Bryson City Secrets: Even More Tales of a Small-Town Doctor in the Smoky Mountains

by Walt Larimore, MD

  As I stepped to the patient’s side, while nurses yelled, “Pant! Pant! Don’t push! Don’t push!” the patient pushed — and out popped baby #2. I didn’t even have time to think about the daddy’s shock at watching all this — much less consider any desire he must have had to cut his babies’ umbilical cords. I just clamped and cut the cord and rushed little boy #2 to warmer #2 where Rick was waiting.

  “Baby #1 is fine,” Rick assured me as he looked down at baby #2. “This one looks great too. Wow, they’re big for triplets!”

  “You OK, Rick?”

  “You bet. Get on back to the mom. I’m fine.”

  To my utter amazement, as I turned back to the mother a small eruption of fluid gushed out of the birth canal.

  “Ruptured membranes!” one of the nurses exclaimed.

  A quick check of the cervix showed that it was still fully dilated and that baby #3 was coming down the birth canal headfirst. I found myself befuddled. How could the cervix dilate when the first baby came out feet first? Later discussions with a specialist in Asheville convinced me that the largest baby, actually the last to deliver, must have been the one closest to the cervix and — whether butt-first breech or head-first vertex — had dilated the cervix. Then, with some sort of fetal gymnastics, the soccer player in the group had kicked open his membranes and made his rapid exit from the womb.

  Surprisingly, this baby took several dozen contractions to move down the birth canal, but with one final push he plopped into view for all to hear his cries.

  “Three boys?” the shocked father exclaimed.

  “Your three sons!” I responded. “Here, wanna cut the cord?”

  “Can I?” He grinned wide in wonder.

  “You bet.”

  After the cord cutting, Rick took boy #3 to warmer #1 and repeated his third baby inspection in ten minutes.

  “All boys look great! Vital signs normal. All had Apgars of 8 and 9,” he announced to the mom, dad, and all present. Nurses worked on each child to get him cleaned up, measured, properly identified and tagged, and capped and swaddled.

  Fortunately, all three boys were in great shape — as was their mom. The dad appeared to be in shock, but I was certain he’d recover — at least one day. Unfortunately, I had forgotten to tag each of the umbilical cords with a different type of clamp for each baby. Thankfully, as nurses so often do, an experienced and very observant labor nurse saved my hide.

  “The long cord is the one the daddy cut. That’s the cord for baby #3. And the shortest cord is from baby #1.”

  I looked at her in grateful amazement. “Way to go! Thanks!”

  She blushed and smiled with pride.

  On Thursday, our hospital shined. The entire staff pulled together and participated in a wonderful set of deliveries. Unexpected, to be sure, but — thankfully! — uneventful.

  Two days after their birth, the triplets were beginning to become jaundiced, and we didn’t have the equipment or staff to care for all three of them. I called one of the pediatricians over in Sylva, who kindly agreed to take the babies in transfer. Because the mom was doing so well, I’d be able to discharge her from the hospital so she could travel to Sylva with her babies. The hospital there had agreed to let her and her husband stay in one of their postpartum rooms until the babies were ready to go home.

  Before they left, I asked her if she had named the boys. When she told me their names, I sat down in shock. On Saturday, Richard, Carl, and Stanley — born in that order — left the hospital in an ambulance headed to Sylva. Their mother assured me the names were all family names. She didn’t know any of the three men we had lost that week. She said she sensed a leading from the Lord in naming each boy. I believed she had, indeed, been given divine direction.

  On Sunday, Rick and I sat together during the worship service. Our singing was a bit more contemplative and our prayers a bit more intense — both those of confession and those of thanksgiving. Ken Hicks’s sermon — on forgiveness and thankfulness, on restitution and redemption — was more meaningful than he could have ever imagined.

  Sunday worship — it was a good way to start a new week. The old and dark washed away; the new and vibrant ushered in. That week, lives were lost, lessons were learned, beautiful births attended, and lasting memories created.

