Bryson City Tales — First-Day Jitters (Part 1)

This is from the seventh 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 to join us.

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Monday morning was my first official day of work as a family physician—the culmination of twenty-four years of education. I almost couldn’t believe the big day had finally arrived. Today, I would just start making a living—almost eleven years after many of my high school friends had begun their careers.

I arrived at the hospital at 5:30 A.M., ready to meet Mitch for rounds. Mitch was, according to the evening supervisor, uncharacteristically late. I stood nervously at the nurses’ station waiting for him. I didn’t have to wait long. In he strode, confident and lively. As he entered the station, as though on cue all the nurses stood to attention and in unison said, “Good morning, Dr. Mitchell.” I’m sure my mouth dropped open. Then a nurse appeared from nowhere with a pot of coffee and a clean cup and saucer. “Thank you, Verna,” commented Mitch, without looking up from the pile of charts that had been carefully organized at his chair. This was not the way we made rounds at Duke. We were lucky if the nurses even noticed us when we entered the station—that is, unless they needed something.

As he quickly thumbed through each chart, he hummed to himself. Then Ray showed up. Same song, second verse. “Good morning, Dr. Cunningham!”

“Good morning, ladies.”

Then another pot of coffee and cup with saucer appeared. Then Mitch was up and walking. “Let’s go see some folks, Walt.” And we were off to visit the patients. I heard the rustling of charts. I looked back at the station as we headed down the corridor and saw Verna putting the charts into a rolling cart and then quickly pushing it as she tried to catch up with us.

As we saw each patient—each having been awakened by a nurse’s aide who preceded us—Mitch asked a few questions, answered a few questions, did a brief exam, and, while doing so, dictated a note that was written in the chart by Verna. Then he would dictate some orders, which she would write on the order sheet—which he would sign—and then we were off to the next patient. The whole process took only a few moments with each patient.

We’d briefly discuss each case. He’d ask what I would do and then briskly criticize each answer. “Son, that’s not the way we do it here.” Attached to this oft-repeated phrase might be, “That would just cost too much money, and the folks here don’t have much” or, “That’s the hard way to do it. How about . . . ?” or, “You’ve got to be kidding! Didn’t they teach you . . . ?” I was beginning to doubt the value of any of my last seven years of medical education—when suddenly we were done.

“Let’s go get a bite to eat before surgery. We’ve got a full schedule today.” We took the elevator—the first of only two in all of Swain County—to the basement and entered the small but comfortable hospital dining room, Eloise Newman’s domain. Eloise, whose culinary expertise had so dazzled us the previous year, had been brought up in the “red meat and potatoes” school of food preparation. If it wasn’t fried and fatty, it wasn’t worth serving. The spread of available food was impressive. But no yogurt, no fruit, no muesli or granola, no whole-grain foods here! Rather, a veritable smorgasbord of yeast rolls and home-made biscuits, butter, homemade jams, eggs (scrambled or poached or fried), bacon, sausage (link or patty), grits, home fries, and pots and pots of strong coffee. This was a nutritional den of iniquity. But did it all ever taste good!

“Walt,” barked Dr. Mitchell, “enough relaxation. Let’s get to work!” With that, we were off to the OR, which was larger and more spacious than I had remembered from my tour when I’d interviewed here. The equipment was spotless and looked nearly new.

“Earl and the board keep us well equipped. You won’t find a better OR suite in western North Carolina,” Mitch boasted. He introduced me to the two nurse anesthetists, Alfred Jensen and Kim Hamrick. Kim’s husband, Mike, was one of only two dentists in the county. Mitch also introduced me to the scrub and circulating nurses and the orderly. For a small hospital this was quite the setup. Ray and Mitch operated all morning, five to six days a week. Big-city surgeons often only operate two or three mornings a week!

That morning I assisted Mitch and Ray with eight surgeries—an elective gallbladder removal for gallstones, a hip replacement, an elective hernia repair, a breast biopsy, the placement of a set of ear tubes in a three-year-old, an upper gastrointestinal endoscopy, and the removal of a large tumor on a man’s back. In some areas, general surgeons won’t do this many cases in a week. But with a referral area of two counties, this OR was kept hopping.

My confidence in the hospital and in these two surgeons soared. They were good—very good. Mitch’s hands were as fast and as skilled as any I had seen at any hospital in which I had scrubbed.

Throughout the morning Mitch invited me to do more and more. My adrenaline surged as I sensed the surgeons and the staff closely watching my every move. Did I know how to properly scrub, gown, and glove? Did I know how to assist—to help the surgeon operate more quickly and effectively? Could I sew—and sew quickly? I answered question after question about anatomy, options, techniques, postoperative orders—sometimes almost nonstop. I felt like a medical student or an intern. It was an intense morning, yet I felt I did well, and I sensed Mitch’s unspoken approval. He left the OR after the last operation, while Ray and I closed.

“Walt, don’t feel bad about all these questions,” Ray said. “Mitch did that to me for weeks. I wish I had done as well as you did.”

I was pleased that Ray was satisfied. It had been a very good morning.

When we were finished, I walked over to the house for lunch.

“Honey, how’d it go?” shouted Barb from the basement. “It went super. Great morning.”
I sat at the dining room table and opened up the Smoky Mountain Times. This small but excellent paper would bring us the news and the printable gossip on a weekly basis.

I heard Barb running up the steps. When she got to the kitchen, she announced, “Honey, Eudora brought a mess of fresh vegetables and greens. She said that the nurses and staff always bring in extra from their gardens and leave it in the staff lounge so that those without gardens can enjoy the pickings.”

This was our introduction into one of the major unreported industries of Swain County, namely, hunting and growing your own food. So Barb and I enjoyed our first lunch of local produce—remarking to one another that there was nothing tastier than fresh, homegrown food.



© 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.

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