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Authors: MD Walt Larimore

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We were left alone to enjoy the best prime rib we had ever tasted. Indeed, you
could
cut it with a fork—and it was over an inch thick. We simply couldn't finish it—but we savored each bite. As we ate, we laughed and conversed. Barb talked candidly about what it was like to be a doctor's wife, and I confided in her about how my initial feelings of ineptitude and stupidity were being transformed into a slowly building confidence.

When Katherine came to check on us later, she laughed. “Can I get you folks a doggie bag?” Her eyes sparkled in the light from the fire that was being stoked by Elizabeth throughout the evening. We nodded in agreement and settled back. The atmosphere was
beyond
romantic, and the service had been superb—attentive, yet giving us the privacy we needed to talk and to revel in each other's company.

Katherine appeared with a tray loaded up with ten or twelve desserts, each one looking better than the other. We finally decided to share a freshly baked peach-and-blackberry cobbler, smothered in vanilla-bean ice cream—a laudatory cap to a wonderful evening. I was apprehensive to think what the bill might be, but when the check came, we were shocked at how little this feast cost. We thanked Katherine for the lovely evening. She graciously thanked us for being her guests and invited us to return. We would—many, many times.

“If you all are interested, why don't you go out and sit on the front porch. There's a nearly full moon that will rise over the valley in a bit. There's some blankets right by the door, and I can bring you some hot chocolate, coffee, or tea.”

We decided to take her up on the offer and had comfortably settled into a rocker for two when Katherine arrived with the hot chocolate. This time, instead of disappearing, she inquired, “Mind if I sit a spell with you?”

We welcomed her to pull up a rocking chair. As the moon rose and illuminated the Smokies, she told us about the history of the inn and how her family had purchased it for her and her husband, Jim. They were recently divorced, so Katherine was now the sole proprietor and chef. She described her upbringing in Sylva and went on and on about her travels, yet how she was always drawn back to these mountains. “There's just something about the Smokies. Mysterious. Romantic. Wild. Lush. Untamable, yet not too large, not too immense.”

I could, even after only a short time in the Smokies, understand her sentiments. Looking out over the moonlit hills—almost silvery in radiance—the dark sky seemed glittered with countless sparkles. This masterful showpiece was ours to just sit and enjoy. Yes, these hills were definitely taking hold of me at a deep level.

Then Katherine spoke, almost in a whisper:

The heavens declare the glory of God;
the skies proclaim the work of his hands.

Day after day they pour forth speech;
night after night they display knowledge.

There is no speech or language
where their voice is not heard.

I looked at her. She was staring out at the hills and sky.

“A bit of ancient wisdom from the Psalms.” She cocked her head toward me and smiled. I wondered if she was blush ing. “Not real sure where that came from. It just seemed appropriate.”

We sat for a bit longer, enjoying the sights and the silence. Barb touched my arm. It was her signal that she was ready to leave. So we stood to go. A simple thank-you seemed inadequate for a woman who had made our anniversary so memorable and us feel so welcome. As I pondered how to put our gratitude into words, she spoke.

“Dr. Larimore . . .”

“Walt,” I corrected.

“Well, OK. Walt . . .” She paused to look at the valley. Her eyes were misty in the full moonlight. “A lot of us young people leave town to get our medical care in Sylva or Waynesville—or even drive to Asheville—at least those who can afford it. But since Dr. Cunningham arrived, some are starting to stay. Now that you're here, I think others are going to stay, too.”

She was quiet for a moment, her hair gently moving in the evening breeze. Then she turned to face Barb and me. “I'm glad you're here.”

I took in a deep breath, not really knowing what to say. In just a few words she had deeply encouraged me, almost empowered me. With the arrival of Rick and the support of our patients, maybe, just maybe, we could overcome the resistance of some of the old-timers, especially some of the doctors who were still so antagonistic about my presence.

While looking out over the seemingly endless mountains, shimmering under the full moon's silver light, I slowly exhaled. “I'm glad we're here, too, Katherine.”

