Page 161
I gasped for breath, and wiped my mouth.
“Take his hips, Bree his shoulders. Move when I tell you, not before.”
We shifted him quickly, my hands holding his head like the Holy Grail. There were people all around us now, but I had no time to look or listen; I had eyes only for what must be done.
I ripped off my petticoat, rolled it and used it to brace his neck; I hadn’t felt any grinding or crackling in the neck when we lifted him, but I needed all the luck I had for other things. By stubbornness or sheer miracle, he wasn’t dead. But he had hung by the neck for the best part of an hour, and the swelling of the tissues in his throat was very shortly going to accomplish what the rope itself hadn’t.
I didn’t know whether I had a few minutes or an hour, but the process was inevitable, and there was only one thing to do about it. No more than a few molecules of air were seeping through that mass of crushed and mangled tissue; a bit more swelling would seal it off altogether. If no air could reach his lungs by means of nose or mouth, another channel must be provided.
I turned to look for Jamie, but it was Brianna who knelt beside me. A certain amount of racket in the background indicated that Jamie was dealing with the spectators.
A cricothrotomy? Fast, and requiring no great skill, but difficult to keep open—and it might not be sufficient to relieve the obstruction. I had one hand on Roger’s sternum, the soft bump of his heart secure under my fingers. Strong enough . . . maybe.
“Right,” I said to Brianna, hoping I sounded quite calm. “I’ll need a bit of help.”
“Yes,” she said—and thank God, she sounded calm. “What shall I do?”
In essence, nothing all that difficult; simply hold Roger’s head pulled well back, and keep it steady while I slit his throat. Of course, hyperextending the neck could easily sever the spinal cord if there were a fracture, or compress it irreversibly. But Brianna needn’t worry about that—or know about it, either.
She knelt by his head and did as I told her, and the mediastinum of the trachea bulged into view as the skin and fascia over it tightened. There it was, neatly lined up—I hoped—between the great vessels on either side. If it wasn’t, I could easily lacerate the common carotid or the internal jugular, and he’d bleed to death right under my hands.
The only virtue to hideous emergency is that it gives one license to attempt things that could never be done in cold blood.
I fumbled for the small bottle of alcohol that I carried in my pocket. I nearly dropped it, but by the time I had poured the contents over my fingers and wiped both my scalpel and Roger’s neck, the surgeon’s trance had come over me, and my hands were once more steady.
I took a moment, hands on his neck, eyes closed, feeling for the faint throb of the artery, the slightly softer mass of the thyroid. I pressed upward; yes, it moved. I massaged the isthmus of the thyroid, pushing it out of the way, hard toward his head, and with my other hand, pressed the knife blade down into the fourth tracheal cartilage.
The cartilage here was U-shaped, the esophagus behind it soft and vulnerable; I must not stab too deeply. I felt the fibrous parting of skin and fascia, resistance, then the soft pop as the blade went in. There was a sudden loud gurgle, and a wet kind of whistling noise; the sound of air being sucked through blood. Roger’s chest moved. I felt it, and it was only then that I realized my eyes were still shut.
70
ALL IS WELL
THE BLACKNESS CRADLED HIM, comforting in its warm completeness. He felt some faint stirring of something outside it, a painful, intrusive presence, and shrank back into the shelter of the dark. It was melting away around him, though, slowly exposing parts of him to light and harshness.
He opened his eyes. He couldn’t tell what he was looking at, and struggled to understand. His head throbbed and so did a dozen smaller pulses, each one a brilliant, tender burst of pain. He felt the points of pain like pins that nailed him like a butterfly to a board. If he could but pry them free, he might fly away . . .
He closed his eyes again, seeking the comfort of the darkness. He felt a dim recollection of terrible effort, his rib-muscles tearing with the struggle for air. There was water somewhere in his memory, filling his nose, wetness ballooning the hollows of his clothes . . . was he drowning? The idea sent a faint flicker of alarm through his mind. They said it was an easy death, drowning, like falling asleep. Was he sinking, falling into a treacherous and final ease, even as he sought the beguiling dark?
