Bryson City Secrets: Even More Tales of a Small-Town Doctor in the Smoky Mountains by MD Walt Larimore Page A

entered the chest cavity. I quickly removed it and inserted my finger through the wound and into Tommy’s chest cavity. I knew this might be uncomfortable for him, but also knew that what I was doing would only take a few seconds at the most. My finger swept between his lung and the inside of his chest cavity, breaking up the many fibrous connections between the two that could clog the suctioning action of the chest tube. Fortunately, Tommy felt no pain — probably because of the lidocaine I had infused into the space.
    I looked up at Tommy, who was trying to see what I was doing. His eyes were still as big
as saucers.
    â€œTommy, when I take my finger out, I’m going to slide this long tube into your chest. For a few seconds it may hurt like the dickens. So I’m going to ask you to take a deep breath, grit your teeth, and hold on to Miss Vernel’s hand, OK?”
    His eyes looked frightened, but he nodded in concurrence. Then he looked at Vernel and back at me as he shook his head. “No way!” he exclaimed.
    â€œNo way what?” I asked.
    â€œNo way I’m holdin’ hands with no girl!”
    The laugher that swept the room sliced through the tension like a hot knife through butter.
    â€œOK, tiger. I’ll count to three, and you hold your breath and grit your teeth — and you hold your own hands, OK?”
    He nodded.
    â€œOne-two-three!” I quickly pulled out my finger and replaced it with the chest tube, which I quickly guided around and behind Tommy’s lung. I could see his eyes and pupils dilate with the discomfort I knew he was feeling, but the brave little boy didn’t make a sound.
    â€œDone!” I exclaimed.
    â€œWhew!” Tommy responded. “That weren’t easy!”
    I handed the end of the chest tube to Vernel, who immediately connected it to suction. As I began to suture and then tape the tube in place, the thick, greenish-yellow pus literally poured out of the little boy’s chest. He was amazed — as we all were.
    After the initial flow of pus was stemmed, I instilled a dilute solution of lidocaine into his chest cavity and gave it a minute to numb the lung lining. Then I irrigated the chest cavity with warmed saline solution to wash out as much pus as possible.
    As I did this, Tommy watched as Maxine began infusing his vein with the antibiotics that, along with the chest tube and the humble prayers of a weeping dad and mom and a young doctor, would save Tommy’s life.
    It was two weeks before Tommy was well enough to go home, but when he did, he was holding the hands of an eternally grateful mother and father. I knew the joy that was in their hearts. I was thankful for our modern medicines and healing techniques. I was grateful for a well-equipped hospital and its caring and competent staff. But most of all I was gratified to have in my black bag the power of prayer and the guidance of the Great Physician himself.

    That evening, while sitting on the park bench behind my house and thinking back through the rush of the day’s events, I came to the conclusion that terror will likely always be part of the practice of medicine.
    Now, of course, most folks don’t know this fact simply because doctors are taught to never visibly manifest the actual terror they feel inside. But it is unavoidable that terror will raise its ugly head from time to time — and never more predictably than with those cases that have the potential to end in death or some other horrible outcome.
    And terror is what I felt when I first saw Tommy and perceived how close he was to death’s door. Sadly, I knew it would not be the last time I would wrestle with such feelings. Such is the fate of those called into the healing professions. It serves to motivate us and impel us into action. And as we age and mature, it will hopefully become a sensation that is quelled by the Great Physician himself, whose command to those of us called to join him