The Best Gift: Tales of a Small-Town Doctor Learning Life’s Greatest Lessons
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CHAPTER 1 -- The Wreck
I was in scrubs, driving the few minutes from home to the hospital in my old “trusty and dusty” pickup truck. It was the middle of a chilly, moonless night. Dr. Ken Byerly from the ER had paged me to come see a patient complaining of chest pain. As I skidded around a corner, I saw scores of flashing lights a few blocks ahead. I drove up to see if I might be able to help and parked behind two fire trucks, several police cars, and an ambulance.
On the other side of a deeply gouged residential front lawn, a police cruiser had crashed into an oak tree. Its front end was wrapped around the massive trunk, and the dashboard thrust back, trapping the motionless driver in a cab filled with smoke. A burning stench permeated the scene while steam hissed from the engine compartment, but there was no visible fire. The remnants of fire-suppressing foam covered the front of the car and the surrounding lawn. The noxious scent of burned rubber and oil contaminated the scene.
I walked over and recognized Kissimmee Police Chief Frank Ross standing close to the vehicle. “What in the world happened?” I asked.
“One of my men was on patrol. He must have fallen asleep. He’s not in good shape and is pinned in.”
“In North Carolina, I had medical rescue and extraction training. Happy to help.”
“Just might need you.”
Firefighters with hoses were at the front and back of the car, while two were positioning their Jaws of Life—a hydraulic tool used by emergency rescue personnel to assist in the extrication of a crash victim from their vehicle.
Frank commented, “Because the doors are jammed, the EMTs had to break the door window for access to stop the bleeding from an ugly head wound and splint what they think is a broken wrist. The wreckage has crushed and pinned his leg. They’ll use the Jaws to open ’em. Dr. Pete Gonzales, who serves as the police department surgeon, is on his way. Y’all may have to amputate my officer’s lower leg to get him out.”
The metal squealed and creaked as the Jaws pried open the driver’s door. The firefighters backed away, indicating to the chief it was safe. “You mind checking him out?” Frank asked me.
“Not at all. Who is it?”
“Gib. Gib Michaels.”
We had frequently worked together. I rushed to the cruiser, crouched next to my friend, and found him unresponsive. His still-buckled seat belt held him upright. He had a cervical collar on his neck and a bloodied bandage around his forehead and scalp. Dried blood stained the front of his face and neck, while still-moist blood discolored the front of his uniform and pooled in his lap. I tried rousing him with no luck.
“Doc, when we checked a few minutes ago, his heart rate was 124, respirations 24, systolic 160,” an EMT said from behind me. “Nasty forehead laceration—to the bone—but the bleeding stopped with direct pressure.”
These numbers were elevated, likely due to pain. At least Gib’s blood pressure wasn’t low, which would indicate shock. “Got a bright light?”
The EMT handed me a small flashlight, which I used to check Gib’s eyes. “Pupils equal and respond briskly. But he’s unresponsive. Severe concussion, at the very least—maybe worse.” Gib had a wrist splint on his left arm, which I lifted to examine.
“Still got a pulse?” the EMT asked.
I unhooked the Velcro and took off the brace. Gib’s left wrist cocked up at a hideous angle. It was a fracture I had seen many times in folks who fall and land on the heel of their palm with the wrist extended. It’s called a FOOSH—a Fall On Outstretched Hand–type fracture. Here, it was most likely from his extended hand hitting the steering wheel or dashboard during the crash. His palm and fingers were ice-cold. I tried to find an arterial pulse on either side of the wrist, but to my dismay there was none, meaning that there was no circulation going to his hand. I knew I had no choice but to reduce the fracture as quickly as possible. Otherwise, Gib could lose his hand. I had done these quite a few times in my brief career but never in this scenario.
The Jaws of Life fired up and pried the passenger side door open. Dr. Pete Gonzales, who also served as chief of staff at the hospital, crawled in. I explained my assessment and plan. “Do it!” he instructed. “By the way, I just came from the ER. Dr. Byerly said your patient with chest pain is stable and in the ICU. No rush to go see him.”
I chuckled. “Well, that’s good news!” I grasped Gib’s left forearm with my right hand and then grabbed his left hand with my left hand as if we were shaking hands. I then pulled my hands apart while extending his wrist to unlock the compressed ends of the large forearm bone—the radius. Then, while pulling as hard as I could, I flexed the wrist while everting it outward. The bones crunched against each other as Gib yelled in pain, but the reduction worked and the deformity disappeared. “His pulse is back!” I exclaimed to Pete. “His hand is warming up.”
