Bryson City Tales (6 page)

“Ella Jo,” her husband cautioned, “don't you think that type of talk's a bit severe for our new friend?”

“No, I do not!” she exclaimed—sitting up in her chair. “You board members”—she was pointing a finger at her husband and then at R.P.—“need to take back a little control from those medical deities. They've been running things just a little bit too long. It's hurting our hospital, and it's hurting our town. What we need around here is a well-timed funeral or two!” She sat back, obviously fuming, but done with her soliloquy.

“Well,” Sally added, “I don't think that's true of Mitch and Ray. Mitch made Ray feel welcome and has brought him right into this community. And the other doctors have come to accept him. Goodness, I even think they like him.”

“That's only because he's with Mitch,” opined Ella Jo.

There was another moment of silence. “What we need to do,” suggested John, “is see if Mitch and Ray would consider taking Walt under their wing. Their office is empty in the morning while they're in the operating room. One of them is off one afternoon a week. So there's room in their office at least seven half-days a week.”

“That's a great idea, John!” exclaimed R.P. as he sat up in his rocking chair. “That could take care of everything.”

I wasn't so sure. Barb gave me that “we need to go” look. “Ladies and gentlemen,” I announced, “it's been a lovely evening. Ella Jo, the meal was above and beyond.” Her smile ran ear to ear. “We've had a long day and have a longer one tomorrow. If it's OK, I think we'll turn in.”

“Oh, you bet. You betcha,” said John. He, Ella Jo, and the Jenkinses stood to say farewell.

“Tomorrow's the start of another day. A great day!”exclaimed R.P. as we turned to leave.

As we walked to our room, I thought,
Beautiful land. Warm
and gracious people. Rich history. But the medical staff and the
hospital—would I want to be a part of them? Or would they
even want me to be a part of them?
My doubts were growing.

chapter four

THE GRAND TOUR

T
he next morning we were due to tour the hospital. We left the inn early so we'd have some time to drive around. The route from the Hemlock Inn to the Swain County General Hospital wound along Highway 19, which intersected Galbreath Creek Road at the edge of Fergusson's farm—the largest dairy farm in the county. Looking south across the farm, the mountains rose steeply to meet a brilliant-blue cloudless sky. We gazed at layer upon layer of misty clouds, slowly floating and drifting over the ridges and hollows—the namesake of the Smoky Mountains.

After turning on Highway 19 and skirting the farm, the road crossed the wide, shallow, but rapidly flowing Tuckaseigee River. The narrow two-lane bridge looked like a relic from the '30s or '40s—its handsome arches beginning to crumble a bit and its concrete walls scarred by many an encounter with wayward vehicles.

Just before entering Bryson City, right across the street from Shuler's Produce (the home of what would become our favorite boiled peanuts), we passed a barn. On the side, in peeling paint, was the injunction to

SEE 7 STATES FROM ROCK CITY LOOKOUT MOUNTAIN—CHATTANOOGA, TN

Right after the barn, Highway 19 became Main Street. In a moment we were in the downtown business district—only three blocks long and one block wide—bookended by the only two traffic lights in town. We turned north onto Everett Street—named after the man who served as Bryson City's first mayor in the 1880s—and then crossed the river and followed the signs to Hospital Hill. As we turned toward the hospital, Barb pointed out a sign:

SWAIN SURGICAL ASSOCIATES DR. WILLIAM E. MITCHELL AND DR. E. RAY CUNNINGHAM

We turned up Hospital Hill Road. At the top of the hill stood the Swain County General Hospital. The general practitioners' offices were across the road from the hospital. We passed their shingles—Harold Bacon, M.D., Eric Nordling, M.D., Paul Sale, M.D., and Ken Mathieson, D.O.—and pulled into the hospital parking lot.

“Walt,” Barb commented, “the hospital is a whole lot larger than I expected.” I agreed. The brick split-level building appeared well maintained and very nicely landscaped with flowers blooming alongside the entrance. With a mixture of apprehension and excitement, we entered through the front doors.

The receptionist was expecting us, and we were quickly escorted to Mr. Douthit's office.