He jerked, flailing with his arms, trying to turn and reach the surface. Pain burst through his chest and burned in his throat; he tried to cough and could not, tried to gulp air and found none, struck something hard—
Something seized him, held him still. A face appeared above him, a blur of skin, a blaze of reddish hair. Brianna? The name floated into his mind like a bright balloon. Then his eyes focused a little, bringing a harsher, fiercer face into view. Jamie. The name hung in front of him, floating, but seeming somehow reassuring.
Pressure, warmth . . . a hand was clasping his arm, another on his shoulder, pressing hard. He blinked, his vision swimming, gradually clearing. He felt no air moving in mouth or nose, his throat was closed and his chest still burned, but he was breathing; he felt the soreness of the tiny muscles between his ribs as they moved. He hadn’t drowned then; it hurt too much.
“You are alive,” Jamie said. Blue eyes stared intently into his, so close he felt warm breath on his face. “You are alive. You are whole. All is well.”
He examined the words with a sense of detachment, turning them over like a handful of pebbles, feeling the weight of them in the palm of his mind.
You are alive. You are whole. All is well.
A vague feeling of comfort came over him. That seemed to be all he needed to know just then. Anything else could wait. The waiting black rose up again, with the inviting aspect of a soft couch, and he sank gratefully upon it, still hearing the words like plucked harpstrings.
You are alive. You are whole. All is well.
71
A FEEBLE SPARK
MRS. CLAIRE?”
It was Robin McGillivray hovering in the doorway of the tent, his dark wiry hair standing up on end like a bottle-brush. He looked like a harried raccoon, the skin round his eyes wiped free of sweat and soot, the rest still blackened with the smoke of battle.
At sight of him, Claire rose at once.
“Coming.” She was on her feet, kit in hand and already moving toward the door before Brianna could speak.
“Mother!” It was no more than a whisper, but the tone of panic brought Claire round as though she had stepped on a turntable. The amber eyes fastened on Brianna’s face for a moment, flicked to Roger, then back to her daughter.
“Watch his breathing,” she said. “Keep the tube clear. Give him honey-water, if he’s conscious enough to swallow a bit. And touch him. He can’t turn his head to see you; he needs to know you’re there.”
“But—” Brianna stopped dead, her mouth too dry to speak. Don’t go! she wanted to cry. Don’t leave me alone! I can’t keep him alive, I don’t know what to do!
“They need me,” Claire said, very gently. She turned, skirts whispering, to the impatiently waiting Robin, and vanished into the twilight.
“And I don’t?” Brianna’s lips moved, but she didn’t know whether she had spoken aloud or not. It didn’t matter; Claire was gone, and she was alone.
She felt light-headed, and realized that she had been holding her breath. She breathed out, and in, deeply, slowly. The fear was a poisonous snake, writhing round her spine, slithering through her mind. Ready to sink its fangs in her heart. She took one more breath through gritted teeth, seized the snake by the head, mentally stuffed it wriggling into a basket, and slammed down the lid. So much for panic, then.
Her mother would not have left, were there any immediate danger, she told herself firmly, nor if there were anything more that could be done medically. So there wasn’t. Was there anything she could do? She breathed, deep enough to make the boning of her stays creak.
Touch him. Speak to him. Let him know you’re with him. That was what Claire had said, speaking urgently but somehow absentmindedly, during the messy proceedings following the impromptu tracheotomy.
Brianna turned back to Roger, looking in vain for something safe to touch. His hands were swollen like inflated gloves, stained purple-red with bruising, the crushed fingers nearly black, raw rope-weals sunk so deep in the flesh of his wrists that she was queasily sure she could see white bone. They looked unreal, badly-done makeup for a horror play.
Grotesque as they were, they were better than his face. That was bruised and swollen, too, with a ghastly ruff of leeches attached beneath his jaw, but it was more subtly deformed, like some sinister stranger pretending to be Roger.
