Race for the Dying (10 page)

“Good God,” Thomas gasped between clenched teeth.

Another spritz of ether, and then Thomas became aware that Alvi was holding her breath as she worked. A final tug, and she let out a soft whistle. “Now look at this,” she said, and held the forceps up. Captured was a shard of amber glass nearly an inch long, tapered to a fine point. “I think that's it,” she said triumphantly. “On top of everything else, when you fell you managed to find a broken bottle.” She clanked forceps and souvenir into the pan and maneuvered a clean gauze pad over the wound, wiping up the rivulet of blood that tracked down his ribs toward the sheets. “Let's debride a little of this dead tissue, and then we're all set.” In a moment, she had a clean dressing in place over the wound.

“You really should have those ribs bound,” she said. “I know it's going to hurt, but let's do that. It'll be easier for you if you swing your legs over the side of the bed.”

After removing the hot towel, she maneuvered him into place, hands amazingly strong and sure, and by the time she had replaced the wraps around his ribs with clean linen, he was light-headed.

“I think that if you're going to do the ice, you should try it more often. Once a day seems insignificant to me.”

“I don't want to be a nuisance,” Thomas said, and Alvi laughed abruptly.

“Too late,” she said, and patted his knee. “Rest until lunch. We'll do the ice and heat again then.”

As he watched Alvi gather up her paraphernalia, Thomas felt only admiration. “Where was your schooling?” he asked.

Alvi, about to push the cart out the door, stopped and looked at him. “I spent almost two years at Grace Normal, over in Seattle. The first year, I couldn't believe how bad it was, so I went back to make sure.” She smiled. “It was. I left.”

“Your medical training.”

“Father knows enough for any ten people. A little rubbed off on me, I suppose.”

“Is that your ambition, then?”

“What, medicine?”

“Yes. There are women in the profession now.”

“Oh, indeed there are,” Alvi agreed, and let that suffice as an answer.

Chapter Seventeen

Two afternoons later, Thomas stood on the front porch, judging the five steps that led down to the fragrant, rough-cut fir of the new boardwalk. Propped uncomfortably on his crutches, he looked down Gambel Street. The workers' voices were muted by distance.

Thomas had deliberately chosen a quiet moment for this experiment. He didn't want hands on his elbow, or words of encouragement, or warnings of disaster. Gert James was busy in the back with laundry, and Horace was off fishing. He hadn't seen Alvi or Dr. Haines all afternoon.

Moving close to the right-hand railing, he took his weight on his right foot, easing the crutches down to the first step. Balanced with his right hip braced against the railing, he paused, considered, and took a slow breath. He shifted his weight, knuckles white on the crutches. The jolt as his right foot found the step was more than he had expected, and set off a wave of fireworks.

“You given any thought to how you're going to get back up, Doctor?”

Thomas looked up to see Lars Lindeman standing on his own step across the street, one hand cupping his bristly chin thoughtfully.

“No,” Thomas said truthfully. “I confess that I haven't. Maybe I shall never return.”

“I got me a wheelbarrow, I suppose,” Lindeman said. “Me and the kid could haul your carcass back up.”

“I'm hoping that won't be necessary,” Thomas said. “I'm just seeing if this is possible.”

“Don't look like it is,” Lindeman observed. “Don't see the point, anyways. There isn't anything at the bottom of the steps that you need to fetch just yet.”

With considerable effort, Thomas turned back, discovering that a mere eight inches could be a daunting precipice.

“I got some news for you,” Lindeman said, raising his voice a notch instead of crossing the street.

“What's that?” Thomas leaned against the railing once more, breath coming in short stabs.

“You want the good news first, or the not-so-good?” Before he could choose, Lindeman continued, “Your steamer trunk arrived this morning. I was going to send Charlie over with it.”

“Ah, that's wonderful,” Thomas cried.

“That's the good part,” Lindeman said. “The steamer got here. Unless you meant to ship an empty chest, then a few things went astray somewheres between here and Connecticut.”

Thomas' heart sank. “What are you saying?”

“I'll fetch it,” Lindeman said, and turned back into his store.