“Outstanding job!” Pete said as Gib moaned. “That may have been what we needed to wake up our officer.”
I replaced the wrist splint. “Gib!” I yelled, gently slapping his cheek. “Officer Michaels!”
“Quit yelling at me!” he responded. “I can hear you. What happened?”
He had no recollection of the entire evening. It’s what we call retrograde amnesia, a sure sign of a traumatic brain injury in which one loses short-term but usually not long-term memory—as was evident with his next statement. “Are you the doctor with the ugly truck?”
“Guilty,” I said, as Pete and I both chuckled. “It’s not fifty feet from us now.”
“Better watch out, Doc,” Gib said, “Chief Ross is likely to have that fool thing towed off!” He chuckled and groaned at the same time. It was great to see him try to smile.
“Let’s see if we can get him out,” Pete said. “I’ve done more than my share of these types of extractions on the highways around here.” He shined a flashlight into the mangled wreckage at Gib’s feet. “Looks like the wreckage has crushed and lacerated his right lower leg.”
Pete turned to the EMTs outside the car and requested leather gloves for each of us. With them on, we contorted ourselves into position to explore the twisted metal, rubber, and interior upholstery that had trapped Gib’s leg. To our surprise, I was able to squeeze my hands down and around his lower leg and foot and protect it as Pete pulled back enough debris to free the leg. Unfortunately, it began hemorrhaging.
“Hold direct pressure!” Pete ordered. As I did, my stomach sickened when I felt the splintered ends of Gib’s tibia and fibula sticking out through the skin.
Pete turned and yelled, “Tourniquet! Stat!” An EMT handed him one, and he placed it below Gib’s knee and cinched it up. “Let go of the pressure, Walt.” I did, and the bleeding did not start back up.
“Walt, you secure the leg. I will let the boys get in here and cut him out of his seat belt. Then we’ll extract him from this side, and you follow. But keep pulling to distract the bones. That will help pull them back and set them.”
“I suspect this will hurt!” Gib predicted.
“Like the dickens!” I said.
“Can I get a pain shot before you do anymore?”
“I’d love to, Officer,” Pete answered, “but we have to have you awake. We may need your help.”
Just then someone outside yelled, “Fire!” I looked up to see flames in the engine compartment. I barely had time to clench my eyes shut and duck my head as a fireball rocked the car.
CHAPTER 2 -- The Prayer
Pete ducked with his gloved hands over his head, while I grabbed a deep breath, held it, jerked backwards, and spun to cover Gib as I threw my arms around him. The flames crackled, and every fiber of my being was screaming to flee the intense blaze that filled the driver’s compartment. The skin and hair on the back of my scalp and neck singed. The temptation to bolt was overwhelming. I prayed silently, “Father, protect us!”
Just in the nick of time, the firefighters on either side of the car, whose training prepared them for such situations, opened their hoses. The flames hissed and disappeared, and the forceful inundation suppressed the fire in seconds. It soaked the three of us to the skin; however, the cold liquid was a lifesaver and felt exquisite.
“Walt, I’m backing out!” Pete yelled as he crawled backward.
“You okay?” I said to Gib.
A firefighter replaced Pete. “Skedaddle, Doc!”
“Suit yourself!” His knife sliced off Gib’s seat belt. I could still feel the heat of the metal behind me. Out of the corner of my eye, I could see more flames erupting from the engine. A voice behind me bellowed, “Get another hose over here. Now!”
“Doc,” Gib said as I looked into his eyes. “It’s okay to leave. Get on out. Save yourself.”
“I’m not leaving without you, Officer.”
He smiled as tears spilled down his cheeks. The compartment was again filling with smoke and steam. Gib and I coughed, and our eyes watered. A firefighter wiggled into the police cruiser from the passenger side to help wrestle Gib out. I extracted his leg from its trap as the man began to pull him out. I resisted the tugging so as to apply traction on Gib’s foot and ankle. It pleased me when the bones sucked back into the wound and crunched together.
The firefighters extricated Gib and laid him on a gurney. One EMT hooked him up to an oxygen mask, while another checked his vital signs. A third began covering his wounds as Pete expertly placed a pressure dressing on his leg and then carefully loosened the tourniquet.
