Newspaper article St Louis Post-Dispatch (MO)

Clinical Evidence Small-Town Doctor Bares Inner Thoughts

Newspaper article St Louis Post-Dispatch (MO)

Clinical Evidence Small-Town Doctor Bares Inner Thoughts

Article excerpt

Dr. Richard Fox has been the only full-time surgeon in this small, coal-mining town for over 30 years.

He's had to use his fist for "instant anesthesia" and keep two hickory clubs in the emergency room for rowdy patients. Run-of-the-mill for a country doctor, he says.

His real struggles have been in treating paralyzed or very ill patients, and in his recently published autobiography, "Working Without a Net: Memoirs of a Small Town Surgeon," he ponders whether euthanasia should become a part of his practice.

"It will be easy. I will take the sheet used to cover Mark and simply stuff it in his mouth. He cannot then cry out and cannot struggle," Fox wrote about a teen-age boy brought into UMWA Union Hospital about 20 years ago. The boy had broken his neck during a football game, and he was left a quadriplegic.

"It is painless for him and takes only two or three minutes . . . I catch the sheet in my right hand and tug it up in a wad. I stop and go to the door. The corridor is full of people - waiting for news here - Mark's mother is with them. I turn to Mark."

Fox couldn't bring himself to kill the youth, whose bright smile disarmed him. The 64-year-old Fox writes, "I failed him, not by neglecting his assassination, but by failing to see in him upon that day a transcendent valor."

The controversial doctor pulls no punches about the hardships and joys of serving as a lifeline to a community where nearly 11 percent are unemployed. Nearly two-thirds of Union Hospital's patients are on Medicare, the federal insurance program for the elderly, and about 13 percent get Medicaid, or aid for the poor.

The book also reveals a bitterness in Fox, who condemns welfare, "liberal Democrats," and what he sees as the loss of personal responsibility in America. He calls for quarantining AIDS patients and drug abusers.

These are sidebars to Fox's conflict over how far a doctor should go to sustain life, and the temptation to end misery by killing. …

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