Colvin used money he had saved from trapping furs to buy for four dollars his own copy of a big medical dictionary, and when he had stored it in memory within two months, to order for one dollar a year’s subscription to Medical Bulletin: A Monthly Journal of Medicine and Surgery, and for three dollars a year’s subscription to Journal of Laryngology, Rhinology, and Otology, and his faithful perusal of each month’s issue of these magazines made him even more knowledgeable and au courant than Kie himself. It was through these magazines that Colvin discovered two rather astonishing facts about medicine: first, that in order to practice the profession legally, you have to have something called an M.D., and secondly, that the only way you can get an M.D. is by going off somewheres to something called “medical school.” Colvin was appalled. Ever since his brief attendance at the Stay More institution of lower learning, he had had a poor opinion of “school,” and he couldn’t quite understand why it was necessary to sit at a desk facing a teacher in order to learn medicine. His memory of the one afternoon at the Stay More school came back to him, and he tried to conceive of sitting at a desk and raising his hand to name the parts of the gastrointestinal system. If he left one out, would the teacher flog him?
But the more he thought about this business of medical school, the more it bothered him. Finally he asked Kie, “Did you ever go to medical school?”
Kie looked around, from left to right, as if there might be somebody else within earshot, and then he raised his index finger to his lips. “Colvin,” he said, “maybe they’s some fellers down to Little Rock has been to medical school, and maybe you’d even find a doctor or two in Harrison who might at least have walked down the hallways of a medical school, but most Arkansas doctors learnt their trade the same way I’m a-learnin you: they just apprenticed theirselfs to somebody who had already learnt it.”
Colvin tried to forget the matter, to bury it in the back of his too active mind, but over the years it would occasionally creep up on him again. On Colvin’s sixteenth birthday, Kie discovered that there was not one single question he could ask of Colvin, on any medical subject, which he could not answer, not even something like “How do you induce spontaneous remission of cancer?” or “How do you restart a heart which has stopped?” So Kie presented Colvin with that most delightful of all treatises, the fourteenth edition (carefully revised and greatly enlarged) of Dr. D.W. Cathell’s Book on the Physician Himself and Things That Concern His Reputation and Success. Kie declared that he had nothing whatever left to teach Colvin; that the Cathell book would instruct him in all the matters of behavior, conduct, ethics, and other subjects above and beyond the acquired science that he had already learned.
There were tears running down the wise, kind instructor’s face, the first time that Colvin had ever seen him weeping, and Kie wrung his hands, the first time that Colvin had ever seen him wringing. “Son,” Kie said, although he had never called him that before and really didn’t mean it in a paternal so much as a sociable way, “I’m a-gorn have to send ye out into the world, all on yore lonesome. You’ll jist have to set up yore own practice somewheres, anywheres so long as it aint in my territory. There’s jist a few things you’ve got to promise, and I want ye to recite these after me.”
And Kie had Colvin raise his right hand and put the other hand, lacking a Bible, on top of the Cathell book, and repeat after him:
I swear that
I’ll be a-thinkin on my ole teacher the exact same way I’d think on my own daddy, and I’ll be a-helpin him out if he ever needs it.
I’ll be using everthang I learnt to make folks well, but not never to hurt ’em or wrong ’em.
I’ll not never be giving no man nary drug that would harm him even if he baigs me fer it, nor will I never be giving no womarn a abortion even if she baigs me fer it.
I’ll not never be a-gorn inter nary a house except to go in thar and heal the sick. I’ll not never go inter nobody’s house to do nothing wrong or seduce some pore gal or feller neither one.
I’ll not never be a-blabbin nothing I hear or learn that aint nobody else’s business to them or nobody, so help me ye gods.
When Colvin had finished swearing this oath, Kie said, “Now you go on and git out of here. You are the seventh son of a seventh son, and any durn fool knows what that means: it means you are a doctor in spite of yourself, it means you couldn’t never stop being a doctor even if you tried. And it means you can cure any ailment under the sun; you can heal any complaint that ever was or ever will be.”
Colvin could not budge. He just stood there, with his mouth open, and his own eyes a-watering up like Kie’s, and finally he asked, “Whose seventh son am I the seventh son of?”
