I Should Have Asked Why the Other Doctors Left

My grandfather and father were the only doctors our Appalachian town ever managed to keep. My dad raised me after my mother died when I was three. He never talked about it much.

For 20 years, he served the town until he died right after I left town for college. He left me money for college and then for medical school. The town couldn’t keep a doctor after that. In the 12 years since I left, they’ve gone through nine. Never one more than two years. It made sense; we were a small town, isolated, and poor. Odd to outsiders perhaps, but that’s all I knew growing up. So, after residency, I came home.

When I first arrived, you’d have thought I was a war hero. People thanked me with tears in their eyes. More than one grabbed my hand and said, “Your daddy would be so proud.” Maybe they were happy to see a familiar face. I found it touching, but I can see how other doctors might find this welcome to be strange. Everyone looked a bit older, but when I look at myself in the mirror, I can see the stress of school and training has aged me twice as much as some.

I moved back into my father’s old clinic, into the same private apartment upstairs where I’d grown up. The place smelled like mildew, dust, and old paper, like an antique drawer opened for the first time in years. I blamed that smell for the headache I had by the third day.

Now, my second week in, the headache has become a steady pressure behind my right eye. My throat hurts, and I’m sweating through my undershirts by noon. There’s a dull pain under my ribs on the right.

After settling in, my first house call was to Ms. Rosalie Shepherd.

The room was dim and airless. Heavy curtains covered the windows. Framed paintings and photographs of women lined the walls.  All of them had the same long jaw, the same deep-set eyes, and the same unsmiling mouth. Mothers and grandmothers, I assume.

A metal basin sat beside the bed, half full of cloudy vomit. Ms. Rosalie lay propped against yellowed pillows. She had a terminal brain tumor. At this point, comfort was treatment.

Then the old woman spoke, “Doctor? Doctor Wilson, is that you? Come here, sweetie, hold my hand.”

When I did, she began mumbling, so I brought my ear closer to her lips. “…Amen.” Then louder for me to hear “Thank you, Doctor, thank you.”

“I’m going to give you something for the pain,” I said as I looked at her pupils. The right was blown wide open.

“I’m on the mend, dear. I knew you could.”

“She’s confused,” the daughter said.

“Has she been feverish?” I asked. “Coughing? Burning when she urinates?”

Her daughter shook her head.

I drew blood anyway to be thorough. When I pulled a vial, it was very dark, even for venous blood.

My next patient that day was a young boy. Classic strep throat. High fever, sore throat, and exudates. But during the visit, the child’s fever dropped. Maybe his fever just broke while I was there.

During the visit, he put his hand on my arm while I listened to his lungs and said, “You feel hot.” I dismissed it at the time because I was back in the humid summers of the mountains.

Three days ago, I was in the store, and I almost jumped out of my skin at the sight of her, Ms. Rosalie. She had no business being in there.

“I am feeling so much better, doctor, thank you for your help.”

I was dumbfounded. This woman should be dead. I can’t remember what I said. Something about getting new scans and a follow up appointment next week.

On my way home, the shadows of the mountains blanketed the road. I started to feel drunk. I noticed the road signs, but I just couldn’t read them.

This morning, Edwin Alden came in for a wound check.

An old farmer, I remembered him from childhood because he used to bring my father eggs and refuse payment for them. He lifted his shirt before I asked.

Below his right ribs was an old, puckered scar. The skin around it was red and tight.

“Your daddy kept this from going bad for years,” he said.

“I’m sorry?”

He smiled and said, “He kept it quiet.”

When I touched the scar, Edwin grabbed my wrist.  

“You got his hands,” he said.

I pulled away.

The wound looked better by the time he left. That sounds impossible, but I know what I saw. The redness had faded, and he stood straighter as he walked out.

Tonight, the dull pain under my ribs became sharp as it split into a raised puckered line. I couldn’t pretend any of this was normal anymore.

I came home to treat my hometown.

I think they are treating themselves with me.

I tore the clinic apart looking for my father’s old records. The official charts were still in the file room, at least the ones that hadn’t been transferred or destroyed. They were useless.

I found the other charts behind the cedar panel in the upstairs hallway. I knew the hiding place because I used it as a child. I kept signed papers and report cards I didn’t want my father to see. He must have found the gap after I left and made better use of it.

There were three ledgers, bound in cracked brown leather.

One belonged to my father, and two to my grandfather. I opened my father’s ledger. It was organized by symptom, with sections for headache, fever, tremor, memory, and growth.

Under each heading were names, dates, and notes in my father’s handwriting.

I found Ms. Rosalie Shepherd under the section listed, ‘Growth’.

Beside her name, my father had written: “Do not accept. Tumor burden too advanced. Must cast out immediately.” Below that, in red pen, there was another line. “If accepted accidentally, cast out within a month.”

I am writing this because I have no idea what he meant, and by my father’s clock, I have a little less than two weeks.

My throat is swollen. The scar under my ribs is warm and tender, my right eye won’t focus, I keep vomiting into the trash can beside my desk, and every time I close my eyes, I hear Ms. Rosalie whispering.

I don’t know where my father put the instructions, but there is an address scribbled in the margin. I know the place. Everyone here knows it.

It’s the old church off Laurel Lane, the one my father told me never to enter.

The church where my father’s body was found.