This is from the thirty-first 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.
THE INITIATION (PART 1)
It just so happened that I was alone in the office that Thursday in July. Ray was shopping in Asheville with Nancy, Rick was on vacation, and Mitch was at his farm. I was covering a very busy afternoon. Helen was pulling patients back into the exam rooms as fast as she could, and I was seeing the folks as quickly as good manners and good medicine would allow.
Because of our schedule, I wasn’t able to have Helen prep me for each case before I walked into each room—we were shakin’ and bakin’! So, you can imagine my surprise when I walked into the procedure room to find Mitch’s son-in-law, Cam, sitting alongside the exam table where a beagle was lying on a blood-soaked towel and breathing shallowly. A dog!
“Doc,” Cam explained, “we tried to find Mitch, but we couldn’t. So we did the next best thang. We brung her up here to you.”
My guess is this was a compliment, but I wasn’t real sure. “What happened?”
“We were a huntin’ after some boar, and Queenie here got gored real bad. I need you to stitch her up if’n you would.”
I stepped forward and took a look at the wound. It ran along the base of the dog’s ribs for about ten inches. It had a thick clot of blood overlying the wound. Helen had already set out a suture tray and a syringe of lidocaine anesthetic. “Cam, can you steady her head for me while I work?”
I scrubbed the wound edges with Betadine and then draped the abdomen with sterile drapes. I numbed the wound edges with lidocaine. When I began to scrub the wound, Queenie stayed still. I assumed she either had a very high pain threshold or was adequately numbed. The wound penetrated the abdominal muscles but fortunately not the lining of the abdominal wall—the peritoneum. I’d be able to close this up.
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 grandfa- ther 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.
- 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
- ‘Twas the Night Before Christmas (Part 1); (Part 2)
- A Surprising Gift
- The New Year (Part 1); (Part 2)
- The Home Birth (Part1); (Part 2); (Part 3)
- The Showdown (Part1); (Part 2); (Part 3)
- The Initiation (Part 1); (Part 2); (Part 3)
© Copyright WLL, INC. 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.