“Superb job with the reduction, Walt,” Pete said.
As they worked, I held Gib’s hand and asked him questions, partially to test his cognition, partially to keep him awake. Chief Ross was on the other side, holding Gib’s other hand, and I could see the mist in his eyes. Over time, I learned that this seasoned public servant had a soft heart for each of his officers and their families.
I knew what I wanted to do next, but could I? With so many people around? The more cautious part of me went into attack mode, warning me, Don’t do it! Or if you do, it will be at your peril! My thoughtful inside voice came to my defense, It’s never wrong to do what’s right, adding, This is a life-and-death emergency!
“You a praying man?” I asked Gib.
“I am tonight, Doc!”
“Could I offer a quick prayer of thanks and for healing?”
He nodded. “I’d appreciate that.”
Just then, a familiar person strode up. It was Pastor Pete Zieg from the Lutheran Church. He served as the chaplain for the fire department. He greeted Gib—they knew each other—and looked up at me. “Are you a praying man, Doc?” Pastor Pete asked.
“I am, Pastor, but will yield to the professional.”
Pete smiled and glanced at the EMTs. “Gentlemen, do we have time for a very brief prayer?”
“Very brief!” one answered.
“That’s how we Lutherans do it,” Pete said, laughing.
Everyone chuckled. Pete prayed thanksgiving for the first responders who saved Gib, asked God for healing and recovery for him and for wisdom for his medical team . . . “in Jesus’s name!”
During the prayer, I had sneaked a peek to judge the response of the men. How did they see this? I wondered. An intrusion? Proselytizing? Ministry? The answer was apparent. Every man’s head bowed; some were on their knees, while others’ hands were outstretched toward Gib while joining Pastor Pete in a prayer of blessing.
“Amen!” Pete finished. “Let’s go!”
“One favor?” Gib said to the EMTs.
“Yes, sir. What’s that?”
“Please take me in your ambulance and not in Doc’s truck!”
“I wouldn’t put me in Doc’s truck, much less you, Officer!” the beaming EMT declared.
There were chuckles all around as the EMTs rushed off with Gib. As we watched the ambulance drive away, lights flashing and sirens screaming, Pastor Pete looked at my pickup and then at Dr. Gonzales. “Can’t you convince him to get a more professional vehicle?”
The surgeon smiled and patted the cleric on his back as they walked away. “Lord knows I’ve tried, Pastor.”
I cherished that old truck. It had been my dad’s, and I would drive it for all the years I practiced in what was now my family’s hometown. Part of the reason was an ornery streak. I didn’t like the way vehicle salesfolk pulled every emotional string they could to sell you something new and shiny.
Another part of me was practical. My pickup was inexpensive to operate and even cheaper to maintain and repair—it was so easy that even I could do most of the work on it. My colleagues, staff, and friends all stifled giggles whenever they saw that the gun rack in my rear window held a large golf umbrella for protection against afternoon monsoons.
My kids, Kate and Scott, learned to drive in that trusty rust bucket on country roads and through fields and forests. We didn’t have to worry about scratching or denting it, which gave us a lot of freedom to have fun. And having time with my children was important to me. When Scott, as a teenager, drove that junker around town, everyone knew it was him. No one else had an uglier or more practical truck. Scott couldn’t go anywhere without being recognized. I’d like to think it kept him out of a lot of temptation and trouble. I made hospital, nursing home, and ranch and home visits in that truck. I loved it.
A year after Gib’s accident, I received an invitation to the opening and dedication of the brand-spanking-new Kissimmee Police Headquarters. Since I had forgotten to bring my invite, the rookie officer assigned to the VIP parking lot didn’t want to admit me—well, I guess he didn’t want to let in that old truck. Then who should walk up but Gib Michaels. He still limped but over the months had made a miraculous recovery. Chief Ross bent over backward to give Gib all the time and resources he needed for extensive rehabilitation. When he was ready to return to the force, Frank eased Gib into his day-to-day duties.
“This man is my family physician,” Gib said, laughing at the incredulous look of the freshly minted patrolman.
“You are a doctor?” the inexperienced officer asked. “Driving that?”
“The man spent an entire night with Dr. Gonzales in the operating room, patching me back together. Took care of me through my hospitalization and several months of rehab. Been with me every limp of the way,” Gib explained, smiling at his pun. “Doc’s an honored guest, no matter what he drives!”
