This is from the twenty-third chapter from my best-selling book, Bryson City Tales. I hope that you’ll enjoy going back to Bryson City with me each week, and that if you do, you’ll be sure to invite your friends and family to join us.
A GOOD DAY AT THE OFFICE
November 17 fell on a Tuesday that year. Barb and I had not yet had our usual weekly date night since moving to town. Today was our eighth wedding anniversary, and we were looking forward to the evening alone. Barb had tapped Dorinda Monteith to be our baby-sitter. She was young but came with very high recommendations. Besides, Kate was an easy child to care for.
Gary’s voice woke us at the usual time. I listened to the day’s news as Barb snuggled close. I melted into her waking embrace. There was a special way we just fit next to each other—content, warm, and relaxed. Our eight-year habit of waking up in each other’s arms would, it looked like, survive into yet another year—although a growing Erin Elizabeth was making the fit a bit more challenging.
Suddenly I felt Erin give a swift kick. “Ouch!” Barb responded, as she moved back a bit to “unsquish our little girl.” She giggled at her comment. I began to sing, “Happy anniversary to you, happy anniversary to you, happy anniversary, dear Barb, happy anniversary to you.”
She let out a contented purr, gave me a sweet kiss on the cheek, and sighed.
“Penny for your thoughts?”
“Oh, Walt, I was just thinking, every time I hear you sing, I realize how good Billy Joel really is.” We laughed and embraced again. I asked Barb where she wanted to go for a romantic dinner. The culinary choices in Bryson City were a bit limited. The downtown grills and cafés, although adequate for lunch, weren’t really fitting for a special evening. As much as we had enjoyed our stay and the food at the Hemlock Inn, the family-style seating didn’t seem conducive to a romantic evening. We were really left with only three choices—the Frye-Randolph House and the Fryemont Inn in town, or the Holiday Inn over in Cherokee, with a reputation for fine dining. We narrowed our choices to the ones in town and decided on the Fryemont Inn, since we’d already enjoyed a five-star evening at the Frye-Randolph House with the Mitchells and the Cunninghams more than a year before. I called to make the reservations.
“Fryemont Inn, this is Katherine. How may I help you?” came the friendly greeting.
“Hi, I was wondering if you might have room for two in the dining room this evening.”
“I think we might! What time would be best for you?” “How about 7:00?”
“That will be fine. What name will you use to place the reservation?”
“Is this Dr. Larimore?” came the reply.
I wondered why she was asking. What had she heard? Carefully, I answered, “Uh, yes, it is.”
“Oh, you and Dr. Cunningham helped save the life of one of our guests who was in the honeymoon suite. She had a ruptured appendix. I’ve been wanting to meet you.”
“Well, I’ll look forward to meeting you also. We’ll be celebrating our eighth wedding anniversary tonight.”
“Oh, wonderful!” Katherine exclaimed. “Do you and your wife like prime rib?”
“We certainly do.”
“If you want, I can prepare that for you. I just need to know ahead of time.”
“That sounds fine to me.”
“Well, Dr. Larimore, expect us to be prepared. We’ll see you all at 7:00.”
Expect us to be prepared. As I hung up, I wondered what those words meant.
After completing the morning’s hospital rounds, I arrived at the office a bit early. Since Mitch and Ray were in surgery much of the time, most mornings I was the only doctor in the office, and my practice was getting busier and busier—for which I was grateful. Rick would be arriving in a week or two, and he’d be able to help carry the load. In addition, we’d be able to begin our maternity care practice. I was looking forward to attending births in our new birthing center.
I had just entered the office when I heard Helen’s voice, “Oh goodness, glad you’re here. I think we’ve got a fracture in here.” I followed the shrill warning to the X-ray room.
There was a tremulous young mother with an even more tremulous three-year-old child in her lap. The tot was holding her right arm against her chest.
“She won’t let me move it to take an X ray. I tried, because I wanted to have it ready for you. But you came here too early, and she’s not cooperating very well,” came Helen’s sharp rebuke—directed at everyone in the room but herself.
