Rugged is the cordial way to put it when it comes to describing the Doc...

Unshaven, his hair more than few days past due for a cut, and with clothes that tend to be worn, patched, and outdated; Doc Preston tends to be more focused on the quality of his work than cleaning up nice and proper for folks.  Unfortunately "bedside manner" doesn't seem to be integral to the man's definition of a job well done. Said to be about as abrasive as his looks, his personality has been described as "a little rough around the edges." Given his usual response to a request for anesthetic is "sure, if you're a sissy," that may be unduly charitable.

Strangely enough he tended to be spoken of quiet well by the local residents around his clinic he used to manage; sort of mean bulldog with a heart of gold. His skills clearly outclassed the living earned from the backwater clinic they say he never turned anyone away; even those that can't pay.  So he can' be all that bad....right?