His hands were lavishly decorated with leeches, too. He must be wearing every leech available, she thought. Claire had sent Josh rushing to the other surgeons, to beg their supplies, and then sent him and the two Findlay boys splashing down the creek banks in hasty search of more.
Watch his breathing. That, she could do. She sat down, moving as quietly as she could, from some obscure urge not to wake him. She laid a hand lightly over his heart, so relieved to find him warm to the touch that she gave a great sigh. He grimaced slightly at the feel of her breath on his face, tensed, then relaxed again.
His own breath came so shallowly that she took her hand away, feeling that the pressure of her palm on his chest might be enough to stop its labored rise. He was breathing, though; she could hear the faint whistle of air through the tube in his throat. Claire had commandeered Mr. Caswell’s imported English pipe, ruthlessly breaking off the amber stem. Rinsed hastily with alcohol, it was still stained with tobacco tar, but seemed to be functioning well enough.
Two fingers of Roger’s right hand were broken, all his nails clawed bloody, torn, or missing. Her own throat tightened at this evidence of just how ferociously he had fought to live. His state seemed so precarious that she hesitated to touch him, as though she might startle him over some invisible edge between death and life. And yet she could see what her mother meant; the same touch might hold him back, keep him from stumbling over just such an edge, lost in the dark.
She squeezed his thigh firmly, reassured by the solid feel of the long, curving muscle under the blanket that covered his lower body. He made a small sound, tensed, and relaxed again. She wondered for a surreal moment whether to cup his gen**als.
“That would let him know I’m here, all right,” she murmured, swallowing a hysterical desire to laugh. His leg quivered slightly at the sound of her voice.
“Can you hear me?” she asked softly, leaning forward. “I’m here, Roger. It’s me—Bree. Don’t worry, you aren’t alone.”
Her own voice sounded strange; too loud, stiff and awkward.
“Bi socair, mo chridhe,” she said, and relaxed a little. “Bi samnach, tha mi seo.”
It was easier, somehow, in Gaelic, its formality a thin dam against the intensity of feelings that might swamp her, were they ever set free. Love and fear and anger, swirled together in a mix so strong her hand trembled with it.
“Take his hips, Bree his shoulders. Move when I tell you, not before.”
We shifted him quickly, my hands holding his head like the Holy Grail. There were people all around us now, but I had no time to look or listen; I had eyes only for what must be done.
I ripped off my petticoat, rolled it and used it to brace his neck; I hadn’t felt any grinding or crackling in the neck when we lifted him, but I needed all the luck I had for other things. By stubbornness or sheer miracle, he wasn’t dead. But he had hung by the neck for the best part of an hour, and the swelling of the tissues in his throat was very shortly going to accomplish what the rope itself hadn’t.
I didn’t know whether I had a few minutes or an hour, but the process was inevitable, and there was only one thing to do about it. No more than a few molecules of air were seeping through that mass of crushed and mangled tissue; a bit more swelling would seal it off altogether. If no air could reach his lungs by means of nose or mouth, another channel must be provided.
I turned to look for Jamie, but it was Brianna who knelt beside me. A certain amount of racket in the background indicated that Jamie was dealing with the spectators.
A cricothrotomy? Fast, and requiring no great skill, but difficult to keep open—and it might not be sufficient to relieve the obstruction. I had one hand on Roger’s sternum, the soft bump of his heart secure under my fingers. Strong enough . . . maybe.
“Right,” I said to Brianna, hoping I sounded quite calm. “I’ll need a bit of help.”
“Yes,” she said—and thank God, she sounded calm. “What shall I do?”
In essence, nothing all that difficult; simply hold Roger’s head pulled well back, and keep it steady while I slit his throat. Of course, hyperextending the neck could easily sever the spinal cord if there were a fracture, or compress it irreversibly. But Brianna needn’t worry about that—or know about it, either.
She knelt by his head and did as I told her, and the mediastinum of the trachea bulged into view as the skin and fascia over it tightened. There it was, neatly lined up—I hoped—between the great vessels on either side. If it wasn’t, I could easily lacerate the common carotid or the internal jugular, and he’d bleed to death right under my hands.
