Authors: David Palmer
Organizing actions to avoid waste motion suddenly acquired desperate importance. Snatched rear-seat cushion over into front; thrust through door opening (through which flames now licked, beginning to char headliner), positioning to bridge infernal moat. (Or
almost
bridge—just lacked length to span, with pond still spreading.)
Seized driver, propped up into approximately seated position, slumped against seat back. Loosened jacket, pulled up over head, zipped shut. Shoved limp arms down into pants; tightened belt to hold in place.
Shrugged own jacket upward, retracting head like turtle. Placed shoulder just below victim's beltline; tugged, felt weight roll onto back as torso collapsed forward. Slid arm under thighs; lifted, jogging shoulder to center load in fireman's carry (And marveled at own strength—while dreading impending consequences of reckless squandering: Sustained consumption rate surely four, five times norm; probably more.)
Straightened experimentally: Bumped roof to gauge relationship between victim's fanny, own shoulders—crouch needed to clear upper door frame.
Fixed seat cushion's location indelibly in mind's eye. Took deep breath, held it; closed eyes, pinched jacket shut over face. And
. . . LEAPED!
Time stopped as again felt blast-furnace ambience envelop whole body. Seemed to hang motionless midair; conscious this time of flames probing, digging, seeking access through flimsy coverings. Oppressive heat, pervasive roar blanketed all other sensations.
Feet blindly seeking landing, but impact somehow unexpected, surprise. Cushion yielded underfoot as knees bent, absorbing extra weight; then airborne again, leaping for fire's boundary—and heart stopped as cushion skidded away from legs' thrust, robbing jump of power needed for distance, throwing balance off.
Eyes snapped open, head jerked forward, trying to get clear of jacket; even at risk of optic burns, needed to
see,
reestablish orientation—
mustn't
fall while still within holocaust!
Dragged fabric clear of eyes just as cool air washed jacket, over clothing, into lungs; as landed, stumbling briefly, on flat, dry,
cool
pavement.
Shrugged victim to ground; conducted hasty inspection for burning clothing—mine, his. Used own jacket to smother small blaze on victim's left pants leg.
Then attention riveted by rapidly forming pool of blood under leg: bright red—arterial stuff. Probably femoral, judging by amount. Must have been lying such that position created pressure block, preventing loss in car. Moving eliminated obstruction. If femoral, had as little as 20 seconds left—less whatever time had been bleeding in car since first moved.
Heavy denim parted like cobweb before preternatural strength: Tore pants leg open from ankle to crotch; then ripped entirely free from garment. Turned victim over; confirmed suspicion immediately:
Deep gash from medial upper thigh to anterior knee—
spurt-ing.
Twisted denim strip into rope; looped about thigh above wound. Looked around briefly, wistfully—no sticks within reach. Slid fingers under bandage, made hard fist; partially stood, stepped three fast turns around body, using own hand as stick, tightening tourniquet very nicely, thank you, but cutting off blood to fingertips in process.
Seized collar with left hand, right still lodged in tourniquet; swung victim back up over shoulder into fireman's carry.
Staggered then, beset by flash of vertigo; suddenly aware of warning twinges as muscles all over body threatened to cramp. Conscious also of perspiration abruptly streaming from body in rivers as autonomic system belatedly noticed calorie-consumption rate, tried to do something about mounting internal temperature. And breathing affected now, too: coming in deep, tortured gasps.
But couldn't complain; not unexpected. In fact, remarkable aspect to condition is why symptoms so long deferred—no idea how was still functioning at all. According to data, painfully garnered through previous supervised (and conservative) experiments, activity level sustained during past few minutes flatly impossible. Should have achieved coma long since through massive fatigue products build-up, with vital organs shutting down from systemic shock; death imminent, barring only most profound life support, treatment.
However, seemed less than opportune moment to question blessing. Set off for van at dead run.
Arrived still conscious but deteriorating: Heartbeat thundering inside skull; lungs afire; cramps attacking in earnest now; black patches flickering across vision; clothing dripping, saturated with sweat.
Terry greeted with "Hello, baby; what'cha doo-in'?"; but couldn't spare breath, time to respond.
Threw open side doors, slung victim into own bunk. Then found couldn't reach tool locker door from bedside. Frantic visual search located crowbar on floor near door (had used earlier to enter drugstore). Made long leg, snagged with foot. Dragged within reach of left hand; substituted for right in tourniquet—with relief.
Stumbled to refrigerator, shaking life back into fingers. Rummaged through stored food; found quart of Gatorade, plastic container of yesterday's chicken soup. Gulped about half Dr. Cade's elixir in single swallow; put away equal portion of Yiddish cure-all.
Worried somewhat over possible consequences: Food, drink not easy travelers in stomach during, right after sustained violent exercise. Especially cold. But knew needed
something
immediately to start replenishment after huge energy drain.
Couldn't
afford
collapse then; didn't have
time
for own problems. Victim about to lose leg—plus certainly in shock, doubtless sinking moment by moment: Even if somehow failed to die as direct result of injuries, shock could finish job—would, untreated.
Returned to bunk. Apprehensively called again upon unnatural strength. Found, to surprise, enough remained to lift foot of bunk one-handed; hold elevated while inserting prop (Gel-Coat kit—flameproofing goodies which should have been used to eliminate much drama from rescue). Would have been easier to elevate legs conventionally, with pillow; unfortunately, supine position unworkable due to wound location: Needed victim prone to treat.
Located Daddy's Number Two black bag, saline I.V. kit from medical supply locker. Rooted through bag; found stopwatch, sphygmomanometer. Took pulse, checked blood pressure: fast, strong, respectively.
