Archive for March 2009

Heather’s New Home

March 15, 2009

        This post is not about stray animals, although we love them.  We have all we can handle, and should not take on any more if we want to stay in the good graces of the neighbors.  Musical instruments are another matter.  

        Take this new one I ran across.  I couldn’t help but fall in love.  She was a broken down little tenor guitar, and needed a home so bad.  We took her in and nurtured her like a lost puppy, and she has found new life.  We named her Heather, after a line in an Irish tune. 

        A couple years ago, I helped a fellow with his CD.  He played dulcimer and wanted a few mandolin tracks.  I was happy to oblige.  He offered to pay me, but I knew his project was on a tight budget and I wanted to help him out and do it professional courtesy.

        People don’t forget though.  I was looking for a tenor guitar to play with Al Donnelly, an Irish folk singer I sit in with every so often.  My dulcimer friend heard and gave me a call.

        “Hey Doc, I hear you are looking for a tenor guitar.”

        “Yeah.  Al would like some of that sound in his Celtic work.  I haven’t seen one in years.”

       “Well have I got a deal for you.  I found one.  You want it?”

        “I’d love to look at it.  How much do you want for it?”

        “It’s not for sale, but I’d love to give it to you.”

        “I couldn’t let you do that.”

        “You might change your mind when you see it.  It has been in my attic for years.  The thing is in pieces.  I forgot it was up there, but I saw it the other day and thought of you.  If you can put it back together you’re welcome to it.”

        It was in bad shape sure enough.  The neck hung by a thread and was bowed like a ski slope.  A couple of frets and a tuning key were lost to posterity.  There were several cracks and it was covered in tar and splatters of paint from when they remodeled their house.

       “She’s beautiful.  We’ll take it.”

        I had some old Stew-Mac banjo tuners at the house.  I put all of it in a cardboard box at took it down to Johnny’s Music.  Our local guitar guru opened the package and pulled out the pieces with tender care. 

        “I agree Doc .  She needs a new home.  Yeah, I can put her back together.”

      “How much?”

       “Hmn.  Fifty bucks and one office visit.”

        “Deal.”

        The ‘Harmony’ decal is half gone, and the lower bout has a huge crack we didn’t try to repair since it got auto-sealed with roof tar.  We couldn’t get out all of the splotches of paint.  It has nicks and gouges and probable bar room battle scars.  Lord if she could only talk.

        But then again she does talk her language.  Tenor guitar is tuned in fifths like a mandola, and has a dark lonesome sound.  When you play ‘Will Ye Go, Lassie, Go?’  it is, to borrow a line from my friend Wayne Benson, about as Celtic as man can get if he grew up two blocks from Burger King.  

        I played it this morning.  The thing looks like you drug it home tied to the rear bumper of your car.  We believe it dates back to the 40s, but is only worth about $75.00 on the market, though much more to me.  After all, Heather is like a stray pup and now part of the family.   She is a mutt, but they are always the best ones. 

Dr. B

 

Here is the chorus to ‘Will Ye Go, Lassie, Go?’

“And we’ll all go together

To pull wild mountain thyme

All around the blooming heather

Will ye go, lassie, go?”

Medical History Repeats Itself

March 13, 2009

        My daughter says some things never change and I am one of  them.  I saw a patient not long ago who reminded me of that fact.

        This lady’s mom was one of my first patients.  The mother had several chronic medical conditions.  I looked after her until she died and was always impressed with her outlook on things.  In spite of her medical troubles the lady was a fun person to be around, and always had a joke or a story.

        I saw the daughter last week.  She has the exact same list of medical conditions.  She deals with them with equal grace.  Not only has she come to look just like her mom, she also tells funny stories, laughs just like her, and even has the same mannerisms and inflections in her voice.  Their idiosyncratic similarities are downright spooky. 

          I treat her with similar meds as what I used with her mother.  I think we would do just as well with the old ones, but the administrators and bureaucrats get upset if you don’t look modern, and I am afraid they might fuss at her or not cover her regimen. 

