Tear In Time (5 page)

 
Reaching over the leg once more, the doctor continued his conical-shaped
incision from the bottom and worked his way to the top. With his hands
saturated in blood, he reached for a long strip of cloth a few inches wide. He
worked around the bone, then pulled up on each end of the strip, lightly
suspending the leg for a moment. He then pulled the cloth up the leg, which
pulled the muscles higher up the bone.

  “Ok,
we've pulled the muscles higher up the bone. I'll cut through the bone as close
to the cloth as I can without cutting through it – the cloth, that is. When we
release the cloth, the muscle will spring back to its original position,
covering the bone by a couple of inches, allowing for greater cushioning after
healing,” Dr. Morgan elaborated.

  He
reached for his saw and placed his thumb on the bone as a guide. Resting the
saw against his thumb, he pulled two times toward himself, leaving a small
pilot slot to start the cut. He then began to aggressively saw through the
bone. In seconds, he was nearly through the bone, as he began to slow. At the
end, he only pulled the saw toward himself, insuring that the bone would not
splinter. With the last pull of the saw, the lower leg completely detached from
the upper leg. At the end of the table, the top-heavy foot rolled to one side
under its own weight, and fell from the table into the grass below.

  The
blood pooled around the end of the stump as the assistant released the cloth
holding the muscle. Quickly reaching for a pre-threaded needle, the doctor
began to tie off the various blood vessels, starting with the femoral artery.

  “Right
then. See those strands that look like tiny pieces of twine? They are the
various blood vessels that supplied the lower leg with blood. Those all need to
be tied off or he'll bleed to death,” the doctor said as he worked.

  With
the bleeding completely stopped, he slowly released the tourniquet and watched
for leakages at the end of the stump. Seeing none, he then began to sew up the
exposed wound. He quickly pulled the extra skin over the muscle and began to
stitch across them.

  “The
ligatures should not be too close, as there needs to be room for drainage of
any excess blood and pus while the appendage heals,” the doctor said as he
stitched, his assistant looking on in fascination.

  When
he was done suturing, he allowed Asst. Fowler to bandage the end while he
rinsed off his tools and threw the bloody foot into a basket to be carried away
later. Turning to his assistance, he said dryly, “Let's hope there won't be too
many of these today.”

  Asst.
Fowler just nodded. The whole bloody experience was almost too graphic for him
as he tried to process the procedure in his mind.

  “Right,
let's have a look at the other fellow, shall we?” the doctor asked
rhetorically.

 
Bandaging the corporal’s amputated leg, he looked up to see that Dr. Morgan was
already cutting away the other soldier’s pant leg, presaging the next operative
process. Moments later, the sound of distant gallops could be heard as more
teams of horses began to arrive, pulling their wooden ambulances as they rushed
the wounded to safety.

  Faster
than they could operate, the privates carried more wounded Union soldiers to
the operating wagon. The basket of amputated limbs mounded over as the doctor
disposed of the useless appendages, throwing them unceremoniously onto the
bloody pile of flesh and bone that had already began to rot in the heat of the
day. As each mangled limb landed on the bloody mound, swarms of flies darted
away, escaping the falling limb, then quickly returned and continued their
forage of filth and disease on their newly found real estate.

  As the
wounded flowed in, they were helped to the shady edges of the grassy clearing
to wait their turn under the knife.  Disheartening moans of agony could be
heard everywhere as the injured men left one horrific world and entered
another. Working quickly to overcome the numbers, Dr. Morgan set up another
operating wagon for Asst. Fowler. Working side by side, Dr. Morgan monitored
his assistant’s work. At first, the doctor assigned simple amputations to Dr.
Fowler, but as the number of wounded mounted and Dr. Fowler began to grow into
his newly acquired skills, Dr. Morgan allowed him to take on more complex
surgeries. With two doctors working, the basket used to dispose of the limbs
had long since disappeared under the carnage.

  The
stench of iron hung heavy in the air from the blood that spewed from the
wounded. Through blank and pallor faces, some stared out into nothingness as
shock deadened reality. Others winced and grimaced with each breath they took,
and still others cried out in agony, each time dying a thousand deaths.

 
Hearing the suffering of their countrymen only served to stiffen both doctors’
resolve to save more men. Throughout the day and into the night, the two
surgeons worked frantically to save the injured and the dying. As their
exhaustion set in, and hysteria and despair overwhelmed them, they searched
within themselves for the strength to continue. Eventually, their own bodies
and minds began to fail them. They had pushed themselves to the limits of human
endurance. With the battle not yet complete, they both knew that tomorrow would
bring further death and pain. If they were going to be of service to the young
men risking their lives for their country, they both would need some much
deserved rest.

  With
the last flicker of light from the nearly spent oil lamps, the blood soaked
surgeons made their way across the other side of the clearing to their two
canvas tents. With a quick change of clothing, they laid down on their cots and
fell quickly asleep.

TT:
Chapter 3

June 8th,
2005

 
Elanger Hospital was a bustling modern hospital with four branches spread out
on each side of the city of Chattanooga; north, south, east, west, and one at the
center of the city, accounting for five in total. Regarded as a teaching
hospital, they developed and performed the latest cutting-edge medical
techniques, producing some of the finest medical staff in the country; although
all too often the advancements came as a result of the gang-related violence
that erupted within the inner city, many times catching the innocent in its
crossfire.

