Back when I was a kid, my mother called Dr. Winston Caine to tell him how sick her baby was. She was certain I had a blood disease and learned he specialized in hematology. Dr. Caine determined I ought to be seen and asked Mom when could she bring in the baby. “Oh, he’s 16 and can drive himself!” she said and, for the past 47 years, the best doctor I have ever known in my life never quite let me live that down.
Winston Paulding Caine, Jr., M.D. was one of the closest friends I have ever had. Down through the years he learned every possible thing about me and, despite it all, we were still dearest friends when the beloved Erlanger physician died during his sleep Monday night. Dr. Caine lived my life with me, was always beside me in the good times and the bad. He soon took care of my entire family – four generations of us – and was as big a part of my family had he been blood kin.
He came to the ER that night in 1971 when I crushed my elbow in a Jeep wreck and was in the hospital room several days later when the infection first reared its head. When they told me that if gangrene set in they would have to amputate my arm, which was taped to the bed rail it was so badly injured, Winston quietly promised, “That’s not going to happen. I’ll get you through this.”
Our huge secret – one that can now be told -- was that I never had an appointment – I’d just show up after slipping in the back door and Winston would yell, “It’s the kid – how’s the baby!” We’d talk sports, kid each other and he’d give me some samples that would heal me right up. He’d played football at McCallie and Vanderbilt and loved to get the “inside skinny” on SEC football, the Orioles and such as that.
Twenty years went by and, gradually, my right elbow really started deteriorating. One day – right after I had the first in a merciless string of 127 surgeries that would follow – he came into the hospital room to tell me my grandfather had just died and held me as I wept. “I’ll get you through this,” he said.
Then the roller-coaster ride really started. One surgery after another, bones breaking inside the casts, surgical pins snapping in two, tendon grafts, cadaver bone, sea coral, nerve blocks, traumatic stress syndrome – we tried everything and I underwent surgeries in seven different states by the world’s greatest experts.
It soon got much worse. It seems that back in 1971 I had unknowingly developed a disease called osteomyelitis, a life-long malady where any infections stay hidden in your bone structure until calamity occurs and they are all “awakened.” I already had “staph” but by 2007 it was joined by “strep,” MRSA, c. diff., candida in my blood stream, and even more perils. If I was a cow they’d have shot me.
Honest, I had three bad types of serious infections at the same time – bacterial, fungal and viral – and the challenge was that when the Infectious Disease wizards would treat one type, the other two species would thrive on the medicine. Once I was quarantined at Mayo Clinic for seven long weeks as the MDs loaded me down with the strongest IV medicine in the world and it wasn’t working. I slugged down Daptomycin and Vancomycin by the barrel, and, at one point, had four surgeries in six days to wash out all the goo that would fill back up overnight. But I had my rock: “Don’t worry; I’ll get you through this.”
Now that’s the good stuff – nice conversation -- but there was bad stuff that Dr. Caine guided me through, too, and this is important to recognize. When I would go to church my “Indian name” was “How’s-your-arm?” Everybody would ask – all the time -- and I would just shrug it off, boldly lying, “Oh, it’s fine,” or “Up and down” but never admitting the truth so I wouldn’t have to talk about it or start crying.
What’s funny, looking back, is that nobody – ever – asked me about my heart. Divorces, heavy and relentless depression – there was no way I could work. Constant nausea and pain – bone infection is really excruciating. I was a wreck. I sold my house, a car was repossessed, and other things I deeply regret. But I must mention it to show how a great doctor – unlike the clergy – treats the whole, the total, even my bad parts. Winston Caine knew it all. He was my rock, my true north. “You let me handle the worrying. I’ll get you through this.”
In the year of 2008 I had 29 surgeries and spent a grand total of three months in either Erlanger or at The Mayo Clinic. Three were emergency surgeries (“I don’t care when you last ate something … we have to operate right now!”) and five early-morning admissions through the emergency room because the pain was absolutely unbearable. I was in ICU three different times and there was one dark day they say I actually “died” for about 22 minutes with no circulation to my arms or legs. My extremities were colder than ice and the “slide show” while comatose was horrifying. It was horrible but Winston Caine never flinched. “Will you quit worrying! I told you I’ll get you through this.”
Today I have no right elbow. The bone in my upper arm is now about half the length of my “original equipment” and the bones in my forearm, which are fused together, end about three inches below where my elbow once was. At the start of 2009, I had a gaping hole about the size of a fifty-cent piece in the void where my elbow was and it drained every minute of every day until November 17th of that year.
I was forced to change the putrid bandages four times a day for eleven months, was constantly on slow-drip IV antibiotics through a line in my chest, and begged two surgeons to please cut my arm off. They refused, saying my hand was too functional despite my withered arm, and Dr. Caine promised, “Don’t worry, I’ll get you through this.”
My last surgery in 2010 was when the last metal components were removed. Antibiotics, you see, work on human tissue but not on metal – the infections cling to the metal and as soon as the antibiotic regime ceases, the germs send word to osteomyelitis headquarters and – boom – the game is back on. After twenty years of fighting, we finally got a break and, other than wear a bulky brace and type with just my left hand, Dr. Caine was able to laugh, “See? I told you. We got you through it, baby!”
Five days before Winston died in his sleep, I dropped by his office. He shut the door and we talked about how good I was doing, how bad he was doing (he was taking chemo for cancer and had leukemia, too), how the refs were still cheating Vanderbilt, how proud he was of his boys, their wives and their grandchildren, how proud I was of my kids (also his patients), how his wife Priscilla was still invincible, the huge thrill he still got every day teaching interns, and a lot of stuff I thought was mindless until word reached me he had died. Then it was remembered as simply glorious.
He was reminded twice that morning he had patients waiting but he barked, “I’m talking to Roy!” Looking back, it was much like the countless conversations we would have when I was in the hospital. He’d come to the room before 6 every morning, wake me up by clobbering me in the bottom of my foot with the heavy chart, and then talk about football scores, the refs who always cheated Vandy, my hemoglobin, McCallie, and where was his coffee. Finally I’d edge in, “Can I get out of here?” and he’d shake his head. “No, you’re still sick. But don’t worry … I’ll get you through this.”
I guess I’d have to admit Winston saved my life three or four times. He could get me through anything. His genius was not confined to medicine, which made him a great healer and a spectacular friend. He was, quite simply, my rock. Because he was so solid and unwavering, I loved him every day and many a night for almost half a century.
What a God-given blessing Winston Pauling Caine, Jr., was to me and countless more thousands whose stories are far better than mine and every bit as real. I thank God that Winston and I both knew that “To live is Christ, to die is gain.” That’s how I know I’ll see him again. What a friend he has been.
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Funeral services will be at noon Saturday at the Signal Mountain Presbyterian Church with visitation beginning at 10:30 a.m.