North Carolina Our State Magazine

North Carolina Our State Magazine has been quite attentive of bluegrass and its constituants over the last few years.  They have included reviews of my book The Mandolin Case, Dr. Temple’s 30 year career as a physician and semi-professional bluegrass musician, some nice coverage of Tommy Edwards of Bluegrass Experience fame, and have kept up with other bluegrass ongoing activities in the state.  Please check their archives for these articles.  I’ve been around the music a long time and find them historically accurate and quite informative.  Thank you to North Carolina Our State Magazine for your insistence on excellent coverage of the Arts in North Carolina, including bluegrass music.

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Rolling Stool Blues

        Before we get into an approach to chronic illness, I gotta tell you this story.

        And this time, I’m gonna give you the disclaimer first.  I am not making fun of my patients.  I respect their right to their opinion and try to work with them however I can. 

        As you get older you care for them even more than when you were young.  Of course, it ain’t quite the same intensity as you feel for your wife and children, but nonetheless, it is true to say you develop a genuine affection for them, especially the ones who have been with you for many years.  It is a lot harder for me to deal with death than it was as a young doc.  In residency, I liked my patients, but after twenty-five years, the bond is much stronger.

        And, I am not poking fun at any dreadful disease process.  I hate it when people come down with things that can’t be fixed.  You know the odds are high their life will undergo permanent change, and not for the best. 

         So, I don’t want to be disrespectful, but at the same time patients sometimes do the dang-est things.  This is one of those stories.  You could either get mad or laugh, and I try to choose the latter.

        You know those little rolling stools the doc uses to slide around in the exam room?  They are necessary for much of our work, and there are some exams I about can’t do without them. 

        For some reason I have had a time keeping my folks off those seats.  They aren’t safe, and children and the elderly can fall off.  We’ve never had anyone seriously injured, but my observation is the very ones who sit on them are often those with the highest probability of hip fracture. 

        Our exam room floors were the sterile linoleum type.  They were easy to clean, but I became concerned someone would get hurt when they fell.  When the nurse brought the patient to the room they would direct them to the proper chair, but once you are out of the room for even a minute, people would get restless and move around.

        One year I went on an all-out campaign to keep everyone off the rolling stools.  It was a miserable failure.  I went on for months, and kept up-ing the ante.  We started with signs in the waiting room, then the exam rooms, and then attached them on the top of the stool itself.  It reached the point where the seats were plastered with stickers and looked about like my mandolin case, which sports bumper stickers from our many travels and shows.  We came up with a variety of slogans.

        “DO NOT SIT HERE.”

        “FOR DR. BIBEY ONLY.”

        And finally, “WARNING: THIS SEAT MAY BE DANGEROUS TO YOUR HEALTH!  DO NOT SIT HERE!”

        It was to no avail.  No matter what I did, I’d come in the room, and some little lady would be seated on the rolling stool.  At times, we’d hear a loud noise, and rush into the room to find someone had fallen off. 

        I tried lectures, and came off as arrogant.  When my efforts to claim possession became too adamant, I sounded egotistical.  I guess it came out like, “How dare any other human sit in ‘my’ seat.”  I didn’t mean it that way.  I became discouraged.

        I did get two responses, though.  The first was from one of my old teachers. I saw most of my old grade school teachers for years, though most have now gone on.  One I am especially proud of just crossed the century mark.  Many of them look at me like they might pop my knuckles with a ruler if I don’t behave.  I see several from my middle school years.  I don’t know why anyone who remembers me from middle school would choose me as Doc, but they do.  Perhaps it is dementia.  Bless their hearts- what a horrible disease. 

       The first response I got was from one of those former middle school teachers.  I came in the room, and there she was on the rolling stool, propped up against the wall.  “Young man, you are going to have to do something about these seats.  They are terribly unstable.”

        I helped her to her feet, and pointed out the signs plastered all over the seat. 

        She peered at the messages over the half-glasses tethered around her neck, and then responded.  “Well, I didn’t see that.”

        I sighed.

        My second response was from a man.  When I came in the exam room, he was seated in the chair for the patients, and the  rolling chair was parked in the opposite corner of the room.  He could not have distanced himself any further without leaving the room.

        “Doc, say them chairs are bad for your health?”

         “Yes.  Yes sir, they are.”  I was pleased.  My plan was taking hold.   

        The patient looked around, and lowered his voice like folks do when they have a personal question.  “Doc, some of dem AIDS patients been sitting in them chairs?” 

        (My wife read this and said the title of this post should be “The Dumb *^^ Blues.”  She has a way of getting to the bottom of things.)

         I never brought up the issue again.  I took down all my signs, called off the campaign, and asked Dr. Lucas, Lynn O’Carroll and Myrd to pick us out some carpet for the exam rooms.  They had said for some time we needed to re-decorate and it seemed like the right time. 

        The carpet makes the work a bit harder for the cleaning crew, but at least now when folks fall off my rolling stool, it doesn’t sound so bad, and the floor isn’t as hard when they hit.  Still no broken bones, too, and I think we’ve improved our odds.

        So much for my skills as an educator.  How in the world do you teachers keep a whole class in line? 

Dr. B

Christmas Pageant

                        

        Today was our annual Christmas Pageant at Harnett Methodist.  It is a time honored tradition, much like yours I’m sure, where all the kids are shepherds and camels and such.  I debated on whether to write this up or not ’cause my agent said it was like asking folks to watch my home movies, but then I found out he was out of the country in Scotland and the only guy I know over there is Dr. Bob so I’m gonna take a chance he won’t see this one.

        The reason the tradition it is so important is the kids.  My young’uns were in it from the get-go, and started out as donkeys, but worked their way up through the ranks.  By the time they finished Confirmation Class their last year of Middle School, they made Mary and Joseph.

        I remember it well, ’cause I was out in the driveway getting them to the car, and someone came up in a pickup truck and wanted me to look at his wife’s emergency rash, and Tommy, Jr. dang near got hit ’cause that head gear drooped down around his eyes and he couldn’t see too good.  My Marie was dressed as a perfect Mary, but she got lost in the moment and hollered out, “Great Gawd-A’Mighty Tommy- Watch Out!”  It wasn’t very becoming of her role, but I got over it quick ’cause at least Tommy didn’t get run over.  Besides, it was my fault she’d say such a thing, ’cause she heard it at the Bomb Shelter the week before, and it wasn’t fitting to take such a young lady down there when Wild Bill was in town. 

