{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/v11vd6r406/manifest","type":"Manifest","label":{"en":["Dr. Harvie M. Attwood"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2017-02-21 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Sam Taggart (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["Video file"]}},{"label":{"en":["Keyword"]},"value":{"en":["Rural Medicine","Arkansas","Family Medicine","Family Physician"]}},{"label":{"en":["Subject"]},"value":{"en":["Harvie Marks Attwood, MD (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/293/459/small/HarvieMarksAttwooddvd.mp4_1759335399.jpg?1759335400","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459","type":"Canvas","label":{"en":["Media File 1 of 1 - Harvie_Marks_Attwood_dvd.mp4"]},"duration":3904.2003,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/293/459/small/HarvieMarksAttwooddvd.mp4_1759335399.jpg?1759335400","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/293/459/original/Harvie_Marks_Attwood_dvd.mp4?1759335379","type":"Video","format":"video/mp4","duration":3904.2003,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459/transcript/84886","type":"AnnotationPage","label":{"en":["Dr. Harvie M. Attwood Interview Transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459/transcript/84886/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Interview with Dr. Harvie Marks Attwood       \n\nGood morning; my name is Sam Taggart.  We are at the Family Practice Center in Pine Bluff, Arkansas interviewing Dr. Harvie Marks Attwood who is originally from Rison, Arkansas.  I think, didn’t you start a practice down there?\n\n“Yes, I did.”\n\nBefore we start this interview, I would like to remind you that this is about you and it’s your interview.  So, we can go in any direction that you want to. It seems like the most appropriate place for us to start is the very beginning.  \n\nTell us about when and where you were born and what were the circumstances of your birth.  \n\n“I was born right here in Pine Bluff, Arkansas at the old Davis Hospital up on Cherry Street on October 21, 1952.  My parents at that time were living in Rison and continued to live there until their death.  I was the 5th generation Risonian with my great, great grandfather moving to Rison in 1865.  We still have some property that was name granted, or deeded, in 1866.”\n\nDid he come here with the river?\n\n“No, he came there to escape reconstruction in South Carolina.  The family originally settled in Newberry, South Carolina in the 1700s with the hest of John C. Calhoun.  Our ancient ancestor and John C. Calhoun were classmates at Yale.  My ancestor was a physician and John C. Calhoun had a best friend in South Carolina that died unexpectedly, so he lamented the lack of physicians in rural South Carolina and he talked my ancestor, Curtis Attwood, to move to Newberry from Connecticut.  So, we’ve had physicians scattered throughout our family history; but I was the first in many generations.”\n\nWhat kind of work did your family do?\n\n“My father was a civil engineer, but worked primarily in the timber industry.  He worked for a family in Rison called “The Elrod Company” who were timber brokers.  They had large contracts to provide telephone poles and piling.  There was a large project in Chicago where they provided over 5,000 poles and piling for a peer and water system project.  My father was the employee who went out and found trees that were suitable for piling and telephone poles, spotting them.  He later moved over as a manager of a plant in Fordyce that made telephone poles out of Pine trees with Creosote and another chemical called Pentachlorophenol, or Penta.”\n\nYou can still smell that when you get close down there.\n\n“His plant was in Fordyce and its long gone now.  There is a new plant right there.”    \n\n\n\nYesterday when I was driving through there, I could smell; I didn’t know what that chemical was, but you could smell something there.\n\n“That’s exactly right.”\n\nWhat did you say it was?\n\n“Penta, short for Pentachlorophenol.”\n\nIt’s a carcinogenic; I feel, right?\n\n“Uh, yeah.  If it is, I ought to be eaten up with cancer because my summertime job between semesters in college was to work at the treating plant in Fordyce.  So, I was exposed to all the Creosote and Pentachlorophenol that one would care to be exposed to.”  \n\nDid you have brothers and sisters?\n\n“I have one older half sister who is 10 years older than I.  Her name is Tony Bradford and she is a former state representative for Pine Bluff and a retired school teacher.  She now lives in Springdale; she recently moved there last summer.”\n\nTalk a little bit about your memories of your childhood, a little kid growing up.  Was being raised in Rison like being raised in the country?\n\n“No; well, yes it was.  I was part of the baby boom and I had lots of friends my age.  Being in a small town in rural Arkansas, everybody knew everyone.  I remember growing up before dial telephones were installed and we had a central operator there at the telephone company.  As a child if I were looking for my mother, I would just ring the phone and say, “Ms. Dedmon, this is Mark.   I need to talk to my mother.”  She would say, “Well Mark, do you think she is at home?” and I’d say, “Yes, mame.”   She would ring and if she wasn’t there, she would say, “Well, she just called a while ago from Ms. Cameron’s house; maybe I’ll ring there and see if I can find her there.”  So, that was our telephone system until dial phones came in and all that went away.”\n\nWere you on a party line?\n\n“No, we were not on a party line; one of the very few places that didn’t have a party line.  Now rural even kind of did have a party line, but that was part of small town America; you knew the telephone operator and you just rang her up and told her who you wanted to talk to.” \n\nOur operators name was Delma, just Delma.  I just remembered her as Delma.\n\n“Ms Dedmons’ first name, I think, was Cornelia.”\n\nI keep up with sports in Arkansas and Rison has always been known for its football teams and basketball teams; I believe.\n\n\n“Not basketball, just football.”\n\nOk, football; but they have always been known for it.  Were you in sports?\n\n“Yes, I was.  In fact, they have this group that supports the football team called “The Hedge Dwellers” because used to, the field was rimmed with hedges and these guys hung out in the north end zone next to the big hedge there.  They have a little banquet every year before the start of the football season and they always asked someone to speak.  For some unknown reason last year, they asked me to speak.  So, I spoke for about 15-20 minutes on the history of football in Rison.  So yes, my father played at Rison, I played at Rison, and my two sons played at Rison.  