'Doc' Oliver looks back on a lifetime career in medicine

George Oliver, M.D. has seen a lot of patients in his 42 years of practice as a general surgeon in the Farmington, Bonne Terre and Fredericktown hospitals. And while "Doc Oliver" retired from surgical practice in Dec. 2001, that wasn't the end of his medical career.

He decided that he still needed something to do, so he spent two days a week practicing medicine at the Missouri State Hospital in Farmington before fully retiring in Oct. 2021, a month short of his 94th birthday — an amazing 62 years in the field of medicine.

Sort of happenstance

A native of Richland in Pulaski County, Oliver ended up in Farmington by accident. He came here for surgical training as part of his medical schooling.

"It was sort of happenstance that I ended up here in that my senior year in training in surgery at Washington University/Barnes," he said. "Our chief there was approached by Dr. George Watkins, a trained surgeon here who was at that time the only board certified surgeon between Memphis and St. Louis. Dr. Watkins felt that he was getting behind out at the state hospital and he was hooked up with the faculty at Washington University School of Medicine (Wash U.).

"[They] agreed to send a senior resident surgeon along with an assistant resident surgeon down here for three months at a time, which worked out to give them some experience and training and some help to Dr. Watkins. I happened to be in the second group to come down here. I had a good experience here, but I had no real thought of locating in Farmington."

According to Oliver, he and the five Farmington physicians at the Medical Arts Clinic "were impressed with each other" and they invited him to come back.

"I did come back and have been here ever since 1959," he said. "It was certainly a good move."

Looking back on his medical training, Oliver called himself an "inborn" Wash U person. When he left home to go to college, he signed up at Wash U for pre-med.

"I had applied for medical school and it seemed kind of distant," he said. "It was pretty tricky to get into Wash U Medical School. They only took about 80 or so students. What a blast it was for a small town kid who never studied in high school to get into Wash U Medical School, because that first semester I just about flunked out.

"One of the professors in mathematics was from Cuba, Missouri. I started taking him home for the weekend and picking him up. He was helpful in helping with college mathematics and keeping me from jumping out the window. I got that done and graduated by going to summer school. I finished my AB Degree in the end of summer 1948. I finished first in my class my junior year and first in my class my senior year."

A general surgeon

After graduating from medical school, Oliver had a one-year surgical internship at Barnes Hospital. As the Korean Conflict was ongoing at the time, he was sent to Fort Sam Houston where he attended a month-long medical field service school and then spent two years at Fort Bragg in the 82nd Airborne. After Fort Bragg, Oliver returned to Barnes Hospital for four years to finish his surgical training.

"My training — as most of us were at that time — was as a general surgeon," he said. "It meant that we did a whole bunch of different things. I came down here and among other things, there was not a gynecologist here. Dr. Watkins and I did all the OBGYN stuff. We did not do heart stuff. It was not really going then but was picking up steam. We did a little vascular, neck and thyroid.

"I did a fair bit of orthopedics. No one was fixing fractured hips when I came here. When I came here I started doing fractured hips at Community, Fredericktown and the State Hospital. One of the things that didn't really occur much then was referring stuff to the city, mainly neurosurgery, heart and more complex vascular. We didn't do much pulmonary."

With the proliferation of specialties, Oliver said that general surgery is a pretty restricted practice now.

"People aren't general surgeons anymore, they are in various subspecialties," he explained. "I have mixed feelings about that. Among other things, people got to know who Dr. Oliver was — he was a surgeon. Nowadays, if you get something, whereas we took care of you that day, you get sent to someone like an orthopedist that may take two or three days before they take care of it."

One of the complaints Oliver has about healthcare today is how the increasing use of computers in the exam room often gets in the way of the physician/patient relationship.

"You go to see your doctor — they have a computer right there that may take away their attention — and a lot of times a scribe," he said.

Oliver has seen other ways in which the doctor/patient relationship isn't as strong as it was in the past.

"As I kind of jokingly put it, I have a sore thumb," he said. "I go to my doctor, they say I have a sore thumb, we'll get thumb tests and we'll let you know. OK. In the older days, we look at it and say you probably have A,B or C here, it's probably not something serious. Give them a pat on the back and say 'you're going to be OK. We'll get the studies and let you know about it.' Probably I would have said come back in a week. Nowadays, you get called by somebody out of the office — 'We've got your thumb tests back and your thumb's OK.' It's still hurting and they've gone.

Art of medicine

"It's helpful for the doctor to be reassuring to you. This I learned way back, they had a doctor at Wash U practicing what was called psychosomatic medicine, he was looking after everything. He ran a study in the Wash U. clinic that 70% to 80% of the people coming in there had significant psychological involvement in their illness. These people were wringing their hands over the sore thumb and making it worse. If you solve that 20-30% of this, they felt better.

