Chapter One
Dead Man Standing
It was one of those sweltering summer afternoons in the Smoky
Mountains that are unknown to outsiders and a distinct surprise
to first-time visitors-humid, sticky, and unyielding. The heavy air
lay over us as though it didn't want us to even move.
"You didn't tell me, Walt," my bride of nine years complained.
We were heading toward our tenth wedding anniversary that fall,
and I had already begun scheming, behind her back, with the help
of our friend Sally Jenkins, to give Barb a bedroom makeover and
a special trip out of town.
"About what?" I asked, trying to feign innocence but suspecting
she had somehow found out about my shenanigans. One
thing that was almost impossible in Bryson City, North Carolina,
was having a secret remain a secret. Somehow news wafted
through our town as easily as mountain breezes.
"About this heat!" Barb exclaimed. "If I had known it was
going to be this hot in the mountains, I might have just stayed in
Durham and let you come up here by yourself!"
Barb turned to smile at me-one of those "you know I'm kidding"
smiles I loved. She turned back to face the mountains. "At
least I would have asked the hospital to put an air conditioner in
the house!"
We were sitting on the park bench we had placed in our backyard
when we moved to Bryson City, North Carolina, over a year
ago. It looked out over an exquisite view across Swain County
Recreational Park, then up and into Deep Creek Valley, and finally
over nearly endless ridges all the way to the most distant mountain
ridges-deep in Great Smoky Mountains National Park-that separated
North Carolina from Tennessee.
"Maybe I could call down to the Bryson City icehouse and
have them send over a block or two for us to sit on."
"You mean that old building down by Shuler's Produce next
to the river? It doesn't look like it's been open for years. How
about you go get us a glass of ice water?"
I nodded and ran into the house to get a glass for each of us-being
quiet so as not to wake up our napping children-and then
tiptoed to the back screen door and out to Barb.
The view was mesmerizing, and we had now seen it through
each of the four seasons-my first year as a practicing family physician-since
finishing my family medicine residency at Duke
University Medical Center.
"I didn't know it would be this hot," I commented. "But then
there were so many things we didn't know about this place until
after we settled here, eh?"
Barb threw back her head and laughed. My, how I loved her
laughter!
"True enough!"
We both fell silent, reflecting on the beginning of our medical
practice here. I had left residency so full of myself. Indeed, I had
been very well trained-at least for the technical aspects of practicing
medicine. But when it came to small-town politics and jealousies,
the art of medicine, the heartbreak of making mistakes and
misdiagnoses-all piled on the difficulty of raising a young daughter
with cerebral palsy, dealing with one very strong-willed, colicky
little boy, and transitioning a big-city girl into a rural doctor's
wife-well, the task was not only full of unexpected events, it was
downright daunting.
Barb turned her ear toward our house for a moment. I could tell
she was listening for the children. Kate and Scott were napping, so
we had the windows open-both to capture any passing breeze that
might happen along and to hear the children if they were to awaken.
My thoughts turned to our small hospital-a sixty-mile drive
west from the nearest medical center, which was in Asheville. In
the early 1980s, Swain County was still a slow, small, sheltered
mountain hamlet. Most of the folks were natives, as were their
parents and their parents' parents. Most all of the physicians, and
the nurses for that matter, were in at least their third to fourth
decade of practice. They had their way of doing things and didn't
"hanker to outsiders"-whom they called "flatlanders" if they
liked you, or "lowlanders" if they did not. They especially resisted
any "newfangled" ways. "Be careful if you say anything negative
about anyone, son," Dr. Bill Mitchell, or Mitch as everyone called
him, warned me. "It'll get back to them-and me-lickety-split."
Rick Pyeritz, M.D., my medical partner and also a classmate
in our family medicine residency at Duke University Medical
Center, was on call this day for our practice and for the emergency
room. In Bryson City, the on-call doctor was on call for hospital
inpatients, the emergency room, the jail inmates of the Swain
County Sheriff's Department and Bryson City Police Department,
the National Park Service, the coroner's office, the local tourist
resorts and attractions, and the area rest home and nursing home.
The fact that one of us would cover all the venues in which medical
emergencies might occur made it very nice for the other six
physicians not on call that particular day.
"When the kids get up, how about we all take a stroll up Deep
Creek?" Barb asked.
"Sounds like a great idea!" Deep Creek was the southern
wilderness entrance to the Great Smoky Mountains National Park.
The creek was wide, tumbling, and ice-cold-a great place to go
tubing or to just hike in the solitude of the park.
We looked across the valley. I looked at Barb as a small breeze
caught her hair and blew it across her forehead. She swung her
head to flip it out of the way. "But until the kids get up," I
inquired, "maybe their parents need a nap?"
"Just what do you mean by nap?" Barb wondered out loud,
tossing a suspicious look my way.
It was my turn to smile and silently look up at the ancient
creek and across the ageless mountains.
Suddenly we were startled by a loud sound. We turned to see
a car screeching around the hospital and heading down Hospital
Hill toward town at a rapid rate of speed.
"Wasn't that Rick?" asked Barb.
"It was! Wonder where he's going?"
In a small town it doesn't take long to find out almost anything.
* * *
Even though on call that Saturday afternoon, Rick had found
some time to lie down on his couch for a nap. Living in houses
owned and provided by the hospital, we were just across the street
from the hospital. We had been friends since our internship year
at Duke. Our varied backgrounds, interests, and character traits-he
a New Englander and I a Southerner; he a single man and I a
married one; he a backpacker, naturalist, ornithologist, jogger and
I a sedentary family man; he an introvert and I an extrovert-drew
us together like opposite ends of the magnet. However, we shared
a love of family medicine and a desire to serve the families that
honored us by choosing us to be their family physicians-and we
were both equally attracted to this rugged wilderness area.
(Continues.)
