Rook: Snowman (8 page)

“Necrotized? You mean his hands are actually
dead
?”

The other paramedic was calling into West Grove Memorial Hospital, telling them what to expect. “Severe frostbite. Yes, you heard that right.
Frostbite
.” When he was finished he nodded toward Clarence and the other students. Clarence had already sawn through the handrail, and now he was coupling up the hose.

“This your idea?” he asked Jim. “Good thinking. You don’t want to warm his hands up too quick.”

Ray was shuddering and bleating and his eyes had rolled right back up into his head, so that only the whites were showing. The woman gave him a shot of ketamine to deaden the pain. Then she said to Jim, in a matter-of-fact tone, “I used to work in Chicago. I’ve seen this kind of thing before, people getting frozen to their car-door handles or their front doorknobs. I was walking on Michigan Avenue once and I went blind because my eyeballs had frozen. If somebody hadn’t pulled me into a shop doorway I could have lost my sight.”

“So what are you telling me?”

“I’m telling you that if the hot-water trick doesn’t get him free, we’re going to have to cut him free. The frostbite is spreading to his wrists already, look. I don’t know how this could happen, but we have to act fast.”

“Jesus. But his
hands
—”

“I’m sorry. We don’t have any alternatives.”

Jim shouted, “Clarence! Is that hot water running yet?”

“Yes, sir, Mr Rook! It’s flowing right now, maximum full top blast.”

The woman paramedic examined Ray’s eyes, and took his pulse and his blood pressure and his respiratory rate.

“His body temperature’s way below normal. His blood pressure’s dropping and he’s going into shock.”

“Look,” said Jim. The blueish whiteness had spread up Ray’s wrists to his forearms now, and his hands were black, as if he were wearing gloves.

“Where’s the goddamned fire department?” asked the Hispanic paramedic, impatiently.

“Can’t you just saw this section of the handrail off?” Nestor suggested. “Just this section that he’s holding on to.”

The woman shook her head. “At this kind of temperature, the hacksaw will probably freeze to the rail. But we could try it.”

“Clarence!” called Jim. “Fetch that saw up here, will you?”

But at that moment, with a loud rubbery bang, the hose connector burst away from the handrail, and the hose lashed from side to side like a cornered snake, spurting scalding-hot water in all directions. Several students were caught by the spray, and there were screams of pain and hysteria.

“Pipe’s busted free, Mr Rook!” shouted Clarence. “It’s all blocked up inside of that handrail, blocked up with solid ice. Going to take something more than hot water to clear that out! Look!”

Jim looked down, and saw thick, brownish slush dripping from the severed handrail, the consistency of marrowbone. The cold inside the handrail was so intense that the hot water from the hose had started to freeze, almost as soon as Clarence had connected it up.

Ray suddenly sagged. The woman paramedic said, “Keep him upright! I don’t want him to tear his hands off!” Jim shifted around so that he could hold him under his arms
and heft him up higher. The woman paramedic said, “He’s gone into arrest!” and the man opened up his first-aid box and picked out a hypodermic. With complete calmness, he filled it with adrenalin and passed it over to the woman. She lifted Ray’s sweatshirt and jabbed the needle directly between his skinny ribs, into his heart. He convulsed, and threw his head back, but his pulse started again, and he let out a thick, cackling breath, and then another.

The woman paramedic checked his arms. The dead whiteness had reached almost up to his elbows, and the grayish black tinge of death was relentlessly following it, like Indian ink staining a blotter. She said, “I’m sorry about this. I don’t have any choice. The speed this frostbite is spreading, we have to get him free right now, right this minute.”

The other paramedic turned to Jim. His face was smooth and his eyes were as placid as stones. “You have to look at it this way, sir. If his hands were trapped in a fire, you’d have to make the same decision. I can’t imagine how this handrail got so cold, but we have to release this boy or else we’ll be going to his funeral.”

Jim nodded. “Okay. Go ahead. Just don’t let him suffer too much.”

“He won’t suffer, sir. The ketamine’s kicked in. And Rachel’s the best there is.”

The woman paramedic said, “Find me a table. Quick as you can. Something to rest his elbows on. How about you, sir? Do you think you can manage to keep on holding him up?”

