As we were leaving, Ray shared some good news. “Walt, Mitch asked me to tell you to take off work until January 2. The hospital’s light, we’ll take your call, Rick’s going to take any deliveries that come in. We feel you need some time with your new family. That sound OK?”
Surprisingly I felt a bit of guilt well up in my gut. I instantly knew that I shouldn’t feel that way, but the medical profession is a selfish mistress, and she teaches you to become beholden and subservient to her—even to the point of sacrificing your own family. “You sure?” I asked, hesitating.
He smiled. “You bet. It’ll be our pleasure. Enjoy your family.”
“I will. Thanks, Ray.”
“Don’t thank me. Thank the general.”
We exchanged a knowing grin.
That afternoon the three oldest Larimores opened their Christmas gifts together while the youngest slept in his crib. As I watched Barb and Kate open their gifts, I felt two distinct and competing emotions. On one hand, I was secretly worried about Scott. Would he have cerebral palsy, like Kate? The ultrasounds had shown normal brain development—but, then again, these same ultrasound exams had said he was a she. I tried not to show my concern. On the other hand, I had an overwhelming feeling of warmth in my heart. What a wonderful wife and family I had been given! What a special season this was for my family!
Before I knew it I felt tears flowing down my cheeks. I couldn’t believe it. I had cried more times this fall than I had in the past decade! It had been in many ways the best few months of my life, and in other ways it had been among the worst of times. At times I felt confident and skilled as a physician, husband, and father, while at other times I felt inexperienced and inept. One group of folks loved our being in Bryson City, while others acted as though they would have been just as happy to see us leave. But as I weighed things out in my mind, I decided that, overall, I was grateful and blessed.
Barb and I had our own New Year’s Eve traditions. We had never enjoyed parties on that particular evening, so we had developed the tradition of having a dinner of hot buttered corn bread and black-eyed peas. We’d spend the meal time talking about the important things we had learned that year. We’d reflect on our most special memories. We’d laugh. Then we’d go to bed early, often awaking at midnight to the sound of firecrackers.
This year we’d invited “Uncle Rick” over for the evening meal—to share in our family tradition. We expected a “plain Jane” New Year’s Eve. It was not to be.
Rick called in the midafternoon. “Walt, I’d really like to take you guys out to dinner. My mom and dad have arrived in town—unannounced—to surprise me. I’d like you to meet them. Can we do dinner together?”
I paused. First of all, I was pretty sure there wasn’t going to be a single restaurant in town open that evening. Our favorites were all closed for the holiday. All of the tourist joints were closed. All the local cafés had announced that they would close after lunch. Besides, I thought, this is our family’s night.
Rick continued. “Best yet, I have a new friend who is preparing dinner for us all at her place.”
Rick’s been in town for only a few weeks, I thought. Who is this new friend?
“I know you and Barb will be turning in early, at least you always have in the past, so how ’bout I come pick you all up about six. I’ll have you home in time for the kids’ bedtime. Sound OK?”
“Let me check with Barb.” I was hoping she wouldn’t be interested, but she was. “Sounds good, Rick. We’ll be waiting for you.”
At the stroke of 6:00 we heard a knock on the door. Rick came in with his mom and dad—Paul and Ida. They had driven from Pittsburgh to see Rick and to get a look at his new town. His mom had a special interest in seeing that his house was in order.
“Let’s go. Dinner’s waiting,” exclaimed Rick. As we stepped out, he whispered, “You’re going to love what I’ve got planned.” I was curious indeed.
“Where are we going?”
“Just for a little ride.” He was smiling.
We settled the kids in their car seats, and off we went, in two cars. The destination became clear as we doglegged at the library. “The Fryemont Inn?” said Barb, looking at me.
We followed Rick up to the parking lot and began to unload. There were no other cars in the lot. Rick smiled. “Katherine is cooking for us all.”
“Katherine?”
