had said that to him, but he hadn’t forgotten the words. He was a prematurely aging attending psychiatrist at a large hospital in Pine Hill, North Carolina. He had graduated from the medical school here, gone through his residency, attained his present senior status. Talk was that he would go a long way, perhaps chairman of the department when the time was right.
Dr Meredith was a non-intimidating, rather dumpy man of thirty-something, with sandy hair and grey in his frizzy beard. He wore the same striped ties he had worn for years, button-down collar shirts, and cotton Dockers. Still wore tight black leather dress shoes, and he pulled on a rumpled tweed jacket whenever he thought the occasion called for it: weekly court commitment hearings held here at the center; patient’s family inquiring as to family member’s progress. Shrinks do not wear white. Bad for patient rapport.
He hated wearing ties. If he ever set up a private practice, it would be T-shirts and maybe a sweater. A cardigan. No, just the T-shirt. Or some jogging sweats. Not that he ever jogged. Assume the air of informality. Patient at ease. Dream on.
Dr Meredith had just completed his rounds, was making medication adjustments to his charts, making mental notes regarding his students and staff, and considering journal club that evening, where he hoped his residents finally would be brought up-to-date on lithium therapy. There was a fine line between maintaining a manic-depressive and killing him, and the foreign resident who had confused q.o.d. with q.i.d. was going to speak at length upon the subject. In broken English.
“Dr Meredith.” The nurse knew better than to interrupt him needlessly, and Meredith felt the tension. “He says he’s your cousin, and it’s urgent.”
“Thank you.” Meredith picked up the phone. He shouldn’t be receiving personal calls here, unless from his wife or daughter. He worked hard, did not like to be interrupted. Once at home, he could find time for friends and family.
“Kirby!” said the voice over the phone. “It’s your favorite cousin, Bob. I got a problem, maybe. Janice told me how to reach you at the hospital.”
“What’s the problem, Bob?” Meredith thought Cousin Bob sounded drunk. He’d rarely seen him sober. Bob Breenwood lived about half an hour’s distance from Pine Hill and ran a small hardware business in a small town. They got together regularly to go fishing. Bob was always drunk. His wife and staff ran the business.
“Just started vomiting. Blood. Can’t stop it.”
Meredith froze for a moment. “How much blood?”
“I don’t know. I was cooking a steak on the charcoal grill, and then it just started.”
“Is it bright red, or is it sort of like dark and clotted, like it’s coming from your gums or sinuses, and you’ve maybe swallowed it and choked it up?”
“It’s bright red, and there’s more of it coming up. All the time. Oh, shit! I got to hit the toilet!”
Meredith was very firm. “Have your wife call 911. Emergency. Get over here without delay. You’re likely bleeding to death from ruptured esophageal varices. Do it now. I’ll be here. For you. There’s no time to waste. You’ll be dead in an hour.”
Possibly putting it a little too strong, but Meredith phoned 911 himself, with frantic details. Maureen Breenwood had already called. Meredith hovered about the Emergency Room, getting in the way, while explaining why an attending shrink was in the way. He was well liked, and the staff were ready when the ambulance Bob’s hematocrit was down to 10, for someone who liked to take down record lows. Typed and crossmatched, the units of blood finally flowed into his arm. He did not go into shock, by some miracle. A balloon was inserted past his esophagus, reducing the bleeding, and his blood pressure finally stabilized at 105/90 from 60/45. He should have been dead.
Dr Meredith observed, but stayed out of the way. He wouldn’t want two or three other shrinks all giving therapeutic advice as he interviewed his patient, and he respected professionalism. Instead he made frequent visits to Maureen, who had left the waiting room for the chapel, and reassured her as she spoke with the priest. Dr Meredith was an atheist, but therapy was therapy. Janice was coming over to be with her.
Cousin Bob was fully stabilized by three in the morning and off to Intensive Care. Dr Meredith checked Maureen into a nearby hotel and promised to phone if there were any complications, then returned to his office in the psychiatric wing and