Bryson City Tales

by Walt Larimore, MD

  She paused again, then snarled, “Yes. I know.”

  Thankfully it wasn’t long before I was informed that Clem lived up in a hollow near town, and Millie promised she’d call the rescue squad—who also took calls at their homes—to meet me at the house.

  I quickly pulled on some scrubs, threw on a coat, and grabbed my traditional physician’s black bag. As I started the car, I felt myself shudder. Instead of being the hero, would I lose my first patient? Imagine the scorn. Imagine the gossip—uh, news—coming from the local radio at 6:00 A.M. tomorrow. I could hear Gary Ayers’s voice. “Well, the new doctor in town, Doc Larimore, lost a patient last night. He was doing an ill-advised home delivery at Clem’s place . . .” I felt my pulse rise with the RPMs of the small engine as I raced down the hill behind the hospital—never thinking of stopping by the ER to ask the ER nurse, Louise, to come along with me.

  I wiped the sweat from my brow as I raced across the Tuckaseigee River bridge and through the town’s two stoplights. My thoughts were racing faster than the engine. I wasn’t sure exactly what was in my black bag. It had been given to me at the beginning of my clinical rotations at the LSU School of Medicine in New Orleans—which I called “Harvard on the Bayou”—in 1975. The bag had been a gift to each medical student from the Eli Lilly Pharmaceutical Company.

  So, I thought, what’s in the bag? And, Will it be of any help? And, What if the ambulance doesn’t get there? All I could think of was getting someone to boil some water. I had no idea why you boiled water before a home delivery. I just knew I had seen it done on one of the medical shows on TV. I just didn’t know why.

  As I rounded the curve leading into the hollow, I pressed the Toyota, and the frantic search began. Which house was it? I found myself saying a little prayer for divine guidance. Driving past a number of homes with no porch light on, I drove around two bends and through what appeared to be a field. Then I spotted a small farmhouse—and, sure enough, the porch light was on. Lord, I quickly prayed, grant me wisdom and calmness. I turned up the driveway.

  As I pulled in by the front of the house, I was surprised to see a middle-aged man sitting, rather calmly, in a rocking chair on his front porch. He stood up as I rushed from the car, forget ting the black bag. He tossed aside the straw on which he’d been chewing, and as he reached the bottom step, stopping only long enough to spit out a small stream of chewing tobacco, he proclaimed, “She’s in the barn.” He then turned and began to walk toward the barn. “Let’s get going, son.”

  I stopped—stunned. As he approached the barn, I stood, mouth agape, thinking, He’s gotten his daughter pregnant! This first perverse thought was followed by others even more nefarious. He’s gotten her pregnant, and now I must complete the dirty deed!

  I could just hear Gary Ayers proclaim on the morning news, “The new doc, who we thought was well trained and qualified, actually delivered an illegitimate child last night on School House Hill—the result of perverted incest—under the attempted cover of a moonless night. In the dark and in secret, he attempted to cover up this most heinous of sins. Now incarcerated in Swain County jail, he is expected to be quickly tried and, after permanently losing his license to practice medicine, will be transported to the state prison in Statesville to serve his life term.”

  The farmer turned to shout, “Hurry up, son. She’s gonna deliver!”

  As I began to follow quickly in the farmer’s steps, I heard a sound that chilled my blood.

  Could it be?

  It was.

  It was a long, low-toned, painful, pleading—“Moooooooooo.”

  It couldn’t be. It couldn’t be.

  As I ran into the barn, I saw my first full-term maternity-care patient in private practice. I had delivered several hundred babies in medical school and residency, but never a baby like this—a white-faced heifer locked in breech—with the farmer placing the mom-to-be in a headlock device.

  chapter nine

  THE DELIVERY

  It’s a bull!” I shrieked. “You called me all the way up here to take care of a bull?” exclaimed the inexperienced people-doctor.

  The farmer turned to look at me. Now it was his turn to be shocked. “Son,” he exclaimed, “this ain’t no blasted bull.” (Never had a truer statement been uttered—pun intended.) “This here’s a yearling heifer. She’s a she, not a he, and she’s in trouble. And, she and I really need your help. Now!”

