By: Richard Gunderman, MD, PhD
IU School of Medicine
Discussions of physician wellness often focus on factors that undermine it, such as overwork, busy work, and scutwork. But it is equally important, perhaps even more important, to explore the enduring sources of fulfillment in a medical career, especially those that mean the most to the physicians we most admire. Otis Bowen was one of the most admirable of all Hoosier physicians.
Dr. Bowen (1918-2010) is best known today for his political service: a member of the Indiana House of Representatives, Speaker of the House from 1967 to 1972, the first person to serve two consecutive four-year terms as Governor of Indiana (1973-1981), chair of the National Governors Association, and the Secretary of the largest Cabinet department, Health and Human Services, from 1985-1989. No Indiana physician contributed more in this sphere.
Yet the heart of Bowen’s story lies elsewhere, in the prosaic sacrifices and satisfactions of a life in medicine, as reflected by the title of his 2000 memoir, “Doc.” Born in Fulton County, the son of a one-room-school teacher who earned $2.50 a day teaching eight grades and doing the jobs of school nurse, counselor, coach, and janitor, Bowen resolved early that teacher was third on his list of career aspirations.
Many years later, Bowen would recall the scene at his father’s deathbed. “Dad,” he said, “I am so thankful for all you taught me. I would never have been able to accomplish the things I have without you.” When he saw his father’s eyes light up and a faint smile come to his face, Bowen “knew that he understood what I said and knew that I meant every word of it.” Simply put, Bowen was grateful and not afraid to express his gratitude.
As a young man, Bowen lacked the funds to attend college and medical school at Indiana University, so he put in countless hours doing difficult work. He hoed potatoes for 10 cents per hour. He shucked oats and wheat for a dollar a day. He mowed grass for 25 cents per yard, 35 cents for large yards. He opened a gas station at 6 a.m., which paid him a penny for every gallon he pumped. He also adhered strictly to a plan to bank 75% of his earnings.
As a freshman at Indiana University, he shared a room containing two desks and one bed. He was so homesick that he almost quit and returned to northern Indiana, but a chance encounter with another student who had learned to overcome the same feelings led him to stick it out. In the summers, he worked at a dairy farm that required him to rise at 3:45 a.m. each workday. He relished hard work.
At Indiana University School of Medicine, he paid tuition of $200 per semester. To support himself, he got his mother to create denim handles for copies of “Gray’s Anatomy,” which he sold to other students for $1.50 apiece. He became one of two “cadaver boys,” who partly supported themselves by selling gold fillings. He worked as an orderly at Wheeler Mission, where every night he deloused homeless men in search of a bed.
After his marriage, his wife, Beth, initially stayed in Crown Point to save money. Eventually, he got a job at the Bailey Funeral Home on North Meridian Street. The director twice gave him $5, once to buy a hat and once to take his wife out for dinner. When Bowen gave blood to the father of a local car dealer’s leukemic father, he found himself the unexpected recipient of a used car, which the Bowens referred to as their “blood car.”
On December 8, 1941, his senior year in medical school, Bowen and his classmates were summoned to Emerson Hall, where Dean Willis Gatch told them they would be graduating early so they could join the U.S. Army’s medical corps. Bowen served in the Pacific theater as a first lieutenant, then returned to Indiana to do his internship in South Bend, which paid $15 per month. Based on his looks, he became known as “Spencer Tracy.”
He then set up his own office in Bremen, purchasing a departing physician’s house, equipment, furniture, and supplies. He hired an office nurse and a secretary-receptionist. He soon realized how much he did not know and rapidly became his own teacher, charging $1.50 for an office visit and $7 for a house call. A typical day began with hospital rounds at 6:30 a.m. and ended at 6 p.m., and he delivered about 10 babies per month.
Occasionally, patients would request a “curbside” consultation, stopping Bowen for advice at the grocery store or local high school sporting contest. He soon evolved a way of handling such requests, saying, “Okay, undress right now, and I will examine you.” He cared for five generations in one family and delivered another family’s 17th baby. He typically worked 80-hour weeks and did everything he could never to miss a funeral.
“In Bremen, I was more than a physician. I was a friend, neighbor, fellow Kiwanian (for 35 years), band booster, and sports enthusiast,” Bowen said.
Throughout his career, he discovered that the worst medical students sometimes make the best doctors, and vice versa. Accustomed to long hours, he often missed meals and lost sleep, but he learned “to remain calm and unflustered and to be patient and tolerant.”
Reflecting on his long career as a physician and public servant, Bowen wrote, “I am pleased to have made a small contribution to a better life and future for Hoosiers and Americans. I have faith in their inherent wisdom, and I believe tomorrow’s leaders will make the right decisions.”
Herein lies a powerful lesson for contemporary physicians: we need, so much as possible, to believe in the patients and communities we serve.
Richard Gunderman, MD, PhD, is the chair of the ISMA Wellness Steering Committee.