by Lynn Morris
He swallowed, and his lips moved just a bit.
Cheney repeated more insistently, “Do you understand, sir?”
“Y-yes,” he whispered.
“Good. I want you to keep listening to everything I say so that you will understand what I’m doing. Also I need you to answer my questions when I ask them.”
James came dashing up with four thick wool blankets in his arms. “Take two to Dr. White,” Cheney ordered, “then go get a stretcher.”
Cheney tucked the two blankets around the injured man, carefully avoiding even the lightest touch on the steel bar. James came running back with the stretcher, a six-foot length of canvas rolled up scroll-style between two wooden rails. “Unroll it, James, so that one rail is very close to this gentleman. That’s it. Now go around to his other side.”
“Sir, what is your name?” Cheney asked, getting down close to the victim’s face and making him look at her.
“Melbourne,” he said faintly. “Cornelius Melbourne.”
“All right, Mr. Melbourne, this is James Roe. He is going to help me get you onto the stretcher. He is going to pull you up on your side, and I’m going to position the stretcher under you, and then James is just going to lower you down onto it. Do you understand, Mr. Melbourne? Do you hear me?”
“Yes…I…understand.”
Cheney motioned to Officer Goodin, who leaned down close to her. The patient’s eyes were focused on her face, and she sensed that her calm expression was his tentative hold on life right now. She spoke in a steady voice, neither loud nor soft. “Officer, I want you to hold that spike steady as James pulls him up onto his side. Can you do that? Hold it exactly in place?”
“Yes, ma’am,” he answered calmly. He went to kneel by James.
Cheney once again leaned close over the man. “Mr. Melbourne? We’re ready. Just relax and let us do the work. Understand? Don’t move; don’t strain; we will do it for you.”
“Don’t…move,” he repeated, his gaze burning into hers.
Officer Goodin put both his long hands on either side of the spike in the man’s chest. She nodded at James. He lifted, Cheney shoved the stretcher under him, and they lowered him down, all in mere seconds. Cheney looked up and saw Dr. White and John standing by, watching.
“Dr. Duvall?” Officer Goodin said, holding out his hand to her. Looking up at him, she shook her head and cut a glance at Melbourne. Officer Goodin nodded understanding, then leaned down close to where she knelt by the victim to speak to her. “Dr. White says the gentleman who drove the coal cart was just kind of shaken up, nothing broken, no cuts.”
Cheney nodded. “Good. James, go ahead and get the wagon turned around, then Officer Goodin and John can load the patient. No bells on the way back. Go as quickly as you can, but as smoothly as you can.”
“Yes, ma’am.” He ran to the wagon and hopped up on the seat. Briskly he pulled the reins and made a clicking noise. Slowly the great horses began to back up.
Officer Goodin motioned toward the body propped up against the phaeton. “I would like to take her to St. Luke’s.”
“Of course. She goes in first,” Cheney ordered, and he nodded understanding.
Cheney looked back down at her patient. Melbourne stared at her, not speaking, not moving. She bent close over him again. “In just a few minutes, you and I are going to board the ambulance. It’s a very short trip to the hospital. For now I would like to listen to your heart. Would that be all right, Mr. Melbourne?” She was making conversation, trying to keep him as focused and alert as she could. If he didn’t give up and slip into unconsciousness, he might very well live—after a successful surgical procedure to remove the spike.
As she kept talking to the man, one part of her mind was busily demanding, And who is going to do this surgery? You? You’ve never done any kind of procedure even remotely like this. Dev is on Long Island tonight, and the surgery must be done as soon as we reach the hospital…if he lives that long….
But I can’t do this alone!
The insistent voice in one dark corner of her head kept on, but Cheney was startled at the thought.
I can’t do this—alone?
No, I can’t….
Not without Shiloh.
“Now, Mr. Melbourne, here we go,” she said, standing up as Officer Goodin and John bent to pick up the stretcher.
The man moved for the first time. Weakly he raised his hand toward Cheney. “Help…me…please.”
She took his hand, swallowed hard, and said, “I will. I can help you, Mr. Melbourne, and I will.”
****
Shiloh Irons-Winslow took off his leather gloves, blew on his freezing fingertips, and rubbed his hands together. His horse, a big lazy quarter horse named Balaam, noisily mouthed his bridle and made a disdainful blubbery sound with his lips.
