An Indelible Presence: The Big Two-Hearted Woman

By Anthony Kovatch, M.D. — Pediatric Alliance — Arcadia




She was like the extraordinary appearance of a rainbow in the snowy winter sky,
Dominating the horizon and even upstaging the setting sun with its brilliance.
Those who witness can neither offer an explanation for such a phenomenon at such a time
Nor imagine the likelihood that this singular and indelible presence will appear again

–The author.


(Musical accompaniment: “What I Did for Love” — from “A Chorus Line.”)


Indelible Presence in action


In the winter of 1996 a little man with two brains — practicing both conventional and alternative medicine at the same time — became entangled with “The Big Two-Hearted Woman.” The little man was down on his luck — the organization he had helped build up by selfless sacrifices over the past dozen years has disintegrated by virtue of administrative abuse to the brink of bankruptcy and his large patient-base of mutual dedication was in the process of being divided up by lots among a coterie of would-be jackals waiting for the ax to fall.

These events beyond my control produced a state of despair and corrosion of spirit like that experienced by Nick Adams, the protagonist of American author Ernest Hemingway’s first major work In Our Time. The young Nick Adams has just returned from World War I action physically and psychologically maimed and his reconnection with nature via the “Big Two-Hearted River” — the giver both of fish for food and of spiritual and psychic redemption — commences the process of his cure.

Her phone call came on a Saturday afternoon shortly after my official severance from the job I could risk no more. “I heard what happened to you — come over to the Bellevue office tomorrow at noon and we’ll talk.” At that time, she was already a legend in the Steel City.

I had known Doctor Mary Charlotte Goessler since she had called me (also on a late Saturday afternoon) fifteen years previously about the result of a placental culture when I was a fledgling Infectious Disease fellow at the Children’s Hospital. When I asked my attendings about her, all nodded solemnly in assent that she was “a very good doctor, a voraciously hard worker, and one-of-a-kind.” Her reputation was that of an uber-dedicated pediatrician with a 99.9% intelligence quotient and an even higher emotional IQ. I thought that she must be a clone of the famous writer and bedrock mentor of the Lost Generation, Gertrude Stein, or a modern-day version of screen star Auntie Mame. She aspired to be a full-time, board-certified cardiologist once, but her patients could not wait.

In the formative years of her practice in the little town of Bellevue, she worked tirelessly every night to make ends meet taking call at a local community hospital — a psychiatric hospital! Her experiences in the psychiatric realm left her with many colorful experiences and she referred to some of us in the Bellevue Pediatrics family (especially the one with two brains who tended to go against the grain) as her “nutcakes.” (“Nutcake” was one of her favorite words!)

On rounds the morning after New Year’s Day one year, I asked her why the “ball of fire” seemed unusually tired — she had seen 30 patients in her office on New Year’s Day while the rest of us watched college football games on our couches all day. For Doctor Mary, it was all about love.

When Bellevue Pediatrics expanded its mission of exceptional care into the rest of the North Hills and into other venues throughout Pittsburgh, her enterprising heart embraced the competitive, male-dominated roll of administrator for the Allegheny General Health system. Another female administrator once described her as the “quintessential business women” — I sensed the underpinnings of jealousy. Similar to how she was in the practice of medicine, Doctor Goessler was intolerant of “wishy washy” bureaucracy and lack of entrepreneurial ambition. I think it would be fair to say that there had been no free lunches in her arduous climb to the top of her profession.

The magnanimous flame of her external heart radiated so widely, the cogency of her voice was so riveting, the mere power of her personality at all times was so overwhelming that we who worked in the practice called her “an indelible presence.” I think Shakespeare summed it up best in “Julius Caesar”:

“Why, man, he doth bestride the narrow world
Like a Colossus, and we petty men
Walk under his huge legs and peep around
To find ourselves dishonorable graves.”    — Spoken by Cassius


I know that Mary Goessler would “tell it like it is” and admit that she could be unyielding in the face of “petty men” and women. However, her devoted patients — the children, but not always the oppositional parents — were given some slack. All members of the Bellevue “family” had to exhibit loyalty — there were no double standards! And in spite of the differences in our brains, our chemistries, and our priorities, Mary was “always a woman to me.”

“Ohhh… she takes care of herself
She can wait if she wants, she’s ahead of her time
Ohhh…and she never gives out
And she never gives in, she’s just changes her mind
And she’ll promise you more than the Garden of Eden
Then she’ll carelessly cut you and laugh while you’re bleeding
But she’ll bring out the best and the worst you can be
Blame it all on yourself… ’cause she’s always a woman to me.

— “Always a Woman” by Billy Joel.


And then there was the second heart…


To be continued…