The Root Doctor

— Russ Hostetler

As soon as I walked into the exam room, she started crying. She did not look away for even a second. She just stared at me, following my every movement with apprehension on her tearful face. Her mother, leaning on the exam table just behind her, started to rub her back gently and told her, in her heavy southern drawl and phonetic understanding of the language, that everything was going to be all right.

I would have expected such behavior from a 2-year-old. At that age, having had the experience of immunization shots, kids just assume you are going to try to kill them, and they cling to their mothers and fathers like pups to the belly of a possum. But even though she was tiny for her age, this girl was nearly 7 years old, and we had met before, years earlier. I thought she’d remember me, but her memory was clouded by the experiences of the intervening two years, and it was clear that she was afraid. I tried to console her.

“It’s OK, LaTeesha. Don’t you remember me?” I reached out and gently touched her knee. She withdrew, scrunching up closer to her mother. I looked to the mother for help.

“LaTeesah, you be awrye. Dis doctah ain’t gonna hurcha,” she consoled. “Let ‘im zamen you so hees can figure out what ta do.” She gently pushed her daughter back to the end of the exam table. The tears continued but with a more quiet sob.

“Of what is she so afraid?” I asked softly.

“Teesha, tell da doctah whuh you so ‘fraid uh.” The mother was gentle and encouraging, not demanding or forceful.

The little girl whimpered a bit more, sniffed, drew a finger under her nose and wiped it on her jeans, then looked up from a bowed head to ask, “You gonna pee on the ground an make mud?”

“What?!” came out of my mouth before I could think, and my tone implying incredulousness was not mistaken by the mother. She looked at my Caucasian face with a look that said she understood my lack of understanding, my cultural ignorance.

“Huh daddy tuhk huh tuh ah root doctah. Fuh a treatmen’, dey tuhk huh intuh duh woods at nye by duh full moon. ’Til he foun duh rye kindduh red clay duht. Den he pissed awn duh duht tuh make mud. Den he strip huh naked an make huh lay down innit an pack duh mud aroun’ huh neck an huh knees an huh elbahs.”*

Translation: Her daddy took her to a root doctor. For a treatment, he took her into the woods at night by the full moon…until he found the right kind of red clay dirt. Then he pissed on the dirt to make mud. Then he stripped her naked and made her lie down in it and (he) packed the mud around her neck and her knees and her elbows.

LaTeesha’s crying intensified. The memory of the trips to the woods, the malodorous mud, and the nakedness overwhelmed her. She crawled up into her mother’s lap. Her mother did not refuse her.

I was dumbfounded. Three minutes is a long time during which to say nothing and do nothing, except allow this youngster to experience the warmth of her mother’s protective embrace, but that’s what we did. I had to pull my handkerchief from my pocket to dab my eyes. Finally, I spoke.

“LaTeesha, that other doctor’s treatment isn’t anything like what modern medical treatment has to offer. Let me examine you so we can figure out what might help you feel better. I promise I’ll try not to hurt you. If any part of my exam hurts, just let me know, and I’ll stop right away, OK?”

She peered out from her mother’s chest. He mother gently pushed her back onto the exam table. I got out my stethoscope and started listening to LaTeesha’s mother’s upper arm. “See, it doesn’t hurt, does it Mom?” I asked rhetorically.

Mom cooperated nicely, ‘Ih doan huht, Teesha.”

I examined LaTeesha carefully. I found a moderate heart murmur (the sound of turbulent blood flow during a contraction of the heart muscle), but no rub (the sound of irritated tissues rubbing against each other). It didn’t appear to significantly affect heart function. Her heart could still adequately pump blood around in her body. I wondered if she had some ballooning of the main blood vessel leaving the heart, a problem left over from the heart inflammation she had when I first met her. I couldn’t see any eye problems with the hand-held ophthalmoscope (instrument for examining the inside of the eyes), but one knee and the contralateral ankle and elbow were tender and a bit red and swollen. I had LaTeesha walk around the room. She limped because her joints were painful.

