Tore open first packet, containing prethreaded fine needle, suture (offered up silent thanks for modern medical technology as did so; would never make good stereotypical female — were own life at stake, couldn’t thread needle in fewer than 20 tries).
Picked up two hemostats. Stared down into wound. Took deep breath. Seized needle with finely-pointed jaw tips of right-hand hemostat. Commenced.
Proved less difficult than feared. Following initial shock (as learned live patients warm inside), technical fascination took over, supplanted apprehension; permitted training to emerge, do job properly. Hemostats gripped needle surely; resultant control wonderfully precise, even down in cramped quarters at bottom of wound. Artery cleanly slit; edges straight; stitches went into place neatly, evenly, closely spaced, just as had when practiced similar repair on hog cadaver under Daddy’s direction.
(Sure wish had practiced oftener; developed semblance of professional competence, speed — sealing high-pressure artery called for such tiny stitches; so little time remained and seam so long…)
But wasted none glancing feverishly at watch; concentrated on task at hand. Mind already made up, subconsciously at least: Would not risk boy’s life to save leg. True, be nice if managed to save it, too — indeed, striving mightily to accomplish repair in time to prevent limb death.
(Mightily — but not quickly; never realized vascular surgery so time-consuming.)
For one thing, one-legged comrade poses significant liability in present-day survival-oriented environment. For another, despite pretensions toward calloused pragmatism, must confess to certain esthetic prejudice in favor of physically sound partner — perhaps even, should circumstances so devolve, mate.
(But repair was taking so long.)
Finally, even granting advantages intrinsic to performing amputation at leisure in Hopkins teaching hospital’s modern operating theatre, amidst latest, most advanced medical wonders (who cares — lack even faintest notion of how to operate them), odds slim for patient surviving procedure. Above-knee amputation serious business, truly major surgery; approached with due respect by most veteran of doctors — likelihood of happy outcome, given amateur-level ministrations in procedure so intrinsically fraught, seemed less a question for serious assessment than object of gallows humor.
(But not laughing; was going to find out unless got move-on — taking too long!)
And didn’t want to cut kid’s leg off! Even if somehow managed to avoid killing him in process, would never be able to meet eyes without cringing inside. Yes — despite full knowledge that dummy’s own maniacal driving brought on disaster; that consequences on his head alone; that own role limited to saving fool life — would still feel guilty…
(Damn — taking too long…!)
Stole glance at watch — at least 16 minutes gone (guestimating from crash) and good half inch yet unrepaired. What to do…!
Discovered mind not made up after all. Convictions wavered, crumbled at moment of truth. Should continue repair, cross fingers for dispensation from immutable metabolic laws? Or gamble on holding blood loss to tolerable minimum with local pressure now that wound largely closed?
(But how much is tolerable minimum — considering losses to present; mitigated by, thus far, just under pint of saline? Further, how effective is local pressure apt to be on femoral spurting — even if wound largely closed?)
Wait. Perhaps another way out. Not cornered — maybe. With luck.
Solution required judicious hemostat placement: Was necessary to grip, pinch together remaining open edges of sliced artery walls with curved jaws; lock handles, sealing shut.
Now could ease tourniquet temporarily, safely…
…If hemostat secure.
…If stitches adequate.
…If no other significant bleeders in wound.
…If abruptly releasing balance of blood supply into previously substantially drained extremity didn’t trigger final shock collapse through major blood-pressure drop…
…If — oh, hell! Simply couldn’t stand it any longer — released tourniquet, poised to take action as required.
Wasn’t. So glad.
Took time then for breather, suddenly aware of first hints of returning fatigue. Peeled off gloves; finished Gatorade, soup.
Removed patient’s shoes, socks; inspected toes as circulation resumed. (Should have at outset: color, temperature key clinical signs to circulation status in leg, foot.)
Sat back, eyes closed, relaxed; breathed deeply, modulating oxygen intake just at fringes of hyperventilation symptoms, hoping to get running start on replacing stores before disintegration set in in earnest. Knew wouldn’t really help, but beat waiting idly for collapse — for which still didn’t have time.
After five minutes, retightened tourniquet, donned second pair of rubber gloves, released hemostat. Lavaged site again, flushing away seepage accumulated from surrounding tissues. Resumed needlework.
And marveled: Delicate stitchery, tiny knots suddenly easy — now no longer racing clock, impeding own efforts through tight-collar syndrome.
Soon last stitch in place; femoral repaired. Only closing-up chores remained, housekeeping incidentals: Rejoining severed muscles, closing skin layers; assembling, installing homemade pressure bandage incorporating splint to prevent knee flexion during initial healing process. Much easier going — nothing life-or-death. And could use larger stitches.
Then followed quick, apprehensive review of own condition. No serious portents detected; so stripped limp body (yes, completely; potentially fastest bleeding tissues on male body concealed by shorts; no shrinking damsel I — besides, modesty lousy reason to lose patient through negligence); examined head to foot, identified additional serious (relative term, this, compared to femoral) lacerations; closed with stitch here, tuck there, bandage where appropriate. Finished by covering with blanket, slipping pillow under head, connecting fresh saline baggie to I.V.
Whereupon, quite without warning, found self facedown next to bunk, viewing world through darkening, flickering mists (viewing two worlds, point of fact), while breathing transformed abruptly into agonizing gasps, heartbeat stabilized at tachycardiac level, every muscle in body knotted into single huge cramp. Couldn’t even cry out. And wanted to.
Could have ended pain by triggering posthypnotic relaxation sequence; but sleep — akin to coma — sure to follow immediately and couldn’t afford yet; important details remained undone:
Van’s right-side double doors gaped wide; driver’s door hung open, too, just as had left it when leaping out. Knew must remedy before letting go: Bound to be dogs in area (have not forgotten [will never forget] dog-pack encounter shortly after emerging from shelter); pooches would be pleased indeed to discover van standing open — and ready access to three helpless occupants.
Besides, Terry’s water, food dishes not filled since leaving Harpers’; no telling how long oblivion might last. Plus urgent need to stoke own fires before going under; nourishment deficit almost as critical as fatigue.
All of which posed problem:
Body on strike. Brain apparently still operating at what passes for normal function, but commands ignored as burnout reaction intensified, symptoms worsened. Try as might, couldn’t elicit so much as purposeful twitch from any voluntary muscle, even unto least finger.