Windblown: The Remarkable Life of Richard S. Buker Jr, MD, a Family Doctor

Book Title: The Remarkable Life of Richard S. Buker Jr, MD, a Family Doctor

Author: Larry W. Halverson, MD

Publication Information: Lavergne, TN, Frugal Fam Doc (self-published), 2020, 432 pp., $24.95, hardcover

Windblown was initially written by Larry W. Halverson, MD, as a tribute to his friend and mentor, Richard S. Buker, Jr, MD, at the time of Buker’s death in 2018. However, it soon grew to be a chronicle of a “legendary family doctor who transformed and toiled to preserve a rural community and an entire region” (p. ix), and now serves as inspiration and renewed calling for all who practice family medicine.

Like many of us, Dr Buker’s early life experiences shaped his career path. As the son of a missionary doctor in Burma, medicine was his obvious career choice. With internship newly required prior to medical licensure, following completion of medical school at Yale he chose to be commissioned as a first lieutenant in the US Air Force to gain access to their highly regarded training. Thus, he began a rotating internship in general surgery, internal medicine, pediatrics, and obstetrics, which ultimately formed the foundation for his future career as a rural prototype for the yet-to-be envisioned specialty of family medicine. The ever-relatable doctor was praised in military reviews as achieving highest marks in “attending to duty” and “solving problems,” but unsatisfactory in “writing records and reports” (pp. 44-45). The intrepid Dr Buker was thwarted from following in his father’s footsteps with the American Baptists due to his marriage to a Roman Catholic, but nevertheless continued his search to serve humanity. This led him to Chester, Montana, to an abandoned hospital and clinic that he would subsequently revive and grow, and where he would continuously practice for more than 48 years.

In Chester, Dr Buker practiced the full spectrum of family medicine long before family medicine became a recognized specialty. Out of necessity, he dealt with trauma, snake bites, surgeries (emergent and elective), and obstetrics, and brought preventive health care, well-child care, and treatment of chronic disease to the community. He exemplified the life of the ideal family physician, balancing his love of his community and medical practice with his family, outdoor hobbies, and scholarly pursuits. An avid outdoorsman, his story teaches us the importance of making time for these pursuits even in the overwhelming circumstance of being the only source of care in the community. In other lovingly described vignettes, we learn the importance of abiding with patients, sitting by their bedsides, and comforting by presence when medical care can no longer heal. We also learn that being a rural physician does not preclude scholarly activity, as he published several thoughtful observational studies in well-known journals including the New England Journal of Medicine. Dr Buker, of course, was human, and the author also realistically includes tales of the difficult times when errors were made, or things did not go as planned. Dr Buker’s pain in these circumstances, illustrated by quoted letters he wrote to family members, mirror the feelings than any of us would feel under these circumstances. In 1971, Dr Buker became board certified in the new specialty of family medicine, a specialty that his career helped to define, passing the exam on his first try.

Halverson skillfully portrays the difficult decisions regarding when to end one’s career. Dr Buker’s love of medicine and for his patients remained strong, but age was taking its toll on his judgment and skills. The author explores the feelings of those working with him, and of Dr Buker himself, as it became clear that it was time for retirement. Despite having asked colleagues to tell him if they felt he was becoming incompetent and needed to retire, he was emotionally devastated when this transpired.

I truly enjoyed this biography, which serendipitously retells the history of our specialty by telling the story of one who went before us and shaped our calling. I am reminded that family medicine is more than just the delivery of medical care but is a specialty in which we are called to abide with our patients, compassionately guiding them through the health care system from cradle to grave, even though few of us continue to provide the full spectrum of care. It has renewed my sense of purpose and calling, and I am grateful to the author of this book for that. This book would make an excellent gift to any practicing family physician in need of inspiration, to a resident in family medicine at the start of their career, or to a student who is considering family medicine as a specialty choice. Well done, Dr Halverson!