“Ole Lizzie Swain’s, rest her soul,” Kie said. And even though he had ordered Colvin off the premises of the cave-house, he relented long enough to tell Colvin the complicated story of how Elizabeth Hansell Swain had come from Cullowhee, North Carolina, with her thirteen children, arriving in Stay More not long after the brothers Jacob and Noah Ingledew had already founded it and named it, and the youngest of her children, her “least’un,” Gilbert, grew into rambunctious manhood impregnating females hither and yon all over the goddamn county, and later opting for his middle name, Alonzo (“I hope ye don’t never choose to be called by yore middle name, U, which sounds like an Englishman pronouncing ‘Hugh’”), under which Alonzo became a doctor after training with Kie—“So you’d best not never practice in his territory neither.”
“Uncle ’Lonzo is my actual paw?!” Colvin asked, dumbfounded. “But how d’ye know I’m his seventh son?”
“Aw, hell, Colvin, he jist might’ve had seventeen sons, fer all I know. And maybe fer all he knows, either. But I’m jist a-tellin the story the way she ort to be told. Now go on and git out of here.” Kie turned his back so that he would not have to watch Colvin leave, because there is a wise and venerable belief, which has both a practical and a pretty reason, that you should never watch anybody go out of sight.
Colvin packed a few of his belongings—his Cathell book and back issues of his medical journals and his clothes, and his copperhead Drakon wrapped in a burlap sack—into the saddlebags of Pegasus, and headed west. His initial intention was to keep going west until he got to California. He had heard many marvelous things about California, what a great land of opportunity it was, and his medical journals had led him to know that it desperately needed some good doctors. Isolated in the cave-house as he had been, Colvin had never heard the legendary Curse of Jacob Ingledew, which doomed any Ozarker who dared venture into California, doomed him into a bad life of ill luck, sickness, poverty, even death.
It was just as well, because the closest Colvin ever got to California, on his journey westward, was the village of Stay More, where, the first evening into his journey, Pegasus came down with what veterinarian Colvin correctly diagnosed as encephalomyelitis. He could have prevented it by immunizing Ole Peg for one season with a chick-embryo vaccine, but he had not, and there was no cure once the virus had taken over. Pegasus died.
Afoot, Colvin was stuck in Stay More…not a bad place to be stuck, come to think of it, in fact the best place on earth to be stuck, but Colvin still remembered too vividly the beating at the schoolhouse and the injunction never to return. That was the third factor giving him pause, the other two being the presence on Main Street not only of the office and clinic of Uncle Alonzo, the man presumed to be his father, but also, directly across the street from it, another office and clinic, that of John Mabrey Plowright, a Stay More native who had done gone and apprenticed himself to an actual M.D. up at Harrison, and after a year’s apprenticeship and perhaps some mail-order lessons from a St. Louis diploma mill, had erected a stake in his front yard with a shingle hanging from it: J.M. PLOWRIGHT, M.D. FAMILY MEDICINE. Colvin stood on Main Street for a while, staring at this shingle, trying to determine how “family medicine” was any different from any other kind, unless possibly it meant as opposed to medicine of individuals who didn’t live in
families, and also thinking about the circumstance whereby the population of Stay More had now grown to the point where it could support two physicians—not a bad idea, because it meant the two would keep each other in line, provide healthy competition, offer second opinions, and ideally assist each other in complicated operations, not to mention being “on call” when the other had gone fishing or something.
Then Colvin turned, climbed the steps of the other doctor, knocked, and when the man appeared, said, smiling sweetly, “Howdy, Paw.”
Alonzo said, “Why, howdy there, Col boy,” and then he coughed and inquired, “What didje call me?”
“‘Paw,’ Paw,” Colvin said, like naming the Asimina triloba tree, which was overabundant in the woods and fields of Stay More. “Kie threw me out, Paw. I reckon he’s done already taught me all there is to know about doctoring.”
“Is that a fack, now?” Alonzo said. “You don’t mean to tell me.” He coughed again, and Colvin, detecting that the breath was also bad, realized it wasn’t merely from nervousness or discomfort; his father likely had a bronchiectasis, but damned if Colvin was going to write prescriptions for lipiodol and iodide of potash for a man capable of writing his own. “So where are you off to?” Alonzo asked.
