I was pleasantly surprised by how quickly I was able to rebuild my practice on my return to New York. Many of my former patients sought me out, providing a solid base for reconstruction. I was on call and available seven days a week around the clock. This was the way I was trained at Duke in my internship where we were on the Johns Hopkins’ system for twenty-four-hour call. I did not consider this a hardship, I thought it was how a real doctor should function. My patients, old and new, were greatly relieved that they had a doctor they could call at any time. What a change from the wartime days when doctors were next to impossible to find. I made my share of house calls when I thought they were indicated and I enjoyed them. I soon realized that my on-call schedule was unusual and the newly minted young assistants in medicine at Columbia-Presbyterian Medical Center seldom made house calls and were hard to find after office hours and on weekends or holidays. Sooner or later this attitude would earn the Medical Center the reputation of being an ivory tower, uninterested in its surrounding community. Focusing on tertiary care was a legitimate goal of the Medical Center, but this should not have been to the neglect of primary care. The nearly five years of practice I had before entering military service had taught me many things that cannot be learned in medical school or in an internship or residency. Scientific training is important, but commitment to service and the care of the patient is paramount in the personal practice of medicine.

Self-referrals were common and some very interesting patients came to Harkness Pavilion from near and far. South American and Central American patients sought out the Medical Center because of its excellent reputation as a clinical center. Many but not all of these patients were well-to-do. Some had been going to the Mayo Clinic in Rochester, Minnesota, or the Ochsner Clinic in New Orleans. They liked to visit New York City and occupied rooms in many of its fine hotels. The city was attractive, clean, and safe. The Medical Center area was safe, clean, and impressive. The patients were especially happy that experienced clinicians, not fellows or residents in training, were the first to see them.