Mitch unfolded the papers, looked them over, and then handed them to me. “Is this the paperwork you sent to the hospital?”
I looked at the papers, instantly recognizing them. “Yes, this is the list of medical and surgical privileges I've asked for. I filled this out for Mr. Douthit before we made our trip out here. Is something wrong?”
“Sure is. Look at page 5.”
I turned to page 5. It was a request for surgical privilegesâcholecystectomy, appendectomy, fracture repair, hip replacement, upper gastrointestinal endoscopy, colonoscopy, breast biopsy, skin grafts, and a plethora of other surgical procedures. The page was blank. I had not checked any interest in applying for
any
of these privileges, because I had not been trained in any of these procedures.
“What's the problem, Dr. Mitchell?”
“Well, you didn't mark that you wanted any of those privileges.”
“That's true, I don't. I'd plan to assist you and Ray with most of these. But I'm not trained to do them as the primary surgeon.”
Mitch looked incredulous. Ray chimed in, “Told you!”
Mitch looked at him a bit sharply and then back at me. “You're a doctor, aren't you? You mean them boys at Duke didn't train you to be a doctor? How can you practice out here if you can't do these things?”
I smiled. Ray broke the silence, nicely expressing my sentiments. “Mitch, that's what I told you. I know that in your day doctors
were
trained to do it all. But not in
these
days. Family physicians like Walt, just like the ones I trained with at the Medical University of South Carolina in Charleston, are trained to take care of about 95 percent of all the problems they encounter. And they're trained to assist a general surgeon. But they're
not
general surgeons.”
Mitch sighed. “Makes no sense to me. If you can't help us in the OR, then you're no more helpful than Sale, Mathieson, or Nordling.”
“That's not true!” exclaimed Ray. “Walt's had
lots
more training than they've had. He's trained in obstetrics and delivering babies. He's trained to take care of infants and kids. He's forgotten a lot more dermatology, gynecology, psychology, and neurology than I ever learned. He knows intensive care. And he
can
help us in the OR. Furthermore, I'll bet he's willing to learn some of these proceduresâaren't
you, Walt?”
Ten eyes were suddenly fixed on meâincluding Barb's. “Well,” I stammered, “sure . . . I'd be willing to learn anything that you'd be willing to teach me.”
Mitch looked at me for a moment, then at Ray. Ray smiled at Mitch, and then they
both
looked at me.
“OK,” Mitch said, standing up and extending his hand toward mine. “We have a deal.” I shook his hand, not entirely taking in what had just occurred.
On the way back along the river toward the Hemlock Inn we were silent. As we crossed the Tuckaseigee River bridge, Barb spoke. “Walt . . .”
“Yes, honey?”
“Did we just agree to move to Bryson City?”
We were quiet for a few minutes. As we turned onto Galbreath Creek Road, I nodded. “I think so, honey. I think so.”
“Me, too,” she said.
“Me, too,” piped Kate's voice from the backseat.
FAST-FORWARD:
AWKWARD BEGINNINGS IN THE SMOKIES
W
e arrived in Bryson City in September of the next year. Kate was nearly three, and after the many months Barb and I had devoted to doing physical therapy with her, she could stand and, with the help of special braces, even walk some.
We spent our first weekend moving into our little house by the hospital. One of my first duties was picking a location in which to place our newest possessionâa wrought-iron park bench. The three of us sat in it together for the first time, gazing out over the Smoky Mountains.
I put my arm around Barb's shoulder and she snuggled close, with Kate tucked into the crook of her arm. “It fits the four of us just fine!”
For a second, Barb looked confused, and then she laughed as she rubbed her beautifully enlarged tummy. “Only five more months to go!” Barb was pregnant with our second child. We were excited about becoming parents againâand this child would be the second grandchild we would give to our families. Kate had been the first.
“You look beautiful,” I whispered, as I pulled my wife close.
“This will be perfect,” she whispered. “Perfect.”
We had expected to spend the weekend alone, just getting moved in, but were in for a delightful surprise. We were both pleasantly astonished and genuinely warmed as person after person dropped by. All day long, on Saturday and on Sunday, hospital employees, board members, a few doctors, local political figures, and the newspaper editorâmost of them accompanied by their familiesâdropped by to greet us, welcome us, and share housewarming gifts. Our root-cellar shelves were rapidly filling with their gifts of canned fruits, vegetables, jams, and stews.
“I'm not sure I'll
ever
have to go to the grocery,” exclaimed Barb.
Sunday afternoon, Dr. Bacon was helping Barb organize the shelves in the cellar. “Well, honey, if you do run out, just let some of Walt's patients knowâand they'll restock it all!” He chuckled. We were soon to realize that he was dead serious.
“Where's the new doc?” came a call from upstairs.
I bounded up the stairs to see a handsome young man who, when he saw me, stuck out his hand. “Howdy, Doc. I'm Gary Ayers, the morning deejay at WBHN. We're the local radio stationâAM 1590.” He paused. “In fact, we're not hard to find on the dial. We're the
only
radio station that can be heard in these parts,” he observed with a chuckle. “Just wanted to come by and meet youâespecially since you guys are a
great
source of information for the morning news!”
