Morning Light (29 page)

They rode hard and fast. At times, when the terrain became treacherous, Clint was forced to slow the pace, fearing that Loni's inexperience in the saddle might cause her to fall. He could put his horses at risk, but he couldn't endanger the woman he'd come to love more than life itself.

Clint wasn't sure how long they'd been plunging forward down the slope. Minutes, hours? Time had become an indiscernible blur when he suddenly heard the frantic barking of a dog somewhere up ahead. He kicked Malachi's flanks to press the gelding to greater speed, praying that Loni could safely keep up with him and the pack animals.

They came around a bend in the creek, and finally Clint got to see Nana, the wonderful Saint Bernard, for the very first time. She was a huge animal. When she barked with eager delight at the sight of humans and came running toward them, Malachi spooked, tossing up his head and rearing to strike the air with his front hooves. Throwing his weight forward over Malachi's neck, Clint rode the horse down, soothed him with reassurances and pats on the neck, and then swung from the saddle to pet Nana. The dog's fur was matted with blood. The warm stickiness made Clint's heart twist with fear.

“Where is he, Nana? Take me to Trevor.”

The Saint Bernard whirled and ran, setting a pace that Clint feared he couldn't match. Fortunately the boy wasn't far away. Clint found him lying beside a burned-out fire, the left side of his lightweight jacket and the earth beneath him soaked with blood, his small face as pale as death. Clint was taken back through the years to the day his mother died. He knew firsthand what pallor like that might mean. Nana circled Clint and the child, whining incessantly.

“It's okay, Nana. Lie down, girl. You did good. He'll be okay.”

Trevor's black eyelashes fluttered. His coffee brown eyes focused blearily on Clint's face. “Who're you?” he asked faintly.

“A friend. We've been looking for you for days.” Clint performed a quick triage. Weak, rapid pulse. Cold, clammy skin. He whipped his pocketknife from his jeans, opened the blade, and carefully cut away the child's jacket and shirt to expose the wound. A dozen curses zigzagged through his mind. The cut was deep, almost to the bone, and blood pulsed weakly from the gash.

“Am I gonna die?” the boy whispered.

“No way, little man. You're gonna be fine. You hear?”

“Are you a doctor?” His voice had grown more faint, and even as he spoke, his eyes went unfocused.

“No, but I'm the next best thing.”

As Clint ripped his shirt off he heard Loni approaching, her boots scrabbling on the loose rocks behind him. “Get me one of our sleeping bags,” he ordered. “He's in shock. We have to keep him warm. Then I'll need some water and soap to wash my hands, and some alcohol swabs to sterilize them.”

As Loni ran to do his bidding, Clint used his knife to slash his shirt into strips, made a pad, and tightly wrapped the boy's shoulder in hopes of slowing the blood flow until he could fetch his first-aid satchel.

“How bad is it?” Loni dropped a canteen, soap, and swab packets on the ground. Then she bent to cover the child with the sleeping bag, careful to avoid the injured shoulder. “He's so pale.”

Nana started whining again. Loni hugged the huge dog's neck. “It'll be all right now, sweetheart. You've done such a fine job of taking care of him. Yes, you have. It'll be all right now.”

“He's about done for,” Clint said softly, just in case Trevor might hear.

“We've got no cell phone reception here. Should I ride back to last night's camp to see if I can call out from there?”

“No time,” Clint murmured.

Loni's face drained of color. “No time? He's dying right
now
, you mean?”

“That's why the dog's so frantic. Somehow she senses it.” Clint leaped to his feet, veering around Loni to retrace his steps to the horses. Then, like a madman, he began slashing the bindings on all the packs to get them off the animals' backs. When Loni reached him he gave her the knife.

“Packs off. All of them. Leave them where they land.”

He ran to the pack that held all his first-aid equipment for both humans and equines. His hands shook as he opened the horse satchel and rifled through the contents to find the syringes, catheters, and saline solution, thankful as he tossed things into his first-aid satchel that he'd been so meticulous about planning ahead for every possible catastrophe.

“What are those for?” Loni's blue eyes looked huge in her pale face as she regarded the oversize syringes and needles.

Clint met her gaze. His heart was thundering in his chest like a jackhammer. “I'm going to give him blood. If I don't we're going to lose him.”

“Blood? A transfusion, you mean? Isn't that dangerous?”

“Very dangerous. If I do it wrong or my blood's a bad match, it'll kill him. But I've got no alternative, honey. He's almost dead. There's no time to ride for help, no time for anything, not until I get some blood into him.”

Clint ran back to the child, praying with every step. He'd never given a transfusion, never even contemplated the possibility. For a host of medical reasons it was not a recommended emergency treatment in the field. As he knelt beside Trevor again, he had to go still for a moment and take deep breaths. He couldn't operate efficiently in a panic. As he washed and sterilized his hands, he lectured himself to find his center and remember everything he'd ever been taught. Even then he was going to need a lot of luck and a miracle.

Otherwise this little boy was going to die. He was already in shock, his pulse rapid and faint.
Please, God. This is insane. I know it's insane. You've got to help me. Reach down. Help me do this right. Please let it work.

He grabbed the child-size blood pressure cuff, secured it around Trevor's uninjured arm, and got a reading that terrified him. The boy had lost a dangerous amount of blood.

Most of Clint's adult life he'd been interested in articles about emergency blood transfusions because he'd always believed his mother might have lived if she'd gotten one in time. On an Internet medical site he had read about two direct, whole-blood transfusions administered in emergency settings with intravenous catheters, eighteen-gauge needles, and large syringes, one to a woman hemorrhaging after childbirth during a terrible storm, the other to an old man, also stranded by inclement weather, who had been bleeding internally. In both instances the caregivers had had charts on the patients and donors, eliminating most dangers of administering mismatched blood to the recipients.

