Gray (Book 3) (14 page)

Benjamin said, “What do you have for antiseptic?”

“There’s a full bottle of vodka,” said Edith. “I’ll get water on the full boil now, sterilize the instruments both ways.”

There were a few surgical instruments from a vet’s office—scalpel, forceps, clamp, probe. Coral said, “Good. I need the anatomy atlas, too. And I want to look at it where Julie can’t see me.”

Edith said. “Anything else?”

“No, I’ll meet you in the other exam room in a minute.” As Edith hurried off, Coral said to Benjamin, “Am I crazy to be thinking of doing this?”

“I don’t think so. Her toes can’t be saved?”

“They’re dead. They’d fall off anyway, but it’s the infection that could kill her. I’m afraid to act, but I’m more afraid to wait.”

“Go with your gut.”

“My gut is telling me I’m a fake doctor. I’m nineteen years old, Benjamin.”

“No, not really. No, wait, don’t interrupt. Technically, yeah, that’s your age. But in experience? You’re older. You’ve doctored me twice for serious injuries and never taken a wrong turn. You’re not some irresponsible child. I trust you. You can trust yourself.”

“I don’t want to screw this up.”

“Then don’t.”

“That easy, is it?”

“You’ll do fine. Tell me what you need me to do.”

“Moral support, I guess, while I read up on bones and ligaments and nerves.”

In the empty exam room, she took the anatomy book—photos and diagrams, both—and studied the human foot. She was planning to remove the distal phalange bones, numbers three and four. She could do it on a dead animal in a lab, no problem. Her dissections always got top grades for neatness and accuracy.

But dead animals in the lab did not scream when you cut into a nerve. They didn’t bleed from functioning blood vessels. Dead animals’ ligaments had lost their elasticity. This would be an entirely new experience for her.

She stared at the photos, memorizing what she was about to see in real life. But what would her patient feel? Coral stripped off her shoe and sock and palpated her own toes, hunting for the sensitive spots, hoping that she felt nothing along those toes. She jabbed herself with her fingernails.

“Ow,” she said. No, she felt that.

“Don’t hurt yourself,” Benjamin said. He had been quietly sitting with her while she prepared.

“I think her toes don’t feel anything—but I’ll have to cut up to where she does feel it. It’ll hurt.”

“You’re a brave person.”

“Julie is going to have to be the brave one,” she said. “I don’t know how it’ll go in there. You might have to really sit on her leg to keep it still.”

“Okay.”

She went back to studying the photos and diagrams, mumbling anatomical terms to herself to remember them. She used to drive her roommate crazy doing that, but it helped her retain the information.

Her pocketknife was in her pocket, as always, and she took it out, flipped open the longest blade, and reversed the knife so the dull side was down. She rehearsed on her own toes the cuts she would have to make on Julie’s. There, and there. Probably need to cauterize a vein at that point. She could leave the tip of a probe in the fire as she started, grab it with a piece of cotton bandaging to keep from burning herself. Cauterize, drop the probe, cut the ligaments here and here. Bones should detach pretty easily then. At that point, she needed to look at the remaining tissue, the damage to it and slice away everything necrotic.

Again, she rehearsed the moves. And again. A shudder ran through her. Not nerves.

“You getting cold?”

“Yeah. Grab the book, please, and bookmark this page in case I need to look at it while I’m operating.” She hoped she wouldn’t need to and that Julie wouldn’t notice if she did need to. Nothing worse than watching your doctor learning as she wields a scalpel.

“Will do.”

“Let’s see how the patient is,” she said, grabbing the lamp.

The other exam room was toasty warm. Coral went to Julie and Abigail backed off to let her close to the patient. “Pills taking effect yet?”

“I’m feeling them,” Julie said, but her eyes were still alert.

“We’ll give them a few more minutes,” Coral said. She turned to the stove. The water was boiling, the instruments in it. Edith had pulled out a stack of cotton bandages.

Coral closed her eyes while she mentally rehearsed. The voices of the others were low, but as she played out the operation in her imagination, they faded to nothing.

Edith’s voice broke through the wall of her concentration. “The instruments are ready.”

