Commentary: A few minutes of education from a master storyteller

Some of my colleagues and I had an opportunity recently to do a little catching up with Dr. Gunther Hirsch, the former mayor and county council president, retired physician, author, world traveler and always one of Havre de Grace's first citizens.

Hirsch has written another book, "Sick! Patients First," whose cover promises, "A refreshing dose of the right medicine for an ailing medical system." In the book, Hirsch, 86, weaves his own remarkable story and experiences as a physician into his critique of the U.S. health care system and makes his suggestions for improving a system, which Hirsch believes isn't as broke as so many politicians and others think it is, just over dependent on "high fallutin' technology" and the expensive practice of what Hirsch calls "defensive medicine," in an effort to avoid malpractice suits, which he writes should be curbed by legislating away the lawyer's contingency fee.

Of course, no Hirsch book, or visit for that matter, can be complete without a few tales of the personal anecdote variety, spiced with plenty of opinions, most that are impossible to listen to without cracking a grin or letting out a few chuckles. "Sick! Patients First," (Outer Banks Publishing Group, and priced just under $10 at, according to Hirsch), is the sequel to the autobiographical "Life After Exile," published two years ago, which tells about Hirsch's early years, first in Nazi-controlled Germany and then in Palestine, where the family fled, and focuses on his family, his career and his settling in the United States after taking his medical degree in Switzerland.

The latest book covers some of that original ground, with less detail about Hirsch's extended family in the early days. This time there is more focus on Hirsch's decision to become a doctor, made with the aid of his late first wife, Poldi, his training in Europe and their decision to emigrate to the United States and what transpired from there. At several points in the new book, Hirsch laments the years 1955, when he first arrived in Havre de Grace and took over a recently deceased doctor's dwindled practices, until 1980, when he reluctantly associated his large family practice with a health maintenance organization, as the "golden age" of medicine.

Many of the personal stories Hirsch weaves into the book are both informative and entertaining. When he started out, for instance, there were 10 family doctors in Havre de Grace, and several discouraged Hirsch from coming there, saying there wasn't enough business to support him and them. By that time, however, Hirsch thought he and his family - Poldi and their two young daughters - had about run out of options after they trekked from western Pennsylvania across Maryland in a beat up car looking for a place to set down roots and establish a practice. So stay they did.

Of course, therein lies one of the ironies of the story and how local history might have been different had the family decided to stay in, say, Oakland or Clarksville, where they also looked. Without Gunther Hirsch in Havre de Grace, healing wounds, delivering babies and often practicing against convention (no tonsillectomies recommended, for instance), there would have been no "Million Dollar Mile" Art Show, no City Councilman Hirsch, no Mayor Hirsch, no County Council President Hirsch, no Harford Memorial Hospital.

The last one may be difficult to fathom for those with short memories, i.e. memories that span no more than 20 years or so. Hirsch truly was the driving force that kept the local hospital from closing during the time the Upper Chesapeake Health organization that owns it felt Harford Memorial had outlived its life and should be turned into a nursing home, with all of Harford County's acute health care needs to be serviced in the new hospital the organization was planning in Bel Air. If Hirsch, his children and a handful of like-minded citizens had not doggedly defended their hospital in front of the state regulatory boards responsible for granting the license for the new Bel Air hospital, one wonders if there would be a Harford Memorial today. As one who personally witnessed the contentious proceedings first-hand, I'd say most definitely no.

So, when we asked Hirsch about the plans by Upper Chesapeake, now part of the University of Maryland Medical System, to build a new hospital and a 20-building medical campus in the far corner of Havre de Grace, by the I-95/155 interchange, he wasn't very happy about it, noting that the location is the last pristine interchange on the interstate between Boston and Richmond. Hirsch lamented the hospital will be followed by motels, gas stations and fast food joints and is all this really necessary for improved medical care in Harford County? (Actually, the Upper Chesapeake site plans calls for a gas station, a few fast food joints and various and sundry retail right smack on the new medical campus!)

Hirsch doesn't dwell too much on his political career, either in person or in his new book. I asked him for his take on the county council's current spending foibles with its staff, but he demurred. In the book, however, he describes the county's health insurance coverage, of which he and his wife partook when he was council president (1998 to 2002), as a "Cadillac plan," in which the employees had little incentive to conserve care because it literally cost them nothing.

One of the more telling passages in "Sick! Patients First" can be found about three-quarters of the way through, where Hirsch writes, "Thousands of thousands of tonsillectomies are performed unnecessarily when palliative treatment will take care of the problem, and the upper respiratory system remains intact. This is just another situation of medical zealousness where billions could be saved." (In the interest of full disclosure, I had mine at age 4. It remains one of the most frightening experiences of my 64 years.)

"In many cases, patients dictate the treatment. 'I have this headache. It is killing me.'

"Why don't you buy some Tylenol and see what happens? 'No, doctor! My neighbor (there is always one of these) had a similar (it's always similar) headache and he waited too long taking pain pills, had an MRI and died of a brain tumor.' The patient insists on an MRI. Nothing less will do."

Hirsch's book contains a few malapropisms, misplaced modifiers and a handful of misspellings, but on the whole it's an entertaining and enlightening read and features some great storytelling. Actually, knowing Gunther Hirsch, one expects nothing less.

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