liver and spleen. They also looked normal, no grainy leukemic infiltrates and no scarring associated with cirrhosis. Next, he examined the stomach. It looked full, but had normal consistency and color. Finally, Moe ran the entire length of the small bowel and colon, inspecting every inch.
Then there it was, the first abnormal finding. Moe had seen that blue sheen to the bowel before in humans, it simply meant the bowel was full of old blood. When looking from the outside through the relatively thin walls of the bowel, the blood looked blue, like venous blood. Other than that, the bowel looked okay, no palpable lesions, no dilation to make one think of obstruction.
Gripping his scalpel like a pencil, Moe sliced through a longitudinal muscular band, one of the taeniae, opening the large bowel. There was a myriad of small, petechial hemorrhages, but certainly not a single, major bleeding site or lesion.
Somewhat confused, Moe went back to the stomach, incising through the fundus. The stomach was full of clotted blood, which Moe simply scooped out with his gloved hands. Again, there were those same petechial hemorrhages, but there was more. In the most dependent portion of the stomach, there was still a small amount of gastric content that had layered out when peristalsis ceased, the heavier particles at the bottom, the liquid at the top. Systematically, Moe inspected this gooey amalgam. It contained mainly gastric juices that formed the top layer, but underneath this veneer, were a few intact grains of barley and some particles of undigested alfalfa cubes.
Moe dredged up the stomach contents in cupped hands, dumping them into a coffee can. Slowly, Moe swirled the stomach contents in the can, almost like panning for gold.
Wait! There was a fleck, something blue in an amorphous sea of pea green. What the hell could that be? What could a horse eat that was blue? Moe reached down with the tip of his scalpel and retrieved the fleck. It was robin-egg blue and about one third the size of a pea. It resembled a jagged piece of a pill. Moe examined it more closely. By god, that’s what it was, a piece of a crushed up pill!
Moe had done that plenty of times with his horses. More than once, he had ground up butazoladine and put it in the horses’ feed when they had gone lame. But he’d never given any pills to Casey, never had any call to. Furthermore, butazoladine was white, this pill was blue. For the life of him, Moe could not think of a common horse pill that was blue. Obviously, someone had been giving Casey blue pills, but why? And who? It didn’t make any sense. Were the blue pills somehow connected to the colt’s death?
With a grim sense of foreboding, Moe closed Casey’s abdominal wall with the O-silk, then wrapped him in a blanket. Tomorrow he would give Casey a proper burial, and he’d have to save his grief till tomorrow too. Tonight he still had work to do. Tomorrow, after he had buried Casey, he would take some of those gastric contents into Ray Mosdell and have him do a proper toxicology screen, but tonight he had to do some studying.
After washing the blood from his arms, Moe trudged up the stairs to his study. He scanned his bookcase for a minute, then pulled the PDR, Physician’s Desk Reference, from the shelf and turned to the section marked: PRODUCT IDENTIFICATION GUIDE. This section displayed color pictures of each pill, arranged alphabetically by the manufacturer. First, was Abana Pharmaceutical with all its pills shown in graphic color, then Abbott. Moe thumbed through the section, stopping briefly to look at any blue colored pill. For instance, Bristol-Myer-Squibb made a blue pill, Megace, which was sometimes used to treat prostate cancer. Flipping the page, Moe continued to search. After a few minutes, he stopped at Dupont Pharmaceutical. They had a blue pill also. It—by god—it was a four milligram Coumadin. That had to be it!
In a flash, it all made sense. Someone had been crushing and feeding Casey Coumadin, a blood thinner. His blood had gotten so thin that he began to hemorrhage from the stomach and bowel, not an uncommon side-effect of Coumadin, and simply bled to death. He had died tonight and Moe hadn’t been there to help him or at least provide a degree of comfort. Alone in the rain, Casey had died, separated from his mother by a pipe fence.
In his mind, he ran through several different scenarios, but there was only one that made any sense. Horses didn’t go to the medicine cabinet, open a vial of pills, then chase them down with a glass of water. Horses had to be fed pills. Casey had been deliberately murdered!
TWO
Moe dressed for work the next morning without having ever closed his eyes. He had finally flopped on the bed at about 3:00 a.m., but sleep did not come. The only possible positive spin of Casey’s murder (yes, it had to be murder) was it had occupied his mind. As a consequence, he had spent little time dwelling on the funeral and his miserable relationship with his father and his family in general. Lying in bed with his eyes wide open, he’d whiled away hours trying to answer the questions, who and why?
The when was easy. Probably the entire week he’d been in Salt Lake City to be at his father’s bedside and subsequent funeral. In a way, that tied into the who. It had to be someone who knew he was going to be out of town, someone he was familiar with. But the why, had him completely baffled. To do something so cruel, so heinous, pointed to someone who literally hated him. Someone who was mentally warped and at least marginally, if not a full blown, psychotic. Someone who was unpredictable and dangerous. Would the killing of Casey satisfy his or her vendetta? Or would there be more?
Moe searched his brain, looking for enemies. Sure there were a few people who didn’t like him: the occasional disgruntled patient, the neighbor with the ranch to the west (not the Rheinhart’s) with whom he had a boundary dispute a few years ago and his ex-wife, Annie. That was about it, except his office nurse who had been harboring a grudge for a few months and Rusty, his partner. They had never got along. But murder a defenseless baby colt, Moe just couldn’t imagine any of them being capable of that. And try as he might, he could think of no one else.
Without stopping to taste, Moe wolfed down a bowl of cornflakes sweetened with Nutrasweet. If he hurried, he could stop by the pathology department before clinic started and give Ray the gastric fluid sample. But it was probably a waste of time. Toxicology would undoubtedly confirm what he already knew. Casey had been overdosed with Coumadin..
At the front door Moe suddenly stopped. He had forgotten to take his insulin this morning, and last night as well. God, his blood sugar must be three hundred. Quickly, he pricked his left middle finger, squeezed out a drop of blood and ran it through the glucometer. Two hundred and sixty-three. Not as bad as he thought. Adroitly, he drew up twenty-five units of regular insulin (five more than his usual dose) and fifteen of lente, bunched the skin of his abdomen between his thumb and forefinger, and injected the insulin. Tossing the syringe in a plastic sharps container, he then sprinted out the door for the garage.
A little late, Moe trudged through the door marked Private Entrance, Moses A. Maihis, M.D. Normally he liked going to the office, seeing patients and his work in general, but not today. Today he was irritable and depressed. Why shouldn’t he be? He glanced at the waiting room for a moment, then immediately felt guilty for what he was thinking. It reminded him of a scene from his childhood. On Tuesdays his father would sometimes take him and Abe to the cattle auction in Cedar City. Prior to the auction, they would corral the cattle in a holding pen. There the cows would sniff each other, mill about and bellow. Usually, they bawled at nothing in particular, except to express their general displeasure at being confined in this strange environment. In a way, Moe thought of his waiting room as a holding pen for patients to trample about, bellow and to voice their displeasure.
Today, the patients seemed especially restless, wandering about, grumbling to each other about the already long wait and debating their excessively high bills with Sally. No doubt about it, this was going to be another impossible day. Lately, they had all been like this, and after taking a week off, today would be worse than usual. Moe scanned the waiting room once again.
