This is from the fifteenth 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.
One day after lunch I walked over to the hospital for afternoon rounds. I saw Louise coming down the hall. Ever since the case of the skintight cast, I had felt uncomfortable being around the ER nurse. I wasn’t sure why.
Perhaps I was still wrestling with the fact that her clinical and practical experience so vastly out- weighed mine. Perhaps it was the reality that she knew these people and their ways so much more intimately than I did. Although she was nice enough, around her I just felt uneducated. And what was even more painful, I felt unappreciated.
Louise was heading toward the ER with a syringe in her hand. I was trying to think of something to say, but she beat me to the punch.
“Dr. Larimore, you got a moment? I need a hand.” She continued on to the ER without comment.
I followed like an obedient pup. As we walked toward the ER, I saw Louise place the syringe in her pocket. An elderly man was coming out of the ER, holding his paperwork and struggling into his plaid coat.
“Louise, the sugar worked like a charm. The hiccups are completely gone. You may never see me again in this place!” He smiled and turned to leave.
Louise smiled and glanced my way. “I’ll explain later.”
We entered the ER, and I could hear the whimpering of a child, which increased in volume as we approached the cubicle. We went in, and I saw a small woman with a four- or five-year- old boy.
“Mae Bell, Dr. Sales says it’s the strep throat and that some penicillin should clear it up pretty quickly.”
I suspected Dr. Sale was on call for the ER. For some reason, Louise always called him Dr. Sales.
Louise went on. “The best way to get the medicine into him is to put it into a muscle.” She paused and pointed to her hip. The mother’s eyes widened a bit as she recognized the “shotlike” gesture. “Is that OK?” asked Louise. The mother began to nod her head yes. Louise continued, “And the best way to get the medicine into the muscle is to have your little one lie down on his stomach. OK?”
The mother continued to nod. The young tot had no idea what was coming. The fully informed verbal consents often administered these days to the very young and their parents were just not a part of medical practice back then—certainly not in Bryson City.
“Henry . . .” Louise now directed her comments at the unsuspecting lad. “I want you to get up on the bed and lay on your tummy so that Miss Louise can check your backside.” Louise wasn’t just “checking his backside,” she was getting ready to give him a shot. Was this lying? I wondered, making a mental note to ask her about this later.
Henry was eyeing Louise with an impressive degree of dis- trust, especially since a white-coat-clad, doctor-looking type of guy was standing next to her. But he allowed his mom to help him up and lay on his tummy—glancing back over his shoulder with grave suspicion.
As Louise moved closer, she instructed, “Mae Bell, can you give Henry a little back massage while I look at his back? And Dr. Larimore, I want you to take Henry’s feet and turn them so that the toes are pointing toward each other and hold them there for a moment.”
I’m sure I looked at her with a furrowed brow. What in the world was she thinking? I had never seen such a thing. But obediently I gently grabbed Henry’s ankles and turned the toes so they were facing each other while his mom rubbed his back.
Louise very quickly pulled down one corner of his pants, took an alcohol sponge from her pocket and rubbed it across the skin, gently pinched Henry’s unsuspecting upper buttock between her left thumb and index finger, and with her right hand reached into her pocket, single-handedly unsheathed the needle, and drove it into his flesh.
Before he knew it, the syringe was empty and the deed done.
As we all released our grip, the full implication of the dirty deed traveled up Henry’s gluteal nerve and spinal column to the pain center of his young developing brain. This resulted in neu- ral impulses that both instantly widened his eyes and tightened his perioral muscles, which caused his diaphragm to contract and draw in a full breath of air. His intercostal muscles then con- tracted with such force that the subsequent yell was heard clear out in the waiting room. The embrace of a loving mother muf- fled the crying as Louise and I stepped out of the cubicle.
“Thank you for the help, Dr. Larimore,” said the nurse as she resheathed the needle and jotted a note on the patient’s chart. “Louise, two questions,” I said. “One, what’s this about
sugar and hiccups? Two, what’s the deal about the toes?” Louise smiled and then slyly asked, “Why, Dr. Larimore, didn’t they teach these things to you all at the big Duke University?”
“Don’t believe so, Louise. We were too busy learning how to save lives.” My hint of humor was obviously not received well as Louise glared at me over her spectacles. “Actually, Louise, I wasn’t taught either technique. What’s the deal?”
“What were you taught to do if someone comes into the ER with a bad case of hiccups that had been going on for hours or days?” Louise quizzed me.
“We usually used intravenous Thorazine. That seemed to work pretty well—at least in the two or three cases I’ve seen.”
“We’ve used Thorazine here, but I can’t even remember the last time. The sugar seems to work just fine. It’s sure a lot cheaper. Just like with Shitake Sam when he broke his ankle, we try to do things the least expensive way we can. Many of these folks don’t have no medical insurance. ’Nother thing ’bout the sugar is that it has none of the side effects that meds like Thorazine can have.”
