July 9, 1993

Physicians to the Rich and Famous

He has been a doctor for a year now and has had two patients, no three, I think --yes, it was three; I attended their funerals.

Mark Twain

Tom Lehrer introduced one of his songs with comments about a doctor who "specialized in diseases of the rich." This is not just a joke; there actually are doctors who specializes in diseases of rich people, but you won't find them listed as such in the yellow pages.

Most people believe that rich people get better medical care, better doctors and better everything than the rest of us. The very opposite may well be true. Doctors who specialize in treating celebrities and rich people may be the bottom of the medical barrel. While it is true that rich people can afford anything, they probably don't get better medical care than a truly knowledgeable person with good medical insurance can get.

Part of Sinclair Lewis's novel, Arrowsmith, is about a young physician who is astonished to find that a well known physician to the rich and famous was downright incompetent. The material for that novel was supplied by physician-writer Paul de Kruif and it is based on his experiences.

I am a biography junkie and am continually surprised at the number of famous people who have been done in by their physicians.

George Washington was treated by his physicians with the then accepted practice of bleeding. He was probably bled to death. He would probably have lived longer if he had never had a physician. In those days chicken soup was probably just as effective as the whole medical profession. At least no one died from drinking it, which is more than could be said of those treated by the second oldest profession. The same might now be said of so-called alternative medicine, which is expensive chicken soup, but relatively harmless. The problem with chicken soup and similar remedies is that there now are effective treatments and genuine cures for some potentially fatal diseases.

The great opera singer Enrico Caruso had a physician who was flagrantly incompetent. When the singer was experiencing severe chest pain and was obviously ill, his doctor bound Caruso's chest and encouraged him to sing in a very difficult opera. It was the equivalent of a doctor sending a football player back into a game with a broken leg. In those pre-antibiotic days, it cost Caruso his life at the age of 48.

Marilyn Monroe had some emotional problems, as do almost all creative people. Her doctors got her hooked on sleeping pills and drug enemas, which killed her. Her psychiatrist did the equivalent of helping someone who is in slight danger of drowning, by throwing her a big rock. By the way, all of the stuff about a conspiracy to murder Marilyn seems to be National Enquirer type baloney. Her shrink was the doctor that the book Captain Newman, M.D. was written about. When I read that book, I couldn't understand why a fine writer like Leo Rosten would write about a psychiatrist who was incompetent. It was obvious that Rosten was unaware that his protagonist was incompetent. Oh well, even very intelligent people can have blind spots.

I remember a Professor of Medicine at the University of California saying "After seeing what we are producing, when I get sick I'm going to go out and eat grass." There is a lot to be said for that. Depending on the condition, letting your body heal itself can be a good idea. There is a firm rule in medicine that, if you feel sick, take it easy. If you feel very sick, stay in bed. A dog or cat knows that instinctively. To do otherwise could cost you your life. This is especially true when you get older --I said older, not old. A person over 40 does not have the resilience of a teen-ager. One way to find out how much resilience you have is to test it. If you don't have it, you die.

My nearest and dearest friend is just getting around to realizing that the world will survive without her for a few days. Before, when she was ill, I used to have to take away her clothes and threaten her with divorce if she didn't stay in bed.

A competent physician can sometimes save your life, but it usually takes your cooperation. The reason that so many incompetents flourish is because most illnesses, that people have, are self-limiting. Usually you'll get better if you just take it easy. Even incompetent physicians seem to be successful, because their cures would have happened without their assistance.

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