Jim said, “Sure. Washington – can you help me?”

“No problem,” said Washington, and bent down so that Jim could seat Ray on top of his back.

Nestor came out, dragging a small wooden table behind him. The Hispanic paramedic took it, and slid it under Ray’s elbows to support them. At the same time, the woman
paramedic was collecting out of her bag everything that she would need for an amputation. Jim saw the sun glint on her saw, and he had to turn away. He found himself looking at a grinning skull badge sewn onto the sleeve of Ray’s sweatshirt. God, he thought. How appropriate.

Deftly, the woman paramedic laid out all of her instruments – saw, scalpels and needles, as well as swabs and pads. As she was doing so, the first firetruck arrived, honking and wailing, and a crew of firefighters came waddling across the lawn, carrying axes and breathing equipment. But by now there was nothing they could do. The Hispanic paramedic had already strapped a transparent plastic mask over over Ray’s face, to give him oxygen and anesthetic, and the woman was tightening tourniquets round each of Ray’s arms, just above the elbow.

“Do you have to amputate them so high up?” asked Jim. “At least if he had his elbows—”

The woman paramedic said, “He’s deep-frozen right up to the middle of his forearm. Unless we amputate right up here, there’s a strong chance that we’ll leave some necrotic flesh, which will mean that he’s very susceptible to later infection. Gangrene, which could kill him.”

She looked at Jim sharply. She had green eyes and ginger freckles across her nose and there was a determination about her which Jim found both daunting and reassuring. If she had the courage to cut off Ray’s arms above the elbows, to save him from dying, then he guessed that he had the courage to help her.

“All of this external tissue is dead,” she said, prodding the black scabby skin that covered Ray’s fingers and forearms. “In most cases of frostbite, the dead tissue is not much more than a shell, and when it peels off, which it eventually will, you’ll have nothing but pink babyskin. Excruciatingly sensitive, of course. But at least it grows back.”

“But this skin isn’t going to grow back?”

“Not in my opinion, no. What’s spreading in his body here is total frostbite. All of the muscles, bone and tendon are frozen solid. Here, look.”

She picked up a scalpel and cut a deep slit in Ray’s wrist. She opened it wide with her fingers, and even Jim’s inexperienced eye could see that his flesh was white and solid, like deep-frozen pork, and that his veins were filled with crystals of crunchy maroon blood.

“At the rate this frosbite is developing, it’s going to reach his shoulders in fifteen minutes.”

The West Hollywood fire chief came up – a short, bristly man with a walrus moustache.

“Hi, Rachel.
Cómo le va
?”

“
Muy bien, gracias. Y usted
?”

“
Muy bien
. What the hell’s happening here?”

“Major surgery, I’m afraid. Can you just ask your people to clear all of the students out of here? This is going to be something that they won’t want to see.”

“You want us to cut that handrail free? We’re carrying hydraulic cutters. Won’t take us a minute.”

“Sorry, chief. It won’t make any difference. And every second counts.”

Jim was fascinated by the way in which she could talk and work at the same time. She picked up her scalpel and started to cut into Ray’s left arm, just above the elbow. The tourniquet was so tight, and his arm was so frozen, that he hardly bled at all – just one big red droplet which rolled down on to his elbow and dropped onto the table underneath.

“
Madre mia
,” said the fire chief. “I think I’ve seen it all now.”

“Please,” Rachel asked him; and it was almost a command. “Please tell all of the students to go back to whatever
it was that they were doing before. We don’t need a crowd of hysterical spectators, not now.”

The fire chief saluted. “Yessir ma’am,” and went back down the steps.

Rachel continued to cut into Ray’s arm. Dennis turned his head away, but Jim watched in horrified fascination, even though he couldn’t stand the soft, slicing sound of it. Rachel dissected a large square of skin and fibrous tissue from the underlying muscles. The flesh was scarlet, like raw chuck steak. She picked up her shining saw and started to cut through Ray’s humerus bone, just above the place where it flared out to meet the elbow. Jim closed his eyes but he could still hear the sharp,
kvetch-kvetch-kvetch
of the sawblade, cutting through human bone. When he opened them again, he saw that Ray’s arm was completely detached, leaving his frozen left hand still gripping the handrail.