  “But I’m not a vet.” I made this obvious statement innocently “But I’m not a vet.” I made this obvious statement innocently enough. I did not know that the county had no veterinarian. I did not know that the physicians in town were expected to treat all the county’s residents—human and otherwise. I did not know that, during my career in Swain County, I would learn to sew up pig-gored hunting dogs, to do an ultrasound on dogs and cats during pregnancy so that the owners could know how many young ones would be available for sale, and to X-ray and bandage animals of every sort that had been hit by automobiles. At that moment of medical crisis in Clem Monteith’s barn, I simply blurted out helplessly, “But I’m not a vet.”

  He looked incredulous. “You’re a doctor, aren’t you? Son, let’s just get to work. Even you can do this.” It was clear that the respect usually accorded to physicians was rapidly eroding in this particular case. Obviously the profession’s reputation needed to be protected—and maybe, in this case, resurrected.

  “Tell me what to do, and I’ll do the best I can,” I announced.

  Clem looked at me like a coach knowing that, if the game’s going to be won, he’d have to encourage his freshman quarterback. Calmly he reassured me, “I know you will, Doc. She’s real special to me. I need help. That’s why I called you. Let’s get to it.”

  He patted the mom on her rump, lifting her tail. I could see two tiny hooves protruding from the genital area. On the floor, between the north end of the south-facing cow and the wall, was a chain connected to a “come-along.” A come-along is a device used to pull a chain connected to a load, and it was most frequently utilized in the county for pulling logs up inclines to the logging roads above.

  Now the plan was becoming clear—even to this rookie.

  After gently wrapping a towel around the calf’s rear legs, Clem reached down to grab his end of the chain and then wrapped it slowly around the now-padded legs. As he did this, I picked up my end of the come-along and inserted its hook into an eyebolt attached to a pole at the edge of the pen.

  “Begin to tighten her up,” he shouted to me.

  I could feel the sweat trickling down my brow—even though the evening was cool—and my palms were sweating. As I slowly ratcheted the come-along handle, the chain rose from the floor between us and began to tighten.

  The mom-to-be tried to look back at us. Her big brown eyes seemed to plead with us to be gentle.

  “Doc, be careful. Try not to go too fast or too tight. Let’s don’t hurt this little one.”

  I could sense his caring and compassion. I suddenly realized that his fondness for his “patient” was not really different from mine. There was at once, and very suddenly, a connection between this farmer and me. Two birth attendants working together—attending the entry of a new life into the crisp mountain air. Without us, this little one—and maybe its mom—likely wouldn’t make it. With us they just might. And the odds depended on one very caring and experienced farmer and one very nervous and green, young physician.

  As the chain began to pull the calf’s little legs, the farmer took off his shirt, threw it to the side, and bent over a bucket of water. He pulled out a bar of soap that was floating in the bucket and began to lather up his right hand and arm. At first I thought, Why in the world is he scrubbing up? And then, Why in the world is he scrubbing only one arm? Then it became clear. He gently placed his right hand and then his right arm up the heifer’s birth canal.

  “I’ll see if I can help you out a bit, darling.” Her body tensed as she sensed him working. I cranked, she pushed and bellowed, and
he manipulated the little one out of the birth canal. Slowly the body began to ease out of the canal. As I was tightening the come-along and sensing its progress, I looked at the come-along and then at the calf being slowly delivered. I began to imagine this device in the hospital delivery room. I could hear Gary Ayers announcing, “The newest doctor in town, Dr. Larimore, has become nationally renowned for his introduction of the ‘birthing come-along’ that he uses in the Swain County General Hospital birthing suites. This specialized and sterilized come-along, similar to the come-alongs used by loggers, has helped the young physician through many difficult deliveries—literally pulling the doctor and newborn out of trouble.” My thoughts were interrupted.

  “Back off, Doc!” Clem shouted. “Back off and get over here!”

  I loosened the come-along and ran to his side.

  “Here,” he said, as he gently guided my hands under the calf’s warm and slimy body. “Help me hold her up!” I placed my arms under the “baby.” Then Clem sensitively and carefully loosened the chain from the hooves.

