Margaret Mitchell’s Lost Letter to a Kansas Horse & Buggy Doctor

Arthur Hertzler at his desk .

Courtesy of the Kansas Learning Center for Health.

A career in medicine is a journey that can take many paths. A few years ago, inspired by a poster symposium at the annual Pediatric Academic Societies meeting, we got hooked on exploring the history of Midwestern pediatrics. Specifically, we wanted to focus on people and events relating to children’s health care in our home states of Missouri and Kansas.^1–4 In 2010, we decided to profile Arthur Emanuel Hertzler, a small town Kansas physician who in his day enjoyed an international reputation following the publication of his 1938 bestseller The Horse and Buggy Doctor.⁵

Once we started our research, information on Hertzler’s life and in particular the pediatric aspects of his practice weren’t hard to find. He started his medical career in Halstead, Kansas, on May 1, 1895, the same day a tornado hit the town.⁶ His practice was varied, broad, and spanned over 50 years. He cared for all the common childhood ailments of the time and quite frequently performed, “kitchen table surgery” on children and adults alike. His stories on the ravages of diphtheria are chilling and his account of the house call he made to drain an empyema on a 14-year-old boy is as graphic and dramatic as anything we might encounter today.⁵ He was a prolific writer who kept records on all his patients and authored 20 medical textbooks, several in popular literature and over 100 scientific papers. Our studies of his books and collected papers from the Clendening History of Medicine Library at the University of Kansas School of Medicine uncovered a man of strong opinions and rambling prose who never shied away from speaking his mind in public or in print.

The last step in our research was a journey to Halstead, population 2,085. We wanted to spend time talking to the locals, see the place where Hertzler built a clinic and a hospital, and review the remaining archives on his life now stored at the Kansas Learning Center for Health (KLCH).

Halstead is a three-hour drive southwest of Kansas City into farm country. Entering the town on Kansas Highway 89, renamed the Hertzler Memorial Highway, we found a typical small Midwestern community. Grain elevators bordered Main Street and flanked the inevitable railroad tracks. A water tower rose in the distance framed by nothing more than the vivid blue expanse of cloudless prairie sky.

The KLCH is in a new building just down the road. It was founded through the Hertzler Research Foundation by Dr. Irene Koeneke, Hertzler’s wife. We were warmly greeted and showed to the piles of scrapbooks and boxes stacked for our visit on a table next to the four-foot high eyeball exhibit. It was quiet because there weren’t any school tours that day; a perfect time for poring through old records.

It didn’t take long to discover the letter from Margaret Mitchell on her personalized stationary dated September 7, 1944. (See Figure 1, next page.) Our first thoughts inevitably were, “The Gone With the Wind Margaret Mitchell?” It was soon apparent that it was indeed the Margaret Mitchell, and that she was a fan as she put it “of Hertzler’s pungent writing style.” Based on our collective knowledge of Arthur’s writing, we easily related. The letter was obviously from one writer to another and typified her special talent as a storyteller. She began by referring to Hertzler’s book Ventures in Science of a Country Surgeon.⁷ Toward the end of the book, in a chapter entitled, “The Writing of Books,” he notes that he had been introduced to Margaret Mitchell, and described her as, “the most remarkable person I have ever met.” ⁷

Figure 1.

Scanned copy of Margaret Mitchell’s letter to Author Hertzler. Courtesy of the Kansas Learning Center for Health. Recreated for Missouri Medicine.

Margaret Mitchell, circa 1941. Source: U.S. Library of Congress.

The next to last paragraph piqued our curiosity. In her letter, Margaret Mitchell tells Arthur Hertzler why, as of 1944, she had not written another book. On further reading we learned that biographers have well chronicled her father Eugene Mitchell’s ill health, protracted decline and Margaret’s immersion in his care. ^{8, 9} They have also recounted multiple other stressors, including her struggle to cope with the notoriety and complexities of her life following the publication of Gone With the Wind, her own poor health, and her husband’s frailty. Interestingly, after her death in 1949 her husband and brother wrote to her correspondents requesting that they destroy her letters⁹ but Arthur had died in 1946 soon after retirement. That letter, tucked away in Kansas for decades, provides the opportunity to revisit Margaret’s thoughts on writing again with the clarity and poignancy of her own words. In a touch of irony she ended by urging him to write more.

The letter from Margaret Mitchell wasn’t the only find. There was a copy of a letter from Albert Einstein dated June 24, 1944, in which he thanks Hertzler for sending him a copy of The Grounds of an Old Surgeons Faith.¹⁰ A retinue of the 1941 Chicago Cubs sent a letter autographed by players, coaches, the manager, trainer, and newspapermen thanking him for the steaks he supplied to their dining car during a train trip through Wichita. They also sent along a thick packet of autographed individual and group pictures; there’s a good one of Dizzy Dean. Fellow Kansan Karl Menninger sent a letter congratulating Hertzler on his career achievements when Arthur retired in 1946. The letters left us flush with the thrill of discovery, but also struck by this sturdy and enduring form of communication much richer in composition than the hastily deleted e-mails and superficial texts and tweets of today.

Ultimately, the most rewarding part of this journey into history was the visit to Halstead. For it was there that we gained an understanding of Arthur Hertzler, the person behind the books. Before we left we viewed the glass display cases filled with memorabilia in the back of the museum. There among the old medical instruments was a large leather bound copy of De Humani Corporis Fabrica Libri Decem the anatomy text by Adriani Spigelii (also known as Adriaan van den Spiegel), published in Venice in 1627.¹¹ From signatures in the front of the book it appears to have once been owned by Franz Leydig. Hertzler was a serious student of anatomy. In 1899, he took a two-year hiatus from his practice to study anatomy and surgical pathology with Virchow and Waldeyer in Berlin. In the Horse and Buggy Doctor he writes of his great respect for his teachers and notes that, “no American teacher ever showed me the many favors that many of these German professors did.” ⁵ We saw the picture of his beloved daughter, Agnes, the black-eyed girl that he refers to several times in The Horse and Buggy Doctor. Agnes, we learned through personal communication with KLCH staff, died at 18 during an appendectomy being performed by her father. The story of her tragic death supplied the heretofore missing perspective into Arthur’s pungent writing style. It also provided us insight into the personal loss that we now understood, from other papers we examined at the KLCH, haunted him throughout his life.

Our poster on The Life and Times of a Kansas Horse and Buggy Doctor and His Recollections on the Care of Children was presented at the 2011 Pediatric Academic Societies Meeting.¹² It focused on Arthur’s professional career as a physician on the Kansas prairie in a time when it took stamina and grit to reach your patients and skill, experience and ingenuity once you got there. It recounted stories of his care for children whom he said, “always came first.” ⁵ But, our poster didn’t tell the less public story we found preserved in the letters, scrapbooks, displays and oral history of Halstead. It seemed a shame not to share it.

Hertzler Memorial Highway sign on the outskirts of Halstead, KS. Photo by R. Schremmer, MD.

Biography

Jane F. Knapp, MD, MSMA member since 1989, is Chair or the Department of Medical Education and Associate Chair of Pediatrics at Children’s Mercy Hospitals and Clinics in Kansas City, and Associate Dean at the University of Missouri-Kansas City School of Medicine. Robert D. Schremmer, MD, is Associate Professor of Pediatrics in the Division of Emergency Medicine and Urgent Care Services at UMKC.

Contact: jknapp@cmh.edu