Barb whispered, “Me, too.”

chapter twenty-five

ANOTHER NEW DOC COMES TO TOWN

T
oday was the day. Rick Pyeritz, M.D., would be joining us in practice. I was elated, as I had been anticipating this day long before we had arrived in Bryson City.

When I entered my family medicine internship at Duke University Medical Center, I was one of only four men in my class of twelve—and the only one from the deep South. My welcome to the world of the erudite, academic, Ivy League nonSouth was abrupt and, to say the least, memorable. During our first day of orientation, the first-year residents walked over to the hospital for brunch. On the way back, I was walking with Lloyd Michener, M.D. Lloyd was a Harvard graduate who many years later would become the first residency-trained chair of the department of family medicine at Duke University. We were chatting about how varied our medical school experiences were. At Harvard he had
seen
a lot of medicine but hadn't had much hands-on experience.

In contrast, during my medical school days at Charity Hospital in New Orleans I did
everything.
Well, maybe not everything, but I did a lot. I had delivered over two hundred babies, participated as first assistant in dozens of operations, sewed up countless lacerations in the emergency room, set fractures, drawn blood, started intravenous lines—even in large veins in the neck and trunk—all procedures usually reserved at most medical centers for
residents in training. However, at Charity Hospital there was more work than there were residents, so the students in those days were able to gain much firsthand experience.

Dr. Michener and I were engrossed in conversation as we approached the door of the Family Medicine Center. Behind us were two female residents from Ivy League medical schools—both clad in Birkenstock sandals and both obviously braless. To me and my narrow way of thinking, both of these were markers of either a hippie or liberal lifestyle—or both. Nevertheless, without even thinking, and simply doing what I had always been taught was proper to do, I opened the door to the center and stood back to allow the women to enter before me. Lloyd cruised past me without a word. However, the two women stopped and stared at me as though I were loony.

One of them stepped forward, got chest to chest with me, and glared up into my eyes. I was stupefied.
What had I done?
It became instantly apparent. She practically shouted, “Just what in the blazes do you think you're doing?” Well, actually that's not an exact quote. She added a number of rather colorful words to her query.

“Just . . . just holding the door open for you,” I stammered.

“I don't need a
man
to do that for me!” she nearly shouted. Her face was as red as a beet and her fists were clenched. I was stunned.

She and her friend stomped into the building, leaving me looking, I'm sure, ashen and shaken.

Eric Pyeritz, M.D., one of my classmates, walked in next. Once I got to know him better, I just called him Rick. I was still holding the door open, jolted and frozen. “You're lucky she didn't slug you,” he laughed as he walked by. That was my first memory of Rick Pyeritz.

The second memory, no more enjoyable, occurred that afternoon and forever branded me among my classmates as an incorrigible chauvinist at worst, or a dumb backwoods southerner at best. The resident psychologist for the training program was showing us three- to four-minute videotaped vignettes of patients telling a story. We were supposed to react to the stories and share how we felt about the story or the situation. Since my dressing-down earlier that day, I was being exceptionally quiet . . . at least until the video vignette of the rape victim.

This vignette was a very close-range face shot of a woman describing the experience of being raped. It was a
very
emotional and disturbing tape. The response was, to me, quite instructive. The women in the group were, to a person,
very
angry about what they had seen and heard. They emoted about how terrible this was and about what needed to be done. The men all seemed to think that the woman was fabricating the story. I noted that the contrast in these two observations was, at the very least, stark.

At that moment in my contemplation, the psychologist asked me, “Dr. Larimore, you've been quiet this afternoon. Would you like to share your thoughts?”

So I shared my perceptions with the group. As I did so, several of the women began to become distressed. But it only took one silly comment from me to cause them to erupt. After sharing my observation, namely, that the women in the group were responding to the emotion of the story and that the men were quite objectively seeing an actress at work telling a story, I asked, “Well, what do you girls think?”

