A Life, A Career, A Look Back

Dear Louie,

I recently learned that the Medical College was awarding me a Distinguished Service Award. In preparation for the event, the organizers asked me for a CV.

Instead of using the traditional resume style, I answered in a narrative manner.

It feels a bit more natural to write it that way.

Take a look if you like.

A Life, A Career, A Look Back

I was born March 14, 1926, in Hartford, WI., and have lived there my lifetime. I was born in the hospital where, later, for 40 years, I practiced medicine: six years in General Practice and thirty-four years in Internal Medicine.

I attended grade school at St. Kilian School, from which I received the 2005 Distinguished Graduate Award.  I graduated from Hartford High School in 1944 and immediately entered the U.S. Navy, spending ten months on the island paradise of Attu in the Behring Sea as an electrician and teletype repair man.

I had always desired to study medicine and was disappointed in being directed to an Electrician’s School rather than into the Navy Medical Corps- their loss. On discharge, I enrolled at Marquette University for premed and later was accepted at Marquette University School of Medicine, from which I graduated in 1953. I am a member of AOA.  

Following graduation, I interned at St. Joseph’s Hospital, Milwaukee, and there was introduced to the concept of Internal Medicine under the instruction of Sam Rosenthal, M.D. , the most intuitive practitioner I have ever met.

The day after receiving my license, I took over an active general practice from a physician in Hartford, who had been called to active duty in the Navy.  He left, and I started my practice, seeing 30 patients on the first day, and it never let up for two years.  I enjoyed general practice, but it was overwhelming for a young family.  After two years, my partner returned, and we practiced together for four more years.

Practicing in my hometown was of greater benefit than some of the distractions. Over the years, “I knew Jimmy” was replaced by “Yes, Doctor”.

However, in the late 1950s, it became evident that medicine was changing. 

Changes in diagnostics, multichannel blood testing, changes in X-ray-assisted diagnosis, and changes in therapeutics all spoke of ongoing transitions in medicine. I was convinced the future belonged to postgraduate preparation, especially in internal medicine.

I applied to Dr. Engstrom, Chairman of the Department of Medicine, for a position in the Internal Medicine Residency Program and was accepted on the day of application when I stated the only thing I took from Medical School, besides a diploma, was the AOA key.  What I didn’t know for years was that Dr. Engstrom had received a cancellation from an accepted resident that very morning of my walk-in application, and I relieved his discomfort and search.

My wife Dorothy and I had four young children and a mortgage, and I decided to commute from Hartford to MCG Hospital for the three-year residency. I commuted for three years, did internal medicine consults on weekends in Hartford, and until discovered by Dr.Engstrom, I did two T&As each Monday morning.  That stopped, thank goodness, after three months. I chose a residency at Milwaukee County General for many reasons, chiefly for convenience and the opportunity to work on free weekends. Those weekends were work-filled. Weekend coverage at Hartford was an on-call schedule from Friday night to Sunday night, with E.R. coverage, office hours on Saturday morning, and clinic/ E.R. responsibility on Saturday night and Sunday mornings.

Somehow, all worked out, and we remained married.

After residency, I opened a solo practice office and practiced Internal Medicine for six years, always looking for a partner with whom to establish an eventual multi-specialty group practice. Internists were difficult to find and almost impossible for small towns.  I kept close contact with the Medical School, and with Dr.John Pedersen and Dr.Jim Cerletty.  I served Ward Rotations of three months at MCGH for a number of years and annually taught Physical Dx, always enjoying the association of the faculty.

Dr. Mike Mally joined me, and we built a multi-practice association, which eventually consisted of 14 doctors in a city of 8000.     To keep professionally and intellectually stimulated, we developed an annual “Doctor’s Bag“ night when, in the early ’70s, Parkview Medical Associates initiated the first postgraduate sessions for Physicians in Washington County.  Our audience was thirty to seventy-five physicians, nurses, and E.R. techs.

This was before the advent of the now-popular postgraduate requirements. Topics presented included the Spectrum of Liver Diseases, Treatment of Coronary Artery Disease, The Many Faces of Depression, Concussions in High School Athletes, and Domestic Violence in Small Town America.

Most of the time, faculty members of the Medical School, specialty-trained cardiologists from St. Luke, MCGH, and a few nationally known physicians furnished by the Drug Pharmacological Houses would serve as the faculty for a four-hour session, one fall night each year.  In 1976, postgraduate demands on a more erudite scale attracted our audience, and we continued the night by developing programs for the nursing staff and high school coaches and the developing Emergency Staff of the community. 

In this venture, the E.R. training took a lot of time, as did the development of the first intensive care unit in the county.  Many hours were spent training the E.R. nurses, the I.C.U. nurses, and training ourselves.  A remote monitor was set up in our office so that accurate monitoring of cardiac patients might be extended until adequacy of nursing observation was obtained. I initiated a fundraising effort with the local Hartford Lions Club, raised $40,000, and established the first monitored cardiac care unit in the county.

