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Authors: MD Walt Larimore

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She giggled and then looked up at her mom. The thumb was out of the mouth, but the right arm had not moved.

“He's a funny man, Mommy.”

“Harrumph. I'd say so, honey,” remarked a still somewhat horrified Helen.

As I put my shoe on, I asked, “Mrs. Fortner, what happened this morning?”

“Well, Doctor, I'm not rightly sure. Me and Julie Lou were walking from the barn. I was holding her hand when she slipped or tripped and nearly fell in the mud. I jerked on her arm to keep her out of the dirt, and she screamed and began to cry. She said her arm hurt and she wouldn't move it. I tried an onion poultice, but it weren't no hep. No hep a'tall.”

Without even knowing it, Mrs. Fortner had given me the diagnosis and confirmed that I was about to cure her child—which I suspected would surprise everyone in the room. But I continued my chitchat. “My, oh my, I've never been taught about an onion poultice. Tell me about it.”

Helen sighed audibly. She had no tolerance for this type of banter. She considered it a complete waste of time. “No way a doctor could see sixty patients a day if he just sits and jaws with every one of 'em,” she would complain.

I began to softly massage Julie Lou's legs. Mrs. Fortner seemed to visibly relax. This was good. When a mother relaxed, the child on her lap or in her arms would also relax as well. By now my right hand was holding Julie's right hand. I felt her relax a bit as her mom explained, “Well, you just boil up an onion till it's real soft. Then you puts it in the foot of a ladies' stockin'. You mash it up real well. Then you press it on a sore area. The heat and the juice of the onion'll heal most anythang.” She smiled confidently.

“Makes sense to me,” I commented as my left hand crept ever so slowly toward Julie Lou's elbow—an elbow I was sure was not fractured. I was thinking that Debra's idea about the onions really
did
make sense. The heat would be good for increasing blood flow, which can reduce pain and inflammation—although I, like Coach Dietz, personally subscribed to the “use only ice for the first twenty-four hours” theory. Also, the softness of the onion mash and the hose would allow it to conform to the curves and crannies of the body. Several years later I would publish information about Mrs. Fortner's “smashed onion poultice” in a medical journal—
The American Family Physician.
Subsequently, I've read about it in a “medical tips” section of another respected medical journal.

With my right fingers I could feel that Julie Lou's hand was warm. Her radial pulse was strong. She gave my hand a little squeeze. These were all good signs. Julie Lou's circulation and nerve function seemed fine.

“Well, let's take a look,” I commented more to myself than anyone. Before anyone could move, I gently squeezed Julie Lou's elbow with my right hand—my thumb on the front of the elbow, and my fingers on the back. I applied pressure with my thumb as my left hand grasped her hand and turned it outward, and then I quickly flexed the elbow, followed by quickly extending it. There was an audible
POP.

I let go of Julie Lou and quickly stood and backed away. Both the mother's and daughter's eyes were as wide as saucers. So were Helen's. Julie Lou let out a shriek and then instinctively pivoted on her mother's lap and reached out with
both
arms for her mother's embrace. Mrs. Fortner hugged her as Julie Lou wailed on her shoulder.

Helen spoke first. “What did you
do?!

“Let's see,” I said. “Mrs. Fortner, can you put Julie Lou down in front of you—see how her arm is now?” Mrs. Fortner looked at me very suspiciously but then very slowly pried Julie Lou away and placed her on the floor in front of her chair. Still crying, Julie Lou reached up to her mom with both arms, flexing and extending her fingers in that universal sign language of all kids that meant, “Come here, Mommy. I want you.”

“Oh, Doctor, it looks like she's fixed,” Mrs. Fortner exclaimed. She ran her fingers along her daughter's elbow, flexing and extending it. “That's amazing!” she said. She then looked up at me. “How
did
you do that?”

“It's really nothing. Quite elementary. We call it ‘nursemaid's elbow.' When a small child's arm is suddenly extended, like when a nursemaid or nanny jerks on the arm of a child she's walking with—or like when Julie Lou fell and you jerked her arm—it causes one of the two bones in the forearm to come out of place just a bit at the elbow. It's fairly simple
to fix. I usually do it without explanation. It's easier for me, the child, and the mom. I hope you didn't mind the surprise, Mrs. Fortner.”

