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Authors: MD Walt Larimore

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That evening, I dropped by Doreen's room. She had received fluids and had tolerated the transfusions without reaction. Her hematocrit was twenty-four, and her color and temperament were both improving. She was sitting up in bed and sipping water. A young man was beside her.

“Hi, Dr. Larimore,” exclaimed an almost chipper patient. “This is my husband, Harold.”

“Pleased to meet you,” Harold said as he offered his hand. “Thanks for saving my wife's life.”

“I'm just glad she got over here in time,” I commented—feeling almost Mitchlike.

He went on. “We were at the plant, working. I got called to the nurse's office. Found Doreen layin' on the bed. Her pants were soaked with blood. I 'bout fainted. Ambulance came to get her.”

“I suspect that was pretty scary, wasn't it?” They both nodded their heads in agreement. I was quiet for a moment, and so were they.

“Doreen, I need to pull out the packing. That will make you feel a whole lot better. Harold, do you want to step out for a moment while I do this?”

“No sir!” he replied. “If it's all the same to you, I'd just as soon stay with Doreen.”

“OK with me if it's OK with your wife.” She nodded, and I pulled on sterile gloves as Louise got the patient into position. “Doreen, as I pull out the gauze, you should feel some pressure but no pain.” Harold was watching intently. Knowing that people sometimes swoon when watching a medical procedure, I said, “You may want to sit down on the chair there. Sometimes there's some blood, and that can make a fellow feel a tad bit weak.”

Harold sat down but didn't let go of his wife's hand. As I pulled on the gauze, it slid out without difficulty. But, to my astonishment, attached to the end of the gauze was a three-inch-long fetus. Looking just like a miniature baby, its eyes, arms, legs, hands, and even the nubs of fingers were all discernible. I gently picked up the little one and placed him in my palm. Their eyes were as big as saucers. So were mine. The word
fetus
seemed so cold, so inhuman. So I said, “Doreen and Harold, this is your little baby.”

They seemed much more curious than sad or shocked. They looked and asked question after question.

Harold asked, “Can you tell if it's a boy or girl?”

“It's hard to tell at this stage, but he sure looks normal.”

“He looks kind of like a real baby,” Doreen commented.

I smiled and nodded. She
was
right. “He
is
a real baby, Doreen. Just real small and real fragile.” I paused for a second, feeling the tears forming in my eyes. I looked at the young couple and felt the first tear fall on my cheek. “I'm sorry he didn't make it.”

Their eyes met, and then they grasped each other's hands even more firmly. Doreen turned back to me, her lower lip quivering and tears beginning to stream down her cheeks. “Can we bury our baby?” she asked.

I looked to Louise for help—having never encountered this question before. The nurse nodded her head yes. So did I. As Doreen's tears continued to flow, she reached out to touch her little one and then gently stroked his head. “He's so soft and fragile.” Then she pulled her hand back and began to weep aloud. Harold moved closer to her on the bed, placing his arm around her and gently patting her back. His eyes were filled with tears. “Now, now, Doreen. It's going to be OK, honey.” Then he collapsed and they wept in each other's arms.

I sat quietly, feeling honored to be able to share this intimate moment with this couple. After they had composed themselves, I suggested, “If you feel like naming the baby, I think it would be a good thing to do.” They nodded affirmatively.

I wasn't sure how to phrase my thoughts—I wasn't even sure if my request was professional or appropriate—but I felt compelled to ask. “Harold and Doreen, your baby is the first baby I've delivered here in Bryson City. He's also the first baby I've lost.” I felt more tears streaming down my cheeks. The words were hard to get out, but I stumbled on. “If you don't mind, and if it wouldn't be an imposition to you, I'd sure appreciate being able to come to his funeral.”

Harold and Doreen both nodded. Then as they wept and hugged, I placed the baby on a small 4 x 4-inch gauze and handed it to Louise—whose cheeks were also tearstained. She left the room.

I was quiet—trying to compose myself. I pulled out my handkerchief and blew my nose. Finally I said, “Doreen and Harold, I was wondering, would you mind if we said a little prayer?”

This was a new experience for me. In medical school and residency we were never taught to pray with patients. In fact, many of my professors thought that bringing religion into medical care was unethical. But I had long ago come to see my patients as consisting of mind, body, and spirit. I knew a loss like this could affect all three.

They nodded. “Lord,” I began, not at all sure that what I was doing was appropriate or correct, “thank you for Doreen's health. We could have lost her today, but did not. Harold and I both thank you for this.” I paused, not sure what to say next. “Lord, thank you for this little baby. I know that he's now in your arms. We ask you to care for him and love him. And I ask that Harold and Doreen would heal quickly and, if it is in your will, that you would allow them to experience the gift of another child—one they can love and raise. Amen.”

They continued to hug and cry in each other's arms. I just sat by, in silence. As they composed themselves, Harold was the first to speak. “Doc, that was very special for us. Thanks.”

I was relieved to realize that my spiritual treatment could be as, or maybe even more, effective than my medical treatment—certainly that they could complement each other. I offered to call their pastor, and they thought that'd be a good idea. Then I left to make the call and to finish my rounds.

