not protein deficiency,” Dree muttered under her breath. And louder, “Does he eat the egg yolks?”
Batsa conferred. “Yes, he eats the yellow parts very much. She gives hers to him.”
“Probably not fats or cobalamin.” Dree looked up at Max. “I thought it was going to be a lack of vitamin B12, but if he’s eating eggs, then it’s probably not. Any ideas?”
Maxence shook his head. “Absorption? Maybe celiac disease?”
“His stomach isn’t distended, though.” Dree asked Batsa, “How about diarrhea?”
Batsa conferred and replied, “She says yes, for a month now.”
Dree blinked and nodded. “Okay, then. Maybe it’s celiac or some other malabsorption problem.” She turned to Batsa. “Tell the mother not to feed him any wheat, wheat flour, rye, or barley. No more bread for him. Get him rice, and make sure she doesn’t put flour in anything that he eats. I don’t know if that’s it, but at least it’s something.”
Batsa relayed the information to the child’s family, who seemed very upset at first that their child would not be able to eat rotis or naan and other bread. After a few more minutes of explanation, the family seemed to get it.
The family thanked Dree and the two guys profusely, of course, as always. The male cousin who had arrived with them gathered the fussing, very ill child in his arms and carried him out of the house.
Dree shook her head. “The pinpoint bleeding around his hair follicles, the bruising, and the joint swelling just doesn’t look like celiac disease, but I don’t know what it is. Celiac disease can look like almost anything, though.”
Max agreed with her. “It doesn’t look like other vitamin deficiency diseases like beriberi or pellagra, which I’ve seen in children when working in remote villages in Western Africa. His hair was brittle. It was uneven and didn’t look like it had been cut, just broken.”
Dree sighed. “I’m not a doctor. I’m just doing my best. I’ve got thirty more patients to see, and the sun goes down in three hours. I’ll have to put him in the back of my mind while I try to help these other people.”
Maxence watched Dree and helped where he could as she whipped through the next couple dozen cases. Many of them were easy. Some needed a few sutures. Others needed reassurance that it wasn’t anything serious. A man needed one of Dree’s precious tetanus vaccines that she slept with to keep them from freezing, which would inactivate them.
Dree was fluttering around her last few patients, dressing a wound on a little boy and explaining to a different young mother through Batsa that cradle cap is not life-threatening and just to scrub it off. She passed by Maxence and whispered, “I still can’t figure out what that boy had.”
He shrugged. “I haven’t seen anything like it.”
“Right,” she said. “Me, either. It didn’t look infectious. There were skin discolorations, but it wasn’t a rash. There wasn’t a wound that it stemmed from. It didn’t look like a parasite or a bacteria or a virus. A month is too long for most infectious diseases to slowly progress unless it was leprosy or tuberculosis, which it wasn’t. This was disseminated and progressive and weird.”
“Why were you looking in his mouth?” Maxence asked.
“His gums were puffy and swollen. His teeth were loose. He was just a little boy, and his adult front teeth shouldn’t have been loose at all. It wasn’t like he’d gotten hit or something, though. All his teeth were the same degree of loose.”
“It’s odd,” Max said. He felt like he should know what this was.
Dree shook her head and cared for her other patients, but Max could see she was fretting about the little boy.
As soon as they closed the door on her clinic and began to pack up the supplies for the motorcycle ride back out to the campsite, Dree said, “It’s got to be something. He was around six years old. He wouldn’t have lived this long if he had some inborn error of metabolism. I mean, they’re all skinny, but they don’t seem malnourished like some other villages we’ve seen.” She ran her hand down the side of her waist and over her hip, emphasizing her hourglass figure. “I wouldn’t call any of the people here curvy, though.”
Maxence’s mouth had gone dry, and he stared down at his motorcycle boots because his hands wanted to follow hers over her lush body. “No, I wouldn’t call any of these villagers curvy.”
When he looked up, Dree was staring