Two years earlier, she had presented with fever, swollen joints, a soft pericardial rub and bright light bothered her. X-rays, lab tests, and a visit to the ophthalmologist confirmed what used to be known as Still’s onset juvenile rheumatoid arthritis and now is called pauciarticular JRA—a form that that affects just a few joints. There are two other types: one that involves many joints, called polyarticular, and another that affects the whole body, known as systemic. The ophthalmologist started her on some steroid drops for a mild inflammation of a part of the eye, a finding that goes along with the positive ANA (AntiNuclear Antibody) test in young females with JRA. I sent her to a pediatric cardiologist, too, and had heard that he had changed my ibuprofen prescription to a shot of steroids followed by oral steroid treatment; however, as so often happened, she did not come back to me. To my shame, I did not follow up with inquiries about how she was doing, either. Looking back, a busy practice was not a good excuse for a primary care physician not to follow up on a patient’s significant and chronic disease.

I asked her mother what had happened after we sent her to the cardiologist. She reported that they went there a couple of times, but the copays imposed by their insurance for doctor visits and medications were a burden. Her ex-husband, LaTeesha’s father, had complained, but when she told him there was no alternative and that he’d have to change his lifestyle to accommodate their child’s medical needs, he came up with an alternative. I wondered how much, or with what, he paid the root doctor.

At first, she didn’t object, because she thought he had as much right to make decisions about LaTeesha’s health care as she did, and a trusted aunt advised her to let the root doctor have a chance to help the child. Additionally, she didn’t have any money for a lawyer, so when he assumed custody of LaTeesha, she felt powerless to fight him. But after a few months, she could tell that LaTeesha was much worse, that she had stopped growing and that her joint pains were crippling her. It took more than eight months to finally get LaTeesha back from her father’s house and bring her to me to restart medical treatments.

“Ih come down tuh thuh sheriff’s depuhtee pullin’ awn one ahm an’ huh daddy pullin’ awn thuh uhthuh. When Teesha scream, day bo’ stop pullin’ an look at each uhthuh. Finuhly, huh daddy let go an stomp back into he house. Dat wuh two week ago, an ah ain’t huh from him since. I wen tuh duh county an got huh awn Med-caid an heuh we is.”

We started her on ibuprofen (the oral anti-inflammatory like Advil), and she did well. Still’s does abate (permanent remission) in some patients, and if there wasn’t too much damage done before such a blessed development, they can lead fairly normal lives. Seeing LaTeesha run up to my office from her mother’s parked car for a follow-up visit led me to hope for such an outcome for LaTeesha.

The mother ultimately moved to Detroit, where she was promised a job with relatives. I imagined that LaTeesha had a good chance of being cared for by a Black doctor in the Detroit area, and I wondered if he or she would take LaTeesha’s history in stride or if he or she would have to pick his or her jaw up off the floor after hearing the story of this child’s potentially dangerous encounter with alternative medicine in the form of a root doctor in Georgia.

(Author’s note: This story is from my country doctor practice in Jones County, Georgia, back in the mid-1980s. Juvenile Rheumatoid Arthritis is now called Juvenile Idiopathic Arthritis. More recent data show that half of these patients continue to have arthritis in adulthood, and half of them are debilitated by the disease. Treatment is much different these days. We now have Disease-Modifying Antirheumatoid Drugs (DMARDs) resulting in improved long-term outcomes.)

Gullah root medicine, practiced in the American South, blends West African spiritual traditions with Christian beliefs and herbal healing. Root doctors use local plants, potions, and rituals to treat ailments, protect against harm, and influence fate. Remedies may include “roots” worn as amulets or buried for effect, and powerful substances like “goofer dust” made from graveyard soil. — Editors

Russ Hostetler found his calling as a physician while working in Conflict Management and Crisis Intervention as a Special Police Officer in Dayton Ohio after graduating from Ball State University with a degree in psychology. His medical career included faculty positions at two medical schools, directorships in three managed care settings and a consultative clinical practice in geriatrics. After retirement, he volunteered as a Senior Medical Officer in Marine Corp endurance events operations, is an active member of the Florida Department of Health Medical Reserve Corps, and is a Healthy Community Clinical Director for the Special Olympics. He enjoys building furniture, tennis, writing, cooking and baking, nursing his understanding of the German language, and being grandpa to several delightful children.