Page 40 of Wild Highland Rose (Time After Time #4)

A t the sound of Aimil's voice, Cameron jerked from his thoughts, quickly turning toward Fingal. The man was twitching convulsively, clutching at his throat, eyes wide. Aimil was grabbing at his shoulder, trying ineffectually to slap him on the back.

Cameron reacted from instinct, his mind focusing on the problem at hand. He rose quickly to stand behind Fingal, grasping him around the chest. Aimil yelled something about stopping him, but Cameron's focus was trained completely on the choking man.

Crossing his hands, one over the other, he made a fist and felt for the diaphragm just below Fingal's ribs. With a quick motion, he pulled upward and inward, hoping to force the man to dislodge whatever was stuck in his throat. Nothing happened.

He repeated the process twice more. In the background he could hear Aimil still screaming, although her wails were slowing. Out of the corner of his eye, he realized that someone was restraining her. He turned his mind back to his patient, shutting out all outside interference.

Decisions had to be made quickly if the man's life was to be saved.

Obviously, the Heimlich maneuver wasn't working.

The obstruction, whatever it was, was firmly lodged in place.

He knew he had minutes to correct the situation or, at best, Fingal would suffer brain damage and, at worst, he would die.

Not exactly the best place for surgical intervention, but there really wasn't any choice. Cameron didn't take the time to question where this new knowledge was coming from. There would be time for that later. Right now he needed to act, and act quickly.

"I need help. We've got to get him up on the table." With a swipe of his arm, he cleared a space, shoving plates, platters and cups aside. Marjory sprang into action and began to clear even more space. The young man who'd been talking to Grania helped him lift Fingal onto the table.

"Roll him onto his back." Cameron's tone didn't allow for argument and the other man obeyed swiftly, turning Fingal over. He was unconscious, his face beginning to turn blue. Cameron drew in a breath. There wasn't much time. He had to establish an airway.

He glanced around the room looking for something he could use as a trach tube, dismissing the feathers on the bird, a quill might work, but it could also be too small.

A bagpipe bellowed as it dropped to the floor.

Cameron glanced at the fallen instrument.

Its owner was frozen in place, staring at the table.

It wasn't often that a fifteenth century musician got to observe a twenty-first century surgeon. Surgeon . The word reverberated in his head, memories pressing hard and fast at the door to his conscious mind. He forced himself to mentally bar the door. There would be time for remembering later.

The pipe from the bagpipe was a little too large, but it might work. He felt for a pulse and couldn't find one. His time for decision making was over. "Bring me the bagpipe." No one moved. "I said, bring me the bagpipe. Now ." Marjory jumped, hurrying to fulfill his request.

She handed it to him and he tried to wrench a pipe from the bellows.

There was a gasp from the musician. With another tug, the piece pulled free.

It was definitely bigger than he would have liked, but it would have to do.

A flicker of light caught his attention.

The pipe smoker was attempting, again, to light the bowl. The pipe. It just might work.

"The pipe. Bring me the pipe." In an instant, Marjory responded, jerking the carved instrument from the man's hand, thrusting it across the table at Cameron. He took it and twisted the base. He wasn't disappointed, the stem easily pulled out of the bowl.

"Let me help." Grania's quiet voice filled his ear.

He placed the pipe stem in her hand. "Wash it out." He turned back to Fingal who was definitely turning blue. "And hurry."

He took a corner of his plaid and dipped it into his wine cup. Not exactly sterile, but better than nothing. "Hold his head and tip it back." The young man obeyed without question, rolling Fingal's head back so that his neck was exposed.

"Marjory, hand me your knife." Marjory began to speak, but his tone of voice offered no latitude for argument. Her mouth snapped shut and she wordlessly handed him the tiny knife.

Dipping it into the wine, he palpated Fingal's neck and after visualizing the incision, cut the skin.

Aimil screamed. No one else moved. The great hall was silent, almost as if everyone collectively held his breath.

Cameron cut through the subcutaneous layer, pushing the skin and muscle apart with his other hand.

The thyroid, thankfully, was not in the way and, with deft hands, he located the third and forth rings of the trachea.

Making a small vertical cut across the two rings, he automatically called for assistance. "Trach tube." Even as he realized that no one would understand his request, the pipe stem slapped into his outstretched hand.

