Doctor Trumble

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         Edward Trumble grew up in a small New England town in which the population was counted in the hundreds rather than the thousands. It was a town where everyone knew not only their next-door neighbors but the families on the opposite side of town as well.

         Matthias Trumble, Edward’s father, was the town’s sole physician, and as such he was its first line of defense against sickness. He was a family doctor, what we today would call a general practitioner. Among his many duties, he was called upon to set broken bones, suture torn flesh, cure colds, deliver babies and relieve pain. Matthias found great personal fulfillment in being a doctor. He mattered. He touched the lives of everyone in town. The physician did his job admirably, and only the most serious cases were sent to the county hospital, which was close to fifty miles south.

         The humble country doctor dedicated his life to his noble profession and to the people of the small New England town. His personal needs were few. He owned a modest house where he and his wife raised their son, a small collection of books that he scarcely had time to read and a fine fishing pole with complete tackle box that was stored in his basement, still unused after thirty years.

         It’s hard to imagine a Dr. Trumble in our world of HMOs, malpractice suits, hi-tech medical testing equipment and highly specialized fields of medicine. In our time, health care has become an industry. We are used to huge pharmaceutical companies that have a pill for every ailment (and a few more to counteract the drug’s side effects). Our hospitals have become medical centers and health care networks. Dr. Trumble had never heard of computerized axial tomography or magnetic resonance imaging. He combated illness with aspirin, penicillin, hot compresses, alcohol baths and occasionally a purgative. He never dealt with health insurance companies or Medicare, and he never handed a patient a formal written bill. In short, he belonged to a bygone era, one in which physicians, lawyers, teachers and other people in positions of authority were respected and served as role model to young and old alike.

         It was no wonder then that young Edward wanted to follow in his father’s footsteps.

* * *

         Edward Trumble began his medical career as his father’s helping hand. By the time he graduated from high school, he was as skilled as any trained nurse. The autumn after graduation, Edward left the small New England town and headed for Boston, where, like his father, he attended college and medical school. After serving his internship and residency at a city hospital, the new doctor returned to the small New England town of his birth and joined his father’s medical practice.

         Young Dr. Trumble soon earned the confidence of his father’s patients. There was a feeling of relief among the townspeople that their lives would not change when the senior Dr. Trumble grew old. His son would pick up the slack and eventually take over the reins. Continuity was a comfort.

         Things were not entirely the same when Edward returned from Boston, however. The young man had a few ideas of his own he wanted to implement. It was a doctor’s responsibility, he strongly believed, to not only treat a patient’s ills but also to actively maintain his well-being. It was a concept few people in the village had ever considered: preventative medicine.

         “So you’re saying the best way to care for a sick person is to keep him healthy in the first place?” the mayor mused when Edward first suggested the overweight politician lose some weight. “I suppose that makes sense. But wouldn’t that be putting you and your father out of business by keeping people healthy?”

         Edward smiled. “You can’t prevent all diseases and injuries,” he explained. “Besides, my father and I will still be kept busy. Preventative medicine involves regular physician examinations and inoculations.”

         The mayor gave the matter some thought and then added, “Wouldn’t this preventative medicine be like the police making sure crimes aren’t committed so that they don’t have to arrest anyone?”

         “Yes. That’s a good analogy.”

         “So if there’s no crime, we won’t need any policemen.”

         “You’re missing the point,” the doctor said. “You need the police to deter people from committing crimes.”

         “Then I don’t see the benefits in preventative measures. If you need police in either case, then why change things?”

         “In preventing crimes, you avoid having innocent people fall victim to crimes. Likewise, if you prevent disease, you avoid pain and further complications.”

         A glimmer of understanding shone in the mayor’s eyes.

         Thus the idea of preventative medicine took seed and began to grow.

* * *

         Time passed and Edward assumed more of his father’s responsibilities. Soon he was carrying the majority of the burden of the practice, and it was his father who took up the slack.

         On his sixty-fourth birthday, he aging Dr. Trumble eyed his son with pride. “You’ve done well. I can look forward to my retirement, knowing my patients will be in capable hands.”

