What is the War of 1812?” “Who is Teddy Roosevelt?” “What is thermodynamics?”
I look up from my Game Boy and stare in awe as my grandfather casually answers every Jeopardy! question correctly, one after another. When the show goes to a commercial break, he turns to me and explains, in meticulous detail, the backstory behind Rudolf Clausius and William Thomson outlining the first two laws of thermodynamics in 1850. As a ten-year-old child, I suppose I assumed that all grandfathers just knew stuff the way mine did.
Have you ever had a brain freeze from a cold drink? Just put the drink in the palm of your left hand and press your tongue to the roof of your mouth, and poof — no more brain freeze. Ever wondered where the word robber came from? My grandpa could tell you all about the feudal lords in medieval Europe who were deemed “robber barons” and how the term became popularized in America in 1859. As I grew up, I realized that not only is he my grandpa, but he is also Doctor William H. Fulton, M.D., and that he has made impacts on countless people’s lives.
He graduated from Indiana University School of Medicine in 1958. After completing his internship at Wishard Hospital and before enlisting in the Army, he practiced family medicine. During that time, he made house calls and learned how to really listen to patients beyond their primary complaints. He knew how to ask the important questions, and he remembered everything. If he saw a patient once, he could recall what they were wearing, how old their kids were, and what their pet’s name was at the next visit a year later. He never saw these details as facts, but rather as pieces of a puzzle or pages in a book that helped illustrate the patient’s story.
After two years in the Army, Doctor Fulton began a neurology residency. That was a new specialty in those days because neurology was not quite its own field. Neurologic problems were treated by neuro-surgeons and psychiatrists. Computed tomography scans and magnetic resonance imaging scans were not available. The field of neurology developed because there was a need for a physician to have an in-depth knowledge of the brain and its pathways, as well as the skill and patience to take a comprehensive medical history.
For someone who had an innate ability and passion for both medicine and history, this was a perfect fit.
In 2004, my grandfather was honored by Indianapolis mayor Bart Peterson to commemorate both his 40th anniversary as a clinical neurologist and his volunteer work in the community. One would think that a physician who had worked that hard would retire to a condo somewhere warm, but he continued to practice. He was again honored 10 years later by Franciscan Health Indianapolis for 50 years of his hospital service there. Still, he kept on running.
In total, he practiced medicine for 60 years, retiring at the age of 87.
In April of my third year of medical school, just a couple months after my grandpa retired, I was fortunate enough to complete my neurology clerkship rotation at the very same office where he changed the lives of so many people. Upon learning that I was Doctor Fulton’s granddaughter, one of his patients told me that she had been going to him since she was a little girl. “He always remembered everything; he always listened, no matter what,” she recalled. This was a common theme I noticed in his patients. Every day I met someone else who expressed how much it meant to them that he would sit and really listen to what they had to say instead of jumping straight to ordering tests, imaging, and medications.
Colleagues in his office kept lists of “Doctor Fulton’s Clinical Pearls,” and one that I heard quite often was, “If you do the wrong test for the wrong reason, you get the wrong result.” In another, he advised his students and colleagues to both “learn something new and teach something new every day.” I now have a collection of his pearls of wisdom that I will carry with me throughout my own career in medicine.
Perhaps my favorite part about rotating at my grandfather’s clinic was reading the chart notes he had written about his patients during their office visits.
I would walk into the room feeling like I really knew the patient. His notes read like 1920s novels, with sentences like, “This kindhearted woman had a misadventure one Wednesday afternoon while enjoying strawberry ice cream. … She has, fortunately, overcome this obstacle and has since had no more seizure episodes.” His patients were more than a name in an appointment slot or a diagnostic billing code. They were all people in search of medical help, with lives, personalities, hobbies, and families that might all affect their diagnosis.
Within the last two decades, the use of the electronic medical record (EMR) has changed the way doctors document patient encounters. Today, when medical notes are written, they are done so in an abbreviated, matter-of-fact way designed to increase the efficiency of charting medical records. My grandpa loathed the EMR. With all its boxes to check and formulaic format, he saw it as more tedious and less patient-oriented. There are certainly many benefits to EMRs — like quicker access to information and looking up past medical histories easily — but for someone who values personal touches as much as my grandpa does, there is understandable frustration with the EMR system. Medicine is not a fill-in-the-blank, check-the-boxes science. Doctor Fulton’s notes were always written like a story because that is the way medicine should be. It is not just about the patient’s chief complaint on a given day; it’s about the patient’s life, their story, and what ultimately led them to come to the physician’s office.
By walking in my grandpa’s footsteps for a month, I learned so much about the importance of humanism in medicine and how much of a lasting impact I can have on the lives of others, simply by listening to them. Meeting his lifelong patient with the seizure disorder was a blessing. I see her in all other patients I treat now. I hear her tell me how much of a difference I can make in someone’s life by treating the whole person rather than just the symptoms.
Now that I have graduated from medical school and am beginning my career in family medicine, I will carry “Doctor Fulton’s Clinical Pearls” with me and hope to always remember that patients are people with stories, families and children, fears, joys, and sorrows. And that my job as a physician is much larger than just clicking buttons and prescribing pills.
Editor’s note: Sadly, Dr. Fulton passed away in January 2023, but his memory and teachings live on in those who adored him.
Elizabeth Hoover Osterman, D.O., wrote this story while a medical student at Marian University College of Osteopathic Medicine in Indianapolis. She subsequently completed her family medicine residency and an obesity medicine fellowship at Mercy Hospital in St. Louis, Missouri. She will return home to the Indianapolis area this summer to practice family and obesity medicine.
Reprinted from What Our Patients Have Taught Us: Physicians Reflect on Lessons Learned About Life, Themselves, and Their Profession (Indiana Historical Society Press, 2023)
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Comments
These doctors are sadly a dying breed. We could use many more of them today, especially in rural areas.