To alleviate some of the costs of medical school, I agreed to spend my first six months as a doctor working in a small town in the Appalachian Mountains. The town, Lost Creek, wasn’t much of a town at all. There were barely four hundred people living in it, many without electricity or running water.
My office was in the government building at the end of the only road in or out of town, a large two-story structure, its white paint faded to a dull gray. The four Roman columns and intricate stonework clashed with the other five squat wooden buildings in downtown Lost Creek. It housed the post office, court, jail, and mayor’s offices, but was mostly used for storage. I cleared one of the larger suites on the second floor of dusty boxes and reorganized it with a few mismatched chairs to create a waiting area.
The first few months in Lost Creek passed without much excitement. I mostly treated mild illness and farming injuries. I got to know most of the residents save for the few families on the outer edge of town off into the woods. They lived in what could only be called shacks, constructed of salvaged wood and metal. They rarely if ever ventured onto the main street where other town members gathered at either the bar, diner or general store. Which is why I was surprised when one of the woods family’s teen-aged daughters came to my office. She was pregnant, by the way her dingy floral dress stretched across her belly, I’d guess seven or eight months.
“You gotta help me Doc,” She said as she climbed onto the exam table.
“What can I do for you?”
“I got bit by one of them wild dogs in the woods.” She rolled up her sleeve revealing a rag bandage.
“Let’s take a look here.” I undid the bandage. The bite area was swollen and weeping with puss. “I’m going to give you some antibiotics for the infection.”
“But what about the curse?” She stroked her belly. “My grandma said that those dogs cursed me. That’s why my belly swoll up. It swoll up with puppies. She gave me some nasty potion to drink, but it didn’t work ‘cause my belly’s still all swoll. I can still feel ‘em moving around inside me.”
“Oh sweetie, there’s no curse. I assure you, you are carrying a human baby.”
“You got to have sex with a man to be pregnant with a baby and I ain’t never had sex with a man, but I did get bit by a cursed dog, so I do got puppies in here.” She pointed at her belly.
I sat down on my stool. “What makes you so sure these dogs are cursed?”
“My grandma says a long time ago a pioneer family was crossin’ through these woods and stole a cow from an old witch. She found where they set up camp and cast a spell on ‘em while they slept. Turned ‘em all into dogs and they been roamin’ these woods ever since. If one of ‘em bites you — your belly swoll up with puppies. You gotta get ‘em outta me. I don’t want to birth no puppy litter.”
“Alight, well, let’s take a look then shall we?” I placed my stethoscope on her belly and listened, hearing a heartbeat. I moved it and heard another heartbeat. I moved it around again and again hearing two more distinct heartbeats. I sat up straight and starched my head. “huh.”
“What is it?” She asked.
“How long have you been pregnant?”
“I ain’t pregnant! That cursed dog bit me last week. Before that, I had a flat tummy but every day since my belly stretched a little more and now I can barely fit into this dress. Those wild dogs be circlin’ round my house day and night and follow me wherever I go. There waitin’ for me now just inside the woods.”
I didn’t have the equipment in my office to prove to her that she was not carrying puppies. I did, however, convince her to take the antibiotics before leaving my office. I helped her down from the table.
“Don’t worry sweetie. Everything is going to be okay. I’ll come by next week to check on you.”
She shook her head in disbelief and left my office.
Four days later a panicked little girl came running into my office.
“My sister! She needs help!” She panted, bending over a little to catch her breath. “Come quick.”
“Alright. Calm down. Tell me what’s the matter.”
“She’s got puppies in her belly, and they’re tryin’ to get out!” She pleaded.
I grabbed my medical bag. “Can you take me to her?”
The little girl led me to a dirt road just beyond the main street. I had a hard time keeping up with her as she ran, barefoot, up the hill. Finally, we reached her shack. I stopped to catch my breath. Just beyond the shack I saw four large dogs. Waiting.
“Come on!” The little girl grabbed my hand and pulled me inside.
There was an old woman shoveling pieces of wood into a cast iron stove. She placed a heavy kettle on a burner. In the corner was the pregnant girl, on her back, knees up, in an ancient brass bed. I went to her. She was panting and writhing in pain. I slid her dress up to her knees. She was fully dilated.
“These babies are ready. I’m going to need you to push. Okay, sweetie?”
“Those aren’t babies in there.” The old woman limped over to the bed. “Did you see ‘em out there? They’re waitin’ to take those puppies back into the pack.”
I did my best to ignore the old woman.
“Sweetie, I’m going to need you to scoot down to the edge of the bed for me. That’s it. Can you open your legs for me? I need to be able to see the babies. That’s good. Okay, now I need you to push down hard.”
She grabbed a fist full of blanket, tightened her face and pushed herself up onto her elbows. The pain hit her hard, and she moaned and grunted. It almost sounded like she was howling.
“I can’t push no more.” She collapsed back onto the bed, out of breath.
The howling continued in her silence. I realized it was coming from outside. First from one dog, then the other three would join in. I looked down and saw that the first baby was crowning. It had a thick head of black hair.
“Okay sweetie, give me another big push.”
She got back up on her elbows. The old woman mopped the girl’s sweaty brow with a rag. The girl clenched her teeth and pushed, moaning in pain. The howling outside grew closer. I positioned my hands to grab the baby. The rest of its head emerged. Two floppy ears and face covered in fur. I pulled it out the rest of the way and stared at it in disbelief. It was a puppy. It began to cry and whimper. The howling outside grew louder. The puppy responded with tiny howls of its own. The dogs outside scratched at the door. The howling and the scratching grew more frantic with each new puppy born. The girl fell back exhausted on the bed after the last puppy was born. The old woman placed the puppy with the others in a small box she had prepared for them. She carried the box to the door and slowly opened it. The dogs, waiting on the other side, followed her movements with their eyes as she set the box down. Each dog came one by one and grabbed a puppy by the scruff of its neck and carrying it in its mouth slinked back into the woods.