This is from the twenty-fifth 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.
ANOTHER NEW DOC COMES TO TOWN
Today was the day.
Rick Pyeritz, M.D., would be joining me in practice. I was elated, as I had been anticipating this day long before we had arrived in Bryson City.
When I entered my family medicine internship at Duke University Medical Center, I was one of only four men in my class of twelve—and the only one from the deep South. My welcome to the world of the erudite, academic, Ivy League non-South was abrupt and, to say the least, memorable.
During our first day of orientation, the first-year residents walked over to the hospital for brunch. On the way back, I was walking with Lloyd Michener, M.D. Lloyd was a Harvard graduate who many years later would become the first residency-trained chair of the department of family medicine at Duke University. We were chatting about how varied our medical school experiences were. At Harvard he had seen a lot of medicine but hadn’t had much hands-on experience.
In contrast, during my medical school days at Charity Hospital in New Orleans I did everything. Well, maybe not everything, but I did a lot. I had delivered over two hundred babies, participated as first assistant in dozens of operations, sewed up countless lacerations in the emergency room, set fractures, drawn blood, started intravenous lines—even in large veins in the neck and trunk—all procedures usually reserved at most medical centers for residents in training. However, at Charity Hospital there was more work than there were residents, so the students in those days were able to gain much firsthand experience.
Dr. Michener and I were engrossed in conversation as we approached the door of the Family Medicine Center. Behind us were two female residents from Ivy League medical schools—both clad in Birkenstock sandals and both obviously braless. To me and my narrow way of thinking, both of these were markers of either a hippie or liberal lifestyle—or both. Nevertheless, without even thinking, and simply doing what I had always been taught was proper to do, I opened the door to the center and stood back to allow the women to enter before me. Lloyd cruised past me without a word. However, the two women stopped and stared at me as though I were loony.
One of them stepped forward, got chest to chest with me, and glared up into my eyes. I was stupefied. What had I done? It became instantly apparent. She practically shouted, “Just what in the blazes do you think you’re doing?” Well, actually that’s not an exact quote. She added a number of rather colorful words to her query.
“Just . . . just holding the door open for you,” I stammered.
“I don’t need a man to do that for me!” she nearly shouted. Her face was as red as a beet and her fists were clenched. I was stunned.
She and her friend stomped into the building, leaving me looking, I’m sure, ashen and shaken.
Eric Pyeritz, M.D., one of my classmates, walked in next. Once I got to know him better, I just called him Rick. I was still holding the door open, jolted and frozen. “You’re lucky she didn’t slug you,” he laughed as he walked by. That was my first memory of Rick Pyeritz.
The second memory, no more enjoyable, occurred that afternoon and forever branded me among my classmates as an incorrigible chauvinist at worst, or a dumb backwoods southerner at best. The resident psychologist for the training program was showing us three- to four-minute videotaped vignettes of patients telling a story. We were supposed to react to the stories and share how we felt about the story or the situation. Since my dressing- down earlier that day, I was being exceptionally quiet . . . at least until the video vignette of the rape victim.
This vignette was a very close-range face shot of a woman describing the experience of being raped. It was a very emotional and disturbing tape. The response was, to me, quite instructive. The women in the group were, to a person, very angry about what they had seen and heard. They emoted about how terrible this was and about what needed to be done. The men all seemed to think that the woman was fabricating the story. I noted that the contrast in these two observations was, at the very least, stark.
At that moment in my contemplation, the psychologist asked me, “Dr. Larimore, you’ve been quiet this afternoon. Would you like to share your thoughts?”
So I shared my perceptions with the group. As I did so, several of the women began to become distressed. But it only took one silly comment from me to cause them to erupt. After sharing my observation, namely, that the women in the group were responding to the emotion of the story and that the men were quite objectively seeing an actress at work telling a story, I asked, “Well, what do you girls think?”
I had no idea that anyone viewed the term girls as offensive. In the South, boys were boys and girls were girls—or sometimes guys and gals. But neither term was pejorative—merely descriptive and respectful. In the North, at least at the Northeastern medical schools and universities, this was apparently about as insulting a term as a male could ever use. The explosion was as vehement as it was immediate.
