Faith and the Country Doctor

Susan Rosenbaum | December 30, 1999

Remote and often medically underserved, generations of East Hampton families coped with illness and injury until past the turn of the 20th century by relying on faith and the occasional arrival on horseback of a lone country doctor.

Not until 1913 was a hospital built in Southampton, if 14 miles from here can be considered near enough, and not until 1948 did an East Hampton Medical Group come together under one roof on Pantigo Road.

But dedication and ingenuity characterized the early local doctors, many of whom until about 40 years ago bore the names of the town's founding families. Some of them left a scientific legacy; others, through their approach to the art of medicine, a personal one.

The Way It Was

Among the early physicians in East Hampton were Dr. Edward Huntting - early 1770s, a Harvard graduate - and Dr. Nathaniel Gardiner, said to have studied in Philadelphia under the top surgeons of Colonial times. Dr. Ebenezer Sage - 1750s, Yale, hailed from Sag Harbor, as did his son, Dr. John Smith Sage - late 1700s, Dartmouth.

Practicing with what little science was known to them, these doctors and a handful of colleagues delivered babies, extracted teeth, and dispensed paregoric, castor oil, and conventional wisdom - charging fees of between one and three shillings a visit, depending on the distance they traveled and whether it was night or day.

The 19th century produced a medical pioneer here. Working with records of his grandfather, Dr. Abel Huntington, and his father, Dr. George Lee Huntington, Dr. George Sumner Huntington, having observed members of several East Hampton families afflicted with a neurological disorder, identified what was first called St. Vitus dance for its characteristic uncontrollable movements, later Huntington's chorea, and now Huntington's disease, and delivered a landmark paper about it in 1872.

Smallpox Scourge

East Hampton is thought to be the only small American community where the disease has shown up in families for more than 200 years. Though not from here, the most familiar victim of Huntington's was Woody Guthrie, the folk singer, who suffered with it for 13 years before his death in 1967.

It was more than 120 years after Dr. Huntington published his findings before the gene for Huntington's was found. Scientists discovered it in 1993, their research funded in part by the Hereditary Disease Foundation (whose board includes the actress Julie Andrews, now a part-time Sagaponack resident).

This region knew smallpox as well, in the mid-1770s, when the afflicted were quarantined in the earliest "pest house" known here, in an isolated area of Northwest. The scourge resurfaced about 100 years later when even the town's doctor, Dr. Charles Bolivar Dayton, who had been a surgeon during the Civil War, came down with a mild form. The smallpox outbreak of 1877 closed schools, churches, and even the road between East Hampton and Amagansett.

House Calls

Toward the end of the 1800s, Dr. Edward Osborne ministered to the sick here, especially the poor, often trekking to Three Mile Harbor, Freetown, and deep into Springs to make sure his patients were fed, and, occasionally, buried. Dr. Edgar B. Mulford of Amagansett treated patients there and in East Hampton in those years as well.

Ailments that today's medicines can cure in a jiffy threatened life and limb a century ago. The Star reported in June 1900, for instance, that while handling some hay one Mr. Mayes of East Hampton suffered a thorn stick to a finger, which within a few days, without benefit of antibiotics, became a full-blown crisis: blood poisoning, which "it was feared might make it necessary to amputate his arm." Happily, an item the following week noted that Mr. Mayes, who was apparently blessed with a vigorous immune system, was "slowly recovering."

Another bright light in local medicine was Dr. Earl R. Carlson, handicapped by and an authority on cerebral palsy. In the 1930s, Dr. Carlson established several clinics for the birth-injured, including, for many years, the summer home of the Carlson School of Corrective Motor Education - on Terbell Lane, East Hampton.

Dr. Dave

And, 99 years ago this month, Dr. David Edwards, a graduate of Bellevue Hospital Medical College in Manhattan, hung his shingle on what was known then as the Purple House, a small building between The Star and the East Hampton Library.

Over his 63-year practice, Dr. Edwards delivered thousands of babies, set perhaps as many fractures, successfully treated yet another smallpox outbreak among menhaden steamer crewmen at Promised Land, Amagansett, and diagnosed what was thought to have been the first local case of Rocky Mountain spotted fever, or "tick fever," carried by dog ticks, on Gardiner's Island.

