“So, you want him to pull it through the skin, between the ribs, around the lung, into the mediastinum, around the PDA, then throw a knot around the tail that’s still coming out through the skin?”
A surprised looking wrinkle had formed in Daussie’s brow. “Uh-huh,” she said, as if astonished that anyone hadn’t thought that was obvious.
At least she didn’t say, “of course,” Tarc thought. He knew his eyes were wide, but he thought he understood Daussie’s plan. “I guess I can try it,” he whispered. Not wanting to move the finger he was holding behind Susie’s collarbones, he said, “Go ahead and unwrap the bundle. I’ll cool her skin to try to keep the needle from hurting when it goes in.”
Sounding mildly scandalized, Daussie said, “The needle and suture are sterile inside the bundle. If we opened the bundle, it’d be really easy to contaminate them. I put some alcohol on the bundle so it’d sterilize the skin underneath it. Just pull the needle through the cloth, out of the bundle and into the skin.”
Irritated at himself, Tarc thought, I’m the one who has the ability to do this stuff. How is she figuring out the best way for me to use that ability?! He carefully avoided thinking his idiot sister might be intelligent. Instead, he tugged on the needle with his ghost, turning it down through the cloth toward Susie’s chest. He poised it right over the gap between her ribs, then took a moment to cool the skin directly under it. He noticed that when he’d really focused on what he was doing with the needle; he’d let some blood leak through the PDA. Glancing up, he said as quietly as he could in view of all the tension, “Daussie, I let some blood slip through the PDA when I was trying to maneuver the needle. That’s probably going to happen more when I’m trying to work it through the chest. Can you pump the blood back into the aorta?”
She said, “Let me try…” Tarc felt some blood disappear out of the pulmonary artery and reappear in the aorta. She mumbled, “It’s hard against all that pressure.”
Eva said, “Try doing it between beats. The pressure’s lower then.”
Tarc felt a couple more squirts of blood appear in the aorta, then Daussie said, “You’re right, that’s easier. I’ll do what I can.”
Tarc cooled the skin a little more, then quickly pushed the needle through it. He glanced up at Susie, but the little girl seemed to be asleep. Kazy was still stroking her hair and murmuring in her ear. Has Kazy hypnotized her too? Tarc wondered.
He turned his attention back to the needle, pulling it in and around the lung. He turned a little corner there, then guided it back toward the PDA. Because his ghost provided a three-dimensional visualization of the structures, it wasn’t hard. He pulled it in deep, then around the PDA and back out toward the surface.
Daussie whispered, “Wait. You can’t tie the knot out here far away from the PDA, it’ll trap a lot of tissue when you tie it down. You should pull it back and take it around the PDA a second time, then tie it as close to the PDA as you can.”
Tarc’d been thinking he’d have to bring the suture back out to the skin to make the knot, but now he realized that was ridiculous. He wasn’t sure why Daussie wanted him to go around the vessel twice before tying the knot, but decided she’d obviously given this a lot more thought than he had. He took it around the vessel a second time then passed the suture around itself to make the first throw of a knot.
Daussie whispered, “I’ve got a hold on the tail end of the suture out here in the bundle. You can just tug on the needle end of the suture to cinch it down.”
Tarc saw Daussie’s hand firmly pinching the bundle. He tugged on the suture behind the PDA, slowly cinching the knot down. As he did so, his ghost showed him the diameter of the PDA decreasing.
He briefly lost control of his back pressure on flow in the PDA and blood squirted through it. By that point, the diameter of the PDA was narrow enough to generate a lot of turbulence. To his ghost, it felt like the blood “whistled” through the gap. Tarc could feel Daussie pumping some of the blood out of the pulmonary artery and back into the aorta, though the amount that had leaked through the diminished diameter of the PDA didn’t seem like it was enough to have caused much trouble. A second later, he’d pulled hard enough on the suture to completely close off the PDA.
Feeling somewhat triumphant, he backed up the needle and passed it around the tail of the suture again to make a second throw in the knot. As he was pulling the suture through to take up the slack in preparation for cinching that throw of the knot, the first throw suddenly came loose.
The ductus arteriosus swelled back most of the way open, blood rushing through it.
Horrified, Tarc realized that he’d panicked when the first knot slipped, pulling hard on the needle end of the suture. This had cinched those two throws in a solid knot—a solid knot that was holding the suture in a loose position. He desperately wanted to swear, but held it in—partly because his mother was listening, but mostly because he didn’t want the child’s mother to hear.
Daussie urgently whispered, “Stop the flow in the PDA again!”
Refocusing, Tarc did so. He said, “We need another suture so we can try this again.”
More calmly than she’d spoken a second ago, Daussie said, “I was afraid Mom might be mad about me cutting off her needles, so I only made one. Which was dumb. But, we might be able to salvage the suture you already passed. I’m going to pull hard enough on the tail coming out through the skin to straighten that limb of the suture. Once it’s straight, you’re supposed to be able to slide the knot along it. Give that a try.”