At the end of our session, everyone left the room except for Rick. His helpful observation: “Boy, that sure was a stupid thing to say!”
I laughed, and then we laughed together.
Rick and I began to build a friendship, as did he and Barb. Since Rick was single and a long way from home, Barb became Rick’s surrogate sister, comforter, confidant, and friend. The three of us did many things together. Finally, during our third year of residency, we decided to go into practice together as soon as we could.
So I was chomping at the bit for Rick to arrive in Bryson City. During my first few months here, I’d been learning the ropes of private practice, settling into this mountain community, gaining, ever so slowly, a sense of confidence in my own style of practice. But Rick’s arrival would propel me into a higher gear. I just knew it!
At last I’d have a relationship here in Bryson City with shared roots and history, shared experience, mutual respect, comparable training and medical perspective, and a similar outlook concerning the value of faith. The thought of Rick and me hanging out our shingles together seemed to me a declaration that we were ready to make a real contribution to the town.
It was a Saturday. Barb had all the windows open, and the cool autumn air was cleansing the house of some of the cooped-up odors that inhabit older homes—especially those that are heated, as ours was, with fuel oil. I was playing with Kate on the dining room floor and Barb was busy in the kitchen, humming as she worked.
Barb was very pregnant and had that rosy look and disposition often seen late in the second trimester and early in the third trimester with pregnant women. The discomforts of the end stages of pregnancy—the heartburn, lower back pain, bladder pressure, small stomach, difficulty sleeping, and the like, had only just begun. But today was bright and pleasant.
I heard the truck—a rented Ryder—struggling up the hill. It was Rick and all of his belongings. The hospital owned an empty house on the opposite side of the hospital from us, and it was Rick’s house-to-be. Following the Ryder truck, in two cars, were Rick’s good friends Andrea and Ben Gravatt. Both were doctors, he an anesthesiologist and she a pediatrician. We had all known each other in residency, and the Gravatts had begun their practices in Asheville earlier that summer. Andrea was driving Rick’s car and Ben was driving theirs.
“Barb, Rick and the Gravatts are here!” I called out.
Her eyes brightened and she quickly took off her apron. “Let’s go!” She was out the door before me. I picked up Kate and followed. The hugs and greetings were warm and intense. It was so good to see friendly and familiar faces!
“Are you glad I’m here?” Rick asked.
“You have no idea,” I said.
The afternoon was spent helping Rick move in. During the afternoon Kim and Mike Hamrick dropped by to help, as did Ray and Nancy Cunningham. Even Louise dropped by, before her shift began, to inspect the new doctor. I suspected that her observations would be spread around the hospital fairly quickly. Funny, I thought. None of the other doctors even came by. Hmm.
By midafternoon, Rick was settled in. Barb had made up his bed, and she and Nancy had the kitchen in order in no time. The Hamricks and Gravatts left by late afternoon. We were sitting in Rick’s living room when Barb brought up the topic of dinner. Nancy quickly spoke up, “Oh, Ray and I are cooking supper for us all, if that’s OK. How about 6:00?”
“You bet, Nancy, that’ll be great,” I said.
We left to go home and clean up for supper. At about twenty minutes before six, Rick was knocking on our screen door. Barb was feeding Kate, so Rick and I stepped out back and took a seat on the bench.
The views of the valley were as lovely as ever, especially now that all the leaves had fallen. The normally clothed hills now revealed their crags and scars, their waterfalls and rock faces. It was a less soft, more rustic view—one that was a good fit for the coming months of snow, cold, and gray skies. Winter in the mountains, not often experienced by the three-season visitors, can be downright dismal, discouraging, disheartening, and depressing. The gloomy season would come to be my least favorite in the Smokies.
“What do you think of the place, Walt?”
“Well, Rick. The views are stunning. The fishing is fabulous. The hiking and birding are amazing.” I knew that Rick was an expert birder. During residency he had taught me to bird-watch, and I had been surprised at how much I enjoyed the hobby.
“How’s the doctoring?”
I quickly recounted just a few of the stories—the murder trial, my first delivery, the miscarriage, the anal angina story. We laughed together. “I knew it’d be interesting,” he commented, “but I had no idea your road would be that full of adventure.” We talked a bit more about football, politics, the scrumptious food at the local inns, and the medical staff.
