The Low Road (20 page)

He crouched closer until his face was only an inch or two from Lee's body, which emanated only the barest warmth. He considered the smattering of hair over Lee's chest, the visible outline of the pectoralis major. There was an older scar on the right side of Lee's waist, the opposite side to where he'd been shot. The body has its own dreaming of course, if only one knows how to read the marks and curves. It is possessed, like any geography, of entire histories, each bump and scar the result of some childhood accident or perhaps other, more sinister misadventures. The time during the holidays he fell from a tree in the neighbour's garden. The day he was hit by a car. Dog bite and knife fight.

Although the area immediately around Lee's bullet wound was inflamed, there didn't seem to be any sign of infection. The entry wound was small, its edges already rimmed by scabbing despite the dark blood seeping from it. Perhaps the bullet was not so deep, after all? Wild ran his hands across Lee's abdomen, searching for any sense of ballooning, for signs of internal bleeding. His fingers traced an arc above Lee's ninth and tenth ribs, feeling for any clue as to the bullet's exact location. Of course it might be anywhere, its trajectory having been altered from contact with muscle or bone. He thought of the abdomen, the body's largest cavity, glistening with viscera: liver, intestines, bladder, stomach, colon.

Lee showed little awareness of what was happening. Wild had arranged all the candles he could find around the lounge room and hung a kerosene lamp from the unpowered chandelier directly overhead. Lee's pale body stretched away in the uncertain light like a small, damp island. Never before had he been so afraid of another person. He was taut with fear, as if something were muscling for release against his drum of skin.

The air thickened with smoke from the candles and lamp. Wild dabbed at the wound again, holding the cotton wool like a knuckle of bread. He hadn't laid a hand on a patient since that terrible night, had barely even touched another human being. Physical contact was always the first thing to go. The world shrank from those it deemed unsuitable; even his wife avoided his touch afterwards. Not that he would have wanted to continue his medical duties, even if permitted. Two years in exile from a portion of himself. He wiped his hands dry on his shirt and wondered how on earth to begin.

Although Wild had never treated a bullet wound, he remembered some of the terminology. Yaw and tumble, velocity and pressure. A bullet doesn't enter a person's body smoothly, tip first, as people tend to think. The physics obscures the fact that it's just one thing thunking blindly into another. The bullet shatters and crumples. Damage to tissue is often caused less by the bullet itself than the shock waves it sends through the body, often creating a cavity ahead of where the bullet stops. Almost as if the body accommodates the object's anticipated trajectory and manufactures its very own injury. Then there are the problems of infection and blood loss. The point of impact is only the beginning.

Again Wild stared at Lee's face. He always suspected that the screen erected between the surgeon and patient before an operation was not for the patient's benefit but to partition the surgeon from the reality of slicing into another human being, who is objectified, whose skin is made yellow through antiseptic, whose signs of life are reduced to bleeps and numerical codes. In this way, medicine is the same as art; it's all about distance. Perhaps, he thought suddenly, that is part of what went wrong on that night. Good surgeons will never address a patient by their first name. An incision is made through a piece of some stranger's body. A girl with bucked teeth. Some middle-aged man with a wife.
Good morning, Mr. Jones. Please, call me Alfred. Well, Mr. Jones, the problem seems to be in the left . . .

Wild prepared an injection of morphine and administered some to Lee. It was a risk, considering the boy's condition, but some sort of pain relief was necessary. Then he allowed himself the same. The drug moved through him like a dark and cumbersome tide, smoothing his edges, making him fluid and mathematical. He digested the sensation for a few minutes, inhaled deeply and rolled up both shirtsleeves. He placed two fingers against Lee's cool neck to gauge a pulse, but his watch seemed to have stopped sometime in the past day or so. Probably knocked it against something on that damn train. He suspected that the trouble caused by a bullet wound was mainly below the surface. If the bullet was lodged anywhere but in the half-inch or so of muscle and fat below the skin, then it would have to wait. At least there didn't seem to be any sort of rattle in the boy's breathing to indicate a perforated lung.

