Larkspur: A Sidewinder Tale - 12. Chapter 12 Gut Punch

Gut Punch

The doctor’s office was around back of the telegraph office, a few places down from the livery. Mitch, after seeing the small sign hanging on the corner of the two-story building, dismounted and tied his mare to the hitching post. Sucking in a deep breath, he followed the boardwalk along the side until he reached a door with the name, Dr. E. Jergens painted on the glass in fancy black and gold letters. He didn’t know why he was fretting so, given he was only doing this to satisfy Coy. Standing in front of it for spell, he peered at his reflection before finally knocking.

The glass rattled loudly, but there weren’t no answer. Turning the handle, he found the door was unlocked. After waiting about a minute, he stepped inside and looked around. He took another deep breath, this time through his nose. It smelled like a doctor’s office, sure enough. The small room was empty, and he called out, but there was only the sound of a clock’s loud ticking on top of a white wooden cabinet. A curtained-off room to the right stirred his curiosity, and he took a peek through the slit.

It too was empty, but was no doubt the examination room, with a strange-looking chair set in front of the large, light-filled window. He turned his attention back to the waiting room and stared at the two chairs facing a scuffed oak table in the corner.

Sorely tempted to leave, he opened the door and stepped out. No one was in sight. Thinking about what Coy would say if he left, he sighed and went back in, reluctantly taking a seat in one of those chairs. He left the door open, though, to help freshen the heavy medicine smell of pine tar turpentine. It wasn’t long before the doctor hurried in.

Mitch guessed the man was a fair bit younger than him, with his hair still a dark gold color, thinning slightly, and his face free of lines. It was surprising to him a doctor could be younger than he was, but he stood and offered his hand immediately.

The man took it, and his handshake was firm. The eyes that met his were a bright and friendly green. “I was on a call outside of town. It’s been a hectic morning that started even earlier than usual. Were you waiting long?”

“Not long at all. I can come back another time if’n you’re busy,” Mitch offered, hoping it would be accepted.

Dr. Jergens took his worn traveling jacket off and hung it on a hook beside the curtained doorway, and then shrugged into a clean white one hanging on the hook next to it “Now is just fine. Had to attend a difficult birth, but mother and son are doing remarkably well,” he said with a tired smile. “Now, what can I do for you, Mister—”

“Willard. Mitch Willard.”

“Mitch? Oh, you’d be the friend of Boone and Coy’s from the southwest?”

“Yep, that’s me. How did you know that, if you don’t mind me asking?”

“There isn’t much happens in Larkspur people don’t hear about, especially someone new coming to town. If by chance you miss something, though, Alan Bright from the mercantile will ensure you hear tell before too long.”

“Ah, yes. One of those in every town. Right friendly fellow, he be.”

The doctor chuckled. “Suppose you’re right about that. Good man, yes… definitely a good man, and more informative than the weekly that arrives on the stage. Heard too you purchased some land next to Red Apple Farm?”

“That’s a fact, I did. Pretty piece of property to plant my boots on. Mr. Bright again?”

“Well, I believe he came by that information from Phineas Lemon, but yes, Alan was the one who told me,” he answered with an amused twist to his lips. “So… what health issue brings you to see me, Mr. Willard?”

“To tell you the truth, I don’t really see the sense to wasting your time, but I made a promise to Coy I would come listen to your opinion.”

“Oh? Well then… why don’t you tell me about what you don’t think is serious enough to need a doctor’s attention, and I’ll be the judge of time wasted?”

Mitch wasn’t sure, but considered he might have somehow insulted the man. “It’s not that it ain't serious… it is in fact, but I already got seen to by the doctor in Red Bluff.”

“Red Bluff? I remember that place—went through there once on the train. Dry and very dusty is what I recall most.”

“You remember it rightly. It’s that way most of the time, away from the foothills. They get more rain in those parts.”

Dr. Jergens nodded. “Still, it seemed a busy town. So what did this doctor have to say?”

“Told me plain I was dying, and there weren’t much to be done for me unless I went east, and only then to confirm his diagnosis.” Mitch tried to grin, but saw it fell flat with the man.

“Dying?” The doc looked startled for a second before his expression cleared. “I see. Did he say what you were dying from?”