        So, I asked the lady and her husband a few questions and once I was certain she didn’t have Rocky Mountain Spotted Fever (right locale- wrong time of year) or toxic epidermal necrolysis (the rash was localized, and her skin wasn’t sloughing off) or sepsis, (no fever, chills or vomiking as they say around here) I gave her a script for some FEP cream (that means For Every Purpose) and told her to come in first of the week.  After the curb service consult (we still do curb service even though there is not an ICD9 code for it- that is another story) we went on to the Church House.  I know you think I am making this up, but this is how is to be a doc in a small town. 

      Well anyway, Marie and Tommy made a wonderful Mary and Joseph, and I’ve still got the home movies if you ever want to see ’em. 

      The kids today did good too, and I think I enjoyed it so much because it reminded me of the old days with mine, especially the  little girl that played the Donkey. 

      The only adult in the whole pageant today was Miss Marilyn on the piano accompaniment, who plays the keys in our Praise Band.  When she missed her cue nine year old Dorothy, little cherub that she is, turned around and directed her to “Hit it Marilyn,” and then those children nailed “Little Town of Bethlehem” like seasoned stage pros.  Before too long, I’m gonna be recruiting some of them to sing with Neuse River- they sing with such attitude.

      My all time favorite pageant was not when my Marie was Mary, though.  That pick-up truck that about hit Tommy Jr. soured me on that one a bit.  The year Marie was the humble donkey still ranks as my favorite.  She sang “I am the Donkey, Shaggy and Brown,” and had on a suit with ears that kept flopping down in her face.  She kept having to brush those donkey ears out of the way, but in the bluegrass way, never missed a note, and stayed on pitch the whole tune.  

      Of course, we had it on VCR and watched it until Marie was so sick of it she couldn’t take it anymore, and made us put it up.  

      Now that she’s gone off to school, I get it out and watch it every year.  In fact, last  December Marfar had gone to do some shopping and I was off, but there wasn’t any picking going on and it was way too cold for golf. 

      Well, me and Miss Violet, the lady who helps us on Wednesdays, got to watching that tape, and when my Marfar came home we were were sitting on the couch watching little Marie sing “I am the Donkey.”  Poor Violet was just a squalling, but I held up pretty good- my contact solution musta gone bad, but I got through it.

      When it comes to your kids, docs are just like everyone else, so I appreciate your indulgence for today’s post- just don’t tell my agent you watched one of my home movies.  I’ll get back to doctor and music stories in short order. 

      And, I tell you what.  I’m gonna do just like every year and watch “A Wonderful Life” and that tape of my Marie as a donkey again just as soon as I get some better contact lens solution- right about this time of year that stuff goes against my eyes and makes ’em water.  I’m sure that’s what it is- I am a man of science, you know.

                                               -Dr. B

                                                

            

Lesson From a Patient

        I had a patient in residency with a most unusual name.  My standard practice is to obscure folk’s identity, but since this was decades ago, and he was 75 then, I guess it is not too bad a HIPAA violation to tell you his full name- Delano I. Dentifiey.  He went by D.

        Back in those days the homeless could come see us interns for free (it may have been the origin of the cliche you get what you pay for) and D was was a regular patient of mine.  

        D was beyond humble.  He was poor, and schizophrenic, but he was appreciative, and we got along.  One time he came in with a rapidly growing mole on his face, and wanted me to take it off.

        I tried to explain.  “Come on, D.  That thing looks bad- I think you ought to see the Derm boys or maybe even the plastic guys.”

        D gave me his usual blank stare, and would only grunt, and say, “You my doctor.”

        I brought in the George Mooney, the Chief Resident, for a second opinion, but D went catatonic on him, and wouldn’t say a word.  

        We talked it over, and George wanted me to press on.  “D’s right, Doc” he said.  “You’re his doc.  He isn’t going to let anyone else do it.”

        Well, we got D to scrawl an “X” on the sign here line, perhaps the worst excuse for informed consent ever, except I did tell him I didn’t have the proper training for the job.  I draped him the best I could (D was scared of being covered up) to keep a sterile field, then proceeded with a piece of minor surgery that was well intended, but inept nonetheless.   

        Sure enough, the pathology was squamous cell carcinoma, but the margins were clear.  I was ecstatic.  I’d cured him!

        The joy was short lived, though.  My nice surgical work quickly became as mess, and my best efforts to patch him up failed.  He was rid of his cancer, but try as I might, he was going to have a big scar. 

        One day a big plastic man was in to give us a lecture, and someone told him D was on the schedule, and everyone had to go look at my disaster.  Well, in front of the whole residency program, that Professor proceeded to tell everyone how many different ways the procedure could have done better.  He said there was no choice now but to let it granulate in by secondary intention.  (Ie, the way nature would heal it up if you didn’t have nothing to do with it.)

        I was a good resident, and made Chief my last year, but on that day, and in the weeks that followed, I was a regular medical Charlie Brown.  I heard it in the hallways- “Did you see that case Bibey did?  What a wreck!”

        D was unfazed.  He came to the clinic every week, brought his knitting, and patiently waited. (D was the ultimate “patient” I tell you.)

        “I’m sorry D.  I didn’t know it would take this long to heal.” I apologized.

        “You my doc.”

        I thought D’s wound would never heal, but by the start of my second year it did, and the scar didn’t look too bad, either.  D never complained about my doctoring and stuck with me to the end of the program.  When I left to go back home to N.C., we exchanged gifts.  D gave me some of his knitting, and I gave him some pants and a sweater, and told him to make sure to check in at the shelter come winter.

        To this day, I remember the lessons D taught me.  I only take off the most minor facial lesions, and then only when the patient fully understands.  After explaining I could leave a scar, and they might lose a point in their next beauty contest, one old farmer said, “That’s O.K. Doc, I gave those up years ago.”

        The bigger lesson was D’s faith, not so much in his Doc, but the simple faith in the healing relationship we all should have in the doctor business, was rewarded.  There is a lot more to healing than pills and doctors, and D, with his humble educational background, taught me that.  The most important lesson for me was that the patient is everything- our reason for being, and without them we might as well go to the house.  I never forgot D’s faith in me, undeserving as it may be.

         If D is still alive, he is very old.  Should you ever be in a big town in Tennessee with a famous Medical Center, and run into a homeless guy with a worn out pair of white doctor intern pants, and the inside label reads “Dr. Tommy Bibey” in perma-marker, you’ll know it’s D.  Whether anyone notices that little scar on his face or not, I am proud for them to know he was my patient.

