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Friday, Apr. 29, 2016

Doorenbos retires after 41 years of caring

Friday, December 7, 2012

Dr. Daryl Doorenbos holds an old medical bag, one of many pieces of medical equipment and items he has collected over the years, as seen by the items on the shelves. He and his wife, Elaine, are looking forward to retirement, after his 41-year career as a primary care physician in Le Mars.
From the countryside and farm life near Boyden, to the halls of Floyd Valley Hospital and the medical clinic, Dr. Daryl Doorenbos has done a lot in his life.

After 41 years as a family practice physician in Le Mars, the doctor has retired to the acreage filled with trees, where he and his wife, Elaine, will enter a new phase of their lives.

Reflecting on more than four decades in the medical profession, Daryl said there have been a lot of changes.

He joined a practice with Dr. Donald Faber, who had been in Le Mars six years, and Dr. Lee Marven, of Alton, who had been a medical school classmate of Daryl's and had also recently joined Faber.

Daryl started work in Le Mars in December 1971.

For the previous few months, he had filled in for a Sheldon physician and then worked with Dr. L.A. George in Remsen.

A member of the 185th Iowa Air Guard, Doorenbos had also completed his flight surgeon training with the group based in Sioux City.

Other physicians in Le Mars were at the Le Mars Medical Clinic and included Dr. H.L. Vander Stoep, Dr. Lawrence C. O'Toole and Dr. Sherman Lindell. Dr. R.J. Fisch also had an office in Le Mars.

Faber, Doorenbos and Marven moved to a new medical clinic building in January 1972, from offices in the former Naef Building.

"When I first came to Le Mars, we were in the old hospital, now the Floyd Valley Apartments," he said.

"We were always going up the stairs to whatever floor you had to go to the patients."

The emergency room was on the fourth floor.

"The hospital had a rickety elevator, or so it seemed to me," Daryl said.

"That first delivery you had, you didn't even know which floor to go to did you?" asked Elaine.

"I though it was on the fourth floor, but I found out when I got there it was on third floor. I made it in time, it was in the middle of the night," Daryl said.

When Doorenbos was recruited, Faber and community members said there were plans for a new hospital.

By 1976, the hospital moved to its present location.

"The old hospital was a solid building, but not very convenient for healthcare delivery," Daryl said.

When he started his career in Le Mars, lab work was done with beekers and pipets, and colorimetric determinations, he said.

"Now, of course, everything is highly technical and very reproducible. Lab error almost doesn't exist now as compared to then. With the old methods, there were lots of opportunities for error," he said.

While they worked in the old hospital building, Faber, Doorenbos and Marven moved into new clinic facilities in January 1972.

The new clinic was very nice, with all the space, he said.

The partnership was called Medical Associates.

"And it all went well for about three years or so. Then everything fell apart, or so it seemed," Daryl said.

Fisch decided to quit practicing, and shortly thereafter Dr. Vander Stoep decided he wanted to cut back.

"Dr. O'Toole had a heart attack and decided to quit. Dr. Lindell probably saw the writing on the wall and left (for a job in Cherokee)," Daryl said.

Suddenly, it seemed, there were only two doctors in town -- Faber and Doorenbos, with Doorenbos needing to complete his flight surgeon commitment to the 185th.

"During that period, where it was just the two of them, Daryl worked and slept, and I was a married single mom with four children," Elaine said.

She withdrew from all her community commitments to concentrate on her family.

"The community, again, showed me how supportive they were," Elaine said.

She would receive phone calls at home for the doctor, and would do her best to explain if he was on weekend guard training, that it if was a true emergency, Daryl could get home in 30 minutes.

Or if it could wait, the doctor would be home after 5:30 p.m.

"Most waited until that 5:30 p.m. deadline," she said.

During this time, the Le Mars community was hard at work trying to recruit new physicians.

"Recruiting at that time became extremely difficult because, first of all, there wasn't much interest in primary care at that time because everybody, or the greatest majority, were more interested in specialty care," Daryl explained.

Also, a new state law required those going into family practice to have a three-year residency dried up the potential flow of new doctors looking for jobs.

Commitments to practice in Le Mars eventually came from Le Mars native Dr. James Powell, who was in family practice residency in Sioux Falls, S.D. Then Dr. Jerry Van Es, came to the practice the following year when he finished classes.

"So there was some light at the end of the tunnel," Daryl said.

During that same time, Daryl took on the job of Plymouth County Medical Examiner.

"You adapt to the circumstances," added Elaine. "He never heard the babies cry during the night at home, and I never heard the phone ring during the night. He heard the phone, I heard the kids."

Even when Powell and Van Es came on board, Daryl said the community continued with physician recruitment efforts.

"The limitation was that people weren't going into primary care. They had a lot of options, where they wouldn't have to take calls as much. Also the city lifestyle, bigger community, and so on," Daryl said.

Daryl felt those that did come to join the practice were more oriented to rural medicine.

"There were a lot of recruitment dinners," Elaine recalled. "Lots of times at restaurants, some of them in our home.

Medicine has changed a lot since Daryl began his practice.