         One time I explained treatment options for her kidney stone and she said, “Dr. B you do what you gotta do.  I don’t care if you have to latch an alligator to my ass to help me.”  It was what her mom used to say when she had a stone.  Like her mom, my patient likes my music and comes out to our shows when we play. 

        I guess Marie is right.  Some things never change and I am one of them.  So are my people.  It makes being a small town doc all kinds of fun and such an honor and privilege.

Dr. B

Something To Do With Money

March 12, 2009

        We used to have an old Doc in town who had the same answer for every problem.  Regardless of the issue at hand, when something was wrong he’d say, “I don’t know what the problem is here, but it has something to do with money.”

        Most people in health care want to do right by people, and they are easy to work with.  But, whenever I run into folks who will not act in the patient’s best interest old Doc’s adage can be used as a powerful  motivational tool.

       Take a case last month.  I had a patient with a couple risk factors and a good story for a pulmonary embolus.  (Blood clot).  I wanted  a CT chest to rule out a clot.  The little chart review person at the insurance company told my people we would have to do a plain chest x-ray instead.  With the diagnosis in question, that is a little better than a coin flip, but not much.  They would not budge.

       Often I have to call, but this time our referral tech was able to make them understand.

       “What should I tell them Dr. B?”

       “Hmn.  Why don’t you go with the BBQ speech?”

       “O.K.”

       In a minute she was back with an accession number.  The CT was approved. 

        The BBQ speech goes like this:

        “Y’all like BBQ?” 

        They usually say yes. 

        “Well, I’m glad, ’cause Dr. B says you might need to visit us for an extended stay.”

        “Why is that?”

        “He wants you to know if anything happens to his patient while you obstruct their care he keeps a lawyer on retainer.  And boy does this lawyer love BBQ.  We have the best down here.  He thinks it won’t take more than two or three years to sort out.  With her being a mother of three, he believes a jury would have enormous sympathy in the event of death from a delayed diagnosis of pulmonary embolism.”

        “Really?” 

        “Yeah.  He said not to worry too much.  This is a rural area, he doubts it would go for more than three mill or so.   Old Dr. B is  a very patient man.  Why he’s like a little terrorist; he ain’t going away.  You’ll love it here.  Like I said, the barbeque  is great.

         There are all sorts of variations on the theme, but the fundamental principle is always the same.  You have to speak to what motivates them.  I gave a up a long time ago trying to make them understand I hoped to help a human being; that matters to them not in the least.  But when you start to talk money they will often listen.  Like the Old Doc said, there’s something wrong here and it’s got  something to do with money.

        By the way, my patient’s blood clot treatment went well, and she should do fine.

Dr. B

Hey Good Looking

March 10, 2009

        We had a gig last night.  It was for a local charity, and I enjoy those.  The guy I played with came up in old time and folk music, but is very eclectic.  Our show is a mix of folk, old time, bluegrass, and a little classical rock and old time country.

        Afterwards folks came up to speak.  I especially enjoy the influence our music has on the young people.  One told me he had picked up the mandolin because of me.  Another started a traditional music club at the school, and I always want to check in to encourage him.

        Overall it was a good show for a doctor.  Of course, I have had a lot of help.  Darin Aldridge has been a major influence for years, and continues to help me.  For the last year and a half I have studied under Wayne Benson too.  If a man can’t learn to play with Darin on his right arm and Wayne on his left, he is hopeless.  I can’t carry their cases, but they have shaped me into a decent amateur.

       But the main influence on me is my Marfar.  She is a busy woman and can’t come to everything I play, but she was there last night.  She had a meeting but slipped away early so she could catch the show.  

        Way back when I started on electric guitar it was in hopes of meeting girls. Well after Marfar came along I gave all that up.  But I gotta admit when I play mandolin and she shows up there is a bit of little boy in me.  When I saw her in the audience I couldn’t help but light up. 