In Rison, you participated in everything; football, baseball, track.  I didn’t do basketball.”\n\nYour memories as a child; were they good memories or bad memories?\n\n“Oh excellent; yes sir.  We lived in a small house there in Rison and two blocks away on top of the hill was my father’s mother.  All in the neighborhood, there were children my age.  Every morning, I would leave the house at 7:00 or 8:00 o’clock and I might come home for lunch and I might not. I wouldn’t come home again until dark and every vacant lot you either had a football game, basketball game, or baseball game going.  Everybody had a bicycle and you just roamed town with each other looking for something to do.  We never got into any trouble.”\n\nHunting and fishing?\n\n“Yes, hunting and fishing; very much so growing up. It wasn’t near the leisure activity it is now because most people were too interested in making a living to spend a lot of time hunting and fishing.  I remember growing up and if you owned a flat bottom boat and had an outdoor motor; you were something of an elitist as far as an outdoors man goes.  Now everybody has a bass boat, four wheeler, and ATV; that’s how much our economy has changed.”\n\nDid you have an extended family?  You talked about having an extended group of friends surrounding you there in town, but did you have extended family?\n\n“Absolutely; to this day, there are one, two, three, four Atwood families still there in Rison.  So yes, most of my family continues to stay in and around Cleveland County.”\n\nWas your family religious?   \n\n“Yes, we belonged to the Methodist Church.  My father was on the Board of Directors and now, I am the Chair Administrative Board of the same church that my great, great grandfather helped found.”\n\nSo there is an Atwood involved.\n\n“Yes.”  \n\nIf it happens; there is an Atwood involved in some sort.\n\n“Pretty much.”\n\nLarry Pierce became a Methodist minister even before he went into medical school.\n\n“Yes, you are exactly right.  I had forgotten all about that.”\n\nDid you have any interests in school or was school a big deal around your family for you going to school and doing well in school?\n\n“Well, I did.  School came rather naturally to me; particularly math and science.  I was encouraged to do well, but it wasn’t a center focus of our family life.  So, I went to Rison High School and graduated first in my class.  I then went to Henderson State College at that time, now University, and actually practiced with the football team for a year.  Not on scholarship, but as a walk on and people said, “You played a year at Henderson” and I said, “Naw, I didn’t ever play.  I practiced a lot, but I never played.”  That was one point I wanted to make when I addressed the high school football team.”\n\nWhere there people in your life as a child; teachers, preachers, or other family members who had a big impact on pointing you in one direction or another; maybe had an impact on your success in life?\n\n“My father was always an impact to be honest and rather soft spoken, but he was looked up to in the community as someone who was rather intelligent.  My high school guidance counselor who was retired from the Air Force, but came back to Rison, told me one time, “You know, your father is the smartest man in the county” and I thought to myself, “How come he aint the richest?”  So, he was looked up to, but he was rather soft spoken.  Let’s see…..”\n\nCoaches?\n\n“No, my first coach that I really remember was Bill Dawson, the father of Billy Dawson.  Billy Dawson was born in Rison and now the new football coach at Fayetteville and lead Russellville to the State Champion last year.”  \n\nAnd moved from Bauxite.\n\n“Yes moved from Bauxite and also the head coach at Nashville for many years; a great success.  But, his father was my first football coach and I lived in mortal fear of that man.  One fellow I did look up to was an assistant coach named “Joe Carrol.”  Joe was the assistant coach to Bill Dawson.  They started the great tradition of Rison football in 1966.  From 1952 to 1966, Rison didn’t really do much.  They were playing schools who were much bigger than they were and kept getting hammered.”\n\n \n\nWhat class of school were they?\n\n“Class A back then.  In 1966, they moved down to Class B.  They just met with instant success, but also due to the fact that Bill Dawson and Joe Carroll became coaches.  I really admired Joe Carroll simply because Joe was plain spoken and really didn’t care who he was talking to; Joe Carroll was going to be Joe Carroll.  All the kids flocked to him, not just myself; the whole team really looked up to Coach Carroll.”\n\nAt what point did you start thinking about what you might want to do with your life?\n\n“Probably the middle of my freshman year in college.  When I went to college from high school, I had no idea what I wanted to do.  My dad and I had talked about it and he said, “Well, why don’t you start out in accounting because everybody is going to need some accounting background no matter what field you go into” and I said, “Ok.”  So, I went into accounting and I excelled in all the math classes; but the business classes, I did not like and I never could quite remember if the credits were on the left and the debits on the right or vice versa.  It never made sense to me that if you wrote a check for something, you debited cash and credited something else.  I said, “How can you credit something when you are taking something away?  That doesn’t make sense to me.”  So, I decided right then that I was going into pre-medicine the second semester of my freshman year in college.  I grew up in Rison and Rison had a small Hill-Burton Hospital built in 1952.  There were revolving door physicians there in Rison because small town Arkansas was hard on physicians and so, I jokingly said, “Most doctors come to Rison and 2-3 years later left divorced and dependent on some kind of medication.”  I didn’t want to do that and so, I had the aptitude; but instead of going into medicine, I went into pharmacy school.”\n\nReally?\n\n“I went to pharmacy school in 1973 after three years at Henderson and graduated in ’75; that was back when you went a total of six semesters straight through in two years.  I was hired by Bill Freeman who was a head pharmacist out at Baptist Hospital in Little Rock in its infancy to become one of the first two night pharmacists in the greater Little Rock area.  Until then, the model was a drug closet at night with emergency medicines and if there were something that had to be administered during the night, the charge nurse would get into the drug closet for whatever it was.  They would write on the manifest, “I used two bottles of normal saline” and then the next morning you would restock it.  Bill had the vision that we really needed to keep the pharmacy open 24 hours a day, seven days a week.  