Completing my internal medicine training in the summer of 1962, I packed my car and, together with my wife and three young children, set out to find a place to practice internal medicine in a town with a good public school system.
While looking for a home from which to practice, I scrounged around for some work–police calls, house calls, calls from the ER–while my family lived on peanut butter and jelly sandwiches.
Along came a job as deputy county medical examiner. It wasn’t what I trained for, and they only paid me fifty dollars per month, but there was little else for me to do, so, why not? I took it. My job was to cover the county while the medical examiner, an old GP and baseball fanatic, absconded to Yankee Stadium, disappearing for baseball season.
I ended up driving all over a large rural county answering calls about accidents, suicides, possible murders, sudden unexplained deaths and the like.
“Autopsies” would be performed in funeral parlors. Imagine the skills of a rookie internist conducting an autopsy!!
To spend time with my family, I would load my dear wife and kids in the car and drive off to a funeral parlor, performing my autopsies while the kids romped around, hiding in the caskets.
One Thanksgiving, in the middle of dinner, I was called to a scene wherein a speeding corvette hit a water tank, split in half and one of the two young men was dead at the scene.
Believe it or not, I hated the sight of blood. Back in medical school, I had nearly fainted watching a film on surgery. Now working as a deputy medical examiner, the horrors I witnessed gave me nightmares. I often dreamed I was being buried alive.
There was a small silver lining. Following a death, the loved ones would come to me, the medical examiner, for comfort and succor. A physician is a physician is a physician. I learned to be silent, to listen, to comfort.
This sent me on a trajectory that, in many ways, defined my nearly six-decade career in primary care. From the beginning, I made it a practice to do grief counseling. I always followed up on the loved ones, including deep discussions about such feelings as ambivalence and guilt.
While I was never compensated for this, the insights and lessons learned were priceless in terms of expanding my capacity for empathy and for a non-judgmental approach to practicing medicine.
On reflection, I would suggest that there are two kinds of accidents: the obvious ones and the “accidents” that wind up shaping our life’s purpose. It is unlikely that I would have dedicated my life to improving the care of the dying and their the families had I not had this serendipitous experience of being a deputy medical examiner.
Joseph Fennelly
Madison, New Jersey
