The starting point (IV of VII): Appalachian remedies

       I accepted a job as a general internist in North Wilkesboro, NC, the proclaimed birthplace of NASCAR. North Wilkesboro and adjacent Wilkesboro are basically one town in the foothills of the Appalachians with a combined population of just over 7,000 persons. I anticipated that now that I was away from the “granola” crowd of Portland, OR and the tribal traditions of Ghana, I would no longer be exposed to alternative medicine. Boy was I wrong! The Wilkesboros opened up a whole new window to my thinking about “alternative” medicine. Now I got to experience “Appalachian” medicine (To be fair, the vast majority of my patients ascribed to traditional western medicine, but it is the exceptions that make for a good yarn!).

            There was a much loved elderly general practioner in town, Dr. Jack Dawson, who unfortunately succumbed to lung cancer during my first few years in North Wilkesboro. Since I was a new practioner in town and one of the few doctors accepting new patients, several of Jack’s patients ended up in my practice. As a result, I became familiar with several concoctions he had dreamed up which the local pharmacy happily compounded for his patients. Depending on a patient’s perceived malady, be it coughing with congestion, stomach upset, or nervousness, one could order up the appropriate “Dawson’s mixture”. I could literally write a prescription for Dawson’s mixture #1, #2, or #3 based on a person’s complaints and the pharmacy would provide the corresponding concoction. Believe it or not, I could even write a prescription for “Snakeoil,” another brew that Dr. Dawson had dreamed up and was highest in demand! To this day, I can’t help but chuckle when I think of Jack Dawson dreaming up a mixture and naming it “Snakeoil,” a name that has been used to belittle numerous “cure-all tonics” that have been peddled over the centuries with claims to fix all maladies (not unlike that which is being sold by the traveling vendors in Ghana in present day). Jack clearly had a sense of humor and for the most part his concoctions were relatively benign combinations of already available over-the-counter medications such as liquid diphenhydramine (the ingredient in Bendryl), milk of magnesia, and liquid acetaminophen (Tylenol), occasionally mixed with some stiffer substances such as bella donna or codeine. They appeared to cause no harm and the patients definitely imbued these concoctions with special healing powers that went above and beyond any of the individual ingredients.

            Aside from Dr. Dawson’s concoctions, I remember an elderly woman I admitted to the hospital with pneumonia. She was 92 years old and came into the emergency room clutching her own bottle of cough syrup brought from home. She swore that her cough syrup was much superior to the ones she might receive in the hospital. It ends up that her cough syrup was actually robitussin mixed with “white lightning” (another name for moonshine and a testament to the surviving illegal distilleries that still abounded in the region). I figured that she had made it past 90 years old, so who was I to deprive her of this apparently effective and calming remedy?

            There was also the woman who came to me from a nearby chiropractor. The patient informed me that she had hepatitis (inflammation of the liver). I asked her to explain the basis for this concern, as I could not appreciate any of the telltale signs of liver problems such as jaundice (yellowing of the skin), nausea, or abdominal pain. She said that her chiropractor had made this diagnosis and had sent her to me to have blood drawn to confirm the diagnosis. Needless to say, the tests all came back normal and I became somewhat wary of this chiropractor.

            On a regular basis, I was introduced to folk remedies and superstitions such as undecipherable herbal remedies and the healing powers of various floras. This reminds me of a little prank played on me by one of my patients. He noticed I was suffering from a cold with a runny nose. He pulled two buckeye nuts out of his pocket and told me that if I rubbed them on whatever ailed me it would get better. Thus instructed, I dutifully rubbed the nuts over my nose and sinuses. He than informed me that he was sure I would be feeling better soon because he had used the very same nuts this morning on his hemorrhoids and he was now free of pain!

[tomorrow… returning to the Ivory Towers]