“Aw, stop your complainin’,” Shiloh said. “I know it’s never this cold in San Francisco. You’re just gonna have to learn to live with it. And be quiet, will you? I can’t hear a thing except your grumblin’.” Shiloh pulled his gloves back on, and the pair walked slowly on, Shiloh leading the horse by the reins and staying close to his steaming side.
Shiloh had acute vision, even in darkness, and now his steel blue eyes scanned right, searching the jumbled outline of old piers and piles of trash that lined the Hudson River. He was walking along West Street on this freezing November night, and the memories that came to him were as strong and tangible as the reek of rotten fish and ancient garbage that hung heavy even on this brittle air.
“It was May ‘sixty-eight,” he mused softly. Right along here somewhere, I found the Lord. The worst, and the best, night of my life.” He stopped and Balaam obediently stopped, with only one small protesting stamp of his off hind. Shiloh narrowed his eyes to scan the huge mound of hay on one of the barges that lined this stretch of the river. He had never forgotten the feral, vicious children who had robbed him that terrible night. They were called “hay barge children,” for they were either orphans or children whose homes must be dismal indeed, for they preferred to sleep on the hay barges at night and either beg or steal during the day. Often when he was going to the hospital to escort Cheney home after her late shift, he would go a few hours early and wander along the river. He would like to find the children who had robbed him on that night so long ago, especially the boy named Rock. Not for revenge—Shiloh’s days of anger and bitterness were long gone—but to help them. Frequently he brought bread and cheese and fruit, hoping to see some of these blighted orphans. But he never did. He just left the food.
Shiloh thought he saw something now, a furtive movement, out of the corner of his eye. But as he searched, he saw nothing except the big mound of hay and an occasional glimmer of the water beyond. It was a black night, with low clouds and only an occasional accidental glimpse of starlight. Snowflakes were starting to fall, already hard and fast.
“Great,” Shiloh grumbled, sounding much like his horse. “Snowing again.” Balaam snorted.
Something small and dark, waving a big stick, jumped in front of the horse. “Your b-b-bunny or your l-l-ife!”
Shiloh and Balaam were both so astounded that they froze. “Huh?” Shiloh grunted in confusion. “What’d you say?”
Waving the stick menacingly, a high, shrill but oddly stuffy voice repeated, “I s-s-said, s-s-s-ir, your bunny or—” The stick waved and suddenly grew bigger and flared up and out, spooking Balaam. Throwing up his head, he whinnied in outrage and reared, hooves lashing out. The dark figure jerked, the offending stick flew, the shadow crumpled, and Balaam came crashing back down to stamp indignantly.
“Wait—” Shiloh finally came alive. He darted in front of the horse, grabbed the boy by the shirt collar, and dragged him out from under Balaam’s hooves. Shiloh shook him. “Get up, you!”
The boy was limp in his grasp, his head lolling like a broken doll.
“Aw, man, you aren’t dead, are you?” Kneeling quickly and cradling the boy’s head, Shiloh looked close—i
t was so dark he could hardly make out the features, though the face was a deadly white blur—and felt his head. He could see that this was a man—a very slight man, but he did have a mustache—with thin, greasy hair. Shiloh could feel the warmth of blood on his fingers. But the man was breathing. He even murmured slightly and his hand scrabbled vaguely. Shiloh felt his pulse. It was weak but steady. The man’s hands and face, however, were icy cold and corpselike.
“Great,” Shiloh rasped. “Okay, Mr. Big Bad, you did it. You’re gonna have to carry him. But—” Shiloh heaved up the unconscious man—”it’s not going to be that big a pain, ’cause this little piffle doesn’t weigh as much as the doc does. But don’t tell her I said that,” Shiloh added hastily. He tossed the man over the saddle like a bag of flour—a long, thin bag, perhaps—and then stooped to pick up the robber’s weapon.
It was an umbrella. A very nice umbrella, actually, made of fine black silk, with no broken spokes and a hand-carved wooden handle. Shiloh couldn’t see what the carving was, but he could feel the delicate etching of some hard, highly polished wood.