For a moment I thought he might be kidding. But he was not. Gary, as I was to learn, was
the
source to the county not only for world and national news, but he was also the mouthpiece for most of the better community gossip.
As Gary left, Dr. Bacon and Barb came up from the basement. “Be careful, son,” warned Dr. Bacon. “If he likes ya, he can make life pleasant indeed. If he doesn't, look out!”
“What about the newspaper editor?” I asked.
“Oh, you mean Pete Lawson?”
“Yep. He was by earlier today.”
“Nope. Not to worry. Pete's as good a newspaper journalist as there is. Plays his stories straight to the facts. I like Pete. A lot!”
And I liked Dr. Bacon. I asked him if he'd give me a personal tour of his orchard, located between our house and his.
“You bet!” he agreed. “Do you want to help with the harvest? I'd be glad to trade a few jars of canned apples, applesauce, and apple cider for your efforts.”
“I'd be delighted.” I smiled as I accompanied him outside, where we strolled through the rows of trees and eventually sat under the large fir tree in front of his house, gazing at the mountains. Dr. Bacon began to share a bit about his past and about the medical history of the county.
“Walt, I'm glad you're going to bring the babies back to our county. I was
so
disappointed when the younger docs and the hospital decided to let Sylva take away
our
babies.”
“Did you attend births yourself?” I inquired.
He looked at me as though I had four eyes. “Did I attend births?” He chuckled. “Why, I've delivered hundreds and hundreds of babies in my time. I've even delivered scores of babies of girls I delivered. Now,
that's
when you know you're getting oldâwhen you deliver your second generation. I've even delivered a few of what I call third-generation babiesâwhere I delivered the baby, the mom,
and
the grandmom. Now you know for sure that I'm ancient.” He threw his head back and laughed. I wondered if I would ever have the amazing privilege to attend the birth of a woman whose own birth I had attended.
“For years and years,” Dr. Bacon continued, “before the hospital was built, why, I'd do all the deliveries at home. Remember taking the Model-T out into the hollows. Sometimes I'd have to push her across the creek bottoms, sometimes get stuck in mud. Would get to the house and stay until the baby was born. Sometimes that'd be hours and sometimes a day or two. Had some basic rules I'd always go by. First of all, I'd get all of the men out of the house. Something about men. They just seemed to get in the way and women always labored better without them.”
“Wouldn't you allow a daddy to see his child be born?” I inquired.
“Oh my, yes. But he'd only be in the way during labor. He could come in for the birthâif
he
wanted and
if she
wanted. But if she didn't want him there, he'd just have to stay out. They seemed to understandâespecially in those days.
“What I really wanted at the house was womenâespecially women who had had babies. Walt, there's not a man in the world that can care for a woman in labor like a woman who has gone through labor. I can't explain it, but a woman caring for a woman just seems to make the labor go faster. If there weren't any ladies present when I got there, I'd send the husband off to get some. It would give him something useful to do.
“I'd also always bring a bundle of fresh newspaper from town.”
“Newspaper? For what?”
“Walt, newspaper is sterile. Perfectly sterile. I'd use the paper as drapes and to keep the bedsheets dry and clean. Also, once I knew the mom and baby were OK, it gave me a chance to sit back and catch up on the goings-on in town.” He chuckled.
“Good obstetrics requires a good portion of patience. I've always said I needed a good cigar and a rocking chair to enjoy while I'm reading that paper. Just let things go their natural way. Almost always came out all right. In over forty years I only lost one babyâand that was from a knotted cord. And,” he emphasized, “I never lost a mom. Not one.”
“But, Dr. Bacon,” I quizzed, “what if you got in trouble? Did you go to a hospital?”
“Nope. In those days we did what was called kitchen surgery.”
“You did the C-sections at home?” I was incredulous.
“Of course. Why not?”
I paused. “Well, the lack of sterility could cause infection and death, and what about the lack of help and proper equipment?”
He laughed. “I guess you've never been exposed to âkitchen surgery,' have you?”
“Nope, that's for sure!” I replied.
“Walt, in our kitchen-surgery days we had to be content to work with no luxuries. We had to learn what essentials we had to have and how to work quickly. This is more than most modern surgeons know. Our system involved small incisions and rapid surgery. I tell you, this minimizes more infection than all the modern face masks and head covers combined. We seldom had
any
wound infections in our kitchen surgeries. The most important factor was prompt surgery. Small incisions. Minimal unnecessary trauma to the tissues. Expert surgical technique. Minimal exposure of any internal tissue to the air. Rapid closure and good dressings. These were the tools and trade of the kitchen surgeon.”
“Was lighting a problem?”
“It could be at times. Indeed. Lantern light is hard to use for surgery. The best light was a car headlight.”
“What did you doâbring a car battery and light into the house?”
He laughed. “No, no. Just have someone drive the car up to the door or in front of a kitchen window and leave the headlights onâpointing into the kitchen. Then a family member would use a looking glass to reflect the light into the wound or onto the perineum. There was no better light than thisâjust as good as any operating room light!”
I was fascinated. “What about anesthesia?”