Bryson City Tales

by Walt Larimore, MD

  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

  When 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.”

  “Here, here,” exclaimed voices around the table as iced-tea glasses were raised in a salute.

  Eloise, a tall, handsome woman, floated around the table serving her guests. She blushed, “Well, my lands! No need to fuss. It’s just a little lunch.”

  “A little lunch!” exclaimed Jack Lyday. Jack was the county agricultural extension chairman. “If this is a little lunch, then the Titanic was a little rowboat.” Everyone laughed.

  “Seriously,” began Earl Douthit, “the board has discussed Eloise’s food before. It’s one of the reasons we have trouble getting patients to leave the hospital after they’re well. Most of them have never eaten so good.”

  Jack added, “That’s why we got Fred to join the board.”

  “Why’s that?” inquired the apparently perplexed attorney.

  “To protect us from a lawsuit when some fool patient eats himself to death.”

  The laughter started again—at Fred’s expense. We basked in the warmth of the group. They obviously liked each other and thought the world of their little hospital. We were feeling more and more like we were with family.

  Eloise reentered the room with a homemade pie in each hand. One was pecan and one was apple—and both were piping hot, with steam rising off the flaky crusts. Behind her was a kitchen staff member with a container of homemade vanilla-bean ice cream. Behind them walked several men in white coats. It was like a parade—and it was time for us to meet the local doctors.

  Introductions were made between us and the six physicians—Bacon, Mitchell, Cunningham, Mathieson, Nordling, and Sale. Harold Bacon, M.D., was the eldest of the county physicians. Although supposedly retired, he continued to see patients in the ER and in his small office next to the hospital. He had in the not too distant past lit up the gossip lines in a two-county area by marrying a decades-younger divorcée of one of the circuit judges. Mercedith Bacon was at the top of the social pecking order in town and very active in the local Democratic party.

  William E. “Mitch” Mitchell, M.D., had served the United States as a Mobile Army Surgical Hospital (MASH) surgeon. He was a political and financial powerhouse in the county. A general surgeon and general practitioner, he had run the county medical proceedings for the twenty-five or so years of his practice and of late had run the local Republican party. After the death of his first wife, and not to be outdone by his senior competitor, he soon married a much younger woman from Asheville, North Carolina—Gay, whose name matched her propensity to laugh and socialize.

  Ray Cunningham, M.D., the youngest doctor of the bunch, had begun his medical career in his hometown only two years before my arrival. He was in practice with Dr. Mitchell in the county’s first and only “group practice,” Swain Surgical Associates.

  Kenneth Mathieson, D.O., had retired to Swain County after years of private practice elsewhere. Also in his late sixties, he found retirement to be unacceptable, and not too long after his arrival, he started practice.

  Eric Nordling, M.D., and Paul Sale, M.D., were both general practitioners in their fifties. Both seemed to be loners; however, I learned that their approach to medicine was as different as night and day. Dr. Sale took care of nearly all of his patients’ medical problems right in Bryson City—referring folks to the “big city” only if absolutely necessary. Dr. Nordling had the opposite approach: He referred as much as he could out-of-town. This conflict in practice and philosophy did not bode
well for the future of their continuing to practice in the same town.

  And yet that day of our first meeting all the doctors and board members seemed to hold genuinely warm feelings toward each other. The laughter was free-flowing. At one time I noticed R.P., Earl, and Dr. Mitchell enmeshed in a hushed and very serious discussion, which apparently ended in harmony—smiles and backslapping all around.

  After dessert, the entire group, including the physicians, began to excuse themselves. Each of the nonphysicians seemed truly glad we were there. The physicians seemed a bit more reserved, but a few were friendly. Dr. Mathieson seemed irritated that I had come to town. Drs. Nordling and Sale also appeared reluctant to welcome me. But for the moment I wasn’t discouraged.

  Suddenly Barb and I were alone with Mr. Douthit. “Cathy,” he called to his secretary, “would you bring me the folder with the offer?”

  Here we go, I thought. Down to business.

  Cathy brought in a manila folder that Earl carefully opened. He began to shuffle through the papers. “Ah, here we go.” He pulled out a single sheet.

  “Walt, we’re not an affluent county or a rich hospital. Our physicians here are not paid even the national average. If you and Barb are looking to make a lot of money, we’re not going to be the place for you all. But if you’re looking for the type of environment and lifestyle that Swain County has to offer, then you’ll be pleased here—and your income will be more than satisfactory.” He paused.

  “Go on,” I encouraged.

  He nodded. “First of all, we would pay for all of your relocation expenses. And we’d want the mover to do all your packing for you.”

  “That sounds very generous, Earl.”

  “To keep your expenses down, we’ll cover all of your professional costs for the first year of practice. I’ve talked to Dr. Mitchell, and he will allow you to practice in his office, with himself and Dr. Cunningham. He will keep any monies collected for your work. We’ll pay him your overhead and any money short on your salary. Any money collected above the cost of your salary and overhead will be split. One-half to Dr. Mitchell, one-quarter to the hospital, and one-quarter to you and Barb.”

  “OK,” I stammered, trying to figure out the implications of such a complex arrangement.

  “We’re offering a first-year salary of $30,000.”

  I was shocked. This was less than the university paid their medical residents in training.

  “Quite frankly, Mr. Douthit, I had expected a more generous offer. Most of the other counties are offering . . .” My voice trailed off. Was I being selfish? NO! After thirteen years of primary and secondary school, four years of college, four years of medical school—all with no income other than Barb’s teaching income, nine months per year—a teaching fellowship in England and three years of residency—not to mention school loans—NO, I was not being selfish. This offer just would not do!

