Oklahoma, 1959. A small county hospital in Enid, 60 miles north of Oklahoma City. A woman named Dora Sims has been sitting in the admissions waiting room since 7:00 in the morning with her 6-year-old son pressed against her side. The boy has a fever of 104 and has had it for 2 days.
Dora has $14 in her purse. The admissions clerk has told her the deposit for treatment is $35. Dora has explained that she does not have $35. The clerk has explained that hospital policy requires the deposit before the physician can be called. It is 9:15 in the morning and nobody has called the physician. Here is the story.
Dora Sims was 27 years old and had been working the night shift at a diner on Route 60 in Enid since the fall of 1957 when her husband had taken a construction job in Tulsa and then stopped coming back on weekends and then stopped answering the telephone and then sent a letter in January of 1958 that said what letters of that kind say and that Dora had read once and put in the kitchen drawer and not read again.
She had a son named Thomas who was five when the letter came and who she had been raising alone in a rented house on the north side of Enid since working nights so that she could be home with him during the days and sleeping when he slept and not sleeping when she could not afford to. Thomas was 6 years old when she carried him into the county hospital on a Thursday morning in March of 1959.
She had worked the night shift the previous two nights and had been home with Thomas during the days tracking his temperature and giving him aspirin and putting cold cloths on his forehead and watching the fever stay at 104 and deciding on Wednesday night that she could not wait another day. Thomas Sims was 6 years old and small for his age with a particular quality of stillness that a sick child has when the fever has gone past the crying stage.
He sat pressed against his mother’s side in the waiting room chair with his eyes half open and his forehead warm against her arm and did not ask for anything, which was the thing that frightened Dora most because Thomas was not a quiet child and his silence meant the fever had taken something from him that she needed the doctor to give back.
She had gone to the admissions desk when they arrived at 7:00 and given her name and her son’s name and described the symptoms and the duration. The clerk had given her a form to fill out and told her the deposit was $35. Dora had filled out the form and brought it back and told the clerk she had $14 and asked if she could pay the remainder later from her wages.
The clerk had said the policy required the full deposit before the physician could be summoned for a non-emergency case. Dora had asked if a 104° fever for 48 hours in a 6-year-old was not an emergency. The clerk had said she was not a medical professional and could not make that determination and that the policy required the deposit.
Dora had gone back to the chair. She had sat there for two more hours because there was nowhere else to go and because leaving meant taking Thomas back into the March cold without having seen the doctor and she could not do that. She had $14 and a 6-year-old with a fever and the particular kind of stillness that she had been watching for two days and that had gotten more still overnight.
She had $14 in her purse and the knowledge that her next paycheck was Friday and would clear the bank on Monday and that today was Thursday morning and that Thomas had been quiet since the previous afternoon in a way that was getting quieter. She had been sitting in that chair for 2 hours and 15 minutes.
She had counted the ceiling tiles. She had read the health department notices on the wall. She had watched the clock above the admissions desk move from 7:00 to 8:00 to 9:00 and past 9:00. Thomas had fallen asleep against her arm, which was not the restful sleep of a child who is well, but the heavy sleep of a child whose body is using everything available for something other than staying awake.
She was still watching the clock when she heard the door open behind her. John Wayne was 52 years old in March of 1959. He had been in Enid for a cattle industry promotional event the previous day, a ranching demonstration at the county fairgrounds that he had agreed to attend as a guest speaker.
And that had involved in its afternoon portion a roping demonstration in which he had taken a turn at the rope and had taken it incorrectly and had a 3-in rope burn across the palm of his right hand that his production manager, a careful man named Bert, had examined that morning and declared required looking at before they drove the 3 hours to Tulsa, where Wayne had a production meeting the following day.
Wayne had told Bert it was a rope burn and did not need looking at. Bert had disagreed in the polite persistent way that good production managers disagree, which is to say, he had said the same thing three different ways until Wayne had gotten in the car. They arrived at the Enid County Hospital at 9:00.
The building was a two-story brick structure on West Maple Avenue, modest and clean with a flagpole out front and a parking lot that was half full at that hour. Bert went to the admissions desk to check Wayne in for the hand. Wayne sat in the waiting room in the tan Stetson and the canvas jacket with his right hand wrapped in a clean cloth.
He looked at the room. Linoleum floor, pale green walls, six chairs along one wall, three along the opposite wall, a window with frosted glass, a clock above the admissions desk reading 9:15, in the chair three down from him, a young woman with a boy pressed against her side. The boy was six, maybe seven, small.
His head was resting on her arm and his eyes were half open and his skin had the wrong color, the pale gray color of a high fever. The boy had his eyes partly open and his color was wrong. The woman had the look of a person who had been sitting in a difficult place for a long time and had stopped moving because movement required a kind of energy she was rationing carefully.
Wayne looked at the admissions desk. He had seen Bert at the counter when they walked in. He looked at the woman. He looked at the boy’s color. He looked at the clock. He heard the clerk call Dora’s name at 9:20. He watched Dora go to the counter. He watched the conversation and he heard it because the waiting room was small and quiet and the conversation was not being held in whispers.
He was six chairs away and the waiting room was quiet and he heard every word of it including the part where Dora asked about the emergency threshold and the clerk said she was not a medical professional and the part where Dora said she would have the rest on Friday and the clerk said the policy required the full amount today.
He watched Dora walk back to her chair. He watched her sit down and put her arm around Thomas and look at her hands in her lap. He sat still for about 30 seconds. Then he got up and walked to the admissions desk. Bert was still there filling out the intake form for the hand. Wayne stood beside him.
