November 6, 2010 in Features, News

Wise Words with Dr. Arch Logan

By The Spokesman-Review
 

Dr. Arch Logan is the medical director at the House of Charity’s clinic in downtown Spokane.

He volunteers four to five days a week at the shelter, where homeless and low-income folks share meals, seek refuge from the elements and find medical care at the clinic.

A handful of doctors already volunteer there, but he could use some more.

Logan, a humble man, finally agreed to do this Wise Words interview so he can make the pitch for doctors for the clinic, which is sponsored by Providence Sacred Heart Medical Center.

He balked at only one question: His exact age.

Logan will concede to being in his “early 90s.” He’s in great shape physically and mentally, but he says he’s aware of an older-age prejudice in our society, and he intends to continue his doctor duties at the clinic.

This is the complete Wise Words interview with Rebecca Nappi. An excerpt was published in The Spokesman-Review Nov. 6.

  • I was born and raised in Rochester, Minn. My dad was a physician at the Mayo Clinic. I had three siblings, all older. Just recently, the last sibling was gone. One was a doctor. One turned out to be a vice president of TWA Airlines. The other married a surgeon. So a lot of medical background. My mother was a homebody but very active. I grew up in the Depression years. My dad had a job so we did not suffer, but my family, my mother particularly, was very giving, always taking food to people. There were some members of our church who lived out on a farm. We were often going out there, because they were having a terribly tough time. Frequently I can remember going out there with my mother, bringing food. We didn’t talk about it much. I was very aware that there was a lot of hardship. So giving became an early part of my life and stuck with me. I remember during the Depression learning how to eat strawberry jam on bread without butter. I also got to the age where all my friends were out getting jobs of some kind. And my dad said, “No, you can’t. We have enough. Leave (the jobs) for the others who need it.”
  • In World War II, I was in the U.S. Army Medical Corps in Alaska. I was headed to the South Pacific, and at the last minute they changed it. What did my generation learn from the war years? Everybody adjusted to it. We knew it was there. Gas was rationed. Food was rationed. Sugar and flour. We were much more frugal as a result of that and remained so through our lives, more so by far than the next generation. And I’m sure that’s the reason. You learn that there are limits to what you can buy, what you can spend. We kept budgets. I don’t know if that’s very popular these days. Maybe it is, but I don’t hear about it.
  • I came to Spokane in 1950. How did I get here? I was looking for a small clinic that was sort of patterned on the Mayo Clinic. Rockwood Clinic at that time was just being set up and formed. I was the seventh doctor there. We had a good bunch of doctors, all of them dedicated to doing the best job they could. It was a wonderful experience to practice with them. What was Spokane like in the 1950s? It was a much smaller community, everything from no traffic to everyone going to the Crescent Department Store.
  • Did doctors make house calls? That’s all I did for the first many years of my life at the clinic. It was a big part of my life. We had a full day of seeing patients at the clinic. We’d make rounds in the morning and afternoon at the hospitals and then we’d make house calls in the evening. My kids would go with me on some of those in the evening. Sit out in the car and wait. They wanted to go. I didn’t see them all day. The littler ones would be content to sit out in the car for a half hour or so. It was safe then. I don’t even remember locking the car. I’d always seem to have one or more house calls, almost every night. That was very common. And in the middle of the night, that would be the worst when they’d call. One guy who didn’t live too far from us would always call in the middle of the night and say said he needed a pain shot because he was in so much misery. I’d get out of bed and go over there. And I remember very clearly another woman whose husband ran a restaurant on East Sprague. She lived way out there. She was asthmatic. In those days, we used different medicines than we do now and I’d have to go out and give her an intravenous shot of something called aminophylline. By the time you get dressed and got there and come back, it was an hour. Why did we do house calls? People expected it. They anticipated it and it was part of your job. We had a call system at the clinic, too, and we’d rotate calls. So in the early years, there were only a few of us doing internal medicine, and we would exchange calls, so I’d often have to go out and see someone I’d never seen before. Even surgeons made house calls. I got used to it. It was a fact of life. We had a bag we carried. I still have it. What was in my bag? Everything from morphine to tongue blades to gloves to scopes and medications. Pretty much anything you’d need. (House calls) were an act of compassion more than anything else. They called. They needed help. And you aren’t about to turn over and go back to sleep. You do your duty. It was just part of the practice of medicine back then. We probably stopped making house calls in the 1960s.