Dr. B

Yankee Picking

        Well folks, I’m off from doctoring for a couple days, and it is a busy music weekend in the County.  Friday night is the annual Habitat for Humanity gig, a worthy cause if there ever was one, and we have our office Christmas party on Saturday, which is just a big jam session.  Sunday it is on to the Nursing Home, and the Moose will sing “Christmas Time’s a Coming” just like Bill Munroe. 

        About ten years ago we had a World Tour T-shirt, which listed our venues at the Fair, the Ayden tractor pull, the Nursing Home, the School House, and other local favorites.  The shirt went over real big, and when Moose wore it at the beach, some young lady stopped him (this is always happening to the Moose) and asked him where she could hear Neuse River play, so for a while there we were world famous all throughout the County.

        I know ’bout our music pretty good, but it occurred to me I had stayed so busy as a doc and picking around here that my exposure to the music has been limited to our version, what I hear from the groups touring through, and from my good fortune to know Darrell, who is the only one in our crowd to turn pro.  As I get older, I hope I might travel more and broaden my perspective.  ‘Bout all I have been exposed to is Southern bluegrass, and it’s great, but I often wonder what the music is like in other parts of the country.
        I do know that guys like Peter Rowan, Gris, and Bill Keith were all from up north, and contributed mightily.  Behind the scenes, some folks grumbled about “Yankee picking” but I never understood that.  They sounded pretty good to me.  Bill Monroe was a southern guru, and he didn’t deride it one bit- he not only embraced it, he hired them all!
        Well, I want everyone to know that here in the County, the bluegrass brethren is always welcome, regardless of race, color, creed, social status, religious denomination or anything else.  All the have to do is want to pick some bluegrass music, and they’ll get along.  Heck, they don’t even have to do that, all they gotta do is give us the freedom to play.
        You see, here in the County, and I suspect everywhere else, based on  how the bluegrass folks from other parts of the country treat me, bluegrass is ’bout like that Lake Woebegone Mr. Keillor talks about, where ugly things like prejudice don’t exist.
        I mean, here in the County we are a bit isolated, and I admit folks can sometimes be wary of newcomers, but if they are good folks I’m proud to say they get treated like family.
        One day a new fellow came to town to look me up, and he wanted to pick some bluegrass music.  He stopped at the Gulf station, rolled down his window, and asked if anyone knew that Doctor who played bluegrass music, and the man at the gas station said, “You talking ’bout Dr. Bibey?  You sick?”
        “Oh, no.  Came down from the mountains and wanted to play some music.”
        The man at the service station looked at his watch.  “Better get on over to his office. He’ll be leaving pretty soon.  All dem Docs play golf on Wednesday, you know.”
        The gentleman arrived right about when I was getting ready to leave for the day, and explained he had come down from the mountains.  Only thing was he didn’t talk like Jake, the only mountain man I knew.  I believe he said he was from some Green Mountains we’d never heard of- some place far away like New Hampshire or something like that.  Well, it made no difference to me. 
        “Whatcha toting there?”
        “Martin.  Any jamming happening?”
        “Yeah, boy.  Going to the Bomb Shelter tonight.  Wanna go?”
        The man had never heard of the Bomb Shelter, but it turns out I had come highly recommended to him, and he trusted my judgment.  We went over to the County Line for lunch, and I called Darrell and the Moose to tell ’em to round up the usual suspects.  If company is in you try to show ’em a good time, you know.
        Well, when we got there, most of the boys didn’t know what to make of it, and a couple of ’em weren’t sure they wanted to pick with the man.  “Can he cut the gig?” one asked. Jake was in town that night, and he was extra worried.  He was a real mountain man,  and sometimes they take to strangers right slow.  
        Moose knew better.  “See that guitar, Doc? It’s bout half wore around the sound hole, and it’s got a lot of cigarette burns.  That man can play. We’d better take a chance on him.”
        Jake stood back in the corner to wait and see as the man strapped on his Martin.  Well, Moose was ‘xactly right- that old boy just wore that guitar out.  He hadn’t played but one bar, and Jake jumped right in the thick of it, and was a sawing away on the fiddle.  We played deep into the night, and it was extra good- the man could cut the gig.
        He was just like us.  Turned out he had done a stint with the Gibson Brothers, and I was shocked to find out they was from upstate New York.  I thought it was all pavement up there, but those boys sounded just like they’d grown up on the farm in Kentucky.
        Well, about 2:00 I had to split, ’cause I had to turn back into a doctor, but the boys stayed on to play a few last good’uns.  Moose told me later when me and the man left, Jake strung together more consecutive words than we’d ever heard him utter.  “Lawd have mercy boys, didja ever hear anything like that?  I’d don’t care if he does talk funny, we need to get him to pick more often.  I wonder if Doc knows any more of dem Yankee Pickers?”
        I figure I need to study up on those Yankee pickers, too. I’d been around a while and had never heard one, ‘cept on records, and I didn’t know they were that good either. 
        I hear a lot of talk about exactly what bluegrass is, and sometimes even some arguing on the subject.  Well, I don’t know about y’all, but to me I don’t care where a man is from.  If he sings an honest song about real people trying to live decent lives in a nonsensical world, then he’s welcome in my circle. 
        I’ve already heard from a fair number of folks from up North, so today I wanted to officially welcome you to this decidedly southern site.  To paraphrase the golf folks, if you know bluegrass you are my friend.  Part of my motivation for writing all this is to spread the bluegrass gospel.  It ain’t as important as the real Gospel, but is is important- if for no other reason when I go to Detroit I need to know who to pick with.  So, keep on picking, and I’ll see you out on the bluegrass road.

                                           -Dr. Bibey

Birds of a Bluegrass Feather

        Well, as we have said, them bluegrass people are thick as thieves, and it’s even true for the bluegrass animals.  I got  a call from a lady the other day who wondered if we would adopt her Sun Conure bird.  Given its’ name was Sassy Scruggs, it was a little hard to say no. The woman was moving to the Windy City, and gonna be in a big condo where they wouldn’t allow animals, and besides, conures are tropical birds, and the climate didn’t exactly suit their clothes as the song says.  And too, the woman wanted the bird to have a bluegrass home, and she knew I was a player, ’cause she had seen Neuse River on the local cable T.V. station last winter when they ran out of news.

