Free Bryson City Tales by MD Walt Larimore Page B

the street to the hospital. Nothing stimulating in that. ”
    I sensed our conversation was coming to a close. The apples were calling my new friend—some needing to be crushed for applesauce, some needing to be cooked, and some needing to be made into cider.
    â€œThe chief value, Walt, of the kitchen operations, over those done in the hospital, is that the young surgeon, the inexperienced physician, had no one to blame but himself for a poor result or an infection after surgery. You young guys, if any of these things happen, tend to blame the hospital or the staff or the nurses.
    â€œThe second value of the kitchen surgery is that it could be done immediately. Young surgeons don’t understand that fear has an adverse influence on surgical recovery. You see, to most people hospitals are scary. They all seem to know people—friends and neighbors—who’ve gone to hospitals and died. Yet they know no one who’s died on the kitchen table. So when the hospital was built and we quit doing most of our kitchen surgeries, we didn’t realize the harm we were doing. Instead of seeing people early in their disease, they waited to come in for help. Patients would resist advice to go to the hospital and only come in when in severe distress.
    â€œSo, when the hospital first started doing surgery, our morbidity and mortality was unacceptably high. This caused more fear of the hospital and produced a vicious cycle. The more people who fared poorly at the hospital, the longer people waited to come to the hospital, and the worse they did when they got there. When we operated at home, we operated earlier in the course of the disease. The patient’s fear factor was much lower. And they just did better.
    â€œWalt, even today, I will not operate on someone who is deathly frightened. It doesn’t matter what causes the fear—I will not operate on a frightened patient. I’ve seen more than one patient who, prior to surgery, said they had dreamed that they didn’t recover—or who confessed that they thought they were going to die and not recuperate—who proceeded to make good on their prediction. Every old surgeon has similar stories to tell from his own experience. When we autopsied these cases, we did not find the cause of death in even one.”
    He took a slow, deep breath. “I believe they were literally scared to death.”
    He slowly stood. “Been a pleasure chatting with you, Walt, but I bet that lovely wife of yours has Sunday dinner about ready. You get on and I’ll bring some cans over later this evening.”
    Later that evening Dr. Bacon did bring over dozens of jars and cans. Our root cellar was well stocked with candied apples, apple chips, applesauce, and apple cider—some of the best we’ve ever had. But the old physician’s real gift that day was grounding me a bit in the history of my profession and my community. I may have known more modern medicine than he did, but not more medicine—and certainly not more interesting medicine!

chapter seven
    FIRST-DAY JITTERS
    M onday morning was my first official day of work as a family physician—the culmination of twenty-four years of education. I almost couldn’t believe the big day had finally arrived. Today, I would just start making a living—almost eleven years after many of my high school friends had begun their careers.
    I arrived at the hospital at 5:30 A.M., ready to meet Mitch for rounds. Mitch was, according to the evening supervisor, uncharacteristically late. I stood nervously at the nurses’ station waiting for him. I didn’t have to wait long. In he strode, confident and lively. As he entered the station, as though on cue all the nurses stood to attention and in unison said, “Good morning, Dr. Mitchell.” I’m sure my mouth dropped open. Then a nurse appeared from nowhere with a pot of coffee and a clean cup and saucer. “Thank you, Verna,”