Bryson City Tales (31 page)

“I'd love to go. Just let me know when.”

“Maybe after the holidays.” He paused. “One more thing, if'n it's no problem.” He looked at his wife and placed an arm around her shoulder. She looked down. “Myra here. . . ,” he paused again, looking for just the right words. “Myra here's thinkin' of givin' my pop some grandkids. If'n we're gonna have one, we'd be right proud if you'd be our doctor.”

“I'd be delighted, Greg. Delighted.”

We shook hands. They both smiled ear to ear.

“Bet she's already pregnant,” observed Barb as we were driving away.

I nodded.

By Wednesday our family preparations for Christmas were complete. Greg Shuler had delivered our tree into the living room. Barb and I thoroughly enjoyed decorating it and had invited Rick over for the occasion. Although we had been married less than a decade, we already had a number of well-established holiday traditions. One was our collection of ornaments from all the places we had lived and visited. Hanging them and decorating the tree was a precious family time for us. As each ornament was hung, we would reminisce about the location from where it came and feel gratitude for the memories we had carried through the years. At one point I sat down and watched my wife and daughter and my partner, each hanging ornaments, telling stories and laughing. Rick held Kate up high as she placed an angel on top of the tree. I had a deep sense of comfort in my soul.

Barb was
very
pregnant with Erin, who was due in another month or so, and she was
so
beautiful when she was pregnant. Her laughter filled our home. And that it was—
our
home. Decorating the tree this way took so much longer than just throwing the ornaments on, but it was such a special time for us all.

Two nights before Christmas I had been on call for the county and had made several trips to the ER—which meant I had slept
very
little. Fortunately, Thursday was only going to be a half-day in the office, so I was looking forward to a “long winter's nap” on Christmas Eve. Better yet, Gary's weather report on WBHN that
morning predicted that a cold front would be coming through that afternoon and that it would be snowing by evening and continue through the night.

Barb exclaimed, “We're going to have our first white Christmas!” Having grown up in Louisiana, neither of us had ever experienced one.

After hospital rounds, I arrived at the office in the costume I was to wear each Christmas for the next two decades—a Christmas tie and festive holiday socks. My staff and patients got a kick out of the doctor's unusual garb.

Midmorning I walked into an exam room to see a four-year-old girl who had a sore throat. Of all my daily visits in the office, I was discovering that I liked seeing kids best. They were so honest and disarming. I loved their candor, their lack of pretentiousness. Plus, there was a lot of kid left in me!

“How's work?” I asked my little patient that morning.

“Dr. Walt,” Erica giggled, “I'm a kid, I don't work!” Mom and daughter and doctor all laughed. Then Erica saw my socks. Her eyes widened in surprise. “Dr. Walt . . .” She paused for a moment, looking from my red Christmas socks to my face. “Dr. Walt,” she repeated, “I
love
your panty hose.”

Now it was time for my eyes to widen as Erica's mom doubled over in laughter.

Suddenly there was a knock on the door.

“Come in,” I said.

Rick stuck his head in. “Excuse me, Dr. Larimore. I need you for a moment.”

“Excuse me,” I said to Erica and her mom as I stepped out. Rick motioned me back toward Ray's office.

“Walt, sorry to disturb you,” he said, “but Barb came in for an office visit. She was concerned that after her shower this morning, she couldn't keep dry.”

“Keep dry?” I inquired. “What do you mean?”

Rick put his head down, and I felt a lump rising in my throat as my heart began to speed up.

“What is it?”

“Well, she came over to be checked, and, believe it or not, she's ruptured her membranes.”

He was quiet for a moment. He suspected the sudden terror that was gripping my soul. Barb was only eight months pregnant. We had had Kate a month early—and she had cerebral palsy. Barb's membranes had suddenly ruptured over a month before Kate was due. All at once I felt almost faint.

Rick's voice softened as he placed his hand on the arms crossed across my chest. “Walt, all of Barb's tests and exams have been normal. The ultrasounds have shown us that your little girl is growing well and doing well. I don't expect
any
problems whatsoever.”

“Thanks, Rick.” I let out a sigh of relief. “Well, what do you think we should do? Wait and watch? Or would you prefer to go ahead and induce labor?”

I asked because these were the two options we usually considered when a woman who was beyond thirty-five weeks gestation experienced rupture of membranes when not in labor. With Kate, Barb had chosen to “wait and watch.” When labor did not begin after twelve hours, Barb's physician had offered her induction with an intravenous drug called Pitocin. Most of my patients choose induction and, given the choice again, I thought Barb would, too.

“Neither,” Rick answered.

“Neither?”
I was shocked.

Rick walked over to the window. “Walt, it's starting to cloud up. We've got a cold front and a possible snowstorm coming through this afternoon.” He paused for a moment. “I'm not at all worried about Barb. Actually, getting her through labor is the easy part. What I
am
concerned about is your little girl. Thirty-five- or thirty-six-weekers usually do well. I know you know that. However, we've only had our new nursery up and running for a few weeks.”

I could sense my partner's concern.

“Walt, if there's a problem with Erin and we're in the middle of a blizzard, I simply won't be able to get her to the care she'd need or get any necessary care to her.”

“Rick, what are you saying?”

