In mid-November, I was standing in a long line at the funeral home to offer my condolences to the family of my friend, Dr. Douglas N. Howe. Doug was a fellow chiropractor and the last of a generation of chiropractors that included my grandfather and father. He was 83 when he died. As I stood in line, I was reminded of that day in December 1968 when I stood on the receiving end of a similar line of those offering their sympathies. I was 19 and my dad - also a chiropractor - had just died at the age of 49.
In the line of well-wishers were two state senators, one United States congressman, the mayor of Pottsville, Pa., and many others that society would label label as important people. But the people who most impressed me and have left an indelible impression in my mind of that day, now 42 years ago, were those who came in bib overalls, the farmers with dirt under their fingernails, the miners who had just emerged out of the pits with coal dirt imbedded in their faces and tears streaking their hardened faces. These were two-fisted drinkers and fighters, tough men in a tough world, weeping. These were my dad's patients. They came to show their respect and express their grief.
My dad died in his office treating a patient. The medical examiner diagnosed his death as a result of a dissecting abdominal aneurism; I diagnosed it as exhaustion. There were many who came up to me, his oldest son, that evening to express their condolences, but the one I remember most was the elderly lady who hugged me very close, not wanting to let go, and said repeatedly," What are we to do now?" My dad literally gave his life for his patients and they all knew it.
My dad practiced in a town bordering the coal and farming regions of Pennsylvania. When I was a young boy, he would take me to work with him on weekends. I had an ulterior motive: Mrs. Kimmel had an ice cream shop on the first floor below my dad's office. She always had a cone waiting for me. My dad's routine was to treat patients during his office hours and then get dinner at a local diner before making his house calls to the local farms.
I recall the day I decided to become a chiropractor. I was 6. It was snowing and my dad had pulled up to a farm. He had to park out on the street and we walked through the snow-covered field. He carried me on his shoulders. He treated the entire family and we then walked back to our '49 Chrysler. When we got in the car I mentioned that he had not gotten paid. My dad simply reminded me that all the family had for dinner that night was a pot of potatoes. I complained that he should have been paid something. Stopping the car on that snowy road, he put his hand on my shoulder and said, "When I get to Heaven I will get everything that is coming to me." When we got home I told my mom that I had that day decided to become a chiropractor.
In 1984, after retiring from a five-year career in the NFL with the Denver Broncos, I decided to move my family back to my home in central Pennsylvania. I opened up a modest office and began serving patients who sought my services. My grandfather had opened a similar office in 1921, as had my dad in 1947. What I found was most encouraging as that I did not have to defend chiropractic. Since 1921 this small coal-region town had been served by a continuum of great chiropractors; I was just an extension of doctors like my grandfather, dad, Doug Howe and Harry Hoffman. Doctors like my father who treated patients, not their benefits, and left a legacy of quality care.
They paved the way for the future generations of chiropractors - like my daughter, who just graduated from National. These young chiropractors will practice in my shadow as I have practiced in my father's for 32 years. My dad never got an award and there was no plaque on his office wall; only his diploma and discharge papers for his military service. He was never recognized as "Chiropractor of the Year," the award the various state association leaders give to each other at state conventions. But he left the profession a bit better than he found it and left a legacy of grateful patients.
So, as I hugged Dr. Doug Howe's daughter back in November, I offered my sympathies, but also my thanks. Thanks to her dad for representing the profession with grace and dignity and leaving it a bit better than he found it; and for paving the way for my generation to continue in his wake.
As General Douglas MacArthur said in his famous West Point speech, "The shadows are lengthening for me now." Someday I too will pass over Jordan. I hope in the context of my professional life as a chiropractor, I will have left the profession a bit better. Perhaps some elderly lady will say at my funeral, "What are we to do now?"
In my 32 years of practice, I have learned the truth of the statement, "The best things in life are not things." The message I am trying to convey is a very simple one. Too often in the rush to pass exams and the lack of historical context upon which to relate to the profession, new graduates forget that the profession was built upon the shoulders and sacrifices of those giants (some known and some unknown) who came before them. I am humbled every week by the gratitude patients have toward their chiropractor; gratitude that we often do not know about or hear until events like funerals bring out an emotional bond between doctor and patient.
We have become so focused on "coding" and "reimbursement" (which I admit are important) at the expense of relationships with our patients that last a lifetime. Research has shown that "patient preference," "patient self-selection" and "patient confidence" are key factors in the healing process. As I now reflect back on those times with my father that I did not understand but he "innately" knew so well about human nature and the power of giving with no thought of return, I realize that they left a lasting impression in my mind. I only wish we could teach these fundamental truths to every new graduate about to enter practice; lessons of life that we often fail to understand, acknowledge and be thankful for.
In closing, my reflections on the lessons that I have learned are not about money or fame, but about the impact on the lives of those we touch that often are never known until our careers (or lives) are over. It is only then that the footprint left by your having served is revealed. This is not what is discussed at management courses or success seminars, but the fundamental truth of having lived a purposeful life. Thanks, Dad, for the most wonderful lesson anyone could have taught me.
