I’m Too Old to Train Another Osteopath

By Steve Paulus, DO

In 1992, after years of practicing mainstream allopathic Family Medicine and part-time Osteopathy, I gathered the courage to devote myself completely to treating every patient Osteopathically, for any illness or injury. The reasons for not previously engaging true Osteopathy as a pursuit, rather than the allopathically infused and permeated effort most DO’s call Osteopathic Medicine was complex. I had to release my misguided belief that a true physician practiced only western allopathically oriented medicine. I needed to gain enough experience and wisdom to recognize that I was fed up with a system dictated by 5-10 minute office visits that did not value close relationships with the people we call patients. Finally, reaching the end of my allopathic rope, I surrendered to my Osteopathic dreams.

The process leading up to expressing my full identity as a physician was convoluted. Though I had excelled in Osteopathic Manipulation as a first and second year medical student, I experienced the typical drought of applied Osteopathy during the last two years of medical school and throughout the course of internship and Family Medicine residency. Upon completion of residency training, I joined a conventional Family Practice in the small California farming community of Watsonville. My day-to-day efforts were spent treating patients no differently than an MD, but my dreams were greater, hoping for an opportunity to express my Osteopathic potential.

During the early years in private practice, I devoted my continuing medical education efforts to expanding my Osteopathic skills and perception. The esteemed DO’s I called my teachers and mentors gave me the necessary experience and helped to heighten my appreciation for Osteopathy. We all can name distinctive or significant teachers who directly influenced our growth and inspired us to develop an attentiveness to the art of Osteopathy. Patients are educators too, enlarging our awareness and showing us that healing does not occur by the rules of a textbook. Each patient teaches us by offering an opportunity to learn, to see something new, to potentially gain an insight, and to broaden our understanding. One such patient is notable not only for helping to give me clinical experience, but for offering something extra . Marion Schaeffer, passed on to me the teachings of a great Osteopath named Ruth Gotsch, DO.

Dr. Ruth Gotsch was, and continues to be, a legend in Central California. As a student of William Sutherland, DO, as a teacher of Cranial Osteopathy, and as a gifted clinician she inspired many DO’s and patients alike with her inner strength, compassion, and skillful application of Osteopathy. She is an icon and a colorful character in this area of California I now call home.

When I finally entered the unique and dedicated practice of Osteopathy in 1992, I assumed the office of Fritz Smith, an Osteopath who served in Watsonville for over 30 years. Many of his patients had originally seen Dr. Ruth, as she was affectionately called. When she finally retired and moved to San Diego, patients affiliated with Fritz. Then when Fritz retired, many of his patients thus moved to my office to receive Osteopathic care. A surprisingly high percentage of the people I saw had been treated Osteopathically all of their lives, either from Dr. Ruth or Fritz. And it was my honor and privilege to continue the legacy of Osteopathy in this community.

Marion Schaeffer was in 1992 a 75-year-old intelligent, assertive, and elegant lady who had seen Dr. Gotsch as a patient for over 20 years. Marion, who I still see periodically, is a tall, muscular, rancher with penetrating blue gray eyes. Her honesty is only exceeded by her directed lack of subtlety. She drives more than an hour to my office for appointments and is a dedicated proponent and advocate of Osteopathic philosophy and manipulation. At the end of her first office visit she asserted, “You don’t treat like Dr. Ruth or Fritz, but you’re close. I can tell you’re a good person and if you’re willing to learn I will teach you to be a good Osteopath. If I can teach Fritz, I can teach you.” She then went on to tell me that Ruth Gotsch was the greatest Osteopath she had ever met. Marion had traveled all over California as a young woman, had been treated by many different DO’s, and it was Dr. Ruth who helped her when nobody else could. When Dr. Ruth retired she began to see Fritz Smith. Fritz had worked with Dr. Gotsch and understood her style of treating; though according to Marion, “He was rough around the edges and needed help.” Over the next year, Marion proceeded to teach me Osteopathy. She encouraged me gently yet forcefully. Marion would guide and direct my efforts moment to moment during each treatment session.

“Don’t rub where it hurts, treat where the problems is.”
“Dr. Ruth wouldn’t do that.”
“You’re pushing too hard.”
“You’re touching too soft.”
“You’re not paying attention . . . Where are you?”

It was impossible for me to escape humility with Marion as a patient. She was in command and I was her (or Dr. Gotsch’s) student. The next month when she returned she would offer, unsolicited, the inevitable feedback that was meant to teach me right from wrong in the realm of healing.

“You made me a wreck after the last treatment.” “I hurt for 3 days, Dr. Ruth never did that.” “You spent too much time on my shoulder and forgot to treat everything else.” “You finally did a good job, that was a great treatment.”

To this day I count Marion Schaeffer, or Ruth Gotsch, DO (I get them confused sometimes) as one (or two) of the greatest teachers or influences in my Osteopathic development. Recently, in a follow up with Marion, she gave me the greatest possible complement, “Dr. Paulus (she never calls me by my first name), you finally treat just like Dr. Ruth. And, don’t ever retire or move away, I’m too old to train another Osteopath.”