        When we did ‘Hey Good Looking’ I dedicated it to her.  There is a line that says the fellow was gonna throw his black book over the fence.  Well for me when I met Marfar I tossed away my black book, traded it for a black bag, became a doctor and lived happily ever after.

        So, as the song says, “Hey Good Looking.  Whatcha got Cooking?”  Better go practice my mandolin.  Gotta do my best when Marfar is in the crowd.

Dr. B

Dr. B’s Secrets to Longevity

March 9, 2009

        I have been a Doc a long time.  Along the way, I have learned some secrets about longevity from my patients.

        Years ago, one of my patients made it well into his hundreds.  I got to where I didn’t charge him.  He was way too valuable in terms of advertisement.  When people asked him how he lived so long, he said it was because he chased young women, chewed Wrigley’s Spearmint gum, and that Tommy Bibey was his doctor. 

        In a small town word of mouth is everything.  A number of people signed up for me as Doc because of that man, but today I have to tell you what is true;  all the credit was due to the Good Lord.

        Last week I saw a lady who was 96.  She was in a hurry to get to the Walmarks.  I asked her if she was going to drive, and she said, “Heavens no, Sis is gonna take me.”  Sis is my patient too and she is 99.  I attribute her long life to that baby aspirin I prescribe for her on MWF, but that is not it.  She knows the real secret is to choose your ancestors carefully!

        Another fellow I had was a volunteer at the Nursing Home in his 90s.  Someone asked him why he did all that, and he said, “Someone has to look after these old folks.”  I love his spirit.  It never occurred to him to ask anyone to look after him; he was all about helping someone else.

        I am not certain why some people live so long, but it seems most of them are sweet little old ladies or farmers.  For the most part aggressive and hostile chain smokers don’t seem fit the profile, although I guess there are a few.

        The Lord knows all the real secrets.  As the song says, when we get to heaven ‘farther along we’ll know all about it.’  There we will have an eternity to figure out what we don’t understand here.

Dr. B

Megan Peeler: My Favorite Country Music Singer

March 6, 2009

        Johnny’s Music Store is our local music hangout.  (The old timers still call it Johnny’s Jewelry and Pawn)  It is a good place to relax.  They have a fine easy chair right next to the Martin guitars.  Sometimes I’ll take a nap there at lunch. They know my schedule and always wake me up in time to make afternoon office hours. 

        One day a new young lady bounced in.  Johnny pulled her aside.  “Hey, Megan, you need to meet Dr. B.  He’s our local music critic.  Plays mandolin with Neuse River.  He’s the gray haired one over in the easy chair by the Martins.”

        She walked over and Johnny introduced us.  “Doctor B, this is Megan Peeler.”

        “Nice to meet you sir.”   This was a country kid with a nice southern drawl.  We shook hands.

        “You need to go catch her show, Doc.”  Johnny said.

        “Where you playing, kid?”

       “Over at the college for the Poultry Association.”

        “They gonna have good food?”

        “The best.  I played it last year.”

       “O.K.  Sure.  I’ll come by.”

        When she left I turned to Johnny asked, “Can she sing?”

        “Dang right she can, Doc.  Won the Colgate  Country Showdown.”

       “The national contest?”

        “Yep.”

        “Wow.  I reckon she can.”  With those credentials, it didn’t take much for John to convince me this was a must see artist.

        Still, even with the heads up I was unprepared for the energy of her performance.  This was a cute kid, but far more than just a new girl singer.  She had a powerful voice.  The show was a mix of both country classics and her original compositions.  She played guitar and keyboards.  Not but a minute into the show I fished around for a pen and began to take notes on a program.  

         In spite of her young age, Ms. Peeler was already a skilled performer who connected with her audience right away.  Pretty soon, the old folks smiled and the young ones danced.  From a musician’s perspective it was clear she had more than than an informal background.  As it turned out she was a magna cum laude grad in Music Therapy from Appalachian State University, so she had plenty of formal music education.