Thomas stood rooted. The old man wasn't going to carry his steamer trunk. The thing weighed more than a hundred pounds.

In a moment, Charlie Grimes appeared, the large trunk on one skinny shoulder, and Thomas' heart sank. Lindeman trudged behind the boy, and stamped his boots on the new boardwalk.

“Pretty fancy,” he said. He beckoned Charlie. “Up on the porch, son.”

Charlie swung the chest down with ease. He glanced at Thomas, then quickly looked away as if this whole mess might be his fault.

“Surprised you didn't have a lock on it,” Lindeman said. “Or did you?”

“Most certainly I did,” Thomas groaned. Not only was the padlock missing, but the trunk's ornate hasp was twisted and bent, torn from the steamer's own less substantial lock. Someone had thoughtfully rebuckled the heavy leather straps that held the cover in place.

“You want Charlie to open 'er up?”

“Yes.” Thomas already knew the answer before the eager youngster had wrestled the baggage open.

“Fella could fit a lot into a trunk that big,” Lindeman observed helpfully as the steamer yawned open.

Thomas sagged against the railing. “Son of a bitch,” he breathed. He glanced up at Lindeman. “Why was it shipped to you?”

“All freight for this end of town comes to me,” the old man said. “I'm the terminal, and don't that sound important, though?” He shrugged.

“What can I do?” Thomas said, more to himself than to Lindeman.

“Not a hell of a lot,” the old man replied. “No way of telling where it all went. Three thousand miles offers up a lot of opportunity.” He nudged the steamer's address plate with his foot. “Dr. Thomas Parks, MD,” he read. “Might have been better to leave the ‘doctor' off. Gives folks ideas. Anything gone that can't be replaced?”

“My books, for one thing.” He tried to tally the various titles that he had packed, books that would take months, maybe years, to replace.

“Doc Haines has enough of them, I would think,” Lindeman said helpfully.

“I suppose he does. All my clothing, other than a change or two that I had with me in my travel bag. My father's pistol.” He grimaced. “Most of my medical instruments. A very fine microscope that my father gave me when I graduated from medical school.”

“All things that a little money can replace,” Lindeman said. He lit his pipe. “Now a man could say that you're free to travel light. Something to be said for that.”

Thomas laughed hopelessly. “Very, very light.”

“How's that ice working, by the by?”

“It's working wonders,” Thomas said. “I'm in your debt.”

“That's okay. Lots of folks carry a tab at the Mercantile.” He grinned. “And by the by, you're dead on right about that mutt. He's got something festering back there at his ass end. Won't leave it alone.”

“We need to do something before it kills him,” Thomas said.

“Wouldn't be much of a loss,” Lindeman said, and Charlie frowned at the remark. “Want the boy to take this inside for you?”

“I'd appreciate that. Not that an empty trunk is of much use.”

“You never know.” The old man turned abruptly and started back across the street. “You need clothes, whatever,” and he waved a hand at the Mercantile. “We either got it. Or can get it.”

“Thanks, Lars.” Thomas followed Charlie and the steamer trunk toward his room. As the boy was turning to go, he held up a hand. “Charlie, surgery is the only thing that's going to give that dog any comfort. Can you help me with that?”

Grimes looked apprehensive. “Wha—” he began, then stopped as Thomas shook his head.

“Before I do anything, someone,” and he emphasized the word, “needs to clean him up. I would think a good bath down at the shore would be a start. Do you think that's possible?”

“I…I…”

“If you could do that without being bitten to pieces, then I could do a proper examination,” Thomas said.

“H-h-he won-won-won't let you,” Charlie said.

“I intend to put him to sleep,” Thomas said. “He'll have pleasant dreams about biting people, and when he wakes up, he'll be back together.” And I traveled three thousand miles to perform my first operation on a mangy dog, he thought. “We'll do the surgery down at the clinic. In the meantime, if you can do what you can to clean him up, it would make things easier.”

“I-I-I'll d-d-do it.”

“You better get back to work before the old man docks you an hour's pay. Thanks for lugging that steamer for me.” Charlie nodded, looked like he wanted to say something, but then abruptly turned and headed back to the Mercantile. He crossed the street in a few nimble bounds.

