February 28, 2013 will be the last day of Dr. John Vardiman’s fifty-year medical career.  All of us are saddened by that occasion but the sadness is tempered by the rich, sailing future his retirement will bring.  John’s medical career has formed a bridge in Jefferson County.  His contemporaries were of a former generation.  Men and women like Joe Reeves, Lethadwin Pentecost, Ken Miller, David Quick, Scott Wallace, Charles Adkins, Harry Starr, (Mark Kubala would be named in that group but he is still practicing), Lulu Smith, Wesley Washburn, Frank Giglio, Fallon Gordon, and many, many more for whom medicine was a personal calling and a true profession.  They established, with John, the foundation upon which those of us who have come after have built. 

It is our hope that a new generation of physicians will arise who will carry on the grand tradition of which John and his contemporaries were a part.  It is as if in the remembering his contribution to medicine that he “passes the baton of excellence” in caring for others to a new generation.  We hope to be worthy of that trust.

John started life in Killeen, Texas as one of three children born to his school-teacher mother and to his father who owned a small steel foundry.  John finished high school in 1953 and in 1957 graduated from college in Georgetown, Texas.  He was accepted to Southwestern Medical School in Dallas, but at the last minute decided he was not ready to start an arduous four-year medical education.  Instead, John joined the Army. 

As he tells the story, he spent two wonderful, care-free years, mostly in Panama, scuba diving and having a good time.  In 1959, he returned to Texas and finished his medical school education in 1963.  In 1962, he married his wife Bradna whom he met when he was teaching a Sunday school class in which she was a member!  In the coming years, they would have two children and five grandchildren.

After finishing medical school, John completed a year of internship at John Peter Smith Hospital and a year of General Surgery residency in St. Louis.  In 1965, he moved to Beaumont, Texas and joined Dr. Herb Hennington’s practice.   In 1970, he moved to Rosebud, Texas.  He describes it as having the second lowest per capita income of any county in Texas.  He spent five years in Rosebud, where as the only doctor, he did everything.   In 1975, the tragic death of Dr. Jim Old, one of Beaumont’s finest physicians, resulted in his being invited back to Beaumont.

John’s style of practice is best described by Theresa Bailey, who was his nurse for many years.   She said of him:

“The first time I met him I was doing Home Health in 1993.  I did know that 6 years later I would work for him.   In 1993, I had one of his patients in home health.   He was a difficult little man.  I noticed some changes in the patient and had problems changing his catheter.  So I went to Dr. Vardiman’s office and sat for two hours waiting to discuss this patient.  Dr. Vardiman finally came out and said, ‘I will meet you at his house at 12:15 tomorrow.’  I left thinking,  ‘Yea, right.’.  But low and behold he showed up and took care of the problem.  I was impressed with his beside manner. 

“On another occasion, we once had a patient who said she could not sleep and that she stayed sick because her house was haunted.  So, Dr. Vardiman made a home visit wearing a surgical gown, mask and gloves, armed with a fire extinguisher.  He climbed up in the attic and discharged the fire extinguisher, came down and told the patient that the ghosts were cleared.  The patient was healed.  She became well and was able to sleep. 

“Another little lady complained that she stayed sick because her house was too dusty.  Again we made a home visit.  Dr. Vardiman spent an hour walking around this patient’s home trying to figure out what to do.  He moved a few items slightly and declared the house dust free and the patient’s health improved.  By the way this was the cleanest house I had ever been in, even the picture frames were dust free.  

“Dr. Vardiman was on vacation once and he called me and said, Can you go out to Mr. ‘Smith and check on him.  I am worried about him.’  Of course, I did as he asked.  I called him from the home with my report and he spoke to the patient and the patient suddenly felt better.” 

No one would call this evidenced-based medicine, but it certainly qualified as patient-centered healthcare.

John continued in that practice until the early 1990s when hospitals began “buying” medical practices.  John became an employee of the Baptist Physician Network.   When that network dissolved, John called Theresa and said, “We are going to join SETMA.”  When John joined SETMA, the community had not yet decided whether SETMA was a good or bad thing.  John would even tell you that he was not sure himself.  Thinking that he was at the end of his career, John expected to work a couple of years and retire.  To his surprise, he continued to grow and in doing so, he aided SETMA in growing as well.  As much as he thinks he benefited from us; we believe and know that we have benefited from his acceptance of us and from his coming to know what we were “really” like.

In his own words, the following are his memories of his first days at SETMA:

“I was 66 years old and wanted to practice maybe another 2 or 3 years.  I joined SETMA and stayed twelve years.

SETMA was a shock.  First, I had to master the electronic medical record (EMR,  which to my five-year-old grandson would have been literally child’s play) but to me was a major hurdle.  My brain and the “electronic brain” seemed to have a hard time getting on the same wave length. But SETMA walked me through it, and walked me through it over and over until finally, I began to get it.

“One day, the computer fell off its track and bounced off the floor and I thought to myself, “There, you ungodly hunk of ceramic chips; I’ve finally killed you!”  (To hear that declaration in Dr. Vardiman’s own voice is riotously funny.)  The computer blinked green, stuttered, then blinked  blue €“ when I replaced it  in the rack it kept right on working (only a mild concussion) and I thought myself €“ “You can’t kill it if you try!!  Well, truth is, of course, these are fantastic machines (damn them anyway) and they have helped make SEMTA what it is.  In fact, SETMA is now recognized world wide (yes, world wide) as an authority on EMR! 