“Good,” said Coral. She was, too, or as ready as she was going to get. “I need to wash my hands.”

“I have warm water over here for you.”

Coral washed twice with the homemade soap, scrubbing under her nails and around her cuticles carefully. They had no latex gloves, so it was going to be bare-handed work. Edith scrubbed Julie’s foot up to the knee, and the surface of the table, and when they were ready, Coral held her hands over Julie’s bare foot and Edith drizzled the vodka over all. She had tossed a couple towels on the floor to soak it up—and to soak up blood.

“Ready?” said Edith.

“You okay, Julie?” said Coral.

“I’m fine. Sort of floaty,” said Julie, her voice slurring slightly.

Everyone was in place and had their instructions. Coral started with the local, pulling it up into her makeshift syringe and then sliding it into the healthy tissue of Julie’s foot. Julie jerked back, and Benjamin leaned in to hold her leg steady.

Coral said to him. “You can let go for now. We need to give this five minutes to take effect.”

The only sound for that five minutes was Abigail talking to Julie and the clink of instruments as Edith laid them out in a neat row on some of the precious sterile gauze. She opened several two by twos, leaving them on the paper, for Coral to grab as needed.

About three operations, and they’d run through all their supplies. A problem to think about on another day. Coral took up a scalpel and tapped the top of Julie’s foot. “You feel that?”

“Vaguely. Are you cutting?”

“Yes,” Coral lied. And then she did, leaning in, pressing the scalpel in, and making the first incision through the skin at the base of the blackened toe.

The smell that wafted out as she cut reassured her she was doing the right thing. Already the odor of rot was strong. She reassessed and cut higher into the foot than she had planned.

An extra pair of hands would be useful about now, but she didn’t have that. As she cut into the edge of healthy flesh, Julie began to struggle, and Edith and Benjamin were both busy holding her still so that Coral could work. Abigail’s voice went on, trying to distract Julie, but Coral didn’t pay attention to her words. She had work to do.

She cauterized the biggest of the veins, and then daubed away the blood. She could see the point of attachment of the ligament, on a rough indentation of the bone.
Here goes
. Grasping the scalpel firmly, she cut through the ligament.

Julie’s leg bounced, and she yelped.

“Hold her tighter,” she said to Benjamin, without looking up.

Coral severed the ligaments to the second toe. Julie began to moan, but Coral tuned it out. She took a two by two and cleaned the area of blood. She could see the nerve that ran through there. The toes were drooping off the foot. She steadied the foot, slipped the scalpel blade under the nerve, and, quick as she could, cut.

Julie shrieked, not a sound that could be tuned out.

“That’s the worst of it,” Coral said. “It gets easier now, Julie.”

The scream eased off as Julie ran out of breath. She was still whimpering when Coral went back to work. She wished she knew how much tissue to sacrifice. She didn’t want to have to operate again, but she didn’t want Julie any more disabled than she had to be.

The severed nerve and ligament had retreated up into the foot. The toes were lying on the table, black and dead.

The blood was making it hard to see. She cauterized again, dabbed at the wound, got a good look at the raw tissue of the foot. No blackened tissue was left, but there was a patch of white she thought was not going to heal on its own anyway. Its absence shouldn’t make much difference to Julie’s balance or mobility. So she carved it away.

Another two minutes, and it was done. A sewing needle threaded with dental floss was set out, and she took it up and sewed, her hands still steady. Ten tiny stitches, and she backed up and looked at her work. Blood was still seeping in one spot, so she took two more stitches there and tied off the thread. The knot wasn’t as close to the skin as it needed to be, so she tried again and got it right the second time.

She backed off and the room swam back into her awareness. Julie was sobbing. Benjamin looked pale and shocked. “Don’t go anywhere,” she said to him. She took up the bottle of local and the syringe and drew up another dose, and, after glancing to make sure Benjamin was hanging on to the leg, injected it. “It’s okay,” Coral told everyone. “Almost done. Just one more shot.”

She glanced down the line of supplies Edith had lined up. “Edith, I’m not seeing the antibiotic.”

“Right.” Edith went over to the cabinets and opened first one, then another, finally coming out with a bottle of antibiotic Coral had taken out of the animal barn.

