East of the Mountains

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East of the Mountains Page 19

by David Guterson


  The surgeon turned to Ben next, his forearm pumping rhythmically. "Pull a little harder," he said. "It's biting into my arm." He nodded when Ben put leverage on Stackhouse's rib and pulled it out of the way. "This is much easier for left-handed guys," the surgeon said matter-of-facdy. "I don't have the same finesse."

  "Is he dead?" Ben asked.

  "He's been out for less than a minute," said the surgeon. "I'm trying to compress his heart and get him started again."

  "You're doing what?" Ben asked.

  "I've got his heart in my hand," said the surgeon. "It isn't too much of a trick, really. You just want to make sure you palm it correctly, don't try to do the work with your fingers, and especially not with the ball of your thumb, which is very tempting and seems right, but what you want is to cup the thing and squeeze it hard and evenly, as if you were wringing a sponge."

  "So he's not dead," Ben said.

  "He was dead," the surgeon said. "I don't know right now."

  "This is a helluva thing," said the medic. "I haven't seen this before."

  "It's the last resort," said the surgeon, the muscle in his forearm still working rhythmically where it disappeared between the retractors. "It's a relatively basic thing. I'm pumping his heart for him."

  "Yeah, but still," said the medic.

  "Sometimes," said the surgeon, "this actually works. If everything goes just right."

  He was true to his word in this regard. Stackhouse's heart began to beat again, quite irregularly for more than two minutes, but then with a racing, regular rhythm, so that the surgeon slid his hand out, pressed it hard against the incision, and with the other checked the carotid artery. Stackhouse's pulse ran thready and wild; his blood pressure was coming up. The sergeant pulled away from his ventilating work, and they all looked at Stackhouse's eyes. The pupils had constricted again, and the surgeon immediately ordered more morphine, lest the patient, stirring toward consciousness, find himself with his chest cut open on a litter in an Italian farmhouse.

  The surgeon did not stop his work, slow down, or relax. Keeping his hand pressed against the incision, he commended the sergeant for his endurance in ventilating the wounded man and urged him to continue for a while longer until he could sew things up. He ordered a urinary catheter and told the technician to cut openings in it and douse it with alcohol. He asked the medic to find a can and half-fill it with water. Without hesitating in his delivery of commands, he told Ben to rinse the scalpel, and when he had it in his free right hand, he made a hole in Stackhouse's chest and plunged a hemostat through it. A technician took over compressing the incision, and the surgeon fed the catheter in, trapping it in the hemostat's jaws in order to draw it out. He tied it off with purse-string sutures, attached a length of IV tubing, and ran the end to the floor. "Tape this in here," he told Ben, pointing at the can of water. "There's some tape in the crate over there. Tape the tube against the inside of the can so the end of it stays in the water."

  He took a deep breath, checked Stackhouse's pulse again—it was racing still, in frantic fashion—and urged the technician with his hand on the incision to apply a sealing pressure. "Just a little longer," he said. "Then we'll sew him up."

  The surgeon leaned over Stackhouse's hip and removed the medic's dressing. "This guy took it in the femoral artery," the surgeon observed, adjusting his glasses. "He took it right in the bone, too—opened the marrow cavity."

  He turned his attention to Stackhouse's shoulder, pulling the dressing aside. "Same kind of problem here," he said. "The subclavian vein has been torn."

  A litter team hurried into the room and deposited another wounded soldier on the bins and crates behind the surgeon. The soldiers left leg was missing below the knee. A tourniquet had been applied, stained red with blood. The doctor turned to examine it, then ordered the medic to twist it tighter and returned his attention to Stackhouse.

  "All right," he said. "We have to turn this man on his side and get this wound taken care of."

  They pulled Stackhouses right arm over his head so that the side of his face lay against his bicep, and they passed the IV around the sergeant technician, who knelt, red-faced, at the blow tube. The surgeon ordered a rolled blanket placed beneath Stackhouse's neck and head to free the right arm for the passage of plasma. Then he swabbed clear Stackhouses hip. The blood welled up immediately. "This guy's down to no clotting factors," the surgeon observed, compressing the wound. "He's bleeding out pure plasma here. There's nothing left to coagulate. He's just lost too much good stuff."

  He opened the hip a bit more with his scalpel, to drain the accumulated blood. He took a closer look inside, made a tamponade of gauze, tucked it firmly into the wound—packing it tightly at the edges—and taped a compress over it. Next he did the same with the shoulder. "Like sticking your finger in a dike," he said. "That should work for a while."

  He turned his attention to the boy behind him, whose leg had been blown off. He tightened the tourniquet and swiveled again. "Okay," he said. "Tell you what. I want this guy"—he pointed at Ben—"to wash his hands over there. Then he can keep a seal on that incision while you"—he pointed at the technician—"get this new man an IV."

  "All right," the technician said.

  "You get this soldier in shape," said the surgeon. "Get him some plasma, take his pulse, get a blood-pressure reading."

  "Yes, sir," the technician said. "The problem is, I'm stuck right here until this man"—he gestured at Ben—"gets his ass in gear. You're just standing there, Private."

  Ben washed his hands and took over the technician's job of sealing Stackhouse's incision. It pushed against his palm a little each time the sergeant blew into the tube. "How is he?" Ben asked. "Will he live?"

  "His heart's beating," the surgeon said. "But he won't coagulate anymore. He needs real blood, quickly."

  "Well, I'm his friend," Ben said. "Maybe he should take some of mine."

  "You O-positive?"

  "I am, yes."

