The Good Doctor

Article by Michael Devault, Photography Brad Arender

Through his work as a physician with The Woman’s Clinic, volunteer efforts and contributions to the arts community, and as an ardent supporter of local youth education, he has directly or indirectly impacted the lives of thousands. For these reasons, and many more too numerous to name, Dr. Terry Tugwell is BayouIcon for the month of January.

Some of Terry Tugwell’s earliest memories are of patient care. His father was a general practitioner in Bastrop, and growing up, Tugwell frequently found himself following his dad to work. Thus began Tugwell’s medical training. It was the late 1960s, and in rural Bastrop, a medical doctor wore many, many hats

“As did most doctors of his generation, my father did everything,” Tugwell says. “They practiced office medicine, admitted patients to the local hospital, performed surgeries, delivered babies. They also covered local emergency rooms. So he spent a large part of his time at the hospital.”

The elder Tugwell also made house calls to patients in and around Bastrop. Though he was young, watching his father’s dedication to his patients inspired him. When Tugwell graduated from Prairie View Academy in 1973, he enrolled at Louisiana Tech with plans to pursue a medical degree from LSU-Shreveport.

Medicine had changed, though, since his father’s generation of doctors had entered the field. Where they “did everything,” the next generation of medical practitioners were becoming more specialized. Healthcare had begun to silo itself into ever-narrower specialties, and Tugwell would have to pick one of these specialties to pursue as his career.

His criteria were simple enough: choose a specialty where the work provided a variety of avenues to prevent “getting bored” as he puts it. As he made his way through his classes and then through his internship, Tugwell found himself increasingly drawn to obstetrics and gynecology.

“It allowed you to serve multiple facets of taking care of the patient,” Tugwell says. “It’s a good mixture of surgery, delivering babies, with a handful of psychology and psychiatry thrown in.”

Also, unlike other specialties, obstetrics and gynecology checked off another important box on the list of criteria: patient relationships. Where many specialties were transient in nature, addressing a patient only so long as they had a particular issue, OB/Gyns engaged with patients over much longer periods of time – years, even their whole lives. A person might see a cardiologist for heart trouble, but once that condition is sufficiently managed, the relationship ends. With obstetrics and gynecology, women choose their doctors early and they typically remain a patient for decades.

“Obstetrics and gynecology allowed me to develop the kind of professional relationships that last many years,” Tugwell says. “A large portion of my practice over the years has been treating personal friends of mine.”

After eight years of medical school and residency, and with a specialty selected, Tugwell returned to Bastrop and established a practice there in 1985. For ten years, Tugwell served the Morehouse community as one of just a few OB/Gyns in the community. This meant he had a lot of work – and time for little else.

By 1995, still single and with little time to pursue outside interests, Tugwell knew the time for a change had come. He decided to close his practice and move to Monroe, where he joined The Woman’s Clinic. Joining the clinic gave Tugwell the collegial atmosphere where he could learn new skills and further develop his practice, while benefitting from the wisdom of senior partners such as Drs. Richard Vines. Having a tight-knit, professional family also afforded him the kind of free time that isn’t available to most solo practitioners.

“Coming to Monroe allowed me to have a social life and to spend time with many of my friends who already lived here,” he says. Tugwell used part of his time to get involved in the community, serving on the board of the Northeast Louisiana Arts Council and immersing himself in the live music scene. Monroe also offered another benefit. “It allowed time for dating – which I’d had very little of in the ten years I was in Bastrop.”

Very quickly, Tugwell found himself in the midst of a new, exciting circle of friends and a swirl of activities. Through his service on the Arts Council, Tugwell met dozens of local artists, musicians, actors and dancers. He’d already become close friends with local artists Glenn Kennedy and Edmund Williamson. And every weekend, it seemed he could catch a show by Johnny O’Neal, Kenny Bill Stinson or Doug Duffey.

“Through the hard work of people like Doyle Jeter at Enoch’s, we were able to enjoy all sorts of just fabulous music,” Tugwell says. “So my horizons were really starting to open up.”

For Tugwell, Monroe was the kind of place he could have a career, put down roots and raise a family, all without life becoming dull. Through his activities in the arts community, Tugwell tapped into an endless vein of fascinating, talented individuals, each of whom seemed to operate with the same goal.

“I’ve found there’s never a boring moment in Monroe, due to the fact that there are what I call magic people – individuals who’ve made living in Monroe an interesting and fun time,” he explains. “I call them the Magic People, because they’re the ones who’ve made things happen, who make things happen in this community, the kinds of things that make quality of life better for people like me.”

Quickly, Tugwell developed a reputation for being a bon vivant and someone people could count on when it mattered. He credits this compassion to his mother, who had a relatively simple philosophy when it came to others.