After initial pleasantries, Mr. Douthit leaned forward purposely. “Walt and Barb, the hospital board has authorized me to aggressively recruit young physicians. Our current physicians are not getting any younger. With the exception of Dr. Cunningham, they range in age from fifty-two to eighty and have been here many, many years. They're excellent, but we must look to the future.”

He paused for a moment. “Our first recruiting success was Dr. Ray Cunningham. He grew up here in Bryson City and then went away to college, medical school, and his surgical residency in Charleston, South Carolina. While away, he met and married a critical care nurse named Nancy. They've been in town for about two years. Ray is in practice with Bill Mitchell—we
all call him Mitch—and Nancy is our infection control nurse here in the hospital.”

Earl continued, “As surgeons, Mitch and Ray are available to do cesarean sections, but we have no nursery and no doctors interested in delivering and caring for newborns. So we're excited about the skills you could bring to our institution—especially with regard to pediatrics, obstetrics, and sports medicine.”

“Sports medicine?” I asked. My interest must have been obvious. For the previous three years I had served the Duke University athletic department as a team physician. For a frustrated athlete such as myself, being able to receive sports medicine training at Duke was a dream come true.

“Well, we have some mighty fine sports programs here at Swain County High School. In fact, even though there's not a thousand folks in town, we'll have one to two thousand folks at home football games. Folks around here take their football real serious. But none of our doctors have been particularly interested in being the team physician. Only a couple, Dr. Mitchell and Dr. Bacon, will even go to some of the games. But they prefer to sit in the stands rather than work directly on the sidelines with the players and coaches. They'll come out of the stands to check out the more seriously hurt kids, but most of the time they leave the minor injuries to the coaches or paramedics.”

He took a sip of coffee and glanced out the window. A gentle breeze was blowing through the trees. He continued, “We'll talk finances later, but first I want our head nurse, Eudora Gunn, to take you on a tour. Then I've got our board coming in to meet with you for lunch. Sound OK?”

There was a knock on the door and an ancient, petite, gray-haired nurse entered. Eudora Gunn had been a doctor's wife. After he died, she continued in the profession and had retired to Bryson City. Earl had hired her early on to supervise the growing nursing staff when the original hospital building had expanded, offering more outpatient services and more beds.

Eudora took us on the grand tour and introduced us to
everyone
. We started in the three-bed emergency room, which was covered on a rotating basis by each of the town's six doctors, twenty-four hours a day, seven days a week. There we met Louise Thomas, who had run the ER for more years than most folks could remember. As Eudora continued to guide us around, conversations with the staff were warm and sincere, sprinkled with laughter. We were feeling more and more welcome.

“Ms. Gunn,” Barb inquired, “has the hospital had trouble attracting new physicians?” (I knew Barb wanted to get an “in the trenches” perspective from a nurse.) Eudora told us stories about a number of young doctors who had come and gone. “In almost every case,” she confided, “the spouse became unhappy with the small-town life—so eventually they left.” We had the distinct and haunting feeling that this might be true but that it wasn't the whole truth!

The lab and X-ray facilities were small but more than adequate for a small hospital. Betty Carlson, the director of the lab, was a delightful woman who told us which lab results we could get immediately and which ones were sent to a reference lab and came back a day or two later. The pathologist in nearby Sylva helped supervise the lab and did all of the pathology studies. If frozen-section studies were necessary, the pathologist from Sylva would drive over to perform the study right in the hospital.

Carroll Stevenson headed the X-ray department. Not only did he provide all the basic X-ray services we would need, but a CT scanner came once a week on a trailer truck. This was big news, as CT scanners were fairly new technology. Also, although Bryson City had no radiologist in town, a consulting radiologist from a nearby city came in three days a week to read X-ray studies and to perform procedures like an upper gastrointestinal series or a barium enema. In an emergency, a radiologist could be called to travel the twenty-five or thirty miles to help us out.

The patient rooms were all semiprivate, although, since the hospital was seldom full, many patients enjoyed having a private room. An old four-bed ward next to the nurses' station was used as an intensive care unit—for the sickest of the hospital's patients.

