The Case of the Missing Blood

Prologue: Deep within a middle-aged woman, somewhere betwixt her brain and heart a microscopic sentry scans a vast network of blood vessels, monitoring the flow of red corpuscles like a forest ranger looking for smoke. He has a worried look on his face. The number of cells passing by his station has steadily declined for some time now; the glow around him turns from its usual scarlet to a pallid pink. He grimly flips open a nearby cabinet door and with one last glance over his shoulder presses a button. Suddenly the entire universe flips on its side, flinging him across the room. The last sound he hears before landing is the metallic cry of "Danger! Syncope! Danger!" then nothing but the rhythmic whistling of quiet respiration.

My name's Percival Clive Woolfardisworthy. I'm a private eye. More specifically, I'm a non-board certified hematologist in private practice, but I like to think of myself as a shamus, not to mention I wish my name was Sam Spade instead of Percival Clive Woolfardisworthy, but it's no use crying over spilled milk. Crying over spilled blood is another matter, though, and that's where I get involved. Like I said, I'm a doc, and finding blood is my speciality. My last case involved a beautiful dame with blood, lots of blood and most of it missing. Actually she wasn't that beautiful - too pale for my taste. Anyway, let me get on with the story before the ice melts in my rock and rye.

I was at my desk, snickering over the shoeshine rag we call a newspaper in this town when the phone rang. I heard my secretary answer and by the tone of her voice I could tell lunch hour was over. Too bad for me - I still had more clues to decipher but then again they don't pay me to do the Jumble. They also don't pay me to model underwear anymore, but that 's another story. She walked in and handed me a scrap of paper. I watched her oscillate out of the room. One glance told me I was in for a long afternoon - at the note, I mean. The words on it jumped out at me like a lioness surprising a klipspringer in the savannah. I saw that last night on The Discovery Channel.

CONSULT - MRS. JONES, ROOM 733, POSSIBLE HEMOLYSIS, WHERE DID THE BLOOD GO? URGENT...

I grabbed my trench coat, checked to see that my stethoscope was loaded and headed out.

It didn't take long to reach the nurses' station, especially after taking a shortcut through a few geezers blocking the hallway...damn physical therapy - always in the way. After inquiring as to the location of the chart in question a nurse tossed it to me. Unfortunately I was facing the opposite direction at the time, but that's one reason they keep fresh ice on the floor. As I nursed my head I studied the chart like Copernicus eyeballing the sun. The facts were right in front of me - right there all scrambled together nice and messy.

It seems that the patient had presented with a hemoglobin as low as a baritone sax solo - 5 grams. Her internist had transfused her with one unit but was quaking in his size eights now. He had what we call "blood panic" - an awkward state when one trembles with fear at the mere thought of the red stuff. I've seen it plenty of times before - the nervous laugh, the stammering, the sudden defenestration from the fifth floor. It was my job to solve the case before more people got hurt. A small crowd gathered around me as I read the chart, but with one wave of my hand they all scattered. Looks like I forgot the Right Guard again.

My brain swirled with ideas as I made my way to interview the dame, but one hypothesis stood out among all the others: why the hell was I on this case? This gal didn't have a hemolytic anemia, autoimmune or microangiopathic. Her MCV was normal and her RDW was normal. The whole thing began to smell like last week's meat loaf. As I interrogated her I became positive my hunch was right. I also was positive my head was going to explode where I had taken one from my bookie last night after I failed to make a down payment on my tab. Luckily a young angel of mercy brought me another bag of ice. I emptied it into my flask and made my way back to the nurses' station, musing on an answer the dame had given: "Chew ice? Yes, I like to chew on ice and have for the past year."

Once again the facts of this case did a can-can in front of me, daring me to stick my neck out, but I decided to cool it and order some more tests. In fact, I let the long shadows appear and decided to call it a day. That night I hid in some lousy joint, piling up the saucers until the coast was clear to go home. My bookie tends to do his social calls after dark, and I wasn't having any of his bull until I got paid. That's called thinking like a detective.

The next day I threw some clothes against the wall and when they didn't stick, put them on and went back to the hospital. Just as I thought - the patient's lab results were unmistakable. Even a blind man could see what they meant, if he could see. Her transferrin saturation was only 3%; her ferritin was 13 and unless my hangover was making me see things her stool was positive for blood. I stood up and gave out a smirk to the poor saps around me. The case was closed. Only later did her internist realize that he had forgotten to ask just exactly how many ibuprofens the dame chewed every day. The correct number was a shocker, even to a old hand like me: 12 of the little blow torches, each one burning a hole into her stomach like a warm knife through a crème brûlée.

I mention the dessert because after presenting my bill I figured I could afford a night at L'Ambroisie. Turns out I was slightly off in my calculations - not in what I thought my efforts were worth, but in what I actually got paid for the caper. The private eye business just ain't what it used to be. I still got my dessert, though.