He swallowed hard, but his mouth filled up with bile and half-digested Chex. Almost all of the students had been cleared away by the firefighters, but he saw a figure underneath the shadow of the large cypress tree in back of the main college building. He strained his eyes, and he could see that it was Jack Hubbard, in his black jeans and black shirt, his eyes invisible behind his sunglasses, watching. A firefighter called out to him to leave the area, but he ignored him and remained where he was.

But Jim didn’t have time to worry about Jack Hubbard. His back was aching from holding up Ray’s unconscious weight, while Rachel was bent over in concentration, doing some incredibly fiddly needlework.

Ray shivered, but Jim knew that he was deeply unconscious. Washington shook his head and said, “Oh, man. I don’t know whether I can take this. Oh, man.”

“Please, Washington. Hold on a little longer.”

“I’m trying to, man. But, man.”

Rachel said, “In the old days, when they didn’t have anesthetic, they used to use the circular method for amputation. You cut off the skin, muscles and bone at successively higher levels, so that the skin met afterwards over the other tissues. It was quick, that was the best thing about it, but it didn’t always give you a satisfactory stump. The method I’m using here takes a little longer, but it gives you a much better stump.”

“A much better stump? Oh, sure.” Jim began to feel faint, and to see tiny prickles of light in front of his eyes. “The flap method, huh?”

“That’s right. See here, I’m going to ligature all of the severed blood vessels in his arm. Then I’m going to take this flap of flesh and stitch its sides and its end.”

Rachel was so matter-of-fact that it was difficult to grasp the enormity of what she was doing. She was saving Ray’s life. But he would never be able to feel anything with his fingers any more: never be able to stroke another animal, and feel its fur. Never be able to touch a woman, and feel her softness through his fingertips.

Jim could see only bone; and gristle; and a complicated array of veins and arteries.

Rachel sewed up his left arm. She must have been good at needlecraft at school, because she managed to tug the flap back together. The surgical thread made a soft rasping sound as she pulled it through his skin.

When she came to amputate Ray’s right arm, Rachel found that the frostbite had already advanced beyond his elbow. His forearm was black and crusty, his upper arm was already white, and she had to cut his arm off just below the shoulder. Again, that slicing sound. Again that rasping saw. Then, over an hour since Nestor had first come running up the corridor to tell Jim what had happened, Ray was laid on to a gurney, his two stumps sticking up like the
handles of a wheelbarrow, and carried, tilting, down to the ambulance.

Stretchers are laid out, the mangled lifted

And stowed into the little hospital
.

Then the bell, breaking the hush, tolls once
,

And the ambulance with its terrible cargo

Rocking, slightly rocking, moves away
,

As the doors, as an afterthought, are closed
.

Jim leaned back against the brick wall, feeling as if he had been in a fight, every muscle aching. Washington eased himself up and stretched his back and said, “Man … I don’t believe it. I just don’t believe it. Nestor stood with his hands covering his face, as if he could only bear to look at the world through the cracks in his fingers. Ray’s amputated arms, along with Clarence’s glove, remained where they were, frozen, all clutching the handrail.

The fire chief came up and looked at them uneasily, uncertain what to do. But it was already becoming obvious that the frost was melting. The ice crystals on the handrail faded away – and with an abruptness that startled them all, Clarence’s red industrial glove dropped on to the concrete. In less than a minute, Ray’s left arm dropped off, too, followed by his right.

Jim said to Dennis and Washington, “It’s okay now. Why don’t you two take the rest of the day off? I think you’ve both done more than enough, and thank you.”

Washington swallowed and nodded. “I just want to know how this could have happened. And
why
, man? Ray was the harmlessest guy in the world.”

Jim gave him a slap on the back. “Being harmless never guarantees that you won’t be harmed. Sometimes the opposite. Now, go on. We’ll talk this out later.”

As Dennis and Washington went down the steps, Lieutenant Harris came stamping up them, closely followed by Dr Sigmund Fade, from the coroner’s department. Lieutenant Harris was short and stocky, with scrubby ginger hair. He wore a white short-sleeved shirt that was almost transparent with sweat. Dr Fade was tall and pale, with a large complicated nose and hands that fluttered weakly around in the air like butterflies.