Bryson City Tales — Shiitake Sam (Part 1)

This is from the twelfth 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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Sam was one of the entrepreneurs in town. Oh, he would never use such a term. But when it came to trying new ideas, he was the man. His dad had farmed the end of a small hollow near Bryson City—mostly corn and burley leaf tobacco. In those days the tobacco brought in more money, but the corn was useful as a supplement crop and to feed the livestock during the cold, gray winters. However, the crops could only be grown on the valley floor and the more gentle slopes, which left a fair amount of steep forestland.

Now, the forest could be logged every few years, but that didn’t provide for the year-to-year needs of the farm or the family. With tobacco prices dropping, and with an upsurge of out- of-towners demanding more exotic menus in the local inns and in the finer restaurants in Asheville, Sam took a hankering to learning how to grow mushrooms.

He had talked first to Mr. Lyday, the county agriculture agent, who didn’t have a clue about mushrooms or how to grow them, or even if they could be grown in our part of the country. But a call to Raleigh resulted in a small bundle of information. Indeed, a particular brand of mushroom, the Shiitake mushroom, loved a hot, humid summer and a cool to cold but damp winter. They did not do well in the direct sunlight, but it was said they would flourish in the relative shade of a forest floor. Furthermore, the ideal growth medium for this particular type of mush- room was a dying oak tree, and our oaks in the Great Smokies seemed to be one of the oaks they loved the most.

So Sam learned how to drill a one-inch hole all across the top of the oak logs, pack a plug of sphagnum moss into the hole, and sprinkle the mushroom spores on top. He ordered the spores all the way from Japan, and while waiting for them to arrive he rigged up a sprinkler system using the crystal-clear, ice-cold water flowing from one of the several small branches (or creeks) on the property.

It wasn’t too many years before Sam’s entire forested cove was covered with logs growing the newest cash crop of that cen- tury. Others in Swain County had smaller patches of Shiitake, and before too long, trucks from Knoxville, Asheville, Waynesville, and even Sylva were dropping by Bryson City once a week to pick up the luscious, fresh Shiitakes. Why, Sam even gave a talk at Rotary Club about his Shiitakes—and that’s where we first met.

Our second meeting was in the emergency room. I was there, sewing up a minor hand laceration, when the call came over the radio.

“Louise, this is Rescue One.”

Now since there was no Rescue Two, I was frequently amused by this type of call. I guess the Swain County Rescue Squad was just planning for the inevitable future growth.

“Go ahead, Rescue One,” Louise responded.

I threw and tied the last stitch, which was admired by its new owner, and then began dressing the wound while Louise learned about our next guest.

“Louise, this is Don. I’ve got Shiitake Sam with me.”

I hadn’t heard this nickname before but knew immediately to whom the paramedic was referring.

“He’s busted up his ankle pretty bad. We’ve put an air splint on it. His vitals are OK. But he’s already taken a fair amount of anesthesia.”

His anesthesia, I suspected, was crystal clear, drunk from a Mason jar, and nearly 150 proof. I suspected we’d smell Sam well before we saw him.

“Ten-four, Rescue One. What’s your twenty?”

“We’ll be there in ten, Louie.”

“Louie” was their nickname for Louise. I could call her Louise but never Louie—at least not yet. Only a few of the locals could call her Louie and get away with it.

“Doc!” Louise exclaimed. “What you doing making a dressing here? Don’t you know that’s my job?!”

She continued to fuss as she completely redressed my patient’s wound. I thought I’d done a pretty good job, but I was continuing to learn my proper place in the scheme of things. And dressing wounds was not the doctor’s place.

While Louise wrapped and fussed, I finished my paperwork and wrote a proper prescription for a pain reliever and an antibiotic. At Duke I would have seen my patient back in twelve to fourteen days to remove the stitches. However, here he’d see Louise for the suture remove. I’d learned that this was just the way it was in Bryson City.

I heard the beeping of the ambulance as it backed up to the emergency room entrance, and in a few moments Don and Billy walked in with Sam and his stretcher in tow.

After quickly transferring Sam onto the emergency room gurney, Don turned to me. “You may not remember me, Doc. Don Grissom. Billy and I met you up at Clem’s place,” and he quickly thrust out his hand to grasp mine. His hand was rough, calloused, huge, and strong. It enveloped mine, yet almost gently gave it one pump.

“Sure, I remember you,” I said. “Good to see you.” I remembered that night only too well.

The smell of Sam’s alcohol-induced “anesthesia” and the deep snores indicating its effectiveness inundated the emergency room. “Doc, his pulses and sensation in his feet are fine,” Louise reported. “I’m gonna take him on over to Carroll in X ray.”

In most ERs the doctor does a history and an exam. But the scheme of things here was that those were part of the nurse’s duties. The doctors in town—in order to preserve their sanity and to try to spend some time at home when on call—leaned quite heavily, as they did in those days in many small rural ERs, on the eyes, the ears, the skills, and the experience of the ER nurse. In a few minutes, Sam, his snores and smell, and his X-rays were back.

“A trimalleolar fracture,” Louise announced confidently.

“I’ll get him ready to cast.”

Before I could catch myself, I blurted out, “Cast? Are you crazy?”

Sam and his gurney ground to an immediate halt.

Louise, looking half-incredulous and half-incensed, cocked her head and said, “Dr. Larimore, I am not crazy, and I’d suggest that you never speak to me in that tone again.”

I could feel the blood rising in my face. “I’m sorry, Louise,” I apologized. “But at Duke . . .” She didn’t even let me finish my statement. I was going to tell her about the studies showing how well these fractures do with an operative technique called ORIF (Open Reduction and Internal Fixation), which means that we surgically open the fracture site, wash out the blood, and then use wires or screws or other hardware to hold the bones together while they heal. I wanted to tell her how I was experienced in assisting the orthopedic surgeons in doing this operation and how quickly we could expect Shiitake Sam to be back on his feet. In fact, with the newfangled fiberglass cast, he could even be tend- ing his mushrooms soon. But I wasn’t able to finish my lecture.

“Young man,” she almost snarled, “you’re not at Duke, you’re in my ER. I’d recommend you not forget it!”

I stood aside, chastised and befuddled. I’d been around a lot of strong-willed ER nurses, but never one like Louise.



© 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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