“I think I want to refer Barb up to Asheville to deliver. Barb is not now in labor, and her cervix is only two to three centimeters dilated. If you leave now, you can be there in an hour. In case of any problems on the way, the hospital in Sylva is only twenty minutes away and the hospital in Waynesville is only forty minutes away. Also, if you leave now, you'll beat the storm. I've talked to Ray; we'll cover your patients. I've talked to the OB group in Asheville and they not only agree with this course of action, but they'd be delighted to take Barb as a patient.”

My mind was racing. I had
so
wanted Erin to be one of the first babies born in our new birthing unit. I wanted our nurses and staff to see that the doctors trusted them and the hospital. That we didn't
have
to travel to Asheville to deliver a baby. I felt like a traitor for even
thinking
of leaving town for the delivery of my own child.

As though reading my mind, Rick continued, “Walt, there's not a person in town who won't understand my sending you all to Asheville. It's the right thing. If anything were to go wrong, it might hinder our chances to see our dreams come true—to have a great maternity care service right here in Bryson City. I haven't been here that long, Walt, but, like you, I'm sensing that some of the older doctors might like nothing more than for us to make one big blunder. I think they'd go after our hides in a minute.”

He was making sense. I was
not
sure that a majority of the doctors would be supportive if there was a misstep of some sort.

Rick continued, smiling. “Worse yet, would you want to hear Gary Ayers airing our dirty laundry on WBHN?”

I smiled. “Guess you're right. Should we talk to Barb?”

“I already have. She's up at the house packing her things and getting Kate taken care of.”

“OK. I guess this is best.”

He walked over to me. “It is, Walt. It is.”

“Thanks, buddy.”

“Look, you drive safe, OK?”

“OK.” I smiled and turned to leave.

“Walt!”

I turned back. Rick reached out and placed his hand on my shoulder. “I'll be praying for all three of you.”

“Thanks, Rick. That's the most precious gift you could give us.”

His gesture of faith and solidarity sunk deep into my soul. To have a compatible practice partner was a joy. To have a true friend with whom to work, one who was a fellow adventurer on the pathway of faith, was even more invaluable.

By the time I got home Barb had an overnight bag packed. She was sitting by our Christmas tree. When she heard me enter the house, she called out, “In the living room!” She stood as I entered. We hugged. “Nancy Cunningham is off today,” she said. “She came to pick up Kate and will keep her as long as we need. I've packed for you and me. We can go anytime.” She paused, turning her head to look at our Christmas tree. Then she began to cry.

“Aw, honey.” I hugged her tight. “Everything's going to be all right. It's going to be all right.”

“I know,” she sobbed. “I'm just so sorry we can't deliver here. I know how important it is to you. This is our home. This is where we're putting down our roots. I'm so sorry.”

I pulled back slightly, keeping my hands on her shoulders. “Honey, your and Erin's health is far more important to me than anything. I don't care if we have to drive to Emory or Duke. I just want you and Erin to get the best care—and I want her to be safe and healthy.”

Barb smiled and wiped her tears away. “I know, Walt. I know. I just wish there was some way to deliver here.”

“Thanks, honey. I do too.”

I put the bags in the car, and we piled in. I started up the little Toyota and pulled away from our home—suddenly realizing that I was driving out of our
hometown
as well. In this hour of uncertainty and anxiety, disappointment and anticipation, I was more aware than ever that our connection with this small town was strengthening and becoming very important to us.

As we pulled onto the four-lane in the middle of the afternoon, it became darker and then began to snow.
Would we make
it to Asheville? Would Erin be safe?
I didn't know what our immediate future held, but more than ever I felt certain about who held the future. I smiled. I was beginning to learn how profoundly important faith is during a medical emergency—and wondered again how people without faith made it through things like this.

chapter twenty-seven

A SURPRISING GIFT

W
e arrived at Memorial Mission Hospital in Asheville in a driving snowstorm. I dropped Barb at the emergency room entrance and parked the car. By the time I arrived in the ER, Barb had been whisked up to the obstetrics unit and was already being evaluated by the admitting nurse, who had spoken by phone with the admitting physician—Sedrick Porter, M.D.

Our admitting nurse, Marie, had been a labor and delivery nurse for her entire career—all of which had been at this hospital. “I am
so
glad you're here,” she said warmly. “It's been unusually quiet. We haven't had a delivery since yesterday, and you all are our only guests—at least for now.”

Admission labs were drawn and a detailed history taken, and then Dr. Porter showed up. He struck us as a quiet and gentle man whom we instantly liked and trusted. What I liked the most was his simple explanation of the options
we
could consider. I was used to physicians telling us what to do, not doctors willing to empower us to make our own decisions. Whether he did this because I was a physician or whether he did this rou- tinely with all his patients, I don't know. I do know, though, that I was forever influenced by his example. I would go on trying to emulate Dr. Porter's approach throughout my career.

“Walt and Barb, there are a couple of options open to you. One, we can wait and watch. You can walk around a bit, Barb, and if labor gets going, hey, that's great. The advantage of this choice is that we won't need to start an IV or use Pitocin. The disadvantage of waiting is that, since your membranes are ruptured, the longer we wait the greater the chance of you or Erin getting an infection—which would prolong your hospitalization and increase your costs. Fortunately, the real risk for this doesn't start increasing until the membranes have been ruptured for eighteen to twenty-four hours.