Eva, hanging over them, said, “Good thinking Daussie. That’s often worked when I’ve had a knot loosen while suturing.”
Daussie tugged on her end of the suture, pulling the thread out straight. Tarc was about to try to push on the knot, when Daussie said, “We need the thread to be straight where it passes through the knot. I’m afraid to pull any harder on my end for fear of tearing the vessels. Tarc you need to pull on the suture just on the other side of the knot.”
Tarc tilted his head curiously, not sure he understood, but he pulled the other way on Daussie’s limb of the suture, just beyond the knot on the deep side. His ghost felt the knot change configuration. If he’d read up on his suture knots like his mother had told him to, he would’ve recognized his square knot had just reconfigured into a slipknot.
Daussie said, “Great. Now push the knot away from my hand out here. It should slide.”
Tarc pushed, and the knot did slide. He pushed it slowly around the corner of the PDA. As he did so, it gradually came tight. Flow in the PDA stopped, though now the knot was back around on the opposite side. “Is it going to stay?” he asked quietly.
Daussie shook her head, “It might slip back the other way. You need to make some more throws.”
Tarc guided the needle around Daussie’s limb of the suture and was about to pull it tight when she relaxed the tension on her end. “Keep your limb tight so I can snug the knot this time,” she said. He did so but complained that he didn’t understand why.
Sounding like she was trying to be patient, Daussie said, “We need to alternate which limb we tighten first. That’s what makes a knot that won’t slip. Now I’ll pull mine tight and you’ll snug your end down.” Tarc did, resolving to read more about knots. Daussie said, “Make another throw.”
They made a couple more throws, taking turns which limb of the suture they pulled tight first.
Daussie said, “I think that’s enough. What do you think Mom?”
Voice trembling with excitement, Eva said, “I think it’s beautiful.”
Daussie lifted her hand, pulling her limb of the suture out of the little girl. Tarc realized she’d used her teleportation to cut the suture next to the knot. “Should I just leave my end in there with the needle?”
“No!” Daussie snapped, though she still kept her volume low. Then she explained, “Needles sometimes travel through the body and cause problems. Bring it back out of Suzie, pulling the suture with it if you can.�
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Tarc did so, thinking to himself that his original fears had been realized. He was just the technician with a gift. Daussie was the one who really understood medicine and told him what to do.
Just before he brought the needle out through the skin, Tarc stopped to cool the skin. As he did so, he glanced up at Susie and saw she was still sleeping. Kazy was still murmuring to her, though her eyes were wide. He imagined that she’d followed the procedure with her ghost.
Once Tarc brought the needle out through Susie’s skin and Daussie had retrieved it for sterilization and reuse, Eva murmured, “Tarc, can you try squeezing the fluid out of a little segment of Susie’s lung? If you can get the fluid to collect in an airway, Daussie can port it away.”
“That didn’t work very well when we were doing it for the guy with pneumonia,” Tarc said.
Daussie softly said, “I’ve been practicing. I’m way better at porting fluid than I used to be. You saw how much blood I moved from the right to the left side of Susie’s heart.” She paused a moment, “Of course, then I was only moving it about a centimeter and I can port short distances a lot faster. It’s going to be harder and slower moving this fluid to the outside of her chest.”
Tarc had an idea, “Couldn’t you just move it into one of the veins nearby?”
Daussie gave a minute shrug, “I could, but what if part of the reason she’s so much worse is that the fluid in her lungs is infected? Moving infection into her veins would be disastrous.” With more resolve, she quietly said, “Let’s start with me just moving the fluid into this bundle of cloth the needle and suture were in. If really seems to be helping her lungs, Mom can bring me a jar to port it into.”
“Okay,” Tarc said, sending his ghost in to check and make sure that PDA was still completely tied off and that the pressure in the arteries to the lungs remained low. He turned his attention back to the lung and said, “I’m going to squeeze some of the lung right under your cloth bundle.”
He did so, milking the fluid out of the alveoli. From there, it moved into the tiny bronchioles, then to larger and larger bronchi. From tiny droplets, it coalesced into a steady flow in the bigger tubes. In the bigger tubes, it vanished as Daussie ported it away. Susie started to cough but settled again at a murmur from Kazy.
Before Tarc moved on to another section of the lung, Eva whispered, “Can you push air back down the bronchi to reinflate that section of lung you just squished?”
Push air? Tarc thought with surprise. He’d never tried it, but decided he didn’t know why it wouldn’t work. In fact, when he tried it, it wasn’t difficult. He pushed air down the bronchus into the deflated section, readily reinflating it.
They settled into a routine, Tarc milking a section and Daussie porting the fluid out. Tarc would reinflate that section, then move on to another. Eva brought them a jar for Daussie to port the fluid into. By the time they’d milked out the lower lobe of Susie’s right lung she seemed to be breathing easier. They did the lower lobe of the left lung, then, feeling exhausted, they decided she was doing well enough to wait and see if her own body could remove the rest.