        As far as me, I don’t care all that much for birds, but I guess the lady knew my wife was a local expert on bird raising, given that she (my wife that is) half raised me.  And too, it might be ’cause we already had a Jen Day conure, which is a close cousin to the Sun variety, so the ladies decided the whole situation was meant to be.

        We didn’t have to think it over long anyway.  My wife wanted the bird to have a good home, and I like to see my wife happy, so it was all good.  There was more to it than that, too.  Our bird is a male named Sammy- Bush or Shelor depending on whether a mandolin or banjo player might be coming to dinner.  Sammy and Sassy; we figured it would be a good fit.

        When the lady brought that little conure over to the office I had to ask if she was any kin to Earl, and she wasn’t.  I did know to ooh and aah over the bird, though.  (Hint to the men folks here- if you are around a group of office women and don’t know what to say in this situation, just smile and say, “Isn’t she precious?”)  This always goes over good.

        Matter of fact, when I took the bird home, that’s the first thing my wife said, and I knew to agree, even though I wasn’t exactly sure why.  It is a good home, though.  The bird needed a bluegrass habitat, and she and Sammy get along famously.

        Lynn O’Carroll at the office said she hopes they’ll conjure up a conure, and if they do she wants first dibs.  We get to name it, though.  If is a girl, I’m voting for Alison and my wife likes Vince if it’s a boy.  (He was bluegrass before he was country.)  One thing about it, though- it won’t be a Reno or a Ralph.  I don’t know that much about birds, but it seemed two banjo players in one house was a plenty, even if they don’t chew tobacco.

        My wife thought it was precious.

  Dr. B

Thru The Eyes of a Country Doctor

        This is a fiction forum, and does not discuss any “real” events.  Specific discussion of a patient’s clinical circumstances is a violation of my personal ethical code, and was long before anyone dreamed up HIPAA, so anything I write regarding patient encounters, while based on my life experience, has been “doctored” significantly.
        However, this post deviates from that standard format.  While very close to the actual events, it isn’t a HIPAA violation, though, because it is my own case.  I write it so you can get inside Doc’s head, but also for educational purposes.  I like to think the story might stick, and one of my readers might benefit someday from the heads up on this particular diagnosis.  

   “Through the Eyes of a Country Doctor”

        Before I start, I’m gonna go ahead and tell you the moral of the story. If you don’t get anything else, please realize we docs are just as human as anyone else. Still, we have a perspective on things folks should not ignore, so you’ll just have to listen for a moment.  Now, that don’t make me one bit better than anyone else.  When I drive my car into my mechanic’s shop, he often figures out what is wrong in two minutes about an issue I have struggled for days to get a handle on it. But as far as Country Doctoring, well, you don’t have to listen, but I would advise you consider my story.
        I was at a music festival digging my favorite bluegrass band, and thought I had a smudge on the bottom of my sunglasses.  It didn’t want to clear up, but we were not around any soap and water and I couldn’t clean off my glasses.  It was getting on towards dark-thirty, and in the lower light of dusk, I thought it went away.  I didn’t think much of it.
        Sunday I woke up and at first thought some swelling of my lower eyelid was in the way, but when I would pull the lid aside the faint smudge in my lower visual field didn’t clear.  I had a feeling I knew where this was going.  There didn’t seem to be much change through the day, but I put in a call first thing Monday morning to my ophthalmologist, who had done my cataract surgery a few years back.
        “Hey, Em. Dr. Oracle in?” 
        “Yes sir, what’s up?”
        “See if he can check me today.  Tell him I’ve got a right inferior nasal field deficit- stable for forty-eight hours.”
        She wasn’t gone long.  “Can you be here at 2:00?”
        “Sure thing.” At least the timing was fortuitous.  My afternoon office schedule had already been cleared off, as it was the day of the once a year company picnic.  I didn’t want to alarm everyone, so I just said I had an eye appointment I’d forgotten.  I gathered up my office guitar, and told them I’d see them at the picnic and play a few tunes.  Deep down inside I suspected it would serve as my pacifier for the day.
        I was a work in, and these were busy guys, so I knew I’d have to wait a while.  I pulled my guitar out and got off to a corner, so as not to bother anyone, but an interesting thing happened.  As I played, tranquility set it, not only for me but the staff, and the patients who were waiting. 
        One little girl was especially entranced, and I ran through a number of tunes for her.  They called me back, and I bid her farewell.  I wondered about her diagnosis, hoped she was just a kid trying to talk her folks into contacts, and said a quick prayer she didn’t have anything bad; she seemed a nice kid.
        Once in the exam room, I pulled the guitar out of the case, and contemplated my diagnostic possibilities as I played.  I could think of dozens, and several I’d rather not have.  Hm.  I had seen a few patients like this who had an ocular melanoma- that didn’t sound so good.  I liked the idea of posterior capsule clouding, but I had already gone through a post surgery laser to clear that up.  I wasn’t an eye surgeon, but my experience was this generally wasn’t something that was recurrent.  Most likely this was a small retinal tear in the top of my eyeball, and given the other possibilities, I made up my mind that would not be a hard diagnosis to accept.
        Dr. Oracle came in and went through the drill.  Drops, the “blue light special” (checking for glaucoma) then the old eye chart.  Doc had rendered me 20/20 with cataract surgery, but prior to that I had a long history going back to a myopic childhood, so I was quick to rip through the memorized lines.  He pulled out the extra bright retina scope, and in short order, had the diagnosis.
        “Peripheral retinal tear, superior segment. You need to stay, the retina man is in the house.”
        “NAP, Doc.  (Not a problem.)  You think it’ll be O.K.?”
        He contemplated an answer.  I could tell he sure wanted it to be, but didn’t have enough data yet- it wasn’t a fair question.  I answered it for him. “Hey, you guys have pulled me through the fire twice- I ain’t worried.  All we can do is our best, and I have faith everything will be O.K.”  I could see him breathe a sigh of relief- docs hate to promise what they can’t guarantee, and yet want to offer hope- it is a fine line to walk at times.
        The retina man, Dr. Smith, came in. Was he ever young.  I remember a favorite patient thinking the new surgeon couldn’t be old enough to take out his appendix.  I had a devil of a time convincing him as his Family Doc I wasn’t the right man for the job.  Smith went through his routine, and a few more tests, and gave the good and bad news.
        “As far as retinal tears go, this one is pretty good.”  I know most patients hate to hear a hole in eye ball is good, but as a doc I followed, and agreed.  He went on.  “The superiors are easier to fix, but over time gravity will work on it.  Not much choice but to fix it.  Your prognosis is good right now, but if it works its way to the macula it is a different animal.  Much harder to fix then.” 
        He discussed his schedule with his tech, then outlined my options.  “It can probably wait a day, but the OR schedule is tight tomorrow. We would go on after a vascular case, and they can be unpredictable as to what time we might go. When did you last eat?”
        “Dang it, I had a hot dog at 1:00. ” What was I thinking?  Man, you’re a doc, you saw it coming, why didn’t you stay NPO? 
        “How do you feel about doing it under local?  I can get a slot a Grace (the surgery center in the next town over) tonight.”
        Sounded like saving Grace to me.  I had  my cataracts done under local, so it wasn’t an unknown.  Hm.  Here I’d known this guy fifteen minutes, and I was turning over the future of my right eye to him on the spot.  Dr. Oracle recommended him, and he had saved me twice.  I trusted him with all my personal and professional being.  I contemplated a minute.  The way I saw it, I could get a second and third opinion, but by the time I did that I’d have several good opinions and one blind eye. “Let’s go for it.”  I sounded resolute, and was. My vision was still clear, and I didn’t see any other reasonable options.
       Well, my wife drove me over to Grace, and everyone was very nice, and they didn’t even know I was a doc at first. Someone found out, and then they got kinda nervous, but I told ‘em my eyeballs warn’t no different than any other human being, and besides they had been kind before they figured out who I was, and that was more than enough for me.
        Being awake for your eye surgery has its advantages.  I could tell from the banter and the light mood Dr. Smith was satisfied about the progress.  I told a few jokes, and we discussed guitars, but I kept the conversation to small talk- I didn’t want to distract him.  When he asked for the Vicryl, I knew he was closing. After he got a stitch in, I told him I wasn’t scared of losing an eye- I could always cash in my disability and hit the road with a black patch and a new stage persona.  I could sense his relief through the surgical drapes.  The thought of a disabled colleague, and one with a microphone no less, was not very consoling. My recommendation to patients is not to say such things until the procedure is completed.
        After it was all over, my vision came all the way back to 20/20. Thanks to Drs. Oracle, Smith and company, I am an ocular cat with nine lives.  When I was growing up in a little  N.C. town, we did not even have an ophthalmologist, much less a retina specialist who could do such fancy things on short notice.  Nowadays, in little towns all across the country, people are able to resume their lives with minimal disruption over a diagnosis that would have disabled them just a few decades ago.  I am just a country doc, but got a state of the art procedure as good as anything the President could get.  I am lucky, in that I have good insurance, but for less out of pocket than the price of a new guitar, I got a new eye.  I don’t buy many guitars- my old Martin does fine, but generally speaking you can’t buy an eye for any price.  It seemed more than reasonable to me. 
        By the way, I hope that little girl was O.K. She was a sweetie.