         When Edward didn’t try to dissuade his father from leaving the practice, the senior Dr. Trumble naturally assumed it was a matter of a loving son wanting to see his father get some much deserved rest and enjoy what years he had left. Sadly, such was not the case. Young Dr. Trumble wanted his father to leave the practice because he felt the older man was no longer up to the job.

         With his father at last enjoying his books and fishing tackle, Edward was the only man in town who answered to the name Dr. Trumble. He suppressed a smile as he sat at the large mahogany desk in his father’s spacious office. The smaller room that had been assigned to him when he returned from Boston would be used for storage. Edward not only accepted the mantle of responsibility that came with being the only physician in town, he grasped at it with both hands. It was a power he’d coveted for a long time.

         Sadly, less than a year after Matthias retired, he suffered a fatal heart attack. The town mourned his death, but few people felt a sense of loss since they had now had Edward to look after them.

* * *

         Unlike his father, Edward didn’t marry. He had no time for a wife and children since he spent the better part of his day at work. It was his office, not his house, that was Edward Trumble’s castle. It was where he looked out over his kingdom and, unchecked by his father, gave in to the temptation to play God.

         The first patient to fall under Dr. Trumble’s scrutiny was Amelia Lewes, the high school principal’s teenage daughter. Amelia was a pretty girl, and although she wasn’t the best of students, she was popular with her peers. This popularity led to an unwanted pregnancy, which in turn brought her to Dr. Trumble’s office.

         “I expect you and the father will be getting married soon,” the doctor said after he broke the unwelcome news to the sixteen-year-old girl.

         “Oh, no,” Amelia cried. “I don’t want to get married yet, especially to…. Well, I’m too young to get married.”

         “Adoption is a suitable alternative. I can recommend a home for unwed mothers in New Jersey. You can go away, have the baby and return after it’s all over. I’m sure your parents can come up with a suitable explanation for your absence.”

         “I don’t want to give my baby up. My parents will help me raise the child until I’m out of school and can get a job.”

         Dr. Trumble was appalled. In his world, unwed women did not raise children, nor was it common for women to work. They were supposed to marry and care for their husbands, children and homes. He knew the girl’s parents were more free-thinking than most people in town and would probably allow their daughter to keep the baby. He feared that given Amelia’s popularity, such a decision would be disastrous. If she raised an illegitimate child, other girls might do the same.

         That would be the first step to the moral decay of my town, the doctor thought as he envisioned a steadily growing number of unwed mothers marching through his office. I’ll have to nip this problem in the bud, use a little preventative medicine.

         When Amelia lost her baby two days later, neither she nor her parents suspected the good doctor had a hand in her miscarriage.  

* * * 

         In effectively diffusing a potential teenage pregnancy crisis, Edward got his first taste of God-like power, and in a short time he hungered for more. When Mr. Potts began an extramarital relationship with his father’s Irish housekeeper, Dr. Trumble hinted that the young immigrant had a sexually transmitted disease. This was a blatant lie, but Mr. Potts immediately broke off the affair and swore never to stray again. When Mrs. Sturgis developed a taste for strong drink, Dr. Trumble told her she had the first symptoms of liver disease and urged her to avoid alcohol. The scare tactics worked, and Mrs. Sturgis embraced temperance.

         Once Dr. Trumble began interfering in the lives of his patients, he couldn’t stop. Where he was once a benevolent sovereign ruling his beloved kingdom, he was now a dictator who made people adhere to his own somewhat narrow moral code.

         Eventually, though, Dr. Trumble had to battle forces beyond his control. Times were changing. Modern transportation was creating a more mobile society. Some families moved out of the small New England town, and new families moved in. For the first time in the doctor’s memory there were children in the grammar school who were not delivered by a doctor named Trumble.

         Since the new residents had no long-held loyalty to either Edward or his father, it wasn’t long before a new word crept into the town’s vocabulary: specialist. Martha Durrant, a pregnant woman who had moved into town from Rhode Island, wanted an obstetrician to deliver her child and a pediatrician to care for it.

         It’s like Amelia Lewes all over again, the small-town physician thought. If Mrs. Durrant goes to another doctor to have her baby, so might others. But there was nothing he could do to discourage the young woman.

         “Doctor, I certainly don’t mean to cast doubt on your medical skills,” she apologized when Edward tried to convince her to let him care for her and the child. “I’m only worried that something might go wrong.”