We reduced mortality from 40% to 18% by treatment of monitored arrhythmias. The Hartford Lions Club, of which I have been a member for 45 years, served as an ICU sponsor and eventually subscribed to donations of over $125,000. I received the Melvin Jones Lions Award for Service, and in 2008, I received the Annual Volunteer Award in Hartford from the Chamber of Commerce.

Hospital administration and sponsorship were different; budgets were without government subsidies, and prayers of the Nuns returned only a finite amount in dollars for R&D. Therefore, city fundraisers for hospital improvements were initiated.  We became fundraisers, public speakers, and donors and were occupied almost continually in the community as we worked and fund drives were carried out for many projects. These chores, along with the practice, continued literally day and night.

Throughout the years, the association with Marquette University School of Medicine and MCGH provided us with a source of physicians for consultation, and MCGH has become our referral center. The contacts with MCGH grew, and our constant referral patterns were primarily with the Medical School.

In a small town with an active medical center, be it ever so small, one is never unrecognized.  Some of this is good, sometimes not so good.  But, recognition always results in improving self and civic agencies.  This constant social service involvement and recognition was and is stimulating and rewarding.  It resulted in many positions on Boards, Church Boards, and Bank boards, and a number of my associates served long tenures on School Boards. Civic clubs asked for participation, and coincidentally, the first persons trained in CPR were from the Hartford Lions, personally trained in post-meeting sessions.

One of the community personal highs was the leadership in fundraising for a Defibrillator Program. This leadership role resulted in the Hartford Police Department being, probably the first department to have an AED in each squad car. This was initially financially sponsored by the Hartford Lions. I spoke of the need, raised funds, taught classes, and was thrilled seven or eight times during the first year by reports from the police who documented the “Saves” as they responded and heroically defibrillated their friends and neighbors.  

In 1990, I retired.  I was tired and discouraged and had been summoned to Madison by some state agency.  The review board informed me I owed the State about $20,000 in Medicare overcharges. It seemed that I was doing too many EKGs,s--3.4 per 100 visits, too many house calls, and too many night visits to the Nursing Home.  After demonstrating one of the earliest “epic” systems for office practice computer documentation and computer records, and obtaining absolutely no help from the state Society Medical Society, I quit.  The charges were false, and the service was deemed exemplary. 

I knew a mistake had been made from the first day of retirement. Again, I sought out the Medical School, saw Dr.Jim Cerletty and was hired as a part time Assistant Professor of Medicine.  I worked three days a week for ten years in the outpatient departments, in the medical clinics with medical students, in the Department of Medicine, and enjoyed it thoroughly. During this time, Bill Schultz was hired, and I learned to know him and became more associated with the Alumni Association.  I think I planned two Alumni Seminars, which were great times. My association with the Alumni Association resulted in about twenty years of Post Graduate Seminar Program Planning for the Alumni Senior Physicians under the management of Bill Schultz.

However, I continued to be active with the Medical Center Foundation of Hartford and chaired the development of an Adult Day Care Center, the 1022 Club.  This is an Adult Daycare Center for patients with early Alzheimer's Disease; it provides a service to the perpetual family caregivers of patients with cognitive advancing problems. The Foundation Chairman and I raised $500,000 for the Center; it was paid for when the “1022 Club” opened. I chaired, participated in, and managed a “GoldBug Golf Tournament” for the Hospital Foundation. The tournament has raised over $750,000 for the Hospital Foundation. One year, I made 145 52-degree wedges as player gifts. Great fun.

The local television channel has been a source of ongoing presentation of articles that I have written on the history of medicine in Hartford and interesting cases seen over the years.  We have also prepared twenty or so programs on Medical topics and recently embarked on a program entitled “Letters to Louie,” a series once a month where I read a letter and speak to the medical content. 

One event during the past five years stands out.  I came onto a supply of over $100,000 of durable orthopedic appliances and outdated, oversupplied articles.  With the help of ten friends, all seniors, we received, identified, sorted, and distributed a semi-truck of equipment to the Free clinics of Wisconsin.  It's great fun and real work.

One might ask if “practice in a small community might be stimulating and rewarding.” 

I answer yes, the service rendered is most rewarding and family involvement produces rewards for all. One can be a “Man for all Seasons,” a professional, a friend, a benefactor, a person of service, a participant, and a husband and father, and still maintain an association with his Alma Mater for his own benefit and that of the medical school.

Since 2000, I have been retired, but am still active in the community.  The Lions, the Christmas Committee, golf, and especially family keep me busy, but not all the time. I still awaken and am in a dream state, treating diabetic keto acidosis at five in the morning.

The association with the Medical School and the Alumni Association has continued to be an anchor to the reality of Medical Progress and an aid in prevention of Early Cognitive Disease.