So my classmate, Smith, I forgot his first name now; but we were the first two night pharmacists at North Little Rock Memorial Hospital.  So, I started working there and if you could imagine after about midnight, things got rather slow.  I was rather busy until about midnight and then things got really slowed down, so I would go just down the hall to the emergency room and hang out there.  I got interested in what the physicians were doing and I started managing the crash cart for Code Blues because we stocked \n\n\nthe crash cart and I knew where everything was.  There were several medicines that weren‘t premixed and had to be mixed at the time of use and I knew how to do that.  So, I started going to all the Code Blues with the crash cart and I got interested in that and said to myself,” You know, I could do this.  This is not that hard given my medical background from pharmacy school.” So, I reapplied and two years later entered medical school.”                  \n\nWhat year was this?\n\n“1977.”\n\nLet’s back up just a little; did you work while you were in high school or college?\n\n“Oh yes, my father and I had a farm just south of Rison with a small cow/calf operation.  At one time, we raised hogs and so, I worked on the farm every afternoon and every weekend for as long as I can remember.  Then during the summers in college, I worked for my father at the telephone treating plant in Fordyce.  I did that for three summers and that was a real incentive to go back to college.”\n\nSo, it was hard work?\n\n“Yes, it was; very hard work.”\n\nI would assume, but did you ever get used to the odor?\n\n“Yeah, pretty much I did; but being an employee and the boss’s son, I got every job that no one else wanted to do.  So, I did that and when I went to pharmacy school, I worked first as a delivery car driver for Kavanaugh Drug Store in the afternoons and then later in my career in pharmacy school, I was Dr. Dan Lattin’s lab assistant.  He had several research projects going on and I worked in the lab for Dr. Lattin.  When I went to medical school; my first two years of medical school, I worked weekends at different hospital pharmacies around Little Rock trying to supplement my income.”    \n\nI would imagine it was really very helpful to be able to do that.\n\n“It was; it was.  Having gone through pharmacy school first certainly made medical school a little bit easier; mainly because, not just that I understood pharmacology as that helped, but  because I understood the terminology.  The first day of pharmacy school, Dr. Jordin gave us a 17 page handout front and back of Latin prefixes and suffixes and you had to have that memorized in the first six weeks; we had some of those on every test.  So when a lectures at medical school said, Oligomenorrhea,” I knew what he was talking about; but you could hear the door or medical dictionaries just whirling in the lecture trying to figure out what in the world he was talking about.  So, I understood the terminology and that helped a great deal.”   \n\n\n\nWhat informed your decision about where you would go to college, pharmacy school, and then medical school?\n\n“Well my decision to go to undergraduate college at Henderson was because I had a lot of friends over there and several friends who were playing football.  At the time, I envisioned myself being able to play college football, so I went to Henderson under that pretense and actually turned down an academic scholarship so I could be on the football team.  One day during practice; Sporty Carprnter came up to me and you had to know Sporty, but he put his hands on my shoulders.  We had run a number of wind sprints and we were all about to die, but Sporty came up and put his hands on my shoulders and said, “Atwood, God made you a plow horse; you aint never going to be no racehorse.”  That kind of summed up my college football career right there and so, I saw the writing on the wall then.”\n\nWhat position did you play?\n\n“I was offensive guard.  After a lot of soul searching and at the end of the spring football practice, I was way down the depth chart and so, I knew I was going into pre-pharmacy and pre-med and getting out of accounting; so I went into Coach Carpenters office and talked to him.  I said, “Coach, I’m going into pre-pharmacy next year and I’m going to have to take physics, two chemistry courses, zoology, and some botany courses; all those had labs in the afternoons.”  He said, “We aint got time for no labs; we have to practice ball in the afternoons” and I said, “Well Coach, I’ve thought about this a lot and I think I have a whole lot brighter future in medicine than I ever did in football.”  Sporty looked at me and he said, “Haus, I can’t argue with you there.”  So, that was the end of that.”   \n\nWere there any people in college or pharmacy school, either one, who had a big impact on you or pushed you in one direction or another?\n\n“My chemistry professor in college, a fellow named Robert Schmidtgall, was well known across the state as an excellent organic chemistry teacher.  He had a huge influence on me because that’s where the biggest and brightest students went was into his organic chemistry class.  In fact, you couldn’t get into that class in summer school because all the guys from Hendrix and other colleges around the state came to Henderson to get their organic chemistry.  Not because it was easy, but because it was very well taught.  He was very influential and kind of instilled in me the idea that I could do whatever I put my mind to.  Until then, I had kind of been a little underachiever and just was gliding through school.  Something in organic chemistry clicked and I got it.  Suddenly, it was fun and fun to study.  It was fun to put these big chemicals together and see how you make them and take them apart.  So, he had a big influence on me.”       \n\nObviously you were a good student at Rison.  Were you considered a good student at Henderson?\n\n\n“I was considered above average, but I had a 3.4 o 3.5 grade point average.  \n\nYou mentioned the fraternity; did you have an active social life while in college and pharmacy school?\n\n“Very; yes, I did.  I enjoyed all three colleges.  In fact, every time I moved up in my education, my grade point improved.  I had about a 3.4 at Henderson, a 3.6 in pharmacy school, and over 3.8 in med school.  So the more difficult it got the better grades I made.”\n\nYou already said that you felt like pharmacy school, or being a pharmacist, prepared you for medical school.  Do you think that is part of the explanation of why you did better as you went along?\n\n“Yeah, but it also made me more focused.  If I thought I could get by with a minimum amount of effort, I would do it.  So, the more complicated things got, the more I had to apply myself.”