  The doctor’s life always has been and always will be a strange and mysterious combination of opposites — parallel emotions that weave together into the fabric of practice. I was grateful to have been given the vision to see that, even when the threads of life are worn or stretched, the Master Weaver is still there — compassionately, competently, and carefully overseeing the creation of a beautiful tapestry, interlacing both dark and light threads into the lovingly created masterpiece embroidery he is accomplishing in the life of each of his children.

  chapter twenty-one

  THE RIFLE

  Dr. Larimore!”

  I didn’t recognize the voice, but her tone was frantic.

  “You gotta come over to the birthing room stat! We got a crazy woman here. She’s crazy, I tell ya!”

  By now I was wide-awake and sitting on the side of the bed. The clock said 2:13. “Who is this?” I asked.

  “It’s Marlene Wiggins. I’m a part-time nurse here at the hospital. The Cherokee Indian Hospital transferred a young woman over here who’s in labor. By the time she got over here — ”

  I heard a loud noise and screaming in the background.

  “Dr. Larimore! Come stat!” Then the line went dead.

  I quickly pulled on my scrubs, jumped into my clogs, and ran out of the house and across the street to the hospital. As I ran toward the birthing suite, I could hear a noise that sounded like someone beating a pot with a spoon.

  As I rounded the corner, I saw a metal object flying across the hall, just missing the head of a nurse ducking in the hallway, who I presumed was Marlene Wiggins.

  “What in tarnation is going on?” I exclaimed as I ran up to her.

  Miss Wiggins, obviously flushed and flustered, pointed at the birthing suite. “She’s gone wild, Doctor. She’s just plain loco.”

  I looked into the birthing suite and saw a most amazing sight through the open door. A short and obviously very pregnant girl, who looked to be sixteen or seventeen, was completely naked and holding an IV pole like a sword. Her hair was disheveled, and her eyes were open wide. She was speaking a language I didn’t recognize as she slowly turned around the room, looking for imaginary enemies. Whenever she would see one, she would shriek and use the IV pole to stab at it.

  Then she slowly turned and faced me. Her eyes widened even further, and she began to run toward me. Instinctively, I pulled the door shut and held it as I heard the IV pole crash into the door again and again as wild shrieks bounced off the door and walls.

  I held the door as firmly as I could. After a moment or two, the shrieks ebbed into sobs. I opened the door a crack and saw the patient lying on her side on the floor, moaning and sobbing, obviously in the middle of a contraction. I could clearly see her perineum; thankfully, the baby wasn’t crowning. I softly shut the door and turned.

  Marlene Wiggins was joined by a small crowd appearing from the nurses’ station like shell-shocked soldiers coming out of a bunker that had been bombed. There were two other nurses, an orderly, two EMTs, and one Mrs. Black Fox! Mrs. Fox was one of the tribal matriarchs in Cherokee who would occasionally accompany to our birthing suite women in labor. Our initial meeting, during the birth of her great-great-granddaughter, had been unpleasant and dramatic for us both — but since then we had established a mutual-admiration society of two.

  Mrs. Fox walked up to me. “Her name is Vanessa White Owl. She’s fifteen years old,” she stated, almost in a whisper. “She’s chanting in an ancient form of Cherokee I’ve not heard in many years. Her baby is due next week. It’s her first baby, and she’s had no medical care that I know of. When she went into labor at home, a neighbor called me. By the time I got to her house, the ambulance had come and t
aken her to the hospital. The neighbors say she is sometimes possessed by an evil spirit. I think they are wrong.”

  I listened to Mrs. Fox with one ear, and with the other I listened to the soft sobs and moaning coming from the room behind me.

  “Why do you think they’re wrong?” I asked of this woman I had learned to admire for her strong intuition.

  Mrs. Fox smiled and answered softly, “I think she has several evil spirits in her.”

  Well, this is definitely not covered in the Williams Obstetrics textbook, I thought to myself.

  “Dr. Larimore,” added Miss Wiggins, “she wouldn’t let me take her vital signs or examine her. Once we got her in the room, she just started goin’ nuts.”

