Elton Lehman’s doctor’s office in Mount Eaton, Ohio, has two parking lots. One is curbed and paved with asphalt. The other has a hitching post. Horse hooves and wooden wheels have left its surface lumpy. This lot is for buggies. An estimated 30,000 to 35,000 Amish live in this part of Ohio. A good many of them are Lehman’s patients.
An osteopathic physician, Lehman, 62, has been doctoring for almost 35 years. He makes house calls. He prepares prescriptions. He has delivered 6,150 babies, including 72 pairs of twins and one set of triplets. Many of his deliveries are second generation. He’s now working on the third.
Lehman is the 1998 “country doctor of the year.” The award, by Staff Care Inc., a national temporary placement firm for doctors, honors Lehman for “exemplifying the spirit, skill and dedication of America’s rural medical practitioners.”
“My mom had 10 children,” says Edna Hershberger, 26. “They all came from Dr. Lehman.” In between deliveries, Lehman treats croup and sets bones, and diagnoses maladies from cradle cap to arthritis. “I do the whole gamut, from prenatal to death,” he says.
Lehman also is the mayor of Mount Eaton, a two-stoplight town with a population of 261. A Mennonite, Lehman grew up a few miles away in Kidron. To the Amish he serves, he is something of a foreigner. “I’m English’ to them,” he says, smiling. Everyone who is not Amish is called English.
On this day, as on most days, Lehman’s waiting room is crowded with a cross section of the community. Conservative Mennonite women wearing starched white prayer caps sit alongside Old Order Amish ladies wearing lace-up boots and black bonnets. An infant is swaddled in black fabric that looks rather like a papoose. On her head is a black bonnet, a miniature version of the one worn by her mother.
Less conservative Amish are here, too, clothed in dresses made of dark double-knit polyester, bought by the bolt at Specter’s dry-goods store and sewn on treadle machines. A small sock-footed boy in suspendered pants and a flat straw hat appears fascinated by an English woman who is reading to him: “I do not like green eggs and ham.” She does not realize the boy only understands the German dialect spoken by his family.
“We have more Amish families than English, but we don’t see the Amish as often,” explains Lehman. “On an English person, I do exams when they’re babies. I do school physicals, camp physicals and work physicals. With the Amish, I see them at six weeks and then it can be 16 or more years later for a work physical. Usually they just come in when they’re hurt or sick.”
The Amish are a determinedly self-sufficient people. They do not accept welfare. Very few claim Social Security. Most in this area reject health insurance. When medical bills get too high, the church pays what the patient cannot. Sometimes, Lehman takes what the family can offer. “We have a quilt I got for taking care of a fractured leg and a rocking chair that was partial payment for delivery of a baby.”
The Amish faith teaches that it is wrong to sue a doctor or anyone else. It encourages members to live a plain life. They shun electricity and cars. Education after eighth grade is forbidden, although, in this area, about 10 percent of the Amish later get their GEDs. Some won’t use telephones. The strictest among them won’t use buttons, and no one wears patterned clothes. Such things are considered prideful, and pride is a sin.
For Lehman, opening a practice was more than an if-you-build- it-they-will-come affair. The Amish self-care approach meant that sometimes an appendix would burst before treatment was sought, sometimes because the patient’s caretaker didn’t want to use the phone or ride in a car to get to the doctor. Instead, they’d have an English neighbor call and relay the information.
“I found if I said, ‘Put Mr. Yoder on the phone,’ he’d get on. It’s OK because I initiated it. If I tell them to get a driver and bring the sick child in, it’s OK. Sometimes I have to sin for them a little bit,” Lehman says, smiling.
When Lehman arrived here in 1964, another doctor sent him to Barb Hostetler, an Amish woman who helped deliver babies at her house, in a room lit by a kerosene lamp. “Doc Lehman was just a beginner when I got ahold of him,” Hostetler says.
She is 78 now, a small wrinkled lady in a black bonnet and a home-sewn green dress that is closed at the neck with straight pins. She got into the birthing business accidentally. After having “only six” of her own children, it seemed she had a knack for deliveries. Service to one mother led to another.
The doctor/helper relationship worked out well. Hostetler would see the women through labor, and Lehman would make the delivery. “Some of these so-called midwives want to do it themselves,” she says. She was happy to have trained help. “I wouldn’t hold it back if the doctor wasn’t there,” Hostetler says. “That wouldn’t be nice.”
Prenatal care remains an issue. “We like them to come in the first trimester, but if they feel good, they don’t come,” Lehman says. Among Amish, sonograms are not routine. Amniocentesis is rare. “We’re not so interested in all this modem,” Hostetler says. “If they find something wrong, they’re not going to have an abortion,” says Lehman, who delivered a great many of Hostetler’s 180-plus great-grandchildren.
To make prenatal care appealing, “We charge one price for prenatal care and delivery,” he says. “It’s a package.” A bargain package. Lehman charges $1,000, with $200 deducted if the bill is paid within six weeks. “It really worked out nice. Doc Lehman didn’t let me down once,” says Hostetler.
Lehman delivered babies at Hostetler’s farmhouse for 20 years before helping start Ohio’s first free-standing birthing center. The center, built without state or federal funds, was dependent on Amish donations. Amish craftsmen built the cribs. Two delivery rooms offer electric and kerosene lamps. A 72-hour stay runs $410.
Lehman’s schedule often lets him go home for lunch with his wife, Phyllis. But he’s used to working nights. Though another doctor has joined the practice, Lehman still spends many evenings in his four-wheel-drive vehicle. “It’s my seventh Jeep,” he says, as he drives past Amish farms and a billboard advertising Swiss cheese and the “World’s Largest Cuckoo Clock.” Since buying the first Jeep, “I’ve driven over half a million miles.”
Sometimes business booms. “A couple of years ago, some English stopped at a toy shop and gave the measles to two boys there. They spread it through the community,” Lehman remembers. “I started at one house, went to the next and the next. I saw 32 cases of measles that afternoon.”
Because the most conservative Amish don’t immunize children, Lehman treats childhood illnesses that are now rare in the rest of the country. Inter-marriage between Amish families has meant a higher than average rate of cystic fibrosis, dwarfism and hemophilia.
Tonight, Lehman’s first stop is at the home of Gideon Gingerich. His daughter-in-law, Frances, is washing supper dishes in a bowl filled with boiled rainwater and soap. Gideon, 73, is in a bedroom of the clapboard house, lying on his side, in pain and crying. “He’s confused and doesn’t know where he is,” Frances says. She is grateful for the house call. “It wouldn’t be easy to take him to the doctor. We’d have to hire a driver.” Lehman catheterizes the man and gives him antibiotics for a urinary tract infection. Lehman charges $78 for a house call.
The next house is way down Route 172 in Trail, Ohio. This Amish family is far more liberal. There is a trampoline in the back yard and copies of Victoria magazine in the living room. Mahala Miller, 92, is waiting in her wheelchair. Her daughter, Esta Bontrager, has been giving her an herbal remedy for congestion. Dr. Lehman says she has pneumonia. Working at the kitchen counter, he mixes up an antibiotic. “It’s silly to have to go to another town to get medicine,” he says.
It is almost dark when Lehman leaves. He still has to check out the new arrivals at the birthing center.
Barb Hostetler thinks God sent Lehman to Mount Eaton. “I just feel that way,” she says. “For some reason, Doc Lehman just cares about us.”