\n\nWhen did you start to think seriously about pairing off with one female and having children and all that kind of stuff?\n\n“Oh gosh, that wasn’t until I was a resident here in Pine Bluff.”\n\nSo, that’s down the road a bit.\n\n“That was down the road.” \n\nTalk about what informed your decision about where you were going to go to medical school.\n\n“Well, it was UAMS or nothing because I did not have the academic background to be able to go out of state.  The first time I applied to UAMS, I wasn’t accepted.  It was because I had been out of undergraduate college for a long time and I went through pharmacy school and worked for a year as a pharmacist.  So, my basic college algebra skills and basic college science skills had waned a little bit.  So, I talked to; I forgot who the Dean of Admissions was at that time, but we went over my MCAT scores and he said, “You’ve got to build your math scores up and you have to build your language scores up.”  So, I bought a couple of work books on college algebra, \n\n\nbasic college math, and a couple of books on “How to improve your vocabulary in 100 days.”   I read those, studied them, and then I brought my MCAT scores up and got accepted.”     \n\nWe always have to talk about the first year of medical school.  What was it like for you?\n\n“Well; since I had been though pharmacy school and worked two years, I was about 3-4 years older than the average guy in my class.  So, I was looked at as the “old guy.”  Now looking back, it was pretty ludicrous; but everybody around me…..”\n\nYou would’ve been 25 or 26 years old?\n\n“Yeah, I was about 26 and all these guys were about 22.  So, I didn’t get much involved with my classmates for the first 6 weeks or so; but my best friend in college, his younger brother was at Fayetteville and played on the football team named Richard LaPargue.  He had a good friend who was his fraternity brother that was in my class.  He said, “Yeah, a good buddy of mine is going to be in your class.  Look him up when you get to medical school.”  So, I did and his name was Michael Bauer.  Mike and I became fairly good friends.  Once that, my circle of friends started expanding after that”.     \n\nAt what point did you think about the idea of going, you already said that you didn’t want to go into practice and follow the pattern that had happened at Rison, so at what point did you start thinking about going into practice in rural medicine? \n\n“Well, I kind of back doored into that.  My parents paid for my education through undergraduate and all the way through pharmacy school, but I promised them when I got accepted to medical school that I was going to pay for this myself.  So, I started looking around at different payment options and like I said, I worked every weekend.  I got a student loan, which I had no debt when I entered medical school.  I had heard about the rural practice loan in that if you practiced in a small town for two years, they would forgive one year of your loan; so, I applied for that and got it.  So, that locked me into primary care and mainly family medicine.”\n\nWhat year was that?\n\n“That was 1977.  So, I was going to have to practice in a town of 15,000 or less to repay that loan.  So, that’s when I decided I was going into family medicine.  I pretty much thought about family medicine.  I didn’t really like surgery.  I didn’t like cutting on people; I do, it’s just something I don’t like looking forward to.  I really didn’t understand the other sub-specialties enough to have focused on that, so I focused on primary care.  Once I got into my third year of medical school, I really toyed with the idea of being an orthopedist.  Having grown up on a farm, I thought it was pretty neat to try to repair things with hammers, screws, nails, and wire….that kind of stuff made sense.”   \n\nDid you know Dr. Ackerman then when you went to medical school?\n\n“Yes, I did.”\n\nDid he try to persuade you to go into medicine at all?\n\n“He and Dr. Kohler both talked to me and said that I really needed to stay and go into the internal medicine program there.  In fact, my senior resident when we were  junior medical students at the Med Center, Internal Medicine Service said, “You’re just a really frustrated internist.  You may be going into family medicine, but you are a frustrated internist.”  I said, “well, ok; whatever.”\n\nWhat about your second two years of medical school, what were they like?\n\n“Oh uh, they were fun.  I mean, I worked nights for two years as a pharmacist prior to going into medical school and I was essentially socially isolated.  I was working when everyone else was off and when everyone else was working, I was off.  So when I got to medical school and we had all our tests on Monday, come Monday night after tests there were 136 med students wanting to party.  This was great, I had people to socialize with and I really enjoyed my second year in med school.  The third year, I enjoyed parts of it and parts of it I didn’t.  Some of it was an emotional struggle; mainly just….I got through it just fine, but…”\n\nDid you live in the dorms?\n\n“No, I lived in a garage apartment about a mile away from the Med Center on Midland Street.”\n\nWere there any and we can go all the way back to high school for this, high school, college, pharmacy school; were there any crises that kind of put you off mark or pulled you back a little bit?  You said you applied for medical school once and didn’t get accepted.\n\n“No, it didn’t……it delayed my goals, but it didn’t really set me back.  It also kind of woke me up that this is not going to be easy and I would have to focus if I want this.  If I want this, I would have to focus, work, and really apply myself.  So, no; probably the major thing that set me back was in December of my internship year, my father died.  That had a major influence on why I chose Pine Bluff to do my residency: One: it was close to home and Two: My father was in bad health.  We still had a farm and I tried to stay close to help him.  That and all the things I had to deal with as I was the head of the family when he died.  We still had cattle, we still had equipment, and I had to deal with all of that and try to keep……”\n\nWere you married at that point?\n\n“No, I was not. I didn’t get married until my third year as a resident here.”             \n\nWhat was the structure of the residency when you came down here?\n\n“Uh; before I got here, I think they started taking residents in 1978.  My dates aren’t real accurate, but it was ’77 or ’78.  The model here was a medical student would come here and do a one year residency and then be lured away by a private physician somewhere out in the state \n\n\ntelling them, “You don’t need to stay there and do that residency for minimum wage.  You can come here.  You’ve already done one year of residency and you can get a license and I’ll teach you everything you need to know about medicine and at the same time, you’ll make a whole lot more money.”  