He had to be in horrible pain for hours before. Does he not pay attention?
Not necessarily...it happened to me in mid 60’s and I had little pain, jut cramping. My doc misdiagnosed it as covid (beginning of covid era) and sent me home to await test results. My fever spiked really high the next day so I drove myself to ER where I was promptly thrown into an ambulance and sent to bigger hospital. Surgeon called me a miracle and said if I had waited 30 minutes longer, I would not have survived.