He said to the clerk, “The boy in the third chair needs to see the physician.” He said it the way he said things that were not up for discussion. The clerk said, “Sir, we are processing your intake right now.” Wayne said, “The boy first.” He said, “What is the deposit?” The clerk said, “$35.” He took the long brown leather wallet from his jacket with his left hand.
He counted $35 onto the counter. He said, “That covers the boy’s deposit.” He said, “Call the physician now.” The clerk looked at the money. She looked at him. She processed the payment. The physician was called within 3 minutes of the deposit being processed. His name was Dr. Holt, a general practitioner of 40 who had been on staff at the county hospital for 12 years and who came into the waiting room 6 minutes after the clerk called him and came directly to Thomas Sims without stopping at the desk and put his hand on the boy’s forehead and looked at his eyes and looked at Dora and said, “How long has he had the fever?” Dora told him. Dr. Holt said, “Come with me.” Wayne went back to his chair. Bert looked at him. Wayne said, “What time do we need to be in Tulsa?” Bert said, “4:00 if we want to eat first.” Wayne said, “We have time.” He sat in the waiting room with his rope-burned hand and waited. Dr. Holt came back out 40 minutes later and spoke briefly to the clerk and then
crossed to Wayne’s chair. He said, “The boy has a bacterial infection that had been going untreated for at least 72 hours.” He said, “If she had waited another day, the fever would have moved to his lungs.” He said it the way a doctor says something he has decided the relevant party needs to hear. Wayne did not sit down.
He stood beside the chairs and looked at the frosted window that led to the examination corridor. He said, “Will he be all right?” Dr. Holt said, “He will be all right.” He said, “She would have lost him by Saturday.” Wayne sat with that for a moment. Then he asked Holt to look at his hand. Holt looked at the rope burn and cleaned it and wrapped it in a proper bandage and said it was not infected and would heal in a week. Wayne thanked him.
He went to the admissions desk before he left and paid the balance of Thomas Sims’ hospital account in full. The total, including the physician’s fee, the bacterial culture, the antibiotic prescription, and the 2-hour observation period Dr. Holt had ordered to monitor the fever’s response to the medication, was $112.
Wayne paid it in cash and asked for a receipt made out to Dora Sims showing a zero balance. He left the receipt with the clerk and asked her to give it to Mrs. Sims when she came out. He went out to the car where Bert was waiting with the engine running and the heater on because it was March in Oklahoma and the morning was cold.
Bert looked at the bandage on Wayne’s hand and said nothing. Where are you watching from? Drop your state in the comments. I want to see how far this story reaches. Doris Sims came out of the observation room with Thomas at noon. His fever had come down to 101 and was still dropping and Dr.
Holt had told her it would be below 99 evening if she kept up the antibiotics on schedule. Thomas was walking on his own. He said his legs felt like water. She said that was fine. He was still tired but his color had come back and he wanted to know if there was a soda machine. She went to the admissions desk to ask about the balance and the clerk gave her the receipt. Paid in full.
Zero balance. She read it twice. She asked the clerk who had paid. The clerk said a man who had been in the waiting room that morning. She described him. Dora looked at the receipt. She had grown up in Enid. She knew the name the same way everyone in Enid knew it and she sat in the waiting room chair with the receipt in her hands and did not move for a while.
She sat down in one of the waiting room chairs and held the receipt and looked at the frosted window for a while. Thomas sat beside her and drank the grape soda she had bought him from the machine in the corridor and did not know what had almost happened on Saturday and would not know for many years.
Doris Sims worked the Route 60 night shift for three more years. In 1962, she applied for a position as a medical receptionist at a physician’s group practice on East Broadway in Enid. She had spent enough hours in the waiting room of the county hospital to understand exactly what was wrong with how it operated and she believed correctly that she could do the job better.
She was hired and she did. She was right. She worked as a medical receptionist and then as an office manager for 22 years. Thomas Sims grew up in Enid watching his mother work and watching her manage and watching her never once ask for help from anyone who had not already offered it. He went to the University of Oklahoma on a partial academic scholarship in 1971 and then to the University of Oklahoma College of Medicine.
He became a physician. He came back to Enid and practiced general medicine for 31 years. Had a practice he built himself that accepted patients regardless of their ability to pay at the time of service. And he was known in the county for this. And when people asked him why he ran his practice that way, including the medical board reviewer who asked him about it during a 1991 audit, he said the same thing each time.
Because a policy is not the same thing as a principle, and he had understood the difference since he was 6 years old sitting in a waiting room in Enid, Oklahoma running a fever of 104, and waiting for someone to decide his mother had enough money to make him worth seeing. Doris Sims died in 2003. She was 71 years old.
Thomas donated three items to the Cherokee Strip Regional Heritage Center in Enid in 2005. The first was the hospital receipt from March 1959, paid in full, zero balance. The handwriting of the admissions clerk neat and even. The second was a photograph of Thomas at his medical school graduation in 1975, Dora beside him in a yellow dress.
The third was a framed copy of the admissions policy of the Enid County Hospital from 1959. One paragraph was underlined in red pen. It was the paragraph about the deposit requirement. Beneath the underline, in Thomas’s handwriting, was a single word, changed. The placard reads, Thomas William Sims, M.D., born Enid, Oklahoma 1953.
Enid, Oklahoma. He was 6 years old and his fever was 104 when a stranger paid the deposit. He became a doctor. He never charged a patient who could not pay on the day of service. He said it was the least he could do. He said a man had paid $35 so that a doctor would come look at him and he had decided when he understood what that meant that he would never be the person who made someone else wait for $35.
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