Clint didn't have Trevor's medical charts and wasn't sure, in his present state of mind, if he'd understand the medical jargon if he did. He had only one thought to console him: that his type O-negative blood made a transfusion from him safer than from ninety-three percent of the world's population. That was the only hope he had, that by some miracle nothing in his blood would cause Trevor to have a reaction.

Please, God, please, God.
The words ricocheted through his mind. Some of his horse syringes held a hundred cc's, large enough for him to use. Saline. He needed to inject Trevor with that before each blood transfer to help prevent clotting. He had no idea how much blood he should give the boy. He could only hope frequent blood pressure readings would give him an indication. He decided to start with a half pint. He would discard and replace syringes in between infusions to minimize the risk of contamination.

Vaguely aware of Loni washing her hands nearby, he laid out several gauze pads to create a sterile work surface before sorting and organizing the syringes, catheters, and needles. Calm. He'd finally found his center. The boy was surely going to die without the blood. He had to stay focused on that. The risk of death for Trevor was far greater without a transfusion than from any post-transfusion reactions he might have. Clint told himself he could do this. He
would
do this. It was a gamble. He knew it. But it was the child's only chance.

Loni knelt beside him. “How can I help?”

Clint handed her a rubber tourniquet. “Put this around my upper arm and sterilize the bend of my elbow with one of those alcohol pads.”

To his surprise Loni seemed absolutely calm. As she dabbed his arm she glanced up. “It's going to work, Clint. Stop torturing yourself.”

“You've seen something?” he asked hopefully.

“No, but from the very start I've always known you would save his life.”

“Even though I'm a universal donor, complications may arise through alloimmunity to my red or white blood cells and various other minor antigens that play a role in compatibility.”

“You're his father. I'm betting your blood is an almost perfect match.”

Clint jerked his gaze to Trevor's face. Now that he was seeing the boy in person, he noted a resemblance that couldn't be denied. Trevor Stiles's small countenance bore the Harrigan stamp. There was no mistaking it. He looked so much like Clint at that age, it was uncanny. The implications pushed the breath from his lungs as effectively as if he'd been punched in the solar plexus by a brutal fist. His son. Sandra had
lied.

Not allowing himself to dwell on it, Clint put a rubber tourniquet around the child's good arm, tapped for a vein, and inserted a catheter. After releasing the tourniquet and taping the catheter in place, he injected the boy with some sterile saline. “I don't have enough of this. I should be pumping him full, and I can't. Isn't that a hell of a note?”

“What's it do?”

“Aids in prevention of clotting. Also builds volume and keeps the patient hydrated. All I can do is hope that the amount I have will help.”

Her voice calm and soothing, Loni said, “He won't get a clot.”

After administering some saline he waited a few seconds, allowing it to work its magic before tapping for a vein on his own arm. When he got a catheter inserted, Loni removed the rubber band and anchored the IV device to his skin with tape. Slowly Clint drew blood into a syringe. Then, even more slowly, he began injecting it into Trevor's arm through the other catheter.

“Why are you doing it so slowly?”

“Trust me, I'm not going slow enough. In a hospital infusion room they take anywhere from one hour to four to transfuse a patient with one pint. There's no way I can set up a slow drip, and we can't spare the time. We have to get him transported to a trauma center as fast as we can.”

“I could go looking for a flat area. Maybe I'll find a place where my phone will work.”

Clint shook his head. “No, I need you here. I don't have enough hands to do this without help.”

When the transfusion process had been repeated a second time, he sat back on his boot heels to rest.

“His color is better,” she whispered. “Or am I only imagining it?”

“I haven't given him nearly enough to make a real difference yet, less than half a pint.” To be certain, Clint took the child's blood pressure again. “It's come up a hair, but not nearly enough. I'm guessing he weighs about fifty pounds. On the seven-percent-of-body-weight scale, his total normal blood volume probably ranges from two and a half to three and a half pints. Judging by his pallor, the clamminess of his skin, his blood pressure, and his pulse, I think he's damned near bled out.”

“Do you know how many cc's are in one pint?”

“Five hundred. I'll wait a few minutes before giving him more blood. I don't want to shock his heart. Jesus help me. I don't know what the hell I'm doing.”

“You know just enough, Clint. God will do the rest.”

During the lull Clint removed the shirt strips from the child's shoulder, enlisting Loni's help in applying pressure with sterile gauze while he cleaned the wound. “Thank God he's out of it. If he were awake this'd hurt like hell.”

When the wound was dressed, Loni continued to apply pressure in between helping Clint administer more blood. It was a painstaking and lengthy process, making her want to scream. But as Clint worked, she saw a faint pinkness returning to Trevor's lips.

“His color
is
a bit better,” she noted aloud. Nana whined and licked the child's limp hand. “There, you see? Even Nana agrees with me.”

“Just pray he doesn't have a reaction. The signs will be hard to detect in an unconscious child. If his pulse accelerates, if you notice him starting to wheeze, if he feels feverish, or if his skin suddenly grows cooler and clammier, be sure to tell me. Adverse reactions usually come on in thirty to sixty minutes. I have nothing on hand to help him through something like that. No liquid hydrocortisone, no oxygen, no bronchodilator for wheezing,
nothing.
All I'll be able to do is stop the transfusions until the symptoms abate.”

“Aren't you supposed to donate only one pint of blood at a time?”

Clint fixed his gaze on the boy's face. “If he needs two pints, that's what he'll get. I may become light-headed, but that's no big deal. You could fetch me some water so I can keep myself hydrated, though.”