Welcome Stranger

One of the movies we watched this holiday season turned out to be a wonderfully relevant commentary on medicine in 1947, and also today. In “Welcome Stranger”, Bing Crosby plays Dr. Jim Pearson, an easy-going, rootless Californian, who takes a locum tenens position covering for Dr. Joseph McRory, a crotchety old country doctor in Fallbridge, Maine, played by Barry Fitzgerald. The country doctor is planning his first real vacation in 30 years, but when he lays eyes on his young replacement, he starts to wonder if he can leave his practice and his little town in the hands of such a stranger to life in small town Maine. The town’s young pharmacist notices that his fiancée, schoolteacher Trudy Mason, played by Joan Caulfield, is attracted to the California doctor, and recruits another young physician to come and apply for the temporary position. As the elder physician begins to change his mind about taking a vacation, he becomes ill with appendicitis. Dr. Pearson (Bing Crosby) does the operation with the pharmacist’s fiancée as first assistant. This convinces the country doctor that Pearson is a capable physician, and the two develop a real friendship during the postoperative recovery period. The relationship between these two very different physicians, who find themselves more and more similar as their friendship evolves, serves as the film’s core motif. The romantic subplot is between Dr. Pearson and Miss Mason. They seem to be getting along better and better and the pharmacist provokes a breakup of his engagement to Miss Mason. The pharmacist’s candidate to cover for old Dr. McRory, Dr. Ronald Jenks, gets turned down for the temporary position now that Dr. Pearson has proven himself, but Jenks doesn’t retreat. He simply hangs out his shingle in competition with the old country doctor. He even plots to replace the veteran physician as Medical Director at the town’s brand new hospital, based on his ability as a younger, more recently trained doctor to bring new ideas and new methods to the small hospital. The hospital board is suddenly leaning in the new physician’s favor. Bing Crosby’s character, Dr. Pearson, comes to the older doctor’s defense with the words: “Nobody has discovered a substitute for skill or wisdom or practical experience… or for goodness of heart.” The only opportunity offered for the older doctor to prove himself current enough to keep his position is to take a test of basic medical knowledge. He reluctantly agrees and Dr. Pearson helps him prepare. Suddenly a medical emergency brings all three physicians to the school, where several boys seem to be in the early stages of a critical illness. The arrogant Dr. Jenks diagnoses them with Eastern Equine Encephalitis and insists that everyone in town gets urgently vaccinated. The seasoned older physician walks around the school and finds remnants of cigars in the sink in the boys’ bathroom. He confronts the boys, who admit they got sick from smoking cigars. His down-to-earth diagnosis puts the book-learned challenger to shame. The hospital board asks him to lead the new hospital into the future. He declines, unless Dr. Pearson decides to stay on and work with him. Pearson at that very moment proposes to Miss Mason, and when she tells him “yes”, he agrees to become Dr. McRory’s new full-time associate. The tension between practical wisdom and academic theory in medicine exists today as much as it did in 1947. The arrogant challenger without compassion and common sense reminds me of some of the doctors striving for power in medicine today, too. That’s what makes this movie a classic; it portrays a bygone era, and at the same time it makes us think about where we are today.

Author’s note: Long after writing this post, I came across the appendicitis story line in A. J. Cronin’s writings about Dr. Finlay, immortalized in books and two TV series.

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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