"It should work. I tested it before I sterilized it." Grania's voice had lost its soft Scottish edge.

Cameron took the tube and inserted it into the trachea. At first nothing happened. Cameron bit back an oath and started to breathe into the tube. A wheezing sound echoed through the room as the man's chest began to rise and fall. Immediately, he began to pinken.

Cameron looked at Grania, forgetting for the moment that she couldn't see him. "We're halfway there. We've got to get the obstruction out."

Grania nodded. "Ye've got to help him, lad," she instructed the young man who had helped get Fingal on the table.

"Pull open his jaw and hold it so that Ewen can reach into his mouth.

" Her voice held the same ring of authority Cameron's had and the man responded immediately, tipping Fingal's head back and opening his mouth. The tube wavered ominously.

"Marjory, I need you to hold the tube." Immediately, she wrapped a hand around the pipe stem, holding it firmly in place. With an approving nod, he wiped off the knife. It was a dangerous retractor, but it would have to do.

"I think I can see it." Cameron looked up at the sound of his assistant's voice, meeting the other man's gaze. "I can see the edge o' a bone. 'Tis just visible. There." The man released Fingal's jaw with one hand and pointed into his mouth.

Cameron moved around until he could look down Fingal's throat.

What he wouldn't give for a penlight. He peered into the cavity and carefully used the knife handle to retract the tongue.

"Hold this." The young man gingerly grasped the knife blade, keeping Fingal's tongue out of the way.

Just below the uvula, Cameron saw the top of the bone.

Grasping it carefully between thumb and forefinger, with a quick jerk, he pulled upward. Nothing happened.

Twisting the bone to the right, he tried again.

Still no movement. He twisted it the other way and felt it give.

With a sharp tug, the bone and gristle pulled free.

Tossing it aside, he motioned for the man to let Fingal go, then returned to Fingal's side, and covered the top of the pipe stem with his finger.

Fingal jerked once and then began to breathe on his own.

Cameron sighed in relief, and held the plug, waiting until he was certain Fingal was breathing normally. "I'm going to need a bandage of some kind."

"Done." Grania's voice was steady as she handed him a thick folded pad of linen and a longer strip to secure it.

Working quickly, he removed the tube and immediately applied the square of linen, pressing against the wound.

Marjory moved next to him, her hand replacing his as he wound the strip of cloth around the neck and bandage, securing it into place with a knot.

Cameron felt for a pulse and was satisfied to feel its comforting beat beneath his fingers.

Fingal's eyes flickered open. His mouth moved, but there was no sound. Panicked, he tried to sit up. Cameron signaled the man to hold him again, and placed a finger across the bandage, effectively covering the stoma.

"It's okay, you should be able to talk now." He kept his voice low and comforting, his eyes never leaving Fingal's.

"What…" The older man paused, sucking in a breath. "…happened?" His voice cracked with the effort, but the words were discernible. Aimil started sobbing anew at the sound of her brother's voice.

"You swallowed a bone, but we got it out. You'll be fine." He patted the man on the arm, remembering a thousand other times he had reassured a patient in just such a way. "Don't try to talk anymore. Just rest."

He shifted his attention to the crowd. "We need to get him to his room." Two men sprang up from their positions of stupefied wonder and, grasping Fingal around the feet and shoulders, carefully began to carry him from the hall. "See that the bandage isn't dislodged."

"I'll go with them." Grania followed them, a wailing Aimil bringing up the rear.

Cameron sat down, his head spinning, the doors in his mind threatening to break open now that the crisis had passed.

"Will he be all right?" He looked up to see Marjory's drawn face. It was a contrast of fear and wonder.

"He should be fine. The fact that he was talking is a good sign. I expect he'll make a full recovery."

Marjory placed her hand on his. It was cold. He automatically covered it with his own. "What...what magic did you do tonight?" Her words were low and her voice trembled.

"It wasn't magic, Marjory, at least not the kind you're thinking of.

It was a simple procedure really. It's called a tracheotomy.

" She bit her lip and gave him a blank look.

"Look, I'm too tired to explain it now. I'm a physician, Marjory, a surgeon.

And though I normally work under less primitive conditions, a first year resident could do what I did. "

"You saved him." Her voice still held traces of awe.