Delicate snow crystals clung to the tree branches like the spectacular blossoming of winter. They gave a sense of suspended time to the still, gray afternoon in central Wisconsin. A vague sense of waiting prevailed. Something would happen soon, it seemed. Somebody would stomp his foot, a child would shout, a bell would ring suddenly. Then the millions of crystals would fall softly to the earth and the animation of life would resume with a rush.
In a small, single-story home on the southeastern edge of this farm community, where the frosted trees lined the streets in a graceful, motionless dance, the quiet drama of one man`s final goodbye was being played out.
It was a private thing that began several months ago, and it involved only a few people each day. They would park their cars out on the street or in the driveway, and then they would come in through the side door of the house to spend an hour or so visiting with Dr. Ben Lawton and his wife, Ruth.
There would be jokes and stories and the shared memories of good times. And there was always the political talk, with the hides of conservatives frequently nailed to the wall amid good-natured derision.
There would be predictions and plans, and then sometimes, despite everyone`s best efforts, there would come very brief moments of silence and sadness. Sometimes it was simply impossible to keep the conversational ball bouncing enough to block out the reality of the tubes that were threaded into Ben Lawton`s body or the occasional catch in his voice when the pain wrenched at him.
Ben Lawton is dying of cancer. The quiet, kindly maestro with a scalpel, veteran of 30,000 surgical procedures was powerless in his own cause, and he faced his inevitable death with the kind of class that has characterized his life.
”There are two ways you can handle something like this,” Lawton said in his quiet, steady voice. ”You can isolate yourself and wallow in self-sympathy, or you can do what I`m doing. I`ve arranged to spend as much time as possible at home and to see as many people as I can, the people I know and love. They come here and we talk about the past and the present and the future. We don`t hold wakes.”
There was certainly no wake on the day of the frosted trees. For the benefit of his visitor, Lawton talked about his childhood in the Kickapoo area of Wisconsin, about his arrival in Marshfield as a young surgeon, about the growth of Marshfield Clinic to become one of the best-known and most-respected medical facilities in the Midwest, about the philosophy and activities that had kept him at odds with many of his fellow physicians over the years, and about how he chooses to die.
The talk was interrupted frequently by telephone calls from friends and associates, and it was punctuated occasionally by Ruth`s laughter as amusing incidents were recalled.
The story that emerged was not just Ben`s. It was Ruth`s, too, of course, very much Ruth`s. And it was a story of the kind of matter-of-fact dedication that inches humanity along on its agonizingly slow climb out of the primordial mire.
They met in high school, in the small town of Viroqua in east central Wisconsin. Ruth was from a farm and Ben was a city kid. They became sweethearts, and after high school, when Ben decided to study medicine, Ruth was suddenly stricken with an eye disease that left her blind. It was a cruel circumstance that was accepted by both of them to such an extent that it never became anything more than that, a circumstance to be dealt with in the course of living normal lives.
They married and struggled with the combination of family rearing–three sons and a daughter–and medical studies at the University of Wisconsin. In 1954, the Lawtons arrived in Marshfield and Ben, as a general and thoracic surgeon, became the 22d physician to join the staff of Marshfield Clinic.
”The concept of group practice was just
beginning to take off,” Ben said in recalling their arrival. ”It was pioneered in Wisconsin and Minnesota, and it was not looked on very favorably by the AMA (American Medical Association). They considered it as some kind of communist plot.”
But take off it did, and almost suddenly, the kind of specialized and expert medical care that big cities took for granted was available to the rural areas.
Some of the credit for that is obviously due Ben Lawton and others of his ilk. Lawton served as president of Marshfield Clinic for three different terms, chafing under the requirements of administration that took him away from his surgical duties but helped to recruit the best medical talent available. Marshfield Clinic now has 242 physicians and despite its size has maintained a reputation as a place where a farmer with mysterious pain or a mother with a sick child can get personalized treatment.
”It has not been easy to get physicians to come to a small town that does not have any recreational water,” Lawton said, ”but one thing we could always offer was the opportunity to do as much work as you could handle. In a place like this the work is there and you don`t have to spend half your time stuck in traffic as you travel from one hospital to another.”
But Lawton has reluctantly accepted the fact that most physicians are not willing to put in the kinds of hours that he did. ”There`s been a change in lifestyle,” he said, ”and I don`t know if it is part of the `me` generation or not, but doctors have gone along with it. They don`t want to be on call seven days a week.”
When that means that a physician who has cared for a woman during her pregnancy is off-duty when she delivers, the professional image of medicine deteriorates, Lawton said.
