Opinion
A medical tradition worth reviving
I have found making house calls to be one of the most meaningful and satisfying aspects of my work as a family doctor. Although they have long been in decline in North America, there are still physicians fighting to save the tradition
When we lived in Halifax I got a phone call one Christmas Day evening about the death of an elderly woman I had been visiting in hospital, She was the mother of a member of the congregation but I ended up seeing her a number of times. She actually died at home because the family made arrangements for her to receive care there in her final days.
I went to be with the family so that we could pray and commend her to God's eternal care. She and her husband lived in one of the swankiest condominium buildings in the downtown and as I approached the elevator I realized that the man waiting there was my doctor, who, it turned out, was her physician as well. We were both a bit surprised to see the other and we chatted on our way up.
A few weeks ago the artiicle above was publiished in the Saturday Globe and Mail and it brought to mind that incident. I was touched as I read it because I found pastoral "house calls" to be a deeply meaningful part of ministry, although my role was in spiritual health rather than physical. Dr. Pimlott began his piece with a story about the death of a woman and the solemn and intimate formality, with her care-giver daughter present, of verifying what had occurred. Dr. Pimlott went on to offer some facts and a reflection on the value of home visits:
Before the Second World War, house calls made up around half of all visits between doctors and patients; by 1950, that had fallen to roughly one in 10, and by the 1980s house calls made up just one in 200 of all such visits...
Not long after I started making those monthly home visits to her, the weekly trips to the emergency department suddenly stopped. Whether or not it was because my regular home visits finally had an impact, or because in her new home she had easy access to the help and advice of a nurse, I cannot say. Nor did I ever ask her. Like many doctors, I am vain enough and arrogant enough to think that somehow, I had changed her behaviour. The more obvious truth is that she changed mine. After years of frustration, I had finally stopped treating Isabel as a problem to be solved and began treating her like a person to be cared for.
Although still inadequately compensated compared to office visits and not always convenient to do, I have found making house calls to be one of the most meaningful and satisfying aspects of my work as a family doctor. They have provided me with insights into the lives of my patients that have helped me to better understand and care for them, and they have deepened my sense of connection to them.
I did have occasions when I was present as parishioners "shuffled off this mortail coil" and it was always a powerful experience. Thankfully, most visits were pastoral in nature with conversation and perhaps a scripture reading, a prayer, and sharing in holy communion. I had my own version of the doctor's bag, a lovely walnut-cased communion set, and a visiting bible, a small version I would have trouble reading from now because of the tiny print.
As with Dr. Pimlott there were individuals I didn't really want to visit and neither did the excellent pastoral care ministers I worked with through the decades in multiple-staff congregations. One imperious old soul insisted on holding court in her bedroom with the stock market scroll on the TV. I eventually convinced her to turn off the set for the time I was there.
I'm grateful that son Isaac, also a United Church minister, visits congregants, mostly older, where they live. As with physicians, home pastoral visits by clergy have been on the decline for decades. More than once colleagues opined that they didn't have time to "sit around drinking tea" (a direct quote) and I wondered what they were doing that was so much more important than this aspect of ministry. Of course, there are so many cautions and rules about time spent alone with vulnerable persons but compassion is still essential.
While I will readily admit that I often felt mildly guilty that I wasn't keeping up with this ministry of presence in Christ's name I have no regrets for the time I "wasted" with my parishioners.
Reproductions of The Doctor, a painting by 19th-century British artist Luke Fildes that depicts a house call to a sick child, hang in many modern family doctors’ offices.
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