Bryson City Tales

by Walt Larimore, MD

  The dining hall was packed. Each of the seven tables had eight chairs around it. John was at the door, greeting each arrival and directing them to their assigned table. Seating and eating was strictly family style—with John arranging and rearranging the inn’s guests at each meal—guaranteeing a variety of conversation with people from all over the country. At our table alone were folks from New York, Atlanta, and Oregon—all escaping to the hills for rest and relaxation—some to read, some to think and meditate, some to hike. There was also a couple from Bryson City named R.P. and Sally Jenkins.

  “Ella Jo’s cooking is known far and wide,” chimed R.P. “We like to come up here every chance we can—at least when John and Ella Jo have an opening at their table.” He laughed, and John Shell beamed.

  As we were gathering at our tables and meeting our meal mates, the young servers were bringing out a smorgasbord of delicacies on large platters and in large bowls. I was curious as to why no one was sitting—everybody was standing and greeting each other—it was almost like being at a family reunion. But I wasn’t left to wonder for very long. At the ping of a small bell, everyone turned to Mr. Shell. At his side was a woman, about the same age but much shorter and rounder—and her smile was as radiant as an angel’s.

  When the crowd had quieted down a bit, John began, “Ella Jo and I want to welcome you newcomers to Hemlock Inn, which is known for having the most beautiful innkeeper’s wife east of the Mississippi!”

  He looked down at her and smiled, and her blush could have warmed the room. She grinned and whispered out loud, “Actually, east of California,” and laughed easily and gracefully.

  “I agree,” he stated emphatically. “May we say grace?”

  We all bowed our heads. Now I must tell you that this only made it easier to inhale the delicious aromas wafting up from the table. I was secretly hoping for a very short prayer—although surprised that there would be one at all. Not that I minded prayer—it was a regular part of my life, at least before meals. As a family we always said grace before a meal. It’s just that doing so at a public dinner was a new and somewhat uncomfortable experience for me. However, after only a line or two, something happened.

  “Our heavenly Father, we thank Thee for this beautiful day and this lovely location,” John prayed earnestly. “We thank Thee for our health and for the activities of this day. And now we bow to thank Thee for this bountiful provision that Thou hast laid before us this evening. Bless the hands that prepared it for us. Bless it to our nourishment. And bless us to Thy service. May our sleep tonight be both sweet and restful. We ask these things in the wonderful name of Thy Son, Jesus Christ, our Lord.”

  During the prayer I had been instantly taken back to my paternal grandparents’ home in Memphis, Tennessee. We held hands as we sat at the table, and my grandfather, a Pullman conductor for the Illinois Central railway’s La Louisiane, would pray, “Father in heaven, we thank Thee . . .” In John’s voice and words I could hear my grandfather—and the feelings of warmth and nostalgia were overwhelming. As he prayed, so did I—thanking God for the blessing of a family, chock-full of memories and traditions.

  I was brought back to reality when the entire room chanted in unison: “Amen.”

  Before the amen’s echo bounced back from the walls of the dining room, chairs were scraping on the wooden floor as the guests seemingly dove into their places and began to dig into the hearty and delicious Southern meal: fried chicken (of course!), perfectly seasoned with a thick, crunchy breading; green beans with ham hocks and just the right saltiness; ham that fell off the bone and could easily be cut with a fork; silky-smooth, creamy potatoes with brown and sawmill gravies; three types of salad with a variety of made-from-scratch salad dressings; candied carrots; at least three types of freshly baked bread, and a basketful of steaming-hot yeast rolls with local clover and wildflower honey butter and a wealth of other delectable homemade toppings and jams. Barb teased me that my eyes were as big as the countless platters.

  During dinner we found out that R.P. and Sally were active in the leadership of Arlington Heights Baptist Church and that R.P was a past chairman of the hospital board of trustees. It finally dawned on me that this was not such a coincidence that the Jenkinses just happened to be here for dinner and seated at our table.