        We got a chance to chat afterwards.  I was impressed this was a young lady who was not so much into the star mentality but one who loved music.  For Megan, music is a medium for human communication.  She was all about a good show, but also interested in composition, theory, harmony structure, and the power of music to heal.  I told her I played the nursing home circuit and she said she had enjoyed doing some shows like that in her journey.  She engaged her audience and addressed the crowd like she was playing a church picnic, but at the same time was a very serious artist. 

        It brought to mind Wayne Benson’s thoughts on John Cowan.  Wayne toured with Cowan a couple years and he said the man always wanted to entertain to the best of his ability. (which is considerable)  If they had a disappointing turn-out Cowan never let up.  He’d say “we can make eighty just as happy as eighty thousand.”  Megan Peeler strikes me as a pro like that too.

        It has been a while since I’d thought about Megan, but there was an article in our local paper today that she’d landed a gig on national television.  She’s gonna sing the National Anthem in Atlanta to open a NASCAR race.  Way to go Megan.  Folks, if Doc mangled the Star Spangled there’d be a revolution to change songs.  (or at least artists)  It takes a real singer to tackle that one, but Megan can do it.

        We never forgot her around here after she came through and did that Poultry Association gig.  If they tell you at Johnny’s Music a new artist is worth your time to go hear you can count on it, and Megan is all that and more.  Y’all look for her on national T.V.  One of these days if I am in Nashville on a book promo I’m gonna see if she’ll sit in with me and sing a tune at the book store.  Her venues grow bigger every year, and by then the young folks might mob the place.  But I suspect Megan Peeler is gonna stay down to earth regardless of how far her star rises.

        And by the way, if Megan Peeler says the Poultry Association can cook up some mean chicken take her word for it; it was good.

        Look for her her on the Cable Speed Channel Atlanta NASCAR race this Saturday, March 7th at 1:30.

        Her web site :   www.myspace.com/meganpeelermusic

Dr. B

Drug Reps

March 4, 2009

        I get along fine with most of the reps.  90% of them work hard, are professional and have some good information to leave with us, though some of it has to be viewed with a jaundiced  eye.

        Every once in a while one will get on my last nerve though.  The ones who don’t realize the patients come first are doomed with me.   One told me he wanted more of my time, and I told him I had a loyalty list.  My wife and kids are at the top, then my patients and my staff, then my bluegrass band, and ‘well son, you are just way down here.’  I rubbed my hand on the carpet for emphasis.

        One fellow came through with some new steroid cream and acted like it was gonna rid the world of all dermatological ills.  “Doctor, have you tried it yet?”

        “Yeah, I used some of the samples.”

        “Wonderful.  How did it do?”

         “Excellent.  My dog had the mange and it seemed to relieve some of the itching for her.”  I don’t think that was what he wanted to hear.

        Another said, “Doctor in my experience…”  I don’t know what he said after that.  No one 25 years old needs to open with that line to me, at least on doctor issues.  Now bluegrass is another matter.  I know plenty of pickers that age who can run circles around me, and I pay attention to what they have to say.  Same way with writing.  I hate to sound arrogant, but that boy isn’t gonna scoop me on the Doctor gig.  He just needs to tell me about his product and let it go at that.

         He did leave me one thing that helped though.  It was some kind of luggage handle wrap thing, and when I turned it inside out so the logo wouldn’t show it worked quite well to shore up the worn out handle on my mandolin case.  Last time I saw him I thanked him for it.  I don’t think he wanted to hear that either.

        But the worst one was years ago.  One day some young lady just gushed over her company’s new blood pressure medicine.   “Doctor, can I leave you some samples?”

        “Yeah, how about a couple boxes.  I have one patient who takes it and he can’t afford his medicine.  I hate to ask for extra, but he really needs it.”

       This was a very attractive young woman.  As she moved closer, I realized her attire was, uh… inappropriate or revealing might be the best words.  I backed up my chair.

        “No problem, Doctor.”  She inched out over my desk.  “I want you to know if you write my antihypertensive, you can have anything you want.”  Her message and the view were both quite clear.

