MOUNT OLIVE — James Lambert often starts his workday at 4 or 5 a.m., with a one-mile walk from his home to his office.
He walks to exercise, to think and to evade.
Lambert has to evade. If patients see his car parked out front, they come in, and his marathon day becomes a sprint.
Lambert, 56, has been practicing medicine in and around Wayne and Duplin counties since 1981. He treats people who've known him since he was knee-high to a grasshopper. He looks after his North Duplin High classmates and current neighbors. He cares for their children and grandchildren. He makes house calls.
In an age when medical conglomerates rule, he is a country doctor and a dying breed.
"He means a lot to this community," says Atlas Price, a former Wayne County Commissioner. "If you or a family member need him, he'll make that special effort. He helps whatever way he can. I've called him for help, quite a bit."
Lambert can get overwhelmed caring for so many who share his history, but then Jerry Wayne from Greenville's 107.9 FM always perks him up.
"From Jerry Wayne to Doc Lambert," Wayne says before spinning the Jerry Butler classic, "Only the Strong Survive." It begins, "Boy, I see you sitting out there all alone ..."
Lambert isn't lonely with more than 10,000 patients in the practice that he took over from M.M. Lownes in the early 1990s. His office has housed such family doctors since 1901.
Lambert loves the grind, moving quickly between exam rooms, joking with nurse Beverly Cashwell and site leader Barbara Birkin. (He calls them B.C. and Ping Pong.) He hustles past 80 files that sit mocking him, needing notes and signatures. He slows when he enters an exam room.
On a recent Tuesday, he greeted Brad Deal, asking after his momma, daddy and babies before discussing the boil on his kneecap. Born premature, Deal, 26, says he'd have died as a baby without Lambert.
"He always makes time for us," says Tammy Willoughby, a Lambert patient, as was her deceased mother, Dixie French, and daughter Jordan. "When he's with you, he's only concentrating on you."
The caregiving goes both ways: When Ludie Waters, 79, came in for a checkup with daughter Gloria Waters-Burch and niece Becky Rivenbark-Cook, they also loved on Lambert a little bit. Waters-Burch brought him a poem; they left him cases of sweet potatoes from their farm.
They worry about Lambert, who was out four months in 2007 -- his longest rest, imposed or otherwise, since 1981-- after surgery for diverticulitis.
Waters has known Lambert since the doctor was a "little bitty boy." On a recent visit, Waters thought Lambert looked too pale, as if he'd skipped lunch again.
She told her daughter, "Go fetch James Royall a Pepsi and some Nabs."
Lambert loved science as a child growing up in Calypso with his teacher mother, sales rep father and sister. He admired Lownes, their family doctor.
"Jim decided very early on what he wanted to be, and he never wavered," says sister Jacqueline Lambert Brewer, now a Wake County District Court judge.
That dream took Lambert from the Duplin County town where he grew up to the Bowman Gray School of Medicine at Wake Forest University. There, his mentors Timothy Pennell and Jesse Meredith encouraged him to pursue general surgery. He chose family practice and his small-town roots.
"I had a fire in my belly for it," he says.
Lambert stoked the fire as a young doctor during hairy weekend hours moonlighting in such places as Taylorsville, Statesville and Elkin. He'd be responsible for doing such things as X-rays and operations.
Later, he'd take his turn riding with the rescue crew. One winter in Mount Olive, a pregnant woman was in labor with twins. The ambulance was taking them to Goldsboro for the delivery during an ice storm. Passing over the Neuse River Bridge, the ambulance spun 360 degrees. Lambert says he thought they would all die.
"I saw that lady last week," he says. "I treat the twins, too. They're all grown up."
Lambert tells sad memories quickly. One Christmas Eve he responded with the local rescue crew to a fire. Two children died that night; a third died later.
Know thy patient
Julian Keith, another Lambert mentor at Bowman Gray, often told Lambert the secret to family practice: You have to know your patient. You have to know his momma and daddy. You have to know what he comes home to at night. Then you know how to take care of him.
When Lambert was treating Waters a month ago, he sat on the floor to examine her feet. He gets as close as he can so he can know as much as he can.
Gilbert Garcia, a surgeon at Wayne Memorial Hospital in Goldsboro, says Lambert provides many details about his patients, a practice that is "more routine than exception."
"He knows them so well," says Garcia, who has been operating on Lambert's patients for 25 years. "That's his style."
Lambert still makes house calls; so do his patients. A high school sports teammate once walked into Lambert's bedroom and rousted him from a nap to help him with his gout.
"It's not a big issue; they're all good people," Lambert says. "They'd give me the shirt off their backs."
A dying breed
Still, not many medical students are interested in Lambert's job. There is a shortage of family doctors. Specialties such as cardiology pay better. In June, the American Academy of Family Physicians -- Lambert is a member -- testified in front of Congress about the danger the shortage poses to public health.
Lambert says such doctors get diabetes, myocardial infarctions and breast masses. But medicine has changed, and medical students often are saddled by huge loans. It's easier to make six figures in the city than to struggle to make $50,000 to $75,000 in a small town.
"You can't go into it for the money," Lambert says. "You have to be called. ... If we lose primary care and family practice and general internists, the system has lost a wall protecting people. ... I'm sure medicine will become more and more socialized, but it'll kill guys like me."
Lambert calls himself a dinosaur, but this T. rex has a legacy. His daughter Jeni used to accompany her dad on house calls and now is doing her residency in radiology at Bowman Gray. Of the many young patients who once examined his stethoscope with tiny fingers, two are now doctors.
24-7 for life
Lambert says he wants to stay on call until he dies. Eighteen years in, he wouldn't change his life. He still loves the medicine and people.
So each morning, after he sneaks into his office, he kneels down among the Wake Forest chairs and liters of Pepsi.
In the last quiet moment he'll have for 12 hours, Lambert says the serenity prayer and the Lord's prayer. He asks for grace, courage, wisdom and strength.
He prays so he may do right by his patients, his neighbors, his friends.
luciana.chavez@newsobserver .com or 919-829-4864