Fatal

CHAPTER 8

The phone had rung several times before Matt snatched up the nearest of the four alarm clocks he had spaced progressively farther from the bed. With the clock disengaged and clutched to his chest, he was working his way back into a right-side-down fetal tuck when he realized the ringing was persisting.

"H'lo?"

"Dr. Rutledge, it’s Jeannie Putnam in the ER."

"That's nice."

"Dr. Rutledge, are you awake?"

"I'm awake. I'm awake. How long have you been working at the hospital, Jeannie?"

"Three months, why?"

"Don't ever believe me when I say I'm awake."

"But are you?"

"Yes." Matt switched on the bedside lamp to be sure. "Only I'm not on call."

"I know, but a man just came into the ER and said his brother keeps passing out. He's outside in their truck but he won't come in unless you're here to see him. The one who came in said he didn't have to tell us his name, you'd know who they were… Dr. Rutledge?"

Matt held the alarm clock beneath the light. Three-fifteen. He groaned and stretched. A dozen aching places on his body cried out in protest. He had finished sign-out rounds at seven in the evening, then raced over to the gym at the Y for his men's C amp;A basketball league — C amp;A, for contusions and abrasions. He had about a minute to warm up before he and a bunch of thirty-to-fifty-year-olds began two and a half hours of full-court battle. Matt had retained some skills from his days as captain of the high school team, but most of the combatants had lost whatever finesse they once had, and had replaced it with a mix of brute force and age-related clumsiness. If it weren't for the so-called referees they chipped in to hire, there was no way the ER wouldn't be flooded every Monday and Thursday.

"I'm awake, I'm awake," he said again. "Just stunned. Jeannie, the men who are there would probably be two of the Slocumb brothers."

"Oh my."

"It sounds like you've heard of them."

"Some. I'm recently from Philadelphia. I thought maybe people were making up an Appalachia story just to shock me. How many brothers are there?"

"Four. The one who came into the ER, is he where you can see him?"

"No. He went back out to the truck. Dr. Rutledge, he smells something awful."

"He may not think so. Do you remember if he has any teeth?"

"What?"

"Teeth. Does he have any?"

"Just a couple in the front, I think."

"Well, that would be Lewis. Tell him to allow you to bring his brother into the ER and begin to take care of him or else I'm going to turn right around when I get there and go home. Be firm. Each of the Slocumb brothers is more stubborn than the next. The only chance you have is to stand up to them. They respect anyone with guts."

"Oh, I've got guts," Jeannie said. "It's permanently losing my sense of smell I'm concerned about."

"Please get his BP and pulse lying, sitting, and if he looks like he can tolerate it, standing."

"Okay."

"EKG and routine labs if you can charm them into allowing it. Also, have the lab type and cross-match for three units and be ready to cross-match for three more."

"You think he's bleeding?"

"No idea. But they would never come to the ER unless there was something very much the matter. They make their own moonshine in this hideous still behind their house. I wonder if maybe the whiskey has eaten away the lining of his stomach."

"I'll get right on it. You're awake, right?"

"The odds favor it," Matt replied, hauling himself out of bed. "I'll be there in fifteen minutes."

The pounding behind his eyes had him trying to remember how many beers he had downed with the guys after the game. Not that many, he decided, given how easily he had been awakened — certainly not too many to deal with whichever Slocumb was slumped on the front seat of the truck.

The Slocumb brothers, Kyle, Lyle, Lewis, and Frank, were all in their fifties or early sixties. They lived together as they had since birth on their combination junkyard and farm — a hundred acres or so located about eight rugged, densely wooded miles north of town. Their mother, who died decades ago, was perhaps the only woman who had ever set foot on the spread. Not once in Matt's long relationship with them had the Slocumbs mentioned their father.

Matt had heard of the "Freak Brothers" from his early childhood. Rumors about the reclusive Slocumbs ranged from bizarre to perverse to downright frightening. Like most children in the area, Matt had been forbidden to go anywhere near their place. He was ten years old when some of the older boys dared him to try to get a Little League contribution from them.

None of the boys were willing to go any closer than the parallel dirt ruts to the farm that (cut off from the narrow highway. One of them told Matt the place Was just a little ways up the road. In fact, it was more than three miles. Matt alternately rode and walked his bike the whole way. At the door of the ramshackle house he hesitated, clutching the donation can so tightly he thought he might crush it. Then he took the sort of deep, calming breath he would one day use just before driving a large-bore needle into a young miner's chest, and knocked.