After dinner at home, the phone was quiet, but my spirit was not. Although I was still on call, I decided to go out to the bench and sit for a spell. The view of the mountains and the cool evening air were both refreshing. I knew that the experience of the loss of a child was as old as the hills around me—and I knew it would never hurt less. And yet I recognized the blessing I had experienced—the blessing of being invited into a young family's emergency and into their loss and grief, to have been summoned into their intimacy, having never even met them before, just by the nature of my profession. I think it was the first time I realized, at the very core of my soul, the wonderful opportunity that had been given me as a physician.

I thought of all the things a patient allows a doctor—even one they've never met—to do or say. They would, without challenge, disrobe at my request; they would tell me things they wouldn't tell anyone else; they would put their very lives in my hands; they'd even make major lifestyle changes based on my recommendations.

Then I realized something that truly gave me pause.
These
men and women who honor me truly honor me by allowing me
to care for them. Most of them were granting me credibility
before I had even earned it. In essence, they trusted me before I
had earned their trust.

As I gazed on the moonlit, misty vistas, I was filled with a sense of expectancy—a realization that God was whispering to me through every clinical encounter, as well as through every moment spent on this bench. A yearning welled up inside of me: I wanted to hear more. And then I had the most powerful realization of my career:
I am meeting people in whose lives the God
of the universe is working—working in profoundly powerful
ways
. It was, for me, an epiphany that would forever change me, my marriage, my life, and my practice.

part three

PLAY: MAKING BRYSON CITY HOME

chapter seventeen

BECOMING PART OF THE TEAM

I
had just finished seeing the last patient on a Monday morning when Dr. Mitchell walked by, reading a chart. He suddenly stopped and whirled around. “Hey, Walt. You going to the game this week?”

“What game?”

He looked astonished and then began to smile. It was a smile I was growing to recognize and despise—a near-sneer of amazement that I was so ignorant as to not know a basic fact of medicine or of town history or of life itself. “You're kidding me, aren't you?” he would always ask, adding his classic, “You stupid?”—sometimes verbally, sometimes just implied.

“No, sir,” I would always reply with a sigh. “I'm not,” meaning but not audibly saying, I'm
not
kidding and I'm
not
stupid.

Then he'd shrug his shoulders, resigning himself to the fact that his young protégé was indeed, as he called it, “city stupid.”

“Well, son,” he began, as he did with all of his lectures to me, “I'm talking about
the
football game.” He paused. I waited. There was
no way
I was going to ask the question that was on my mind:
What football game?
Fortunately he continued the lesson. “Swain County's going to be playing Sylva Friday night. 'Bout as good a rivalry as there is around here—although the Robbinsville game is always a battle too. Anyway, 'bout ev'ryone in town goes.”

My mind flashed back in an instant to the impact that football had had on my life. The peak of my personal football career was my sophomore year in high school. I started as a defensive cornerback on the Robert E. Lee High School junior varsity team. The other cornerback, Chris Stuart, and I could read each other's mind just by looking at each other. We were, in my opinion, a great team. I loved playing alongside him and being his friend. It was my best year.

The last two years of high school ball saw me on the sidelines, insisting on trying to be a star wide receiver when in fact I had no offensive talent whatsoever. My pride overshadowed the simple fact that if I ever wanted to see time on the field, I needed to return to the defensive side of the ball. To my permanent chagrin, I simply never swallowed my pride on this matter.

So it only made sense to me, as it does to most physicians who are somewhat pathologically frustrated athletes, to become involved in sports medicine—as I had done during my training at Duke. Suddenly my mind flashed back to a discussion I'd had with Mr. Douthit almost exactly one year before: “Folks around here take their football real serious. But none of our doctors have been particularly interested in being the team physician. Only a couple, Dr. Mitchell and Dr. Bacon, will even go to some of the games. But they prefer to sit in the stands. . . .”
Sit in the stands?
I thought. That was anathema.

Mitch broke into my reverie. “Anyway, if you and Barb want to go to the game with me and Gay, we'd love to take you.”

“Mitch, Barb doesn't enjoy football very much, and sitting on a cold bench this far along in her pregnancy would be uncom- fortable, so I doubt she'd want to come along. But how would you feel if I went up to the school and talked to the coaches about becoming the team physician?”

He furrowed his brow, looking a bit shocked. “Why, son,
I'm
the team physician—have been for years.”

Oops
, I thought.
I didn't know that. What to do? What to
say?
Suddenly I had an idea. “What I meant, Mitch, was the team's
sideline
physician. I've been told you like to sit in the stands with your wife. I'd kind of like to be on the field. You know, check any injuries when they're fresh. Get to know the kids and the coaches a bit.”

His look softened. Maybe I was overcoming the offense I had unknowingly inflicted. After all, he had known most of these kids since birth. I did not. But there was a problem.

“Son, the coaches can do that. They know when to call me.”

“I suspect you're right,” I answered, my mind racing for options. “But perhaps I could handle some of the routine injuries and then I'd only have to call you for the more serious ones.” I knew, and I suspect he knew, that I was posturing. But he nodded anyway.

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