DR. KENNETH CARTER, M.D., CONTRIBUTED THE NEXT THREE STORIES

Dr. Kenneth Carter, M.D.—Doctor Ken, as he is known to most of his patients—is an experienced physician, certified by the American Academy of Family Physicians. He grew up on a farm in northwestern Minnesota and graduated from the University of Minnesota Medical School with an M.D. degree in 1968. He has practiced in Granite Falls, Minnesota, since 1970. Some of the hats he wears include that of a Family Physician, with a focus on geriatrics. He serves as Yellow Medicine County coroner, medical director of Granite Falls Hospice and as Granite Falls Home Care Director. Please meet Dr. Carter through stories from his practice:

Frieda Schultz

Frieda was eighty-five that day. I knew that her husband of so many decades was eighty-six. She had been a regular visitor to my office. A bun of gray hair perched on the back of her neck. Years of sun and wind had creased her face. Her frame was lean, her limbs angular, and arthritic fingers were as gnarled as burls on a forest oak. Her cotton dress was homemade, lines stark, some nameless dark shade. Its hem reached mid-calf. Frieda Schultz wore the proper uniform of a southern Minnesota farm wife.

I sat before her, attentive.

“It’s that Arthur-itis again,” she said.

“Where is it acting up this time?” I asked.

“Knees.”

I leaned forward and palpated the bumpy joints. “Sore?”

“Not to that. Hurts to walk and wakes me up at night.”

I went through the litany of treatment that arthritis invokes: warmth, rest-plus-exercise of a gentle sort, aspirin or ibuprofen. Her somber features did not relent.

Something more? So often a declared “symptom” is merely a ticket to gain a doctor’s attention.

I asked, “How are things going at home?”

She looked at me full on. “Terrible! My John doesn’t love me anymore.”

“How have you decided that?”

“He hasn’t wanted to make love with me for six months.”

Ah. Some human needs have no expiration date. I leaned forward again and touched her arm gently.

“It may help to remember that John is eighty-six, and diabetic. There are things a man really can’t help.” I explained about the disease and its erosive effects on masculine performance. “From what I’ve seen of him,” I said, “I find it hard to believe that he has quit loving you. Maybe a little patience on your part?” She nodded tentatively. “A little, uh, help from you?”

She nodded briskly. Her smile was as bright as all outdoors on a sunny day. She bobbed up and strode to the door. Her knees seemed to have discovered renewed strength and vigor.

I dictated on her chart and paused, bemused. Should I call John, a friendly alert?

Clinton

The thing about starting a practice somewhere is that... it has to start sometime, somewhere. I was new to medicine and new to the community, a village of four hundred people. That comfort which experience bestows must be earned the hard way. I hoped that the confidence I donned each day was not too obviously brand new.

Incessant ringing of the doorbell to my home awoke me one night at 2:30 a.m. I stumbled downstairs and opened the front door. Two elderly gentlemen seized the front of my pajamas, both talking at once.

“Clinton lives next door to me... ” shouted one.

“He’s been out deer hunting and... ” chimed in the other.

“Spent the evening at the Powerhouse Tavern, stumbled home after they expelled him... ”

“Fell out his own bathroom window, been running amok ever... ”

“... since and he’s scaring everybody. Figured you should come.”

I asked where he was at the moment.

“Back alley, half block west.”

“Can’t you hear him, Doc?”

I pried myself loose, threw on enough clothes that I wouldn’t be arrested myself, and decided to drive my car into the dark alley, using its headlights for illumination.

My proud doctor’s satchel still bore its original coat of polish. I had stocked it with nearly as many supplies as the City Drug Store downtown. Heavy. I positioned the car to shine beams along the alley. Clinton lay against Johnson’s garage. Several neighborhood men had attached themselves grimly to assorted parts of the lad’s anatomy. If they were winning the fight to hold Clinton down, it was not obvious.

I popped open my medical case and drew a dose of intravenous sedative into a syringe. I edged close to the pile of twisting arms and legs. Clinton kicked a leg free on the precise moment I held my syringe at the ready. Sedative and all, it soared away into darkness. Gone. I groped in my bag of tricks again. Thorazine, a drug used to quiet a psychotic patient—when there is no alternative.

The men sitting on Clinton subdued him enough that I was able to slip a needle into an arm vein. I learned that the drug also works on a rambunctious drunk; quiet and peace returned to our dark alley.

