Tales of Anyar

by Olan Thorensen

  “A badly broken leg, you say? Let me gather a few more things. I’ll be ready after I wake Wanda Tahn next door to come stay with Sonya while I’m gone.”

  She added more instruments and supplies to her main medical bag, then filled a smaller satchel. Satisfied that she was as ready as she could be, without examining the patient, she checked Sonya, pulled the cover back over her, and gave a soft kiss to the blonde head. Sadaro waited by the cart, rocking back and forth and wringing his hands. She woke Wanda, talked to her, and quickly climbed beside the cart’s driver.

  “I’ll send word back when I know how long I’ll be in Seminang,” she called to Wanda, as the driver whipped the donkey with the reins.

  During the two-mile ride to Seminang, she saw scattered tree clumps separating neat paddies and their crops with plant heads resembling rice but tasting like corn. The grit-like gruel served as a staple of villagers’ diet, supplemented by vegetables, fish, occasional meat, and what looked to Marta like amaranth grown on the valley’s slopes. She couldn’t be sure because she’d never tasted amaranth, but the dense red, yellow, and purple seed clusters and leaves looked like photos she’d seen.

  Tonight, she couldn’t quite make out the amaranth’s colors, but stars lit the road and paddies. No moons ever lit the night—a lack more than compensated by the panorama of stars. She had never had an interest in astronomy, but one of her sons had festooned his adolescent room with star maps and space telescope posters. His regaling her about the universe gave her enough background to recognize this solar system must be part of a globular cluster of stars. Depending on the night’s atmospherics, she thought she could make out color differences: sharp blue stars, whitish ones she suspected were shades of yellow, a few red, and her favorite—a green star.

  A disadvantage of the illumination provided by the sixty to seventy brightest stars was that their light prevented people’s eyes from detecting fainter stars—giving the sense that the cluster represented the entire universe, instead of the infinite expanse suggested by the clearest nights on Earth.

  After first arriving, she’d spent lonely hours staring skyward at night, straining to see a familiar constellation behind the cluster’s stars. Now, she glanced up only occasionally to search for something familiar and to feel a pang of loss. The cart’s wheel rolled over a rock, and the jolt brought her back to the current night’s call for her help.

  “We’ll be there in a moment, Pan Marta,” said the driver, breaking into her ruminations. “We all hope you can help whoever the man is. Everyone’s afraid.”

  She didn’t recall the driver’s name, though she associated him with a home in Seminang where she’d performed an appendectomy on a ten-year-old adolescent—fifteen Earth years. The longer year made for extended seasons, which didn’t bother her as much as the longer days she estimated were twenty-seven Earth hours long.

  “I’m sure everything will be fine,” she said. The pro forma assurance nagged in the back of her mind. Even after three years, she didn’t have the lifetime of experience necessary to intuitively understand this society and its variants. Any change in routine unsettled her, being too fraught with uncertainty.

  When they pulled into Seminang, torches illuminated a small square with a water well at its center. Six mounts stood reined to a tying post—otherwise, the square was deserted. The torchlight let the driver see her puzzled expression.

  “People are staying in their homes with their families. No one wants to be out and identifiable if anything goes badly.”

  She climbed out of the cart without responding to the nervous driver and collected her two bags from the cart floor. He led her to a thatched-roof, general-purpose building used by the village chief for meetings and public affairs. Inside, a strange man dressed in a white shirt, blue jacket, and blue pants lay on a narrow table. The left pants leg had been cut away, exposing a gruesome break below the knee. Five other strange men surrounded the table. All the men wore similar clothing she recognized as either military or an important family’s livery.

  A worried Chief Ramat stood to one side, while the white-haired village healer, Satrio Rafo, examined the leg. Marta considered Rafo both a first-aider and an herbalist, the valley’s expert in medicinal plants, some of which she believed efficacious enough to use. She knew Rafo’s family worked a section of paddies because payment for medical services by villages was spotty and commonly involved bartering with goods and services, rather than paying with the silver coins used in rural areas. She knew of gold coins, though she had never seen one.

