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Point of View


By Donald W. Smith, M.D.

Iwould have been fond of Rolfe Humphries in any case. But the fact that he had spent some time in the 1960s as an adjunct professor of classics at Dartmouth College, my undergraduate alma mater, clinched the deal for me.

Rolfe came under my medical care soon after he retired to California. His academic credentials were impressive. He had taught English, Latin, and creative writing at various institutions, including his own undergraduate alma mater, Amherst. His literary honors included a fellowship from the Academy of American Poets and membership in the National Institute of Arts and Letters. His translations of Virgil, Ovid, and other great Roman poets, as well as his own published verse, had led to his twice being a finalist for the National Book Award—in 1957 and 1969.

I recount this brief biography to set the stage for the story that follows—the story of a man of letters who had a sense of humor and an ability, through verse, to mock his own medical afflictions.

My first contact with Rolfe was on a house call. I found him wheelchair bound and tethered to an oxygen line; he had ostensibly been diagnosed with a terminal case of chronic obstructive pulmonary disease. But over the ensuing months, after several more house calls and thanks to help from Rolfe's wife, Dr. Helen Spencer Humphries, a board-certified ob-gyn, he became ambulatory and got off oxygen. His presumed respiratory difficulties ended up playing no part in his subsequent medical problems.

Wit: As luck would have it, Rolfe shortly thereafter suffered a perforation in the sigmoid portion of his colon. Peritonitis set in, and I had to refer him for a colostomy—surgery to create an artificial opening to the colon. Rolfe often communicated with me in handwritten verse, which I have to this day. This description of a colostomy shows his characteristic wit, and a touch of cynicism, but no rancor:

A new ejection orifice,
The doctors think, would be quite nice.
I'm not so sure that I applaud
This project, by m'eternal Gawd.
If Jesus wanted men to go
Around like that, He'd make them so,
Or else permit them to excrete
Through their big toes, or soles of feet.
The project called colostomy
Has no appeal that I can see.
Why take off one back-cellar door
And then construct a couple more?

After patients have colon surgery, their resumption of bowel function is of great interest to their doctors and nurses. This interest manifests itself in such questions as "Have you passed wind?" Rolfe's commentary on that query came in the form of a limerick:

A horrible huckster called Healy
Broke wind through his membrum virile.
When they asked him "But why?"
He replied, "Surely I
Have the right to express myself freely."

Twitting: Following his colostomy, Rolfe underwent extensive rehabilitation, mostly with a physical therapist named Ron Brock. Rolfe could not resist twitting Ron in doggerel verse; the title of these lines is a reference to the number of Rolfe's room:

Hymn #382
The church's one foundation is physiotherapy.
For all my consternation, I know it's good for me.
Ron Brock is her apostate and also acolyte,
And I'm the futile fossil who never does it right.
Past pools of diarrhea I show my stagnant feet,
To where I think I see a white throne, a mercy seat.
Yet this is all delusion,
All wishful thinking's trick,
Of null and void the fusion:
Enough to make one sick.

Erudition: Rolfe was also a great conversationalist. I must admit that my multiple house calls before his surgery were not entirely altruistic. Of my own volition, I would prolong these visits, basking in his erudition and his tie to Dartmouth. Sadly, he died about a year later, in April 1969, of a leaking infected thoracic aortic aneurysm. His obituary filled a quarter of a page in the New York Times.

After Rolfe's death, Helen, who was also a patient of mine, asked formedical clearance to run some Colorado rapids, then to explore the Amazon, and later to visit an Alaskan glacier. Before each of these trips, her electrocardiogram showed runs of asymptomatic arrhythmia. But I gave her my medical blessing, which is required for such expeditions, and she returned unscathed—only to die following a minor gynecological procedure at another hospital.

One may wonder why, four decades later, I have chosen to write about these long-gone patients. All internists have unforgettable patients; Rolfe and Helen were without question two of mine.

The Point of View essay provides a personal perspective on some issue in medicine or science. Smith graduated from Dartmouth College in 1951, went on to serve in the U.S. Army, and then earned his M.D. at Stanford. Now retired, he for many years was an associate clinical professor at the University of California at San Francisco and also had a private practice in internal medicine and chest diseases. The story he relates here took place well before today's attention to patient privacy, but Smith is certain, had he thought to ask, that Humphries would have been willing to have his saga (and doggerel) shared. That is significant, since it was not possible to obtain permission from Humphries, or from his wife, since both are deceased—nor did they have any children whose permission could be sought. So the magazine's editors consulted with an ethics expert on the DMS faculty, who felt that publishing the piece was defensible in light of all those factors.

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