Bryson City Secrets: Even More Tales of a Small-Town Doctor in the Smoky Mountains (15 page)

What just happened!
? I thought to myself. Usually the response to the epinephrine is rapid — but
never
like this!

“Pressure is 210 over 130!” Bonnie exclaimed as the cardiac monitor raced up to 180 beats per minute. “And respirations are 42 per minute!”

“What did you give him?” I bellowed to Sandra.

“Epi, just like you asked.”

“How much?”

“3 cc's.”

Instantly I knew what had happened. And so did the student! I could see the shock on her face as she gasped and then clasped her hand to her mouth. The normal dose of epinephrine should have been 0.3 to 0.5 cc's. The patient had received 6 to 10 times more adrenaline than he needed, and I had no antidote for the overdose. But I knew that if his heart could survive the onslaught for just another moment or two, the effect of the overdose would quickly pass.

I turned to Bonnie. “Get O
₂
started stat. Five liters per minute.”

I barked to the student, “Open up the IV. Let's try to wash the epinephrine out of his system. And be sure to have some Inderal ready should we need it.” Inderal was a medication I could use to control his blood pressure and heart rate. But I didn't want to give it unless it became absolutely necessary.

The next few moments seemed like an eternity. But slowly and steadily the boy's blood pressure, heart rate, and breathing all eased down to normal levels. And as his did, so did mine.

Then the patient quickly woke up, shaking his head.

“What happened?” he asked.

The collective sigh of relief in the room gave way to smiles.

When Don and Billy arrived, the patient was stable. As they prepared to transport the young patient-prisoner to the hospital, I talked to the boy. His name was Sam Tanager. He was fifteen years old and in jail awaiting a hearing for breaking and entering at a downtown store with another young man.

“I made a big mistake, Doc,” Sam told me. “I won't make another one, I'll tell ya that.”

“Is your daddy McCauley?” Don asked.

Sam blushed. “Yeah.”

“The same McCauley Tanager who's a member of the school board and a deacon at Cold Springs Baptist Church,” Don commented to me. “Pretty important fella in the community.”

I nodded, as Barb and I had come to know McCauley and his wife, Laura, fairly well. We often ran into them at community events or local restaurants.

Sam's head dropped to his chest. “Yep. Mom and Dad were pretty embarrassed by the whole thing — as were my two sisters. I just got in with the wrong type of friends.”

Then he looked up at me. “But Doc, I'm goin' clean. I made a mistake, but it won't happen again. I'm goin' back to my church and back to my spiritual roots.”

“Well, Sam, I'm glad to hear that. I think one of the most important aspects of becoming a real man is to be able to admit our mistakes, to learn from them and then to try to avoid making the same mistake again.”

Sam's head dropped. “I hope the Lord'll be willin' to take me back.”

“I can guarantee you that he will.”

Sam looked quizzically at me. “You think so?”

“I
know
so.”

Sam furrowed his brows in a deeply skeptical stare. “Sam,” I explained, “he says so in his Word.”

“Where's the Bible say that?” Sam asked.

“It's in the book of 1 John. It says, ‘If we confess our sins, he is faithful and just and will forgive us our sins and purify us from all unrighteousness.' So, Sam, our job is admitting our mistakes. The Bible calls that ‘confession.' Then God's job is to forgive us and make us clean.”

“Cool!” Sam exclaimed as the doubt on his face transformed to delight. “That's
really
cool.”

“I agree, Sam. It's an
incredible
promise. So I'll tell you what. You think about it a bit, and we can talk more later. In the meantime, the boys here are going to take you over to the hospital. I suspect you'll be there a day or two. We need to be sure you're not going to have a delayed reaction to the stings and the venom. OK?”

Sam nodded. “Will someone call my parents?”

“I suspect Dean's already doing that. But I'll make sure.”

He smiled and extended his hand to me. “Thanks, Doc. I'll never forget you savin' my life. I know I'll never be able to repay you.”

As I shook his hand, Sam Tanager seemed truly grateful. I wondered if the kid
had
turned a corner — if he had turned away from the evil with which he had flirted. But I had no way of knowing for sure if he was sincere — or just acting.

As I headed to my office, I asked Bonnie to invite the EMT student to come and see me. When Sandra arrived, I asked her to sit on the sofa and closed the door. I pulled my desk chair around the desk and took a seat by her as she blurted out, “Dr. Larimore, I'm so sorry!” Then she burst into tears.

I let her cry for a moment and then reached to pull some tissue from a dispenser on my desk. She took it and blew her nose.

“Sandra,” I began, “I appreciate your apology.”

She blew her nose again and wiped the tears from her face.

“I think learning to apologize for the mistakes we make is a critical skill to learn. And I'm afraid most doctors never learn it.”

She smiled and sniffled.

