Transcription of Dr. Connor Moore for the show “Life, Examined”, #84
Dr. Lisa: Last Autumn I received a pleasant surprise in the mail in the form of a gift from a fellow physician, Dr. Conner Moore and this is his book Black Bag to Blackberry. Dr. Moore had been listening to my radio show and reached out, of course he could have no idea how much I loved to read and how great a gift a book is but he made my day. I’m very fortunate to have him in the studio today to talk about his experiences over 40 years of being a pediatrician in Maine. Thank you for coming and talking to us Dr. Moore.
Dr. Moore: Thank you Dr. Lisa. I appreciate that and I’m very appreciative of the work you’re doing for pediatrics. On your show I know that you’ve had people come in and talk about immunizations and other child issues. I thank you for doing that. That’s an excellent program.
Dr. Lisa: Well, lets talk about pediatrics and children in your book which you wrote not too long ago, you wrote
“In order to be a pediatrician I learn that I would need a keen sense of humor and wonderment. Pediatricians need to know the parents’ occupation and the child’s hobbies and sports interests preferably without glancing at their office chart.
Special attention must be paid to any gift a child offers you. Be it a drawing, a Popsicle stick house or a rock. Days off were not really off. There always seemed to be emergency caesarian sections or exchange transfusions. My vacations were restorative but when I returned from them, my partner would immediately take off for his 10 days of relaxation.” Takes a lot to be a pediatrician in Maine, doesn’t it?
Dr. Moore: It does. When I looked at places to settle after finishing my residency in Cincinnati in 1968, my wife was Canadian and we thought we either go to Northern Wingwood or maybe Oregon or Washington. My fellow residents and professors in Cincinnati were just aghast. Not only was I leaving academic medicine but I was going to practice medicine in the far North.
I think they envisioned polar bears. They said, “How long are you going to stay there?” I said, “Probably till I die. It’s going to be a good place to raise kids.” They were just aghast that was happening. When I got their newsletters over the years they were always changing jobs or hospitals about every five years.
They were not staying in one place for a while. The joke was that Saco and Biddeford seemed to be in the center of things. If you put a compass in Mystic one in Biddeford and swing it around it’s equally distant from Montreal, Boston and New York as the old Vermont farmer saying goes. We always thing we’re right in the middle of things.
Dr. Lisa: My family is from Biddeford. My dad’s family is from Biddeford. They used to work in the mills. We have that connection.
Dr. Moore: Yes.
Dr. Lisa: My family felt like it was the middle of everything too.
Dr. Moore: Yes.
Dr. Lisa: I think this is a good place for you to be helping the children of Maine.
Dr. Moore: Excellent.
Dr. Lisa: How did you come to be in Maine? What was it about Maine that initially drew you here besides raising children?
Dr. Moore: I think all the pediatricians at that time in 1968 were practicing solo out of their houses. They were desperately looking for partners. I partnered with Dr. Maurice Ross who was a native of Biddeford and he came to your county following his residency in Philadelphia and brought a lot of interesting things as far as IV treatment for newborns, newborn care, and umbilical catheters and that sort of thing.
I was impressed at the advanced pediatric procedures that he brought into Maine. I think that looked like a real challenge. I think along my way I’ve had to make decisions very quickly. Once when I was in high school I had a chance to go over to Germany in the field for the rotary club once but I decided not to do it because I didn’t know any German.
I woke up in college a couple of years later and said that was really stupid. I’m not going to make that mistake again. I had to decide very quickly whether to be a pediatrician when I was in the air force. I didn’t have enough training to be an internist and I had to make the decision five minutes whether I wanted to work with the pediatricians for two years or just be a general medical officer.
I had to make a decision as far as which road to take when I left Cincinnati. I was lucky enough to sit next to Robert Frost who was at Dartmouth when I was a freshman at Dartmouth in 1956 several years before he died. He talked to the freshman class every year. As a kid from the suburbs I had very little knowledge about stone walls and swing on birches didn’t make a whole lot of sense.
I think his poem about two roads diverging and I took the one less travelled. Made sense back then and having made friends with fishermen, lobstermen and farmers over the years, I think all of this poetry makes much more sense. A lot of times I had to make decisions on careers paths and I had to make them very quickly and I think this worked out very well.
Dr. Lisa: Indeed you have to make decisions very quickly often in medicine especially if you’re practicing in what I would consider a frontier medicine situation back in the late ‘60s or early ‘70s.
Dr. Moore: I think it’s all in one evening when I had a sick child with croup that there’s no senior resident to call, no hospitals to call. It was just me, the nurse, the parent, and the sick child. That was really something to think about. That happened very quickly after I came here. York County is large. Dr. Wilson and I are the only two pediatricians in York County.