“He called it tumor disease at first. Another time he called it carcina—carcino—something like that—said it were growths inside the body, like what you see inside butchered cattle and hogs sometimes.”

Doctor Jergens frowned. “The word is carcinoma, sometimes applied to a number of different conditions. And what did he base such a diagnosis on?”

“I’m not rightly sure, but truth is I was sicker than an old dog.”

“And? I’d appreciate if you would explain what you mean by that.”

“Surely… was bad… real bad. Were weak like I ain’t never been—that came first. Then I couldn’t hardly breathe, my guts turned to water, nothing stayed in my stomach at all, not even water more than a sip or two, and I lost weight powerful fast. The doc said the weight dropping off so quick was because of the disease.”

“Or the simple fact you couldn’t eat,” he said in a tone that Mitch found curious. “Anything else?”

“No… I don’t think so… other than I coughed all the time, and was spitting up blood.”

“From your lungs or abdomen?”

“Not rightly sure about that either. There was so much pain I didn’t much care what was coming from where. Mostly when I coughed, though, I guess, but there was blood a time or two that run out of me from the other end.”

“Red blood?”

“Yep, a couple of times I reckon.”

“I see, and where was this pain?”

“Mostly my whole chest… and my left side. Don’t know if it was my guts or what, but it wouldn’t let up most days.”

“And when was this? May I?” He reached forward and pulled Mitch’s bottom eyelids down, looking closely at first one, and then the other. “Good. So when was this?” he asked again.

“Ah… about four, five months ago, I reckon. It’s been almost three—or thereabouts—since I got up from my bed and rode out of town.”

“Were you still feeling sickly at that time?” He reached out and took Mitch’s hand, examining the fingernails and pushing on the skin around them. As far as Mitch remembered, no doctor had ever looked at his fingernails before… or pulled his eyelids down either, for that matter.

After he got over the surprise of it, he answered. “Surely was, yep, and had been the same way for a couple of months.”

“Why did you leave when you did if you were still sick and in so much pain? Did your doctor approve of you traveling?”

"He surely didn't. Told me to stay put when I mentioned I was thinking on it."

"Yet you left anyway. Why would you do such a thing, Mr. Willard?"

Mitch shrugged. “Well… cause I could, I reckon. I was still feeling poorly, but the pain let up enough I could move around. I was finally able to get out of bed without someone’s help… weren’t easy, though, but I truly didn’t want to die in there.” The doc’s question reminded him of just how desperate he’d been to leave at the time. “Always loved my house, but it was feeling like a pine box with the lid soon to close. I’d rather pass on under the stars, given a choice.”

This time Dr. Jergens did smile at him. “I can understand that, but if I were to tell you to stay put, I’d expect you to stay put. How are you feeling now?”

Mitch understood right then this doctor accepted no nonsense from his patients. Even not knowing him at all, his respect for him grew. Doc Bailey had lost interest in what was going on with him over time, but something told him this doctor wasn't one to give up on a patient. “Ah… guess you could say I’m having me a good spell.”

The man’s eyebrows rose, as if waiting for more. Them eyes were kind, but they bored right through you when he wanted to know something. Mitch had heard his own described the same way more than once.

“Ah… Doc Bailey said I could have some good spells… well… he said I might have a good spell, but it didn’t mean I weren’t still dying.”

“He did?” The man looked and sounded genuinely surprised. Might even be he was mortified.

Mitch couldn’t really tell for sure, though, and he was usually good at reading people. “It’s what he said. I figured he didn’t want to get my hopes up when I mentioned getting out of bed and hitting the trail.”

“That’s an interesting approach.” This time Mitch was sure he heard judgement. “So, what about right now… today? How do you feel?”

“I feel good. Really good most days, but I do still cough now and again.”

The doctor nodded, as if he’d expected to hear such. It stirred Mitch’s curiosity; what was the man thinking? “Would you say it’s worse than it was?”

“Not by a long ways. Ain’t even close to that… just a little aggravating now. Spent a month or more where I couldn’t hardly catch my breath.”

“I see. Did you cough up mucous during that time?”

“Mucous?”

“Thick spittle, often green or yellow, and sometimes brown.”

“Oh that. Yep, plenty of that, and all them colors for sure.”

“And now?”

“Not near as much. Mostly white spittle with some thickness to it.”