         “Young woman,” the doctor countered angrily, “I’ve delivered breach babies and performed caesarian sections. I’m prepared for any emergency.”

         “Just the same,” the pregnant woman insisted, “I’d feel more comfortable with a specialist.”

         Edward managed to control his anger and maintain a professional demeanor, but on the inside he was seething with rage. How dare Martha Durrant seek the care of a doctor from outside the town? How dare she not have complete faith in his abilities? And what if others followed her lead? Soon the townspeople—his patients—would be going to all sorts of doctors for their ailments: neurologists, podiatrists, gynecologists, cardiologists, dermatologists and god knows what other ologists were lurking out there to undermine his authority and destroy his practice.

         I can’t allow this to happen, he thought and came to the conclusion that the young woman must die. I just have to do it in a way that looks like an accident.

* * *

         Dr. Trumble waited in the cover of darkness for Martha Durrant’s husband, a milkman, to leave the house and head for the dairy. When he was sure the woman was alone, he crept across the back yard and let himself in the house.

         He brought a can of kerosene with him and proceeded to sprinkle the accelerant on the living room and kitchen floors. He then emptied the remainder of the can at the foot of the steps that led to the bedroom upstairs. Once the fire was started, the unsuspecting mother-to-be would have no means of escape.

         With a mad, sardonic grin, the doctor reached for the box of matches in his pocket.

         “Don’t strike that.”

         Edward dropped the match and spun around, stunned by the voice. “Who’s there?” he cried.

         “Put the matches away. You don’t want to kill that woman.”

         Edward recognized the voice. It was the same one that had taught him to read and patiently explained the need for a physician to clean his hands and sanitize his instruments.

         “Father!” he exclaimed with shock.

         “Yes, my son.”

         “You’re dead. I signed the death certificate myself.”

         “I had to come back,” the specter explained. “Think of it as preventative medicine: I have to prevent you from making a terrible mistake.”

         “This is no mistake. Martha Durrant must die. She’ll spoil everything if she goes to a specialist. She’ll destroy my practice, the same practice you started long ago, the one we’ve both worked so hard to maintain.”

         The ghost shook his head. “It’s not about you, son, or about the practice we built. You don’t become a doctor so that people will revere you. You become a doctor to serve your fellow man.”

         Edward wasn’t about to listen to reason, though. “After all I’ve done for the people of this town, this is how I’m repaid. Didn’t I keep them alive? Didn’t I heal their bodies and ease their pain? Didn’t I stop foolish young girls from begetting illegitimate offspring? Didn’t I keep married men and women from breaking their vows and endangering their immortal souls? Didn’t I stop people from ruining their lives with strong drink?”

         “Yes,” the father agreed. “You did a lot of good for the people of this town, but you also overstepped your bounds. I’ve repeatedly overlooked your interference in your patients’ lives, but this is simply too much. I can’t allow you to commit murder.”

         “I am a doctor and a damned good one at that,” Edward insisted. “I must therefore do what’s right for the people of this town, and that means making sure no one destroys all the good I have done.”

         “By killing an innocent woman and her unborn child?”

         “You were the one who told me that sometimes it was necessary to amputate a gangrenous limb.”

         “Yes,” the father said wearily, “and that a cancer must be cut out before it can destroy the rest of the body.”

         Edward suddenly felt his feet burning and looked down to see that the kerosene beneath him had ignited. In a matter of moments his trousers were ablaze.

         “Father!” he screamed. “Help me!”

         “I’m sorry, son, but I can’t, for you’re the cancer that threatens the well-being of my town.”

* * *

         Many things have changed in the small New England village since Dr. Trumble broke under the pressures of his job and tried to murder one of his patients. After the physician’s charred body was laid to rest, his house and office were put up for sale. An enterprising developer purchased the prime corner lot and erected a multi-story professional building.

         Although Matthias would be delighted that the building was named in his honor, Edward would surely be horrified to know that the Trumble Health Center housed more than a dozen doctors of various specialties, men and women who would forever change medical care as the people of the small New England town knew it.

Salem once played a doctor on a his favorite soap opera, "Nine Lives to Live." They killed him off when it was time to renegotiate his contract.