A Measure of My Days. - Review - book reviews

A Measure of My Days The Journal of a Country Doctor David Loxterkamp, M.D. University Press of New England, $24.95, 320 pp.

At the ungodly hour of 4:30 A.M., David Loxterkamp rises from his bed, feeds the cats, prepares the coffee, flips on his laptop computer and, to the accompaniment of the "Carmelite Vespers" of George Frederick Handel, commences writing about his life as a family doctor, a family man, and a Catholic in the small town of Belfast, Maine, where he has lived for the past thirteen years.

A Measure of My Days: The Journal of a Country Doctor is the product of this daily ritual. The book takes its title from Psalm 39, in which the psalmist seeks "the measure of my days, what it is, that I may know how frail I am," and details one year in Loxterkamp's life and medical practice. It records, as he explains in the introduction, "the particulars of a life lived on the coast of Maine. Of Belfast and its seven thousand inhabitants, including my wife, Lindsay, and daughter, Clare. It is a story about my work and about those who share it."

Loxterkamp's journal is a thought-provoking pleasure. He describes his surroundings, his patients and co-workers, his family and friends, with fine, pointed detail, and with an almost disarming honesty. He doesn't mince words. "I despise few patients," he writes, "but one of them resurfaced over the weekend. He was my patient until he pushed me too far." He freely admits relief when his wife miscarries, citing the need first to "put our marital house in order." Of his Catholic faith, he concedes, "I am a cafeteria Catholic" who takes what he needs of the doctrine and sheds the rest.

The journal also serves as a timely meditation on the state of small-town, family medicine. Loxterkamp struggles to remain personally engaged in a system increasingly dominated by managed care and specialists. He must also contend with patients who drink or smoke too much (so many of the patients he writes about suffer from either lung cancer or emphysema), or who are immobilized by desperate poverty. Belfast, he points out, is located in Waldo County, among the nation's poorest. It's comforting to know that there are doctors such as Loxterkamp out there, who still believe the practice of medicine is a form of community and Christian service. Much of the book, in fact, discusses his efforts to create a community hospice program that serves not just the needs of the dying, but of the surviving family members as well.

I had expected Loxterkamp's book to be a sort of James Herriot-like study of rural life concentrating on humans rather than farm animals. This is to say, I expected a book detailing the idylls of rural existence, full of attractively vexing characters and anecdotes, the story of the kindly doctor making house calls and dispensing wisdom along with bromides. The kind of story to make one yearn for the simple life.

Instead, the journal recalls the short stories of Maine author Sarah Orne Jewett, whose unadorned chronicles of a declining seacoast community and of the ordinary men and women who live there are by turn wistful, tragic, and inspiring. Also, as with Jewett's remarkable short story, The Country of the Pointed Firs, Loxterkamp's journal manages to carry the reader forward in a leisurely, anecdotal manner.

Loxterkamp has an ability to uncover just the right details to convey a complex emotion or to describe a character or setting. As with Jewett's fictional Dunnet Landing, the town of Belfast and its surroundings become a character in itself, a personality clearly defined, its influence on the lives of its inhabitants well-outlined. Indeed, so completely does Loxterkamp describe his town (often by detailing the routes of long runs he likes to take when time permits) that I would have appreciated the addition of a map. Where, exactly, do the Loxterkamps live? Where are the cemetery and Searsport Family Practice? Or the home where the weekly Renew meeting (a Catholic discussion group to which Loxterkamp is devoted) gathers?

Just as compelling as the setting is the internal landscape Loxterkamp describes. As he strives to be Everyman's doctor, he struggles with his faith, his marriage, and thoughts of having a second child. He is afflicted with recurring, sometimes immobilizing bouts of depression, and suffers, too, from anxiety attacks that take the form of dreaming that he is choking on a small, plastic object. These might stem, he suggests (but never goes so far as to determine), from his unhappy childhood in Iowa. He was an adopted son whose father, also a family physician, died of a heart attack when Loxterkamp was a child; his mother, forced to return to work, drank too much, and expected too much of her children. At times Loxterkamp gets a bit petulant, and I couldn't help wondering if his slightly obsessive nature might be tougher to take in person than on the printed page.

The thing I like best about personal journals is that they tend to raise questions, to dissect emotions and fears and doubts without any obligation to resolve them. They provide, as Loxterkamp himself puts it, "the vapor plume of an author's life, fresh and obvious in the making." Of his effort, Loxterkamp writes, "it has provided me with an awareness that one often reaches in the fifth mile of a run or the tenth year of a medical practice or when infatuation peels from the person you love." It is this sense of heightened awareness that Loxterkamp encourages, by example, in his reader.

It snowed the very morning I finished this book. Driving my daughter, Annie, to school, we passed by a field that I usually overlook in my rush to be on time. Snow lined the tree branches and covered the ground. I might not have noticed how lovely it was, had it not been for David Loxterkamp's gentle and poetic reminder that the details of my own life merit greater attention.

Clare Collins is a free-lance writer. She lives in Pawcatuck, Connecticut.

COPYRIGHT 1997 Commonweal Foundation
COPYRIGHT 2004 Gale Group