 Dr. B

        Post Script:  Not long after all this happened, I saw a patient who lost most of the sight in her left eye years ago.  She began to have similar symptoms, but just thought she needed new glasses and put off an appointment.  She got some vision back, but it was far from a perfect outcome.  There are no guarantees in medicine, but I hope by posting this story, one of my readers is able to recognize the symptoms earlier, and have a chance at a better result.

                                           

Bomb Shelter Loyalty

        Several folks wanted to know what the Bomb Shelter is like.  Others wanted some insight into the lifestyle of a country doc.  I decided to tell you an old Bomb Shelter story that might satisfy both requests.  Except for the fictional parts, it is a true story, but the names have been changed to protect both the innocent and the guilty.

        The Bomb Shelter, owned by Jack Barber, is a longstanding N.C. watering hole for bluegrass musicians.  It is an authentic 1950s prewar (cold war) bomb shelter converted to a bluegrass haunt when the standoff with the Russians wound down.  I can not divulge its whereabouts, as that is a highly guarded secret in the eastern N.C. bluegrass community. 
        The crowd is a tight circle of players, mostly good amateurs, with the occasional professional sitting in. Everyone knows everyone in the bluegrass world.  As one of my patients used to say,  “All you bluegrass boys is thick as thieves.”  John Hartford said bluegrass was the last American small town, where we were an extended family, and no one locked their doors.  Treachery is rare in our world.  Expensive instruments can be left out without fear of theft.  Oh, of course, there are times when someone will break the rules.  When it happens, an all out search is launched.  The national trade magazines, like BGU, (Bluegrass Unlimited) will run an ad until the piece is recovered, as they did years ago when a well-known banjo finally turned up in a Brooklyn pizza parlor.  The perpetrator is seldom criminally punished, but their fate is much worse than that, as they are permanently ostracized from the bluegrass music community, becoming as well known as a PGA pro that would try to make his living moving the ball in the rough when unobserved.    
        All that being said, though, newcomers are always welcome into the circle, as long as they understand bluegrass etiquette. 
        One night a new man showed up at the Bomb Shelter.  He played a decent flat pick guitar, and had a passable voice.  We were glad to get to know him, as you often needed a man to fill in, and I entered his data into my Wizard filed under music, guitar, and lead singing.  (The Wizard was the predecessor of the Palm Pilot.)  I was one of the first in town with one of these gizmos, and it came in quite handy.  Mine was filled with a quite wide variety of contacts, everything from bass players to neurosurgeons.  The session was going along great, and someone called for “Catfish John,” a standard made famous by the Country Gentlemen, and popularized in this area by a gentleman named Floyd Freeman, who had played in a number of bands, and toured with Monroe for a few years as one his countless Bluegrass Boys.
        Floyd was one of my favorite patients.  We first became acquainted one night in a bluegrass emergency.  He had a show booked, and his mandolin player had cancelled out on him.  Seems the boy wanted to stay home and watch rasslin’ on T.V. with his mama, and would not budge.  With only two hours till showtime, Floyd was desperate.  I was off duty and agreed to fill in. 
        Freeman was a powerful singer; we blended well, and cut the gig without incident.  The true emergency came up after the show.  Backstage, Floyd rolled up one of his pant legs for me to inspect.  He had an obvious D.V.T. (blood clot.) After an urgent admission and some heparin he was cured up, and much appreciative.
        After that I was his Doc for a number of years, and also did a few shows with him every year.  We became fast friends.
        He had several medical problems, but in fairness to him, I don’t feel is would be right to outline them on the net, so I will leave it simple.  One day when I was out of town he died unexpectedly.  When I found out, I went home and cried.  As it turned out, there wasn’t anything anyone could have done, but it still hurt, and hurt bad. 
        We all went to the funeral.  As always, these are sad events, but there was some levity when folks were called on to recall some of the humorous anecdotal road stories he had accumulated over the years.  A number of musicians were there, and several impromptu performances reminded us Floyd wouldn’t want us to linger in sadness too long.  The preacher commented that the Docs didn’t know exactly what was wrong, and I wanted to TESTIFY, but held my peace.  I figured the minister’s job was to try to comfort the family, not me, and of course didn’t say anything to the contrary. 
        Some Doc avoid funerals, because they can be volatile.  One went to a service for one of his patients, and was spotted by a young man who pointed at him and shouted out, “There’s the S.O.B. what killed my grandma!”
        Darrell was only nineteen at the time, but in the wisdom of a kid who hit the road as a teenager, he understood.  He came by the office the next day, and strummed through a few bars of Catfish John on my office Martin.  “You know Tommy, I knew Free real good.  I went on road trips with him when I was only fourteen, and we had a lot of time to talk.  I don’t really think he wanted to go on like things were getting.  He was too short of breath to sing anymore.  I believe he knew he was going to die before too long.  There warn’t nothing you coulda’ done about it, and you don’t need to go blaming yourself.  I am sure he ain’t blaming you from heaven.
