Big Daddy Medicine Man

For the past three years, Dr. Scott Kelso has lived a topsy-turvy life. For two weeks each month, he leaves his home in Washington, DC to practice medicine on the nightshift in the Emergency Room of a hospital in Fort Defiance, AZ. It’s not a lifestyle for everyone, but it works for Kelso. His patients certainly agree: they call him Big Daddy Medicine Man.

Fort Defiance is in the northeast quadrant of the Navaho Nation, an autonomous area covering 27,000 square miles (roughly the size of New England) in the Four Corners region of the Southwest. There are overlapping layers of federal, state, and tribal government including a self-administered judicial system, tribal law enforcement, primary and secondary schools, a Native American college, and since 2004, the Tsehootsooi Medical Center, a 52-bed general medical and surgical hospital originally administered by the Indian Health Service, but now privately operated by the Window Rock Chapter of the Navajo Nation.

Kelso sleeps during the day. At 8pm, he reports to the ER and is on duty for the next twelve hours. He’s likely to see almost anything: multiple gunshot wounds; a dual stabbing (quarreling brothers); massive head trauma from a cast-iron skillet wielded by an angry wife; hypothermia (patient fell asleep in a ditch for five hours in sub-freezing temperature); a severely altered state from eating a toxic lily (patient thought it was an onion); insulin shock (lots of diabetes on the Rez); multiple patients with blood-level alcohols that would kill a horse. Oh: and one automobile accident victim who actually did hit a horse standing in the middle of the road. Kelso treats most patients in his ER, but the most severe cases must be airlifted to Albuquerque, the closest hospital with a trauma center, some 200 miles away.

Kelso’s ER is a front-line operation. Because everybody knows or can quickly reference everybody else, not a lot of time is wasted on paperwork. Health care is a federal entitlement program for tribal members: patients walk in, get treated quickly, no questions asked, no insurance hassles.  Also, because there is little depth of field in the hospital—no cadre of resident specialists to refer patients to—Kelso actually gets to practice clinical medicine, a dying art in his profession. He see things he wouldn’t encounter anywhere else: hanta virus (carried by mice), brucellosis (a bacterial infection carried by bovine or ovine cattle), even bubonic plague, a virus carried by prairie dogs transmitted to humans through flea bites.

The health care professionals who work alongside Kelso admire him, partly for his medical expertise, partly for his gurney-side manner, and partly for his utter lack of professional hubris. No one has ever heard him respond to a patient request with “Ask your nurse.”  One colleague with years of patient care under his scrubs says, “Doc’s never above it all and nothing is beneath him. He’s right here in the middle with us and with the patients. Never seen anything like it; I love the guy.”

At Fort Defiance, Kelso has relearned the art of connecting directly to his patients, many of whom may have walked for hours just to get to the hospital.  He has also learned that Anglo medicine has its limits. Now when Kelso bumps up against a patient’s belief in a more traditional cure—a sweat lodge, a hitaalii’s complex sand painting, or a sing—he backs off. He’s heard “Doc, you wouldn’t understand” more times than he can count. His first instinct is always to practice the medicine he was trained to practice, but with every shift, he is learning to appreciate another kind of medicine, a more spirit-driven healing art. “Who knows what really heals a patient,” he says with a shrug.

Jamie Kirkpatrick

(For publication in American Cowboy magazine, June/July 2017)

Cocktails With Cain

(For the Washington College Magazine, Spring 2017)

Cocktails With Cain

So I’m sitting at my desk, minding my own damn business, when the phone rings. It’s a dame I know. “Busy?” she asks.

“A little,” says I.

“I want you to read a book. You do know what a book is, don’t you? It’s Jimmy Cain’s long lost novel. About a cocktail waitress.” And she hangs up.  That’s how it all started, I swear it.

Jimmy Cain, as in James Mallahan Cain to you. The same James M. Cain whose father was President of Washington College from 1903-1918; the same Jim Cain who graduated from that very college in 1910; the same wiseguy who learned to write dialog from talking to the guys laying down the brick sidewalk along Washington Avenue; the same guy who became a hard-drinking Hollywood writer who earned a reputation as a master of noir fiction with novels like The Postman Always Rings Twice, Mildred Pierce, and Double Indemnity; the dead man that Ray Hoopes, Vice President for College Relations back in the Cater days, wrote a biography about instead of the one he was supposed to write about Doug Cater; that Jimmy Cain.

So I dialed up Amazon and plunked down $7.99 for “The Cocktail Waitress,” all 453 pages of it. You know what? It wasn’t half bad…

OK; enough is enough; I’m not really a noir guy. To be honest, it’s a genre I tend to eschew, but now that I’ve had a sip of it, I’m beginning to wonder why. The plot line is simple enough: widow with great legs, a beckoning balcony, and a fiery temper whose recently deceased husband was an abusive drunk loses toddler son to spiteful, childless sister-in-law, gets job as a cocktail waitress, (turn the page), weds a rich but sickly old man, falls for handsome swain, (turn the page), gets in a bunch of trouble, and I’ll leave it at that for now…

If writing—at least noir writing—is all about plot, dialog, locations, and characters, then “The Cocktail Waitress” is right up your dark alley. You’ll want to leave a big tip for Joan Medford, the you-can’t-help-but-stare-at cocktail waitress who serves up drinks and Cain’s lowbrow storyline without spilling a drop of either and her down-and-out circle of friends. (Think Garth Brook’s “I’ve got friends in low places/where the whiskey drowns and the booze chases/my blues away.”) Maybe you’ll come to pity Earl K. White III, the rich old man with angina who falls for Joan and her shipwreck story. You’ll swoon over Tom Barclay, the handsome rogue with the rakish grin “that defied you not to like him” and “a scent that took something loose in a woman and coiled it up tight.”  All the while, you’ll be soaking up the all the seedy atmospheres, snarky dialog, wrong-side-of-the-tracks locations, and sudden plot twists that are the hashtags of Cain’s hardboiled crime novels.

Speaking of plot twists…well, I won’t, except to say that no story of Cain’s is a straight line and in this one, the final twist may well take place after every author’s favorite two final words: The End.  But no matter: noir is noir and what’s not great prose can always be shined up with some good storytelling.

James M. Cain died in 1977 at the age of 85. At the time of his death, there were rumors about an unfinished novel but it would take researchers seven years to find the missing manuscripts. (Notice the plural.) What was really found were scenes—variations of scenes, in fact—so what was ultimately polished by editors and eventually published as “The Cocktail Waitress” was more like the ghost of a Cain novel—or maybe more like an unclaimed body in the morgue, if you catch my drift.

Jamie Kirkpatrick

Jamie Kirkpatrick is a writer and photographer whose work has appeared in The Washington Post, Philadelphia Inquirer, Pittsburgh Post-Gazette, and Baltimore Sun. His “Musings” appear every Tuesday in The Chestertown Spy.   Jamie and his wife Kat live in Chestertown.  (To read more of Jamie’s writing, visit his website: