[Home To Blessing 01] - A Measure of Mercy

by Lauraine Snelling

  “Dr. Bjorklund?”

  “Yes, come in.”

  One of the nurses peeked in the door. “Dr. Whitaker needs you in the ER.”

  “I’ll be right there.” She dropped her letter off at the desk as she flew by. “Please see that gets in the outgoing mail.”

  “I will.”

  Astrid grabbed an apron off the line of hooks beside the door to the emergency room and, after making sure she had her stethoscope and pad and pencil, tied the apron strings as she walked in.

  “He’s over here.” A nurse beckoned from one of the curtained cubicles. She held the curtain back for Astrid to enter.

  “Notify the charge nurse that we need an operating room immediately,” he said, glancing up at Astrid.

  The nurse hurried out of the room. “Hold this for me.” He nodded at the other side of the gurney and the patient.

  A young boy lay on the gurney, both legs smashed beyond recognition. Astrid took the strings of the tourniquet and finished tying it off. The flow of blood ceased.

  “I’m going to have to amputate both legs. There is nothing I can do to repair such destruction.”

  The woman standing with the boy hid her eyes with one hand, her groan preceding the shaking of her shoulders.

  “He fell under the wheels of a dray,” Dr. Whitaker muttered to Astrid.

  Astrid had to swallow the acid from her stomach. Such terrible wounds. Why wasn’t he in school, where he would have been safe? She turned at another groan from the woman and caught her as she fainted.

  “Get her out of here.”

  Another nurse jumped to his bidding.

  “Give him another whiff of ether. He’s coming around.”

  Astrid picked up the cone and the bottle to administer the anesthetic. .

  “The operating room is ready,” a nurse said at the doorway.

  “Good. Let’s go.” He stepped back, and two orderlies took the head and foot of the gurney and wheeled it out while Astrid and the doctor headed for the scrub room.

  “Have you done an amputation before?” he asked.

  “No, sir.”

  “We’re going to have to take both legs off above the knees, which condemns this lad to life in a wheelchair. He probably lives in one of the tenements with flights of stairs that he will not be able to manage, even with crutches, if he can somehow learn to use those. He’ll most likely end up a beggar on the streets.”

  Astrid fought the tears that his words brought.

  “That’s if we can keep gangrene from setting in and taking his life.”

  Would dying be preferable to a life like that? The thought made her want to vomit. Was this another side to doctoring she’d not considered?

  18

  The grate of saw on bone lasted two lifetimes.

  Astrid held steady to administer more anesthetic if the doctor asked, but every particle of her being screamed “Run!” She willed herself home to the fall, when they would soon be cutting wood for the stoves, but there was no way she could convince herself that was what was going on.

  “Are you all right?” one of the nurses asked under her breath.

  “I will be.” Astrid gritted her teeth and bent her knees slightly. She’d read that could help keep her from fainting. She’d never fainted during an operation before, but then she’d never heard bone being cut before either.

  The boy stirred beneath her fingers, and she snapped back to the hot lights and heavy air.

  “Another drip, stat.” The doctor’s voice cut through the remaining fog.

  With more drops of chloroform, the boy sank into unconsciousness again.

  “Dr. Bjorklund.”

  “Yes, sir.”

  “Let the nurse take over your job. I want you to observe and assist me with this.”

  “Yes, sir.”

  Maybe it was the fumes floating upward that were causing her to be woozy. The nurse took over, and she stepped to the opposite side of the table.

  “You see that I had to remove the bone high enough to where I had good skin to work with. Also to bone that was not injured.” He glanced across at her, and she nodded, recognizing the long flaps of skin that he indicated.

  “One of the greatest trials for an amputee is the pain of bearing the weight on the artificial limb, so this way we cushion the stump as much as possible. Sometimes double amputees decide to use a four-wheeled flat board, propelling themselves with their hands. Others choose a wheelchair. This boy is young enough that he might adapt to crutches. Now, we fold this one under first, then cover it with the front flap and stitch around it. This is a technique developed during the Civil War when so many of the wounded lost a leg or foot.” He handed her a threaded needle and picked up another for himself. “You start on that side, and I’ll start on this.”

