Bryson City Seasons — Turned Tables

This is from the twenty-fifth chapter from my best-selling book, Bryson City Seasons, which is the sequel to Bryson City TalesI 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 morning dawned crisp and cold. I bounded out of bed and headed to the children’s bedroom for my favorite morning ritual— to give Kate and Scott what I called their “cock-a-doodle-doo.”

I would sit on the side of the bed of each child and softly sing, “Cock-a-doodle-doo, I love you; cock-a-doodle-doo, I love you; cock-a-doodle-doo, I love you—cock-a-doodle-doo.”

Once Scott was awake, he’d be completely awake, and I’d lift him out of his crib and carry him to our bedroom to play with his mom in bed. Then I’d head back to the kids’ bedroom. Kate would awaken more slowly, but as she’d begin to wake up, always with a smile on her face, she’d stretch her arms above her head as I would give her a vigorous rubdown across her chest and tummy.

Then I’d help her with a series of stretches. I’d massage her spastic muscles and slowly flex and extend her joints through their range of motion. But even with the massages and therapy, I noticed that Kate’s contractures were worsening.

That morning, as I rubbed her spastic muscles, I came to the realization that the constant spasticity was slowly and steadily pulling in such a way that her joints were increasingly losing their mobility.

As a dad, I didn’t want to subject Kate to any more pain. I knew the recovery from surgery would be challenging and potentially painful. I knew the therapy she’d need would be tedious and diffi- cult. I felt myself once again asking God, Why Kate? And in my pity I also thought, Why me?

As I rubbed her legs, my mind turned to Rachel Bell—a little girl I had treated that week.

Her father and mother didn’t like or trust doctors very much. Their farm, located far up an isolated valley near town, was fairly self-sufficient. Other than an occasional trip to town to sell fruits and vegetables at Shuler’s Produce Stand and to pick up staple goods, they kept pretty much to themselves. Having met David Bell at the market and taken a liking to him and his family, I had invited him to bring the kids in for well-child checkups. He just smiled and said, “If’n they ever need a doctor, we’ll call. Don’t see no reason to waste good money when I can see they’re all doin’ fine.”

“David,” I protested, “the county will pick up the costs of the visit and any immunizations. It shouldn’t cost you a cent.”

“Well then, Doc,” he continued, “don’t see no reason to waste good time bringin’ the children into town to see you when I can see they’re doin’ just fine.”

I knew that arguing about finding problems early would be lost on this mountain man. But I also sensed if he needed any help, he’d call.

The call came one Saturday afternoon. Louise phoned the house to tell Barb that I needed to come over to the emergency room to see a child who’d had an accident. Once I was there, I saw David sitting beside the gurney. Next to him, his little Rachel moaned in pain, her arm in a homemade sling. I greeted David and then slowly removed the sling. Rachel’s elbow was obviously deformed. I quickly checked her radial pulse and the sensation in her fingers. Thankfully, there was no sign of nerve or artery damage.

“She fell off the roof of a shed,” David explained. “Tried to catch herself but done broke her arm. Figured if it healed like this, she’d be crippled. Doc, I don’t want my daughter crippled. Can you fix her?”

“X-rays are already done,” Louise told me.

“Let me look at the films, David.”

After viewing the films, I returned to ER with good news.

“David, there’s no fracture. Rachel has only dislocated her elbow. I can fix it fairly easily, and all things being equal, she should heal just fine.”

After I numbed a patch of skin behind the elbow with an ice cube, Louise discreetly slipped me a syringe of lidocaine so Rachel wouldn’t see it. I slowly inserted the needle through the ice- numbed skin and then injected lidocaine, painlessly sliding the needle toward her elbow joint. When the needle penetrated the joint lining, I felt a tiny, almost imperceptible pop, and then I aspirated a bit of yellowish joint fluid. This was a very good sign—as bloody joint fluid could indicate a small fracture not seen on the X-ray. I emptied the lidocaine into the joint and then withdrew the needle. Rachel never even knew she had received a shot.

I stood up and walked to her side. “Rachel, I need to tug on your arm a bit. It shouldn’t hurt much, and it will make your elbow feel a lot better.”

Her eyes filled with tears as she looked over to her father. He gently reached over to take her left hand. “Honey, you can trust Doc. I do. This may hurt a bit. But Doc’ll make you better.” He smiled at her, and I could see her anxiety melt away. “You keep your eyes on mine, honey. Okay?”

