The System #2 (5 page)

Darla nodded, annoyed. “We know the risks, Doctor. But even you told us that he’ll die if we don’t. There’s no
decision
to make here. This boy is the reason we’re alive…if it weren’t for him, we wouldn’t be here. All of us.”

“I’m well aware that I’m here because of Ethan,” Doctor Krause replied curtly. She ran her fingers through her hair and looked at her daughter, who hadn’t moved from her spot in the corner and watched the conversation with a bizarre juxtaposition of eagerness and apathy.
 

Joey entered the den, looking bleary-eyed; he’d taken to waking up in stupor, lumbering around in a state of perpetual confusion. How he had managed to situate himself in a prime position to move goods and services around after the Release baffled Darla. In the old world, he had been a gas station attendant and used his access to gasoline to set himself up in the first few days, but beyond that, Joey’s lack of discernible gifts made him more like a houseguest who had overstayed his welcome rather than a member of their small, but functioning community.
 

The man cleared his throat. Joey was young, but not too young: baby-faced, accompanied by a smattering of wrinkles on his forehead, crows-feet around his small, beady eyes. “So, this is it, huh?” he asked. “Operation day.”

Darla nodded.
 

“Who’s going then?”

“I am,” Darla answered without hesitation. “I just need someone to stay with Teddy.”

Ethan let out an involuntary groan and the room’s attention shifted back to him. Doctor Krause nodded as if someone had asked her a question and she was answering in the affirmative; she pursed her lips and pointed a long, bony finger at Joey.

“You stay here,” the doctor commanded.

Joey nodded and gnawed on a hangnail. “Good. I mean, like, I don’t even think I could do it. You know?” He shuddered and searched with his teeth for any other scraps of skin to pull and bite.

Even when Doctor Krause first suggested amputation, Joey’s pallor shifted from bright and rosy to a pastel yellow. The jaundiced look returned whenever Joey glanced at Ethan’s injuries—the black and blue and bumpy canvas of the boy’s non-functioning legs.

“Great,” Darla said. She didn’t entirely trust Joey to watch Teddy with the same attentiveness as the other housemates, but if her choices were that or missing out on Ethan’s surgery, it was an easy decision.
 

“We’ll totally play together. A fun game. Fun board game. Or something just fun,” he trailed off as he met Darla’s gaze, her hand itching above the gun in her holster. The short, dark-haired Raider put his hands up in surrender. “Yeah, jeez. I know, Darla. I’ll take good care of him. I’ll be the best babysitter ever. I always wanted kids or nephews…I’m not saying I’m good with kids, but I can be Uncle Joey. I mean, don’t even worry about it. It takes a village, right?”

Darla raised a single eyebrow and locked her eyes, and dipped her chin. “Joey,” she started, her tone a cross between menacing and exasperated.

“Yeah?” Joey replied.

“Seriously. Shut up.”

Darla and Doctor Krause carried Ethan out of the house on a stretcher lifted from a crashed ambulance. Ainsley followed behind. They entered the secured house through the open garage. At the far end of the garage they placed the stretcher down and worked together to pick up Ethan and carry him into the house—they went through a mudroom and through a small hallway and into the bright and light living room. A long dining room table, meant to seat a large gathering at Thanksgiving dinner, was their operating table. Darla outfitted it with blankets and pillows, and all of the surgical accouterments procured from the local hospital—which was not an easy journey.
 
Joey had found their last supply in a shop nearby: a battery operated handsaw. And he looked close to vomiting as he handed it over, the realization of its use dawning on him.

After all three women worked together to get his limp body on the table, Ethan lay exposed in just a pair of blue and white checkered boxer shorts. He had been in and out of consciousness, but as they gathered around, his eyes fluttered open and he saw Darla first.

“Hey,” he said to her and attempted a smile.

“It’s time, kiddo,” Darla replied and she grabbed his hand.

“Okay. Okay,” Ethan closed his eyes again. “I can do this.”

“You’re strong,” Darla told him. “Strong and ready. You’ve got this.”

“Doc?” Ethan rolled his head to the side. “What’dya got for me? We doin’ this old-school? Whiskey and a mallet to the head?”

“Morphine and a local anesthetic. Only I can’t give you much morphine…the risk is too great without a way to monitor your vitals closely. I’m sorry, Ethan…you will feel
some
of this.”