“She would say, ‘Always try to look beyond what a person does and understand why they do what they do, because it’ll help you to be kind to their mistakes,’” he says. Not only does this approach evoke a sense of compassion, it also helps avoid judgmental behavior.  For a doctor, especially, that’s a critical faculty to have.

“You have to be open, to listen, and try to never be judgmental,” Tugwell says. “Hopefully, you’re able to relieve a lot of their worries, concerns or fears with compassion and kindness.”

Put another way, that’s where listening becomes a big part of his practice – that handful of psychology and psychiatry that helped attract him to obstetrics and gynecology in the first place. When patients come to their doctor with health issues, often the unknowns of a situation are as distressing as the symptoms that brought them in. They’re afraid of what’s going on in their bodies, and they don’t know to whom they can turn.

“Very frequently, a person just needs to have some fear of theirs acknowledged, addressed and relieved,” Tugwell says. “Many times, you do just as much good with your words than you do with your hands or your surgical skills.”

Whether it’s sitting around with friends, encouraging a local artist or taking care of a patient, the influence Tugwell’s mother has had is clear. Dr. Tugwell is a listener. Perhaps this is because he’s most closely aligned to his nature when he’s talking to patients.

“I’ve always found it extremely rewarding to sit down and talk with someone who is frightened about some aspect of their life or their relationships and to be able to help quell those fears,” he says. “To me, that’s every bit as rewarding as any of those surgical skills one has.”

While talking with his patients has remained constant, little else in the practice of medicine has. Like his father’s generation before, this generation of doctors is overseeing radical shifts in how medicine is delivered – and in the industry that delivers it. Medical imaging has improved outcomes, while less-invasive surgical techniques mean better patient outcomes.

The ability to operate on patients with far less post-operative pain, by performing most of our procedures laparoscopically, as opposed to having to surgically open the patient’s abdomen,” he says.  During a laparoscopic surgery, doctors make a series of small incisions through which they insert various tools, guided by a small camera. Smaller incisions mean less pain, fewer infections and a reduced chance of complications. “This was a quantum leap in the field of gynecology, as well as other surgical specialties. Now, robotic surgery is moving even further in that direction for some specialties.”

That Monroe boasts numerous surgical facilities equipped to deliver the latest in laparoscopic and robotic surgeries highlights one of the biggest factors that drove Tugwell to remain in Monroe. Another of those factors is the community of doctors that exists here to support the patient community.

“Practicing in Monroe has been a pleasure because of the support and encouragement of the medical community – and the excellent facilities we have here,” he says. “I don’t know how many people realize how lucky we are, in a small city like Monroe, to have the quality of physicians we do. At any given time, I’m able to get assistance from colleagues in other specialties – general surgery or urology, for example – when I need it. There’s just a great, collegial atmosphere among the vast majority of physicians here.”

The biggest factor driving Tugwell’s desire to remain in Monroe? Family. Tugwell is one of six children, and he has a large, extended family that remains extremely close, gathering for holidays, birthdays and special events dozens of times a year.

“I didn’t want to be too far from my immediate family,” he says. “We’re particularly close, and we enjoy each other’s company. I didn’t want to miss out on anything, because I lived somewhere far away.”

He also didn’t want his kids to miss out on that closeness, either. The father of three children with his former wife, Sarah Brasher Tugwell, he wanted to provide for his children the same environment that his family had given him.

“I was raised in an environment that was confident, secure and loving,” Tugwell says. “That’s what Sarah and I have tried to provide for our kids, that same sense of security and love that I had growing up.”

Kids came later in life for Tugwell than they did for many of his colleagues. That’s had a benefit that he’s come to appreciate more and more each day.

“I’ve realized the importance of time spent with my kids,” he says. “The pleasure of being with them and their friends keeps me young at heart – and entertained! I don’t have much time to be concerned or depressed about the foils of aging, because I’m surrounded by so much youthful energy.”

In between seeing patients, surgeries, concerts and visits with friends, Tugwell attends virtually every football game, every soccer game, every dance recital. Along the way, he’s begun to notice a new trend crop up, too.

Those life-long patients are everywhere. They’ve become friends of his, and babies he’s delivered are now friends with his kids. And with more than thirty years of practice under his belt, he’s starting to see another new trend, too.

“Several years ago, I started delivering babies of babies I’d delivered in the past,” he says. Though he very much enjoyed delivery, as the demands of family increasingly encroached on time spent with patients and delivering babies, Tugwell made the decision to discontinue obstetrics, though he continues to practice gynecology at The Woman’s Clinic.

And, thanks in part to all of that youthful energy, chances are he’ll still be there in another ten years or so, for yet another generation of patients. Until then, he’ll be at Enoch’s, or at the ballet, or wandering an Art Crawl, or watching a soccer game or tending to the needs of a patient. Always surrounded by friends and family, wherever he is, he’s sure to be enjoying life the life of a good doctor.