spooky.”
“You wouldn’t be the first,” Matt said.
Looking absolutely ridiculous in a paisley-print johnny, grizzled Kyle Slocumb, the youngest of the brothers, nodded his approval as Matt walked through the door. Lewis Slocumb, who seldom spoke a word he didn’t have to, was seated in the corner, half asleep. Matt went straight to the bedside and began his examination as he asked questions.
“So, Kyle, what’s the deal?”
Skin pale, palm creases pale, nail beds pale. Jeannie might be right about his being spooky, he thought. Anemia of some sort was already at the head of the list of possibilities.
“Ah got up ta take me a piss an’ got all dizzy, Doc. Lewis says Ah passed out, but he tends ta zaggeration.”
“Any pains?”
Pulse thin, rapid.
“Jes the usual.”
“You drinking much of that rotgut you guys make out there?”
Belly soft. Maybe a little protective muscle tightening over the stomach.
“A course Ah am. But so’s the rest a the boys.”
“Your stool any unusual color?”
“My what?”
“Your stool. Your bowel movements.”
“My what?”
“Your shit, Kyle. Your shit.”
“Oh, that. How should Ah know? Nobody in their right mind ’ud ever look down thet outhouse hole.”
“Whazza story, Doc?” Lewis asked.
“I don’t know, Lewis. Maybe low blood.”
“You’ll fix him up.”
“I’ll fix him up, Lewis.”
Matt did an efficient but detailed physical exam that showed a significant drop in blood pressure when Kyle sat up. Low blood volume, low blood count. Anemia. Now it was time to look for a source of blood loss, starting with the most likely. Matt pulled on a rubber glove.
“Whazzat fer?” Kyle asked.
“I think you can guess, Kyle. Roll over, face the wall, and pull your knees up toward your chest. I need to see if you’re bleeding inside.”
Kyle did as he was asked, but the moment Matt’s gloved finger touched his anus, he shrieked, stiffened his legs out, and began bellowing over and over again like a wounded beast. The staff—two nurses and the ER doc—came charging into the room.
“Ah din’t think he ’uz gonna lak thet,” Lewis drawled.
“Well, why in the hell didn’t you say something?” Matt replied, much louder than he had intended.
Jeannie Putnam and the two others stood at the doorway, transfixed. Matt, his gloved finger pointing skyward like a fan at some bizarre sporting event proclaiming his team was number one, smiled at them sheepishly.
“I . . . don’t think I waited long enough for Kyle to agree to this procedure. Apparently it’s a touchy area for him.”
“Apparently,” Jeannie said. “Um, Dr. Rutledge, can we be of any help?”
“Well, actually, you can be sure that blood you sent is cross-matched for six units, and you can tell the lab we really need his hematocrit.”
“Is he bleeding internally?”
“That’s my guess.”
“Guess?”
“I’d be a bit more certain if I could get some stool to test for blood. Kyle, how about if I go up there with a little Q-tip?”
“Nope.”
“Look, Kyle. It’s three-thirty in the morning and you’re sick and I have to know why. Now, either you let me do the procedure I want to do, or I promise you I’m going home and back to bed.”
“What?” Kyle and Jeannie exclaimed in unison.
“Ya wouldn’t leave me, Doc,” Kyle said.
“Oh, but I would. Believe me, I would. Dr. Ellis here can take care of you for now, and in the morning they’ll find you another doctor. That is, provided you’re still alive in the morning. Now, what’s it going to be?”
For half a minute, there was only silence. Then slowly, Kyle rolled back to face the wall and drew his knees up.
“Darn but yer an ornery summabitch doctor,” he said. “Y’uz ornery as a kid an’ ya jes got worse since then.”
“I’ll be gentle, Kyle,” Matt replied.
BY SIX-THIRTY, THE impending crisis surrounding Kyle Slocumb was over. The hard-won rectal exam disclosed black stool that tested
“You wouldn’t be the first,” Matt said.
Looking absolutely ridiculous in a paisley-print johnny, grizzled Kyle Slocumb, the youngest of the brothers, nodded his approval as Matt walked through the door. Lewis Slocumb, who seldom spoke a word he didn’t have to, was seated in the corner, half asleep. Matt went straight to the bedside and began his examination as he asked questions.
“So, Kyle, what’s the deal?”
Skin pale, palm creases pale, nail beds pale. Jeannie might be right about his being spooky, he thought. Anemia of some sort was already at the head of the list of possibilities.
“Ah got up ta take me a piss an’ got all dizzy, Doc. Lewis says Ah passed out, but he tends ta zaggeration.”
“Any pains?”
Pulse thin, rapid.
“Jes the usual.”
“You drinking much of that rotgut you guys make out there?”
Belly soft. Maybe a little protective muscle tightening over the stomach.
“A course Ah am. But so’s the rest a the boys.”
“Your stool any unusual color?”
“My what?”
“Your stool. Your bowel movements.”
“My what?”
“Your shit, Kyle. Your shit.”
“Oh, that. How should Ah know? Nobody in their right mind ’ud ever look down thet outhouse hole.”
“Whazza story, Doc?” Lewis asked.
“I don’t know, Lewis. Maybe low blood.”
“You’ll fix him up.”
“I’ll fix him up, Lewis.”
Matt did an efficient but detailed physical exam that showed a significant drop in blood pressure when Kyle sat up. Low blood volume, low blood count. Anemia. Now it was time to look for a source of blood loss, starting with the most likely. Matt pulled on a rubber glove.
“Whazzat fer?” Kyle asked.
“I think you can guess, Kyle. Roll over, face the wall, and pull your knees up toward your chest. I need to see if you’re bleeding inside.”
Kyle did as he was asked, but the moment Matt’s gloved finger touched his anus, he shrieked, stiffened his legs out, and began bellowing over and over again like a wounded beast. The staff—two nurses and the ER doc—came charging into the room.
“Ah din’t think he ’uz gonna lak thet,” Lewis drawled.
“Well, why in the hell didn’t you say something?” Matt replied, much louder than he had intended.
Jeannie Putnam and the two others stood at the doorway, transfixed. Matt, his gloved finger pointing skyward like a fan at some bizarre sporting event proclaiming his team was number one, smiled at them sheepishly.
“I . . . don’t think I waited long enough for Kyle to agree to this procedure. Apparently it’s a touchy area for him.”
“Apparently,” Jeannie said. “Um, Dr. Rutledge, can we be of any help?”
“Well, actually, you can be sure that blood you sent is cross-matched for six units, and you can tell the lab we really need his hematocrit.”
“Is he bleeding internally?”
“That’s my guess.”
“Guess?”
“I’d be a bit more certain if I could get some stool to test for blood. Kyle, how about if I go up there with a little Q-tip?”
“Nope.”
“Look, Kyle. It’s three-thirty in the morning and you’re sick and I have to know why. Now, either you let me do the procedure I want to do, or I promise you I’m going home and back to bed.”
“What?” Kyle and Jeannie exclaimed in unison.
“Ya wouldn’t leave me, Doc,” Kyle said.
“Oh, but I would. Believe me, I would. Dr. Ellis here can take care of you for now, and in the morning they’ll find you another doctor. That is, provided you’re still alive in the morning. Now, what’s it going to be?”
For half a minute, there was only silence. Then slowly, Kyle rolled back to face the wall and drew his knees up.
“Darn but yer an ornery summabitch doctor,” he said. “Y’uz ornery as a kid an’ ya jes got worse since then.”
“I’ll be gentle, Kyle,” Matt replied.
BY SIX-THIRTY, THE impending crisis surrounding Kyle Slocumb was over. The hard-won rectal exam disclosed black stool that tested
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