  He looked at me. “You go ahead and deliver her,” he said, smiling. My mind flashed back six years earlier to the moment when the chief resident in obstetrics at Charity Hospital in New Orleans allowed me to perform my first delivery. “Here, Walt,” Dr. Warren Lombard gently instructed, “come here. You go ahead and deliver her. You can do it. I’ll be right here with you.” And then this gentle man, this expert obstetrician and superb teacher, had guided my hands with his as I attended my first human birth.

  “Careful, son, careful,” the farmer counseled, as I was transported from New Orleans back to the barn. I began to pull gently. I looked up at the farmer. His eyes were saying, “You can do it, son, you can.” Even the mom-to-be, now looking at me quietly, seemed to be confident. So I began to pull, and ever so gently the calf began to come out. First the shoulders. Then the neck. Before I knew it, the head emerged.

  I guess I was expecting a baby the weight of those I had delivered while in residency, not the eighty-pounder I was now delivering. When she was born, I either weakened or couldn’t bear the weight alone—and she and I and the farmer all collapsed to the hay-covered floor.

  The calf immediately began to breathe. The farmer got up to release the mom from the headlock. All I could do was stare in disbelief. There she was—half in my lap and half on the floor—my first full-term delivery in private practice. My first complicated delivery. My first vaginal breech delivery. Sure it was a heifer, but what a beautiful calf she was! She had lived. Her mom had lived. I had lived. The sudden rush of emotion surprised me. I felt tears stinging my eyes.

  The mom turned and began to nuzzle and lick her baby. With this stimulation, the calf began to struggle to get to her feet. I released her and she wobbled to her mom. As they touched noses and the mom cleaned the newborn, I could only sit and watch with admiration the circle of life, once again completed. I felt so fortunate to be there to witness once again—up close and personal—the continuation of life, the miracle of life. Dear Lord, I silently prayed, thank you for guiding my hands. Thank you for this special experience.

  Unknown to me, during the delivery the paramedics had arrived. After getting to the barn, all they could do was watch a new, young physician they had never met attend his first delivery. They stood quietly by, probably not knowing whether to laugh or groan.

  They watched the farmer as he offered me his calloused, hardened hand and I took it. He pulled me to my feet. And with an uncalloused and soft heart he gave me a hug. “Thanks, Doc. Thanks. You helped me save the calf.”

  When he released me I could see that his eyes were a bit misty. “You did good. Real good.”

  I was taken aback by the moistness in his eyes. Then it struck me. This was not just an animal to him. This yearling heifer was something more special than that. It was my first inkling of a mountain reality—that a man’s herd was an extension of his family, especially if he had only a few animals. His life revolved around his animals and his sustenance depended on them. He grew to love each one of them, to name them, to learn their peculiarities and their habits. He could read them—and the weather—better than you or I could read the newspaper. My admiration and respect for the farmer grew immensely in just a few microseconds.

  “No,” I told him, “thank you. I appreciate the opportunity and the teaching.”

  He smiled. As I turned toward the door, for the first time I saw the paramedics. They too were smiling from ear to ear. As I approached I heard the mountain drawl of one I would come to know so very well over the years. “You the new doc?” asked the shorter and slightly more portly of the two.

  “Yes, I am. I’m Walt Larimore. Thanks for coming.”

  “I’m Don Grissom, and this here’s Billy.” I turned back to be sure the farmer, the mom, and the baby were OK. Being assured that all was well, we bade them good-bye and left the barn. As we stepped outside, I continued, “I hope this was no trouble. I didn’t know it was a cow.”

  Don put his hand on my shoulder. “Not to worry, Doc, we’ve had lots stranger calls than this. And . . . well, the outcome was pretty good, wasn’t it?”

  Billy, trying to heap more encouragement on me than I deserved, continued, “Besides, Doc, we’d rather be called when we’re not needed than not be called when we are needed.”

  I sheepishly thanked them again, told them I looked forward to getting to know them, and walked over to my Toyota and hopped in. Only then did I realize that the front of my scrubs was soaking wet, as were my hands—wet and sticky. Fortunately, there was a rag in the glove compartment with which I could wipe my hands and the steering wheel.