The only virtue to hideous emergency is that it gives one license to attempt things that could never be done in cold blood.
I fumbled for the small bottle of alcohol that I carried in my pocket. I nearly dropped it, but by the time I had poured the contents over my fingers and wiped both my scalpel and Roger’s neck, the surgeon’s trance had come over me, and my hands were once more steady.
I took a moment, hands on his neck, eyes closed, feeling for the faint throb of the artery, the slightly softer mass of the thyroid. I pressed upward; yes, it moved. I massaged the isthmus of the thyroid, pushing it out of the way, hard toward his head, and with my other hand, pressed the knife blade down into the fourth tracheal cartilage.
The cartilage here was U-shaped, the esophagus behind it soft and vulnerable; I must not stab too deeply. I felt the fibrous parting of skin and fascia, resistance, then the soft pop as the blade went in. There was a sudden loud gurgle, and a wet kind of whistling noise; the sound of air being sucked through blood. Roger’s chest moved. I felt it, and it was only then that I realized my eyes were still shut.
70
ALL IS WELL
THE BLACKNESS CRADLED HIM, comforting in its warm completeness. He felt some faint stirring of something outside it, a painful, intrusive presence, and shrank back into the shelter of the dark. It was melting away around him, though, slowly exposing parts of him to light and harshness.
He opened his eyes. He couldn’t tell what he was looking at, and struggled to understand. His head throbbed and so did a dozen smaller pulses, each one a brilliant, tender burst of pain. He felt the points of pain like pins that nailed him like a butterfly to a board. If he could but pry them free, he might fly away . . .
He closed his eyes again, seeking the comfort of the darkness. He felt a dim recollection of terrible effort, his rib-muscles tearing with the struggle for air. There was water somewhere in his memory, filling his nose, wetness ballooning the hollows of his clothes . . . was he drowning? The idea sent a faint flicker of alarm through his mind. They said it was an easy death, drowning, like falling asleep. Was he sinking, falling into a treacherous and final ease, even as he sought the beguiling dark?
He jerked, flailing with his arms, trying to turn and reach the surface. Pain burst through his chest and burned in his throat; he tried to cough and could not, tried to gulp air and found none, struck something hard—
Something seized him, held him still. A face appeared above him, a blur of skin, a blaze of reddish hair. Brianna? The name floated into his mind like a bright balloon. Then his eyes focused a little, bringing a harsher, fiercer face into view. Jamie. The name hung in front of him, floating, but seeming somehow reassuring.
Pressure, warmth . . . a hand was clasping his arm, another on his shoulder, pressing hard. He blinked, his vision swimming, gradually clearing. He felt no air moving in mouth or nose, his throat was closed and his chest still burned, but he was breathing; he felt the soreness of the tiny muscles between his ribs as they moved. He hadn’t drowned then; it hurt too much.
“You are alive,” Jamie said. Blue eyes stared intently into his, so close he felt warm breath on his face. “You are alive. You are whole. All is well.”
He examined the words with a sense of detachment, turning them over like a handful of pebbles, feeling the weight of them in the palm of his mind.
You are alive. You are whole. All is well.
A vague feeling of comfort came over him. That seemed to be all he needed to know just then. Anything else could wait. The waiting black rose up again, with the inviting aspect of a soft couch, and he sank gratefully upon it, still hearing the words like plucked harpstrings.
You are alive. You are whole. All is well.
71
A FEEBLE SPARK
MRS. CLAIRE?”
It was Robin McGillivray hovering in the doorway of the tent, his dark wiry hair standing up on end like a bottle-brush. He looked like a harried raccoon, the skin round his eyes wiped free of sweat and soot, the rest still blackened with the smoke of battle.
At sight of him, Claire rose at once.
“Coming.” She was on her feet, kit in hand and already moving toward the door before Brianna could speak.
“Mother!” It was no more than a whisper, but the tone of panic brought Claire round as though she had stepped on a turntable. The amber eyes fastened on Brianna’s face for a moment, flicked to Roger, then back to her daughter.