Twenty minutes later he was on the dirt road again. In his basket was a sausage sandwich on homemade bread. On his wrist was a bracelet forged out of bent horseshoe nails. And in the donation can were two crumpled, oil-stained dollar bills. Before a day had passed, the whole town had some version or other of the story. Matt's father docked him two weeks' allowance for disobedience and forbade him from going near the place again. From that time on, Matt kept his monthly visits to the farm a secret. Since returning to Belinda from his residency, he went out there every so often to do some doctoring or just to catch up. There was very little, if anything, he had learned about the four men over the years that he didn't like, although none of them would qualify as a prize-winning conversationalist. And he knew for a fact that there was a whole new generation of kids who were being forbidden by their parents from going near the Freak Brothers. The Slocumbs most definitely preferred it that way.

Matt threw on his favorite pair of denims and a plaid work shirt, and pulled on his boots. There was no chance he would be returning to the cabin before his workday began in earnest.

The envelope was lying on the floor by the front door. Matt had actually stepped on it before he noticed it. It was a plain white envelope, darkened in spots with grime and grease. "Dr rutlege" was printed in pencil on the front, in a labored hand. Given the shape Matt was in after the rugged basketball games and the postmortem at Woody's Tavern, the envelope might have been there when he got home. He flipped on some lights in the living room and tore it open.

Dr.Rutlege.

you are Rite.

Theres poyzon barryed in the Mountin.

find it thru the Tunel in the Cleft.

giv the Reward to them as needs it.

signed

a caring Frend.

The uneven scrawl was similar to the writing of many mountain people — mixed uppercase letters with lower, with phonetic spelling and no consistent attention to punctuation. Regardless of who wrote it, they were clearly on the right side — his side. His heart pounding, Matt put the note back in its envelope and stuffed it into his jeans. Quite possibly, this was the break he had been working for.

The tunnel in the cleft.

Matt had lived in the area much of his life, and still had no idea what the line referred to. But whoever wrote the note knew, and so, without a doubt, others did, too. Buoyed by the turn of events, Matt jumped on his Harley and raced down the hill toward the hospital.

He rolled his motorcycle to a stop next to the brightly lit Emergency entrance and dropped the kickstand. The Slocumbs' battered Ford pickup, parked nearby, was empty. For no particular reason, Matt guessed the one who had been passing out was Kyle — the most outgoing and obstinate of the eccentric Slocumb quartet.

Jeannie Putnam, wearing a set of maroon scrubs and a surgical mask, was waiting for him in the surprisingly busy ER. She was a tall woman in her late twenties, with a good grasp of emergency medicine and an obvious empathy for the patients.

"We're grateful for your coming in like this," she said.

"Which brother is it?"

"Kyle. And you were right about the other one. It is Lewis."

"Labs off?"

"Kyle drew the line at getting any tests until you were here to order them."

"Lord."

"But I changed his mind," she added with a wink. "I even got him to put on a johnny. He's really sort of cute."

"You should see the room the four of them sleep in. 'Cute' isn't the first adjective that would come to mind. But I am glad you appreciate some of his charm. What did you order?"

"The usual, CBC, Chem 12. Plus the cross-match. Tell me again why you ordered it?"

Matt shrugged and shook his head. "I don't know. Kyle's never had any medical problem that I've had to deal with. Something you said about his passing out then waking up sounded like low blood pressure, so I thought maybe he was bleeding internally."

"If you have made the correct diagnosis over the phone at three A.M., I would consider you very 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?"

Betty 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. "Urn, 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 positive for blood. Perhaps cowed by the procedure, Kyle put up little resistance to swallowing a thin plastic tube, which Matt slid up one nostril and down the back of his throat into his stomach. Years of smoking potent homegrown cigarettes had done in his gag reflex, making the often difficult insertion a snap. The stomach contents aspirated through the tube were old blood (coffee grounds in appearance) and some streaks of fresh, bright red blood as well. Transfusions had quickly replaced the lost blood and circulating volume, so that by the time Kyle was wheeled into the GI Suite for an examination through gastroenterologist Ed Tanguay's scope, he had recovered his color and stabilized his blood pressure.

"So thet's it," Lewis Slocumb said as he and Matt walked together out of the ER. The dewy morning air was fragrant.