“I’ll feel it,” he repeated.

“You will,” Doctor Krause told him as she gave him his first shot. “But I’ll do the best I can.”

“Can’t I get a spinal or something? You need electricity for that?”

Doctor Krause smiled and adjusted her glasses. “Ethan, we don’t have options. I’m not a surgeon and I’m not an anesthesiologist. I want to keep you alive…we have to do this the way I know how.” She looked at him and winced. “I’m sorry.”

“Don’t be—” Ethan closed his eyes.

Darla held his hand.

The doctor administered another round of injections into Ethan’s wounds. He didn’t even flinch as the needles entered his flesh. She picked up a block of fabric off of one of the side tables—it looked like a luggage strap and it wrapped around Ethan’s leg five inches above his knee. Doctor Krause sighed and glanced at her ragtag surgery technicians; she looked calm, but her clamped jaw and narrowed eyes gave her away: she was nervous—scared even. She had been honest about her position as a family doctor; it was a job that did not lend itself toward emergency amputations. But it was too late now. They were committed.
 

“Okay, Darla. Ainsley,” the doctor instructed and she passed around a box of surgical gloves and masks. They covered their hands and their mouths and stood waiting for further instruction.
 

Doctor Krause motioned for Ainsley and she took a step forward.

“Darla, I’ll need you to hold Ethan still as much as possible. Start near his shoulders. Ainsley…when I ask for an item, grab it quickly.” The doctor placed a hand on Ethan’s leg and pinched slightly. Then she asked for a scalpel and extended her gloved hand backward; her daughter picked up the metal instrument and placed it in her mother’s open palm.

Then Doctor Krause started an incision an inch above Ethan’s knee. The blood started to run down the sides of his legs, not a gush, but a trickle, and she mopped it up in a swift wipe with clean, cut towels. Blood matted down his leg hair and made his skin a rosy color. She ran the scalpel along that line and then dug further: past the skin and into a white layer of fat.

Ethan’s leg jerked upward and Darla moved into position, wrapping her arms around Ethan’s shoulders and hugging him tightly to the table. Ethan started to yank and groan. His face was white, his teeth chattered against each other, rattling inside his mouth.

“Shhh….shhh,” Darla repeated and with her hands secure on Ethan, she could not stop to wipe away the tears that started to roll down her cheeks. She let them run and drip, but she tried to will herself into finding every iota of strength. “It’ll be over soon. It’ll all be over soon.”

The incision went deeper.

Ethan screamed, even in his fevered state, and rolled his head from side to side. Doctor Krause looked up, unperturbed, and paused until the wailing died down before moving to the red, stringy muscle.

“Clamps,” she called and Ainsley answered by placing several within her reach. “Thread.” The doctor started to clamp Ethan’s exposed veins and sew several others shut. Still the blood seeped through the towels below his leg, turning the white into crimson.

And still Ethan screamed, calling out gibberish, guttural exclamations of pain. Sweat pooled along his brow.

“Darla,” the doctor said in a near-whisper. “If you could…there’s a bit more morphine we can use. This will be the last though or we risk overdose. Ainsley?” The young woman handed Darla a syringe as Doctor Krause continued running the blade into Ethan’s tissue and muscles and clamping the remaining, exposed pieces of his leg. Darla positioned her body against Ethan’s and then jabbed the analgesic into his upper leg. Ethan still whimpered and groaned, but his eyes closed, his head flopped to the side. His breathing became ragged and labored.

“Check him,” the doctor said and her voice was tense and terse. Her daughter rushed wordlessly past Darla and listened through her mother’s stethoscope at Ethan’s heart.

“Fine. Fast, but normal,” came the reply as Ainsley moved back into position.

The doctor reached the bone. Ethan’s skin above the knee hung limply without anything to support it. Leathery and loose, it didn’t even look like skin anymore.

“Saw,” Doctor Krause demanded and the saw was delivered. She flipped it on and the buzzing sound filled the room—Darla looked away as Doctor Krause instructed Ainsley to tug upward on the flesh to expose the bone. With ease and without flinching, Ainsley worked the fat and muscle around the bone, creating a clear path. Manhandled and cut to shreds, the inside of Ethan’s leg began to look like ground beef.