All in all, we were increasingly impressed as we toured this small but more than adequate hospital. We liked the facility, and we liked the people. While not dazzled, we were well pleased.

Toward the end of the tour, Ms. Gunn said, “Let me show you a surprise.” We exited from a side door and crossed the road to a small house sided with green cedar shingles. To us, the long narrow house looked like the shotgun houses we'd come to love while in medical school in New Orleans. As we walked up Eudora explained, “The hospital owns this home. They've allowed me to live here, but now that I'll be retiring I'll be moving out. The hospital would be willing to make this home available to you all, for as long as you might need it, at no cost.”

Barb and I looked at each other with surprise etched in our eyes.

When we opened the screen door, we stepped into a fairly modern kitchen. The dining room's large picture window overlooked the rolling hills of the Swain County Recreation Park and the nearly endless vistas of the Deep Creek Valley and the Great Smoky Mountains National Park. As though in a spell, we were drawn to the window. “It's beautiful!” Barb gasped. Kate giggled contentedly.

At one end of the house was a master bedroom connected to a nursery. At the other end was a living room and a guest suite. There was a large basement and a root cellar. The root cellar was dug into the stone and lined with shelves full of canned fruits, vegetables, and meats. “People can stuff all the time and bring it to the staff at the hospital. I keep it down here because the temperature in the root cellar is sixty degrees year-round. You won't find yourself having to buy a lot of food, I suspect—just the staples.”

Back outside the house I was drawn toward the fruit tree orchard behind the house. “That's Dr. Bacon's orchard. He tends it ever so carefully. You'll have all the apples, peaches, and pears you could ever eat. He lives right here behind the hospital. He's even older than me!” Eudora laughed out loud and continued, “Goodness, he's almost eighty and has been practicing here for nearly fifty years.

“Well, we better get back. You need to meet the board.”Eudora took off in the direction of the hospital. We followed. Kate had fallen asleep in her stroller.

As the nurse led us down the driveway, Barb put her arm through mine, leaned toward me, and whispered, “Other than being right next to the hospital, I think it's perfect! I already know where all our furniture will go—and it will all fit!”

chapter five

THE INTERVIEW

W
hen we returned to the hospital, we were escorted to Mr. Douthit's office. The conference room table was set for lunch; a group of men and women stood by the table talking. When we entered, everyone became very quiet and turned to stare at us.

Mr. Douthit broke the silence. “Ladies and gentlemen, this is Dr. and Mrs. Larimore and little Kate.”

He introduced us around. We knew John Shell and R.P. Jenkins. We met Horace and Ruby DeHart, Jack Lyday, Fred Moody, and several other board members. We were seated for lunch, and Eloise Newman, the hospital's registered dietician, came with her staff to serve us.

Now, after having interviewed across the width and breadth of western North Carolina, we had eaten way too much hospital food. So our expectations for this event were very low indeed. But what was served us that day was a feast. The crispy, nicely spiced fried chicken, almond-covered rainbow trout, and garden-fresh green beans, carrots, and broccoli smelled glorious. The mouth-watering aroma of yeast rolls was accompanied by a collection of what I suspected were homemade jellies and jams nestled around a small pot of butter. And the food tasted even better than it smelled.

“Like Sunday dinner at my grandmom's,” reminisced Fred Moody. Fred was a local attorney and the chairman of the board. He had graduated from one of the state's finest law schools, the University of North Carolina, and he had come to Swain County to practice law. He looked at me and said, “Dr. Larimore, this is one reason
not
to come to Swain
County. The eating is just too good. I weighed only 160 pounds when I began my practice here. Now look at me.” He was smiling and rubbing his tummy.

“Now, Fred, we're supposed to encourage the Larimores,” chimed in Ruby DeHart. Mr. and Mrs. DeHart looked to be in their late seventies. They had lived in the county for decades and were active in local cultural affairs.

“Well, the Larimores are staying with the Shells out at the Hemlock Inn,” added R.P., as John Shell began beaming. “So they've already been exposed to Ella Jo's culinary expertise. But I've got to tell you, Eloise, there's no better hospital food anywhere in this country.”