  When they finished, he asked for water for those in the room. “We don’t need any dehydration problems or fainting for any of us.” He looked to those assisting him. “If you need to step outside for a moment, now is the time to do so, before we start the second leg.”

  Stepping outside was only a prelude to what Astrid ached to do. Her entire insides screamed at her to run. Run all the way back to Blessing. Or at least down the street to a small park she had located on one of her few walks.

  “All right. Let’s begin again.”

  A nurse removed the dressings on the second leg, equally as damaged as the first.

  “You will assist in cleaning out the debris.” He nodded to Astrid. “Excise the tissue to healthy tissue.”

  Astrid removed bone splinters and bloody bits that she didn’t bother to identify.

  “Suture any blood vessels so that we can release the tourniquet.” As they cleared the operating field, he continued. “We will make the cut on the bone here.”

  Astrid forced her eyes to remain open, constantly ordering her mind and hands to obey. When she inhaled, the heavy odor of blood clogged her nostrils. Before she could compensate, her knees buckled, and the light went out.

  She came to sitting on a bench, one of the nurses holding her in place with a hand on the back of her head, forcing her head down. She coughed and choked on the fumes of the smelling salts held near her nose.

  “What ha . . . ?” She added a groan as she realized where she was. “I fainted?”

  “You aren’t the first nor will you be the last.” The nurse let her sit upright. “Get your head down again if you feel faint.”

  Astrid leaned her head against the wall behind her. “I think I’m going to be sick.”

  The nurse handed her a basin. “You aren’t the first. Next time you’ll get through just fine.”

  If there will be a next time. “But I’ve assisted on I don’t know how many surgeries. Why this now?”

  “The heat, the length of the operation, and most likely fatigue. All those things. Dr. Bjorklund, this is not the end of the world, or your medical career.” Her voice firmed up as she spoke. “I’ve nursed more students, both doctors and nurses, through things like this. Have you ever done an amputation before?”

  Astrid shook her head but stopped as even that slight motion caused her stomach to send up warnings.

  “Ohh.” This time she gave in to the retching. When she finished, the nurse handed her a wet cloth.

  “Wipe your face. Breathe deeply, and when you can, stand, wash up, and go lie down in your room for a while. We’ll call you if necessary.”

  Astrid did as ordered, not that she had much choice. “Thank you.”

  The nurse rose. “One day you’ll be coaching some other hapless student through this same thing. Next time you’ll do better.”

  If there is a next time, she thought again. Mortification weighed like a suit of armor, dragging at her shoulders and clanking about her ankles. She emptied the pan and rinsed it out at the sink. Then, after removing her operating room garb and stuffing it into the laundry bin, she made her way to her room and collapsed on her bed. Surely this was what failure felt like.

  �
�——

  LATE THAT AFTERNOON, she found herself outside Dr. Franck’s office door. The idea had come to her when she woke from a dead sleep, afraid she’d slept through afternoon class, evening rounds, and supper. But instead, she’d only missed dinner, and her stomach didn’t feel much like food anyway. Since today was not an anatomy class day, she’d not seen this teacher for two days. While he’d probably heard of her ineptitude, she knew she needed to talk with him. She raised her hand to knock and let it fall to her side. Why ask? He’d only say no and most likely make fun of her besides. She started to turn away but something made her grit her teeth and knock on the door.

  “Come in.”

  Fully understanding how a mouse might feel with its foot in a trap, she pushed open the door and stepped inside. The only item on his desk was the book he was reading. All the other books were shelved, and every paper must have been in the place assigned it because no paper was visible. How did he do it?

  “Yes, Dr. Bjorklund?” Clipped and to the point.

  “I . . . I have a request.” She’d started to say favor but changed the word.

  He nodded for her to continue.