Lifted eyelids, flicked sunlight across pupils with hand mirror. Were unequal, nonreactive; plus unmistakable twitching movements: nystagmus—concussed certainly.
Then froze, transfixed.
All this time—while examining in car, on sidewalk; lifting, dragging about, carrying; attaching tourniquet, checking vital signs—had dealt with discrete anatomical components. Never connected dots; never mentally assembled into whole person. Never
saw
face. Until then.
Was kid . . . !
Little, if any, older than self.
Comprehension dawned suddenly: Had thought was dealing with adult; carrying, in addition to own compact tonnage, perhaps three times again own weight (heft difficult to judge when heart is pure, strength is strength of ten). In fact, apart from peak efforts (unsticking door, traversing flaming moat with piggyback passenger), exertion level hardly more than doubled. Could have accomplished most heroics almost as well without metabolic short circuit. Well . . . maybe.)
However, with understanding came chilling realization: Clinical picture even less rosy than first appeared. Healthy blood pressure reading but snare, delusion in child when hemorrhage a factor. Young cardiovascular systems amazingly resilient when challenged; simply pump faster, harder as blood volume diminishes, maintaining adequate pressure the while.
Right up to sudden, catastrophic, final dissolution; total failure.
Viewed thus, pulse rate most disquieting: Suggested important fraction of total blood supply already gone. And quick review of wound confirmed loss still in progress, though slowed by tourniquet.
Agonized for endless moments, poignantly aware of limitations of own training; indecision compounded by mental processes blunted by physical, mental fatigue. Knew, of course, what needed doing; but shrank from unavoidable conclusion regarding by whom.
(Granted, possessed requisite knowledge. Inescapable, since Daddy [pathologist or not] one of only two doctors in town, often called upon to perform emergency-room care, usually in own home, invariably at odd hours when no one available to assist but Yours Truly. Watched closely then; listened attentively to accompanying lectures. Even, at proud paternal urging, acquired skill at certain limited surgical techniques, practicing on animal cadavers. But never—alone, unaided—so much as placed Band-Aid on
person
.)
However, time—blood—wasting. And own condition now serious impediment to concentration, precision work. (Maybe wasn't burning energy at quadruple usual rate; couldn't know what overload factor consisted of. But knew was exhausted; never experienced such fatigue before.) Nor without long rest, much nourishment, was condition likely to improve. Which ruled out usefully immediate future. Unless . . .
Weighed options carefully—shuddered. But saw no way out. Closed eyes, directed consciousness inward. Took deliberate, deep breath; held briefly; released slowly, exhausting tension with it. Then—for second time in only minutes—triggered hysterical tap.
Like magic, felt vision clear, hands steady, cramps abate. But not fooled: Heart still hammered; was still fountaining sweat; breathing, though no longer paroxysmal (regular now, slowed to point where wouldn't affect dexterity), still amounted to panting. Condition unchanged: Beneath veneer was still totally exhausted. Tried not to dwell on probable cost when came time to pay Piper. Hoped benefits of sufficient duration—surely wouldn't work third time.
Took seat on campstool at bedside. Bent over leg; drew wound lips apart to assess damage extent, severity. Blood volume made visual structure identification impossible. Removed saline baggie from kit; extended I.V. tube, chopped off end. Squeezing bag to provide pressure, used as hose to irrigate, cleanse area. Worked pretty well, but relief only temporary: Adjoining tissues full of slowly oozing bleeders; and at very bottom of gash, visible now, gaped slice in femoral artery, welling gently afresh with each systole, reflooding area with bright red blood.
Which wouldn't do at all; had to see to work. Pondered briefly; then cranked another turn into tourniquet. Uncomfortable about solution: First Law of Tourniquets holds
must
be loosened every 12 minutes, 18 at outside. Failure to comply results in tissue death downstream, autolysis, ultimately gangrene.
But here question less clear: Two-inch rent in artery wall complicated equation; hydraulic principles demanded concern at least equal to other factors. (Probably more than equal, as continued to debate matter: Blood geysering out through least resistant path certainly of negligible value downstream—and even if somehow beneficial, advantages accruing to leg moot if body to which attached promptly expires as side effect.)
But knowledge that choice impending if artery repair not completed within time limit acted as incentive to speed work. Fell to; gathered, set out, organized equipment.
Hosed down wound again. Scrutinized closely; breathed sigh of relief: Tourniquet now achieving desired result; arterial flow stopped. Virtually imperceptible seepage remained from vascularity in surrounding tissues, but makeshift lavage spray adequate remedy.
Next juggled odds quickly, unhappily. Time most critical, true; but upon reflection, concluded potential shock consequences justified investing whatever time necessary to start I.V. before undertaking actual repair.
And if Daddy watching from Above, made him proud: Had I.V. inserted, taped in place, saline flowing—all within single minute. (Practice on long-suffering arm simulacrum [paramedic training aid] paid off: Found vein first try.)
Performed necessarily abbreviated scrub, using drinking water, soap, finishing off with alcohol slosh. Squirmed into rubber gloves with difficulty—not easy, solo, while maintaining asepsis.
(Mostly unworried about infection per se; Teacher's opinion holds
H. post hominems
immune to known human disease. But key words, even if Teacher's very own, are "opinion," "known," and especially
"H. post hominem"
[of which victim surely must be one—but don't
know
that]—and would be humiliating to perform repair successfully; then lose patient to toxemia through preventable gross sepsis. So within limits imposed by surroundings, did best to adhere to sterile procedure.)
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.