  Dr.
David Warner burst through the swinging wooden double-doors and headed to the
scrub station.

 
"Ok, what do we have?" he asked as he turned on the water and pulled
on the soap dispenser, releasing a large dollop into his hands. Vigorously he
scrubbed from his fingertips to his elbows as he listened to his supporting
staff inform him of the emergency.

 
"Doctor, we have a gunshot victim with an entry and exit wound between the
seventh and eighth rib, entry through the abdomen. Her belly's distended, must
be filling up with blood. Her vitals are low, about eighty-five over sixty. Her
Foley output is bright red and she’s hypovolemic from the blood loss. Triage
has intubated her and already infused 2 liters of plasma," replied
surgical resident Kerry Stadler, as he too scrubbed in for emergency surgery.

 
"So she's prepped?" Dr. Warner asked.

 
"Yes, doctor. Prepped and ready," Dr Stadler replied.

 
"Films?" Dr. Warner asked in abbreviated speech, a function of his
occupation.

  Before
he could receive an answer, surgical nurse Jill Edwards burst through the door.
Pulling her mask from her face, she anxiously reported, "Doctors, you'd
better hurry. Her vitals are dropping fast. BP is eighty over fifty-five, pulse
ox is eighty-five."

 
Without hesitation, Dr. Warner quickly responded, "Gloves and gown, now!
And set up a thoracotomy tray, along with a laporatomy just in case."

  Both
doctors washed the soap from their hands and arms quickly as the pressure and
anxiety of the situation worsened.

 
“Should we get an ultrasound in here?” Dr. Stadler asked as he started to tie
his gown.

  “Yes,
STAT!” Dr. Warner replied urgently.

  As the
two doctors quickly donned their attire, Nurse Edwards pulled on her protective
mask and rushed back into the OR to prep the ultrasound equipment and set up
the thoracotomy tray.

  Moving
through the double doors, Dr Warner heard the sounds of alarms as the medical
equipment coldly reported a patient in crisis. He scanned the various devices
as the patient’s levels continued to drop into the danger zone.

  As he
rushed to the patient’s side, Dr. Warner's eyes widen in disbelief as he
realized the age of the tiny victim. "My god, she’s just a baby. How old
is she?"

 
"Eight years," Nurse Edwards replied, her voice sadly exposing what
her mask disguised.

“What’s her
name?” Dr. Warner asked.

“The chart
says Lena Williams,” Nurse Edwards replied.

 
Shaking his head in disgust, he listened as the cardiac monitor sounded slower
beats and become erratic. Immediately, he reacted out of instinct.

  “She
needs volume NOW. Hang another two on the rapid infuser,” He said, his voice
showing the strain as the youth of his patient weighed heavy in his mind.

  “BP's
seventy over fifty and dropping, pulse ox is eighty-two,” Dr. Stadler informed
his mentor and colleague.

  “I just
lost her pulse,” nurse Edwards cried out as the cardiac monitor sounded the
unmistakable tone of ‘flat line’.

  “Push
an amp of atropine. Charge the paddles to fifty,” Dr. Warner retorted back.

  Nurse Edwards
quickly wheeled over the defibrillator and programmed the setting to Pediatric,
while charging the external paddles to fifty joules. She quickly handed them to
Dr. Warner, then injected an amp of atropine into the patient’s IV.

  As Dr.
Warner prepared paddles, Dr. Stadler scanned the young patient’s belly with
ultrasound. Rotating the small metallic wand at various angles, images showed
on the monitor, confirming their suspicions of the hidden trauma.

  Having
applied conductive gel, Dr. Warner placed one of the paddles to the upper right
clavicle, and one just below and to the left of the young patient’s left
nipple.

 
“Clear,” Dr. Warner called out.

  Dr.
Stadler broke off his examination just as Dr Warner depressed the buttons on
the paddles, delivering a charge to the heart as well as other nearby organs.

  The
patient’s body convulsed from the current coursing through her. Her chest
heaved and expanded, then fell and contracted back onto the table. The three
medical personnel focused on the cardiac monitor for signs of activity. They
held their breath in vain: the monitor continued to report a single monotone
sound of flat line.

  “Still
in V-fib,” Dr. Stadler cried out. Desperation could be heard as he spoke.

  “Fifty
again,” Dr. Warner called out once more. He replaced the paddles in the
previous locations and delivered a second charge. Again the tiny patient's body
convulsed. As the three waited for the electrical shock to dissipate and reset
the heart, the cardiac monitor registered a single ‘beep’, then another and
still another as the young patient's heart began to return to its singular
function, pumping life's blood once again through her tiny body.

  “Sinus
tach,” Dr. Stadler cried out in relief.

  Dr.
Warner roughly placed paddles back on tray. “Ultrasound?” he asked Dr. Stadler,
who had now resumed his examination, nervous sweat beading up on his brow.

 
“Belly's full of blood. Looks like some major hemorrhaging where the bullet hit
the spleen, pancreas and kidney. Eighth rib is broken too.” replied the Dr.
Stadler, now regaining his composure.

  “OK,
eight blade,” Dr. Warner requested.

 
Instantly, Nurse Edwards handed him a scalpel from the tray of stainless steel instruments,
butt end first, taking care not to slice her own hand as she pulled away.