EMERGENCE (15 page)

(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.

Too busy twitching
in
voluntarily; spasming, in fact: Body jerked, convulsed, shuddered in response to multiple random cramps attacking, releasing, attacking again from head to toe. Ravages flopped body about like chicken recently deprived of head (uncomfortably apt simile; brain quite as unable to communicate with body as if physically separated).

Thrashed for timeless, endless interval. Several seconds at least. Then subsided into gently quivering heap, face up, limbs intertwined in Gordian disarray; cramps abated, muscles relaxing, going limp—pain easing toward residual ache. Would have sighed with relief if such possible, but breathing not among voluntary functions then.

Besides, knew relief was only fool's paradise: Could feel heat; knew face was flushed. Could feel perspiration volume increasing, sweat streaming from entire body; dripping where possible, collecting in hollows elsewhere—one pool quickly threatened to overfill valley formed by nose, cheek; invade eye. And breathing rate such that nose began to run.

Suspected was not pretty sight. But not encouraging to realize Terry, intently peering down from stand, actually had nothing to say. Just made big, round, worried eyes; stared first one eye, then other. And
know
what it takes to dismay my brother.

But worry surely nullest of exercises. Understood problem; knew only solution was food, sleep. And knew
must
finish chores first.

So again turned perception inward. Concentrated. Groped for
ki
within soul. Felt it stir. Created channel, felt flow begin. Gently guided into right arm. Willed dead meat to move.

Terribly pleased to note response. And not a little amazed.

Expanded control zone. Levered body into sitting position; then rolled over onto hands, knees. Moving most carefully (nothing worked without painstaking, step-by-step supervision), crawled forward to driver's seat.

Where paused momentarily, mulling options, calculating odds. Shortest route involved climbing into seat to reach door handle. But never seriously considered as solution (as well might have been mountaintop). Or could go around; between seats, past engine cover, under steering wheel. Farther to travel. But level.

Even so, had to stop en route, rest. Twice.

Eventually, however, fingers closed limply around door handle. Marshaled forces for effort—pulled door shut hard enough to secure latch. Barely. (Noted, gratefully, front windows rolled up far enough for safety; all others swing-out construction, couldn't open far enough to pose security risk.)

Then—somehow—managed to turn around under steering wheel, avoiding getting snagged on pedals in process; set off on return trip amidships.

Arrived in due course within reach of side door handles. Again assembled energies (what remained), swung door shut—even remembering to close in proper order: Rear first, then front, so overlapping latches engaged instead of rebounding, negating efforts. Experienced profound thrill, sense of accomplishment, from having done it right.

Considered taking brief time-out for rest but realized wouldn't help. So heaved self upright on knees, ignoring tendency for surroundings to orbit own vertical axis. Scooped up saucer full of parrot seed mix from container on counter; lumbered (still on knees) to stand, prepared to dump contents into sibling's food cup.

And stopped, confused: Was full. As was—now visible at far end of perch—water cup.

Set down saucer carefully. Tried to think problem through, but not easy: Data input too fast; of such anomalous, almost contradictory nature; mind functioning so slowly. Shook head—regretted at once: No one in such condition should move head quickly. Ever. Pain obscured vision momentarily. When receded, found self leaning against side doors, head resting against window glass, eyes closed.

Solution obvious, but reached only after labored deliberation: Of course food, water untouched: Had embarked from Harpers' this morning—several lifetimes prior—
something under an hour ago!
(Indeed, Albert knew whereof spoke: Time
is
relative; truly flies when having fun. . . .)

Probably smiled as arrived at conclusion. Which expression surely faded as eyes opened, focusing on glare from holocaust surrounding Trans Am, mere hundred yards behind van. Building in which vehicle embedded now well involved: Smoke, fire gushing from windows many stories up, obviously spreading rapidly.

And given shoulder-to-shoulder nature of downtown concrete-canyon architecture, only matter of hours before entire block ablaze—in fact, as flames gutted high-rises, structures' collapse sure to follow; filling, bridging streets with burning debris, spreading conflagration from block to block. Only few more hours before entire city engulfed in fire storm.

Implications percolated slowly but with finality. Knew taste of defeat: truly bitter—age-old cliché accurate, but woefully inadequate.

Not that had given up. Though slowed, dulled, mind still functioning more or less coherently; knew if passed out now would never wake: Van's destruction, together with frail contents, guaranteed as blazing walls crashed down to fill street where parked.

But problem deeper than mere awareness of threat, unflagging resolve. Body pushed too far; was finished: Utterly in grip of fatigue-toxin-overdose-induced myasthenialike collapse, paralysis. Not a single cell from voluntary musculoskeletal group responsive to brain's commands—doubt house-current application would have elicited so much as twitch.

Tears began to trickle from under lids as eyes closed, body slid limply down door, crumpling onto floor to lie unmoving. Final thoughts were fading jumble fuzzy with disappointment, regret, outrage: Had come so close; felt so
cheated—

"Hel-
lo,
baby . . . !" wailed Terry in anguished tones.

—and horror: Hoped smoke, fumes, big piece of falling debris would find us before flames; couldn't bear thought of retarded twin, gorgeous feathers ablaze, rolling about floor, struggling, screaming. . . .

Waking was nice: gradual, luxurious process, allowing time to revel in same cozy lack of urgent purpose which always attended first awareness on summer mornings during school vacation. Bed was lovely: firm; made up with cool, clean-smelling sheets; light, soft blanket. And from somewhere floated lilting chords of Beethoven's
Pathétique
sonata.

Once got around to opening eyes, saw that surroundings comprised large, cheerful, well-appointed bedroom, simply reeking of restrained good taste.

Had no idea where might be, how got there, or why; and didn't much care. Was sufficient that felt marvelously rested, deliciously comfortable—until essayed first lazy stretch.

Accompanying yawn brought cognizance of tube up nose; a discovery so startling, almost distracted from surprise of learning right arm immobile, apparently strapped down. Deliberate swallow confirmed tube also present in esophagus. Unpleasantly so.

Followed tube with eyes to bottle hanging on stand at bedside. Didn't need to read label to recognize Isocal HCN, first choice amongst medical community for endogastric feeding of comatose patients.

And next to Isocal hung partial baggie of Ringer's lactate—saline with electrolytes added. From it ran tube to I.V.—plugged into right arm.

As pondered these phenomena (with rapidly dwindling enthusiasm), yet another anomalous sensation intruded amongst already churning thoughts. Or perhaps
lack
of sensation more accurate: For first time in living memory, had awakened without awareness of overfull bladder. Which realization flowed without pause into dawning perception that Something Was Amiss in
that
region as well.

Began immediate left-handed exploration to determine quality, extent of damages. Was dismayed to learn attire consisted of overlarge (knee-length) tee shirt—and
diaper
. . . ! Complete with safety pins. And, speaking as expert baby-sitter, quite professionally executed. (Strategically located slit in crotch of mortifying garment admitted [as suspected] Foley catheter.)