“Watch his breathing,” she said. “Keep the tube clear. Give him honey-water, if he’s conscious enough to swallow a bit. And touch him. He can’t turn his head to see you; he needs to know you’re there.”
“But—” Brianna stopped dead, her mouth too dry to speak. Don’t go! she wanted to cry. Don’t leave me alone! I can’t keep him alive, I don’t know what to do!
“They need me,” Claire said, very gently. She turned, skirts whispering, to the impatiently waiting Robin, and vanished into the twilight.
“And I don’t?” Brianna’s lips moved, but she didn’t know whether she had spoken aloud or not. It didn’t matter; Claire was gone, and she was alone.
She felt light-headed, and realized that she had been holding her breath. She breathed out, and in, deeply, slowly. The fear was a poisonous snake, writhing round her spine, slithering through her mind. Ready to sink its fangs in her heart. She took one more breath through gritted teeth, seized the snake by the head, mentally stuffed it wriggling into a basket, and slammed down the lid. So much for panic, then.
Her mother would not have left, were there any immediate danger, she told herself firmly, nor if there were anything more that could be done medically. So there wasn’t. Was there anything she could do? She breathed, deep enough to make the boning of her stays creak.
Touch him. Speak to him. Let him know you’re with him. That was what Claire had said, speaking urgently but somehow absentmindedly, during the messy proceedings following the impromptu tracheotomy.
Brianna turned back to Roger, looking in vain for something safe to touch. His hands were swollen like inflated gloves, stained purple-red with bruising, the crushed fingers nearly black, raw rope-weals sunk so deep in the flesh of his wrists that she was queasily sure she could see white bone. They looked unreal, badly-done makeup for a horror play.
Grotesque as they were, they were better than his face. That was bruised and swollen, too, with a ghastly ruff of leeches attached beneath his jaw, but it was more subtly deformed, like some sinister stranger pretending to be Roger.
His hands were lavishly decorated with leeches, too. He must be wearing every leech available, she thought. Claire had sent Josh rushing to the other surgeons, to beg their supplies, and then sent him and the two Findlay boys splashing down the creek banks in hasty search of more.
Watch his breathing. That, she could do. She sat down, moving as quietly as she could, from some obscure urge not to wake him. She laid a hand lightly over his heart, so relieved to find him warm to the touch that she gave a great sigh. He grimaced slightly at the feel of her breath on his face, tensed, then relaxed again.
His own breath came so shallowly that she took her hand away, feeling that the pressure of her palm on his chest might be enough to stop its labored rise. He was breathing, though; she could hear the faint whistle of air through the tube in his throat. Claire had commandeered Mr. Caswell’s imported English pipe, ruthlessly breaking off the amber stem. Rinsed hastily with alcohol, it was still stained with tobacco tar, but seemed to be functioning well enough.
Two fingers of Roger’s right hand were broken, all his nails clawed bloody, torn, or missing. Her own throat tightened at this evidence of just how ferociously he had fought to live. His state seemed so precarious that she hesitated to touch him, as though she might startle him over some invisible edge between death and life. And yet she could see what her mother meant; the same touch might hold him back, keep him from stumbling over just such an edge, lost in the dark.
She squeezed his thigh firmly, reassured by the solid feel of the long, curving muscle under the blanket that covered his lower body. He made a small sound, tensed, and relaxed again. She wondered for a surreal moment whether to cup his gen**als.
“That would let him know I’m here, all right,” she murmured, swallowing a hysterical desire to laugh. His leg quivered slightly at the sound of her voice.
“Can you hear me?” she asked softly, leaning forward. “I’m here, Roger. It’s me—Bree. Don’t worry, you aren’t alone.”
Her own voice sounded strange; too loud, stiff and awkward.
“Bi socair, mo chridhe,” she said, and relaxed a little. “Bi samnach, tha mi seo.”
It was easier, somehow, in Gaelic, its formality a thin dam against the intensity of feelings that might swamp her, were they ever set free. Love and fear and anger, swirled together in a mix so strong her hand trembled with it.
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