  She swallowed the lump in her throat that threatened to choke her. “In the dissecting of the cadaver, do we ever do an amputation?”

  “No.”

  “Then how does one learn to do the procedure?” she asked him respectfully.

  “Have you ever sawed wood?”

  “Yes, sir.”

  “It is much the same. Primarily, you need a freshly sharpened saw.”

  Her insides quivered at the mention of the instrument. She sucked in a fortifying breath. “Would . . . ah . . . could one do an amputation on the leg of the cadaver?”

  He stared at her. “You would want to do that?”

  “Yes, sir.” She swallowed again. “I fainted this morning in the operating room. Dr. Whitaker had asked me to assist with a young boy who had fallen under a dray, and his legs were destroyed.” Tears burned behind her eyes, but she blinked and raised her chin.

  “I made it through the first leg.”

  “I see.”

  Surely that wasn’t a twinkle she detected in his eyes. “I understood from your admittance papers that you have performed a number of surgeries with your training doctor.”

  “Yes, sir. But no amputations. Mostly birthings.” Why, oh why, did I ever think this was a good idea? Because this is why I came to Chicago.That’s why. The argument in her head made her hands twitch to cover her ears.

  “I see.”

  Is there nothing else you can say? She heaved a sigh and turned toward the door.

  “Where are you going?”

  “It is obvious that you are not willing for me to experiment like this. Thank you for your time.”

  “I said nothing of the kind. If you truly believe in what you see as necessary, then you must have the backbone to see it through.”

  Hope shot from her heart to her head. She spun back to face him.

  He was leaning back in his chair watching her. “We have an extra cadaver at the moment. I believe that I will do a demonstration in tomorrow’s class and give everyone an opportunity to use the saw on a real bone. You are dismissed.”

  “Thank you.” She exhaled again. And perhaps you will allow me to do more after the others have left, if I ask. I do have the backbone. It’s my stomach that seems to be the problem here. She felt the door click behind her. While leaping down the stairs would not be professional in the least, she still felt like doing so, along with giving a whoop or two. Instead, she made her way down to the children’s ward and stopped to check on Benny, as she’d come to know his name by carefully filling in his chart with all the vital signs and observations.

  His eyes fluttered open when she checked his pulse and listened to his heart.

  “I hurt.”

  “I know. I’ll get you something more.” She patted his shoulder. Seepage through the bandages covering the stump of his right leg concerned her. She felt his forehead. Warm but not hot. “If I bring you some soup, do you think you could eat it?”

  He nodded, his eyes shadowed by the pain.

  “I’ll be right back.” She left his chart at the end of his bed and stopped at the nurses’ station. “Please give Benny another spoonful of the laudanum and honey mix, and I’ll bring up some chicken soup for him.”

  “He refused to eat earlier.”

  “Was he awake?”

  “Off and on.”

  “Has he had any visitors? Like a mother or father?”

  She shook her head. “I have a feeling he is one of the homeless children who live on the streets. We get many of them now that we’ve opened the hospital to care for children as well as women.”

  “But there was a woman who brought him in.”

  “She didn’t stay around, so we are assuming she was not a relative.”

  “So there are children out there with no one to feed and care for them?”

  “ ’Tis a disgrace, it is.”

  Astrid stared at the nurse. “I’ve read about such things but somehow never thought it was real.”

  “Oh, it’s real all right.”

  “So who will care for him when he leaves here?”

  “He’ll go to the poor farm or the orphanage. He might be a runaway from either place already.”

  Astrid chewed on the side of her lip. “I’ll be right back. Please give him the pain medication right away.” The nurse nodded. Astrid headed for the kitchen, her feet clacking out her frustration down the hall and the stairs. What was this world coming to that children lived on the streets? Toby and Gerald did. The thought stopped her like a glass wall. No wonder they’d hopped a train, hoping they’d find something better farther west.

  When she returned with a mug of chicken broth with a few mashed noodles in it, and a spoon, Dr. Whitaker was examining the boy. She waited at the foot of the bed.

