The Moon by Night (2 page)

“Very well,” Cheney agreed with secret amusement. “Then quickly go tell James and John to hitch up the ambulance. And check the ambulance box to make sure it's fully stocked.”

Dr. White turned and ran out as Cheney headed toward the long rows of the supply shelves with her medical bag. Cheney hurried up and down the long dim rows of the shelving, stopping here, holding up the lamp to squint at a label, whirling and running to another shelf, searching frantically for the supplies she needed.
This storage area is still so disorganized. There are so many things without labels, no diagrams of the layout…and here's the Lady With the Lamp running up and down. Only I'm more like the proverbial bull in the china shop than like Florence Nightingale
.

Finally she finished and ran outside. She met Dr. White running back from the livery. Breathlessly the intern told Cheney, “There's nothing in the ambulance box except for a few rolls of surgical lint.”

“What!” Cheney said sharply. “I thought I had made it clear that—oh, never mind. Do you have a medical bag?”

“Yes, ma'am, in the physicians' sitting room.”

“Then come on. Let's get it and grab a few more supplies. Are both James and John still at the livery?” Roe's Livery serviced the hospital and was handily located right on the south side of the block. James and John Roe, two young brothers, often drove the ambulance when the male attendants couldn't leave the hospital.

“Yes, ma'am, and they've already almost got the ambulance hitched up.”

“Then let's run.”

Within three minutes they were in the ambulance, rounding the corner out of the drive on two wheels, both brass bells clanging loud enough to alert people on the streets for miles around. Inside the box of the ambulance Cheney and Dr. White gritted their teeth. The echoes of the harsh clangor inside were almost unbearable.

It was fifteen blocks down to Tenth Street. The numerous carriages, riders, hansom cabs, hackney coaches, carts, and pedestrians that filled the street somehow managed to clear out in front of the speeding ambulance wagon.

It seemed an age to Cheney, but actually they covered the perilous blocks in only twenty minutes. Before the heavy wagon had come to a stop, Cheney threw open the doors and jumped out, with Dr. White close behind her.

Officer Sylvester Goodin met Cheney. He was a tall, thin man, stoop-shouldered, normally with a pleasant homely face that reminded Cheney a little of Abraham Lincoln. Now he seemed more like a gargoyle with the garish lamplight making his face look cratered and grim and his shoulders hunched against the freezing cold.

Behind him Cheney saw a phaeton turned on its side in the middle of the street, its frame a bunch of spiky rods going every which way. A still form with a long mantle thrown over it was sitting half upright against one big spoked wheel. Another policeman knelt beside a man lying in the street near the overturned carriage.

On the other side of the carriage was a coal cart pulled across the street, blocking traffic. A man leaned up against the side of the cart, his face a little pale.

Officer Goodin said, “Good, I'm glad it's you, Dr. Duvall. One dead, one man slightly injured, and one severely injured. That man back there was driving the coal cart. Maybe Dr. White—good evening, ma'am—should see to him.”

“Of course,” Dr. White said, hurrying toward the cart.

Officer Goodin took Cheney's arm and said softly, “I think you're going to want to see this man, Dr. Duvall.” As he was talking he pulled Cheney's arm gently, and she allowed herself to be led toward the man lying in the street. As they neared the prostrate victim, the other policeman rose, and Cheney saw the injured man clearly for the first time. It was an enormous struggle for Cheney to keep the shock from showing on her face.

The man had a steel spike sticking out of his chest. He looked up at her with eyes stark with horror. His face was dead white, his lips colorless. He was a fairly young man, Cheney thought, nicely dressed.

Cheney knelt by him and took his hand. It was limp and freezing. The street was muddy, and the man was covered with the icy muck. She was conscious of James Roe, the older boy, behind her. “James,” she said softly, “go get the blankets out of the wagon. All of them, please.”

She turned back to the man. “I am Dr. Cheney Duvall. What is your name, sir?”

He didn't speak, just looked up at her with stricken eyes.

“I'm going to check your injury first,” she told him calmly. He was wearing a quilted vest, and quickly Cheney cut both it and his white shirt underneath. The shirt was not showing a very large bloodstain.
Good, the spike has effected a tamponotic staunch
.