“What’s a fine muffin like this doin’, anyway, mugging self-respecting men and horses out here like this?” Shiloh asked Balaam, shoving the umbrella into the saddlebag. “Aw, quit your whinin’. It’s all your fault anyway, knockin’ him out cold like that. Speakin’ of cold, let’s step it up a little, Balaam. Snow’s getting heavy, and I guess I need to get this little sneak-thief someplace warm before he dies on me.”
Two
Lifeline
“Put him in Surgery 3,” Cheney told James and John as they carried Cornelius Melbourne into the hospital on the stretcher. They turned left into surgery while Cheney started toward the nurses’ station straight ahead. A weak cry from the litter stopped her, so she motioned to the duty nurse, and the two followed James and John into the operating room. The boys placed the patient, litter and all, on the surgical table. Cheney said firmly to Melbourne, “This is Nurse Kitty Kalm, Mr. Melbourne. She is going to stay with you, because I must attend—”
“No, no,” he said. “Don’t leave me, Dr. Duvall. Please don’t leave me….” He was beginning to show signs of increasing agitation, though only his hands twitched. He kept his eyes locked on Cheney’s face. She knew that sometimes patients with horrible-looking injuries could not bear the sight of them, so they obsessively fixated on something else. In Mr. Melbourne’s case, Cheney seemed to be his tenuous lifeline.
She took his hand. “All right, then, I won’t leave you.”
He relaxed a little, and some of the dreadful panic diminished in his eyes and expression. His hand was cold and clammy. His lips were blue. Cheney knew that he must have surgery immediately. To Nurse Kalm she spoke in the quiet monotone that seemed to soothe the patient regardless of what she was saying. “Is Dr. Batson here?” “Here” for Cleve meant at the hospital, the office, or his home, as they were all on the same block. He always alerted the hospital of his whereabouts.
“No, ma’am. He came in after lunchtime and said he was going downtown, that he had several patient calls to make. He left a list if you would like—”
“No,” Cheney said, the casual tone in her voice belying the urgency in her eyes. “Mr. Melbourne must have surgery immediately.”
Nurse Kalm nodded. She was a cheerful, capable young woman who had that rare intuitive gift of understanding sick people and their needs. Now she considered the pale man on the surgical table thoughtfully. His expression did not change, and his gaze did not waver from Cheney’s face.
“I can assist,” Nurse Kalm said in the same confident tone Cheney had been using, perceiving the patient’s state of mind. “I have anesthetized in eight procedures, all successful.”
“I’m going to assist,” Cheney said. “I need a surgeon.”
Kitty’s eyes widened, but she was careful to speak quietly. “Aren’t you going to do the surgery, Dr. Duvall?”
“No. I’m not qualified to do such a procedure.”
“Then Dr. Pettijohn will have to do it.”
She and Cheney locked eyes for long moments. Cheney’s mind was a whirl of confusion. Nurse Kalm watched Cheney with what seemed to be clinical curiosity, waiting for her momentous decision.
To their surprise Cornelius Melbourne whispered weakly, “Dr. Duvall…have you ever…done surgery?”
She looked down at him and started to make excuses, but in that moment, her mind quieted and she answered with the simplicity of truth. “Yes, I have. I have just never done the particular surgery that you require.”
To her amazement the barest flicker of amusement showed in his dull eyes. “Never had…anyone…with a steel spike sticking…out of his chest? Fancy that. I…want you to do it, Dr. Duvall. I want you…to operate on me.”
She smiled at him, suddenly calm and sure. “Very well, Mr. Melbourne, I will.” He even managed a weak smile as he clung to her hand.
Now certain of her course, Cheney told Nurse Kalm, “I want you to go tell Nurse Nilsson to take charge of the wards and do rounds with Dr. Pettijohn. Ask Dr. White to join us, and you come back to assist.”
“Yes, Doctor.” She hurried out.
Cheney looked down at Cornelius Melbourne, and he looked up at her. He was growing weaker by the minute. The procedure to remove the spike and repair the damage was going to be perilous. His chances of surviving the surgery were not good.
As she looked deep into his eyes and studied his expression, she could see that he knew all of that. He was afraid, but he had put his hope and trust in her. Cheney knew she had one more duty to perform for this patient before she sent him on what might be his last journey.
