Bryson City Tales — Settling In (Part 2)

This is from the sixth 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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“Walt, I’m glad you’re going to bring the babies back to our county. I was so disappointed when the younger docs and the hospital decided to let Sylva take away our babies.”

“Did you attend births yourself?” I inquired.

He looked at me as though I had four eyes. “Did I attend births?” He chuckled. “Why, I’ve delivered hundreds and hundreds of babies in my time. I’ve even delivered scores of babies of girls I delivered. Now, that’s when you know you’re getting old—when you deliver your second generation. I’ve even delivered a few of what I call third-generation babies—where I delivered the baby, the mom, and the grandmom. Now you know for sure that I’m ancient.” He threw his head back and laughed. I wondered if I would ever have the amazing privilege to attend the birth of a woman whose own birth I had attended.

“For years and years,” Dr. Bacon continued, “before the hospital was built, why, I’d do all the deliveries at home. Remember taking the Model-T out into the hollows. Sometimes I’d have to push her across the creek bottoms, sometimes get stuck in mud. Would get to the house and stay until the baby was born. Sometimes that’d be hours and sometimes a day or two. Had some basic rules I’d always go by. First of all, I’d get all of the men out of the house. Something about men. They just seemed to get in the way and women always labored better without them.”

“Wouldn’t you allow a daddy to see his child be born?” I inquired.

“Oh my, yes. But he’d only be in the way during labor. He could come in for the birth—if he wanted and if she wanted. But if she didn’t want him there, he’d just have to stay out. They seemed to understand—especially in those days.

“What I really wanted at the house was women—especially women who had had babies. Walt, there’s not a man in the world that can care for a woman in labor like a woman who has gone through labor. I can’t explain it, but a woman caring for a woman just seems to make the labor go faster. If there weren’t any ladies present when I got there, I’d send the husband off to get some. It would give him something useful to do.

“I’d also always bring a bundle of fresh newspaper from town.”

“Newspaper? For what?”

“Walt, newspaper is sterile. Perfectly sterile. I’d use the paper as drapes and to keep the bedsheets dry and clean. Also, once I knew the mom and baby were OK, it gave me a chance to sit back and catch up on the goings-on in town.” He chuckled.

“Good obstetrics requires a good portion of patience. I’ve always said I needed a good cigar and a rocking chair to enjoy while I’m reading that paper. Just let things go their natural way. Almost always came out all right. In over forty years I only lost one baby—and that was from a knotted cord. And,” he emphasized, “I never lost a mom. Not one.”

“But, Dr. Bacon,” I quizzed, “what if you got in trouble? Did you go to a hospital?”

“Nope. In those days we did what was called kitchen surgery.”

“You did the C-sections at home?” I was incredulous.

“Of course. Why not?”

I paused. “Well, the lack of sterility could cause infection and death, and what about the lack of help and proper equipment?”

He laughed. “I guess you’ve never been exposed to ‘kitchen surgery,’ have you?”

“Nope, that’s for sure!” I replied.

“Walt, in our kitchen-surgery days we had to be content to work with no luxuries. We had to learn what essentials we had to have and how to work quickly. This is more than most modern surgeons know. Our system involved small incisions and rapid surgery. I tell you, this minimizes more infection than all the modern face masks and head covers combined. We seldom had any wound infections in our kitchen surgeries. The most important factor was prompt surgery. Small incisions. Minimal unnecessary trauma to the tissues. Expert surgical technique. Minimal exposure of any internal tissue to the air. Rapid closure and good dressings. These were the tools and trade of the kitchen surgeon.”

“Was lighting a problem?”

“It could be at times. Indeed. Lantern light is hard to use for surgery. The best light was a car headlight.”

“What did you do—bring a car battery and light into the house?”

He laughed. “No, no. Just have someone drive the car up to the door or in front of a kitchen window and leave the headlights on—pointing into the kitchen. Then a family member would use a looking glass to reflect the light into the wound or onto the perineum. There was no better light than this—just as good as any operating room light!”