“Let me have a look, Helen.”
She backed away—I suspect quite unhappily.
I knelt down in front of the scared-to-death pair. I tried to be warm and friendly. No use in getting them any more wound up. It would only make things more difficult later. “Hi there. My name’s Dr. Walt.” I smiled at the mom.
She returned a small smile. “I’m Debra Fortner. This here’s Julie Lou.”
I looked at the little girl. Right arm pinned to her chest and abdomen. Left thumb deeply sucked into her mouth. I began to touch her shoes. “These are beautiful sandals, Julie Lou. Dr. Walt likes them a lot. Can I have them?”
She removed her thumb only a bit, to smile and then to remark, “No. You’re too big.”
I smiled back. She was warming up. “Dr. Walt thinks you’re right.” I sat on the floor next to her and removed my loafer. Helen was apoplectic. Her mouth hung open in mild horror. I placed my loafer next to Julie Lou’s sandal. “Yep, you’re sure enough right, Miss Julie Lou. My foot is way bigger than yours. I could never wear your sandals. No way.”
She giggled and then looked up at her mom. The thumb was out of the mouth, but the right arm had not moved.
“He’s a funny man, Mommy.”
“Harrumph. I’d say so, honey,” remarked a still somewhat horrified Helen.
As I put my shoe on, I asked, “Mrs. Fortner, what happened this morning?”
“Well, Doctor, I’m not rightly sure. Me and Julie Lou were walking from the barn. I was holding her hand when she slipped or tripped and nearly fell in the mud. I jerked on her arm to keep her out of the dirt, and she screamed and began to cry. She said her arm hurt and she wouldn’t move it. I tried an onion poultice, but it weren’t no hep. No hep a’tall.”
Without even knowing it, Mrs. Fortner had given me the diagnosis and confirmed that I was about to cure her child— which I suspected would surprise everyone in the room. But I continued my chitchat. “My, oh my, I’ve never been taught about an onion poultice. Tell me about it.”
Helen sighed audibly. She had no tolerance for this type of banter. She considered it a complete waste of time. “No way a doctor could see sixty patients a day if he just sits and jaws with every one of ’em,” she would complain.
I began to softly massage Julie Lou’s legs. Mrs. Fortner seemed to visibly relax. This was good. When a mother relaxed, the child on her lap or in her arms would also relax as well. By now my right hand was holding Julie’s right hand. I felt her relax a bit as her mom explained, “Well, you just boil up an onion till it’s real soft. Then you puts it in the foot of a ladies’ stockin’. You mash it up real well. Then you press it on a sore area. The heat and the juice of the onion’ll heal most anythang.” She smiled confidently.
“Makes sense to me,” I commented as my left hand crept ever so slowly toward Julie Lou’s elbow—an elbow I was sure was not fractured. I was thinking that Debra’s idea about the onions really did make sense. The heat would be good for increasing blood flow, which can reduce pain and inflammation—although I, like Coach Dietz, personally subscribed to the “use only ice for the first twenty-four hours” theory. Also, the softness of the onion mash and the hose would allow it to conform to the curves and crannies of the body.
Several years later I would publish information about Mrs. Fortner’s “smashed onion poultice” in a medical journal—The American Family Physician. Subsequently, I’ve read about it in a “medical tips” section of another respected medical journal.
With my right fingers I could feel that Julie Lou’s hand was warm. Her radial pulse was strong. She gave my hand a little squeeze. These were all good signs. Julie Lou’s circulation and nerve function seemed fine.
“Well, let’s take a look,” I commented more to myself than anyone. Before anyone could move, I gently squeezed Julie Lou’s elbow with my right hand—my thumb on the front of the elbow, and my fingers on the back. I applied pressure with my thumb as my left hand grasped her hand and turned it outward, and then I quickly flexed the elbow, followed by quickly extending it. There was an audible POP.