“Are you a Christian, Mr. Melbourne?” she asked. “Do you know the Lord Jesus Christ?”
“No,” he answered. “I have attended church all of my life, and I know of the Lord and His salvation, but I have never asked Him to save me. I would like to do that now, and I want you to pray for me.”
Cheney bowed her head and closed her eyes. She knew that he kept his gaze trained on her. “Dearest Lord, Mr. Melbourne needs your love, your salvation, and your healing. I pray that in his heart he will seek you in spirit and in truth, for you have promised that those who do will find you, and you will take them in.
“Give me strength as I operate on him. I humbly ask that you guide my hands and my eyes and my thoughts so that I may perform this procedure perfectly. And I ask that you heal this man, Lord. Amen.”
He closed his eyes and prayed, “I am a sinner, lost in darkness, Lord Jesus. Save my…soul. Give Dr. Duvall skill and knowledge and the guidance she needs, Lord. And if you…decide to bring me home, I ask that she will always know in her heart…that I have been saved.”
When he opened his eyes again, Cheney could see fear still lurking, but he seemed more at ease than before. She said, “I’m going to go wash my hands and get the surgical supply tables ready. Just over there, do you see? I’m not leaving the room.” He nodded, then let go of his death grip on her hand. As she moved away, she paid close attention to the sound of his breathing. His respiration was still shallow, but he didn’t immediately start hyperventilating as soon as she got out of his line of vision.
“Nurse Flagg is going to give you an anesthetic, chloroform, which is going to put you to sleep,” she told him as she worked. “And Dr. White, who was with us in the ambulance, will be assisting me with the surgery. You are in St. Luke’s hospital, and when you wake up, you will be in a comfortable private room.”
She kept talking until Dr. White and Nurse Kalm returned. They scrubbed their hands, and Dr. White and Cheney took their places beside the bed as Nurse Kalm readied the anesthetic. Cheney smiled at him. “I will see you later, Mr. Melbourne.”
“Yes, and whatever happens, Dr. Duvall, I’m glad that you are the doctor taking care of me. Don’t forget that.”
“I won’t,” Cheney promised him. “Now Nurse Kalm is going to anesthetize you. Just close your eyes…relax…”
; As soon as he was unconscious, Cheney yanked the blankets off him and said to Dr. White, “Hurry. Cut the clothes off him. Nurse Kalm, I want you to continually monitor his respiration and pulse and take his temperature every five minutes. Let me know immediately if there is any change.”
“Yes, Doctor.”
“Oh, Dr. Duvall, he is absolutely filthy,” Dr. White said. “The mud has soaked through his clothes, and it’s caked all around the injury.”
“I know. I didn’t want to take off his clothes and clean him up until he was unconscious.” Cheney began sponging him off with a saline solution. Taking a plunger, she began squirting jets of the solution all around the spike in his chest. “He was half-frozen already, and I didn’t want to make him more miserable than he was. All right, this is good enough, Dr. White. We can finish cleaning him up after the surgery. Try not to touch any place but this area where we’ve washed him off. Now let’s wash our hands again in the carbolic acid solution and swab his whole chest area with it.”
“I don’t really know how to assist you, Dr. Duvall,” Dr. White said uncertainly. “I’ve never even seen an operation like this, much less assisted at one.”
“Neither have I,” Cheney said, “so we’ll just have to figure it out together. Nurse Kalm, have you ever seen a procedure like this?”
“No, Doctor,” she answered. “When I worked at Bellevue, I saw two patients come in who had been stabbed, and the knives were still imbedded in their chests. But they were both dead.”
Cheney nodded. “It’s a miracle this man is still alive.”
Dr. White observed, “There’s so little blood. I would have thought a person would just be swimming in it with an injury like this.”
As Cheney carefully swabbed around the wound, she could see that almost no blood was seeping from around the spike. “That’s because the spike itself is exerting enough pressure on the blood vessels to stop them up, as it were. Visualize sticking a pencil through a piece of paper and then looking at the underside where the pencil has gone through. Little bits of the paper will be turned under all round the pencil, correct? Just so here. The ends of the severed vessels are turned under all around the spike, so there’s minimal bleeding. Of course, this tamponotic effect wouldn’t have worked if the spike had struck a major artery, because the pressure of the blood flow would be too strong.”