  Don, one of the EMTs, spoke next. “We were called to transfer her here from the Cherokee ER. Her vital signs there were normal. But she was beginnin’ to act agitated and didn’t seem to be hearin’ what the staff there was sayin’. They drew some blood and got a urine sample for routine labs and for a drug screen. Mrs. Fox came with us in the ambulance, and whenever the patient became agitated, Mrs. Fox would talk to her in Cherokee and calm her down.”

  “Can you calm her down now?” I asked, looking down at the diminutive ancient woman.

  She calmly shook her head. “The spirits have control of her now.”

  All of a sudden I heard a cacophony of loud banging. I turned back to the door and cracked it open. To my horror, Vanessa was using the IV pole like a hammer to ravage the oxygen and suction outlets behind her bed.

  I closed the door and turned to the orderly. “Turn off the oxygen and suction valves to this wing stat!” He nodded and left.

  I turned to Marlene. “Call the police and get them up here now! I need this area secured. Also, have the ER nurse call in the OR team and the on-call surgeon. I want them to set up for a stat C-section.”

  Marlene’s eyes opened as wide as saucers.

  “Now, Miss Wiggins!”

  She turned to run to the nurses’ station. I turned to the EMTs. “Don, can you get on your radio and call Millie down at county dispatch? Have her find Oliver Trimble. He’s the wildlife and fisheries officer. Tell Millie to call him at home. If he’s not there, get Millie to have the sheriff find him and get him here stat. Tell Millie he must bring his rifle with him!”

  “His what?” asked Don.

  “You heard me. He must bring his rifle with him!”

  Billy, Don’s partner, smiled. “His rifle? What you gonna do. Doc? Shoot her?”

  I nodded. “That’s exactly what we’re going to do.”

  I heard a gasp and turned to see Mrs. Fox, her hand over her mouth in shock, slide down the wall into a squatting position and begin chanting in Cherokee.

  chapter twenty-two

  THE SHOT

  My men have the wing secured,” Carl Arvey told me.

  Bryson City’s police chief, though short, was stocky and strong. I turned and could see two of his officers at the entrance to the wing. “We brought some Mace, and we’ve even got a tear gas canister. How ’bout we toss that in there? That’ll calm her down.”

  “I don’t think that’s necessary, Carl. I wouldn’t want the chemicals to affect the baby, after all.”

  “No problem,” the chief assured me. “We could just toss a stun grenade in there. That would shock her enough so my men could get in there and restrain her.”

  “Carl, I don’t want to risk harm to the baby.”

  “You sure?”

  “Chief, to tell you the truth, I’m not sure about anything when it comes to a case like this.”

  “Well, you want me to call in a couple of my young officers over here? They could rush the patient and take her down and secure her so you could give her a shot or something.”

  I smiled at his approach to the problem. “No thanks. She seems fairly calm at the moment. I’m just going to let her labor until Oliver gets here.”

  “The wildlife officer?”

  “Yes, one and the same.”

  Before Carl could respond, I heard a wild scream and another torrent of sounds and thuds from the room. I ran over to the door and slowly cracked it open, stunned by the sight that met my eyes. The patient was now standing on the bed — still completely naked — once again brandishing her IV pole like a sword, swinging it wildly from side to side. With each swing, another small hole appeared in the room’s Sheetrock.

  I closed the door and looked at Don and Billy. “What’s Oliver’s ETA?” I asked, sure that my voice sounded strained.

  “He’s on his way,” Don answered. “At least that’s what Millie told me.”

  Another scream from the room was followed by another torrent of Cherokee words mixed with curse words in English, which then dissolved into moans as Vanessa went into another contraction.

  “Doc,” said Carl, “I’m gonna have to send my men in there. They can get her down and subdued without harmin’ her, I’ll promise you that!”

  “I appreciate it, Carl, but it’s the baby I’m most worried about.”

  “Walt!”

  I turned to see Dr. Mitchell walking rapidly past the guards and toward me.

  “Evening, Mitch.”

  “What’s goin’ on?”

  I quickly explained the situation to Mitch and described my plan.

  “You sure?” he asked.

  “Yes sir. I think it’s the best chance we have of not harming the baby.”

  “Then I’ll get scrubbed and get the OR ready. Jenzen’s already back there and ready to give anesthesia. Once she’s down, you get her back to me as fast as possible, ya hear?”