Chapter Eighteen

Restless after too much dinner and not quite enough brandy, Thomas stared up at the dark ceiling of his room. He had written a lengthy letter to his father, then torn it to pieces, impatient with the letter's tone of self-pity and its casual criticism of John Haines' evening habits. After all, hadn't he imbibed nearly as much as the older man? Hadn't he let the warm buzz of liquor silence the demons in his joints, just as Dr. John Haines might find relief from the ravages of old age?

Thomas heard the clock strike midnight, and then the quarter hour, and eventually, half past. The night noises continued, including one dog whose bark reminded him of a metronome, a steady, deep four-quarter time of relentless impatience. He counted the beats—whoa, whoa, whoa, pause whoa, whoa, whoa, pause, on and on without hesitation.

The barking was nearby, and Thomas guessed that the gimpy Prince was standing in the middle of Lincoln Street, not far from the front steps of 101.

Somewhere in the house, he heard movement and muttering, and then the clock struck 12:45 a.m. Thumping steps, this time with no effort to keep them quiet, were followed by another door closed none too stealthily. Now Thomas heard urgent voices that must have originated from the front of the house.

The walls of the house blocked the conversation, and Thomas found himself straining to hear. The dog continued its cadence, but the voices fell silent.

In a moment, his door opened so quietly that he wasn't sure whether it was a breeze or a person.

“Thomas?” Alvina's voice was husky.

“I'm awake.” He felt her hand on his right arm and could smell her fragrance.

“Can you get up? Charlie's hurt. Here, I'm turning on the lamps.” The flash of a match was jarring, and as the light flooded the room, he saw that she wore only a flannel nightgown, her hair in disarray down below her shoulders.

Feeling the strength of her hands on his arm, in a moment he was upright. She threw the robe over his shoulders and pushed the chair closer.

“What happened?” he asked. “You said it was Charlie? The boy from across the street?”

“Yes, and I don't know what happened,” she said. “I think he may have been stabbed.”

“Is he conscious?” His chair was already in motion.

“I think so.” Alvi pushed him down the hallway, then turned abruptly through the parlor toward the front door.

“Did you wake your father?”

“That's not possible. You can tell me what to do.”

“My medical bag,” he said. “I don't have that. You said that the nurse—”

“I don't think that's going to do you much good,” and she didn't explain why. They rounded the corner to the foyer. Horace was kneeling on one knee, and Charlie Grimes was stretched out on his back on the carpet, his feet just inside the front door.

The young man drew up his left leg and then stretched it out, then again, a rhythmic motion as if he were trying to walk away. His left forearm was raised, hand clenched in a fist hovering in the air. He wore a scruffy homespun shirt above muddy woolen trousers. His shirt was unbuttoned and his long johns torn open. Horace held a folded towel against Charlie's white chest.

“This is impossible,” Thomas said, flustered by the awkwardness of the wheelchair. He looked frantically around the room. “Can you lift him onto the divan? I can't reach down to the floor.”

Horace reached out, took Charlie's left hand, and brought it down to press on the towel.

“I got his head.” He rose and Alvi moved quickly to take the victim's legs. Together they half-lifted, half-dragged Charlie to the couch. Horace let out a loud grunt as they lifted the boy up. Charlie's legs pumped, and his eyes were wide and staring, his mouth trying to form words.

“Does he have family?” Thomas asked and took the stethoscope from Alvi.

“I don't think so.”

“Then Horace, will you fetch Mr. Lindeman? We may need his wagon.”

“That dog's out there.”

“Oh, for God's sake, man. Just tell the dog to shut up. He won't hurt you.”

His left hand with its bandaged thumb was awkward, and it took him a moment to find a way past the bandages around his skull for the stethoscope's right earpiece. With the instrument settled, he pulled himself as close to Charlie as he could. Easing the boy's hand away, he lifted the towel and frowned. A single small wound, perhaps a centimeter long and the width of a small knife blade, punctured the left side of Charlie's pigeon chest, the slice just touching the inside margin of the nipple.