"There have been a number of diseases described that were not known when I was in medical school," he said.

Diagnosis is more scientific now and less clinical. That amounts to new chemistries and compounds, and new protocols that have been developed that increase the certainty of diagnosis from when he first started, Daryl explained.

"And I enjoy the challenge of diagnosis, because it's easier to treat once you understand what the underlying pathophysiology is of what's going on," he said.

New medications through the years have also made treatments more successful.

For example, improved medications for blood pressure now cause fewer side effects and offer more efficient treatment, he said.

End of life issues have changed since his school days, too.

"I would say the attitude communicated when I was in med school was that death was a failure," Daryl said. "To help people deal with end of life really involves relationship more than science."

He learned from those he worked with.

"I wish that I would have learned in medical school more about dealing with the end of life As it was, I learned a lot of that from my nurses," he said.

The most rewarding thing he has found through his medical career is the relationships he has made.

He does wish he would have had more time to spend with patients.

"In the early years here, probably the first 10 years or even more, it was much more triage than it was prevention-oriented," he said.

Moving to the new hospital in 1979 was nice, at least there were no more stairs to run up and down.

"The problem was, that was the time when we were the most busy. Fortunately the clinic was right next door," Daryl said.

He points out one thing extremely beneficial to the primary care doctors was the specialty support from surgeon Dr. Edward Grossman, radiologist Dr. Glenn Van Roekel, and surgery help from Vander Stoep.

Today, both the clinic and hospital are managed by the Avera Health Care System in Sioux Falls, S.D.

The community benefits from the clinic and hospital, and the partnership with Avera, according to Daryl.

"The (clinic and hospital) employees, who are in large part members of this community, are taking care of their friends and family, so there's personal involvement because of that," Daryl said.

He also has some advice for those going into medicine, and thinking of primary care and family practice.

"I guess I would say in primary care, particularly in rural areas, if you appreciate relationships, it's a great job," he said.

Being anonymous is not an option.

"You have to be comfortable with living in a community with your patients -- seeing them in church, at the grocery store, and social gatherings, and so on, and even embrace that option rather than being anonymous and not as involved," Daryl said.

"To me, primary health care has been rewarding in not only being given the opportunity to study the science of why we are the way we are, but also emotionally and theophilosophically why we are the way we are. Hopefully we understand life better," he reflected.

Daryl started college studying psychology, but between his junior and senior year, he made the decision to go into medicine.

He took most of his pre-med requirements his senior year at Drake.

"Overload is what they called it," said Elaine.

The switch in Daryl's career path caused Elaine to make changes, too. At the time, she was also attending school and working in the office of orthopaedic surgeons.

"I didn't want to be a doctor's wife, but he was quite enthused about this, and convinced me this was the route to go," she said.

Daryl grew up on a farm near Boyden, with his first eight years of education in country school. His high school years were in Boyden, and then they merged into Boyden Hull Public School.

In 1963, he married Elaine, his high school sweetheart.

His first year of college was at Northwestern College. in Orange City.

He transferred to Drake University in Des Moines, where he graduated with a psychology degree.

Elaine earned teaching degrees in social sciences and English. The couple moved to Iowa City for medical school, and then on to Spokane, Wash., where Daryl did his internship at Deaconess Hospital.

After more than 35 years, Doorenbos took his practice in a new direction.

Daryl cut back on a full-time workload at the clinic.

"My partners have been very supportive in allowing me to do that," Daryl said.

Elaine added, "Gradually cutting back has given us a taste of what could be considered in retirement,."

The couple has done a lot of traveling. Now they will have a similar opportunity without boundaries.

"I can't think of anything that I can do in my retirement that's more fascinating and rewarding than what I was doing," said Daryl. "Maybe woodworking and golfing and travel may be more interesting than I anticipate."

Daryl also has another interest -- medical antiques.

When the old Le Mars clinic closed in the 1970s, Daryl acquired some of old pieces of equipment.

Through the years, he's collected many more items, and has shared some with the Plymouth County Historical Museum for its medical room exhibit. It may be time to share more with the museum, he said.

There's also their four children and seven grandchildren, ages 4-13, to visit.

The couple's three daughters live in the Minneapolis area and work in the medical field.

Pam is in family practice. Laura is a pediatrician and currently a stay-at-home mom.

Her husband, Eric Kehrberg, also from Le Mars, is a pathologist.

Susan considered medical school, but listened to sister Laura to find a balance in life, and is now a physician's assistant.

Son Ryan, told his parents he needed to be outdoors, and now works as a fisheries biologist with the Department of Natural Resources at Windom, Minn.

"It's hard to walk away from the job. But it's easier, of course, to wind up because there are very capable people than remain to provide the medical services to the community," Daryl said.

The Doorenbos's work in caring for the community ended with Daryl's retirement last month.

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Congratulations to Dr. Doorenbos on his retirement. His dedication to the community is well appreciated. I wish many happy years to Daryl and Elaine as they pursue a new phase in their lives.

-- Posted by marfitz on Mon, Dec 10, 2012, at 4:49 AM

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