“My apologies, sir,” the youthful patrolman stammered.
Gib leaned toward me. “But you better watch out, Doc. Chief still doesn’t like your old rust bucket. He says it’s unbecoming. And you are the only physician that drives a truck.” It was great to see him smile after a year of so much suffering.
When I left the ceremony, I noticed a card on my windshield—one of Chief Ross’s business cards. I turned it over and chuckled as I read it:
The Police Dept. received a complaint about a junky brown truck reflecting negatively on this new complex. Requests the truck be towed. Please donate to the Salvation Army.
Every time I read the card, I laugh and am awash with warm and wonderful memories—even though it’s been over three and a half decades since that day. That truck endeared me to the locals. Maybe it helped me become accepted sooner than I would have otherwise.
I remember my last day making rounds at the hospital before moving to Colorado a decade and a half later. As I jumped into that old truck, I noticed that about 80 percent of the vehicles in the physicians’ parking lot were pickup trucks.
What had been anathema and even abomination was fashionable. Who would have thought it? Now the doctors’ preferred vehicles were very expensive pickups. Nevertheless, my old truck allowed me to reflect on just how very much my family, that community, and I had changed. Although we had traveled some awfully bumpy roads before we got there!
CHAPTER 3 -- It’s Hot Here
After four years of practice in Bryson City, North Carolina, on the southern border of the Great Smoky Mountains National Park, my young family moved to Kissimmee in Central Florida, where we lived in a small ranch home as John Hartman, MD, and I built our family medicine practice.
John, his wife, Cleta, and their three girls had purchased one of the few houses on the shore of Lake Tohopekaliga, which is very close to Kissimmee’s historic downtown. These heirloom homes, some of them over fifty years old, infrequently appeared on the market. After a patient of mine mentioned that hers was going up for sale as she was looking to downsize, Barb, my wife, and I visited with her. Only three doors down from the Hartmans’ home, it turned out that this patient’s gorgeous lakeside home, with its large southern live oak trees providing ample shade on three acres, was ideal for us. We quickly sold our first home while completing the appraisals, inspections, and legal agreements on the lakeside home in record time. We were convinced it would be our forever home; however, it needed some minor renovations. Our contractor estimated the face-lift would take several weeks, so we moved into a rental house in a neighborhood just across the street.
John and Cleta introduced us to our new next-door neighbors, Bill and Polly Prather. Bill, like many locals, was a descendant of Florida pioneers. Being a retiree and part-time travel agent allowed him to cultivate relationships with novice bird-watchers like me. We would often “bird” together on Saturdays. I rarely talked because Bill had so much to say. His knowledge of birds, Florida history, the cattle industry, church history, and myriad other topics was legendary, as was his wry sense of humor.
One scorching midsummer day, Bill and I drove to the ranch owned by Geech and Connie Partin. They were patients in our practice and had given Bill and me permission to walk the property whenever we desired. Their driveway was one mile of dirt road. The earthy, damp fragrance of the countryside permeated the heavy, humid air as we drove by lush pastures occupied by grazing Brahman and Angus cattle. We parked in front of their small brick home.
After a few hours of hiking and bird-watching, we arrived back at the car. Geech and Connie came out to greet us. Geech’s round face was tan and creased by years of sun and weather. He was short, stocky, and well-muscled, with fingers twisted and ravaged by arthritis and many cowboying fractures. Connie’s silver hair crowned a thin face, wrinkled from ranch living, but with a radiant smile that expressed welcome. She carried a tray with a pitcher of cold tea and glasses. “Won’t you two have a seat and join us a bit?”
“How could we say no?” Bill exclaimed.
“It’s a sweltering day, ain’t it?” Geech said as we all sat under the shade of a tree, putting his iced glass up to his forehead. “It’s hotter than blue blazes. Why, I believe it’s hot enough to fry eggs on the sidewalk or for our chickens to lay some hard-boiled eggs.”
“Here in Osceola County,” Bill said, “there are only two seasons: summer’s here or summer’s coming.”
Geech laughed. “I’ve always said, ‘There’s only two seasons around here: January and summer!’”