  The driver said something to Ramat, who nodded toward the table. Marta walked over to stand next to Satrio Rafo. “Greetings, Dan Rafo. Chief Ramat asked to come to see if I could help.”

  She carefully avoided giving the appearance to Rafo or any of the other village healers that she intended to usurp their positions but had come merely to assist. In many difficult cases, no one pretended she wasn’t in charge, but she and the five village healers maintained the pretense.

  Today was different. Rafo’s pleading look when he saw her left no doubt that he wanted someone else—anyone else to be responsible for this case.

  One of the men wearing what she now believed was livery looked at her skeptically. She wore blue but not of good-quality cloth, unlike what he would see in larger cities or the capital. She wore common folks’ sandals, and her two bags were worn leather.

  “ You’re supposed to be the best healer in this valley?” he snapped.

  “Yes,” said Ramat. “Pan Marta Witwurt will do the best for Lord Etullo.”

  Don’t make it sound like you’re praying , Marta thought.

  “Maybe we should take a wagon and go to a larger town,” said another of the men.

  From Marta’s limited contact with the higher castes, she believed timidity only fueled their disdain.

  “Make up your mind, Dans. I came all the way from Tagel to help Lord Etullo. If you don’t want me to look at him, say the word, and I’ll go back home to sleep.”

  The man lying on the table groaned and spoke. “Suhandro. Let her look at it and see what she thinks she can do.”

  Marta looked at the patient closely for the first time. His hair and beard were cut and manicured in the manner of the higher castes. She thought his common light brown complexion resembled coffee with too much cream added. Lines of pain etched his face, and he gripped the thigh above the break.

  It was bad. Both the tibia and the fibula were broken in two places. Sharp ends of bone protruded, and the leg sat in a pool of blood.

  “How did it happen?” she asked.

  The standing men’s leader cursed. “A damn child ran into the road. His Lordship’s mount swerved, tripped, and fell on Lord Etullo’s leg.”

  “She’s only three years old and wandered outside her home,” said Ramat desperately. “She didn’t see you.”

  Four and a half , calculated Marta. A year was fifty percent longer here than on Earth. I’ll bet they were racing through the village at full gallop and never gave a thought to anyone in their way .

  “Perhaps if you had been going slower, this wouldn’t have happened,” said Marta, annoyed at the man’s attitude and suffering a momentary lapse in judgment.

  Ramat paled in the torch and candlelight.

  “Enough!” grated Etullo, his jaw clenched from the pain. “My leg. I know. It’ll have to come off, so get on with it.”

  Marta leaned closer to the leg. “Bring the candles in closer.” It was as bad as her first glance indicated.

  The bones didn’t shatter , she thought. If there were too many pieces, there would be no choice but amputate. As it is, they look like clean breaks. The problem is getting the pieces to stay aligned. It’s not like single breaks where a good, simple splint can do the job. At home and in a hospital, I’d use titanium screws to hold the pieces together. Here, I doubt they know titanium exists.

  It’s more important that Sonya and I stay below the radar. Having no one notice us outside
this valley has worked for three years. If I do a procedure no one here has ever seen, I’m asking for trouble.

  She pretended to continue examining the injury, while her conscience warred with self-interest. She sensed she’d run out of time when several of Etullo’s companions began to shift their feet and grumble.

  It’ll be hard enough with the bones, but if arteries are severed, they’ll have to be closed first.

  She addressed Etullo. “I’m going to loosen the tourniquet, so I can tell if major blood vessels were cut.”

  He nodded.

  A piece of rope and a stick had been used for the tourniquet. “Get me a length of cloth I can tear. The rope will damage his flesh. I’ll release the rope, so I can see how much bleeding there is, then I’ll put on a cloth tourniquet.”

  Ramat rushed out of the room and returned moments later with a woman’s tattered dress. Marta ripped a five-foot-long, three-inch-wide piece. When she released the tourniquet, blood pulsed out of the spot where a jagged bone jutted from Etullo’s leg.

