Viewpoint: Reflections on ‘local knowledge’ 



By Dr. Bill Horner 

The life of my friend, physician and former colleague, Edward B. Gilmore, M.D., came to its inevitable end at 11 a.m., Monday, Aug. 8, 2022. In the nautical parlance, he slipped his mooring for the last time, crossed the bar and headed out to sea on his final voyage.  

Given his Harvard educations at the medical school and Massachusetts General Hospital, you might imagine that he was a yachtsman – perhaps, even, born in New England. He was neither, but on his metaphorical ship, he was the unquestionable captain. That ship was the Mount Desert Island Hospital. The hospital and patients from the surrounding communities were his medical domain for over 40 years. 

Ed came from one of the most un-yachty places imaginable, on the banks of the Monongahela River, in the small city of Clairton, Pa., just a few miles south of Pittsburgh. The Clairton Coke Works, one of the largest, supported the burgeoning1950s steel producing industry of the “Steel City,” then in its prime. During my last bedside conversations with Ed, he told me about his early exposures to medical practice in Clairton, including making house calls with the local GP in a horse-drawn carriage. How did he go from Clairton to Boston? I felt a calling, he told me. That calling was most certainly connected with an unusual mind, as we have discovered in the many medical awards in both his training and practice, as well as the depth of medical knowledge he brought to his local community. 

Local knowledge is said to benefit both recreational sailors and working fisherman as each navigates the tricky tides and currents and underwater unknowns connected with their respective passions for the sea. A physician must navigate some tricky and complicated unknowns in the practice of medicine, for which he or she relies on what is called “Base of Knowledge.” This base is never settled or final. It should grow throughout one’s career, a true example of life-long learning. Ed’s base was massive and never stopped growing. I know this because I was lucky enough to be his colleague. 

He came to Bar Harbor in 1971 and was shortly thereafter joined by his Harvard junior resident, O. Lee Haynes. Mutt and Jeff. Haynes, a huge mind in a huge body; Gilmore, a huge mind in a not-so-huge body, always adorned with a bowtie. They joined a medical group created by a beloved surgeon, Dr. Llewellyn Cooper, and the Doctors Stewart: Nancy (OB-GYN) and Winston (general practice). It was into this mix that I was introduced in 1972. 

They say that it takes 10 years to train a general surgeon: five years to educate him in the cocoon of residency and five years to correct his mistakes once out in the world. This is, of course, over-stated, humorous to us, and hardly humorous to the lay public, but serves to underscore the critical need for post-training mentors and role models. While it was Dr. Cooper who modeled for me calmness in the operating and emergency rooms – and the use of humor in such circumstances – it was Ed Gilmore who taught me the grace and respect that can be achieved in the doctor-patient relationship. He embodied for me the essential qualities of intelligence and empathy that are so elemental in helping people get better. To get back to their lives. 

Ed Gilmore gave a lot to this island place: himself, his brilliant mind, his time and his heart. His legacy can be found in his name on the Critical Care Unit he worked so hard to create. Nurses were his colleagues whom he treated as equals. Their relationship was one of mutual respect and caring. In his final illness, the number of nurses wanting to help take care of him is a testament to their shared careers and respect. 

His style of practice, rooted in an earlier and less electronic time, reflected the expectation on both the physician’s and patient’s parts that “I will be there for you.” The inevitable encroachment of advancing medical complexity on time has made that ideal increasingly difficult to achieve. Yet, in his professional life to the end, he maintained that standard. I know. I was his patient. 

Farewell, my friend and colleague. Yours was a life well lived. 

 

Dr. Bill Horner is a retired surgeon who lives in Bar Harbor. 

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