It took four attempts, but then the bone broke free. Doctor Krause tossed the amputated leg to the ground and it fell with a thunk. Then she sprang into action, removing clamps, stitching veins, and positioning the remaining pieces of Ethan’s leg around the clean-end of the bone. She took the skin flaps and, like wrapping a burrito, folded them over the muscle and fat.

She began to stitch the top and bottom skin flaps together.

In less than thirty minutes, the entire procedure was completed. Ethan’s stump was stitched crudely and wrapped with layers of gauze.

His lower leg lay abandoned on the floor.

Blood splattered their clothes and the floor, and the room smelled like sweat, blood, and fresh meat. Doctor Krause removed her rubber gloves and shook her mask free and exhaled through her mouth.

Ethan moaned and shifted, but he did not wake.

“That’s it?” Darla asked.

“No,” Doctor Krause replied. “He has risk of infection and shock and phantom pain. And morphine addiction, if we need to keep him sedated. Among other risks and worries. And I don’t have any knowledge of prosthetics…so, he’ll never walk again. If he lives. No. This is not over for dear Ethan.”

Ainsley coughed into her shoulder and sniffed. She stood rooted to the floor, the stethoscope still around her neck.

Darla kept her hand on Ethan’s arm and felt how hot his skin had turned. “What can we do? How can we help him?”

“Nothing. We can’t do anything more,” Doctor Krause replied. She put a hand on her daughter’s back and gave her a small push back toward the garage. “Go on,” she said in a small voice to Ainsley. “Help watch the child. Go relieve Joey.” Ainsley obeyed, and she slipped out of the house with her head bent low, and her shoulders hunched. Then the doctor turned back and crossed her arms, looking around the room.

“What can
I
do?” Darla called—her voice rising in fear and anger. “Is there anything I can do?”

“We will stay with him until he wakes. Then we’ll move him back into his bedroom and care for him there.” She marched into the dining room and grabbed a chair by its back and dragged it over to their makeshift operating table. After checking Ethan’s vitals once more, she sat down and closed her eyes. Darla refused to sit and she refused to move. She stood by her friend, and looked at the horror they had created; her stomach ached.

After five silent minutes, the women heard shuffling in the garage and steps in the hall. They lifted their heads in unison and waited with curious expectancy.

Darla figured the news would be Teddy-related; after all, what other reason would Joey or Ainsley have for venturing back? She gave up a silent prayer that Joey had kept an eagle eye on her rambunctious child, and that the news from the house was benign.

But it was Principal Spencer who materialized from the dark of the hall and into the light.

The last time Darla had been anywhere near Spencer, she was shuffling away three angry and confused people from the entrance of the high school after he had told them, “
Get out. You’re not my problem anymore.
”

He held a metal flask in his hand and he took a swig, bearing his top teeth as he sucked down his daily allotment of bourbon. Then he surveyed the carnage and whistled low and long.

“Looks like I missed all the fun,” he said, his bloodshot eyes resting for a quick second on Ethan’s discarded limb. His mouth curled downward in disgust. “Jesus, this looks messy.”

“Good afternoon,” Doctor Krause said in reply, her voice easy and calm. But she didn’t budge from her chair, nor did she leave her eyes on him for long.

“Yeah, and a hell of an afternoon it’s been,” he said. Then he nodded to Darla, who regarded him with crossed arms and blatant disdain. “I’m here on official Whispering Waters business.”

“It can’t wait?” Darla asked him, rolling her eyes. “If you haven’t noticed…your timing is shit.”

“No, it can’t,” Spencer replied and he took a step closer.

“Just stop where you are. You can speak to me from there,” Darla took her right hand off of Ethan’s arm and lifted it up to halt him in his tracks. “He’s at risk for infection. Do you mind? What right do you have to just waltz in like this?”

“I’ve been talking with Joey—”

“I’m sure the conversation was riveting.” Darla rolled her eyes.

“Yeah, well. We decided it was best for me to move up here. Join you guys.”

“Like hell you will,” Darla said and she took a step away from the table and toward the door.
 

Doctor Krause turned from the debate and stood up from her chair. She busied herself with Ethan in a calculated attempt to avoid confrontation with the man who had unceremoniously whisked her away—she checked his temperature again and wrapped the blood pressure cuff around his arm, squeezing the bulb in her hand and watching the dial spin and shudder.