“Indeed! While you all were in Asheville, she came into the office to see you, Walt. She had a cold or something. Since you weren’t there, I saw her. We hit it off fabulously. I told her what was going on with you guys, and she said she wanted to cook you a congratulatory dinner when you were back and settled. She called a couple of days ago, and we talked for a while. One thing led to another, and she made this terrific offer. Wouldn’t take no for an answer. Said she’d be alone otherwise. She loves to cook. So, that was that.”
The steep driveway had been scraped clear of snow, as had two parking places next to the entrance. I carried Kate on my back in a carrier and helped Barb up the steps. She was still sore from the difficult delivery. Rick toted Scott in the car seat.
We walked into the dining room, which was cozy and warm and permeated with the smells of fir. A fire roared in the large stone fireplace. Katherine had cut and hauled into the dining room four- and five-foot-long logs and had a spectacular fire blazing. We could feel its warmth from across the room.
“Hi, everyone!” Katherine called out, sticking her head out of the kitchen door. “Have a seat. Make yourself at home! I’ll be out in a jiffy.”
We took off our coats. I settled Kate into a high chair. The lights were on their lowest setting, and a beautiful Advent wreath with five large candles burning adorned the middle of the dining table that stood in front of the fireplace. The gleaming hardwood floors reflected the glow of the fire. The paddle fans that hung from the raftered, vaulted ceiling were silent, allowing the snapping and popping of the wood in the fireplace to fill the dining room with its welcoming melody.
In a few moments the kitchen door swung open and Katherine appeared, carrying a tray of hot apple cider and mugs. She placed the tray and mugs on the table, threw her long blond hair back off her shoulder, and greeted Barb with a warm hug.
Then she bent over Scott, who was sound asleep. “She’s so cute.”
Barb, Rick, and I looked at each other and laughed.
“What are you all laughing about?”
“Long story,” Rick responded, “but she’s actually Scott.”
Katherine laughed out loud. We all laughed with her. As Katherine served the cider, Rick told her the whole story.
“Well,” she observed, “given your knowledge of anatomy, Dr. Larimore, maybe it’s better that I saw Dr. Pyeritz in the office.”
Her eyes met his, and mine met Barb’s. I wondered, as did Barb, if this relationship might be—or become—more than professional.
After the cider had been consumed, Rick helped Katherine carry the pitcher and mugs to the kitchen, while Rick’s dad and I put a couple more logs on the fire. In a moment, they returned with bowls of cheese soup. After the soup dishes were cleared, Katherine and Rick disappeared into the kitchen once again. He returned with a set of wine glasses and a bottle of wine. “From my personal cellar, a bottle of 1978 Sterling Reserve merlot. It’s one of the best merlots made in California—and a terrific year, too!”
Barb and I smiled at each other. That was the year Kate was born. As Rick poured the wine, Katherine reset the table and then disappeared into the kitchen with Rick. Soon they came back with a massive platter of meat and potatoes.
“Ta-da,” sang Rick.
“Thick center-cut pork chops, marinated, coated with a thick graham cracker crust and slowly baked,” added Katherine. “Served with baked apples, candied yams, and green bean casserole.”
Rick pulled Katherine’s chair out to seat her and then pulled up to the table.
“Walt, if you don’t mind, I think a prayer of thanksgiving
is in order.”
“Rick, I couldn’t agree more.”
He looked at his dad. Paul was a large, handsome man with beautiful silver hair. “Dad, would you say our grace?”
“Be delighted, Son.”
He reached out, and we each held hands around the table and bowed our heads. “Lord, thank you for tonight. Thank you for friends. Thank you for the safe birth of baby Scott. I ask you to protect him and to grow him into someone who will make a difference—truly make a difference in this world. Thank you for Katherine and her hospitality. Thank you that Walt and Rick can be partners. Bless their practice. Thank you not only for this last year but also for the years to come. Bless this food to us and us to your service. Amen.”
Katherine took her wine glass and raised it in a toast. “To new friends—good friends—and a new year!”
“Here, here!” was heard around the table as glasses clinked.