She took two two-inch rolls of gauze from her medical bag. “I'm going to secure your injury, sir,” she said with deliberate vagueness but with assurance. She placed the fat rolls of gauze on either side of the spike, watching him. He didn't flinch. She knew that with some types of shock the patient did not feel pain, and this man seemed to be oblivious to it. Gently she packed the linen close and received no reaction from him.

“I'm going to make sure that you're secure and stable so that we can take you to the hospital,” she continued as she took his pulse and respiration. His pulse was thready but regular at fifty-eight beats per minute, which was slow. His respirations were shallow, like small sighs. Cheney knew that he was in shock and there was very little she could do about it. She also knew that when a patient was not bleeding profusely and his pulse was slowing instead of fast and erratic, often the phenomenon was a temporary reaction rather than a slow decline into unconsciousness and death. Another encouraging factor was that he was still alive nearly thirty minutes after the accident. There was a good chance, with emergency surgery, that he would live.

“Sir, please listen carefully to me,” she said, suddenly speaking out authoritatively and loudly. His gaze, which had been growing steadily blanker, honed in on her face again. “I am going to stabilize you and take you to the hospital. I want you to concentrate very hard on staying awake. I need you to tell me what you're feeling so that I know best how to help you. Do you understand?”

He swallowed, and his lips moved just a bit.

Cheney repeated more insistently, “Do you understand, sir?”

“Y-yes,” he whispered.

“Good. I want you to keep listening to everything I say so that you will understand what I'm doing. Also I need you to answer my questions when I ask them.”

James came dashing up with four thick wool blankets in his arms. “Take two to Dr. White,” Cheney ordered, “then go get a stretcher.”

Cheney tucked the two blankets around the injured man, carefully avoiding even the lightest touch on the steel bar. James came running back with the stretcher, a six-foot length of canvas rolled up scroll-style between two wooden rails. “Unroll it, James, so that one rail is very close to this gentleman. That's it. Now go around to his other side.”

“Sir, what is your name?” Cheney asked, getting down close to the victim's face and making him look at her.

“Melbourne,” he said faintly. “Cornelius Melbourne.”

“All right, Mr. Melbourne, this is James Roe. He is going to help me get you onto the stretcher. He is going to pull you up on your side, and I'm going to position the stretcher under you, and then James is just going to lower you down onto it. Do you understand, Mr. Melbourne? Do you hear me?”

“Yes…I…understand.”

Cheney motioned to Officer Goodin, who leaned down close to her. The patient's eyes were focused on her face, and she sensed that her calm expression was his tentative hold on life right now. She spoke in a steady voice, neither loud nor soft. “Officer, I want you to hold that spike steady as James pulls him up onto his side. Can you do that? Hold it exactly in place?”

“Yes, ma'am,” he answered calmly. He went to kneel by James.

Cheney once again leaned close over the man. “Mr. Melbourne? We're ready. Just relax and let us do the work. Understand? Don't move; don't strain; we will do it for you.”

“Don't…move,” he repeated, his gaze burning into hers.

Officer Goodin put both his long hands on either side of the spike in the man's chest. She nodded at James. He lifted, Cheney shoved the stretcher under him, and they lowered him down, all in mere seconds. Cheney looked up and saw Dr. White and John standing by, watching.

“Dr. Duvall?” Officer Goodin said, holding out his hand to her. Looking up at him, she shook her head and cut a glance at Melbourne. Officer Goodin nodded understanding, then leaned down close to where she knelt by the victim to speak to her. “Dr. White says the gentleman who drove the coal cart was just kind of shaken up, nothing broken, no cuts.”

Cheney nodded. “Good. James, go ahead and get the wagon turned around, then Officer Goodin and John can load the patient. No bells on the way back. Go as quickly as you can, but as smoothly as you can.”

“Yes, ma'am.” He ran to the wagon and hopped up on the seat. Briskly he pulled the reins and made a clicking noise. Slowly the great horses began to back up.

Officer Goodin motioned toward the body propped up against the phaeton. “I would like to take her to St. Luke's.”