“Are they really that resistant?” asked Rick about the staff.
“Well, working with Ray is a dream,” I said. “You’ll love him. Harold Bacon has been terrific. Mitch is a tough taskmaster, but he’s totally supportive of our being here. Paul Sale has been friendly, but a bit standoffish. Drs. Mathieson and Nordling have been downright ugly at times. When I’m walking down the hall toward them, they hightail it the other way. Patients and staff tell me that their comments about my living here and my practice style are less than complimentary. Hopefully you’ll have better luck than I’ve had.”
“I’m not sure. The dentist that came by this afternoon . . .” “Mike Hamrick?”
“Yes. His wife told me that some of the doctors in town don’t like you or Ray. You know, Walt, you’d think they’d be glad to have some help.”
“I know. I guess they’ve just been at it for so long it’s hard to give up what they’ve always had or to let in any new blood.” Rick added, “This afternoon Louise told me that none of the older doctors ever take time off.”
“That’s true. Paul Sale takes a week twice a year, but he tells me he forces himself to stay away so that by the time he gets back, he can’t wait to get going. I’m not sure I’ve ever seen Mathieson or Nordling take time away. Gay forces Mitch to go with her—once in a while. I’m not sure Dr. Bacon has ever left town.”
“They really are married to their medicine, aren’t they?” Rick mused.
“I think that’s right, Rick.”
For a moment we looked out over the mountains.
Then I laughed as I remembered a story Louise had told me.
“Rick, once you get to know her, I think you’ll love Louise. She told me the cutest story about Dr. Bacon. She said it happened way back when he was a younger man. He had been going day and night for nearly a week. Between delivering babies and dealing with an outbreak of typhus, he had been forced to keep up his round-the-clock visits until he became nearly exhausted. He finally reeled into his house late one evening and crashed into bed next to his wife. He told her, ‘Don’t let anyone wake me up unless it’s life and death.’”
“So,” asked Rick, “what happened?”
“Well, in the middle of the night there was a knock on the door. A neighbor told Mrs. Bacon the story, who then scurried to the bedroom. It took her a bit to rouse the good doctor, but when she did, she told him that a woman who lived only a few doors down from Dr. Bacon’s house was having a heart attack.
“Dr. Bacon groaned and pulled himself out of bed complaining, ‘She’s the most obese person in the county and she’s always thinking she’s having a heart attack—but she has the heart of an ox. If it is a heart attack, she won’t survive long. If it’s not, I’ll commence to tell her off—like I’ve been meaning to do for some time. Either way, I’ll be back soon!’
“Louise said the woman reportedly weighed over 300 pounds. She rarely got out of the house, and she was always suffering from one medical affliction after another. She seemed to take great delight in having the doctor visit her at home.
“So Dr. Bacon staggered sleepily down the street, following a frightened family member into the house and to the bedside.
“He was so tired that he pulled up a chair by the bed to take a history and to perform a brief exam. The patient was a massive mound of flesh—but in no apparent distress. Dr. Bacon asked a few questions, determining from the history that her discomfort was almost certainly not from her heart. He took her pulse, examined her eyes, nose, tongue, and throat, and then placed his right ear on the left side of her chest in order to listen to her heart—having left his stethoscope at home.
“Dr. Bacon asked her to start counting. To start with one-two-three and to continue until he told her to stop. ‘Madam,’ he instructed her, ‘count very slowly.’ Being one to always follow the doctor’s directions, she began her counting.”
Rick began to groan and laugh as the story drew to its inevitable conclusion.
“The next thing Dr. Bacon remembered was feeling the morning sun on his face and hearing a fatigued woman’s faint voice saying, ‘Six thousand four hundred, six thousand four hundred and one.’”
Rick began to double over in laughter. Soon we both were laughing so hard we were crying.
“Boys, it’s time to go to the Cunninghams,” shouted Barb from the dining room window.
“Well, Walt,” Rick summed up, “should be an interesting practice.”
- 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
- An Evening to Remember
- Another New Doc Comes to Town
© 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.