“I see. And your bowels?”

“My bowels? Oh, you mean….”

“Yes, do you form firm stools?”

“Ah… I didn’t back when I was doing so poorly, but they’ve been… firm yes… back to the usual for a while now.”

“Do you ever see any blood or black colored patches in them?”

“I don’t always look, but no, when I do, they look normal-colored, I reckon.”

“And can you take a deep breath?”

“Sure can.”

“And does it hurt at all?” he asked as he felt both sides of Mitch’s neck with his fingers. He pushed hard enough up under his jaw he let loose a squeak. He felt a mite foolish at making the noise, but the doctor didn’t seem bothered.

“No… no, I can’t say it hurts to breathe anymore.”

“And that’s been the case for a while too? Lift your arms all the way up, please.”

Mitch did, and the man's fingers pushed and prodded through his shirt at his armpits. He couldn’t help wondering what the man was looking for. “Ah… breathing ain’t hurt for weeks now. Coughing makes my throat feel raw sometimes, but that’s all.”

“Understandable. All right, you can put your arms down now and follow me.” He slid the curtain on the exam room doorway to one side while Mitch walked past him, and then closed it after them. “Take off your shirt and sit in the chair for me, please.”

Mitch did as he was asked, shucking his shirt and setting it on his lap. He watched as Dr. Jergens opened a slim wooden box and took out a contraption he’d never seen before. “What is that thing?”

“Something that was only invented a couple of years ago. To be accurate, it’s called a Cammann Binaural Stethoscope, and it allows me to listen to some of your internal organs, specifically your heart and lungs. Your previous doctor probably used a tube made of wood?”

“No, nothing like that. He put his ear on my chest to listen.”

“I see. That is surprising in this day and age—a very old practice indeed. There are new developments in medicine every day. Perfectly fine for its time, but this stethoscope is much more effective at diagnosing a patient’s health. It can help me detect any abnormalities in your different heart chambers, even blood flow, and of course air sounds traveling through your lungs.”

“So you’ll be able to hear the tumors?”

“No, not exactly, but I will be able to tell if there are any restrictions in your airways, as well as how well your lungs actually function.”

“Restrictions like what the tumors cause?”

“Exactly. If there are tumors or growths of concern, they would reduce the capacity and strength of your lungs, but let’s not get ahead of ourselves. His gaze traveled over Mitch’s upper body. “Have you been able to gain any weight back?”

“Since I’ve been staying with the boys, I sure have. I didn’t eat much on my trip here, but I’m eating good now. Reckon I got as good an appetite as I ever did have.”

“Excellent. You’re a little thin, but still a good weight, so there’s no need to gain much back. Can you tell me what these scars are from and how old they are?”

“Being a sheriff most of your life means you have plenty of opportunities to take some bullets, and I had more than my share. These are all old ones. It took me a while, but I finally learned how not to get shot.”

Dr. Jergens chuckled. “I supposed you’d have to if you didn’t want the alternative. This one along your bottom rib, what was that time like?”

“That was worse than the one in my gut for sure. They had to dig the bullet out and I swear it bothered me for two years or more.”

“Hurt to breathe?”

“Like the dickens, and whenever I twisted, but fortunately it weren’t on my shooting side, so I could hold a gun fine. What are you asking about that one for, Doc?”

“Well… I would suspect this one is still aggravating from time to time, am I correct?”

“I suppose. I got to be careful how I sleep sometimes.”

“Muscle damage and scar tissue most likely. They are often cause for chronic pain.”

“Chronic?”

“Means every so often it could flare up. Could even be frequent. Does coughing set it off?”

Mitch nodded. “It sure don’t help.”

“Can you open your mouth wide for me?”

Mitch did as he was asked and the doctor peered in.

“Good healthy teeth—something I wish I saw more often. Keep doing whatever you're doing to keep them that way. Now, turn your head towards the window for me. Yes, that’s good. Hmm… just as I thought,” he said, as if to hisself. “Okay, I think it’s time I listened to what’s going on inside. All you have to do is sit still and breathe normally until I tell you different. Lean forward please.”