“How do you administer it?”
She looked confused. “The Thorazine?”
I chuckled. “No, no. The sugar.”
“Oh, well, it’s real simple. Just take a heaping tablespoon of granulated sugar—I get it from the staff lounge—and have the patient swallow it down.”
“Yep, that’s it. Usually works in ten to fifteen minutes.” “How does it work?”
“Dr. Larimore, I don’t have a clue,” she answered bluntly. “I just know it does.”
“OK. So what’s the deal with the toes?”
Louise perked up. “I do know how that one works. Let me show you. Dr. Larimore, stand facing the counter.”
I did, but asked, “Louise, you’re not going to give me a shot, are you?”
She laughed, “No sir. No shot. Just a demonstration. Here, I’ll do it with you.” She stood and faced the counter beside me. “Now turn your toes in so they’re pointing toward each other,” she instructed. We both turned our toes in. It’s a good thing no one’s watching this! I thought.
“Now,” she continued, “try to tighten up your buttock muscles.”
I tried, but my gluteal muscles just wouldn’t contract—at least not very much.
“Wow,” I commented. “That’s really great!”
“You see, pointing those old toes pigeonlike keeps the but- tocks from tightening up. You can do this standing or lying down. By preventing the tightening of the gluteal muscles, you can relieve some of the pain for the patient. That’s just the way it is.”
By now there was no more whimpering from the cubicle. Mae Bell and Henry appeared from behind the curtain—no worse for wear. As they left the ER, I turned to Louise.
“Louise, just one more quick question. You really lied to that little boy, didn’t you?”
“You told him you were just going to check his backside— when you knew all along you were going to give him a shot. Isn’t that lying?”
“Well, Dr. Larimore, I’ve learned that misleading statements made for the benefit of the patient or the family are sometimes appropriate. They’re just white lies.”
I furrowed my brow. “Louise, isn’t a lie a lie? I mean, is there really any difference between a white lie and a lie? Aren’t they both really just the same thing?”
She paused to rub her chin and then explained, “Not really, Dr. Larimore. One intends to deceive and one intends, in a car- ing way, to help.”
“But,” I persisted, “both of them are still lies. How can a lie help a situation?”
Louise smiled kindly, if perhaps a bit condescendingly. “Dr. Larimore, after President Carter was elected, I heard a story ’bout his momma, who had a home in Plains, Georgia. She hated to do press interviews. She resented the way the reporters mis- characterized her son and what he stood for—especially his spir- itual beliefs.
“So after her son’s election, his staff persuaded her to do an interview with a well-known national magazine. Miss Lillian did not want to do the interview, but she agreed—as long as it was done in her home on her home turf and the interview was lim- ited to thirty minutes or less.”
I was wondering where this was going but continued to listen.
“On the appointed day the reporter drove up to the house, walked past the Secret Service agents and up to the front porch. She knocked on the screen door. Miss Lillian greeted her and took her into the parlor, where they both sat down. Miss Lillian offered her no refreshments, which would be highly unusual, even rude, in that area of the South.
“The reporter tried to make small talk. Miss Lillian’s response was to look at her wristwatch and say, ‘You have twenty-seven minutes.’
“The reporter began her interview with what was to Miss Lillian one of the most offensive questions she could be asked: ‘The president has been quoted as saying that his religious beliefs would compel him to never knowingly tell a lie. You raised the president from the time he was a baby. You saw him grow up. During that time did you know him to ever tell a lie?’
“Miss Lillian’s cheeks flushed, but she remained cool on the outside. ‘When you say “lie,” asked Miss Lillian, ‘do you mean a white lie or a black lie?’
“It was the reporter’s turn to flush. ‘What’s the difference?’ she asked indignantly. ‘Isn’t a lie a lie? I mean, just what is a white lie?’
“Miss Lillian stared right at that reporter lady and said, ‘A white lie is like . . . ,’ she thought for a moment and then continued on, ‘a white lie is like when I met you at the door and said, “‘It’s so good to meet you.”’”
Louise threw her head back and laughed. I laughed with her. She had made her point.
From that moment on I began to feel comfortable around Louise. Maybe it was because I relaxed about not being the know-it-all that doctors are often led to believe they should strive to be. Perhaps I was becoming more accepting of the fact that as long as I was to practice medicine, I would need to continue to learn and be taught—by my patients and by my colleagues.
Louise and I developed a special relationship. Sure, it was a bit bumpy at the start—but, like a fine wine, it mellowed and matured into something very valuable to me. No lie. Not even a white one!
- 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
© Copyright Walter L. Larimore, M.D. 2016. 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.