With the syringe in place and the air suctioned from the pneumothorax, it was essential to prevent its recurrence and keep the patient breathing. This meant going ahead with a full closed-tube thorascostomy.
The first step was to create an airtight seal around the tube. Barely registering the frantic activity around him, the young doctor lifted a scalpel from an instrument tray and sliced into the flesh between the ribs, making a horizontal incision. Then he took a Kelly clamp off the tray and pushed it into the incision, holding it by the shaft, expanding it to spread the soft tissue and create a tunnel for his finger. Blood splashed up around the clamp as he removed it from the opening and pressed his gloved finger between the lips of the cut, going in as deep as his knuckle, carefully feeling for the lung and diaphragm. After assuring himself that he had penetrated through to the intrapleural area — the space between the lungs and ribs where the air pocket had formed — he asked a scrub nurse for the chest tube and carefully guided it into the opening.
He paused, studied the patient, and exhaled a sigh of relief. The patient’s breathing was stronger and more regular, his skin color vastly improved. A water collection system at the opposite end of the chest tube would keep the air draining from the patient’s chest while insuring that no air was drawn back into it. To complete the procedure, the young doctor would suture the skin around the tube to preserve the seal.
A very long night still lay ahead, but Thibodeau would have something like a fighting chance as the doctors hustled him into the OR, opened him up, and got a look at the extent of the damage that had been done inside him.
SIX
A look of quiet gratification on his face, Harlan DeVane watched the line of three flatbed trucks roll along the hardpack at the eastern border of his ranch as they approached the airstrip and the waiting Beech Bonanza in a cloud of dust. Now, before midday, the sun was a firebrand hanging above the battered old camiones and the wide, flat pasture closer by, where he could see his cattle, prime heifers imported from Argentina, grazing indolently in the heat. There was no wind, and the ash and smoke from the forest fires seemed an inert smear above the horizon. Once the afternoon breezes stirred, however, it would rise and spread into a blanketing gray haze, dimming the sun so that one could look directly up into it with the unprotected eye. It was a price of development that DeVane found regrettable, but he was a man who dealt with realities as they presented themselves. The loggers bulldozed new roads, and the opportunistic peasant farmers and ranchers who came here to settle followed along those roads, and because the soil was quickly depleted in the Amazon basin — good for no more than three years’ growing of crops — they would clear previously untouched tracts of forest as their fields dried up and grew fallow. The cycle was implacable yet unavoidable. Nothing in life came free of charge, and most often you paid as you went.
“It appears the plane soon will be on its way, Harlan,” Rojas said, taking a sip of his chilled guapuru.
DeVane looked at him from under the brim of his white Panama hat. His skin was tightly stretched over his cheeks and almost colorless. His eyes were a frozen shade of blue set deep in their sockets. He wore a white double-breasted suit that had been custom-tailored from some lightweight fabric, probably in Europe. The collar points of his blue silk shirt were neatly buttoned down under blue-and-yellow pinstriped suspenders. Unbothered by the torrid weather, he seemed to occupy his own still pocket of space, putting Rojas in mind of the lion-fish that floated in the waters of the Carribean — so illusively delicate in appearance, so serenely poisonous.
“And you, Francisco?” he said, speaking Portuguese although Rojas was proficient in English. “Will you be leaving with it? Or can I assume you’ve made other arrangements?”
“You know it is my habit let the perico fly on separately,” Rojas said. “As a precaution.”
DeVane was inwardly amused by his choice of words. The cocaine made you manic and talkative. Like a parrot, perico in Spanish. It was a term of low slang he might have expected from some street-level dealer in San Borja, not a Brazilian police official of considerable rank. But Rojas was of a type. A gutless, corrupt, lazy little south-of-the-equator bureaucrat trying to affect the manner of an outlaw. Light a firecracker outside his office window and he would hide quailing under his desk.
“I’ll have my driver take you back to the airport in Rurrenabaque when we’re finished,” he said. “You’re entitled to feel safe.”
Rojas heard the note of derision in DeVane’s voice and held his hands apart.
“Things happen,” he said. “I expect no problems, but as always will be relieved when the shipment reaches its destination.”
In fact, Rojas thought, his relief would begin the moment he was out from under the hard eyes of DeVane’s bodyguards. And away from Kuhl. Kuhl seemed less a human being than a cold precision weapon… and how dangerous it was for such a murderous instrument to be controlled by someone with a boundless appetite for wealth and power. Kuhl had acquired a forbidding reputation on his own, but there was no doubt that his association with DeVane had enhanced his innate capacity for violence and given it a chance for its fullest, bloodiest expression.
Yes, it would be good to be elsewhere.
Rojas reached for his glass again and took a long drink. This was not the first time he had met with these men, and by now he ought to be able to curb his uneasiness. The trick was to steer his attention away from Kuhl and the armed guards. Concentrate on his physical surroundings. He would try, and be satisfied if he were halfway successful. Certainly the scenery was pleasant. They were at a table shaded by a flowering mimosa in the foreyard of DeVane’s impressive ranch house, a place of rambling sunbaked walls and a tiled roof that might have been built for a Spanish Don — some descendent of the Conquistadores perhaps — with only the swimming pools and tennis court on its desultory grounds betraying its far more recent vintage. Quite grand indeed, and just one of many lavish homes DeVane kept around the world, traveling continuously between them as he oversaw his far-reaching business empire.
Out across the grassland, the camiones had reached the tarmac and lumbered to a halt in the shadow of the waiting plane. Rojas watched as their ragtag Quechua drivers began to unload the backs of the trucks and carry their bundles toward the Beech’s cargo bay.
“Your ability to keep the Indians loyal is extraordinary, Harlan,” he said. “I’d never ever have expected it.”
DeVane studied his face.
“How so?” he said. “They’ve traded with Americans before.”
Rojas tried to make his shrug look casual. “Yes, but not on the terms you have set. It is a singularly unusual arrangement. Buying from the Peruvians, employing the local cocaderos only for refining and distribution…”