York County is larger than Rhode Island and about two thirds size of Delaware. I didn’t realize how much land there. There was people coming for an hour and a half to drive to get into Biddeford. We worked pretty much on our own. There was no neonatal intensive care unit Maine Medical Center, no child intensive care center, no hospitalist…
We had to do a lot of that stuff on our own and made many frantic phone calls back to my professors in Cincinnati and they would my hand through crises sometimes. We got to know a lot of the doctors in Boston. We got their inside phone numbers and their private lines. If we got into real problem we could call them through the back lines and I think that worked out fairly well. I think for a couple of years it was just the two of us in York County. It was busy.
Dr. Lisa: One of the things that you talked about in your book was this idea of the LMD or the Local Medical Doctor. Before you finished medical school or before you finished your training, you had this experience of people outside the hospital being referred to you somewhat derisively as the LMD. The LMD did this or the LMD did that but not always put forth in a favorable light. Then you became one of those.
Dr. Moore: Right. She was on the other foot. One day in Cardiology Clinic in Cincinnati a child was standing with a questionable heart disease by LMD and I thought this child probably does not have this disease and it turned out the LMD was right. There was Marianne Moulton who just died recently was a female pediatrician. York County used to call me with kids pneumonia and meningitis on a Friday night and she was almost correct with her diagnosis.
There’s no question that she was on the other foot. Sometimes when we’d send kids down to Boston with the correct diagnosis the initial physical would come back that the child sent down with vomiting or rash or something and where they just ignore the diagnosis and that we sent the child down where it was correct to begin with.
Very often the chief of pediatrics appreciated the LMDs and sort of the people who were under him and other heads of departments. It was somewhat derisive but it was interesting.
Dr. Lisa: You also ended up needing to rely heavily on the people that worked with you; your nurses, the other members of the hospital staff, your office receptionist, and your office staff. These people came to offer a lot of very good valuable information about patients in their families and how best to care for them.
Dr. Moore: I’ve got a whole chapter in the book about whether the diagnosis was made by the receptionist or the nurse or the physical therapist and we just have to rely heavily on these. The people at the front desk knew these families very well and if somebody, Mrs. Jones is really upset about her child and she very seldom got upset or anxious we knew that there was something going on.
They certainly spotted several children with meningitis as they walked through the front door of the office or children with a very serious disease. They were really well tuned in. They would also give us the heads up if the child’s grandmother had died or something like family is getting divorced or something. They really knew these families well.
I think it started to unravel after a few years with out of wedlock babies and divorces. The receptionist said we can’t keep these family folders together any long because they’re just not holding up. We had to go to individual child folders. The people in the office knew what the relationships were as far as families and children around town.
Dr. Lisa: What you’re talking about is you used to keep families, if you’d have a family of three kids you keep them all in one family folder.
Dr. Moore: One folder and we had to go to different names doing it by alphabet it because the family just didn’t sit together sometimes anymore.
Dr. Lisa: That does speak to the importance of the relationship between the physician and the patient. Your staff and the patient’s family and how often it was very long term.
Dr. Moore: It was. Even though I’m retired my wife is my office manager for a while. We still go into Hannaford and have people come up telling us who they were from 20 or 30 years ago and it’s not an infrequent situation. A lot of the employees in my office were there for 20 or 25 years. You didn’t get a telephone free when you called in. You could talk to somebody immediately and word would filter back that so and so had a sick child and they were coming in. I think that technology is good today but I think we have to meld it with programs that still foster these intense relationships with the families.
Dr. Lisa: For several years I was a solo family practitioner and my patients had my phone number and they called me in the middle of the night. That’s actually become pretty unusual as physicians have joined physician groups and hospital groups but for you that wasn’t unusual at all.
Dr. Moore: We had a primitive answering service and I was always fearful answering the phone at 3:00 in the morning that I’d get a long number call back so I answered my own phone at home. There were some drawbacks to this and some of the calls got more bizarre as the evenings went on. My best phone call, most interesting phone call came at 3:00 in the morning is my child is, raising my dog just 18 in Hiller or I’m here college and I can’t sleep.
I thought I would call you.” Got a whole list of interesting phone calls. The other thing, my wife being a pediatric nurse, for a while we didn’t have any doctors in the emergency room in so many medical center so we had to go up and see those sick kids. I remember a couple of evenings when I gave the advice of take two aspirin now and have him see in the morning.
My wife would kick me in the back and she said, “You have no idea what’s going on with that child. If you don’t go up there now I’m never going to get back to sleep again. ” I had my own safety net at home as far as making sure I went up to the emergency room. It sounds bizarre when the hospital doesn’t have any doctors in the emergency room. I remember that’s the way it was for a few years.
Dr. Lisa: One of my favorite parts of the book is getting towards the end where you’re giving some pretty practical suggestions for how to keep kids healthy. For example, let them go outside and read to them.
I don’t think you remember this, but you were describing being part of the Raising Readers’ ceremony in your office where Barbara Bush gave a book to one of your patients. The part that you don’t remember is that I was there too.
Dr. Moore: My goodness.