“Sounds easy enough.” Mitch did as he was told and the doctor pushed on a lever that caused the chair back to lay flat. It reminded him of a barber’s chair. He watched as the doctor separated one end of the stethoscope contraption and put it into both ears. It was comical-looking, but he didn’t laugh. The other end appeared to be brass and was shaped like a little bell. He was surprised when the doc went behind him and placed that end against his skin, jumping slightly at the coolness of it. Old Doc Bailey had only placed his ear to his chest, not his back.

“Sit up straight please and remember to stay still. Just take normal breaths,” Doc Jergens repeated. After a minute or two of him moving the contraption around and tapping his finger against his skin, he asked Mitch to take a deep breath and hold it. Mitch did, long enough he thought he would pass out before the doctor told him to let it out. They repeated the process again and again before he moved around to the front. Again, there was more deep breaths and holding them before Mitch was asked to breathe normally.

“I’m going to listen to your heart now,” the doc said as he stood in front of Mitch, his concentration clear. Finally, with a sigh, he stepped away and set his contraption down. “You got a heart strong as a young horse, Mr. Willard.”

“I reckon that’s good?”

“It’s very good. How old are you.”

“Forty-seven, nearing forty-eight.”

“So yes, excellent for a man your age who’s been shot up like you have. Please lay back for me now.”

Mitch did, and the doctor moved close to the chair again, his hands examining Mitch’s stomach and up under his ribcage. He was pushing hard enough to make him grit his teeth and grunt in discomfort.

“Did that hurt?”

“No, I reckon not. Not used to getting poked so hard is all.”

“I find no one is,” he said with a grin as he continued poking and pushing. It weren’t long before he stepped away again. “Well, you’ll be relieved to know I’m done prodding you. Nothing to be concerned with in your abdomen.”

“Just the tumors in my chest?” he asked, needing to hear it said.

“Tumors? About that, Mr. Willard. I’m pretty confident in saying if there are any tumors in those lungs of yours, they are of no significance to your health.”

Mitch sat dead still and stared at this man who’d just said the impossible. It was as if his senses had up and left him—like when a fella gets gut punched and the breath ain’t coming—but the longer he stared, the more he could see the doctor had been serious. He finally let the words sink in, and then found the air to make his voice work. “But, how… how can that be? Don’t make no sense. Doc Bailey was so sure. How could he have been wrong about something like that?”

“He wasn’t wrong about you being sick, and he might have been right about how close you were to dying, but I suspect he would have eventually given you a different diagnosis if you hadn’t left town… and if you didn’t die.”

“I… I don’t understand?”

“And sometimes neither do we, to be completely honest. We doctors have to make our best guess in certain situations, and all the symptoms you described told your doctor it was extremely serious, and I would bet he’d seen similar cases in that town which resulted in death. What he got wrong was the cause of your illness, not its severity. Do you understand what I’m saying?”

“I was sick enough to die, but it weren’t because I had tumor disease.”

“Exactly.”

“So… why was I so sick then?”

“I can only speculate, because from what I see now, you have almost fully recuperated and are in quite good health. But, that said, I’m fairly certain it was an infection. Some doctors would call it inflammation, like with consumption, but we are learning that is inaccurate, or at least incomplete. It’s the same idea as a wound infection, but internal, and the lungs are a very susceptible organ. Once it sets in, it can be very difficult to treat. Unfortunately, while some recover, many—even most—don’t. You can put your shirt back on,” he said with a gesture as he packed his stethoscope back in its wooden box.

“I believe you had a grave internal infection, which in turn caused inflammation of your bronchial system, centered mostly, or at first, in the lungs, and constantly aggravated by the damage of the dust you’d breathed in over time.

“Bronchial?”

“Oh… yes, simply put, that’s basically any part of the body used for the breathing process, from your nose to your throat to your lungs. It’s all connected, and a serious infection spreads easily, and can eventually make it impossible for the lungs—the bronchial system—to function. Do you understand?”

“I think so,” Mitch answered, remembering how hard he had to work to draw breathe into his lungs. He’d felt at times like he was drowning. Still shook at what the doc had said about him having no tumors, he fought some dizziness.