  “I will, Mitch.”

  “And keep her well oxygenated, ya hear?”

  “Yes sir.”

  He turned to walk away and then caught himself — turning back to face me and extending his hand to me. We shook as he whispered, “Good luck, son.”

  “Thanks, Mitch,” I answered as he turned to leave.

  I turned to Mrs. Fox, still seated on the floor, still softly chanting prayers. I walked over and sat by her.

  “Excuse me, Mrs. Fox.”

  I waited for the chanting to stop, and then the wizened woman looked up at me. “Yes, Doctor.”

  “Can you tell me what Vanessa is saying when she’s yelling in there?”

  Mrs. Fox nodded. “She wants the baby out and says that her heart is in pain.”

  “Does she say what type of pain? From the contractions?”

  “No,” she answered softly. “It’s heart pain.”

  “Chest pain?” I asked.

  Mrs. Fox looked down and whispered, “No. Pain from the rape.”

  “The what?” I exclaimed.

  “The rape. She’s yellin’ that the pain she’s havin’ is from bein’ raped by her cousin. She’s cryin’ that she’s carryin’ his baby and that the baby is evil. She’s askin’ the evil spirits to take the baby. And if they won’t, she’s askin’ the Great Spirit to take her.”

  “Do you want to try to talk to her?”

  Mrs. Fox shook her head. “When a woman is in hard labor, it’s hard to talk sense to her.”

  I smiled and nodded in agreement.

  “But when she thinks the evil spirits are in the room, anyone who enters will be considered evil. I think you’ve been wise to wait.”

  “Mrs. Fox, I can’t wait much longer. I’m worried about her baby.”

  The woman looked up at me with her deep, dark eyes. “Even the baby of a rape?” she asked.

  I nodded. “Yes, Mrs. Fox, even the baby of a rape.”

  She looked away, silent for a moment, and then commented, “But this baby was conceived in evil. That makes the baby evil.”

  I paused for a moment, not sure how to respond. I wanted to be respectful, but my heart was deeply troubled by her words. I quickly prayed, Lord, give me words that are compassionate but true.

  I took a deep breath and then began. “Mrs. Fox, I deeply admire the tradition of your people. There’s so much I need to
learn from your nation — and there is much I’ve learned from you personally. But I believe that what you are saying is deeply wrong.”

  I could feel her staring at me as I continued to look across the hall — at the door of the birthing suite that hid a woman writhing in a pain I couldn’t even begin to imagine.

  I continued. “Mrs. Fox, I don’t believe a nation that is just and good will condemn an innocent baby for the sin of its father. That child is innocent. The biological father committed the evil — an unspeakable evil. But doesn’t this blameless baby deserve the best we can do?”

  I looked at Mrs. Fox, who glanced away for a moment. When she looked back, her eyes were misty and her voice soft. A solitary tear fell down her left cheek as her lips very subtly began to quiver. As she composed herself, she whispered, “In the old days, the child of rape was considered evil and was taken outside the village and left alone.”

  “For what?” I asked.

  “Either to die and be eaten by animals or to be taken by the Great Spirit.”

  I thought for a moment about the horror of this practice. And then I had a thought. “Mrs. Fox, why would the Great Spirit want a child if he or she were evil?”

  I could see that she was deep in thought and sensed I should continue. “Mrs. Fox, what conceived the child was an evil act —horrible and terribly wrong. But the baby isn’t guilty, is he?”

  Slowly, almost imperceptibly at first but then more firmly, Mrs. Fox shook her head. “No, she is not!”

  “She?” I asked.

  “Yes, the baby is a girl.”

  “How do you know?”

  “I just do. I’ve never been wrong about this. It’s part of my gift — knowin’ the sex of the babies.”

  In the room across the hall, I could hear the patient’s moans crescendo as another contraction wracked her body. My worry titer, which was already high, was now approaching a near-panic level. I could sense terror again welling up in my soul. At that same moment, I thought of the words of the Great Physician him-self: “Do not be afraid.” I took a deep breath, praying for calmness and the success of my plan. Then I had an idea.