        Darrell broke into another chorus of  Catfish John.  “Mama said, don’t go near that river…. No one did that one as good as Floyd Freeman, huh doc?”  Darrell always could call for the right tune.  I guess he was right about Floyd too, but it took a long time to get over his death.
        Getting back to the Bomb Shelter, when someone called for “Catfish John” that night the new man was in town, I’m sure you now understand how that would bring back significant reminiscence for all of us.  Jack Barber still owned Floyd’s old Herringbone guitar, and though it was several years after his death, Floyd Freeman’s memory was still fresh.  The new man had heard him sing somewhere along the way, and commented how much he liked his style. After a moment, he looked at me in a peculiar way, and paused to study my features.
        “Ain’t you a doctor?”  He asked me in the wary way people often do in the beginning. 
        “Yep.  Bibey.  Tom Bibey.  Pleased to meet ya’.”  I extended my hand to shake and howdy. 
        He took a longer look.  “Ain’t you the doctor that killed Floyd Freeman?”  Usually the Bomb Shelter rocked.  Now it was the quietest moment there we had ever experienced.
        I broke the silence.  “Sir, doctors can’t say much about cases due to confidentiality.  However, I can tell you with absolute certainty that I did not kill Mr. Freeman.  If you are not prepared to retract your statement, then we’ll have to go outside and settle this.”  I never had quite gotten over losing Floyd- he was a good’un. 
        I looked at the boy and immediately wondered what possessed me to issue such a challenge.  Usually, I let reason outvote a flash of anger.  He was at least twenty years younger than me, and the veins on his tree trunk neck were popping out like ropes.  
        At least I had the sense to choose good friends.  To my right was Moose Dooley.  He had some flecks of gray in his beard, and was twenty pounds over his rasslin’ weight, but he was still formidable.  Once we played a festival in Lillington, and we had dared him to enter a tough man contest over at the gym, where he had finished second.  We had ragged him unmercifully, until one night he proclaimed there were some guys around tougher than him, but none were in the room.  He seemed to have lost his humor regarding the subject, and I noticed no one ever brought it up again.
        Stroker, our flatpick man, was lean and quiet.  Sometimes he’d go three days without eating, a habit he acquired while in the army special forces. He grew up in the country just north of Winston, and they say he once stayed in the cage with the King County orangutang for five minutes.  He’d seen a lot worse foxholes in his time than this one, and moved in to cover my left flank.
        Barry Graylord was the tenor man that night.  Barry had been an all star linebacker for the Harnett High Mad Hornets, and had a baseball tryout pending with the Braves one spring, until he broke his femur in football season his senior year.  His meathook paw on my shoulder was significant reassurance.
        As for me, well, I ll have to admit my first concern was whether or not the boy would dislodge my cataract implant if he hit me in the left eye.  I’d grown up myopic and my only decent sport was golf.  I’d spent my formative years reading books and taking bubble tests, and my physical abilities had been significantly eroded through years of practicing medicine.  My standard position was to never call a vote until certain of the outcome, and in my resentment had rushed to judgment.  I just had to hope the crowd didn’t start chanting,  “Fight, Fight, Fight…”  The logs in the woodstove sizzled.  It was very quiet.
        Darrell edged over and glared at the man, but I waved him off as best I could.  Those hands and fingers were his livelihood, and besides, he had a gig with the Gentlemen at Oakboro that weekend, and I didn’t want to wreck the show.  Simpkins stood by Darrell.  With his two hundred fifty pounds, the scales were starting to look significantly out of balance to the newcomer. 
        I must tell you that new history transpired that night at the Bomb Shelter.  And no, a fight did not break out.  First, let me tell you the Bomb Shelter is a peaceable place.  There are very few absolute rules. It is as laid back as it gets, an atmosphere of hot dogs left over from the V.F.W. cookout, Co-Colas, and Nehi grape drinks.  Other than cigarettes and occasional white liquor whiskey, vices are to be left at home so as not to disturb the picking.  Except for one time two years ago when Wild Bill was placed on six weeks probation after wrecking his wino cycle into the retaining wall, and letting out a string of cuss words in front of Jack’s grand kids, no one has ever been banned. 
        Jack is the law in the Bomb Shelter and he quickly moved in to enforce the house rules. “Son, I’m going to have to ask you to leave.  Dr. Tommy here takes care of most of us, and we don’t allow any disrespect here.  Also, you and your people are no longer welcome in this establishment.”  Jack was always polite, but firm, and besides, the boy was significantly outnumbered.
        He put away his Martin and headed for the door.
        The Moose stopped him before he was gone.  “Boy, that’s a nice Martin you have there.  Do you like it pretty good?”
        “Yeah, it’s a good guitar.  Why do you ask?”
        “Well, if you ever come back here you might as well give it to me, because I’ll break your knuckles and twist your fingers into pretzels, and you’ll never be able to play it again.”  When the Moose got his blood up, it was a scary sight.  I knew Moose well enough to know that he wasn’t serious, but that boy didn’t, and he immediately disappeared never to grace the door again.
        We resumed playing without any further discussion.  I was glad the newcomer wasn’t much of a player, as we wouldn’t miss him as badly as if he’d been a hot picker.
        I was thankful for Moose Dooley and all my buddies, too.  That boy woulda flattened old Doc faster than the King County Rangatang if I’d had to tangle with him alone.