The dinner was delicious. I reveled in the crackling logs, the flickering of the fire as it reflected off the ceiling rafters and the floorboards, the peals of laughter, and the warmth. Dessert was a warm peach cobbler with homemade vanilla-bean ice cream accompanied by mugs of strong coffee. After we had shared dessert, Rick’s mom and dad set out to explore the inn. Katherine pulled her chair close to the table.
“Gentlemen,” she warned, “I must tell you something.” She was quiet for a moment. “You know that I’m not from around here. And until recently I’ve not sought medical care here.” She looked at Rick and smiled. “But my business is here. I know the local people and I hear them talk.” She was quiet, sipping her coffee and staring into the fire.
Rick cocked his head. “What’s on your mind, Katherine?”
Her eyes suddenly glazed over. She seemed almost to shudder. She looked at me and then at Rick. “You guys are so needed in this town. You have so much to offer.” She took another sip of coffee, then continued. “I’m not sure all the older physicians want you here. I’m not sure they’re not as threatened as can be by you two. I think the only thing that’s saving your hides is that you’re sharing office space with Mitch and Ray for now.”
Although I had suspected the same, I hadn’t heard someone outside the medical community verbalize it. To me, this made the potential conflict between the younger and older physicians much more likely—maybe even more threatening. I wondered what this would mean.
“What should we do?” asked Rick.
“Your best,” she responded. She looked into his eyes. “Just do your best. They’ll never be able to beat that. If you are both as good of doctors as I think you are, and if you’re as good of people as you seem to be, you’ll do just fine. Just fine.” She sighed. “For the town’s sake—and for your sake—I hope you can ride it out.”
We were quiet for a few moments. “Well,” Katherine broke the silence, “let’s get you all out of here.” She stood and started to clear the dishes.
“Can we start the dishes?” asked Barb.
“Oh, heavens no!” pealed Katherine. “You guys get outta here!”
We gave her a hug and loaded back into the cars to travel back across town. The moon was reflecting off the snow, and it was hauntingly beautiful. At the top of Hospital Hill, Rick helped us get into our home. We said good-bye to him and his parents. By 10:00 the Larimores were all snuggled into bed.
No firecrackers awoke us at midnight, nor did we see the ominous clouds gathering on the horizon. A storm was headed straight toward us.
The first snow of the new year came on New Year’s Day—about four inches of fresh powder lying on the bench just behind our house. The thermometer read twenty degrees above zero. But inside, the house was warm.
I had forgotten to turn off the clock radio, and at 6:00 A.M. sharp Gary Ayers’s voice shocked us out of our slumber. As I rolled over to turn off the radio, I was surprised to hear him say, “On the home front, WBHN is proud to announce that Dr. Larimore, the team physician for the Swain County Maroon Devils, likes our little town so much that he and his wife, Barb, have decided to increase our population by one. Welcome to our newest citizen, Scott Larimore, born on Christmas Day!”
We laughed out loud. Barb confided, “Our son—almost famous!” I was just glad Gary hadn’t mentioned that the birth took place in Asheville.
Now awake, I pulled on my slippers and robe and went into the children’s bedroom to get Kate up.
“Katie,” I whispered, “there’s snow outside.”
She shot straight up in bed, her eyes as wide as saucers. “Snow!” she yelped and quickly crawled from her bed to run, as best she could without her braces, to the window.
“Wow, oh wow, Daddy. Wow, oh wow! Can we go out and play?”
“After breakfast we’ll go out and play, OK?” I heard a movement behind me and turned my attention to the crib. My little boy was beginning to arouse. I walked over to watch him grimace and squirm. Although he was still sleeping, he appeared to be exercising his new plumbing system.
Then I noticed it. He was the color of a carrot.
I picked him up, gave him a hug, and placed him on the bassinet to change his diaper. He was yellow all over. Even the whites of his eyes were yellow. My baby was jaundiced!
I know I shouldn’t have panicked. After all, jaundice is common, especially in breast-fed children—particularly in premature breast-fed children. But sometimes a physician doesn’t think like a physician—especially when it comes to his own children.
