Sunday, March 15, 2015

"They Did What They Could"


Dr. Paul Isaak was one of the earliest--and longest-lasting--pioneers of medicine on the central Kenai Peninsula. Photo circa 1960 in Soldotna.
THEY DID WHAT THEY COULD

SEPTEMBER 2009

Soldotna resident and six-year Navy veteran Jack Farnsworth was feeling so lousy at one point in 1952 that he decided to visit Kenai nurse Jo Davidson to see if she could determine what was ailing him. After examining Farnsworth, Davidson grew concerned.

She told him that he likely had appendicitis and needed to get to the military hospital in Anchorage as swiftly as possible. She injected him with penicillin and contacted the 10th Air Rescue, which happened to be flying back from a mission to Kodiak and agreed to stop in Kenai to pick up the patient.

Air Rescue flew Farnsworth directly to the Elmendorf Air Force Base hospital, where doctors operated and discovered an appendix nearly ready to rupture. Afterward, the patient spent the next two weeks recuperating and—as his wife, Dolly, put it—receiving 48 separate injections of penicillin in his butt, which was sore even after he was discharged.

Jack Farnsworth at his Soldotna home, late 1940s.
Despite the hospital stay and all the discomfort, however, Farnsworth was a lucky man. In addition to receiving competent urgent care while living in a place nearly devoid of advanced medicine, he was cured, and he walked away from it all free of charge. As a veteran, he qualified for free military medical service.

On top of that, he had been lucky even before he got hit with appendicitis. When Dolly had joined him in Soldotna, she had left behind a job in Anchorage with the Army Exchange, which had provided her with medical coverage. Before she moved south, she became pregnant, and under the terms of her insurance she had to be covered until the baby was delivered, even after she quit her job.

Like the bill for the appendectomy, the maternity charges were nil.

Until at least statehood, most residents of the central Kenai Peninsula were not so fortunate. Very few had any sort of medical insurance, and the vast majority operated on a pay-as-you-go basis.

The Farnsworths, in fact, were uninsured for most of their first 25 years on the peninsula. Jack, who died in 1967, received family coverage temporarily when he worked for the Teamsters—long enough to pay for tonsillectomies for his twin daughters. And Dolly said that the first time she earned health insurance on her own was in 1973, when she went to work as part of the Indian Action Program in Wildwood.

The rest of the time, Dolly said, the Farnsworths paid for each medical expense as it arose, just as did most people on the central peninsula prior to about 1960. In fact, for many residents not involved in some government-based occupation—transportation, law enforcement, and education, for example—regular medical coverage did not begin until the local economy began to boom in the late 1960s and early 1970s.

In those early days—and in the village days of Kenai before ground was even broken in Soldotna—medical care, and the ability to pay for it, was a much more tenuous affair than it is today.

Prior to 1960, when Dr. Paul Isaak and Dr. Elmer Gaede opened the Soldotna Medical Clinic, there had been few regular doctors in the area, and none had stayed for long.

In the mid-1950s, Dr. Marion Goble opened a practice in Kenai, starting in the leased ice cream parlor of Louisa Miller and then moving into her own residence on McCollum Drive. Goble fixed broken arms, delivered babies, helped the Farnsworths when their twins had ear infections—and sent the worst cases to hospitals in Seward or Anchorage.

Physician Robert Struthers (left) and dentist Charles Bailie chat in 1966.
From the mid-1960s to the mid-1960s, other physicians--Dr. Robert Alden Struther, Dr. Joseph Deisher, Dr. Allen W. Barr, and Dr. Osric Armstrong--also came briefly and went quickly.

And for dental care—before Dr. Calvin Fair began his practice in 1960—there were four choices: semi-retired Dr. Clayton Pollard of Kasilof, who usually worked on patients in his kitchen; Dr. Russell Wagner in Seward, who by 1960 was hampered by the effects of polio and nearing retirement; John Monfor, a Kenai resident who was trained by the U.S. Army in dentistry in the Philippines; and Dr. Lloyd Jones of Anchorage, who made periodic trips to the Kenai until Dr. Fair arrived.

Beyond those services, there were midwives, public and private nurses, home treatments, and people who knew enough to be helpful in a pinch.

Residents who needed care that couldn’t be provided locally needed to get to Seward or Anchorage, a move that could be problematic in the early days of the Sterling and Seward highways, especially when the weather was bad.

In an emergency, if 10th Air Rescue was unavailable, private pilots might be called upon to fly to Anchorage or through the pass to Seward. If flying was impossible, someone usually volunteered to navigate the rough gravel roads to a distant facility.

“You could always find someone, if it was a real emergency, in Kenai or Homer, who would fly ’em— if they could beg, borrow or steal the gas,” said Shirley Henley, a former public health nurse.

And, regardless of the situation, most folks had no insurance to help them with the costs of getting well. Consequently, most people expected to pay in full immediately after services were rendered, or to begin a series of payments until the debt was cleared.

“People were pretty honest around here (back then),” Henley said. “And if you didn’t pay your bill, people weren’t very
Dr. Clayton Pollard, many years before moving his
family to Kasilof and settling in to semi-retirement.
friendly to you.” Most people realized, she said, that each person who failed to pay his bill meant that the bill for everyone else would climb higher.

For residents whose families required considerable medical or dental care, the costs meant skimping elsewhere. For instance, Henley’s daughter, Ruth Denison, needed orthodontia, and the treatment required the Denisons to travel frequently to the orthodontist in Anchorage. Since the roads were bad, they usually spent the night in a motel and returned the next day.

“I remember one time George (her first husband) mentioned the fact that Ruth had a Cadillac in her mouth,” Henley said.

Dr. Charles Bailie, who became Kenai’s first full-time dentist in 1963, said that, although people were expected to pay, no doctor or dentist was going to refuse care, especially for a serious condition.

“I’m an old-time dentist. I used to take the people, whether they had the money or not,” said Bailie, who retired in 1993. “A lot of homesteaders didn’t have a lot of money. If they were in pain, you took care of the pain. If they paid, that was fine. If they didn’t, that was fine, too. Some people just didn’t have the money, and they’d bring these kids in. And you can’t let little kids suffer. And so I would take care of what I could.”

Generally, people found ways to cope. When Dan and Mary France moved from Soldotna to King Salmon for a few years, Mary used to call back to Dr. Isaak whenever one of their sons became ill. “He always took my calls, regardless,” she said. “I would tell him what I thought was wrong with the boys, and he would tell the health nurse (in King Salmon) what to give them, that he would prescribe.”

Another time, according to Soldotna resident Al Hershberger, Art Frisbie accidentally shot himself in the armpit with a 30.06 rifle. “It was at night in the winter, and I was re-covering the skis from my airplane in Emmett Karsten’s garage when they came looking for me to take (Frisbie) to Anchorage,” said Hershberger.

“Of course, I couldn’t go without skis, so I took him to Wildwood Station, and the Army doctor patched him up and had the C.A.A. call an Air Force plane flying nearby to land and pick him up. The MPs and the doctor escorted us to the Kenai airstrip where the plane was waiting. They took him on to Elmendorf Hospital.”

Hershberger, who has lived in Soldotna for more than 60 years, also remembered that once Dr. Howard Romig told him that the Matanuska Valley colonists in the 1930s “would give him a hind-quarter of moose for an appendectomy.”

Whatever it took, whatever currency was required. Insurance may not have been commonplace, but common decency was.

 

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