Bryson City Tales (38 page)

Helen entered the room, “Sorry to keep you waiting, Dr. Larimore. What suture do you want?”

“Helen, how about a 3–0 chromic for the fascia and sub-q and a 2–0 nylon for the skin?”

“
Nylon
for the skin?” Helen asked. Oh, how I wish I had inquired as to why she was questioning my decision, but unfortunately I did not.

“Yep, nylon will do just fine.”

I closed the layers quickly and then carefully closed the skin—ever aware that my boss would see my handiwork. After the wound was dressed and an antibiotic shot administered, Queenie seemed to perk up a bit.

“She should be as good as new. You can take the dressing off tomorrow and have Mitch take the stitches out in ten to twelve days. If there's any infection or swelling, please let us know.”

“Thanks, Doc,” replied Cam, as he picked up Queenie to leave.

Friday afternoon I was standing and writing a note when Mitch walked up to me. He stopped and looked up at me. “You stupid?” he asked.

That question
still
surprised me, even after nearly a year of practice with him. Fortunately, I was hearing it less often. Nevertheless it was still a shock to hear such an abrupt interpretation of my deficiencies. So my stunned response was the same as usual.
“What?”
I replied.

“You stupid?” he repeated.

My mouth, per usual, dropped half-open. Then I smiled to myself. “Well, given my registering Independent in
this
town, I guess you could
officially
call me stupid.”

He looked astonished. “Follow me,” he instructed.

He led the way to the procedure room, and I followed like a heeling puppy. Inside the room I experienced a sudden déjà vu.

There on the procedure table was Queenie, her side looking like it did twenty-four hours ago—
before
I sutured the wound. It was opened up and covered with a huge clot.

Mitch lectured, “When Helen asked you if you were sure you wanted nylon suture, you shoulda thought twice. Who in the world would sew an animal with
nylon
—especially a wound within reach of her teeth? If the wound is on top of her head, then nylon's an option. But her abdomen . . .”

He paused, but the silent completion to the phrase rang across the room,
You stupid?

“Son, you have to use steel suture in an animal like this.”

Steel
suture?” I was incredulous. I had never heard of or “seen such a thing.

“Yep, we keep it in the office for cases just like this. Well, let's get started. Before I die, I want to get you educated a bit. You may have graduated from Duke, but you've still got a lot to learn.”

So I assisted my mentor—the master, the surgical sculptor, the medical maestro—as he worked. I had to admit that, even after nearly a year in his office, he was still a joy to watch. And, quite frankly, next to him I often did feel, if not stupid—well, a bit inept at least. But as I watched and then began to learn how to throw stitches with the easily bent and knotted steel suture, I smiled. I knew that once again I was learning—and learning a lot. I think I knew that I was at least somewhat less stupid than the year before, and hopefully I would be even less stupid the next year. At least that was my goal.

Delivering a calf locked in breech and sewing up a boar-gored beagle would be unusual events in the life of any first-year doctor. But for me, these events did shed light for me on the value of these animals. I was also coming to appreciate the value of hunting and fishing to the people of this area—the bond between these men and nature. Entering into this bond with new friends opened doors for meaningful connections with them that would otherwise have been impossible.

I had some of my most meaningful experiences while fishing. I was coming to especially value my fishing buddies and experiences, which took me far away from the pressures of medicine and were, in their own way, healing and refreshing. One such experience occurred on my first fishing trip with Greg Shuler, the Christmas tree farmer.

Greg came to pick me up at 5:00 A.M. in his old ramshackle truck.We were headed to Graham County to look for a very special fish—the steelhead trout. We stopped in Robbinsville at a café already packed with men—hunters and fishermen—drinking strong black coffee and smoking. Greg was not a man of many words, but I liked him. As we ate scrambled eggs with country-smoked bacon and ham surrounded by grits and biscuits smothered in butter, he shared a bit of his family's history. His great-grandfather had come into the county on a wagon and set up a farm west of the small settlement of Almond. His grandfather and father had been born on that farm. His voice slowed measurably as he told of the government coming in and taking over the farm. They clear-cut the land around the barn and home place, as the men took those buildings apart, board by board. The lumber and all of their belongings were loaded onto a flatcar and hauled over to Bryson to be reassembled on what would become the new home site—the place where we had purchased our Christmas tree. Then the valley was flooded to become Lake Fontana.

“My daddy still tells the story of'n how when he were a youngins' how he done sat on the back of that thar train when it pulled out. He war lookin' back at the valley that'd become the lake. All them trees done been cut back. The river war flowing through this terrible scar in them woods. Daddy just whittled on a stick with his pappy's Buck knife as the train pulled out. He said all his dreams war left behind in that thar valley.” Greg took a sip of coffee, his eyes still looking away to another time, another place.

“He's n'er been well since then. Has to git his medicines at the VA hospital in Asheville. But he don't git no carin' thar. Just gits prescriptions.” Greg emptied his mug. “He done left his dreams and his heart in that valley.” We stood up to leave. There was laughter echoing off the walls of the café—but it wasn't Greg Shuler.

