Before crossing the railroad bridge, this document can be found next to a dead body hidden behind a boulder to the right in The Scalled.
"My Dere Simeon,
You ben 'mor then cousin to me sinse we was littl childrun an I hope youl help now that im in som trubl spesially on acount its to do with medisin. I will jus say plane that I am with sines of the sifilis an afrade I will be sent to live with them Scalled wich I am terible scaird an hateful to do. An I nown well taint saif to fuck nun but Papa Knoth sinse God an Jesus protecs him from all siknes on this werld but God an Jesus dont protect me nun so I need yur help.
God Bless an keep you,