“I was thinkin about Californy,” Colvin admitted. “But my horse broke down. You could either give me another horse, or you could move over and make room for a third doctor in this town.”
“Hellfire, boy, didn’t Kie warn ye to stay out of my territory? He tole me to stay out of his’n, and I don’t aim to let ye practice in mine. I’ve already got all the rivalry I can handle from Jack Plowright across the road yonder.”
“Tum bene fortis equus reserato carcere currit,” Colvin began to recite, because doesn’t any kid want to impress his daddy? “Cum quos prætereat, quosque sequatur, habet.” And when Alonzo failed to look impressed, only annoyed, Colvin offered the translation, “A good horse runs better if he’s got other horses to beat out.”
“I caint afford to give ye a new horse,” Alonzo said. “You’ll jist have to find some other way to git to Californy.”
“That aint what I’m talkin about,” Colvin said. “I’m talkin about maybe you and Jack Plowright both would be better doctors if you had a real thoroughbred to have to run against.”
“Shit on a stick!” Alonzo grew red with anger. “Sonny boy, you aint but a little spadger still wet behind the ears! You caint be more’n what? Fifteen? Sixteen year old? You think anybody would trust their life to you? Hell, you couldn’t even—” Alonzo coughed, gagged, spit up some blood into his handkerchief, and then had another paroxysm of coughing. Colvin was sure it was generalized bronchiectasis, but he wanted to be able to discount emphysema in association with it.
“Dad, what are you a-takin for that there cough?” he asked.
“Jist horehound, and a bit of tea from butterfly weed root,” Alonzo said.
“Could I see yore hand.” Colvin took his father’s hand and checked it for clubbed fingers and hypertrophic osteoarthropathy, apparently negative. “Doctor,” Colvin said respectfully, “if ye don’t mind, I’d like to do a bronchoscopy.”
“Say what?” Alonzo said.
“Doctor, we need to rule out any furrin bodies in yore trachea and bronchi,” Colvin suggested, “if ye could lend me the borry of yore bronchoscope.”
“Aint got ary of them newfangled gadgets,” Alonzo admitted.
“Do ye reckon Jack Plowright might have one?”
“Maybe, but I aint about to ask ’im fer it.”
“Then I’d best do it fer ye, Paw,” Colvin said. “I’ll be right back.” And before his father could stop him, he had gone out and crossed the road and knocked on the other doctor’s door, and when the man answered, the man who would become his lifelong competition and his nemesis, Colvin squared his shoulders and said, “Doctor Plowright, sir, I’m Doctor Colvin Swain, nephew of the good gentleman across the street, who, I’m a-feared, may have contracted dilatation of the bronchi with secondary infection, most likely unilateral bronchiectasis of the lower lobes.”
“Serves that bastard right!” Jack Plowright exclaimed. “Jist what he needs!”
“My bag is missin its Hampton bronchoscope,” Colvin declared. “Could ye see yore way to lendin me the borry of your’n, fer jist a secont?”
“Wal, I don’t rightly know as I’ve got ary,” Doc Plowright said. “What do they look lak?”
Colvin described the instrument and offered to help Doc Plowright search among his apparatus for it, and sure enough, there it was, although it wasn’t the Hampton but the Crowell model, which would do. “I don’t reckon it’s been sterilized, if ye aint never used it?” Colvin asked, and then he said, “Thanks a load. I’ll be back with it lickety-split, afore ye even notice it missin,” and he took the instrument to his father’s and sterilized it, and said, “Doctor, if you’ll be so good as to open wide, and hold real still…” and he performed the bronchoscopy, ruling out foreign obstructions. He borrowed his father’s microscope to examine the sputum and determine which organisms were involved in the infectious process. Then he mixed up a dose of wild cherry syrup with potassium iodide in it, administered a teaspoon to his father, and told him, “Now, Doctor, I’m a-gorn to have to put ye into a position for postural drainage.”
And he showed his father how to hang over the side of the bed with his head on the floor, so that gravity would drain the pus from the dilated bronchi. “How long’ve I gotta stay this way?” Alonzo asked.
“Months, even years maybe,” the young doctor prognosed, and although he did not mean that his father had to stay constantly in that awkward upside-down position, he did honestly mean that his father might have to carry out the procedure every morning and evening for a very long time.