A large bull ambled up to the fence a few yards behind us and bellowed. “Doc, you remember Wrinkles,” Geech boasted. “You’ve met him on trips out here.” He turned to Bill. “He’s my favorite, and he knows it. Weighs almost two tons, but he’s just a big, blubbering baby. He follows me around the pastures like a puppy.” Geech laughed. How I loved his laughter, which came easily for him. We finished our tea and said our goodbyes. However, when I opened the car door, it felt like I was opening an oven door with the heating element turned up high.
“This car is so hot, I’m sweating like a politician on election day,” Bill commented as he turned the air on high. We had to wait a moment for the “cool” air to blow in before we could head home.
Once we were moving, I commented on the temperature. “I can’t imagine living here without air-conditioning!”
“You’re not the only one to complain about living here. I’ve read about Spanish soldiers stationed down here in the early 1800s calling Florida a hideous, loathsome, diabolical, God-abandoned mosquito refuge. Those were their actual words!”
Bill laughed. “Even the future US president Zachary Taylor, who commanded troops down here for two years, said that he wouldn’t trade a square foot of Michigan or Ohio for a square mile of Florida.”
I chuckled. “Sounds like the Sunshine State wasn’t very popular with early settlers.”
“You’re right. It’s easy to forget that Central and South Florida were once America’s last frontier. Settlements down here didn’t even begin until well after we won the West. In the 1880s, the numbers of hearty pioneers in Central Florida were only in the hundreds. One visitor said if he owned land here and in hell, he would rent the property here to someone else and live in hell.”
“What brought folks to this area?” I asked.
“An industrialist from Philadelphia, Hamilton Disston, bought four million acres of Central Florida from the State of Florida in 1881 for twenty-five cents an acre. He began dredging canals, waterways, and draining the swamplands. His headquarters was in a small pioneer settlement on the shores of Lake Toho called Allendale. In 1884 Allendale incorporated as Kissimmee City and developed into a hub of commerce and trade.”
“What type of industry? Allendale had to be some kind of backwater place back then.”
“Literally!” Bill said, laughing. “The town became the home port for steamboats plying the Kissimmee River from Lake Toho south to Lake Okeechobee, which some call Florida’s Inland Sea. But it was the railroad that took Kissimmee to another level. The first one connected Kissimmee to Tampa and Jacksonville. The lumber and cattle industry exploded. By 1890, the population of Kissimmee had ballooned up to almost 2,500 folks.”
“Cattle are still big here. How long did the lumber industry last?”
Bill shook his head. “Not long. And with the loss of lumber, the population shrank to less than a thousand. After World War II, the city’s focus shifted to tourism. Then in 1971, Disney World spurred growth here in Kissimmee to the 15,000 we have today.”
“Has the growth been good?”
Bill thought before answering. “Locals learn to put up with the heat, humidity, mosquitoes, snakes, alligators, and bugs, but the worst varmints for most of us are the growing swarms of tourists. But for me, the most significant positive is the folks that live here. Down-to-earth, as honest as the day is long. They would do about anything for you. Living here my whole life has given me lasting memories of a little town where people have a lot of fondness and respect for each other.”
We pulled up to my rental house. “You say that I’ll get used to this weather, Bill, and maybe so, but I’m not so sure. Anyway, we’ve fallen in love with the people here in Kissimmee. I can’t imagine ever leaving.”
“I don’t think anyone should underplay the importance of living where people are kind, caring, and compassionate. That’s what makes a place a community, not just a town. And Kissimmee still has that in spades.”
I nodded and thanked him for a morning of terrific birding and his review of local lore and legends. But most of all, I cherished his giving me a fresh appreciation of our new hometown—one in which I hoped my family might one day be considered “locals” and not “outsiders.”[i]
Chapter 3 It’s Hot Here
[i] For this chapter, I refreshed my memory with the following: (1) an interview with Geech and Connie’s daughter, Kathy Baker, in October 2019; (2) Jovida Fletcher, “Coming of Age in Osceola in the ’50s Meant a Lot of Freedom,” Orlando Sentinel, June 3, 1990, tinyurl.com/y53lgplm (subscription required); (3) “History of Kissimmee,” Osceola County, tinyurl.com/yy3gw9z2; (4) Larry Manfredi, Birds of Central Florida: A Guide to Common and Notable Species, pamphlet ed. (Ft. Lauderdale, FL: Quick Reference Publishing, Inc., 2009); and (5) “One Town’s Origins: The History of Kissimmee,” Osceola County Historical Society, tinyurl.com/53m485hn.