Doc Jergens peered at him with a sympathetic expression before continuing. “As well, you have an old, chronic injury to your left side which left considerable scar tissue, some of which I can actually feel through the skin around the original wound. That tissue can get inflamed from time to time. That likely increased the severity of your pain while coughing. The infection itself would cause bleeding in your lungs, throat and esophagus. Your whole bronchial system would have been under attack. I’ve seen this type of infection a number of times—we don’t have a name for it yet—but it’s been referred to as ‘the fever’ and other names for many years. I can tell you those lucky enough to recover take months before they feel back to normal, and some suffer permanent damage to their breathing, and consequently, their physical strength and mobility.”

“But I haven’t?”

“Not that I can hear. Your lungs sound perfectly healthy, and your vigor has obviously returned, but it might be a while yet before you are fully recovered. Residual coughing is to be expected.”

“Residual? Does that mean it could go on for a while?”

“Exactly. In fact you could always have some cough, although I don’t expect that will be the case, based on your lung sounds.”

“So, if I have blood in my spit after I cough, that’s all right?”

“Do you?”

“Yep. For the first time in a while, but I laid on cold ground about four nights ago for a few hours, and got to feeling chilled.”

“How much blood are we talking about?”

“Hardly any… just a few spots of it, and none for almost two days now.”

“Your throat appeared irritated when I looked. Does it feel that way?”

“Yep, some… when I cough, but it’s getting better.”

“Any change in your bowels over the last few days?”

Mitch shook his head. “Just the coughing is all.”

“Then I don’t think it’s anything to worry about, but don’t drink anything too hot for a few days, and I would strongly suggest you avoid getting a chill of any kind. I can’t say for sure how your lungs will react in the future, but we’ll pay close attention to them over the coming months. As well, please keep in mind breathing in really cold air can activate your cough, so be vigilant this winter. We don’t want you coughing.

“The blood is coming from your throat because it hasn’t fully healed yet, but it should clear up on its own. I want you to come back in two weeks, just to be sure everything looks and sounds good, but I’m as confident as I can be you are a healthy man, Mr. Willard.”

“Mitch. Call me Mitch, if’n you’re comfortable with it.”

“All right, Mitch. I can see this comes as a shock to you, but I assure you I’m not wrong about this. You are not dying anytime soon… unless another bullet happens to find you.” He chuckled at his own joke, and Mitch smiled, feeling a lift of some of that awful weight he’d been carrying.

“Do you have any more questions for me? Anything at all?”

“No… well… I got one, I guess. How come I was one who didn’t die?”

“Only the Lord can answer that, I’m afraid, but I expect getting away from all that dust likely aided in clearing your lungs of the infection. Other than that, I would say a man who has survived as many gunshot wounds as you have, has to have a strong constitution… and a healthy share of good luck.”

Mitch thought about the old Indian poultice Doc Bailey had put on him, but didn’t bring it up—maybe next time he came in, he’d tell him about it. What mattered was he had a future, and whether luck or the lord or some Indian medicine had played a part in bringing him to Larkspur, he was thankful just the same.

“Can I ask you a question now, Mitch?”

“Surely.”

“I’m a curious man, and I can’t help wondering about something. Why did you buy your land if you believed Dr. Bailey’s diagnosis?”

Mitch didn’t mind the question, and didn’t need to think about his answer. “I love them boys, Coy and Boone, like they are my own blood… like they’re my sons… and I wanted to leave them something good when I was gone. Guess they’ll have to wait a few years yet before they can claim it.”

The doctor smiled, a full one this time. “I’d say at least twenty-five or thirty if you listen to your doctor when he tells you to do something.”

“I plan on it, doc, I surely do.”

He was shaking as he walked outside, after settling his bill and agreeing to return in two weeks. How wrong Doc Bailey had been was a hard thing to accept, so he stood on the boardwalk going over in his head all he’d just heard. The fact was, when all was said and done, he did believe everything Doc Jergens had just told him.

Mitch hadn't felt like a dying man lately, not at all, and turns out that feeling in his gut what he'd ignored, had been right. Somehow, Coy had known it too. Someone brushed him lightly as they walked past, and it spurred him to get moving. He wasn’t sure what to do first—he knew there were folks who deserved to hear what he’d learned, and he owed Coy something fierce—but his new land was calling to him. He made a decision what felt the right one to him.

He had a sudden and strong urge to speak his thanks to the Good Lord and the Great Mother, so he would go home and burn some more of that sweet smelling sage. Yep, that's what needed doing first.

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