“He's been stabbed,” Thomas said. A quick survey showed no other blood, no other injuries. Eyes closed, Thomas roamed the bell of the stethoscope across Charlie's chest. The heartbeat was irregular and feeble, almost panicky, an odd muffled sound as if someone had wrapped the heart tight in a piece of flannel.

“Charlie, can you hear me?” Thomas said, and saw no answering flicker from the patient. “Alvi, help me roll him a bit. Onto his right side.”

That accomplished, he listened with the stethoscope down the boy's side and across the back.

“All right,” he said. Taking the instrument out of his ears, he glanced up at Alvi. “What do we have that's sterile? I need to follow the wound track to see if the blade actually damaged the heart. If not, we may be able to aspirate some of the pericardial blood for some relief. Otherwise…” He held up his hand with thumb and forefinger spread far apart. “A slender Nélaton probe, if John has one here. Otherwise, a blunt, slender probe of any kind.”

“It will be a few minutes,” Alvi said. “We have only the one small gas sterilizer here.”

“Then do it,” Thomas said. “Then we can see about transporting the boy to the operating theater at the clinic.”

The young woman hesitated, and Thomas turned to look full at her. “Well? I need that probe, Alvi. And sterilize a Robert's pericardial trocar at the same time.”

“I'll see to it.”

Thomas turned back to his patient. The wound bled scarcely at all, just a little, nasty slit in the pale skin. A quick survey showed no other obvious injuries. The boy's hair was filthy, but no blood was crusted, no goose eggs betraying a blow to the skull. The knife wound, as insignificant as it might first appear, had been enough.

Bruising around the edges of the wound showed where the handle of the knife had impacted the flesh, the bruise of the blunt trauma marking the outline clearly. The weapon had been small, with the sort of handle one would expect to see on a folding Barlow or similar efficient pocketknife—not the large guard found on a hunting knife. One side of the wound was sharply cut by the edge of the blade, the opposite side blunt…the typical wound from a single-edged weapon with a slender blade, driven in hard to the hilt.

“Charlie, look at me.”

“Thomas used his right thumb to lift first one eyelid and then the other. The boy's eyes were glassy and unresponsive. His legs stopped walking. With the stethoscope once more in place, Thomas strained to hear the faint pulse. If the pericardium had been cut, or a nearby vessel, the blood would fill the sack around the heart, suffocating it to a standstill. If the heart itself was cut, then everything depended on the nature of the wound to the cardiac muscle.

Like any muscle, the heart could heal from minimal injury, given time. A wound that actually punctured any of the heart's chambers would be invariably fatal in all but the rarest of circumstances.

Thomas sat back, resting his hip. It was so easy to slice open the thoracic cavity of a cadaver, resecting the ribs out of the way with a careless crunch of the shears, opening the way to examine the organs that lay underneath.

“How did this happen?” he murmured, but Charlie Grimes had settled into a coma, his heart fluttering in protest as the flood closed around it, his breath coming in shallow jerks, his chest shivering rather than rising and falling in regular breaths.

Footsteps thumped on the front porch, and Horace James appeared. “He's on his way,” he announced.

Even as he said that, Alvi reappeared.

“We need one of the clinic's ambulances,” Thomas said to Horace. “Can you arrange that?”

“An ambulance?” the handyman said, puzzled.

“It'll be faster to use one of Lindeman's buckboards with a hair mattress in the back,” Alvi interrupted. “The probe and aspirator will be ready in five minutes. It's not a Roberts, but I think it will work.”

Thomas thumped his fist on the arm of his chair in frustration, and as if in response, Charlie's eyes snapped open and he rose partially on his elbows, mouth open wide. Easing him back down, Thomas once more adjusted the stethoscope. The rattle of the lad's breath was loud, and for a moment his heart sped up, strong but irregular, to 160 beats a minute, then faster, impossibly fast. It stopped, missing ten or fifteen beats, then surged again for as many, then stopped. This time, it did not kick again. Charlie managed one more choppy breath and then his body sank into the divan.

“Any wagon will do,” Thomas heard himself say. He continued to listen, astonished, as his first patient in Port McKinney expired under his touch.

“He gone?” Horace asked.

“Yes, he's gone.” They heard footsteps on the porch, and Lars Lindeman limped to the door, opening it slowly as if he might disturb them.