  Damn! she thought. I was hoping he’d lucked out. One of the bone ends cut the anterior tibial artery. I’d have to go in and suture it closed and hope it’s a fairly clean cut and not sliced down the artery’s length. In that case, at home I could resection using a piece of vessel from elsewhere, but not here.

  She moved to look down into Etullo’s sweating face. “There’s a chance I can save the leg, but I can’t guarantee it.”

  “How good a chance?” he asked.

  “Probably less than one in two. Even if I can stop the bleeding and get the bone pieces back together, the leg might still have to come off.”

  “Do what you can.”

  “Lord Etullo, are you sure you want this woman to treat you?” said the man named Suhandro. “How competent can she be, if she’s living here?”

  “Suhandro, what are the options?” said Etullo. “You’ve seen the leg as I have. If she fails, the leg is still lost. We make decisions on what’s possible. I’ll let her try.”

  Suhandro shook his head. “It’s your decision, Lord.” He turned to Marta. “If Lord Etullo dies, you and this village will be held responsible.”

  Marta stepped back from the table. “In that case, I cannot try to save the leg. It would be a difficult operation, and no one can tell the outcome. The best doctors and healers can lose patients for reasons beyond their control. I cannot put the lives of the villagers at risk.”

  Suhandro snarled and put a hand on the hilt of one of three knives on his belt. “You will do as you’re told.”

  Marta swallowed and prayed she understood the society well enough. “And who are you to threaten me ? You wear Lord Etullo’s colors, but if not for that, what caste are you? High enough to threaten someone wearing blue?”

  Suhandro’s eyes narrowed. “You wear blue, but how do I know it’s by right and not imposing?”

  “Enough!” said Etullo. “Suhandro, we’re wasting time, and these are not the old days.”

  His eyes shifted to Marta. “The village chief called you Marta Witwurt. Pan Witwurt, I give my word no retribution will come, no matter the outcome of your efforts.” He looked back at his retainer. “You understand, Suhandro?”

  “Yes, Lord, but if I believe she is incompetent and your life is in danger, I will stop her and have the village healer take the leg.”

  “Get on with it,” said Etullo to Marta.

  “We can’t do anything yet,” she said. “The treatment will be difficult and must be done with great care. There’s not enough light yet. We’ll have wait until the sun is up enough, which should be in another three hours.”

  No reason to tell him we’ll have to wait days or weeks to see if the leg can survive having so much blood flow stopped. I think the posterior tibial artery is still intact, so periodically releasing the tourniquet will allow partial blood flow to the tissue below the breaks. If that’s not enough to keep the leg viable, I’ll have to amputate. But she could worry about that later; she had to proceed assuming the leg was salvageable.

  “While we’re waiting for more light, there are things that need preparing. In the meantime, I can’t give you morxtin extract for the pain. It’ll have to wait until I start to operate.

  Etullo seemed to stifle a groan, then gathered himself. “I am Lord Etullo of the House of Ko. I will bear what I must.”

  Whatever helps . She controlled her temptation to blow off his macho bullshit. He must be a tough bastard , she conceded. I’d be screaming in agony, yet he’s able to carry on rational discourse.

  Opioids were unknown. Severe pain was treated with an extract of the venom from a bright orange-colored centipede-like creature that grew two feet in length. A bite was often fatal, but small amounts deadened nerves. However, it had to be used judiciously because the effect wore off in about an hour, and more had to be applied. Although the numbing effect was temporary, the life-threatening characteristics were cumulative. Too many applications could add up to the same effect as a direct morxtin bite.

  She turned to Ramat. “Give him water whenever he wants it and keep someone wiping his face with cool water. We also need to send to Gawfur village for the man there who makes jewelry.

  “Dan Suhandro, village chief Ramat will bring someone who needs to accompany one of your men to the village of Gawfur. It’s the one you passed when you first entered the valley. There’s a man there named Bikmun. He makes jewelry and does other metal work. We need to bring him here as fast as possible, and he’s to bring his tools and the smallest steel nails he has.”