She nodded her assent as she continued to look at her pa. I gently positioned my hands and then quickly pulled down on her forearm and relocated the elbow with an audible pop. Rachel shrieked, more from surprise than pain, but kept her eyes on her father.

“We’re done!” I pronounced as I gently flexed and extended her elbow. “Good as new!”

After taking post-reduction X-rays and finding them normal, I placed an Ace bandage on the elbow, gave David some written care instructions, and arranged Rachel’s arm in a sling.

As they stood to leave the ER, David shook my hand. “Thanks, Doc. It ain’t easy for me to bring one of my kids to the hospital. I was sure she done broke her arm. I knew it would hurt powerful bad to set it. But I knew there was no other way for her to get fixed. Thanks, Doc.”

Suddenly I was transported back to Kate’s room as she said, “Thanks, Dad.” I smiled at my little girl as I continued to exercise her contracted left knee and ankle. Without knowing it, David had given me a blessing and taught me a lesson. The trust he placed in me would be the kind of trust I would need to place in Kate’s doctor. As was true for Rachel, I now knew Kate would not get better without an orthopedic intervention.

Then a silent whisper entered my mind. I didn’t tell you the trip would be comfortable. But I did promise to walk every step with you! It wasn’t an audible voice but a still, gentle voice that was unmistakable.

At that moment I knew we would need to return to Duke. And I knew Kate would need to go through surgery. I knew the tables would be turning. For this case, I would not be the doctor; I’d be just the father of a patient. It would likely not be comfortable—for me or for Kate—but I now knew it was necessary for her and for her parents.


Arriving back at Duke was like a reunion. Kate’s therapists were all there to see her—and, more important, to hug and kiss her. Barb and I were also delighted to see them.

When all the tests were done, we had a visit with Dr. Bob Fitch, who was Kate’s pediatric orthopedist at the Lennox Baker Cerebral Palsy Hospital. He confirmed our expectations: Kate would need surgery—and not just a single incision but perhaps up to a half dozen—to lengthen tendons around her left hip, knee, ankle, and foot.

Dr. Fitch explained that the recovery would be slow and would require her to be in a cast and a wheelchair for four to six weeks and undergo intensive physical therapy. He spent a great deal of time with us, explaining the other options and then the risks, benefits, and costs of each option—including not doing surgery.

He carefully answered our questions and encouraged us to take time to talk about what we had learned and to pray about what to do. He also offered the names of several colleagues at other medical universities from whom we could obtain a second or even a third opinion.

We knew we didn’t need another opinion. It was time for me to practice what I had preached. I needed to place the same kind of trust in Kate’s doctor that I was asking my patients to place in me.


  1. The Murder (Part 1)(Part 2)(Part 3)
  2. The Arrival (Part 1)(Part 2)
  3. The Hemlock Inn (Part 1)(Part 2)
  4. The Grand Tour (Part 1)(Part 2)
  5. The Interview (Part 1)(Part 2)(Part 3)
  6. Settling In (Part 1)(Part 2)
  7. First-Day Jitters (Part 1)(Part 2)
  8. Emergency (Part 1)(Part 2)
  9. The Delivery (Part 1)(Part 2)
  10. The “Expert” (Part 1)(Part 2)
  11. The Trial (Part 1)(Part 2)
  12. Shiitake Sam (Part 1)(Part 2)
  13. Wet Behind the Ears (Part 1)(Part 2)(Part 3)
  14. Lessons in Daily Practice (Part 1) — Anal Angina(Part 2)(Part 3)(Part 4)
  15. White Lies
  16. The Epiphany (Part 1)(Part 2)
  17. Becoming Part of the Team (Part 1)(Part 2)
  18. Monuments (Part 1)(Part 2)
  19. My First Home Victory (Part 1)(Part 2)
  20. Fisher of Men (Part 1)(Part 2)
  21. Fly-Fishing (Part 1); (Part 2)
  22. Something Fishy (Part 1)(Part 2)
  23. A Good Day at the Office
  24. An Evening to Remember
  25. Another New Doc Comes to Town
  26. ‘Twas the Night Before Christmas (Part 1)(Part 2)
  27. A Surprising Gift
  28. The New Year (Part 1)(Part 2)
  29. The Home Birth (Part1)(Part 2)(Part 3)
  30. The Showdown (Part1)(Part 2)(Part 3)
  31. The Initiation (Part 1)(Part 2)(Part 3)
  32. Home at Last (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.

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