We drove west from the town and then up a long dirt road, finally pulling off the road as far as we could get and hopping out into the predawn silence. In the valley I could hear the hoot of a great horned owl. Day was just breaking as Greg opened the back of the truck.

“I n'er asked ya, Doc. You done got a fishin' license?”

I smiled, remembering when Don Grissom took me fishing. “Yep. Got it just after I moved here.”

I could see Greg's nearly hidden smile.
He knew.
“News” like this travels fast and lingers long in Bryson City.

Later that evening, back at the Shuler home place, we cleaned our catch. Greg's pappy came down to look over our trophies. He didn't say a word. He examined our catch, and then he smiled and laughed—and continued to laugh. I wasn't really sure what he was laughing at or about, but in his laughter I heard the welcome of a neighbor. Somehow for him, I had completed a rite of passage. From that time until his death, he and his family were valued patients and friends. After his death his son brought me a small box. I opened it slowly and tenderly. Inside it was an old Buck knife, which has remained one of my most valued possessions—a sign that I had, in some small way, become part of their family.

That same summer I also experienced my most memorable social event of my first year in Bryson City. Monty Clampitt gave me a phone call—
the
phone call that was to initiate an unforgettable adventure.

“Doc, you still interested in working with us at the rescue squad?” I had taught a class one Thursday night on how to use the newly developed adrenaline syringes that could be self-administered by a person in the earliest stages of an allergic or anaphylactic reaction. I was surprised to see how many of the boys on the rescue squad I'd come to know throughout the year. I told Monty I'd be honored to work with them—as would Dr. Pyeritz.

“Well then, I'll drop by the office this afternoon with the paperwork for you boys. If you want to attend the meetings every Thursday night, we'd love to have you, but we're willing to waive the attendance requirement, knowing you all's call schedule. If you're willing to come teach an occasional class and be available to come with us on some of the calls on which we might need a doc, that'd be just fine.”

“Monty, that sounds good to me.”

“One other thing.”

“Yes.”

“There's a way that docs can be certified in advanced field first aid and in wilderness medicine. You may want to consider some of that training over the next year or two. It might come in handy if we ever need you in the field.”

“Sounds good, Monty. I'd like to see the information the next time it crosses your desk.”

That evening we filled out the application, not only for the local rescue squad but also for the state and national association—as well as the insurance and release forms. (Obviously the attorneys had gotten to these fellas.) As Monty gathered up the forms, he told us about a training session scheduled for that Friday evening at the station house—and that we'd be welcome to come and meet the rest of the squad.

“Well, Monty, I think I can make it.”

Rick added, “I'll be on call, but I'll get down there if things are quiet at the hospital.”

On Friday evening Rick was caring for a woman in labor. So I drove alone to the rescue squad building for the training session—an update on water rescue. During the session there was a sudden alarm. Monty leaped to his feet and ran over to the radio receiver to listen to the call. “Swain County Rescue, this is Swain Command Center, over.” I recognized Millie's caustic voice. Now, the command center was just a little desk in the sheriff's small office—but the name sure sounded official and “big city.”

“Swain County Command, this is Swain County Rescue, over.” I smiled. It seemed to me that he should have said, “Millie, this is Monty. What do you need?” It would have been quicker and more natural, but admittedly and markedly less official-sounding.

“We have an overturned boat on Lake Fontana just west of the new T. A. Sandlin Bridge. One person missing. Search-and-rescue needed stat and requested by officers on the scene. Over.”

“Ten-four. Swain County Rescue responding with water rescue units. Will notify you of ETA when under way. Over.”

“Roger. I'll notify the officers on the scene. Over and out.”

As Monty was speaking, the squad leaped into action. There was no need to sound the rescue siren, which echoed across the valley and called squad members to the station, as they were already there. The trucks, lights blazing, were pulled halfway out of the garage so that the trailers containing the inflatable rescue boats could be attached behind them. Men were grabbing their equipment bags.

“Walt, hop in the passenger side of Unit One,” Monty instructed. “I'll be driving.”

“You want me to go?” I shouted.

“You bet, son. You're one of us now!” He turned to run around the unit. I paused for a moment.
You're one of us now!
It sounded incredible.

“Come on!” I heard him shout. I jumped in, he turned on the siren, and we were off.

I had never ridden in the front of an emergency vehicle. In medical school, while on one of my ER rotations, I had ridden in the back of ambulances out on emergency calls—but never up front. It was exhilarating, and I could easily see how one could become addicted to the rush—seeing people pull over as you raced by them. We sped up the hill toward the four-lane and then headed west.

“Swain County Command, this is Swain County Rescue, over.”

“Swain County Command here. Come on back.”

This sounded to me like two truckers talking over CB units. I almost expected to hear Millie add, “Come on back, good buddy!”

“This is Unit One en route to the Sandlin Bridge. ETA 10 to 15 minutes. I do have Dr. Larimore with me. Over.”

“Roger that, Unit One. Did you say you have Dr. Larimore with you?”

“Ten-four, Millie. He's on his first rescue squad call.”