She had no idea of the correct dose, so she was conservative. She could dose her again tomorrow morning if there’d been no ill effects. Probably the gluteus would be a better injection site, but Julie’s calf was right here, plenty of muscle tissue, and it was already sterile. She injected the antibiotic quickly and then backed away.

The severed toes were still lying on the table. She reached forward and flicked them to the floor, where they lay on the vodka-soaked towels. She kicked the towel over to hide them.

With every second, her awareness expanded beyond Julie’s toes. The room was hot, and a scene of carnage, and everyone in the room but her was looking traumatized. Maybe not Edith so much, but the others. Even Benjamin.

Julie was sobbing, still. Coral picked up the bottle of vodka and handed it to Edith. “Give her a drink, see if it helps at all.”

She went to stand by Julie’s head. “I’m sorry it hurt so much.”

Julie shook her head, back and forth, slowly. Coral had no idea what she was trying to communicate, if anything at all.

She patted her arm. “You did great, Julie.” She backed off and looked at Edith. “I need a second,” she said, and left the room.

In the waiting room, for some reason, she could smell the scent of rotting flesh more strongly. Her mind was replaying the operation, every cut, every decision. The whiteness of the nerve. Red blood oozing over blistered and blackened flesh.

She had to run for the front door. Outside, she leaned over and vomited onto the snow.

It wasn’t the smell or the blood, though; it was the responsibility that was making her sick. What if she’d failed Julie? What if she’d put her through that pain and failed to save her?

She spat, and then walked a few steps away. Her knee ran into a berm of snow, piled up from the shoveling. She couldn’t see a damned thing out here.

The door behind her opened with a squeak. “I brought you the bottle of booze.” Benjamin.

“Save it for disinfectant.”

“I have some water, too.”

“Yeah, that’d be good.”

She felt his body bump against her, and then he pressed a plastic bottle into her hand. She took off the cap and held it a few inches from her fouled mouth, poured some, swished it around her mouth and spat it out. She did that again, and then she took a swallow, feeling the slight burn of bile in her throat. She took another drink to wash the taste away, and handed him back the empty bottle. “Sorry, I finished it.”

“No worry,” he said. “Come back inside. It’s cold out here.” He put an arm around her shoulder and guided her back inside.

“You see better in the dark than I do,” she said.

“You were amazing in there,” he said.

“Not really.”

“I was watching you. Your focus was, like....” He trailed off. “I don’t even have the word. Complete. Impressive.”

“You’re nice,” she said.

“I can’t believe how fast you did that. It was like you’d been doing it your whole life.”

“I didn’t want her in pain for any longer than she had to be.”

“She’ll be okay,” he said.

“I hope.” Coral took a deep breath, and it felt like the first time she’d breathed in minutes. “If you want to go home, go on. I need to stay with her. Make sure she doesn’t have problems.” Though if she had problems, Coral didn’t know what she could do. A reaction to the antibiotic, shock, anything like that, and she’d be out of her depth. Bleeding, she could stop. A stitch could be replaced. But anything more?

“She’ll be fine,” said Benjamin.

“You think so?”

“Thanks to you.”

It was nice of him to say so, but Coral was not feeling proud of what she’d done. Maybe it had to be done. Maybe Coral was the only person among the three hundred people in Boise who could have done it. But it didn’t feel good that this was the case. It felt like an enormous burden. “Okay. I’m ready to face her again.”

Edith was cleaning up the mess Coral had left in the treatment room. Coral stooped down to whisper to her, “Don’t throw away the toes. I want to study them later on.”

Edith looked shocked, but she recovered quickly and nodded. “I’ll take everything to the other room.”

“Thanks Edith. You did great.”

She whispered, “I’m glad I didn’t have to do what you did.”

Coral managed a wan smile. She stood and walked to Julie’s head. She wasn’t crying or moaning any more. Her color was okay—a bit pink, so no sign of shock. Her eyes were closed.

Abigail looked over the bed at her and mouthed a word. Coral didn’t catch it, and she shook her head. Abigail tried again, slower, and Coral caught it: “Meditating.” Good. If Julie had any technique in hand that could chase the pain away, good for her. Coral had run out of ways to help her.