”A lot of doctors don`t want to work very hard,” he said. ”That and the blatant display of prosperity on the part of some doctors have soured a lot of people on physicians. I`m afraid that the general public has come to look on us as very greedy. The two-Mercedes syndrome does not sit well with people.”
Lawton has driven Chevrolets most of his life, and has also bought several second-hand Cadillacs from colleagues. ”`I never paid more than $3,000 for a car in my life,” he said.
The rapid advance of sophisticated technology, much of which is difficult for people to understand, has also been a factor in increasing the gap between physicians and their patients, Lawton said.
”I don`t see much chance for improved relations unless it is forced by increased competition due to the glut of physicians,” Lawton said.
”The ultimate solution will be at the ballot box,” he said. ”Some form of intervention of a major
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nature is going to be required, and we have to elect representatives who are sympathetic to the problem of providing compassionate and complete medical service to all of the people. It has been a long time coming and I wish I could be around to see it.”
Lawton has been an active supporter of liberal causes and has on his office wall one of the pens that was used by President Lyndon Johnson to sign the Medicare bill into law.
”Doctors were against this at the time because they claimed that we were already taking care of the old people,” Lawton said. ”That was certainly proven wrong. My God, the old people who were not getting care flooded our offices and the thing ended up as a bonanza for the medical providers.”
Lawton`s voice has the ring of life-long conviction as he speaks of his politics. ”I`m almost a Roosevelt type liberal and I`m not ashamed of it,”
he said.
He also has strong feelings about his astounding record of surgery. ”You have to be a little bit proud, I guess,” he said. ”You remember the victories.”
Among the victories is Betty Sharenbrook, who came to Lawton with cancerous hips and little chance for recovery. Lawton literally cut her in half, severing her spinal column and removing most of her body below the rib cage.
At the time it was one of only 11 similiar procedures done in the world, and one of only four to succeed, Lawton said. Sharenbrook not only survived but went on to lead a very active life, keeping her own house with the aid of a mechanic`s creeper and a wheelchair, and fishing local waters at every chance. At the age of 75 she attended a special driver`s school in order to drive herself to fishing spots.
”She is truly an incredible person,” Lawton said. ”I`d like to see her before I depart, but my house is not wheelchair-equipped.”
Lawton is home against the advice of some colleagues who think he would be better off in the hospital. But he is obviously his own man in the matter and also did not consult with anyone about flying to Madison to attend the University of Wisconsin graduation of his youngest son several days after this interview.
Lawton is a member of the University of Wisconsin Board of Regents, and has served several terms as its president. ”I feel a great debt to the University,” he said. ”I owe it for my entire career and it has been gratifying to be able to give some of my time to it.”
The onset of Lawton`s disease began with back pain that could not be tracked down. Last fall it finally showed up on CAT scans as cancer of the pancreas. ”By the time there is pain, it means that it is out of bounds,”
Lawton said. It also means that time is short, a matter of months at the most.”
Lawton is unable to eat and wears a device that feeds nutrients into his body and also allows him to regulate the amount of narcotic that he takes. The end will come, he said, with complications from some other disease or a degree of pain that will be intolerable, at which time he will cease to take nourishment.
”It is obviously not a pleasant thing to think about,” he said, ”but the end must come for all of us. Most of us don`t get the chance to have a hand in it, as I have, and in that respect I am lucky.
”The response from people has been a very gratifying thing. I am fortunate to have so many good friends and to know that they care enough to come here and spend a little time. There`s been quite a parade of people through here in the past couple of months. I would like to have had some more time, but you have to play the hand that is dealt to you. You learn that in this business.”
Ruth Lawton sat in a chair nearby and listened as her husband spoke. She nodded to acknowledge the brutal truth of Ben`s statement, and then she tilted her head to ”see” him in the inflection of his voice and the rustle of his clothing as he moved against the pain that was always there.
There was one of those brief moments then when the Lawtons` matter-of-fact acceptance of fate seemed unreal, and emotions seemed to poke out of the shadows like the tentative snouts of hungry rodents.
”I don`t expect any breakthrough in cancer research that will help me,” Lawton said, ”but I think the breakthrough will come. It will probably come in bits and pieces and it may come unexpectedly out of some unrelated basic research. That`s why it is so important to support this kind of work.”
It was late afternoon, time for Ruth and Ben Lawton to lay out the plastic containers to mix the solution for the IV pump that Ben wears.
It was time for Ben Lawton`s goodbyes to end for the day.
Outside in the winter dusk, the ice crystals still clung to the trees, survivors of a rare, windless winter day when the Earth seemed to hold its breath.