I had no idea that anyone viewed the term
girls
as offensive. In the South, boys were boys and girls were girls—or sometimes guys and gals. But neither term was pejorative—merely descriptive and respectful. In the North, at least at the Northeastern medical schools and universities, this was apparently about as insulting a term as a male could ever use. The explosion was as vehement as it was immediate.

At the end of our session, everyone left the room except for Rick. His helpful observation: “Boy, that sure was a stupid thing to say!”

I laughed, and then we laughed together.

Rick and I began to build a friendship, as did he and Barb. Since Rick was single and a long way from home, Barb became Rick's surrogate sister, comforter, confidant, and friend. The three of us did many things together. Finally, during our third year of residency, we decided to go into practice together as soon as we could. So I was chomping at the bit for Rick to arrive in Bryson City. During my first few months here, I'd been learning the ropes of private practice, settling into this mountain community, gaining, ever so slowly, a sense of confidence in my own style of practice. But Rick's arrival would propel me into a higher gear. I just knew it! At last I'd have a relationship here in Bryson City with shared roots and history, shared experience, mutual respect, comparable training and medical perspective, and a similar outlook concerning the value of faith. The thought of Rick and me hanging out our shingles together seemed to me a declaration that we were ready to make a real contribution to the town.

It was a Saturday. Barb had all the windows open, and the cool autumn air was cleansing the house of some of the cooped-up odors that inhabit older homes—especially those that are heated, as ours was, with fuel oil. I was playing with Kate on the dining room floor and Barb was busy in the kitchen, humming as she worked. She was
very
pregnant and had that rosy look and disposition often seen late in the second trimester and early in the third trimester with pregnant women. The discomforts of the end stages of pregnancy—the heartburn, lower back pain, bladder pressure, small stomach, difficulty sleeping, and the like, had only just begun. But today was bright and pleasant.

I heard the truck—a rented Ryder—struggling up the hill. It was Rick and all of his belongings. The hospital owned an empty house on the opposite side of the hospital from us, and it was Rick's house-to-be. Following the Ryder truck, in two cars, were Rick's good friends Andrea and Ben Gravatt. Both were doctors, he an anesthesiologist and she a pediatrician. We had all known each other in residency, and the Gravatts had begun their practices in Asheville earlier that summer. Andrea was driving Rick's car and Ben was driving theirs.

“Barb, Rick and the Gravatts are here!” I called out.

Her eyes brightened and she quickly took off her apron. “Let's go!” She was out the door before me. I picked up Kate and followed. The hugs and greetings were warm and intense. It was so good to see friendly and familiar faces!

“Are you glad I'm here?” Rick asked.

“You have
no
idea,” I said.

The afternoon was spent helping Rick move in. During the afternoon Kim and Mike Hamrick dropped by to help, as did Ray and Nancy Cunningham. Even Louise dropped by, before her shift began, to inspect the new doctor. I suspected that her observations would be spread around the hospital fairly quickly.
Funny,
I thought.
None of the other doctors even came by. Hmm.

By midafternoon, Rick was settled in. Barb had made up his bed, and she and Nancy had the kitchen in order in no time. The Hamricks and Gravatts left by late afternoon. We were sitting in Rick's living room when Barb brought up the topic of dinner. Nancy quickly spoke up, “Oh, Ray and I are cooking supper for us all, if that's OK. How about 6:00?”

“You bet, Nancy, that'll be great,” I said.

We left to go home and clean up for supper. At about twenty minutes before six, Rick was knocking on our screen door. Barb was feeding Kate, so Rick and I stepped out back and took a seat on the bench. The views of the valley were as lovely as ever, especially now that all the leaves had fallen. The normally clothed hills now revealed their crags and scars, their waterfalls and rock faces. It was a less soft, more rustic view—one that was a good fit for the coming months of snow, cold, and gray skies. Winter in the mountains, not often experienced by the three-season visitors, can be downright dismal, discouraging, disheartening, and depressing. The gloomy season would come to be my least favorite in the Smokies.

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