doctors, like our pediatricians and my ophthalmologist, move from exam room to exam room all day long. How hard it must be to stay focused on the person they’re treating, with so many daily demands.

A recent study showed that doctors with higher levels of mindfulness were more “patient-centered” during their exams, and that their patients were more satisfied with their visits to the doctor. (A nice summary of these issues can be found here.) Listening mindfully can bring us more fully into our daily interactions, allowing us to actually experience the person in front of us.

I’m quite sure my grandfather had no formal training in mindfulness, as he lived at a time when Mindfulness^TM had not been branded like it has now. But like all effective healers, he seemed to know that compassionate presence was the foundation of any healthy relationship.

I was rarely his patient (not counting all the times my mom called her dad on the phone to describe a child’s symptoms); he examined me after a fall at age 8 that left me with a mild concussion, carefully assessing my symptoms and, in hindsight, taking pains not to alarm me at a time when I was having weird visual symptoms and feeling electric shocks in my upper body. When I was about 13 years old he heard my horrible cough that would leave me gagging and unable to catch my breath, and gave me a shot based on his diagnosis. His listening made him effective—my cough soon resolved.

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Just as important as listening, perhaps, Dr. Spencer seemed to know that healers need to be healthy. Nobody ever described my grandfather as “stressed.” On the contrary, people who knew him well said he was “very, very relaxed.” Part of me is perplexed by how a busy doctor could face a waiting room full of sick people six days a week and not feel the stress. How was it possible?

Maybe the most important factor in avoiding unnecessary stress was that Alec Spencer seemed to have no need to impress people. Since he wasn’t worried about what others thought of him, he didn’t have to be anyone other than himself. He was a doctor, he was good at it, he loved it, and he loved people. He also trusted people, and he seemed to trust himself. He was quietly dedicated to a life of service—to his family, his countless patients, his community. He even served a term as mayor when the need arose.

When asked how he slept so well at night, Dr. Spencer referenced a verse from St. Paul’s letter to the Romans: “… so far as it depends on you, be at peace with all men.”

Above all, Dr. Spencer seemed to know that while he was the one working, the work wasn’t about him. He was fond of referring to himself as “just a physician’s assistant,” suggesting that he was serving someone greater than himself. Although he had little patience for organized religion, he seemed to have a firm belief in God as creator and protector of the natural world—a world that Dr. Spencer loved and took care of not only as a doctor but as custodian of 100 acres of forest outside of West Liberty.

Those acres of hills and streams also held a key to his long and successful career. Dr. Spencer made time to rest from his work and to do the things he loved—go fishing, be with family, spend time with friends in his cabin, split wood, tend to the ponds on his land. His was a very balanced life. He knew how to relax. He took time for lunch each day, and generally stopped working by 5:00 or 6:00 PM to have dinner with his family. And of course he had his bourbon at the end of each day, mixed with orange juice or ginger ale or lemonade depending on the season.

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Toward the end of his life Dr. Spencer asked my mom, “Carolyn, how old am I?”

“You’re 83, Dad.”

“Eighty-three!” he exclaimed. “How did I get to be that old?”

He had had several mini-strokes, and then contracted a lung infection that affected his oxygen levels and clouded his thinking. But even close to the end of his life his eyes would light up when he saw his wife of 58 years, with “the unabashed smile of a young man in love,” as my uncle put it.

I remember the morning my mom called me when my wife and I were living in Bar Harbor, Maine. Her voice was choked as she said, “Seth … my dad died.” I knew he’d been sick and I know that death is inevitable, and still it was hard to believe. How could someone who seemed larger than life no longer be alive? The flags flew at half-mast in West Liberty on the day of his funeral, as the community mourned the man they knew as “Doc” and that we knew as “Papaw.”

As the final words were said at his graveside on that February day just before his coffin was lowered, a sudden wind whipped through the cemetery, blowing hats and papers. It felt like Dr. Spencer’s final bit of mischief. I thought of the lines from a song, “… did you catch his face before they closed the lid? I swear I saw him wink once and flash me that old grin. Oh, you know, that would be just like him…” (“Just Want to See,” Cowboy Junkies).

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Years later I was driving with my wife to Baltimore to be with her family after her grandmother died, the last grandparent either of us had. On the drive I suddenly was flooded with memories of my own grandparents, a kind of “Proustian moment.” I could smell the fried apples with cinnamon that they would make, and the country ham, the canned green beans, the Jell-O salad.

I vividly remembered the last time I visited with them, the only time my wife met my grandmother and grandfather. We had sat with Dr. Spencer at dinner as he told stories, using his distinctive hand gestures. He struggled at times to find his words, an effect of the mini-strokes. As these memories washed over me I was able to see my grandparents more clearly as whole people, much more than I could when I was younger, or even when they’d been alive. Maybe my becoming a parent had helped. A window had opened on the past, and I wanted to look inside as long as I could.

I suspect that open window led me to want to know my grandfather as he actually was, beyond the superhuman that we imagined him to be. I will never know many things about him that I wish I did. In the end most of what I know about his priorities are based on his actions, how he lived his life: Love your family. Work hard. Serve others. Forgive. Spend time in nature. Alec Spencer was not a saint. He was human, and he showed through his work the healing power of human connection.

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I am grateful to my parents, Carolyn Spencer Gillihan and Charles Gillihan, and my uncle, Darryl Spencer, for their reflections that contributed to this post.