"Dr. Dave" was known as much for his hunting and fishing prowess as his skill as a quintessential general practitioner. He served his community at every level: as Town Health Officer until the Suffolk County Health Board was created, and on which he sat until his death, a United States Public Health Service physician, treating members of the Coast Guard, president of Southampton Hospital's medical board and chief of surgery, and president of the East Hampton Board of Education.

Polio Conquered

The day after his death on May 7, 1964, Dr. Edwards's niece, Jeannette Edwards Rattray, the late editor of The Star, wrote of him:

"I will never forget sitting by the doctor's desk while he looked at me over his glasses like a quizzical kindly father and asked, 'What seems to be the trouble?' Or lying on a lonely bed in the Southampton Hospital at midnight and hearing the familiar quick step and brisk voice down the hall. I felt that the trouble was eased already. The responsibility was shifted to his strong shoulders."

By the mid-1960s, the fear of infantile paralysis - polio - that had haunted parents for decades had been eradicated. Though a massive effort, children here and throughout Suffolk County began receiving the polio vaccine, making history of the crippling virus. Dr. Doris Zenger, East Hampton's first female physician, a pediatrician, played a key role in insuring that the children here were protected.

Southampton Hospital

In February 1913, three years before a wave of polio swept the region, Southampton Hospital officially opened a 20-bed facility on property donated by Samuel L. Parrish, a Southampton benefactor. In 1918 a flu epidemic made clear that the hospital would have to undergo a second of six expansions. A year later, a laboratory was established, and, by 1925, a nursing school opened.

From the very start, it was the generosity of both local community residents and the often high-profile fund-raising parties of the summer colony that fueled the growth of the hospital, where Jacqueline Kennedy Onassis was born, Willem de Kooning and Truman Capote were among the patients, and Charlotte and Ann Ford volunteered their time.

By its 75th anniversary, it had grown to nearly 200 beds.

Only recently, did Southampton Hospital's financial footing founder: Its leadership in the mid-'90s misread the early-warning signals of spiraling costs and constraints under managed care and it began a fiscal slide that would end in a $50 million loss over a mere three years.

At this writing, the hospital has charted a course for recovery, which will include an alliance, for the first time, with a group of hospitals west of here known as the North Shore Unversity-Long Island Jewish Hospital System.

Future Prognosis

No longer remote, South Fork families need only log on to the Internet to sample a global menu of health care options - one sign, experts say, that the information explosion in medicine has only just begun. Health insurers are expected to tighten constraints on patients as the population ages and puts more demands on medical facilities and personnel. In the immediate future, patients and their families will make more and tougher decisions about everything from how much money to spend for an outside-the-network consultation to which drugs to take.

Indeed, advertising by pharaceutical companies directly to the public shot up by 23 percent - to $1.32 billion in one year alone, from 1997 to '98, according to a recently published report, "HealthCast 2010," by PricewaterhouseCoopers, accountants. The report refers consistently to "consumers" of health care, rather than patients.

Gene Science

In coming years, the "e-world" in medicine can be expected to ease and speed such transactions as referrals and test result reports.

For physicians, searchable databases can be expected to multiply exponentially, allegedly enhancing any doctor's access to research results, procedures, and therapies - no matter where his or her office might be.

Meanwhile, within only a few years after the turn of the 21st century, one of the most valuable medical discoveries ever is expected come to light: the mapping of the human gene - all four billion characters of it.

The Human Genome Project, as it is called, will in time enable patients to learn what flaws in their genetic makeup predispose them to illness. Genomics, then, will begin to reshape the emphasis in medicine from treatment and cure to screening and prevention.

Through a new science of pharmacogenetics, doctors will be able to custom-prescribe pharmaceuticals for each patient, based on his or her genetic profile.

Meanwhile, technology continues to improve bioengineered organs, transplantation, and new vaccines. With the new age of choice come the inevitable questions of ethics and economics, some of which are already naggingly unanswered. As those surveyed in the HealthCast report noted, "the combination of aging societies and the expanding possibilities offered by medical science presents harsh dilemmas. . . . Soon, the issues of how much governments, insurers, and individuals should pay to extend life or improve quality of life in old age will be flashpoints."