"Just about," Matt replied. "We'll keep our fingers crossed that all Dr. Tanguay finds is some gastritis. That's like inflammation of the stomach lining. If it's a little ulcer, that'll probably be okay, too."

"But if'n he got cancer he's finished."

"Not necessarily. We can cure stomach cancer with surgery. But let's not go there until we hear what Dr. Tanguay finds. We're lucky he could do Kyle so quickly."

"If'n thet doctor sez ol' Kyle has to stay overnight, Ah think he'd jes leave."

"I was thinking he ought to stay anyway, just to get some medicine for his stomach and maybe another transfusion."

"Ah tell ya, if'n he kin walk, they's no way he'll stay."

"I got him to let me do that exam, Lewis. I can talk him into staying."

Lewis Slocumb turned and looked up at Matt. The sharpness in his blue-green eyes was belied by the rest of his weathered, scruffy face.

"Wer different, Matthew," he said. "It's a way we done chose fer ourselves an' it don' mean nothin' ta us thet mos' folks think wer crazy or sick or evil. Thet is, 'til we cross the line inta their world. It ain't nothin' we enjoy doin', b'lieve me it ain't. Kyle an' me crossed thet line this mornin'. Now we want ta cross back as quick as possible. So yew make thet happen, Doc, an' we'll take our chances. Our kind, the mountain folk, unnerstand thet so long's ya don' hurt no one, ya kin be whoever ya want. Mos' people down here in town ain't none too pleasant ta us, an' thet goes fer yer hospital, too."

Matt was so astonished, he could barely reply. Lewis Slocumb hadn't called him anything other than Doc since his return with his M.D. He had also just spoken more words than Matt could ever remember.

"Okay," he managed. "I'll do what I can to get Kyle out of here. But if I think he's in danger, you're going to have to sign him out against my advice."

"We'll do thet. An' donchew worry none. We ain't gonna sue ya, no matter what."

He guffawed, coughed, and spat.

Matt gazed east at the flush of morning sunlight brightening the sky from behind the hills. As he did so, he slipped his hands in his pockets and connected with the envelope.

"Hey, Lewis, tell me what you make of this," he said, handing it over.

He felt pretty certain that all of the Slocumbs could read to some degree or another.

"Don' make nothin' of it," Lewis said.

"You mean you don't know what the guy who wrote this note is talking about? You don't know where the cleft is?"

Lewis scuffed at the ground with the toe of his worn high-cuts.

"Ah mot know, then agin Ah mot not."

"Lewis, I just saved your brother's life, and I've been coming out to the farm to check on you guys for years. This note is very important to me. It has to do with the mine."

"Ah know what it has ta do with. Ya really got a burr up yer butt fer thet ol' mine."

"I have good reasons," Matt said, suddenly exasperated. "My father and my wife, for two. A couple of dead miners, for two more… Lewis?"

"Ah 'preciate what ya done fer Kyle in there, Ah surely do."

"So?"

"It's really thet important ta ya?"

"It is. I put out notices offering a reward for information about illegal chemical waste dumping by the mine, and this note was slid under my door."

Lewis scuffed thoughtfully, covering up the gouges he had made in the sand.

"So, whar's the big news?" he asked finally.

"What do you mean?"

"Ah mean, they's lotsa folks livin' in the woods what knows 'bout the cleft an' the tunnel and even 'bout the crap the mine people keep inside."

Matt's pulse began to race.

"What do you mean 'crap'?" he asked.

"Chemicals, jes like ya sed. Barrels of 'em."

"Hot damn. Lewis, can you take me there?"

Lewis sighed.

"Inside the mountain? Ah s'pose Ah kin."

"When?"

"When ya thinkin' ya'll be done with Kyle?"

"I don't know. Maybe late this afternoon."

"Then we'll talk late this afternoon."

"But you know about this poison the note talks about?"

"Ah know."

"And you'll take me to see it firsthand?"

"Ah 'spect Ah will, but Ah cain't say rot now. It's sorta up ta m' brothers, too."

"Lewis, surely you knew I've been trying to get something on BC and C. Why haven't you said something to me about this before?"

"We lak ya, Doc. But we lak eatin', too."

"What's that supposed to mean?"

"It means Stevenson an' them people at the mine bin paying us ta keep quiet 'bout what we know."

"I don't understand. What connection do they have with you?"

Lewis rubbed at his chin, then sighed again.

"Per a time, we done hauled the stuff in thar fer 'em," he said.