  During the short drive down School House Hill and back up Hospital Hill, I found myself overflowing with relief and gratitude—not unlike what most physicians feel after an emergency situation where the work is done well and the results are satisfying.

  As I arrived home it was nearly 3:00 A.M. Not much time to sleep before another day of practice would begin. Walking to the house, I could see that a new moon had risen—on our small community, on its newest member, and on a new career.

  Gary Ayers woke us up at 6:00 A.M. Barb nudged me awake, begging me to “turn that thing off.” But, half-asleep, I smiled and felt a warm comfort when Gary announced, “The new doc in town, Dr. Walt Larimore, delivered his first baby in the middle of the night last night—a white-faced heifer up at Clem Monteith’s place. Word is the cow and calf are fine. No word on the doc . . .”

  By late that morning, the news was all over town. The reviews, according to those who talked to “Doc” John, the town’s gregarious pharmacist at Super Swain Drug Store, were “generally good.” I was later to learn that, coming from “Doc” John, this was a high compliment indeed—rarely extended to an “outsider.” During evening rounds at the hospital, nurses and doctors were offering their congratulations and smiles.

  I was sitting at the nurses’ station, writing a progress note on a patient’s chart, when I heard: “Heck of a way to start your career.” The statement was followed by a chuckle from Dr. Bacon. The octogenarian smiled. “I’m proud of you, son. Didn’t know they taught much animal medicine up there in the ivory tower of Duke.” He chuckled again as he took off down the hall at a brisk pace—his hallmark. I presumed, perhaps mistakenly, that this was a compliment—and thus considered the praise of a respected colleague to be sweet.

  Mitch chimed in from across the nurses’ station. “Tell you what, son, when we get an afternoon free, I’m gonna teach you all about cattle. Why, I’ll even teach you how to conceive those things!” Before I could ask him to explain what he was talking about, he had left the station and was heading down the hall.

  The next day Helen asked me if I had a minute to speak to a patient in the lobby. Mitch’s nurse had a devilish smile on her face.

  “What’s going on, Helen?”

  The smile quickly left as she perceived me to be questioning her authority. “Just come with me to the waiting room, you
ng man. Now!” I didn’t argue.

  As I entered the lobby, it took me a minute to recognize Clem. He was cleaned up—but then so was I. He had his left arm around a homely woman, seemingly dressed in her Sunday best. He walked over with an ear-to-ear smile, missing a few teeth, and began to enthusiastically pump my hand.

  “Doc, just came by to say thanks once again for what you done the other night for me and my family. This here’s my wife, Doris.” I was to learn that they had no children. Indeed, Clem’s herd and his wife were his family.

  “Well, it’s good to see you again, Mr. Monteith, and it’s good to meet you, Mrs. Monteith.”

  “Clem and Doris will work just fine for us.” Clem smiled and then dropped his head for a moment, seemingly gathering his words. (I was to learn that this is a common behavior in the area. It gives the speaker time to think and builds the drama of the moment.)

  “Doc, we’re just here to say that we know you’re new in these parts and we know you haven’t done lots of animal work, but we think you done real good and we want you to know we appreciate it.”

  “You’re more than welcome,” I stammered, more embarrassed than thankful.

  “Doc,” he said falteringly, “we don’t have any way to pay you back for your service just yet. But we’ll pay you when we can.”

  “That’s OK,” I replied. After all, I hadn’t even considered charging for my services. No one had ever taught me how to provide medical services to cows, much less how to charge for those services.

  He paused for just a moment. I wasn’t quite sure what to do—or what to say.

  “Go ahead,” Doris spoke up. “Go ahead and tell him, honey.”

  “Well, Doc, we want you to know that we named the calf after you.”

  Wow, I thought. Possibly a prize-winning hybrid white-faced heifer. And furthermore, named “Dr. Walt Larimore” or “Professor Larimore” or just “The Doc.” Man-o-man! I was beginning to feel a bit of pride welling up, only to be overcome by curiosity. “What did you name her?” I asked.