Dr. Lisa: You and I actually, I think met each other before. I was a medical director for Raising Readers and you are a reader yourself.
Dr. Moore: I didn’t realize that.
Dr. Lisa: This is one of the things that you say we should all do for our kids.
Dr. Moore: I think we fostered that back even when I came to your county back in the late ’60s early ‘70s. I think I’ve read some studies to show that if a child has ten books at home they will, children’s books, they will become much better readers later on. You think that would be a piece of cake. Well some low-income families those books are $15 or $20 a piece. That’s a lot of money. Who is the lawyer who is the head of the Raising Readers?
Dr. Lisa: Owen Wells from the Weaver Foundation
Dr. Moore: You’re right. I wrote an article, letter to the editor and I said For all the things are doing some legal foundation these Raising Readers is probably the most bang for the buck where I’ve seen they’re really they should be proud of them. There’s been a prototype for other states that come and visit the program.
My son in Colorado has a similar program. One of the simple things like putting safety caps on pill bottles. It costs some money but take some thought but it’s not rocket science. It’s something if you get some dedicated people you can implement this. It just makes a huge difference down the line.
Dr. Lisa: As does encouraging children to go outside.
Dr. Moore: Yes. My kids have all been hikers. We take our grandchildren out on hikes. I think they’ve done a study in England showing the benefits of getting outdoors as far as mental health problems or ADHD. It’s absolutely critical.
I think a lot of the kids have this environmental depravation syndrome where they don’t get out they’re watching TV or playing games inside. I think there’s a lot of evidence that the kids really need this. Probably one subconscious reason that I moved to Maine maybe a lot easier to take it outside here than other parts of the country.
Dr. Lisa: How has it been to have the tables turn and to be a patient now yourself? You contacted me and you said, “This is my story and I think you should also know that I have Parkinson’s. I’ve been working with the Medically Oriented Gym and they’re doing a lot of interesting work there and maybe you should look into it.” How has that been for you to be the patient now?
Dr. Moore: It is. I think there was a movie called The Doctor. I forget who played the leading role. It is a surgeon who has cancer of the lungs and the tables are …
Dr. Lisa: William Hurt.
Dr. Moore: Yes. The tables were turned and he has to take a number in clinic and wait for the radiation and the operating room turns the tables on him. It has been a bit of a wakeup call in that direction. I usually don’t drink when I’m out eating but sometimes my balance is a little bit off going to the men’s room later on.
You can see people looking or sometimes I’ll have a little trouble getting change across the counter to a clerk or something that maybe a little short with me and you just get a little hint of what some of the kids with cerebral palsy or other disabilities must go through. I think even today I took my medicine on time but my voice is not usually as good as it is. I’ll have good days and bad days. Sometimes it can do that without notice.
I think we have a group at the MOG of six or seven people with Parkinson’s who’ve got to know each other. It’s like a moving support group. It’s really been an interesting evolution. There’s a chap I take from church, I won’t give his first name but he has Parkinson’s and he’s a couple of years older than I am. Has been a patient about 11 years.
A lot of trauma gets stuck in doorways and I said this was going to be a project. I held my breath and he’s done magnificently. He’s back driving his truck, he’s walking much better. I’ve been asked by other people in church, “What the hell have you done with him?” Pardon my French.
He’s a new person, he’s brighter. This is just a little part of the program of interacting. I think medical school they’re having medical students wear blinders so they see what it feels like you being blind or they can simulate some other disease processes. It’s a wakeup call.
Dr. Lisa: Dr. Moore, I know that you and I could spend so much more time talking about this. We’ve barely scratched the surface over the 40 years that you’ve been practicing medicine and even probably the 20 something years before that in your life. I know that many children in Southern Maine who are probably now adults or a good chunk of them are now adults have benefited from your wisdom, your care, your compassion, your connection and also all the work done by your wife to keep your family and your practice going.
Dr. Moore: Thank you very much. I hope there were some little truisms or words of wisdom that floated out today and the things I’ve learned over 40 years. As you said we just scratched the surface for some of that but I thank you again for the work that you do with children on your radio show. I think that’s some excellent program. Thank you.
Dr. Lisa: Where can people find a copy of your book, Black Bag to Blackberry?
Dr. Moore: It’s available on Amazon. I know that they have them in Nonesuch books in Biddeford. I’m sure if they went to the Nonesuch store in South Portland and ask them to send some books down there they would certainly do that. If anybody wants to contact me, I do some speaking gigs in PowerPoint around the book. The Jesse’s gift address is Box 1234 Biddeford 0405.
I think something worth looking out for because out of the probably thousands of boxes there’s only one box that goes 1234. Somebody was working very diligently behind the scenes to get that box number and it’s a just an interesting turn of events.
Dr. Lisa: We’ve been speaking with Dr. Conner Moore, a retired pediatrician and now author of Black Bag and Blackberry. Thanks for coming in.
Dr. Moore: You’re welcome.