So, they didn’t have any residents graduating from this residency until 1981. When I started here, they had their first resident, named Roger House, that actually completed the residency and after that, it got the ball rolling and everybody was completing the residency.  Well not everybody, but most people stayed for the full three years.  But until then, they were “one and done” around here.”     \n\nExpectations changed too then.  You can’t get an internship now and go out and find….\n\n“Well you can, but you can’t be board certified in anything and you can’t get hospital privileges or approved by the insurance companies.  But you still can; there is not a law saying, “You can’t practice medicine, you have to have one year of internship.”  Now that is very interesting as that law wasn’t in place when I graduated in 1981.  All you had to do was complete four years of medical school and pass the FLEX exam, the old Federal License Exam, which I did.  The law said, “Once you completed you course work and pass the FLEX exam, you got a medical license.”  You didn’t have to complete a one year of internship.  Well in 1981 when I finished my course work on March 9th, there were 7,700 Cuban refugees at Ft. Chaffee and they were looking for clinic doctors at Ft. Chaffee.  I had been basically very frugal through my four years of medical school because I had been paying for it myself and they were paying $1200.00 a week cash for anyone that worked in the clinic up there.  Buddy, I got on I-430 and got there as fast as I could.  I worked from the second week in March all the way up until the day before I started my residency here in Pine Bluff at Ft. Chaffee as a clinic doctor and that was an education.”\n\nAfter your time in Ft. Chaffee, you came down and started your residency?\n\n“Right.”\n\nThat would have been what year?\n\n“July 1, 1981.”\n\nYou were here for three years?\n\n“Right and Bud Lyndsey, James Lindsey, was the residency Director.  We had two other faculty, Ragu Yalamanchili and then I forgot who was the third year; he had just finished his residency in Florida and came up here.  He only stayed a year, but we had three faculty.  My residency wasn’t loose, but it wasn’t nearly as regimented as what I was used to at UAMS.  So, you rotated with your private physicians in the hospital and you worked hard, but you would read to try to make sure you didn’t look stupid.  It just wasn’t as intense as what I was used to at UAMS.”\n\nWere any of the private physicians or any of the teachers that had a big impact on you?\n\n“Well; Don Miller, the AHEC director, here at Pine Bluff probably had the biggest influence on me.  The main thing I learned from Don was that you could say anything to anybody as long as \n\n\nyou can get them to laugh.  My interview here was the dangness thing I have ever been through.  When I came down to interview for residency position, Dr. Miller’s office was right down here and he was my first interview that morning.  So, unbeknownst to me; I didn’t know Dr. Miller and George Ackerman were best friends, but they were best friends all through residency and had collaborated to get internal medicine rotation here in Pine Bluff.  So, I had asked Dr. Ackerman to write a letter of recommendation from me for residency.  I’m introduced to Dr. Miller and he pulls up a chair and sets it right in front of his desk and says, “Sit down.”  I said, “Yes, sir” and so, I sat down.  He has my packet in front of him and says, “So, you want to be a family medicine doctor, do ya?” I said, “Yes sir, I do.  To me, that’s what medicine is all about; being a primary care doctor.”  He said, “And you think you want to come to Pine Bluff, do ya?”  I go, “Well, yes sir.  I’m from this area and my family always utilized JRMC as their hospital.  I’m just from Rison down the road.”  He said, “Well, George Ackerman says here, “I’ve known Dr. Atwood’s family for over 40 years and they’re from fine South Arkansas pioneer stock” he then said, “Dam son, we’re going to train you not breed you.”\n\nThat’s cute; I like that.\n\n“I looked at him and said, “You know Dr. Miller, I could probably do both.” From then on, he and I were fast friends; he was as much as friend as he was an educator.”        \n\nDid you feel like your residency trained you for what you would ultimately do?\n\n“Yes, I do; I do.  I thought it left a lot of it up to the individual.  We are all adults here and well educated people and you have to take responsibility for your education and some applied themselves a whole lot more than others.  But, it gave you every opportunity that you needed to be trained.  In fact, I went straight from being a resident to a faculty member and Don Miller talked me into doing that.  He brought me into his office probably around February of my third year and said, “What are you going to be doing in four months from now?” I said, “Dr. Miller, I don’t know yet.”  He said, “I’ll tell you what you’re going to do; you’re going to stay here and be faculty.”  I said, “You think?” and he said, “Yeah, I know.” So, he recruited me to stay as faculty and I’ve been faculty ever since.”\n\nLet’s talk about the setting up of the office in Rison; you did that at some point.  So, when did that happen?\n\n“That happened in October of 1985.  I had a rural practice obligation, but yet I got a year off to set things up.  So, Dr. Miller and I sat down and collaborated about building a clinic in Rison and using it as a rural practice site for the residency.   I was going to run it and be on faculty, but at the same time have residents rotate through; not to run the facility, but just to work with me down there and I thought that was a good idea.  We had two residents that had just graduated who were building a brand new clinic in Fordyce, Paul Davis and Mark Floyd.  As the contractor was finishing up their office in Fordyce, Dr. Miller said, “Why don’t we get him to build one just \n\n\nlike that in Rison?” So, I talked to the contractor and he said, “Well yeah, I can do that.”  I think I paid $32.00 a square foot to have that clinic built.”\n\nAnd that was in the late ‘80s.     \n\n“It was the summer of ’85.  The bank at Fordyce said, “We’ll loan you 100% of the money with no down and no other collateral other than the clinic because we trust you.  We know your family and we think that this will be a success.” So, they did and on my birthday, October 21, 1985, we saw the first patient in the Rison Family Medical Clinic.”  \n\nHow did that work out?\n\n“That worked out well, except it lost money.  As you can imagine in a small town in rural Arkansas, there was a lot of need; but not a lot of means.  Again being rather soft hearted, I knew who could pay and who couldn’t and a lot of people who couldn’t pay, I grossly under billed.  