Boreal B[l]og

I’m not sure why I did it, last Sunday afternoon.  I was tired of doing zooniverse inputting, I had answered 16 algebra problems online, and I didn’t feel like doing any more of them either, so I googled my pediatrician from 60 years ago, Frank Disney.  I wasn’t sure what I’d find, so I added, “rochester ny” and hit return. 

I had remembered Frank Disney as the elderly man (he was two years older than my father) who visited me at home when I had strep and lay febrile and miserable in my bedroom.  When I got my well-child exams, I went to the pediatric practice about 2 miles from home, and saw Disney or his partner Burtis Burr Breese.  My mother once told me that when Disney treated my brother, he told her, “I can’t make him half well for you, so if he gives you any trouble, just have him go out and play along Route 20.”  She loved that line and it became part of our family lore.  Later, Drs. Breese saw me at home; they each had their own style, and I liked both of them.

Disney and Breese founded the practice after the war.  Disney had been working at the blood bank in Rochester early in the war, shipping hundreds of pints to New York City every week, and then was himself sent to the South Pacific from 1943-6.  He was discharged as a Captain, and that is all he listed on his CV.  I have read much about that particular theater of war, and I wonder exactly what Disney did there and where exactly he was, knowing that it was a difficult place not to become ill, let alone die in war, and he was still in the area several months after hostilities ended with Japan.  Not a word, which was typical with the Greatest Generation.  

Disney and Breese practiced at a time when they made house calls every evening, hoping they could get useful information by phone, assuming they could get the operator.  That’s where I intersected the practice. I remember more than one house call, when I was sick, got a shot, and the next morning awoke feeling well.  And while I didn’t learn this until today, I did not form antibodies to that particular strain of strep, and there are many strains of Group A.

At least 35 articles came out of their practice in the 1950s and 60s. The physicians were interested in Group A Streptococcal disease. I am part of multiple data sets. Carriers of streptococcus were uncommon, about 4% of people, but my brother was one, and from the information they learned, he was treated, which perhaps finally ended my long history of periodic strep throats, one more of which would have led to a T & A.  They sampled their patient records every 15 days to randomly study their practice, a superb approach today—simple, not difficult, and effective.  They did this with pen and paper, no computers, just good minds. They were doctor-scientists-humanists, words of honor. 

I now realize how lucky I was to have my strep throats treated by experts, so my risk of complications of rheumatic fever and acute glomerulonephritis was minimized.

Disney knew that house calls were not efficient, but from the interview I read, he learned much about the family dynamics and the child from being in the house and seeing the interactions. I made house calls occasionally as a neurologist, and I agree completely.  When he and his partners realized that white counts and cultures were important to diagnose and treat strep, they had the children come to the practice.  Still, somewhere in the recesses of my mind there was one of their ancillary workers who came over and cultured the recesses of my throat.  I can’t swear to it, but I think it happened.

Disney thought it would be a great idea to charge parents an annual fee for unlimited visits. He was only about 50 years ahead of his time. The other pediatricians in town were not at all interested. 

He was interviewed in 1996 about his life and practice. Disney remembered when he was a young boy, in the early 1920s, when a child could not go to a store without a doctor’s note saying s/he was not infected with poliovirus.  In short, the country was more sensible in the 1920s than it is in the 2020s.

When the Salk vaccine came out for polio, the practice was besieged by parents wanting the vaccine, wanting to know when they could get it.  When the Sabin vaccine appeared, I was in the first cohort to get it, and I remember where I ate the coated sugar cube in the southeast corner of the junior high school by Twelve Corners, which still stood, when I drove by there in 2013. 

The same occurred with measles vaccine:  the parents wanted it immediately. They did, after all, know what these diseases could do.  There were measles epidemics about every 3 years in most cities, which I did not know.  Apparently, an epidemic was enough to give temporary herd immunity until it dropped low enough, probably below 80%, for it to again infect anyone who hadn’t had it.  I remember having measles; it was the sickest I have ever been.

I sure wish we had Frank Disney around today to tell us that pay per visit is not an efficient way to practice, although it certainly may be more lucrative. Or to show us that good science can come out of a working medical practice in Brighton, something I tried to do years later and thousands of miles further away, with not at fault injuries and chronic pain, with right hemispheric stroke patients, who were awake but kept their eyes closed, and with the fact that female spouses came into the exam room when their husband was being examined three times more often than men did for when their wives were the patient, and that depression was—and is—a major concern of the practicing neurologist.

I really wish Disney could tell people about measles and polio, that having a note from the physician to go to the store was once thought by Americans as necessary, was considered neither a hardship nor a violation their constitutional rights, because you didn’t want a family member to get polio.  

That’s up to me to say for him in the Age of Covid to all of those who are alive because of people like Frank Disney. 

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