“My God,” he said, “what happened?”

“Charlie was stabbed,” Alvi said. Her face was a mix of emotions.

Lindeman advanced to the divan. He looked down at the boy. “Stabbed, you say?” The Mercantile owner's face was pale, and he held his hand over his mouth as if trying to catch a burst of words that he regretted. “Where'd you find him?”

“Right smack on the front step,” Horace replied. “I got up to see what that damn dog of yours was yammerin' about, and there Charlie was. He was sittin' on the top step.”

“Well, I don't know…” Lindeman started to say. “Christ, this is…” and his voice trailed off.

“What is it?” They turned to see John Haines, hair disheveled, dark velvet gown bunched around his ample paunch.

“Charlie Grimes has been killed,” Alvi said. “He died before we could do anything to help him.”

Haines shuffled across the room, adjusting his glasses as he did so. At one point he appeared to lose his balance, and took a short step sideways to steady himself.

Thomas removed the cloth, and Haines glanced at the wound, cocking his head sideways and holding his glasses for a better view. He shook his head and straightened up. “Damn shame,” he muttered and turned to his daughter. “Did you send someone to fetch Eastman?”

“Not yet.”

“That needs to be done before the body is taken to Winchell's. Horace, will you see to that, please?”

“I want to do a postmortem,” Thomas said quickly as Horace left the room. “If the remains can be removed to the clinic…”

“Good God, man,” Haines said testily. “Whatever for? A single knife thrust to the heart. That's fairly obvious, I should think. And autopsies are Winchell's province, not ours. He's the county coroner.”

“Then I need to speak with him about that,” Thomas said. He looked at the small pan where the instruments waited. “If we could have treated him sooner—”

“Sooner would have made no difference,” Haines said. “You could have been standing beside Mr. Grimes at the moment he was wounded, and there would be nothing you could do.” He sighed. “But suit yourself.” He regarded Thomas critically. “Don't misunderstand me. We have no problem removing the body to the clinic, Thomas—if that's what Winchell wants to do. It's you that is at issue.”

“Me?”

“You're hardly ready to stroll about town.”

“But the boardwalk is nearly finished,” Thomas persisted. “And if not that, then a wagon.”

“I see.” The corners of Haines' eyes crinkled a bit. He watched as Alvi spread a blanket over Charlie Grimes' corpse.

“With your permission, I'll be happy to remain at the clinic until I'm fully ambulatory.”

“Oh, come, come,” Haines said with a dismissive wave of his hand. “Hardly that. Besides, I don't think we want to miss your company at the dinner table, or during our evening sessions in the library.” He took a deep breath and removed his glasses, holding them up to the nearest gaslight. “We'll see what can be done. Now, tell me how this all happened.”

“We don't know,” Thomas said. “Horace found the boy on our front steps. The dog's barking awoke us.”

“I never heard him. You're telling me that young Mr. Grimes was not brought here by companions, or the like? He stumbled here unassisted?”

“We don't know,” Alvi offered.

“He could have been…well, hell. He could have been anywheres in town,” Lindeman said. “Got himself a taste for the bottle, I'm afraid. Always was a scrapper. Him stammerin' didn't help none. My guess is that he got himself in a scrap downtown, maybe. Someone stuck him there, or followed him back up the hill, maybe. I didn't hear him one way or another. Didn't hear nobody cry out. Didn't hear no argument.”

“Well, Eastman can sort it all out,” Haines said. “Damn unfortunate is what it is.” He turned and peered at the large grandfather clock. “What time is it? My God, just after one.”

Alvi touched her father's arm. “Go back to bed, Father. I'll talk with Butch when he rouses himself.”

Haines nodded and shuffled closer to the divan. He reached down and pulled the blanket back to clear Charlie's face, standing silently with the linen in hand. “Such a waste,” he said. “What was he, all of seventeen or eighteen?”

“Would have been eighteen come Thanksgiving,” Lindeman said.

“You don't say?” He flipped the linen back and turned to Thomas. “You be careful, young man. You're not ready for any of this.” To Alvi, he added, “See that he behaves himself, Alvina.”