They all stood up, stretching their backs and working the kinks out of their necks. Suddenly, despite having waited patiently for more than an hour, Susie’s mother rushed forward. “You’re stopping?! You haven’t done anything!”
Eva tried to reassure the mother, pointing out that Susie seemed to be breathing better. Tarc had a massive headache. He rubbed his temples and saw Daussie rubbing hers too.
He thought, It’s probably a good thing Susie’s mother doesn’t know what we actually did. He looked over at Susie, seeing she still seemed to be sleeping peacefully as Kazy gently stroked her hair. That hypnotism stuff works really well. I wonder if I should try to learn how to do it?
~~~
When Tarc left the back of their sales booth, he found Henry Roper anxiously waiting for him. “Everything okay?” he asked.
Tarc nodded, “A little girl we saw yesterday came in again today. She was a lot sicker when she first arrived, but she’s better now.”
Roper moved on to what he was really worried about. “Did you get a chance to look around for any ancient devices?”
“Only a few minutes. But there were shelves all around the sides of the room. I gave them a brief once over. Most of the stuff that’d been on them must’ve rotted over the centuries because mostly I just found piles of crud.” Tarc had been digging in a pocket. Now he pulled out one of the things he’d thought might be tools. “I found a bunch of these,” he said, getting a good look at it himself for the first time.
Henry reached out and took it from him, rubbing dust off of it to expose a shiny, silvery surface. It had a tube on one end, then the metal curved and split into forked plates. A crusty cracked wheel was on a small axle between the two plates. When Henry tried to turn the wheel, it came apart and fell off the axle. “It was a pivoting wheel,” Henry not sounding particularly happy. “It probably mounted on something else that’s missing.”
“Isn’t it made out of stainless steel?” Tarc asked.
“Yeah,” Henry said, “so it’s valuable just for the metal. I was just hoping for something… more exciting.”
“Well, there were a bunch of them,” Tarc said, reaching into another pocket. “I thought these were some kind of tools,” he said, handing them to Henry.
“Oh, this is nice. It’s a pair of pliers. You can use them to grip or squeeze things,” Henry said, demonstrating its action.
Tarc frowned, studying its somewhat shiny surface. “Is it made out of stainless steel too?”
“Probably not. It’s most likely regular steel with chrome plating on the outside.”
Tarc handed him some more devices. Henry identified some screwdrivers and a couple of wrenches. There were a couple of things he didn’t recognize but still thought were tools. “It looks like you found somebody’s tool set,” he said. “Or, maybe it was a workshop. Were there any big things that might’ve been ancient vehicles?”
“Nothing that big,” Tarc said. Then he remembered the piping. “There was some…” he paused as he realized he’d better not describe any of the pipe structures that were completely buried in the dirt. He resumed, “There was some piping. Some of it was partly buried under dirt that’d fallen into the room, but one part that was sticking out was shaped a little bit like a chair with a small wagon wheel on either side of it.” He shook his head, “It didn’t make much sense.”
Roper looked excited, “It sounds like it might have been a wheelchair. I’ve heard of them, but never seen one.”
“Why would anyone want a chair with wheels on it?” Tarc asked.
Roper shrugged, “If they amputated your leg, or even if it was just broken, a wheelchair would let you get around. Back in those days, people who broke their backs usually lived even if they were paralyzed. Nowadays they die but they knew how to take care of them in the old days. Paralyzed people lived in wheelchairs too.”
“Oh,” Tarc said unwilling to admit he hadn’t known people could be paralyzed by breaking their backs. In retrospect, it seemed obvious when you considered the spinal cord was inside the bones of the back. There’s so much to know in medicine, he thought with dismay. To Roper, he said, “Did you find out who owns the salvage rights on that property? Maybe I could get you some more stuff.”
Henry looked frustrated, “No one seemed to know for sure. In this area, the Baron actually owns everything and people lease land from him. There’s probably somebody who’s leasing it, but they may not want to own up to that right now because they don’t want to be blamed for the little girl getting hurt.” He shook his head, “Once they’re sure she’s okay, there’ll probably be a fight over it.” He sighed, “But, by the time they work everything out, we’ll be long gone from here.”
“Yeah,” Tarc said, feeling disappointed as well. He’d really wanted a chance to explore those other rooms.
Roper held up the tools Tarc had gotten him, “
You want to pick one as your personal payment for helping me? I know I already paid your dad for your time, but it’d seem a shame if you didn’t get something of your own.”
“I’ve been wanting some stainless steel,” Tarc said, pointing to the tube and forked plates arrangement that had held the wheel. “It seemed like you didn’t think this was something you could sell as anything besides raw stainless steel, right?”
“Oh, that’s great,” Roper said, handing it over. “What a perfect coincidence—to have the thing you wanted most be the thing I least desired.”
~~~
At the wagon, Tarc found his family full tilt into preparing dinner for the caravan. As usual, when Eva was busy with healing, Daum had been filling in at cooking. With a cocky smile he told Tarc, “With you guys busy healing, I’ve been driving Nylin, Grace, and Farlin like mules.”
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