“Why no. No. I certainly don't. I cain't thank you enough, Doctor.”

Helen had recovered from her shock and surprise. Apparently she had never seen this before.

“Well, do you need me to X-ray the elbow, Doctor?”

“Nope, Helen, no need for that.”

“How about a sling for the arm?”

“Nope. Won't need that either. She's as good as new.”

I turned to a beaming Mrs. Fortner. “Thank you, Doctor. Thank you,” she said again.

I leaned over to a now quiet Julie Lou—whose lower lip was still quivering but who was moving her elbow without pain.

“Can I have those sandals now?”

“No!” was the emphatic answer, spoken over a poutingly protruding lower lip.

I suspected both Julie Lou and her mom would be back for future visits. I think Helen was secretly impressed—although she never let on, at least to me.

As I left the office that afternoon, I reported on my hospital patients to Mitch, who was on call for the county, and told him of our evening plans.

“You and Barb have a good time. A good evening.”

As I turned to leave his office, he continued, “Oh, by the way . . .”

I turned back to face his desk.

“Helen told me about that Fortner girl. Good job, son. Good job. I think you taught the old girl something—and
that's
something in itself. She's been around a long time. I'm pleased.”

Mitch rarely gave such direct praise. It was a special gift. I nearly floated out of the office.

chapter twenty-four

AN EVENING TO REMEMBER

A
s I walked up to the screen door at home, Kate wasn't there waiting, as she usually was, but I could hear Barb humming in the kitchen. This is always a good sign. When's she's humming, she's happy. Barb's joy always lifts my spirits. Before I got to the door, I could smell her fragrance—it was
Tatiana
, her favorite perfume. I didn't think it was too bad either!

As I opened the door, she was there to meet me. She was all ready to go. Her hair and makeup were perfect. Her simple but elegant maternity dress was stunning. Wow, she was beautiful! She gave me a hug and a long kiss. Wow, again!

“The sitter took Kate out for a walk in her stroller. It's just us.”

“Want me to cancel dinner reservations?” I asked suggestively.

Barb backed up a bit and smiled, her arms still resting on my shoulders. “Take your time, big boy. Your lady and your baby are ready for a night on the town.” She affectionately rubbed her expanding abdomen with both hands. “Besides, Dorinda and Kate will be back in a bit. Now go get ready and let's blow this joint.”

We drove across town and up the hill just south of the main traffic light. After a little dogleg around the library, we pulled into the small parking lot of the Fryemont Inn. We strolled up the front driveway toward the main entrance—a large front porch with several occupied rocking chairs and a nearly endless view up the Deep Creek Valley. The famous Smoky Mountain haze was setting in as the sun retreated behind the distant peaks. The air was cool. We stood in each other's arms for a few minutes, slowly and deeply breathing in the crisp, clean mountain air. The view, the surroundings, and the air were all invigorating.

How welcoming to then step into the large, warm sitting room, with rocking chairs and overstuffed couches scattered comfortably about. Several were arranged in front of the large stone fireplace. We followed a long narrow hall that led to the dining room. The foyer outside the dining room displayed framed articles from scores of food critics and travel correspondents lavishing praise on the inn and its chef-owner, Katherine Collins. The pictures showed a lovely woman who possessed a beautiful smile and long sandy blond hair.

Finally we opened the old entry doors into the dining room. In the background we heard the croonings of a 1940s-sounding album. The dining room was nearly seventy feet long and about forty feet wide, with a floor of wide maple planks. Large dark timbers supported the vaulted ceiling. We were the only people there. As we moved into the room, we saw it: a massive stone fireplace with a large fire roaring inside. In front of the fireplace, perhaps ten to fifteen feet away, was a small round table set for two. It had a bouquet of freshly cut flowers and a scented candle.

After a few moments, a young woman came from the back and greeted us. “Hi, I'm Elizabeth Ellison. Are you the Larimore party?” We smiled, as the reservation book was otherwise empty. As we were escorted to our seats we felt like a king and queen.

“Katherine has asked me not to provide a menu,” Elizabeth explained. “She will be cooking a special meal for you.”

