No Deuce. No Bruce.

Exile Island has spent more time focused on excrement than any other season of Survivor. First, Bobby christened the outhouse, and this week, an impacted colon forced Bruce to leave the game.

The episode got off to a rocky start, as Bruce complained of a stomach ache the morning after Sally's elimination. Apparently, he hadn't had a bowel movement in more than ten days -- not since before the Reward trip to the Panamanian village. He said he couldn't "pass a deuce." As a result, he was in so much pain, he was having trouble walking.

He had just enough energy to prepare for the day's Reward Challenge. Castaways were given voodoo dolls to decorate in their own likeness. Cirie used wadded-up vegetation to give her 3-foot-tall doll huge breasts. Danielle used artificial plants for hers.

The challenge itself required the Survivors to answer poll questions about their tribemates. After writing down their answers, everyone turned them into host Jeff Probst, who tabulated the answers. Then, they were asked the same questions again, but needed to answer with what they guessed was the consensus of the rest of the group.

A correct answer earned each contestant the right to cut a one length of rope that withheld a torch from striking an opponent's voodoo doll. After three lengths of rope were cut, the doll would get torched, and its corporeal counterpart was out of the game. A variation of this "choose which of your buddies to knock out" game is played every season, and usually the most liked or feared tribe member is left at the end.

The order in which contestants were taken out by their tribemates wasn't much of a surprise, as Terry fell first, followed by Bruce, Courtney, and Danielle. It was the answers to the questions that surprised several of the castaways:

1. Who does the least around camp - Danielle
2. Who never shuts up - Courtney
3. Who mistakenly thinks they run the show - Shane
4. Who would you trust with your life - Cirie
5. Who wouldn't you trust to watch your back - Terry
6. Who's the biggest poser - Courtney
7. Who's the moodiest - Shane
8. Who succumbs to intimidation - Courtney
9. Who's the most annoying - Courtney
10. Who would never survive on their own - Cirie

Courtney, who's too self-involved to have any idea how she's perceived, was stunned that people thought she was annoying. And Shane, the initiator for every vote and alliance, said he wasn't trying to run the show.

A string of correct answers allowed Cirie to knock Shane and Aras out, winning her and two tribemates of her choosing an overnight trip to a spa. She was also given the choice of who to send to Exile Island. Out of loyalty to her old tribe, she sent Terry away, and then asked Aras and Danielle to join her on the trip, based on prior promises.

Being excluded, despite what he thought was a close friendship with Cirie, sent Shane into a fit. He kicked sand and stomped around, responding to Cirie's sheepish, "I'm sorry," with a pouty, "You are sorry!"

Shane's tantrum and Courtney's stunned expression after hearing her name as the answer to multiple questions gave Cirie, Aras, and Danielle plenty to laugh about as they enjoyed a helicopter ride, mud massages, and more food than even Aras could finish -- though he tried his best to eat everything they were served.

That night at camp, Bruce's abdominal pain became so intense that he asked for medical attention. Courtney tried to soothe Bruce by singing to him, but he was able to whimper, "Don't," saving himself and viewers from further agony.

Paramedics arrived by boat and felt Bruce's condition warranted a trip to the hospital. A totally nude Shane helped carry Bruce on a stretcher to the boat.

The winners of the reward challenge returned in the morning and got the scoop on Bruce from Courtney. Shane started pouting again, until Aras and Cirie reassured him that they would all be in the final four together.

On the morning of what should've been the Immunity Challenge, a boat brought Terry back to camp from Exile Island. Jeff was with him, and he filled everyone in on Bruce's status.

At the hospital, doctors had discovered that Bruce's entire digestive system, including his colon and bladder, was blocked. Bruce would be okay, but he could not return as a competitor. As a result, the day's Immunity Challenge was cancelled. This was effectively an Immunity win for Terry, who likely would have been voted out at Tribal Coucil -- and would have had to use the hidden Immunity Idol to stay in the game.

The doctors planned to evaluate Bruce's condition before the next Tribal Council to determine if he was well enough to serve as a jury member. Jeff didn't clarify what would happen if the answer was no, but Nick, who just missed being a jury member, would be a likely choice to take Bruce's place.

After Jeff left, everyone talked about Bruce as if he were dead. The women cleared debris from Bruce's rock garden and arranged rocks to read, "Bruce" and "Luv U." In place of the customary exit interview to close the show, producers showed footage of Bruce practicing karate on Exile Island.

Next week, Cirie fights with a fish and Shane develops his own, more technically savvy, version of Season One contestant Greg's coconut phone: a BlackBerry handheld device made from a block of wood.