  Suhandro stood looking at her.

  I bet he’s trying to decide if I’m of high enough caste to be ordering him around. A little sugar here is needed to get the big oaf moving.

  “Please, Dak Suhandro. Lord Etullo’s condition and the best chance to save the leg depend on all of us doing everything we can as quickly as we can.”

  She hoped that shifting from the common “Dan” to the more honorific “Dak” would soften his attitude. Whether or not her ploy worked, Suhandro shouted for one of the other men, and shortly thereafter the man galloped off with a village youth sitting behind him and holding on.

  Sooner than Marta expected, the rider returned, this time with a middle-aged man seated behind him—the youth had presumably been left to find his way home in the dark. While they were gone, Marta had directed Ramat to prepare an operating position, and she used paper and quill to sketch what she needed made.

  She had the jewelry maker lay out the small steel nails and tacks he used in his trade. Next, she selected a dozen of the best size available. Then she pulled him over to a set of candles and held the paper near the light. On the sheet, a crude drawing of a screw showed its spiraling groove. “You know what a screw is. What you’ll be doing is converting these steel nails into screws. You’ll need to cut into the shaft, as shown, so that when I turn it, the small screw twists into bone and holds firm.”

  “Into bone! What—?” exclaimed the old man.

  “Just do it, as quickly as you can,” she said. “When you’re finished with about a dozen of the ones I pick out, I’ll take those while you’re making more screws like the first ones. I’m sure Dak Suhandro will be pleased to see the speed of your work. I’ll give you two hours to finish the first ones.”

  She hated making the implied threat, but there wasn’t time for more questions or excuses.

  While she waited, she continued to direct the men setting up an operating table outside, and once again thanked the fates that infections were rare. Humans were not subject to invasion by local microorganisms, and however people had come to this place, they’d brought relatively few infection-causing microbes with them.

  Just over two hours later, the craftsman hurried to her with the screws, shiny from fresh filing. She didn’t doubt that the sweat beading on the jeweler’s face resulted from Suhandro standing by his shoulder the entire time.

  “Here they are, Pan Marta. I did the best I could in the time
I had.” His words contained an unspoken prayer that she found the screws acceptable.

  She examined what he held out on a white cloth. The screws were so crude, she would have been disbarred from using them in any hospital she’d worked at.

  “They’ll do fine. Thank you for your quick work. I’m sure no one else could have done better. Continue making more in case I need them.”

  There. That should absolve him if anything goes wrong .

  For the next half hour, she set out her instruments and mentally rehearsed how she would proceed. When the sun was a hand’s width above the eastern hills, it was time.

  “Dak Suhandro, please bring Lord Etullo to the table we’ve set up.”

  Four of Etullo’s retainers carefully carried him to the table. Despite their caution, his wan face and gritted teeth confirmed what he felt every time the leg moved.

  She put a hand on his chest and leaned over him. “Lord Etullo, I am ready to begin. I’m going to tell you what I’ll be doing.” The explanations were more for Suhandro’s benefit, so he didn’t react badly as he watched her work.

  “The broken ends cut at least one of the blood vessels in your leg. I’ll have to sew the cut shut or reattach the ends, if I find the cut all the way through the vessel. If more than one has been cut, they’ll all have to be repaired. If I can’t succeed, then I’ll have to take the leg. Once the vessels are repaired, I’ll put the bone pieces back together as well as I can and hold them together with these.” She held up one of the newly made screws. “They’re made of steel, and there is a chance your body will not tolerate them. Unfortunately, we can’t predict how your body will react. For some people, there’s no reaction; for others, it will happen within days. In the worst case, they would have to be taken back out, and you might lose the leg. Hopefully, there’s no reaction or it comes on slowly; then the bones will have healed enough that the screws can be removed by another operation without your losing the leg.”

  She motioned for the men to bring closer several stands supporting the largest mirrors in the village. Sunlight created shadows, and she’d be working over and inside the leg. She would direct onlookers to change mirror positions to reflect sunlight into the wounds as she worked.