Part II of pioneering in family medicine: Persistence pays off

For the better part of 1974, I and Larry (my classmate and future practice partner) and our spouses had been driving up to a small community near Peterborough, Ont., hoping to establish a family medical office there.But by the winter, our options seemed to have evaporated. There didn’t appear to be any site that would make a decent clinic. We did have the support and encouragement of a small group of people in the community and this led to meetings with the Smith Township Council, who were also very supportive but that wasn’t going to find us a place to plant our feet.However, during our wanderings in and out of Bridgenorth, we kept passing by a little rectangular brick building with boarded up windows, sitting on a sizeable plot of land across from the Pines dance pavilion. We learned that it was a former Catholic primary school, called The Holy Family School. Would this place be suitable for us? We advised the Smith Township council that we thought, with a little work, it might be just the thing. Council got permission to let us look it over.Superficially, it was in rough shape. A decade of dust covered everything and all manner of detritus lay about. But it was a solid building. It had two classrooms, one behind the other. There were entrances at each end of the building—one for the boys, one for the girls—linked by a broad hallway running the length of the building like an off-centre spine, with the front and rear classrooms on one side, and the principal’s office and a room containing a monstrous oil-burning furnace opposite. Moving further back, there were two large bathrooms and a utility room set up on the same side as the furnace room. This place had potential, but why had it closed?Significantly, the history of this region played a hand. Ennismore Township, fondly called “The Holy Land” because of the number of descendants of original Irish Catholic settlers who moved into this region to farm, is situated across Chemong Lake, linked to Bridgenorth by the long causeway mentioned in Part I. St. Martin’s Parish is the parish for the community and includes a full primary grade separate school to this day. We were puzzled as to how and why this little Catholic school was originally built in a Protestant community like Bridgenorth when so many Catholic families lived across the lake in an established Parish that also had a school. In a few years, I learned the answer.In the meantime, Smith Township Council went ahead and made an offer to the Separate School Board. Local governments had the first right of refusal for any property owned by the Catholic Diocese that was being considered for sale, and so the offer to purchase an unused property must have been a “Godsend” for the Board. For our part, we agreed to cover costs associated with designing and renovating the interior to accommodate our practices - we were now a partnership with the township to jointly develop a primary care centre. Council, for their part, agreed to do the clean up, get the furnace in working order, add air conditioning to the building, ensure the well and pumps were in working order, added a mansard roof around the upper borders of the building to make it look less blocky, and graded out a gravel parking lot.Off we went to our favourite bank, and secured loans for $25,000 each. The cost to the Township to purchase the property and do the major infrastructure updates came to about $50,000—basically an equal investment. We would be tenants with a very attractive lease arrangement, given that we had also invested in the property and we took some solace from the fact that we could write off costs associated with leasehold improvements. The front classroom was large enough to design both of our offices and exam rooms and we set to work doing up drawings. The administration offices would make a nice waiting room. The front entrance would be the entrance to the clinic and the hall could be split length-wise in half. The outer half would remain as a narrow hall, while a small receptionist’s office, bathroom and clean-up room lined up behind one another along the length of the inner half. Within the classroom, we designed two nice exam rooms and personal offices for each of us that were arranged around the walls of the classroom. The central area would serve as the nursing area. Our own offices would have huge windows that overlooked the Robinson farm just south of us. It was a very functional arrangement.The original community group advocating for us was able to use the back classroom as a day care centre. This down-at-heel little building was suddenly turned into something of value to the community.In 1975 following his residency, Larry secured a locum at a clinic in the North end of Peterborough. This worked well for him, as a number of his patients came from “out Bridgenorth way,” and when he ultimately moved out there, he had a nice, core practice. This actually worked well for both of us, because he got to engage with people who could assist us. He met a local builder with a very good reputation, who agreed to take on the renovations. Once he had a copy of our plans for the office space, he was able to set to work and the shape of the clinic began to develop. Happily, Larry was able to be in the area now to supervise things as they progressed, taking a large burden off of me.I scrimped wherever I could in setting things up. The carpet in my office was an incredibly awful, cheap remnant. The panelling actually looked like it had already been used for a few decades in some other office. My exam tables were built out of wood by a Grade 12 high school trades class and were inexpensive and remarkably functional. Our electrocardiograph machine was used, purchased from a retired veterinarian. During this time, I was completing my residency in London, and Ann and I made a number of weekend trips up to review the progress of the clinic. It was pretty exhausting—we still remember those weary road trips back to London on late Sunday nights. I joined Larry in the spring of 1976. We hosted a formal opening, with our community champions, local officials, even the Hon Hugh Faulkner, MP and cabinet minister in the Trudeau government, in attendance. In June of 1976 we moved to Peterborough into a nice little house close to the hospital.On Saturday, July 1, 1976, I began the first weekend on call in my career. It wasn’t long before I took a call from a mother who was concerned because her teenage daughter had developed abdominal pain after consuming frozen peas. Thus, I handled the first case of appendicitis in my practice, and the subsequent 41 years is history.It was slow starting up a practice from scratch back in the day. As noted, Peterborough region was already well-served. For a few weeks, I enjoyed perusing the latest Road & Track magazine during quiet afternoons. However, that changed quickly. Surgeons learned I was available for assisting. I got a position as the Medical Advisor to a seniors’ complex, and did emerg shifts. The absolute beauty of a gradually expanding practice was that I had time to get to know so many of my patients. I also enjoyed counselling, and had no trouble finding office time to do so. I can recall on occasion actually having coffee with a patient as we reviewed some condition or other.Years later, an elderly farmer from Ennismore came in for a visit. He told me the history of the property. In the late 19th century, a farmer was accused of murder and was tried, found guilty and sentenced to be hanged. The priest across the lake at St. Martin’s parish interceded on his behalf and pleaded for mercy by the court. The execution was stayed, and not long after this, the real culprit was found and the farmer was freed. As thanks, he severed a sizeable corner of his property and gifted it to the Catholic Church—the very corner the school was located on. So, this little piece of land was born out of goodness and faith, and I can’t think of a better outcome for it.Not long after he told me this story, he was found by a neighbour, sitting on his tractor in the drive shed, hands on the wheel, just after finishing seeding. He passed the way all farmers should.The two of us family doctors went on to very satisfying practices. We delivered babies, held hospital privileges and rounded on our patients. I actually had ICU privileges in the day. We frequently scrubbed in to assist surgeries being done on our patients—something that kept our knowledge of anatomy and pathology alive, as well as sustaining comfort in doing procedures. We took part in emergency department on-call, and we did house calls. We sat on hospital committees, and we visited our patients in nursing homes. In those days work was extremely varied and increasingly busy.We could not have done this without our partners caring for our families, our homes. Ann worked part time between children, as a Public Health Nurse. Her income basically paid for our holidays and our savings. With me working in the abhorrent Ontario fee for service system as a GP, her contributions made our lives easier. I have no regrets.Stay tuned for part III. Dr. Tom Bell is a past medical advisor to the Schizophrenia Society of Canada an and a retired adjunct professor of Family Medicine in the Queens University. Dept. of Family Medicine. He is a current board member of the Morton Medical Centre in Lakefield.

Part II of pioneering in family medicine: Persistence pays off

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