Wednesday, February 4, 2009

One doctor's bag

I wondered a while ago about the likely contents of the doctor's bag I remember from the housecalls of my childhood. The Life photo archive offers what might be the best answer I'll ever find.


[Photograph by W. Eugene Smith, 1948.]

Smith took this photograph while working on what became the September 20, 1948 Life feature "Country Doctor," a look at the daily routine of Dr. Ernest Ceriani, of Kremmling, Colorado. I'd like to know what someone in medicine might find interesting in the details of the full-size photograph.

[T., any thoughts?]

comments: 5

T. said...

My first thought was, "I LOVE Michael Leddy's blog!!!" THANK YOU for bringing this wonderful photograph to our attention. It's a classic. I am tempted to go to allposters.com to order a copy for my wall.

My first reaction to the actual contents of the bag was, "Whoa, that's a lotta glass - bottles, syringes..." The practice of medicine today in the United States is completely dependent on plastic and unimaginably cruel to the environment.

How I wish I could read the labels well! This is very much the bag of a general practitioner, I think, more medical than surgical in his practice (or, if this had been a medical bag from the Philippines, his or her practice - we were 50/50 almost from the start). I was struck by how much is still in use today - the sulfa drugs, silver nitrate sticks, caffeine and theophylline, phenobarb, and of course procaine hydrochloride, the local anesthetic more commonly known as Novocaine.

I'm still from the generation that learned on sphygmomanometers like the one pictured, and our stethoscopes have gotten more expensive but are still based on this ubiquitous design.

A specialist's bag is so different from a generalist's. When we carried the anesthesia bag to emergency intubations during residency we had big orange bags, bigger than this, with equipment centered around one thing: the airway. Laryngoscopes, gum elastic bougies, masks, tubes, and the like. Perhaps I should do a companion post to your "doctor's bag" posts! Not long ago I was contemplating what I'd put in a home-grown doctor's bag if my family and I had to go out into the wilderness or something...an epi pen and some benadryl to be sure, analgesics, material for IV access and airway management, wound care supplies as this bag has...

I didn't notice this link on your 9/06 post: www.doctorbag.org - you might enjoy a look there. You might also like, as I did, this doctor's reflections on his bag - an heirloom of sorts: http://findarticles.com/p/articles/mi_qa4100/is_200601/ai_n16027931.

I love artifacts, and I so enjoyed looking through these with you. Thank you for this time happily spent!

Michael Leddy said...

Thanks for all your insight into this photograph, T.!

And if anyone is wondering where the caffeine is to be found: look for the box underneath the long black vials on the right. The two small containers at the top of the box are marked CAFFEINE AND SODIUM BENZOATE, used, as T. says, for "preop headache." Thanks, T., for explaining that one too.

T said...

At least, that's one example of today's medicinal use of caffeine benzoate! Another is for preemies with apnea...

Back when this photo was taken, though, I wonder what it was most commonly used for. Headache too, maybe?

Or to pull an all-nighter in college...?

Macon D said...

Wow, amazing how many things are in that bag.

For some reason, I still remember vividly a photo from that story. Not from when it was first published before my time, but from sometime in my childhood. The exhausted doctor himself.

Michael Leddy said...

Look at how far down he's smoked that cigarette — back from when doctors endorsed Camels.