  As Kate happily munched on a drumstick and mashed potatoes, we visited with a tableful of new friends. Most had been at the inn for one- or two-week visits, year after year, for many years. We learned that true newcomers, such as us, were uncommon—a rarity, in fact.

  The dinner discussion was the typical talk of the day—where people went, what they did, what they discovered. Questions to the newcomers centered on who you were, where you were from, and why you had been so foolish as to never have visited the Hemlock Inn before. Upon discovering that we were considering this little hamlet as our home, a cacophony of oohs and aahs circled the table, peppered with comments like, “I’d sure move here if I could,” and, “You sure are lucky to pick a place like this,” or, “Honey, see what I told you? Young professionals are moving out here.” These comments were an encouragement to us and increased our rapidly growing feelings of fondness for the area.

  After we had finished dinner and Barb put Kate in bed, we joined the Shells and Jenkinses on the porch, pulling a group of rocking chairs into a semicircle. Dusk was beginning to fall over the valley, and as it did, the autumn colors of the trees underwent transformation through a cornucopia of colors. The hills almost seemed aflame. The wind was blowing gently.

  Barb broke the companionable silence. “John and Ella Jo, what led you all to move to the area, or are you from here originally?”

  “Oh no, we’re not from here,” John answered. “But we love this area. Moved up here from Atlanta to own and operate this lovely little inn in this beautiful locale.” He paused to consider how best to articulate his thoughts. “There is so very much here that we like. The history of the area is a rich one. The people are wonderful. The weather’s great, and there’s plenty of fresh air and water. It’s a safe community—a great place to raise your kids. The schools are good, and the teachers are top-notch. It’s a religious community. The hunting and fishing and hiking are superb. And thanks to Mr. Douthit, our little hospital is just fabulous—given its size.”

  He paused again, looking troubled, almost confused about where to go next. R.P. Jenkins intervened, “Walt, our surgical services at the hospital are excellent. Dr. Mitchell and Dr. Cunningham bring in a lot of business and a lot of patients. They do a lot of surgery and do a good job. Our operating rooms are large and modern—they have all the best equipment. And our two nurse anesthetists are fabulous. People will travel here from quite a ways away.”

  John interjected, “And some of our medical services are good. We’ve got a new lab and a new emergency room. Our new X-ray equipment is state-of-the-art. Dr. Sale does an excellent job, but . . .”

  There was a moment of silence. John and R.P. looked at each other. What is going on? I wondered.

  “What the men are hesitant to say,” interrupted Sally, “is that we have a number of physicians that are . . .” She paused. “How should I say this? They are, uh, getting older. Sometimes they can be moody or cantankerous. People around here get a little tired of that. So they leave and take their medical business elsewhere. That’s not good for the hospital or the community.”

  “The older folks, the ones who have trouble traveling, don’t seem to be leaving to see doctors in other towns,” explained R.P. “But the younger families sure are.”

  “And,” added John, “it doesn’t help that none of the doctors deliver babies anymore. That’s one of the reasons we’re so excited about the possibility of you coming here. Your experience and training would be perfect for our little town.”

  “I wouldn’t expect things to change overnight,” warned R.P. “But as folks get to know you, they’ll certainly stay and have their babies here.”

  “Just like they used to,” Sally m
used.

  Quietness reigned for a few moments as we relished the cool air and the enveloping dusk.

  “Well, folks,” I said, “Barb and I are excited about finding a home for our family. We’re eager to settle down and to build a practice somewhere. So tomorrow’s going to be a special day for us. We’re looking forward to seeing the hospital and the town and meeting the board members and the other doctors.”

  Both couples looked at each other. Then Ella Jo spoke her first words to me, “Dr. Larimore, I have to be honest with you. I’m not sure some of the doctors want to meet you.”

  This unsettled me. I was quiet.

  “They’ve become so comfortable with the status quo. They’ve got plenty of patients and they make enough money. I’m worried that you might be a threat to them. There’s not been a new doctor around here in quite a while. And those who come usually get shooed right away. It’s downright shameful.” She seemed almost angry.

  “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

  The 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.