Bryson City Tales (34 page)

On the twelfth day of Christmas we celebrated Barb's thirtieth birthday. Part of the celebration involved borrowing a large wheelbarrow and shovels from Dr. Bacon. Rick and I hauled the Larimore Christmas tree out of the house and down the road to the site of our new office building. Together we pushed the tree up to the most southwest corner of the lot—the corner that was projected to be untouched—just above what was to be the new parking lot. We dug a hole and then rolled the Norwegian spruce's ball into the hole and backfilled the tree. We stood back and admired our handiwork, a tradition we would repeat on every twelfth day of Christmas that we lived in Bryson City.

As I sat on the bench that evening, trying to keep warm in a winter coat and hat as the sun set, I reflected on the planting of the tree—and on our hopes that the tree would take root and grow. It was beginning now to feel like our family and our medical practice was starting to take root in this small town. I was beginning to feel comfortable in my profession as a small-town generalist. We were settling into our new home and our new town—and falling in love with them both. It felt like a great start to the rest of life—a new year, and a new decade. I still did not see the bad moon rising.

chapter twenty-nine

THE HOME BIRTH

Patricia Johnson, M.D., was a devoted physician in nearby Robbinsville. She had the only medical clinic in Graham County—a county that had no hospital. Patients needing hospital care either drove south to the hospitals in Andrews or Murphy, or northeast to Bryson City or Sylva. I had gone to visit her during my first weeks in town. I immediately liked her and immensely respected her. She was specially gifted to minister to her patients in this remote environment.

From time to time, maybe for a year or two at a time, a physician might join her in practice. But they always would leave. When Patricia had no physicians assisting her and when she went on vacation, the entire county was without a doctor. On these occasions, she would call one of the doctors in Andrews to cover emergencies for her practice. Occasionally she'd call over to Swain Surgical Associates.

Helen took the call from Robbinsville. “Dr. Larimore, Dr. Johnson on the phone for you.”

I excused myself from the patient I was seeing and went to take the call in Mitch's office.

“Hi, Pat, how are you?”

“Walt, I'm just fine. Are you getting acclimated over there in the big city?” She laughed and I chuckled.

“I am, Pat, I am. Mitch and Ray are breaking me in, and I'm actually beginning to learn the ropes a bit. Rick's here, too, and he's been a great help.”

“That's great. I've always appreciated Mitch's surgical skills, and he knows
everybody.
Ray seems to do a super job, and I'm looking forward to meeting Rick one day. You need to bring him over here to visit.”

She paused for a second.

“Walt, I need a big favor. I'm taking off for a ten-day vacation. If something should come up or if my staff needs a question answered, can I have them call you?”

It seemed like a simple enough request.

“Of course, Pat, it would be a pleasure.”

That night an ice storm hit and continued throughout most of the next day. The roads were a mess. Late in the afternoon the call came.

“Dr. Larimore, this is Elizabeth Stillwell. I'm a midwife in Graham County. I'm attending the home birth of a woman named Isabella Shoap, and I need some help. She's been in labor for about thirty hours, and her cervix has been completely dilated for five hours. The baby is fine, but Isabella's tiring out on me. When she pushes, the baby's head comes into view just a little bit. I've tried every position and potion I know, but I think she just needs a little help. Could you bring a forceps or a vacuum over and give me some help?”

I paused for a moment to think. I knew Dr. Johnson delivered babies at her clinic, so I presumed, wrongly I later learned, that she provided coverage for the midwives. Nevertheless, I had not been counting on something like this. Now I was facing a thirty-mile drive during an ice storm. The drive on narrow mountain roads could be tricky in good weather. In January it could be downright dangerous.

Black ice,
they called it—patches of crystal-clear ice on top of the asphalt and looking as black as the asphalt. If you drove onto a large patch, you could lose control of your vehicle in seconds. If you spun off the road in a section that had no guardrails, you could end up in a deep ravine and not be found until spring—or so the rescue squad tales led me to believe. I was more than a bit uncomfortable with this whole affair.

“Mrs. Stillwell, wouldn't it be better for me to send the rescue squad over to pick you all up? We could do the delivery over here. Besides, the ambulance would be better able to handle the ice.”

“Dr. Larimore, I'd love to, but there's just no way.”

“No way?”

“No way. These folks have never been to any doctor but Dr. Pat. They don't like doctors, and they absolutely will
never
go to a hospital. They're staying right here.”

Elizabeth lowered her voice to a whisper. “Doc, if you don't come, I think this kid could die. I'd sure appreciate your help.”

I was cornered. “Mrs. Stillwell, I'll have to drive real slow. But give me the directions, and I'll get there as quick as I can.”

After hanging up the phone, I walked into the minor surgery room and interrupted Mitch, who was doing an in-office procedure. I explained what was going on. He smiled.

“Walt, when I was younger, I'd make those visits over there. If I've told you once, I've told you a hundred times, delivering babies is a young man's sport.”

I thought for a second.
He's never told me that!
But before I could express that thought, he continued. “Walt, don't be stupid. It's a mess out there. You try driving in this, and you're likely to hit the black ice, spin off the road, and die in some secluded ravine. And . . . ,” he paused to look up from his patient, “I don't want to take your call if you die. So why don't you call the rescue squad? Their truck has snow tires and chains, and it handles ice pretty well. And then you'll have some help if you need it. You get along, and Ray and I'll finish up things here and round on your patients at the hospital.”

