this is just an impression, i have no documentation to back this up but i believe this story was inspired by childhood folk stories he heard when he would go on doctor rounds with his father and he was entertained by relatives who wanted the boy to feel at home, and stories tended to get a little spooky sometimes as i recall from summer nights back in the sixties visiting with relatives; and i don't think things changed a whole lot since my grandparents were adults when Howard was a boy. Also, Howard was a gleaner and an observer and a heavy reader so he took things from many sources and turned them to his favor added with his vivid imagination he came up with this gem of a story. I agree this is among my all time favorite of scary stories and i love it very much.