Benjamin stood leaning against the door, his knee bent and his boot sole planted against the door. His arms were folded. The very sight of him was a comfort.

Edith made him move a moment later when she carried out the bloody towels. Coral followed her into the other treatment room, carrying a lantern.

In low tones, Edith and she discussed what Julie’s care should be like. “Doesn’t she have anyone, family?” asked Coral. She was surprised no one was here, demanding to see Julie when she had not shown up for supper.

“She had a new boyfriend, but about six, seven weeks ago he didn’t come back from a scavenging trip,” said Edith. “No one knows what happened to him.”

“Poor Julie,” said Coral, and she meant it. Losing someone she cared for, and then losing part of her own body? “I’ll stay here with her tonight. You go home, get some rest, and then you can watch her tomorrow while I sleep.”

“You sure?”

“I don’t want her to be alone for a couple days, so we need to take shifts. We need to change the bandage, watch closely for infection, and try to manage her pain somehow.”

“And keep her warm.”

“Yeah, another reason she needs to stay here.”

“I’ll check our fuel supplies and make sure we have enough to run the stove 24/7,” Edith said.

“Maybe in three or four days, she’ll be out of the woods. I’d like to keep her warm for that long.”

Edith nodded. “How much antibiotic are you going to give her?”

Coral hadn’t thought it through. “Assuming no ill effects, a shot twice a day for four days. And then we’ll see.” If there was any sign of infection, she’d increase the dosage she’d already guessed on. If at day four, Julie was healing, Coral would stop the treatment and try to save what portion of the drug she could for other patients.

Benjamin was waiting in the hall for her. “I’m staying too.”

“There’s nowhere for you to sleep. And our bags, our blankets, they’re back at the apartment.” They had gotten their old sleeping bags and blankets laundered, and Abigail had brought them back to the apartment. They were tucked next to their burlaps sacks, with Coral’s old boots, now repaired, and some other supplies Benjamin had borrowed, begged, or stolen. “You may as well go home.”

“I’ll stay,” he said, and after a closer look at his expression, Coral knew not to argue with him. The three of them returned to the treatment room. Julie was resting, her arm over her forehead.

“We can line some chairs up, make a bed for you in here,” Edith said to Benjamin.

“It’s warm enough in here I don’t need blankets,” Benjamin said. “My jacket will be plenty warm enough.”

“I’ll come back early tomorrow,” Abigail said, “and bring breakfast for you three. Unless you need me here all night?”

“Thank you, but we’ll be okay,” Coral said. “I’ll sleep tomorrow, during the day, back in the apartment. But if there’s another emergency—” and she glanced at Julie “—you have someone come and wake me.”

“It’s a deal,” said Edith and, soon thereafter, she and Abigail left, sharing a dim flashlight taken from a clinic shelf to make their way home.

Benjamin lined up the chairs for a bed and offered it to her, but she shook her head. “I’ll stay up. I want to keep an eye on Julie.”

Her patient had fallen into a fitful doze. The bandaging over her foot was stained with blood, but as Coral examined it in the lamplight, she thought the bleeding had almost stopped. Good. She wanted to leave the wound alone for the next several hours. She’d change the bandage when Edith was here.

Benjamin dozed on the bed of chairs. Coral sat watching Julie breathe. From time to time, she became restless, and Coral held her hand and try to soothe her. In the middle of the night—maybe two or three o’clock, Coral guessed—Julie woke with a moan and could not get back to sleep.

Coral opened the cabinet and took down the pain meds she had at her disposal. There were too few. And Coral, somehow, had become responsible for doling them out correctly among three hundred people. She shook out two more Tylenol with codeine and helped Julie swallow them.

She looked in the bottle, which held only six pills now, and thought seriously about pocketing it. One day, weeks or months from now, she or Benjamin would need pain meds.

Think of it as payment for services rendered.

She couldn’t, though. She could only think of it as theft. Yes, she knew that’s who she was now, a person who would steal some of the last remaining resources of a group who had done her no harm.

But not right this second.

