For a heartbeat I had to force myself not to turn around immediately and go looking for Vance. I stepped to Ethan’s bedside. His skin had that gray, damp cast I have learned to fear. He was holding his right side protectively, every movement careful and incomplete. “Ethan,” I said, keeping my voice level, “I need you to try to straighten out for me.”
He tried. The effort triggered a sharp gasp that seemed to rip straight through him. “Can’t,” he said through clenched teeth. “Hurts too much.”
I performed the gentlest palpation I could manage, and the moment my hand touched his right lower quadrant, he flinched so violently he almost came off the table. Rebound tenderness. Guarding. The involuntary rigidity of a body trying to protect an inflamed, contaminated abdomen. Five hours of progressive pain. Fever climbing. Tachycardia. The puzzle had assembled itself. This was not merely appendicitis. This was likely a ruptured appendix, maybe recent, maybe already spilling contamination into the peritoneal cavity. My mouth went dry.
“Where is Dr. Vance?” I asked.
The nurse hesitated only long enough to decide honesty mattered more than politics. “Room Four.”