So, that rocked along for about 8 years and finally Harry ward says, “We’re going to have to do something, because y’all are losing money.”  We’re not making money and suddenly, everybody became cost conscious.  So, Dr. Miller collaborated with Larnell Davis who was head of Jefferson Comprehensive Care Services Incorporated, which is a community health center conglomerate here in Pine Bluff who has clinics all over Jefferson and now some in Pulaski County.  They would take over the administrative duties and the billing for the clinic and we would give them our numbers; because their numbers weren’t real high for the amount of money that they were getting.  They would pay for the operation of the clinic.  That went along for a long time even after I left.  When Dr. Miller decided to retire, he asked me to apply for the job as AHEC Director and I got that.  I made AHEC Director March 1, 1995, so I was about six months shy of 10 years in Rison.  I was the only full time physician in Cleveland County.  We had two other semi-retired older physicians who were working in Rison at the time, Dr. Barbara Barksdale and Dr. Cecil Dickerson.  They only saw patients a few hours each day.” \n\nAre there any physicians working in Cleveland County now?\n\n“Yes, Dr. Kimberly Golding who is a graduate of this residency.  She works in the clinic building that I built and HRSA still runs that clinic; so, she works for them.”\n\nHow much time is she down there?\n\n“Oh, she’s down there 5 days a week; she’s full time.”            \n\nWhat’s the population of Cleveland County?\n\n“Cleveland County, last I saw, was upper 7,000; 7700-7800 somewhere like that.”\n\nIs it losing population?\n\n\n“It’s fairly neutral; all the counties around it are losing population, but Cleveland County has kind of held its own.”\n\nI want to go back to the Cuban experience and back to late medical school and early years of residency; how long did it take you to get comfortable having someone think of you as a physician or you thinking of yourself as a physician?\n\n“You know, I don’t know; that took a long time.  I knew I graduated medical school and had done very well in medical school and did well in my residency, but as far as being Dr. Attwood; you know as you grow up, you have all these physicians up on this pedestal and I never really envisioned myself up there with them.  I just didn’t. You can never be a hero or it’s hard to be a hero in your home town.”\n\nBut you were there off and on for 10 years.\n\n“Right.”\n\nSo you ended up practicing on a lot of your friends and family members.\n\n“Oh yeah and family members; I jokingly tell people that while I was in Rison, I developed a theory of metropolitan medicine and I haven’t published that theory, but it is my own theory of metropolitan medicine.  It means that the larger population center that you practice in, the smarter you are.  I was in Rison and to them, I was probably the dumbest son of a bitch they ever had there.  Doctors in Pine Bluff were a lot smarter than I was.  Now the doctors in Little Rock are a lot smarter than the ones in Pine Bluff and the ones in Memphis are a lot smarter than the ones in Little Rock.  The ones in Houston are a lot smarter that the ones in Memphis.  Hell in New York and the Mayo Clinic; Lord, they are just geniuses’ compared to you.  If someone wanted to go to some place in a larger city, I never argued.  I just said, “Yes sir, you go right ahead.”\n\nYep, “Don’t you think?  Don’t you think I need to go?” And I’d say, “Yes, mame; I think you do.”\n\n“Yes; yes, I think a second opinion would be wonderful.”\n\nTalk about your life and experience as a teacher and as the AHEC Director; teaching students and have the young doctors changed?\n\n“I take my job seriously, but I never take myself seriously.  Teaching residents and seeing the light bulbs come on is probably what I enjoy the most.  I don’t brag on myself, but one thing or one talent I do have and that’s taking very complex medical situations and distilling them down into something that most people can understand.  That’s what I do with the residents; I try to explain things in terms that they understand.  Like, I give a lecture on metabolic acidosis and alkalosis and if you go to most lectures on that, it gets so far down in weeds that no one can \n\n\nreally put it to practical use.  Well, my lecture is “here’s what you are going to need to know at 2:00am in the emergency room” and “here’s how we are going to do this.”  So, that’s what I enjoy the most.  When I’m here making rounds, I round in the intensive care unit because most of the faculty here don’t like to do that; I love to do that.  I attend in the ER, where you see patients and if someone needs to be admitted, I attend those and make sure that that is done properly and then I round in the hospital.  Probably my least favorite thing to do is be in the clinic.  I like clinic work; I just don’t like the EMR part of it.  I do not like that.”\n\nHow long have you guys been on EMRs?\n\n“Probably about 10 years now and it just to me is not intuitive.  Anymore in the hospital, it is fairly intuitive and I can blunder my way through that.  But in the clinic, holy moly, I have to get a nurse all the time and ask, “How do I do this?” or “Show me how this works.  It’s been there 10 years and I still don’t know it.”   \n\nDo you deliver babies?\n\n“I did up till 1999; we delivered probably 20 a month through this residency.”\n\nDid you do your own sections?\n\n“No, we consulted OBGYN doctors to do our sections.  We did our own post-partuml tubals and D\u0026Cs and things of that nature; but, I didn’t do sections.  I never was trained and it was convenient as OBGYN doctors here kind of wanted to have one finger in what we were doing anyway.”\n\nHow many residents were reported here?\n\n“Right now, they have a 9-9-9 residency. Up until last year, we were 12-12-12.  I applied and got an NIH grant to expand the residency to 12-12-12 for five years and we did that.  But when the grant ran out, the hospital at that time was not interested in putting forth more money to keep that level of training going; so that got cut back to 9.  Now the new hospital administrator came up to me last week talking about what we can do to get back to 12-12-12 as they are willing to pay for it.  But, it fell off last year and this year.”                      \n\nOne of the general purposes of AHEC is to get young physicians into rural medicine. How successful are y’all?\n\n“I think we have been as successful as anybody in the country.  It’s not near as good as we would like, but I think we have been very successful.  Arkansas is always in the top 5 in the nation and usually within the top 3 in retaining the number of residents it’s trained within the borders of the state and that is largely in part due to the AHEC system.  