Pathologist C. Barrie Cook was talking about the issues of contemporary medicine: malpractice insurance, health insurance, AIDS, the quality of care in hospitals.
Seated in his living room, he spoke easily, a man who wanted to be a country doctor but who is not at all surprised to find himself in the progressive, energetic Fairfax City of today.
In the fall, Cook, a physician for more than 30 years, received the A.H. Robins Community Service Award from the Virginia State Medical Society.
The award is a yearly recognition of someone "who has exhibited outstanding leadership above and beyond the practice of medicine -- leadership in the community and in the community and in activities that help to make our world a better and more pleasant place," said Dr. Richard L. Fields, past president of the Medical Society of Virginia, who presented the award to Cook.
"I was quite surprised by that," Cook said of the award. "There are a lot of other doctors in Virginia who have done more meaningful work than I have -- taken care of people, for instance."
His wife Jean, sitting across from him, gave him a look that seemed to say that he could say what he wanted, but he deserved that award. She disappeared and came back bearing the plaque he received from the society.
"Now, Jean, don't get all these things out," Cook said. During the evening, Jean Cook often left minutes at a time to bring in some award. At other times she was essential in helping to jog the doctor's memory. For instance, when asked about the Rotary Club's Polio Plus program, a worldwide effort to eradicate polio, he became the pathologist, speaking professionally of smallpox, malaria. "Yes, I've been involved in the program," he said.
"You're the director," Jean Cook interjected.
"Well, I suppose I am."
The Polio Plus program is one of many projects in which the seemingly tireless 63-year-old doctor is involved. Where does he find the time between his two main professional obligations, chairman of the pathology department at Fairfax Hospital and of the Board of American Medical Laboratories, one of the largest labs on the East Coast, which he helped found more than 20 years ago?
Time for Polio Plus, the American Cancer Society, the Boy Scouts, the Northern Virginia Regional Park Authority, Wolf Trap? Energy enough to have reared with his wife their five children, now grown, and still take in at least 17 -- he and Jean cannot remember exactly how many, but at least 17 -- foreign exchange students during the years?
He shrugged, smiled. He reached out and patted his dog Rose on the head.
Cook started talking about the park authority. He described his 20-year relationship with the parks, the early years of raising money and buying land, giving Northern Virginia one of the most admired regional park systems in the country, 9,140 acres in all, including a 5,000-acre parcel bordering Bull Run and Lake Occoquan of which he is especially proud.
So where does all this energy and spirit come from, Doctor?
"I eat well," he shot back, as if anticipating the question. He seemed more comfortable diagnosing anything other than himself.
"Your mother had a lot of energy," Jean Cook said, a little perplexed herself.
"Yes, she did," the doctor said, pondering the statement.
C. Barrie Cook grew up in the small town of Front Royal. He does not remember exactly when he decided to become a doctor. His father, a country doctor, died when he was very young.
"My mother thought one of us should become a doctor," he said of his older brother and himself. That and a doctor friend of his father's prodded him toward medical school at George Washington University while he served in the Navy. In 1951, he found himself in Boston at the Mallory Institute of Pathology. One of Cook's mentors had suggested a deeper-than-usual immersion in pathology for the young doctor because he thought pathology, the study of disease and its process, is a fundamental discipline in medicine. Cook liked it so much, he made it his specialty.
Cook's wife of 38 years grew up in similar circumstances in Richmond. Her father, a physician, died when she was young. Jean Carrington studied music in college and as a postgraduate, and her husband reminisced about the importance of her music to her, and to him.
"When we were first married, I bought Jean an upright piano for our apartment," he said. "Cost $600. I worked three jobs to get that piano."
Cook started his own laboratory as a complement to his pathology and teaching duties at area hospitals. "I wanted a little independence," he said. "Though, if I was starting out today, I'd have second thoughts about it."
He mentioned the prohibitive costs of everything from office space to unemployment insurance, items that were not an issue in rural Fairfax County of yore. "These days, a good many young doctors come out of medical school owing thousands for their educations and they don't have the luxury of setting up shop on their own and waiting for some patients to walk in the door," he said.
A typical day in Cook's life starts at 6:30 in the morning. "I like to get in some tennis at 7 a.m., most days," he said. "Then I eat breakfast."
How about those mornings when you have meetings at 7 and don't get any breakfast, Jean Cook reminded him.
"Yes, there are those," he said. "Lots of meetings."
To most people his schedule would seem to be filled with meetings. There is a meeting at the hospital. There are whole mornings or afternoons covering the operating room, where he examines tissue samples or processes surgical slides. Conferences with colleagues, with the chief of medicine at Fairfax.
Of course, there is American Medical Laboratories. More meetings. Dictation.
Dictation? For instance?
"Well, today I was dictating a paper."
"A medical paper?" Cook has written or cowritten a number of papers.
"No," he said, "a paper for a class I'm taking." Reluctantly, but good-naturedly, he described another of his pursuits: getting an MBA from Marymount University in Arlington.
He usually gets home about 6:45, unless there is a park authority meeting or, until recently, a road bond hearing for the highway that runs near his home, an issue in which, of course, he was involved.
Meanwhile, Jean Cook practices piano. She performed recently with the Shenandoah Conservatory Orchestra and for a scholarship concert at George Mason University. In addition to hours of practice, she has 17 students, some of whom she was preparing for a recital the next day.
Dr. Cook's evenings are spent going to still more meetings, or making phone calls and arrangements for Jean Cook's performances. He manages her career and concert dates. Also, he helps raise money for a music scholarship in her name at George Mason University. Weekends he reserves for homework if he is not on the road doing work for the state medical society or its parent, the American Medical Association. "It's the closest thing doctors have to a union that's not a union," he said. "No one is required to join.
"I've slowed down a lot," he said. "Some nights I just say no.
"I'm basically an optimist," he said. "I'm an optimist 80 percent of the time." He attributed a large part of his positive outlook to his wife and his faith. He and his wife attend Truro Episcopal Church, sing in the choir, and urge their children to attend. "Though," he added, "I don't think it's motivated me to do any of the things I've done.
"Most women wouldn't have put up with me. The word 'divorce' has never been in our vocabulary," he said of his wife.
"But we've been lucky," he added. "We both have interests that keep us going."