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Dr. Dave is a live one. In bartender patois this means that he can entertain himself and the two or three people next to him. He is low maintenance and thusly beloved.

He held a staff position at a large teaching hospital in the Twin Cities until an HMO bureaucrat began to visit him with his medical opinions. Dr. Dave had been to the end and back again with the treatment of the frail human condition and had seen plenty of blood in forty years of doctoring. The twenty-something bean counter hadn't so much as a layer of dust on his MBA when he began to exercise his medical judgement.

When managed health care made its first appearance, it did so subtly and with great deference to the science of health. The physician would be the last authority on whether or not a procedure was necessary and the health maintenance organization would merely process the paperwork. As the profit potential became apparent these organizations merged and mutated into something like an ultimate medical authority. A second or third opinion was now irrelevant because their judgement and their actuary tables held final sway in every case.

Dr. Dave was prepping for what should have been a routine surgical procedure when the phone rang and his life changed forever. The patient had been experiencing severe abdominal pain and Dr. Dave knew how to fix it. The surgery would carry some additional risk for the seventy-three year old patient but she had been under his care for decades and he knew that she had an otherwise strong constitution. The young man on the telephone told him that the patient did not fall within the age guidelines and that the insurance company would not cover the procedure.

Dr. Dave asked the young man where he had attended medical school and was greeted with total silence. Before the young administrator could regain his composure and quote more actuarial data, Dr. Dave told him that there was a medical procedure that he might consider for himself. If the man's buttocks were sutured, all of his shit could come out of his mouth. Dr. Dave hung up the phone and as the Hippocratic oath demanded, repaired the nice old lady's abdomen.

It's one thing to tell the shop foreman or the restaurant manager to "take this job and shove it," you can always wash dishes down the street. It takes some chutzpah to flush a three hundred thousand-dollar a year gig over someone else's tummy ache.

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Dr. Dave loved the science of healing more than life itself so he was able to leave the job but not his profession. He concluded that money was the problem so he simply took money out of the equation and hung up his shingle, as an independent contractor, in the poor part of town.

The Pine Ridge Indian Reservation is the second largest such sovereignty in the United States and it is by any definition among the poorest places on Earth. The unemployment rate on Pine Ridge is over 80 percent and the average household income is about $3,000 a year. The soulful tribes lacked financial resources but Dr. Dave was humbled by their respect for the miracle of life, so he devoted his to prolonging theirs.

The most striking contrast to his old life was the reverence for seniority among the Native Americans. The relative value of a human life decreased with age in the white man's world and senior care was determined with a mathematical cost/benefit analysis. In the Lakota tradition, children are given to the grandparents to raise until they reach the age of five or six and only then are returned to their parents. An important matter would never be discussed, much less decided without consulting an elder. Dr. Dave felt right at home on the Rez, where old equals wise and the Hippocratic oath is common sense.

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I smile hard when Dr. Dave shows up at the bar. He always acts a little embarrassed when I introduce him as Jakob Dylan's pediatrician but he's proud of the association. He had doctored all five of Bob Dylan's children at one time or another and had been a friend of the family since Bob's last name was Zimmerman. We'd pump him for the inside scoop on the celebrities and he'd forget about the Rez for awhile.

The last time I saw him he was in town for the funeral of Bob's mom, Beatrice. Beatty was, by all accounts, a typical Minnesota mom with some atypical progeny. I had tended bar for charity functions at which she was a guest and had spoken to her several times in the past, so Dr. Dave and I had her in common. I didn't recognize the name on her "Hello, my name is" sticker, so the nice elderly lady who accompanied her whispered, "You know who that is don't you? That's Bob Dylan's mama!" I got the impression that the sweet old ladies traveled as a pair and it occurred to me that the only thing better than being a living legend is being the creator of one.

Dr. Dave knew that Beatty was the sage calm behind her renowned offspring and deeply mourned the passing of a quietly grand soul. Beatty, like her famous son, spoke very little to reporters but granted a rare interview a year or so before her death. She was more eloquent than Hippocrates or Bob Dylan or Dr. Dave.

"My hope in life is that everyone stays well, health-wise. When the phone rings and everybody's OK, I'm happy, you know?"


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