When morning came, she woke Benjamin to keep an eye on the sleeping Julie while she went to use a latrine. She took the  bucket of water warming by the stove outside with a cube of local soap to wash her face and hands. It was a nice perk of being the doctor, having warm water to wash in and a whole tray of soap stored at the clinic. This morning, Benjamin shared her perk, using the rest of the warm water.

There was a storage tank for water inside the clinic. A pair of men from a logistics group filled it twice a week at the river and hauled it back. Coral filled the bucket again from that and set it on the stove.

She fed the stove from their woodpile, which was almost all scrap lumber, and not very big pieces of it at that. She mentioned it to Benjamin.

“I’m not sure if fuel or food is going to become the critical problem first here,” he said.

She jerked her head, indicating they should finish the discussion in the hall. “Both are low, then?”

“I don’t really know about the food, but from what I’ve seen, the fuel is dangerously so.”

“What’s going to happen when it runs out?”

“Nothing good,” he said.

“Then we should be well away from here by then, shouldn’t we?”

“They’ll last another week. And they can function longer if there’s a major find out there. That’s not impossible.”

“I’m ready to leave any time you are. Though I’d rather stay the next couple days, while I’m looking out for Julie.”

“We’ll make a plan for when she’s past the worst, then. And there’s more to learn before we have that discussion. I might see something that tells me we should get going that very night. Could you be okay with that?”

She could hand Julie’s care to Edith with no worse than a twinge of guilt. “Yes.”

“Are you getting used to the place?”

“I’m getting used to it in some ways. But I’ve been missing the good old days, you know?”

“Meaning what?”

“With you and me, alone. Like when we were camped at a reservoir. Rabbit stew and fish fillets. Working on my arrows.”

“We can leave any time you like.” He frowned. “But the days of plentiful fish and rabbits might be gone.”

“Especially if you don’t get your rifle back. Hard to shoot game with your finger.”

“I think I know where the rifle might be, but I’d rather not have to break in there. Not unless we’re minutes from needing to run, for whatever reason.”

Coral heard the front door open and said, “We’ll talk about it later.” She hurried up front to see who it was.

It was Abigail, with a steel bucket. “Breakfast for the three of you,” she said, holding it up. “The bucket is clean, Chef promised.” She looked past Coral. “How’s Julie?”

“Hurting, but she slept most of the night.”

“That’s good, right? She doesn’t have a fever?”

“No, no fever.” Without any sort of thermometer, Coral had to take temps Grandma fashion, by feeling the face and neck of her patients. Julie had felt near normal all night. Coral hoped it lasted.

“Did you bring breakfast for yourself, too?” Coral asked.

Benjamin was bringing the waiting room chairs back out as Abigail said, “No, I’m headed back to eat with Doug at the table. And then, can I talk with you back at the apartment before you go to sleep?”

“Sure,” said Coral, though she was feeling bone-tired and in no mood for a friendly chat.

Abigail left, and Benjamin and Coral sat to share a few cups of porridge with tiny cubes of Spam or some other processed salty meat. The chef had been generous with their three servings, and when she was done eating, there was still plenty for Julie, and she felt full for the first time in a long while. 

Keeping his voice low, Benjamin said, “I have to get to my work assignment.”

“Did you have enough sleep?”

“Yeah, you’re the one that was awake all night.” He pulled her in for a hug. “You did great in there, with the surgery. I’m proud of you.”

When he turned to leave, she was surprised to find herself teary-eyed at the praise. She was tired though, and the stress of the previous night still weighed heavily on her.

Edith showed up early, and Coral was happy to turn Julie’s care over to her. Edith promised to make Julie eat breakfast when she woke, and Coral said she’d bring dinner for Julie along when she came to relieve Edith for the night shift.

The daylight outside seemed brighter—or more glaring—as she walked to the apartment building. She stumbled on a step at the entrance and barely caught herself in time. Sleep would be welcome.

But when she got into the apartment, there was Abigail, waiting for her. She’d said she wanted to talk. Coral managed a smile as she sat in the living room across from her. Light was coming in a window where Abigail had pulled the heavy drapery back. The apartment seemed even colder after the heat of the clinic all night.

Abigail looked worried. She had frown lines between her eyes, and she was rubbing her own thighs, a hard, nervous gesture.