  “I see you ordered more morphine.”

  “Yes, sir. Also a spoonful of laudanum with honey.”

  “Good. I was about to do the same, to be given as needed. I will leave you in charge here. The dressings need to be changed in the morning. If he begins to run a fever, what will you do?”

  “I will sponge him with cool water, force liquids, and lay cold wet sheets over him if need be. At home we’ve used ice chips wrapped in cloth at the neck and placed the patient’s hands in cold water. Usually we could use a tepid bath, but with his legs like this, they shouldn’t get wet.”

  “Very good, Dr. Bjorklund. May I add one more thing?” He studied her. “I always pray for my patients. I believe God is the Great Physician.”

  “Yes, sir.” If only Mor were here. She would pray, she and Pastor Solberg. But they weren’t here, and so far God had not answered her prayers for healing in the past. Why should He start now? Remember the exam. The thought caused more consternation. Did God pick and choose which prayers to answer and ignore others?

  She put the inner discussion aside. “And, sir, I want to apologize . . .”

  Before she could finish he waved her to stop but smiled as he left the room.

  After supper she checked on Benny again and then returned to the dissecting room to pull her cadaver out of the cooler. Red Hawk met her as she locked the gurney in place.

  “I had hoped to be here before you.” His glare said more than his words.

  I was hoping you wouldn’t come at all. What could she say? Sorry? No, that made no sense. Why was he so . . . so rigid? No, that wasn’t the right word. But it was more than unfriendly. “Oh” seemed the only answer appropriate. Why was he polite, almost friendly, at times and then harsh or even rude at others?

  “You’ve gone ahead of me.”

  “Yes.” Why does it matter? she wondered. She laid out her instruments, wishing she had a saw and the permission to use it.

  They both went to work, he still on the leg and she up to the abdomen.

  “You are going ahead of the rest of the class.�
��

  “I know.” She studied the diagrams in her textbook. While she’d assisted now on two abdominals, she’d not had time to study each organ. Perhaps if she had known the abdominal cavity more fully, she’d have been able to save Vernon.

  As clearly as if she were standing right behind her, Astrid heard her mother say, “I do the best I can with what I have, and I trust God to supply the healing.”

  Trust God. Her mor made that seem so easy. But it wasn’t! What about the times God didn’t heal? Like with Vernon. Like with Anna’s baby. And what about Benny now? Was God going to turn His back again? Or was it all her fault?

  She finished the abdomen and then returned to the leg she had mostly completed, locating and tracing the nerves. Such small tissue to have such impact on the body working correctly.

  But visions of a small boy falling beneath the iron-shod wheels of a loaded dray wagon kept getting in the way. Where would a small boy who was a double amputee go to heal and begin a new life? If only she could send him home to Blessing. Surely someone there would take him in.

  “Are you feeling ill again?”

  She stared up at Red Hawk, who was looking at her, waiting for an answer. “I’m not sick.” The light dawned. “You’ve heard?”

  “I’d say probably everyone knows.”

  Astrid stared at him. It was humiliating enough to have it happen, yet to be the brunt of gossip and snickering—what could be worse?

  “Nurse reminded me I was not the first to faint nor likely to be the last.” She tried on a grin, thinking it more along the line of a grimace, but at least it wasn’t tears.

  “She’s warned us all as we take the surgical rotation.” He jotted some notes down on his pad.

  “You’ve already gone through the surgical?”

  “The first one, but there are three or four I think.”

  “I see.” But she didn’t. Were they designing a special rotation just for her? And if so, why? She glanced up at the clock on the wall. She’d been here for two hours already. “I need to go check on my patient.”

  “I guess I’ll put this away—again.”

  “Thank you.” She studied him for a moment, deciding to ignore the again. She had gotten the gurney out. Just because he was being rude again didn’t mean she should be. A soft answer turneth away wrath. The verse in her mind stopped her. Why was always the question. Maybe he was as homesick as she was?