“Of course. She goes in first,” Cheney ordered, and he nodded understanding.

Cheney looked back down at her patient. Melbourne stared at her, not speaking, not moving. She bent close over him again. “In just a few minutes, you and I are going to board the ambulance. It's a very short trip to the hospital. For now I would like to listen to your heart. Would that be all right, Mr. Melbourne?” She was making conversation, trying to keep him as focused and alert as she could. If he didn't give up and slip into unconsciousness, he might very well live—after a successful surgical procedure to remove the spike.

As she kept talking to the man, one part of her mind was busily demanding,
And who is going to do this surgery? You? You've never done any kind of procedure even remotely like this. Dev is on Long Island tonight, and the surgery must be done as soon as we reach the hospital…if he lives that long….

But I can't do this alone!

The insistent voice in one dark corner of her head kept on, but Cheney was startled at the thought.

I can't do this—alone?

No, I can't….

Not without Shiloh
.

“Now, Mr. Melbourne, here we go,” she said, standing up as Officer Goodin and John bent to pick up the stretcher.

The man moved for the first time. Weakly he raised his hand toward Cheney. “Help…me…please.”

She took his hand, swallowed hard, and said, “I will. I can help you, Mr. Melbourne, and I will.”

****

Shiloh Irons-Winslow took off his leather gloves, blew on his freezing fingertips, and rubbed his hands together. His horse, a big lazy quarter horse named Balaam, noisily mouthed his bridle and made a disdainful blubbery sound with his lips.

“Aw, stop your complainin',” Shiloh said. “I know it's never this cold in San Francisco. You're just gonna have to learn to live with it. And be quiet, will you? I can't hear a thing except your grumblin'.” Shiloh pulled his gloves back on, and the pair walked slowly on, Shiloh leading the horse by the reins and staying close to his steaming side.

Shiloh had acute vision, even in darkness, and now his steel blue eyes scanned right, searching the jumbled outline of old piers and piles of trash that lined the Hudson River. He was walking along West Street on this freezing November night, and the memories that came to him were as strong and tangible as the reek of rotten fish and ancient garbage that hung heavy even on this brittle air.

“It was May ‘sixty-eight,” he mused softly. Right along here somewhere, I found the Lord. The worst, and the best, night of my life.” He stopped and Balaam obediently stopped, with only one small protesting stamp of his off hind. Shiloh narrowed his eyes to scan the huge mound of hay on one of the barges that lined this stretch of the river. He had never forgotten the feral, vicious children who had robbed him that terrible night. They were called “hay barge children,” for they were either orphans or children whose homes must be dismal indeed, for they preferred to sleep on the hay barges at night and either beg or steal during the day. Often when he was going to the hospital to escort Cheney home after her late shift, he would go a few hours early and wander along the river. He would like to find the children who had robbed him on that night so long ago, especially the boy named Rock. Not for revenge—Shiloh's days of anger and bitterness were long gone—but to help them. Frequently he brought bread and cheese and fruit, hoping to see some of these blighted orphans. But he never did. He just left the food.

Shiloh thought he saw something now, a furtive movement, out of the corner of his eye. But as he searched, he saw nothing except the big mound of hay and an occasional glimmer of the water beyond. It was a black night, with low clouds and only an occasional accidental glimpse of starlight. Snowflakes were starting to fall, already hard and fast.

“Great,” Shiloh grumbled, sounding much like his horse. “Snowing again.” Balaam snorted.

Something small and dark, waving a big stick, jumped in front of the horse. “Your b-b-bunny or your l-l-ife!”

Shiloh and Balaam were both so astounded that they froze. “Huh?” Shiloh grunted in confusion. “What'd you say?”

Waving the stick menacingly, a high, shrill but oddly stuffy voice repeated, “I s-s-said, s-s-s-ir, your bunny or—” The stick waved and suddenly grew bigger and flared up and out, spooking Balaam. Throwing up his head, he whinnied in outrage and reared, hooves lashing out. The dark figure jerked, the offending stick flew, the shadow crumpled, and Balaam came crashing back down to stamp indignantly.