        By now my back was to the wall. The office intercom was just to my left.  I paged Paig.  “Hey Paig, this young lady needs directions to Harvey Surgical.  She’s late for her appointment.”

         Paig came in and led her away by the ear.  She marked her card with an ‘X,’ the office code for no appointments.  My people are protective of me like that.

        It is a good thing for the girl it wasn’t Marfar who educated her.  I only made a ‘B’ in Orthopedics and I m not sure I could have fixed the child up.

        We never saw her again, but my guess is she didn’t make it as a rep.  I hope she didn’t anyway.

Dr. B

Snow Lady/Snow Baby

March 2, 2009

        We had a big snow and the South is paralyzed.  I have four wheel drive and can get around O.K.  Back in the old days, I always got to the hospital, but one time someone brought a child to the office for a well baby check.  That didn’t make much sense to me.

          Nowadays I am a gentleman farmer Doctor, though.  We have hospitalists and I am an outpatient Doc.  It is the first time I ever recall it, but Corporate called off work for the day.  It was the right decision.  The odds that someone could get hurt trying to come in are higher than the odds I could help them today. 

        Years ago one old Doc told me he always worried when it snowed.  He was afraid his people would figure out they didn’t need him!  That might happen to me too, but the idea is to work yourself out of a job if you can.

        Me and Marfar chased the snow all winter.  We were too late to see it when we visited Tommy and too early when we went to see Marie.  Ms Marfar says it is a sign I need a day of rest, so I guess I am resigned to eat gumbo and pick her favorite tunes all day.  It is a tough job, but I promised.  

         Ms. Marfar is the Snow Lady, but today I want to tell you about Snow Baby.  Twenty years ago we had a big snow one day, and I had a new baby in the nursery.  I enjoyed snow days and weekends, ’cause all the coat and tie crowd stayed home.  Instead of paperwork duties, you spent your time with patients and families. 

          I checked this little girl in the nursery.  She was a cutie; had a full head of downy hair that stood straight up.  She looked about like a new born chick.

         I sat in the room with the family for a minute and drank a cup of coffee.  Outside, big snowflakes were falling.  We watched for a moment.

           “She’s fine, just as pretty as can be.  Look at all that snow, I’m gonna call her Snow Baby.”  The name stuck.  The child came to see snow as a celebration of her birthday, and was school age before she realized any other baby on the planet might have been born that day.  Whenever I saw her, be it as Doc or at school function, I never called her by anything but Snow Baby.

        Snow Baby was by the office not long ago for a physical for Nursing School.  “You sure have grown up mighty pretty, kid.  I knew you were a keeper from the get-go.  Say you’re going to nursing school?”

        “Yes sir.”  

        “That’s great.  Sure is a need.  You’ll never be out of work.”

        “That’s what Daddy says, too.”

        I signed off on the form and handed it back to her.  “Make sure they make a copy up front.  Gotta be able to prove I checked you.”

        “Shoot, Dr. B you’re the only doctor I’ve ever had.  Who else would a done my physical?”

        “Hm.  I guess you’re right.  I’m glad you’re gonna be a nurse.   Maybe you can look after me in the Nursing Home.  There ain’t but one Snow Baby.  I don’t trust just anyone, you know.”

        “Heck, Dr. B.  You ain’t anywhere near old enough to be in the nursing home, but you know I’d look after you.”

        “You always were a good kid.”

       Being a country Doc is not a get rich quick scheme but it has its rewards.  I wouldn’t trade places with some insurance guy.  When you have the honor to look after someone as fine as Snow Baby, you realize your career had some meaning, at least in your little corner of the world.  He might make a million bucks a year, but I got to be Snow Baby’s Doc, a privilege no executive perks could ever trump.

        Well, Marfar calls and I gotta go.  She wants me to try ‘White Christmas’ on the guitar.  My singing voice is more akin to Bob Dylan with a bad cold than Bing Crosby, but my job today is to make the lady of the house happy.  Put on some gumbo and a pot of coffee, Snow Lady, I’m off for the day.

Dr. B