By 8:00 A.M. Rick was making a home visit. The lab results were in by 10:00 A.M. Scott was indeed jaundiced—not dangerously so—but his bilirubin levels indicated the need for therapy.
“I have an idea, Walt,” Rick exclaimed. “Follow me.”
We put on our coats and walked across the street to the hospital. Peggy Ashley was the charge nurse that day. Rick explained his plan.
“Well, we’ve never done that before,” she responded. “Have you talked to Mitch or Ray about it?”
Rick’s cheeks flushed a bit. “No,” he retorted. “Why do I have to? I’m an attending physician here. This is standard medical practice. It’s just that we’re not doing it in the hospital.”
Peggy thought a moment. “Well, I guess we could give it a try and see how it goes.”
Before I knew it Rick and I were pushing a hospital bili light across the road and into my children’s room. Years before it would become popular, we were doing home phototherapy in Bryson City.
When an newborn infant’s liver isn’t yet up to speed, the bile that is normally excreted by the liver can build up in the bloodstream, resulting in the carrotlike color of the whites of the eyes and the skin appearance that doctors call jaundice. If the levels of bile—called bilirubin—get too high, they may damage the brain. So while waiting for the liver to begin its life-saving work, the bilirubin levels can be reduced to safe levels by simply exposing the skin to certain frequencies of light. Back then this was accomplished with what were called bili lights—two banks of fluorescent bulbs that would be positioned over the baby. The baby’s eyes would be covered to protect their eyes from any possible negative effects from the light, and the lights would be left on, day and night, until the bilirubin levels were normal and the liver was working properly.
So we set up a hospital-like nursery in our home. The nurses were kind enough to come over every four hours to check on us and on Scott. Betty and the lab techs came over twice a day to do heel sticks to check Scott’s bilirubin levels. By the ninth day of Christmas the bili lights were turned off. On the tenth day of Christmas Rick and I rolled the lights back to the hospital.
On the twelfth day of Christmas we celebrated Barb’s thirtieth birthday. Part of the celebration involved borrowing a large wheelbarrow and shovels from Dr. Bacon. Rick and I hauled the Larimore Christmas tree out of the house and down the road to the site of our new office building. Together we pushed the tree up to the most southwest corner of the lot—the corner that was projected to be untouched—just above what was to
be the new parking lot. We dug a hole and then rolled the Norwegian spruce’s ball into the hole and backfilled the tree. We stood back and admired our handiwork, a tradition we would repeat on every twelfth day of Christmas that we lived in Bryson City.
As I sat on the bench that evening, trying to keep warm in a winter coat and hat as the sun set, I reflected on the planting of the tree—and on our hopes that the tree would take root and grow. It was beginning now to feel like our family and our medical practice was starting to take root in this small town. I was beginning to feel comfortable in my profession as a small-town generalist. We were settling into our new home and our new town—and falling in love with them both. It felt like a great start to the rest of life—a new year, and a new decade. I still did not see the bad moon rising.
chapter twenty-nine
THE HOME BIRTH
Patricia Johnson, M.D., was a devoted physician in nearby Robbinsville. She had the only medical clinic in Graham County—a county that had no hospital. Patients needing hospital care either drove south to the hospitals in Andrews or Murphy, or northeast to Bryson City or Sylva. I had gone to visit her during my first weeks in town. I immediately liked her and immensely respected her. She was specially gifted to minister to her patients in this remote environment.
From time to time, maybe for a year or two at a time, a physician might join her in practice. But they always would leave. When Patricia had no physicians assisting her and when she went on vacation, the entire county was without a doctor. On these occasions, she would call one of the doctors in Andrews to cover emergencies for her practice. Occasionally she’d call over to Swain Surgical Associates.
Helen took the call from Robbinsville. “Dr. Larimore, Dr. Johnson on the phone for you.”
I excused myself from the patient I was seeing and went to take the call in Mitch’s office.
“Hi, Pat, how are you?”
“Walt, I’m just fine. Are you getting acclimated over there in the big city?” She laughed and I chuckled.
Bryson City Tales Page 24