In other words, the doctors that train in the state tend to stay in the state.  We have a large number of residents in South East Arkansas that come to this program. In 2013 when I stepped down as residency \n\n\ndirector, the hospital had a new administrative position called the Medical Director for Regional Relations and Referrals and they asked me to be that Medical Director.  What it was was that they wanted somebody with a physician recruiter liaison to go around to doctors in South East Arkansas and talk to them about “Why are you sending patients to JRMC?” or “Why are you sending them somewhere else? How can we do better?  What are the problems that you see?”  They wanted me to be that person because: 1) I trained over half of them and 2) I knew them personally from them sending patients to our residency and we never questioned, “Why are you sending them here?” we just said, “Just send them and we’ll take care of them here.”  So, I think we done a very good job in that aspect.” \n\nGoing back to your wife and your family; when were you married and what is your wife’s name? \n\n“My wife is Debi Attwood. Like a lot of physicians, I have been married and divorced a couple of times.  Debi is my third wife.  I got married my third year of medical school and have two sons who are 32 and 30 years old.  One is a civil engineer who just yesterday started a new job in Fayetteville.  His name is Malcolm, same as my father.  He was working in Hot Springs for the last 5 years as a civil engineer there, but he got a new job in Fayetteville.  My younger son is actually a hospital administrator with St. Vincent’s.  He is in charge of their specialty clinics in Little Rock.  He manages all their outpatient specialty clinics for St. Vincent’s.”\n\nNo Matter if you are an AHEC Director or a solo practitioner; there is a lot that a family has to adapt to to being a family of a physician.  How did your family adapt to that?\n\n“Well, they got used to not seeing me a whole lot and they got used to not seeing me on holidays and weekends because dad is working.  When I got divorced, I got custody of my two sons when they were in the 1st and 2nd grade.  I essentially raised them pretty much by myself.  My mother and my sister were a big help when I had to be on call; particularly every third night on OB call.”\n\nAnd this was all in Rison?\n\n“This was all in Rison and I had to drive to Pine Bluff.  If we had somebody in labor, it wasn’t like call me if you have trouble.  If we had somebody in labor, I came up here and we were at the elbow at the delivery for every delivery.  But, they were used to dad being gone a lot.”       \n\nTalk about your personal involvement in the social life of Rison or the social life of Pine Bluff; schools, religious things.\n\n“I been involved with the Methodist Church ever since I moved back to Rison and was Chair of the Pastor-Parish Relations Committee for a long time there at the church, which is a job that nobody wants.  It is if the congregation sees something that the pastor is doing or not doing, I’m the guy that gets to go talk to him about it.  Then about four years ago, the long-term Chair to \n\n\nthe administrative board stepped down and they asked me to be the Chair to the Administrative Board.  In Rison, I have been the physician for the football teams since we opened the clinic in 1985.  I don’t travel with them, but I’m at every home game and if they get any athletes that get injured, the coaches call me to ask what to do unless it’s really an emergency and they ship them right on.  But, I’m involved with this organization called “Kick Start Cleveland County” and we try to develop things within Rison and Cleveland County again to keep it from withering on the vine as so many of the small towns of South East Arkansas have.”\n\nWhat other towns are in Cleveland County besides Rison?\n\n“Well mainly Kingsland, New Endindburg and Woodlawn.”\n\nSo, Is Rison the County seat?\n\n“It is the county seat.”\n\nHow many people are in Rison?\n\n“1,350. I’m continually amazed at what the world’s view of rural medicine is.  When I first took over as AHEC Director, the American Academy of Family Medicine was going to have their annual convention in New Orleans and two days before that convention, they were going to have a rural health meeting.  Dr. Miller was bound and determined that I was going to go to that rural health meeting, so I said, “Sure, I’ll go.”  Herb Finley was the Residency Director and I told Herb that I was going to this rural health meeting in New Orleans and the American Academy of Family Medicine and he said, “Oh great, you’re going to go talk to all the rural health experts from New York and Los Angeles.”  I said, “Oh, you’re kidding.”  Well when I got there, the smallest town represented at the rural health meeting was Buffalo, New York.  They asked me where I practiced and I told them and they were aghast.  We had a break out meeting where Working with Community Health Centers and Your Community and I said, “I want to go to that and hear what they have to say.”  So when we got there, there were about 20 of us in the room.  They asked, “How many of you are already working with community health centers in your town?” and the naive guy that I am, I raised my hand.  I was the only one in there that raised their hand and he said, “Good, you can lead this session.”  So, the world’s view on rural medicine is very different from mine.”                       \n\n\nHave you enjoyed what you have done so far in the practice of medicine?\n\n“I have; particularly looking back at the residents that have come out of this residency and how well they do.  Our residents are sought after.  Fully, 20-25% of our graduates each year go straight into emergency medicine.”\n\nIs that right?\n\n“They don’t go into clinic practice; they go into emergency medicine.  About half that number go into hospital medicine.  We only had one resident out of 12 last year that graduated that actually went into a clinic; the rest were either ER doctors, went into a fellowship, or became hospitalists.”\n\nI realize that this is not a real thing, but it is close to a real thing; within the catch of America that represents Pine Bluff and the surrounding areas, is there one area that you don’t feel like it gets adequate coverage?\n\n“Oh yes, absolutely.  It’s the Dumas/McGehee area.  They both have; Dumas has a brand new, very nice hospital, but they have one physician, Dr. Chambers.  Poor David, he’s drowning every day.  I went down and visited him when I was still the Medical Director for Regional Referrals and he’s seeing, that clinic is packed every day.  He also is admitting to the hospital and helps cover the ER.  I don’t know when he has time to breathe.  