Oliver is a strong believer in the healing power of a physician when they are able to relieve some of the anxiety felt by patients when seeing a doctor.

"In some illnesses, it's the principal thing," he said. "Asthma, for example. People can get upset about something and cause an asthmatic attack. I think it is less prominent in the caring that I think it should be. If you come in with something and maybe I can't nail it down specifically, but I can tell that it's not going to kill you. I can pat you on the back and say, ''you're going to be OK.' Man, what a difference that makes to any of us, me included. This was referred to back in my medical school days as the 'Art of Medicine.'"

Another form of psychological healing used by doctors is commonly known as the "placebo effect" — a beneficial effect produced by a placebo drug or treatment which cannot be attributed to the placebo itself, and is instead due to the patient's belief in the treatment they have received.

Oliver offered an example of the placebo effect from his days in practice.

"One of the guys that was a year senior to me in surgical residency came into the emergency room with terrible pains of appendicitis," he said. "Everything indicated he had appendicitis. He was hurting so bad, he was begging us to give him something for the pain.

"One of the interesting placebos is a shot of sterile water. Sterile water burns like a narcotic. He got a shot of sterile water and he was thanking us. He felt so much better and then later got his appendix removed. That's how all of this can work."

Diagnostic tools

While in his day exploratory surgery was occasionally used when testing results turned out to be inconclusive, Oliver said he rarely performed them. He noted, however, that the diagnostic tools available to doctors today are much better than they were in earlier times.

"It might be in a situation where you have something in your findings that might be suspicious," he said. "There might be a few people that had symptoms that were really serious and you've done all these studies and couldn't find anything. In desperation, you would elect to explore and look to see if you could find what the problem was. Sometimes you could find something and sometimes you couldn't. It was a perfectly logical and legal thing to do. We didn't do it for the fun or profit.

"Now we have the ultrasound studies. When I was finishing training, they were just beginning to use it and it was terribly unreliable. Second, we now have CT scans which can show detail that's almost like you're looking at it. When you have studies of that sort in the colon, x-rays can show something is there, a CT scan can show nothing there."

One change in healthcare that Oliver had trouble adjusting to is the way that the health insurance industry determines a patient's medical treatment rather than the physician.

"The physician made the decisions and it was not a problem," he said. It was expected That's what you're supposed to do. If you go into the hospital, right off the bat the hospital starts getting 'clearance' for you through the insurance company. For operations, you better get clearance.

"Earlier in doing thyroid procedures I would frequently keep people overnight to be sure they were OK and comfortable. I had done this procedure for a young woman and she went home. The phone rang and it was a girl out in California with the insurance company wanting to know why I had kept her in the hospital overnight. I said it was an operation. I said to her 'I bet if you would have had this operation you wouldn't want to go home.' She said, 'I did and I didn't!'"

Oliver would frequently have Dr. Karraker or Carleton as his surgical assistants.

"Ordinarily I had one or the other assisting me," he said. "Then the insurance companies come along and they didn't want to pay an assistant. So, now I think it's exceptional to have physicians as surgical assistants."

Something to do

In retirement, Oliver serves as vice president of the Parkland Health Center Foundation and is also Emeritus Instructor in Surgery at Washington University School of Medicine.

"I tell everybody, if you're going to retire, be real sure you have something to do," he said. "On Monday morning if you don't have something to do, usually by 10 a.m. the walls are already closing in. There are a lot of people that do end up unhappy with their retirement just because of that."

Having several hobbies, Oliver stays as busy as he wants to be. A founding member of the 67 Gun Club, he is still involved in his lifelong passion for hunting — as his basement of trophy heads will attest to.

"Something that is important to me is that I have a grand-slam of bighorn sheep," he said. "There are four varieties of bighorn sheep in North America. The White Dall, the Stone Sheep, the regular Big Horn, and the Desert Ram. I hunt elk especially. I used to duck hunt some. I used to regularly turkey and deer hunt locally. I have reached the point where I really don't enjoy killing something unless it's a real record size."

As part of his interest in hunting, Oliver took up the hobby of making rifle stocks, engraving metal and inlaying gold on rifle barrels. He takes pride in the oak leaves he engraves.

"I try to cup the leaves and shape them and put in the veins," he said.

Now that he's retired, what kind of relationship does Dr. Oliver have with his doctor? For instance, does he argue with his physician?

"To a point," he said. "No, you usually discuss it with them. I go to Dr. Kirkley. We discuss what's happening with me and he's quite willing to accept if my medicine needs to be changed some. He goes along with it or not. I've never fussed with him — he's too smart. In some ways it's uncomfortable to be the doctor of another doctor."