“Thanks, Mitch.”

As I turned to leave, he cracked, “Break a leg, son.”

Cute,
I thought. Now came the toughest call of all. I had to call Millie.

“Swain County Dispatch,” she snarled.

“Millie, this is Dr. Larimore.”

Pause.
“Yes. I know.”

“Millie, I need you to have Don Grissom call me here at the office.”

“You short on appointments, son? I think it's against the law to solicit for business.”

I smiled. I actually thought I might be growing to like this old curmudgeon.

“Nope. Just need him and Billy to take me to an emergency delivery up near Robbinsville.”

“Your car not working?”

“Millie, it's working fine. I just may need some help up there. And to tell the truth, I'm not sure my little Toyota would do very well in the snow and ice.”

Millie sighed. “Son, you thinking about investing in a new car? On a doctor's salary you might could even afford one.”

Cute,
I thought. “Yes, I probably do need a new one. But for now, I need to get up to this place in one piece.”

Thankfully it wasn't long before I extracted a promise that she'd call Don Grissom—and in minutes he was on the phone.

“Whatcha got, Doc?” he asked.

I explained the situation.

“Doc, we do this all the time. Be glad to be your taxi out there to the mountains.”

We stopped
by the hospital to pick up an emergency delivery kit and then headed out of town. The mountains were covered with ice. Old-timers called it “rhine ice.” It completely covered each trunk, branch, and twig. The trees looked like ice sculptures. It was hauntingly beautiful. But I was nervous about the branches overhanging the road. I knew that the heavy branches—now weighed down with ice—could break off and fall. Being struck by one can result in some pretty horrific injuries.

Fortunately the ride out wasn't as bad as I had imagined. Don explained how the older docs, especially Dr. Bacon, had done home deliveries for years. “Once Sylva brought in an obstetrician, the guys here just quit delivering the babies. So, folks wantin' a hospital delivery go over there. Those wantin' to stay home just call the granny midwives. There's only a few of 'em left, and their practices are very secretive. Tell you the truth, Doc, I think the old midwives do a better job. We almost never get called to a problem.”

Billy, usually the quiet one, couldn't resist sharing some local lore. “Some folks say that if the granny midwife loses a baby, the family just buries the baby and never calls the coroner. It's never reported to the officials. The local clergy know, and they'll help with the burial and a small family service. But otherwise it's hush-hush.”

“Yep,” chimed in Don, “you'll see a lady, pregnant as can be, then next thing you know she's skinny as a rail and has no baby. Just says she ‘took off some weight.' But everyone knows what
really
happened.”

“Don't you guys have to report those sorts of things?” I asked.

Don and Billy looked incredulously at each other, then at me. In unison they chimed, “You stupid?” I laughed. Obviously they'd been around Dr. Mitchell
way
too long!

Don went on, “That'd be one sure way to get kilt. There's some things a fella's not to mess with—and this is one of them.”

The ambulance became very quiet. I sensed I was treading into some fairly deep weeds.

Billy was the next to speak. “Doc, speaking of the old docs.” He paused for what seemed like several minutes.

“Yes?” I prodded.

Billy looked at Don, who nodded. “Go ahead, Billy. It's OK.”

Billy sighed. “Well, Doc, the way we hear things, some of the older guys really have it out for you and Dr. Pyeritz. They don't particularly like Dr. Cunningham either, but since he's hooked up with Mitch, they
have
to tolerate him. You and Dr. Pyeritz being in their building has bought you some time for now. But . . .” He paused again. “Doc, be careful. Watch your step. They've got the nurses reporting to them everything you all do. I've heard they're as mad as hornets about Dr. Pyeritz treating your son at home.”

Now it was my time to sigh. “Anything we should do?” I inquired.

Don spoke next. “Well, you've got a lot of the town behind you. The athletic department and the rescue squad are in your camp. You know the park rangers like workin' with the younger doctors. But the old guys are powerful politically. I'd say you just keep practicin' good medicine and good citizenship, and you'll be all right.”

“I appreciate you boys sharing this with me. I know you didn't have to.”

They both nodded.

As it began to get dark we turned off the main road, up a narrow, twisting snow-covered lane. In the headlights we could still see a single set of tracks in the snow and ice from what I presumed was the midwife's car. The cabin looked decrepit from the outside, where a single car was parked near the door. There were two rusting cars on concrete blocks nearby. And there were piles of items gathered from dumpsters and other trash scattered around the front and the sides of the cabin. A small barn was off to one side.

“Doc, it's probably pretty cold and crowded in there. How 'bout we keep the unit runnin' and stay put, less'n you need us. OK?”

I nodded and grabbed my equipment bag and went to meet Elizabeth and the family. Before I could lift my hand to knock, a fifty- or sixty-year-old woman opened the door and let me in. She closed it quickly behind me.

“Glad you're here, Doc. Let me take your coat. I'm Sally Scroggins, a friend of the family. Elizabeth's in with Isabella.” The cabin was small and not well insulated. But it was clean and well kept. The common room had a small kitchen on one side with a potbelly stove that had a crackling fire going. On top of it a large pot of water was steaming but not boiling. On the other side of the room several people were sitting around a small lantern. Sally quickly introduced me to the pastor and several family members—children and adults. They seemed to glare at me, and not one of them spoke a word or moved from their chairs. Clearly I wasn't very welcome here.