Dumas and McGehee both desperately need physicians. We did a good job with Monticello, we did a fair job at Fordyce, we have a physician in Rison, and two in Lake Village.  But, we just have not convinced anybody to go to Dumas.  We have one resident that is graduating this year that is going back to McGehee, but he’s from McGehee.  His name is James Renfro and they can’t wait until young Dr. Renfro gets to McGehee.  But, we have not done a good job there. We left several….”\n\nIs there a reason for it?\n\n“I don’t know; I don’t know.  It is a scary thought when they go down there and look at the workload and see.  I’ve always said, “If you want to really practice good medicine and do what you want to do, the opportunities are abound in South East Arkansas.  But if you’re going to a town like Dumas, you will need about two or three of your buddies to go down with you.  You can’t go down there by yourself, you’ll be overwhelmed.” \n\nIs that much the same thing you thought when you looked at going into practice at Rison?\n\n“It was, but I knew I had the support of AHEC here.  And that’s one of the real problems with rural medicine; it’s not the pay or the lifestyle, it’s the isolation.   You’re out there daily by yourself and sometimes when you really need help; there is nobody there to help you.  They keep sending them back to you and you can’t fix them, so you try to send them somewhere where they can be fixed; but 1.) They don’t have any means 2.) Half of them don’t have transportation \n\n\nand 3.) You don’t have anybody that is willing to come to your rescue, particularly mental health and drug and alcohol problems.  But, they keep coming back wanting you to help them and it’s very frustrating and heart breaking at times.”\n\nAgain, were there people who influenced you in medical school?\n\n“Of course Dr. Ackerman did because again when we talked before, he was one of the wise old sages at the medical center who every medical student inspired to be like; he and Dr. Abernathy.  Another one was; I did a rural preceptorship between my freshman and sophomore year in England, Arkansas with Dr. Willie Harris   Willie was a mess, but Willie taught me and important lesson and it was the first thing I used to tell residents every year on the first day orientation.  I said, “The means which patients use to determine whether you are a good physician or not has nothing to do with how much medicine you know.  It’s “Do you act like you care” or “Are you going to be available” and “Are you going to try to help them?” and if you can instill that trust in that patient, the battle is won.  But if you come in irritated wondering why the hell they are taking up your time, I don’t care how smart you are, your battle is lost.”  Willie taught me that lesson.  So, it was George Ackerman and Willie Harris who influenced my career profoundly; I guess that says something for me.  But I realized after I got on in my medical education that Willie wasn’t the best clinician there ever was, but he was the best practitioner I ever knew because his patients adored him.  He acted like he cared and he was going to do something for them.  He patted them on the back, hugged them, and acted like they were his best friend.”\n\nWhat has been the most gratifying part of practicing medicine for you?\n\n“Mine is looking at the legacy of what this residency, not what I have done, but what the residency has done as far as providing good physicians for this state, that has been the most gratifying.”   \n\nWould you do it again?\n\n“Oh yeah, I would \n\nDo you think the DO schools in the state will have any effect on rural medicine?\n\nThat remains to be seen and I’m not belittling it, but that means I am.  1.) They are going to have to have structure in the third and fourth years of medical education.  What I have seen is that there are some very good DO Schools and we’ve had some very good DO residents.  For the last three years here, I taught residents who were DO graduates, but I worry about the model that the new DO schools are developing.  They provide the first two years of basic science and their undergraduate education and then the clinical years are left up to the student themselves to find rotations.  We’ve been a major’s hospital for two osteopathic schools; Lake Erie and I think for now Majors Hospital may be for Hattiesburg.  Those students come up here and they are told, “Ok, you are going to have to have a month of psychiatry and two months of pediatrics.  Go find somebody to do it with.”  Well, there is no structure, there is no quality control, there is no making sure that the students read and studied.  They rotated with a private physician, but were they really educated?  Well, that bothers me.  If there is good structure to their third and fourth clinical years, yes they will have a definite impact.   They’ve had an impact here; Pine Bluff was the first osteopathic approved internship in the state and we are still the only osteopathic approved family medicine residency in this state.  Fort Smith is approved for an internship; but if they go and stay for the other two years, they go to the allopathic family medicine residency.  We are dually accredited and they have helped us stay afloat for years and we’ve had some very, very good DO residents who make very, very good doctors.  In fact, two years ago our top three residents were DOs.  But, it remains to be seen because the model being purported now bothers me.”                  \n\nI have one last question; you are talking to your great, great, grandchildren, somebody who knows you as a picture on the wall.  What would you like for them to know about you and what you would wish for their lives?\n\n“Well, one thing I would want them to know about me is one of the most profound things I was told in medical school by Dr. Ackerman.  He came to lecture to us one day in my sophomore year and said, “You know, I have been in this business for 30 years and one thing remains constant; the questions of medicine never change.  It’s just the answers.”  Things were are doing now, 20 years from now may be looked upon as complete heresy, but we were doing the best we could at the time with the knowledge we have.  So, I fully believe that 50 years from now when you look at what we are doing at this day and time, it’s going to be completely foolish or wrong.  So, just know that we were doing the best job we could do with the best information that we had.  I want them to know that there are lots of ways to measure success and a lot of it isn’t money; it’s in what you leave behind.  Hopefully with this residency program here, we’ve left behind something that is beneficial to the citizens of this state for many years to come.”       \n\nThank you sir; that completes our interview.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/161624/file/293459#t=0.0,3904.2003"}]}]}]}