The house was utterly silent, as if moored to the bottom of the sea. It was unsettling. He worked his trembling hands into a pair of gloves and wondered about leaving the boy there and fleeing, but the idea was a mere cul-de-sac. After all, where would he go after that?

In desperation, Wild thought back to his studies. Back to the basics. Always let the patient know exactly what's going on. Take them through it. Talk to them, include them in the proceedings. The best doctors have relaxing voices. He thought of Sherman's refined whisper. He hummed anxiously for a minute, then cleared his throat and began to speak out loud, falteringly at first, just a mumble really, but with a rising momentum like a song discovering itself in the singing. As he did so, he began to work.

Well then, he said. What are we going to do with you? What we'll do is get this thing out of your body. A bullet. A bullet. We'll just . . . We'll see what we can do. With a bit of luck, it's more or less still in one piece because I don't think we can go digging around in there looking for bits and pieces. We'll be OK. We'll be alright.

I was a good doctor in my day, believe it or not. Before everything fell to pieces. Seems like a lifetime ago, now. Several lifetimes, actually. Incredible how quickly things can happen. Woman once came into my surgery with a two-inch nail jammed under her bloody
eye
. Walked in off the street into the waiting room like something from a horror movie. Incredible. Don't know how it happened, she was very cagey about it, but we managed to remove the thing. Eased it out from beneath the eyeball, patched her up and sent her on her way. She was drunk as a skunk, of course. Probably went on back to the pub or something. Drunks are lucky like that. Stupid, but lucky. Probably have their own damn saint. Irish, no doubt. Nobody celebrates their inadequacies like the Irish. Maybe I should have been a drunk. Nobody likes junkies. Not even junkies like other junkies.

He paused with the scalpel above Lee's body. It was straightforward. He would slice, the skin would peel back slightly at the edges, there would be blood. A bead of sweat trickled down his nose.
He would slice, the skin would peel back slightly at the edges, there would be blood.
Above him the kerosene lamp growled its throaty, monotone growl. He bent over, close enough to detect the smell of dried mud on Lee's neck, the uric waft of his own fear.

People sometimes forget that the patient is always the one in charge, he continued in what he hoped was a soothing tone. Directing the traffic, as it were. Everything revolves around the patient. Without him, we are nothing.
Respect the patient
, Sherman used to say.
Listen to what they have to tell you. Watch them and learn.
Fantastic man. Great doctor. The best. Of course the things people say are not always the heart of the matter. Good doctors know how to read the signs, to see beyond what people say, to read their body language and so on. Sherman could run his hands over someone's skin and detect cancers and blockages and organs not working properly; like reading Braille.

Wild lowered the scalpel to Lee's flesh and moved it horizontally at the point where the imaginary transpyloric and lateral sternal planes met. He was careful not to go too deeply. Nestled somewhere beneath was the colon and, a little further north, the gall bladder. It was possible Lee's liver had been damaged, but there was nothing he could do about that here. He made a small incision, no more than an inch across.

Lee stiffened and groaned softly, little more than a sigh. He licked his lips, but his eyes remained closed and he made no other outward signs of discomfort, although he must have been in extreme pain. Fresh blood spurted from the incision, paused on the swollen lip of flesh and slunk over the ribs and coagulated on the table.

Still clutching the scalpel in his right hand, Wild stepped back. I'm not up to it, he thought. I can't do this. Apart from anything else, I'm not
allowed
to do this. He needed to mop up the blood. He needed to make another incision at a right angle to the first. He needed to find the bullet and remove it and then he had to stitch Lee up again. Damn. He looked around. The archaic domesticity of this house was suddenly rather pathetic: its faded rugs and dried flowers, the footstool beside the couch like an obedient dog. Damn.

Despite his anxiety—or perhaps because of it—he felt exhausted. What he wanted, what he really wanted, was to lie down, sink into the deep couch, curl up and sleep. When she was about two-and-a-half, his daughter, Alice, was convinced she could vanish if she herself couldn't see. They played hide-and-seek in the garden and when it was her turn to hide she would just stand there with her hands over her eyes, grinning like a mad person at the apparent genius of it. Her straight, dark hair and tiny fingernails. Then the pantomime of searching the bushes and undersides of the house followed by the extravagant surprise at finding her on the lawn in full view. She would be fifteen now, beyond the grip of innocence, although in many ways finally hidden from him, her father. After all these long years, it was he who'd vanished down the rabbit hole.