  I glanced at my wife and saw that she was trying to hide her disappointment. “Now, I can tell by the looks on your faces that the salary appears inadequate. However, we feel the entire offer may be of interest to you.” He paused and then continued. “On top of what I’ve mentioned, we will offer you, at no charge, the home that Mrs. Gunn showed you earlier—for as long as you wish to live there. The hospital will cover the cost of any and all repairs and of all utility bills and phone bills. In addition, you are both welcome to dine at the hospital at any time at no cost.”

  I looked at Barb again. She seemed a bit more interested.

  “We will also pay for all of the costs incurred by you both when Dr. Larimore has to travel in order to obtain his continuing medical education. We would just ask that you preapprove these expenses with me prior to traveling.

  “We will also provide for all your insurance needs—malpractice, car, home, medical, dental, life, and disability—which should save you considerable funds.”

  This was starting to sound better.

  “In addition, we want to build a brand-new office building. Our current physician office facilities are not what we would like. So the board has had conversations with the North Carolina Office of Rural Health and with the Duke Endowment. We would like you to help us design a family medicine center, to be located within walking distance of the hospital. We’d like to begin recruiting other family doctors who could join you in this building as our older physicians begin to retire. This building will not cost you any money, but just the effort to help us design a wonderful facility for our clients—your patients.”

  This was starting to sound much better.

  “Last, but not least, we want you to help us design our new in-hospital birthing center. We’d like to take the old delivery rooms and make them into two comfortable and attractive birthing suites that will be the envy of any hospital in the state.”

  He sat back and took a deep breath. “Walt and Barb, I don’t expect you to decide overnight. Please take this information, think about it, and let me know your decision when you’re ready.” We agreed.

  As we left the hospital, offer in hand, my mind was swirling. There is so much that seems attractive, almost charming, about this town and its medical community. Yet neither Barb nor Ihave ever lived in such a small hamlet—so far from family and, Barb reminds me, a mall! We’ll need time to talk, to debrief, and to pray.

  “Walt,” pleaded Barb, “let’s find a place to walk and talk.” We decided to drive up the Deep Creek Valley. At the northern end of the valley was the border of the Great Smoky Mountains National Park. We parked and strolled up the wide walking path beside the creek—it was smooth enough to roll Kate in her stroller. During the summer the creek would be filled with the shrieks of kids tubing over the white-water rapids—but today it was peacefully quiet. Within a short time we were alone—just the rustling of the wide rushing creek, the singing of the birds in the thick overhead canopy, and the joyous sounds of Kate singing and humming.

  Thick mountain laurel and rhododendron bushes hugged the path. We passed two waterfalls and sat, overlooking each, simply to discuss our impressions and concerns. Maybe it was the sheer beauty of the place—or the warmth of her people—or the hospital’s overwhelming need for updated medical skills and technology. Maybe it was our need to feel needed—to make a difference. Whatever the reason, our hearts were in agreement. Barb leaned over to me as we sat by Indian Creek Falls and pronounced, “Walt, I think this is the place!” I smiled in agreement.

  We left the park and drove west from town out to the Nantahala River, where we watched fly fishermen and kayakers at play. We soaked in the quiet, marveled at the lushness of the hills, and breathed in the clean mountain air. We spent the afternoon driving around the small town—and up the valleys and dales surrounding her—and into some of her larger hollows. It was a warm afternoon and the sky was a crystal blue. Our peace and confidence only grew. Eventually, as dusk began to descend, we drove back to town for our scheduled dinner with the partners of Swain Surgical Associates.

  We parked and walked up to the gracious manor where we were to dine. What was then known as the Frye-Randolph House was originally a small Victorian lodge, built in 1895 by Captain Amos Frye. The captain later expanded it to an L-shaped plan, complete with lovely gables and a stone-pillared porch. Captain Frye and his wife, Lillian, lived in the house while the captain’s palatial Fryemont Inn was being constructed just up the hill. After the captain’s death, Lillian, by then the first practicing female attorney in western North Carolina, continued to practice law and run the inn until her death in 1957.

  Dr. Mitchell and Dr. Cunningham were sitting outside with their wives, and they stood as we approached. Introductions were made all around. Gay Mitchell and Nancy Cunningham were the kind of sparkly people everyone instantly falls in love with. Their smiles were gracious and their laughter was infectious. We immediately liked them both—Gay the louder and more buoyant, effervescent, and outgoing; Nancy the more quiet and reserved. Unlike their husbands, both had been raised elsewhere, but they were quick to sh
are with us their newfound love for the mountains and Bryson City.

  The dinner bell rang, and we were escorted into what appeared to be a beautifully kept private home. Only the tourist brochures on one wall gave away the purpose of the Frye-Randolph house. We were shown into a private dining room where rich linens covered the table and candles glowed warmly. Our five-course meal was accompanied by light, friendly conversation. The proprietor and his wife, Bill and Ruth Adams, were in and out of the room—obviously great friends of our hosts and most hospitable to Barb, Kate, and me.

  After dinner we were shown to the sitting room. A small fire was burning in the fireplace, and as Ray lit his pipe, the room’s aromas were heady and warming.

  “Walt,” said Bill “Mitch” Mitchell, almost sounding stern, “Ray and I think you’d be a great addition to our medical staff. And we’d love for you to join us in our practice—at least until your new medical office can be built. But I’ve just got one concern I need to discuss with you.”

  “What’s that?” I asked. My curiosity grew as Gay pulled out a folded sheaf of papers from her purse.

  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 privileges—cholecystectomy, 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.