I let go of Julie Lou and quickly stood and backed away. Both the mother’s and daughter’s eyes were as wide as saucers. So were Helen’s. Julie Lou let out a shriek and then instinctively pivoted on her mother’s lap and reached out with both arms for her mother’s embrace. Mrs. Fortner hugged her as Julie Lou wailed on her shoulder.
Helen spoke first. “What did you do?!”
“Let’s see,” I said. “Mrs. Fortner, can you put Julie Lou down in front of you—see how her arm is now?” Mrs. Fortner looked at me very suspiciously but then very slowly pried Julie Lou away and placed her on the floor in front of her chair. Still crying, Julie Lou reached up to her mom with both arms, flexing and extending her fingers in that universal sign language of all kids that meant, “Come here, Mommy. I want you.”
“Oh, Doctor, it looks like she’s fixed,” Mrs. Fortner exclaimed. She ran her fingers along her daughter’s elbow, flexing and extending it. “That’s amazing!” she said. She then looked up at me. “How did you do that?”
“It’s really nothing. Quite elementary. We call it ‘nursemaid’s elbow.’ When a small child’s arm is suddenly extended, like when a nursemaid or nanny jerks on the arm of a child she’s walking with—or like when Julie Lou fell and you jerked her arm—it causes one of the two bones in the forearm to come out of place just a bit at the elbow. It’s fairly simple to fix. I usually do it without explanation. It’s easier for me, the child, and the mom. I hope you didn’t mind the surprise, Mrs. Fortner.”
“Why no. No. I certainly don’t. I cain’t thank you enough, Doctor.”
Helen had recovered from her shock and surprise. Apparently she had never seen this before.
“Well, do you need me to X-ray the elbow, Doctor?” “Nope, Helen, no need for that.”
“How about a sling for the arm?”
“Nope. Won’t need that either. She’s as good as new.”
I turned to a beaming Mrs. Fortner. “Thank you, Doctor.
Thank you,” she said again.
I leaned over to a now quiet Julie Lou—whose lower lip was still quivering but who was moving her elbow without pain.
“Can I have those sandals now?”
“No!” was the emphatic answer, spoken over a poutingly protruding lower lip.
I suspected both Julie Lou and her mom would be back for future visits. I think Helen was secretly impressed—although she never let on, at least to me.
As I left the office that afternoon, I reported on my hospital patients to Mitch, who was on call for the county, and told him of our evening plans.
“You and Barb have a good time. A good evening.”
As I turned to leave his office, he continued, “Oh, by the way …”
I turned back to face his desk.
“Helen told me about that Fortner girl. Good job, son. Good job. I think you taught the old girl something—and that’s something in itself. She’s been around a long time. I’m pleased.”
Mitch rarely gave such direct praise. It was a special gift. I nearly floated out of the office.
- The Murder (Part 1); (Part 2); (Part 3)
- The Arrival (Part 1); (Part 2)
- The Hemlock Inn (Part 1); (Part 2)
- The Grand Tour (Part 1); (Part 2)
- The Interview (Part 1); (Part 2); (Part 3)
- Settling In (Part 1); (Part 2)
- First-Day Jitters (Part 1); (Part 2)
- Emergency (Part 1); (Part 2)
- The Delivery (Part 1); (Part 2)
- The “Expert” (Part 1); (Part 2)
- The Trial (Part 1); (Part 2)
- Shiitake Sam (Part 1); (Part 2)
- Wet Behind the Ears (Part 1); (Part 2); (Part 3)
- Lessons in Daily Practice (Part 1) — Anal Angina; (Part 2); (Part 3); (Part 4)
- White Lies
- The Epiphany (Part 1); (Part 2)
- Becoming Part of the Team (Part 1); (Part 2)
- Monuments (Part 1); (Part 2)
- My First Home Victory (Part 1); (Part 2)
- Fisher of Men (Part 1); (Part 2)
- Fly-Fishing (Part 1); (Part 2)
- Something Fishy (Part 1); (Part 2)
- A Good Day at the Office
© Copyright Walter L. Larimore, M.D. 2017. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.