                                                      -Dr. B     

Doc Goes to the Courthouse

    “Dr. Bibey Goes To The Courthouse”

        For two days last year, I was on jury duty, and I thought folks might get some insight by hearing of my experience.  And no, I wasn’t in any trouble or a malpractice case- it was a jury selection for a criminal case. I ended up being released because the defense deemed my background and life experience as a physician might be prejudicial in this particular case, at least that was my interpretation.  We are supposed to be confidential about it, but the event was a year ago, and I fictionalized the experience anyway, so I can recap my thoughts without fear.  Here’s how my two days as a potential juror went.
         On Monday afternoon we went and watched a movie about the court system and filled out some paperwork.  My County is small town, U.S.A., and I knew almost everyone there.  I sat down beside the only dude I didn’t recognize, and it turns out he was an ex-con and convicted felon.  (Like me, he ended up being released, but for different reasons.)
        We put our hands on the Bible to swear in- me and the cocaine guy were together- and after a few hours we were released for the day and told to come back at 9:00am Tuesday.  I went to the office and somehow the first patient I saw knew all the details, even down to knowing I was to go back at 9:00am the next morning!
        The next morning we filled out some more paperwork, and were told we could go to the bathroom, but to be back in ten minutes.  Ten minutes turned into a hour.  I did not take anything to read.  Because of this error, I had to watch an infomercial for Victoria Principle’s skin care line.  That was bad enough, but the next program was a weight-loss/dance gig commercial pitch, and after five minutes of that I got up and told everyone that I was sorry, but I couldn’t take another minute of “Hip Hop Abs,” and had to stretch.  Half of the potential jurors were my patients and most of the rest of them knew me through music and asked the lady in charge if it was O.K. for me to bring my mandolin.
        When we went to jury selection, some of the  lawyers laughed at a couple of my answers.  I still can’t figure out why all these legal people find me so humorous, but it invariably happens every time.  One time I was in a deposition about a car wreck, and the attorney stopped dead in his tracks and said he felt like he was interviewing a medical Mark Twain, and hadn’t had so much fun in years.  I need to figure out why I am so amusing to all these legal guys before one of these things turns serious. 
        Of course, I knew of all the attorneys, clerks, recorders, bailiffs etc, etc, and perhaps I was excused on those grounds.  Those of us not selected went back to the jury room, and waited again. 
        Finally the lady in charge (I’m not positive of her title) came into the room and told us before we left she wanted the other potential jurors to know that I was Dr. Tommy Bibey, and was a fine doctor and the best musician in the County, (I’m glad she wasn’t under oath- far from true there- well I’m an O.K. Doc, but not worth two cents as a professional musician) and they needed to come out and hear me play!
        Then the three folks I wasn’t sure I knew came up to me and wondered if I would be their Doctor, and as did the ex-con, who now considered me his friend!  Dang-est thing I ever saw, and I wondered if somehow this was related to them worrying I might just say whatever came to mind- a dangerous thing for a man under oath.  I guess all that  had some bearing on why they didn’t keep me that day.
        All told, it was a peculiar foray into a world I had no bearings in, and I was glad to get back to the office and see some sick people.
        I went home and thought about it and figured I better be the best Doc I can, ’cause I had the strange revelation that here in the County I’m not sure I wanted to go over to the Courthouse for anything more than a look-see.
        After all that, I was glad I was in no trouble, and as Walter Hagen would say, decided to go home and smell the roses.

 Dr. B

Rassling Rangatang

                               

                         “The Preacher, The Doctor, and Riley, The Rasslin’ Rangatang”

 

      I was at Wednesday night journal club when a call came in from Darrell. Seems his guitar man was under the weather, and they needed me to fill in for a show at the King County Fair that weekend.

      Now, Darrell was the best mandolin player in these parts by a long shot, but when I filled in he would switch off to guitar and I’d cover the mandolin. If I was unsure of a part, he’d teach me on the way to the show. It was one of my favorite gigs.

      Darrell carried a top shelf band. He was an expert singer and instrumentalist, and Summer, the girl singer, was downright inspirational. The dobro man was a spot-on player and told all kinda funny country tales, and the Ed “Lightning” Littlerod, the bass player, shook the rafters with the high tenor in some fine brother duets with Darrell. It was great family entertainment, and I was honored to be a part of it.

      This particular day, Darrell had a new banjo man I hadn’t played with. I never did get his full name, but they called him Preacher Vincent. When I heard him warm up, I was perplexed as to why Darrell had chosen him for the slot. Now, he was a good enough player, mind you, but Darrell could have his pick of anyone in the South, and to my ear the man was about an average professional musician. I suppose Darrell had his reasons.

      We stopped at the Cracker Barrel on the way, and Preacher Vincent rendered a mighty fine prayer. Now I began to understand. The road could be long and hard, and I could see how a man like that on board could inspire you to go on another day. I guess it was akin to having a doc on tour- you never knew when it might come in handy.

      Darrell is a professional musician, and  tends to every detail, so we got there in time to set up, go over the tunes, and have an hour to kill. Someone suggested we take in the midway, so we lit out to sample the vinegar fries and elephant ears. In a few minutes, we came up on Riley, the Rasslin’ Rangatang. It was quite a spectacle- all these good old boys who were gonna whup that Orangutan and impress their girlfriends. Of course, they were unsuccessful without fail. If you could stay in the ring for five minutes, you’d win a giant Panda bear for your girl. The only man I’d ever heard of who had done that was Stroker, the guitar man in our band, and he had just retired from Army Special Services when he did it. It sure wasn’t a gig I’d sign up for.

      We watched for a few minutes and one of those well lubricated boys began raggin’ Preacher Vincent. Preacher was quite a clean cut sort, and a kind and well mannered man. After all the years as a doc, I had developed a reasonable intuition as to folk’s intentions, and my sense was this red-faced good ole boy had decided to target the preacher. This could be trouble.

      “What kinda work you do, man?”

      “Oh, the Lord’s work, sir.”