I had a moment to contemplate the situation. Here I was, as far from orderly Academia as the north pole is from the south, with an unconscious young tough who could awaken at any moment. No one during training had told me that medicine might be so confrontational!

By then, town constable Fred Johnson had arrived. Fred drove an old station wagon which, with the back seat laid flat, could carry a stretcher. Fred was our town’s law, and also its entire ambulance squad. If Clinton awoke on the way to the nearest hospital, located in a town ten miles away, both Fred and our patient would be at risk.

There was no built-in means of securing Clinton to the stretcher. Looking for something to immobilize the lad, we found a fifty-foot electric cord in a nearby garage. We wound cord around him and the stretcher until he could have passed for a mummy. Fred headed for Our Sisters of Peace Hospital, I following in my own car. En route, Clinton slept as quietly as a hound pup dreaming in the sun.

He awoke toward suppertime. I poked my head cautiously around the jamb of his hospital room when I called to recheck him. It pays to use circumspection; one never knows. When he spied me, Clinton had the good grace to blush clear to his toes.

I was only weeks away from my internship, and medical school curriculum is encyclopedic. Still, I couldn’t recall having had a course in Subduing Wild Patients in a Dark Alley in the Middle of the Night - 101. Maybe I had just finished the course. Got a passing grade, then.

Until Death Do Us Part

Glacial-till landscape, gently-rolling hills and broad fields characterize southwestern Minnesota. It is the eastern edge of our country’s Great Plains. The terrain offers little hindrance to violent weather. Many of Minnesota’s worst winter storms roar out of Canada from the northwest. We call them Alberta Clippers, furies that can pounce with little warning.

I received a call from the community hospital. A woman in labor. I drove through howling snow that was rapidly forming drifts. Sometime after midnight, I welcomed our newest citizen into the world.

When I pushed open the hospital door to head for home, kernels of snow riding winds as cross as Old Man Simmons during one of his gout attacks slammed me in the face. Like peering into the maw of a sandblaster. Discretion did its thing, and I headed back into the hospital. A night spent on the atrocity called the doctor’s-lounge bed seemed a better choice than heading for home.

The storm abated along about noon and I headed out again, visions of a nap dancing in my head.

The telephone rang at 3 p.m. I was county coroner, and yes, Sheriff Robertson, I was available. The next town north? On my way.

I arrived at the scene and found rescue-squad and county law-enforcement personnel waiting. They plopped me onto a sled pulled behind a snowmobile and wrapped me to my ears. The machine growled past a venerable farmhouse, across open fields for more than half a mile. We stopped next to a small knot of officers, huddled against winds still pushing loose snow into swirling snow devils.

I have noticed that whenever professionals must attend a found body, they stand in an awkward circle, looking everywhere but at the death that summoned them. Almost as though apologetic for still breathing in the presence of one who never will again.

I crawled out of the cocoon that had been constructed for me on the sled and knelt beside—the bodies of two elderly people lay huddled together in a cradle of snow. A man and a woman.

“Al Johnson,” Sheriff Robertson said somberly, “and Bess, his wife. Both widowed, they’ve only been married three or four years. Bess was blind, but old Al there took care of her so well that she never wanted. Damn shame.”

“What happened?” I asked. “How’d they manage to get clear out here?”

“Had to have walked. Imagine, that wind and cold last night. They’d been out to supper at the Wayside Café. When they started for home, it wasn’t that bad yet, but you know these Clippers. Al made it as far as the beginning of their driveway when the car stalled in snow. Must have figured they could make it that last hundred yards to the house. Set out, anyway. Near as we can figure, Al must have been guided more by the wind than by what he should have seen. ‘Course, Bess being blind, she couldn’t have helped. Doc, they missed the grove of windbreak trees around the house and barnyard by only twenty yards. So damn close, but so damn—”

“Yeah,” I said.

Al and Bess. Each past eighty. They had struggled across arctic terrain for more than a mile. I tried to imagine it, then tried even harder to scrub the picture from my mind.

The nature of being a country doctor, of being a coroner, is that you see frozen bodies every so often. It’s odd about people who have died of exposure. They look so... so as though all they have to do is wake up, crawl to their feet, and we can all go and have a beer while we laugh about the whole episode.

Al and Bess stick in my mind. Side by side, locked in icy permanence. What I never will forget is how tightly they still held hands.

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