“You're just beginning your career in health care. And I'm here to tell you that you're going to make lots of mistakes. We all do. But the difference between those who are good and wise in practicing the art of medicine and those who are not is learning from our mistakes — and trying our best to never repeat them. Make sense?”

She nodded, and I continued. “Those prisoners on the work crew — they've all made mistakes, eh?”

She nodded again.

“And so have I, Sandra. Lots of them!”

Her eyes widened a bit. “You have?”

It was my turn to smile. “You bet. Like the Bible says, ‘We have
all
fallen short. . . .' The key is to learn to recognize and admit our mistakes and to learn from them. OK?”

She smiled, nodded one last time, and said, “OK.”

“See you tomorrow. It's a new day.”

Sandra left, and I turned to look out across the mountains. I sensed Sam and Sandra
had
both learned from their mistakes. And time would prove Sandra to be a competent and compassionate caregiver. As for Sam, only time would tell, but I was optimistic.

chapter sixteen

KING ARTHUR

A
re you on call this weekend?”

The question wasn't an unusual one from Ella Jo Shell. Often when she or her husband, John, came to the office, they'd inquire if Barb and I might be interested in joining them and their guests for a meal at their pleasant and popular inn. Our first night in Bryson City, when Barb and I first interviewed for a job here, had been spent at the Hemlock Inn, and we loved returning time after time to enjoy Ella Jo's timeless recipes and the Shells' effervescent hospitality and delightful guests.

I'm sure my eyebrows lifted in anticipation as I replied, “Nope, I'm not on call. Rick's towing the load this weekend. In fact, with Barb and the kids visiting her parents, I've even taken Friday off for some quiet time and to finish a ‘honey-do' list Barb left for me.”

Ella Jo fairly beamed. “Oh, goodie!”

“Goodie? What's so good about chores?”

“No, no, no,” Ella Jo laughed. “It's not the chores I'm excited about. I've got a great excuse for you to do something
really
fun on Friday afternoon.”

I sat down on my rolling stool and looked curious.

“Walt, you like hiking in the park, right?”

“You know it,” I responded.

“Did you know that it's nearly impossible to take a walk in the national park without sensing the influence of Arthur Stupka?”

“I did not. And just
who
is Arthur Stupka?”

“John and I call him ‘the King of the Great Smoky Mountains National Park.' He was the first and probably the greatest naturalist the National Park Service ever hired — at least for this park. He's retired now and is up in years, but every year he comes to the Hemlock Inn for a couple of weeks and leads our guests on tours. He's arriving Friday morning, and I'll bet he'd be happy to meet you and take you with him on a hike in the afternoon.”

An excuse to postpone some chores, combined with the forecasters' prediction of a stunningly beautiful spring weekend, was too tempting for me to turn down. “Wow, Ella Jo, thanks for thinking of me.”

“You come up to the inn about two o'clock, OK?”

“I'll be there.”

I later learned from Rick, an amateur ornithologist, that Arthur Stupka truly was considered a “king” to bird-watchers, biologists, and botanists alike. He had spent decades accumulating exhaustive observations in the Great Smoky Mountains National Park. When I arrived at the inn on Friday afternoon, he was waiting on the porch, gazing across the valley at the Alarka Mountains in the distance. I expected him to invite me to sit a spell and chat, but he didn't. Instead, after he greeted me with his hearty handshake and “Let's take a walk!” he made a beeline toward the parking lot. Within minutes, I was driving toward the park.

Mr. Stupka wore a crown of white hair, and his face was ingrained with the wrinkles that accompany years of sun exposure. He smiled easily but spoke infrequently as his alert and active eyes darted around the landscape we were passing. His few words were mostly in the form of questions as he inquired about my background, training, family, and practice. He seemed most interested in my triple majors at LSU in zoology, chemistry, and biochemistry.

As we entered the park and my car slowly meandered down the steep, winding road, he pointed to a turnoff. “Park there, son!”

A few minutes later, we were walking down a lovely, isolated trail. Every step took us deeper into the Smoky Mountains wilderness. At first my companion was silent. I sensed he was using every sense to size up the hills, the forest, and the wildlife. Arthur was more a walker than a hiker — his pace being an easy and leisurely saunter as opposed to the rather rapid and forced pace of the hikers I usually observed on the Appalachian Trail. I was wondering if this might just be because of his age when, appearing to read my mind, he spoke.

“When I'm in my park, Walt, my steps are slow. Usually younger people are uncomfortable with that. They have to get used to it.”

I smiled to myself as we stopped so my new friend could listen carefully to the sounds of the forest — the rustling of the wind and the chirping and singing of scores of unseen birds. As I would find out, he knew what made every single sound and what the sound meant.

As he began to walk again, he explained, “My pace isn't slow because of my age. And it's not from having to adjust my step to match the many thousands of untrained trampers I've guided through the woods during my career here in the park. It comes from my reading of Thoreau. You ever read Thoreau, Walt?”