I was fascinated. “What about anesthesia?”

“That was a problem. Nothing worse than to have a patient half-asleep—or, worse yet, waking up during the surgery—or, even worse, to have your volunteer anesthetist go to sleep from the fumes! So I’d usually take my nurse or my wife, who knew how to administer the chloroform—in the early days—and ether more recently. Of course, in the last few years, portable masks of halothane were a godsend. If my wife or my nurse wasn’t with me, I’d have to train a family member or friend. Actually, some of the country pastors who’d always show up during my sick calls got pretty good at helping me pass the gas.”

I was quiet—feeling a bit uneducated in spite of having just come out of a prestigious medical school. I couldn’t imagine the rush, the fear, the excitement of a kitchen C-section—or a kitchen anything.

Dr. Bacon continued, “Walt, some of my best surgery was done under these adverse conditions. It’s hard to explain, but there was something much more exhilarating about driving through the elements to attend a woman delivering a baby at her home than there ever could be walking across the street to the hospital. Nothing stimulating in that.”

I sensed our conversation was coming to a close. The apples were calling my new friend—some needing to be crushed for applesauce, some needing to be cooked, and some needing to be made into cider.

“The chief value, Walt, of the kitchen operations, over those done in the hospital, is that the young surgeon, the inexperienced physician, had no one to blame but himself for a poor result or an infection after surgery. You young guys, if any of these things happen, tend to blame the hospital or the staff or the nurses.

“The second value of the kitchen surgery is that it could be done immediately. Young surgeons don’t understand that fear has an adverse influence on surgical recovery. You see, to most people hospitals are scary. They all seem to know people— friends and neighbors—who’ve gone to hospitals and died. Yet they know no one who’s died on the kitchen table. So when the hospital was built and we quit doing most of our kitchen surgeries, we didn’t realize the harm we were doing. Instead of seeing people early in their disease, they waited to come in for help. Patients would resist advice to go to the hospital and only come in when in severe distress.

“So, when the hospital first started doing surgery, our morbidity and mortality was unacceptably high. This caused more fear of the hospital and produced a vicious cycle. The more people who fared poorly at the hospital, the longer people waited to come to the hospital, and the worse they did when they got there. When we operated at home, we operated earlier in the course of the disease. The patient’s fear factor was much lower. And they just did better.

“Walt, even today, I will not operate on someone who is deathly frightened. It doesn’t matter what causes the fear—I will not operate on a frightened patient. I’ve seen more than one patient who, prior to surgery, said they had dreamed that they didn’t recover—or who confessed that they thought they were going to die and not recuperate—who proceeded to make good on their prediction. Every old surgeon has similar stories to tell from his own experience. When we autopsied these cases, we did not find the cause of death in even one.”

He took a slow, deep breath. “I believe they were literally scared to death.”

He slowly stood. “Been a pleasure chatting with you, Walt, but I bet that lovely wife of yours has Sunday dinner about ready. You get on and I’ll bring some cans over later this evening.”

Later that evening Dr. Bacon did bring over dozens of jars and cans. Our root cellar was well stocked with candied apples, apple chips, applesauce, and apple cider—some of the best we’ve ever had. But the old physician’s real gift that day was grounding me a bit in the history of my profession and my community. I may have known more modern medicine than he did, but not more medicine—and certainly not more interesting medicine!



© 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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2 Responses to Bryson City Tales — Settling In (Part 2)

  1. Lisa Fair says:

    I forgot how much I love this book. Bryson City is so different these days. It sounds like a wonderful place to practice and it certainly was a time when people appreciated their doctors more. I have found my place in the world for now. I am really enjoying Ft. Knox and the people on base. It is a shame they are closing the hospital. I am looking forward to your new book about your Dad. My Dad was in WWII and so I went to NCSU on a full veterans affairs scholarship. I get to pay back by serving the soldiers and their families here. It also helps that I don’t have to go through boot camp.

  2. Dr. Walt says:

    Lisa, thanks for your kind words. They are a blessing to me.


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