“My first weekend on call at SETMA was cultural shock.  SETMA had about six doctors then and over sixty hospital patients on average!!  I’d been seeing at most twelve patients in a weekend call; so even with three SETMA doctors on call, I was seeing 20-30 patients €“ all of whom were very sick.  I felt like an intern again.  But medicine (always the jealous mistress) has you dutifully falling into line and pretty soon that “chore” became a joyful burden €“ (a burden, I think, only a physician can appreciate and understand.)”

Absent from this story so far is a theme which has run through the past twenty-five plus years of his life.  John has always been a romantic €“ a cavalier €“ born of a day which has long disappeared.  He loved the sea and he loved boats.  If you listened to his life story for long you would hear of the stories of the ship builders and of the fishermen of the northeastern United States.

“The way, they did business,” he would start, “was by their word of honor.  A boat captain would walk down one side of Main Street and see the ship builder walking the opposite way on the other side of the street.  The captain would speak to the builder, touching the brim of his cap, ‘Cap, build me a sixty-foot schooner.’  The response was equally brief but with out words, the builder simply nodded and tipped his cap.”    Six months later, John continues, these men of habit and of honor, walking down the same street again in opposite directions, would reverse roles. This time the builder would speak and simply say, “Boat’s ready.”  The captain touched the brim of his hat and nodded.  The transaction was complete, sealed by the honor of men’s word.  John is such a man and longed to live among such men. 

Because my father was a man of his word, John was to learn that SETMA was built on such principles.  He admires and values that.  In fact, the metaphor of my own life involves a boat.  I think every life should have a metaphor which defines that life.  My metaphor was formed when  I was four and half years old.  We were poor but didn’t know it.  One day, my father borrowed a wooden boat and we went fishing on Little River in central Louisiana.  The boat had three seats and there were four of us. My father, my mother and my older brother occupied seats and I, as the youngest, sat in the bottom of the boat.  Sitting there, I simply did what any ordinary 4 and a half year old would do, I rocked the boat.  My father thought it was funny but my brother and mother were not amused.  It seems that all of my life, I have simply, “rocked the boat.”

John’s life-theme had more substance than words.  And, he did not want just to rock other’s boats; he wanted to build his own.  In 1987, his dream took shape.  As pictures are better than a thousand words, you can go to the following two links and see this story unfold:

http://biggeekdad.com/2011/06/handmade-sailboat/
http://www.youtube.com/watch?v=SN4kmlAxvGU

John felled the trees, hewed the logs into planks, and did numerous other things building his boat.  If you have seen the movie, “Message in a Bottle,” you have seen John’s boat.  He built the same boat in which Kevin Costner sailed away at the end of the movie.  Few things bespeak of the character of John Vardiman than the fact that in April of 2010, he finished the boat. Twenty-three years and it was done. 

What a triumphal day.  April 16, 2010, the boat was launched, but the story had only begun.  Tragically, an accident occurred at the launch and John’s foot and lower leg were crushed.  That was a Friday.  On Saturday, like the sea captain with his word of honor, John was told, “whether you can work or not, SETMA will pay your full salary and benefits for at least one year.”  Within in a few days, it became apparent the foot was not salvageable.  Dr. Vardiman’s lower leg and foot were amputated.  

A lesser man would have sunk into a deep depression and many would have given up and died.  Not John.   He recovered and before his prosthesis was fitted, he began to make rounds again.  To make this possible his grandson, Ben, pushed him in a wheelchair and got the charts for him.  This was less than two months after the accident.  He was told repeatedly, “You don’t have to do this,” but remember his generation and remember the sea captain.

“I want to come back to work fulltime,” announced John Vardiman, three months after getting his prosthesis.  John submitted to extensive testing and examination before seeing patents and he passed all test with flying colors.  He completed rigorous continuing medical education courses, also.  Mentally, emotionally, physically and spiritually, he was whole and still the same doctor he always had been. 

Now three years later, we come to the end.  His spirit is intact and John commented of his time with SETMA:

“SETMA has created the only multispecialty clinic in Southeast Texas (something like herding a bunch of CATS)  and has made it very successful .   I’m proud to be one of those cats.

SETMA made me a better doctor and a better person.  SETMA has set the bar high and we all have had to stretch every day to try to hurdle that bar.

SETMA has cared for me as if I were the aged patriarch, through my wife’s’ three critical illnesses and through my amputation episode.  They have been extremely generous with me, all the while heaping upon me more respect and esteem than I deserve.  Thank you, SETMA.”

If we are to weigh in the balance the measure of the value received by SETMA, by Beaumont, or by John Vardiman in these past fifty years, the balance is heavily weighted on the side of SETMA and  Beaumont.  We have been the beneficiaries.  And, as we say farewell to our friend and colleague professionally, we are comforted by the fact that we will have a life-time of friendship and that as we shall see him sailing away, it will only be  to see him return again and again for years to come. 

John, “your boat’s ready,” and with the tip of our cap and with the nod of our head, like the boat captain and builder, we bid you Godspeed.