  • This clinic was started in the 1970s by Sister Peter Claver, a wonderful lady. Sam Shikany (a family practitioner in town) and Fletch Luger, but mostly Sam, ran the clinic from them until late in the 1980s. I think Sam got tired. He was looking for someone else. He kept asking me to try it, so finally in 1990, I said, “OK, I’ll try it.” I went down and worked with him one day and saw a few people and he said, “That’s it, you can take over.” Before I knew it, I was in charge. I had retired in 1985. By the time Sam was looking, I wanted to keep my hand in some way and I didn’t know how to do it. So when Sam asked, I thought, “This will keep me involved in medicine to a certain extent.” And this sounds sort of corny, but I will say it anyway. There are missionaries in my family. My first cousin and his dad and another cousin were medical missionaries through the Presbyterian Church. I had always wanted to go over and join one of my first cousins in missionary work in Lahore, Pakistan. When this came along, I thought, “Well it’s a poor substitute, but it’s sort of like that.”
  • Had I has much exposure to homeless people? No. I suppose like anyone else, beforehand, I’d see them on the street, they’d beg and I’d turn them down and not think about it very much. I soon learned they are the same as the rest of us, except for their bad experiences that brought them here. They are survivors. I do not understand survival to be honest with you. I don’t understand why some of these people prefer to sleep outside under the bridge than to come in. I remember a man with the beginning of gangrene in his foot. I said, “You’ve got to come in and sleep.” He said, “No, I’ll never sleep inside again.” I don’t know whatever happened to the gentleman. That’s the reason I don’t understand survival. Some of them are seemingly content with their life as it is. And they are on disability, so they get a check every month. They are content to come down here. And yet there are others who are homeless and just fighting it like mad. I’ve known several people trying to get into college and some of them do. Then, I have people who have gone way downhill, well-to-do businesspeople, and they have just gone down the hill because of – nowadays drugs – it used to be alcohol.
  • What are some of their medical problems? The most common are the ordinary things like colds. A lot of people with hypertension and some heart problems. We do see some abdominal problems. Athlete’s foot. Skin problems. We see infections and over the last few years, we’ve seen some MRSA. We see a lot of trauma, people who have been injured by fights and falls. When I treat them, a lot of them tell me their stories. We’re so busy now that I don’t get as much time to sit and talk to them. Some of them are just fascinating people and their backgrounds are interesting to hear. A lot of them were in the service. They are very open. Over the years I can’t remember asking a fairly personal question and not have them answer. Even about their jail time. They are very open about having been in prison and even what they are in their for. Do they ask me questions? About my age. That’s the most common. I give them a vague answer, of course. I just tell them, “I’m getting there.”
  • Is there a common denominator in all their stories? Abuse in childhood, very common. Mental illness. One day I was talking to Ed about them and he said he thought 90 percent are probably mentally ill. The addictions started out with things like meth, which is still around, but then it was prescription drugs. A year or more ago, we had to stop using or prescribing any kind of narcotic. Even the simplest codeine, as well as drugs like Xanax. We will just not use it. They were pouring in saying how much they needed it. And they didn’t. We do have substitutes but they aren’t that happy about them.
  • What’s my pitch for doctors? If they have any interest in medicine and want to continue some involvement, this is an ideal way to do it. They have contact with patients. There is no night call, no weekend call, nothing obligatory at all except to show up here once or twice a month for an afternoon of seeing people. The facilities are excellent. The pharmacy is well-stocked. All they have to do is bring themselves down. Doctors are under so much stress and pressure to see as many patients as they can because the reimbursement is so poor. I honestly would have trouble pitching it to someone working his backside off all day long and doesn’t want to give up an afternoon. A newly retired doctor would be best. They would have lots of nurses to help. It’s not an issue at the moment. We have student nurses from the school of nursing two days a week, Tuesdays and Wednesdays. They spend a few hours, mingle with the guys.
  • What will doctors get out of volunteering? I say we see people on the lowest rung of the ladder. They have contact with people they have rarely or ever had contact with in a patient-doctor relationship. I think it’s valuable. You get to know they are real people with real problems in their life. If you just sit and listen to them, it’s therapeutic. Many times more so than the pills we give them. I come back to the word compassion. I think it’s an act of that.
  • Did having this come to as a widower help? It was a godsend. It gave me somewhere to go and something to do that I enjoyed. It filled the hours. And that was extremely important in those early days. Not that it isn’t now. I just got relicensed. I have a license valid for the next two years. Whether I will personally last that long, I don’t know. But I’m not going anywhere, as long as I have my mind.

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