While his father was hanging upside down over the edge of the bed, Colvin took over his routines, borrowed his black bag and his horse, and successfully treated a variety of Stay Morons for a variety of ailments: sigmoid diverticulitis, tetany, mercury poisoning, gout, scurvy, hookworm, whooping cough, asthma, diphtheria, and rabies. Although there was much skepticism among the citizenry over Colvin’s qualifications and credentials, owing largely to his extreme youth, a singular fact of his practice was soon noticed and widely voiced: he never lost a case. Not one of his patients ever failed to be cured, not even those suffering with renal failure, anthrax, snakebite, general paresis, and gunshot wound.
So famous and popular did Colvin become that the only way Doc Jack Plowright could hope to compete with him was by attempting to beat him to the patient. This became literally a horse race in which Doc Plowright would jump atop his nag, Lucifer, and try to reach the patient’s house before Doc Colvin Swain, riding his dad’s sorrel mare, Sadie, could get there. Stay Morons took to pari-mutuel betting on which of the two would win. Lucifer actually was the better animal, and often Doc Plowright arrived first, but just as often he made the wrong diagnosis or prescribed the wrong treatment, so people who sent to the village for a doctor learned to instruct the messenger to be sure and give Doc Swain’s mare Sadie a good drink of coffee mixed with corn whiskey in order to speed her up. Doc Plowright began to hate the younger Doc Swain as much as, or more than, he had ever hated the older Doc Swain, and he would spend the rest of his life dividing his time between his patients and his attempt to sabotage his competition. Indeed, the only way he managed to keep any patients was by charging only half as much as the Swains did, whatever they charged, even if it was produce or livestock. If you had to give one of the Doc Swains a whole hog to get your appendix removed, Doc Plowright would do it for you for only a piglet.
Over the years, Doc Plowright became known as the poor folks’ physician, and the Doc Swains were viewed as limiting their practice to “quality.”
Socially, no such distinctions existed. Socially, Colvin Swain saved the life of Oren Duckworth and thereby earned his right to free mingling with those who had originally driven him away from the Stay More school
yard. Oren lost the ability to breathe, and while Doc Plowright treated him for pulmonary disorders and the older Doc Swain attempted to treat him for hemolytic anemia, Colvin’s stethoscope told him that it was congestive heart failure, specifically left ventricular, and taking the patient’s history, deduced that it was associated with syphilitic disease of the aortic valve. Colvin sedated Oren with chloral hydrate, and then he addressed the assembled family: “Do any of y’uns know what foxglove looks lak?” Oren’s sister Dulcie was sent out to gather a quantity of the leaves of the foxglove flower, from which Colvin extracted the glucoside digitalin, and administered it to Oren along with one of Kie’s favorite incantations, with pronounced beneficial results. Oren, recovering, said, “Doc, I shore am sorry fer that time I whupped ye at the schoolhouse.” And Oren’s pretty sister Dulcie walked him to his horse and told him, “If ever you’d like to have a sweetie, I reckon I could step out a time or two.”
But “stepping out,” in Dulcie’s view as well as that of the typical Stay More girl, did not necessarily mean leaving the house. For all of the still-told stories of how the older Doc Swain had cajoled hordes of females into the back brush and the hayloft and even the creek bed, the younger Doc Swain was to discover, when he finally had a spare moment to experiment with courtship, that the best he could hope for was a usually chaperoned situation in which some member of Dulcie’s family was nearby, possibly in the same room, while Colvin and Dulcie attempted to make conversation. They had little to talk about. After discussing the weather and the chances of rain or continued drought, they would attempt to tell the latest joke that they had picked up, but most of Dulcie’s jokes were silly or simple, and most of Colvin’s were somewhat risky, and neither of them laughed at the other’s jokes. Dulcie, having observed that her mother and her mother’s friends loved to discuss their illnesses and physical problems, tried to get Colvin to talk about his patients, but he never forgot Kie’s fifth precept, namely, that the good physician never discloses any information about his patients, so Colvin would not even tell Dulcie who he had been treating, let alone for what. Usually, Colvin and Dulcie sat in silence until it was time for him to go.
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