By now Wild's entire body was shaking, as if possessed by fever. Breath fluttered in his throat. He was aware of time passing, could sense its trembling movement. He'd spent two years outlawed from the possibility of being responsible for another's life—and now this? Unconsciously he raised a hand to his mouth to chew a thumbnail, only to realise what he was doing and stop himself.

Lee groaned and clutched at his left side. The pool of blood on the table swelled until it outgrew its thick meniscus and trickled onto the wooden floor. Another groan. What if he died? What if the boy died? What then? And he
was
dying, that much seemed obvious. Right in front of him. Dying right in front of him. Again.

What should I do?
And Frank's round, unshaven face staring, disbelieving, staring at him.
What? You're the doctor.
Thinking that Frank probably should shave twice a day—maybe he usually does but missed today because of the fuss of the pregnancy and so on—and realising even at the time that it was an idiotic thought. And that silence and the feel of it in his hands, as good as dead, everyone waiting. The silence peculiar to tragedy. Everyone waiting.

Tears assembled in Wild's eyes. One thing at a time, he thought. One thing at a time. He stepped forward to test Lee's pulse again. Faint. The skin was still cool, but there didn't seem to be any immediate sign of arrhythmia. Ideally, Lee's knees should be bent but there was no means to keep him balanced in that position and it would make access even more difficult. He wished there were someone else present, just so he could ask:
What do you think we should do?
He wanted no more than that, only the companionship of a question.

But there was nobody. He inhaled deeply then mopped up the blood and drew the skin apart. Meditatively, he ran his hands over Lee's skin again, feeling for clues, for signs of swelling or rupture, all sense and feeling crammed into the tips of his fingers. Through his very hands, he breathed.

Let me tell you about the ribs, he murmured. There are usually twelve on either side but not necessarily. Sometimes more or fewer depending on the development of—what's it called?—a lumbar rib, I think. Something like that. The middle ones are of a certain shape and have particular characteristics—thin and flat with a groove for nerves and vessels—but the first two and the last three are different again. I suspect that your ninth or tenth ribs are broken, which may well have saved your life.

A long pause before he spoke again. Doctor Sherman was not too badly equipped, he said at last. Luckily for us. These forceps are perfect. Hold on, son. Hold on. Skin is amazing stuff. The stretch and the ability to repair itself. Strong and stretchy. Waterproof. Think of a pregnant woman. That stomach. Jane was huge when she was pregnant with Alice. Incredible. Big as a house she was, almost as wide as she was tall. I know a lot about the body. How it works and what goes where, but the idea of pregnancy still amazes me. That you can carry something alive within your own body, a version of yourself. And afterwards, it's almost as if nothing has happened. The day after Alice was born it was as if she had been with us all along, which maybe she had in some obscure way. The child you have is always the only one you ever could have had.

Wild stopped talking and looked up, realising this was an idiotic conversation. Tell that to Frank and Louise, he thought. People only believe in fate when the outcome is positive. It's in the face of disaster that we entertain other, multiple possibilities, when we imagine better alternatives.
What is
and
what might have been
stare longingly at each other but will never converse.

People look in all sorts of places for their proofs of God, he continued. But it's right here. You're walking around in it. All you need, under your nose. A vessel of wonders, sloshing about inside, perfectly arranged. Think of . . . well, think of just about anything to do with our bodies and you'll be amazed. In fact at this very moment certain cells are running around your blood looking for antigens so they can present them to the T-cells because they can't recognise them unless this happens and then the T-cell can get to work to repel the foreign body. So much work even in breathing. So much for the body to do to convert everything to useful stuff. No wonder we get so tired. No wonder our bodies wear down. Just to fight infection, which your body will be doing right now, as we speak. At the ends of science is God.