Elizabeth left us alone to enjoy each other, the fire, and the relaxing environment. We reminisced about our first months in Bryson City. In many ways, it wasn't what we had expected, but we weren't really sure we had known what to expect in the first place. We laughed about my first delivery and the missed world-record muskie. We contemplated my first patient who had had a miscarriage and the couple whose honeymoon had been derailed by a ruptured appendix. We reminisced about my experiences with Louise and Millie. I mused about how delightful it is to practice with Mitch and Ray—and to get to know Dr. Bacon—but also how unwelcoming and unfriendly Drs. Mathieson and Nordling had become. Barb bubbled as she discussed the imminent arrival of Dr. Rick and the not-yet-imminent arrival of Erin Elizabeth. But we spent most of our time talking about how most of the townsfolk were making us feel so welcome—especially the football community.

“You really enjoy working with that team, don't you, darling?” asked Barb, as she reached out to hold my hand.

“The coaches, the kids, and the parents have all made me feel so welcome. I
do
love working with them.”

Barb smiled her beautiful and sparkling smile. I squeezed her hand.

Then, out of nowhere, someone was at our side—radiant, warm, and friendly. “You
must
be the Larimores.” She offered her hand first to Barb and then to me. “I'm Katherine Collins. I'm pleased to meet you and delighted that you've chosen to come to the Fryemont Inn for your anniversary.”

“Is it usually this quiet?” I asked, wondering if maybe the food might be suspect.

She threw her head back as she laughed. “No, no. In the summer, we're booked solid from Memorial Day weekend through Labor Day weekend. Then we fill up again for two or three weeks during the color season. We close the inn after Thanksgiving and don't reopen until the first of April—although this year I'm thinking about keeping the dining room open all year long. Anyway, this is our quiet time. We use it to freshen up the old place—and to welcome new friends.”

She continued, “It will be my pleasure to serve you a special feast tonight. I've prepared my favorite specialty—slow-cooked prime rib. But first, Elizabeth will bring out some appetizers. How does that sound?”

We nodded eagerly.

“Fine,” she said, “I'll let Elizabeth keep an eye on you, and I'll go to work on the rest of the dinner.”

In just a few moments Elizabeth appeared with two small plates. “This is smoked Smoky Mountain rainbow trout. We smoke them using an old family recipe. On top is a puree of caviar and capers and on the side some homemade thin croutons. Enjoy.”

We did. When Elizabeth reappeared, our plates were empty.

The next course was what
Katherine called her Silver Queen corn chowder, a thick creamy chowder that was slightly sweet and a bit spicy. The soup was accompanied by freshly baked, piping-hot sourdough rolls and honey butter that melted in our mouths.

Each course left us more and more enchanted with the inn as the evening progressed. Others came into the dining room but were seated near the windows, away from us. We felt as though we had the place to ourselves.

The salad dish was fresh milk mozzarella cheese on top of thick ripe beefsteak tomatoes that Katherine grew in her vegetable garden at the inn. When topped with freshly ground pepper and dried basil, it was magic.

As the salad dishes were being cleared away, Katherine reappeared. “Are you still hungry? In a moment I'll bring the main dish. The A-1 prime rib comes from a farm near here where the grain-fed cows are raised without chemicals or hormones. The beef is lean and so tender you can cut it with a fork. I've been slow-roasting it all day, over salt, in my oven. Would medium be acceptable?”

We felt our mouths watering and nodded in eager agreement as she disappeared, soon to return with two giant plates. On each one was a huge slab of prime rib surrounded by mashed potatoes, crisp steamed garden green beans and snow peas with a small section of zucchini and squash.

“The potatoes are Yukon Gold—the best—slow-cooked and mashed with a bit of garlic, fresh sour cream, and pepper. I steam the peas and beans. They're fresh from the garden, so expect them to be a bit sweet and crisp. The zucchini and squash casserole is a recipe from my grandmother. And no, I won't share the recipe with you!” She mocked sternness, and we all laughed. This royal service was infusing our evening with an even deeper sense of celebration for a marriage and a career that were both launching into a hopefully pleasant and enjoyable future. We had no way at that point of seeing the storm clouds forming on the horizon—clouds that would threaten my very ability to practice medicine. But at this particular and special moment, we were celebrating.

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