      “The Lord’s work! God almighty, boys, ya’ll hear that! You a preacher?”

      “Yes, sir, as a matter of fact, I am.”

      “You believe in miracles?”

      “Oh, most certainly.”

      “Miracles, huh? Well I’ll tell you what’s the truth. It’d be a miracle if you could hang with that rangatang three minutes.” The old boy was gettin’ lathered up trying to impress the crowd. “Hell, I’ll bet you a hundred bones you can’t stay in there fer two.”

      “Well, sir, I appreciate that, but I just am not a bettin’ man. In my line of work it just ain’t allowed, you know, but thanks anyway.”

      “Ain’t allowed ’cause you’s scared. Scared, he is!” the man shouted to the onlookers. “Don’t you think your Jesus would save you?”

      “Well, of course He would. Jesus will save us from all our sins.”

      “The hell with sin, you need to worry ’bout him saving you from that rangatang.” By now the crowd had grown quite large. They roared with laughter.

      “If you insist, sir.” Preacher tugged on his sleeves, and pulled off his coat and shirt.

      I moved to intervene, but Darrell motioned for me to hold my peace. “Dang it Darrell, Preacher is a good man, but that rangatang’s gonna tear him to pieces. The dobro man is a right stout boy- I think me and him and Lightning can take that there redneck- we can’t let Preacher do this.” Darrell was unperturbed, and motioned for me to be quiet.

      The preacher stripped down to his boxers; we had a show in a half hour and he didn’t want to ruin his clothes. He said a quick prayer, and prepared to enter the ring.

      Preacher stopped at the gate, and addressed his tormentor. “Sir, as I said, I am not a betting man, but I would like to make one last proposal.”

      “Sure, buddy- last request, huh?”

      “I don’t care for your money, but if I hang tough with this rangatang for two minutes, I want you to promise me you’ll turn your life over to Jesus.”

      The man turned a mite nervous. “Make it three.”

      “Three it is then.” Preacher breathed one more prayer, and moved to step inside the cage.

      “Now dad-burn it Darrell, you gotta stop him. He ain’t that bad a banjo man.” I moved towards the preacher. 

      Darrell restrained me by the elbow, and offered a brief but confident reassurance. “NTW, (bluegrass for not to worry) Doc.”

      Well, that preacher got in that ring, and I ain’t never see’d nothing like it. Lord have mercy, it musta’ been divine intervention, ’cause he was holding his own with the King County Rasslin’ Rangatang. Even the redneck was amazed. I tell ya’ though, the rangatang was extra tough, and after four or five minutes, I could tell he was wearing the preacher down. As the self-appointed ringside doctor, my concern escalated, and I began to hope they would call the fight based on my medical opinion. I grabbed the chain link fence with both hands, yelling, “Come on Preacher, you’ve already won, get outta there!” Brother, that preacher didn’t have any give up in him.

      At the seven minute mark, the match took a most remarkable turn. Preacher made some kinda World Wide Wrestling choke hold type move, and got that rangatang flat on his back. I started a ten count as fast as I could go. I figured I only made a “B” in Orthopedics, and wasn’t sure I could fix him up. Besides, we had a show to do in less than an hour. 

      Right at the count of nine that rangatang flipped the preacher over and commenced to throttling him. I cast an eye Darrell’s way, and this time he was concerned. Oh my Lord, what were we going to do? I put my hand over my heart, said a prayer and noticed something in my pocket. Dang, it was my emergency kit- I musta’ forgotten to take it out when I left the office.

      Now, my portable ‘mergency kit only had two drugs. One was an EpiPen for anaphylaxis- definitely the wrong choice for that rangatang ’cause it tended to energize you, and it seemed he was revved up enough and doing pretty well without it. Hm, might help the preacher though, but I worried it could give him a cardiac arrest.

      The other drug was Valium. I contemplated what the orangutan dose might be, but it didn’t seem to be a good time to quibble over details- better give the whole vial and hope for the best. 

      Darrell tried to stop me, but I dashed by him, jumped in the ring, and plunked that syringe right in that rangatang’s gluteus maximus, and targeted the upper outer quadrant to avoid the sciatic nerve. I had a brief mental image of me and that nice lady at the insurance company justifying expenses for an orangutan life care plan to the company president, and it warn’t no pretty sight. I said a prayer for good aim.

      Well, when I popped that rangatang right in the rear end, that beast stood up, turned around, raised his arm to swat at me, and looked me right in the eye before his eyes rolled back in his head, and then he fell straight to the ground. I checked his pulse. Thank God I hadn’t kilt him.

      “Now, Doc, what’d you go and do that for? I had him on the ropes!” Preacher was as calm as he could be.

      Well, when he climbed out of that cage and passed by that redneck, the boy was speechless. Preacher looked right at him and said, “Now son, I expect to see you at my church Sunday. If you ain’t there, I’ll see to it we find you. You don’t back down on your word to the Lord, and we had a bet you know.”

      The boy managed a meek, “Yes, Sir.”

      Well, we had a dandy show, and I reckon I got figured out why Darrell had hired that preacher man as his banjo player. Not only could the man say some fine grace over a plate of chicken, but Darrell had been street smart since he was a teenager. A man like that could come in right handy on the road.

      Late that night the bus was humming along the highway home, and I went to the back to visit. “Preacher, I must say that’s an extra fine Panda bear. I believe the missus’s will like it, don’t you?”

      “Sure do, Doc. If you don’t mind, I don’t believe I’d tell her how I came about it.”

      “Oh, sure thing. I agree one hundred percent. You know something, Preacher. I never leave the office with that emergency kit in my front pocket. I don’t know why I did that.”

      The preacher smiled. “Oh, I do, Doc. When I heard you were coming on the trip, I prayed that the Lord would send any medicine we might need. As Christian brothers, we all bring something to the table. The Lord knows what it is, we just have to seek His will. I reckon my prayers were answered, huh?”

      “I reckon, so, Preacher. If I wasn’t a believer, I sure would be now.”

      “One more thing, Doc.”

      “Sure Preacher, anything.”

      “Don’t tell anyone I was scared there at the end. Might ruin my image.”

      “Yes sir, Preacher Vincent, I promise.” From then on, me and that preacher were fast friends. Maybe he was a little scared at the end, but I as long as Preacher and the Good Lord were on my side, I reckon I warn’t gonna be scared of much of nothing, ‘cept maybe them rangatangs.

Dr. B