  "Okay," the surgeon answered. "Right now we'd better sew him up. Then we'll draw a pint out of you and drop it into him."

  "Take more," Ben told him.

  The surgeon used sutures of heavy black silk, working rapidly. He pierced the skin and looped around the ribs to draw the incision together. "This is dicey," he said to the sergeant. "If you don't sew things good and tight, you end up with an air leak."

  "Hey," the sergeant answered, pulling the anesthesia mask aside. "The guy's breathing again."

  The surgeon anchored the catheter to the skin with three sutures around it. "Air-tight," he announced. He called for a fifty-milliliter syringe, attached it to the catheter, and suctioned air from Stackhouse's thorax. He broke the syringe free and attached the catheter to the IV tube snaking into the bucket. "Take a look," he said to the sergeant, rubbing his face with the back of his wrist. "We've got air coming out of the chest now. See those bubbles in the water?"

  "My God," said the sergeant. "What a miracle."

  He drew a blanket over Stackhouse, tucking in its edges. "Christ," he said. "It's a miracle. It's a goddamn resurrection."

  "Call it what you will," the surgeon said, still rubbing his face and scratching his nose with the back of his hairy wrist. "But you could learn to do it, too. It isn't something from a Bible story. You go to med school, you can do it."

  "Look at that," said the sergeant. "The guy's back from the dead."

  "It's a miracle," Ben agreed.

  "We'll talk about it after the war," said the surgeon, turning to the boy behind him with the tourniquet on his leg. He checked his pulse, two fingers at his throat. "In the meantime, sergeant, I again need plasma to throw at this other poor bastard."

  They drew two pints of Ben's blood, and he sat in a daze while the technician disconnected the plasma line and started Ben's blood into Stackhouse. A third soldier was hauled in on a litter, but Ben didn't look at him. Instead he cradled his head in his hands and stayed that way until they passed him into the keeping of Father Carr,
the Third Battalion chaplain. Father Carr consoled him a little, but seemed himself at a loss. Then they went into the night, down the hill with other men, toward the rear, away.

  For three days Ben stayed in the rear, wrapped in blankets on a cot. The division psychiatrist interviewed him twice to determine if he was fit for service, and in the end they put him back in the line with recruits brought in from the replacement depot. Ben spoke to none of them. It was better that they remain nameless—they would leave less of a wake.

  He made no pretense of fighting as the regiment advanced over the plain of the Po to liberate Bomporto, San Benedetto Po, Villafranca, and Verona. Fortunately, he was not much called upon except in the fighting to liberate Torbole, and there he squatted behind a wall and didn't participate. When the surrender came, they sent him to Bolzano, where men from his company commandeered shotguns and pistols from the Beretta factory, and guarded a warehouse in which the Germans had hidden paintings plundered from the galleries of Florence. In the distance rose the Dolomites.

  On the train to Livorno he had nothing to say, though other men were loud and raucous in expectation of going home. They steamed down the spine of Italy in boxcars, and men drank wine, leaned from the cars, and waved to the peasants in the fields. It was July-hot and oppressively humid, but nobody seemed to mind very much and the general atmosphere was one of mirth. They passed fields of battle, towns shelled, farmhouses shattered, the plains strewn with burned tanks.

  Ben sent a letter to Rachel in Marseilles, and she came to Livorno aboard a hospital ship on a leave of twenty days. He looked for her in a makeshift encampment of army tents by the Ligurian Sea, just north of the city. It was midafternoon, a day of still heat, and he was sweating, unshaven, and filthy, dressed in military issue khakis and a military tank-top undershirt, his skin darkened from his days in Italy, his lips chafed by the wind. He asked around and was told by a nurse that Rachel had gone down to the sea to swim, and he went in search of her.

  He found her wet, her hair in flat strands, wearing a plain blue bathing suit. A lean woman with amber skin, older than he remembered. But the smell of her mouth was as he recalled. She wept a little, looking at him. She, too, was harder, darker. She held him tightly and stroked his hair. "Never you mind," she whispered to him. "Never you mind now, Ben."

  That night they took a room in town, over a bakery. The toilet stall was two flights down. There were mice about, and from the street outside came the clamor of wee-hour drunks. Without a fan, they flung open their window, and yet there was no relief from the heat, and the mattress beneath them was soaked. The noxious smell of the towns sewers, the exhaust of cars, the smell of the bakery, the lamps in flats across the narrow way, the clattering passage of motorcycles over the ancient cobbles. They dragged the mattress onto the floor. Ben lay on his back gazing up at her face, held lightly in his hands. Very close, her hair falling into the space between them, the girl he remembered from the orchard country, a woman now in a foreign country, her long arms on either side of his head, Rachel sweating over him at five A.M., at dawn.

  They were married the next morning by an army chaplain glad to dispense with regulations. No blood tests required, he said, nor did he care that the bride was an officer, the groom an enlisted man. There were many such weddings afoot, it seemed, and the chaplain performed them with a generosity consistent with the circumstances. The end of the fighting, he explained to them, had inspired many couples with love, and who was he to thwart them? God worked in strange ways, he droned: out of the cinders of ten million deaths were born the seeds of marriage. And how to explain that except as Gods will at work among us in this world? The divine hand lay in it; God used the attraction between two people to further the unfolding of His scheme. The chaplain wished them the very best, bade them exchange vows of mutual fidelity in good times and bad, in all such conditions as the years might bestow, instructed them in signing the documents, and sent them on their way. Ben and Rachel, once outside, requisitioned the chaplains jeep, in which he'd left the keys.

  They bought two bottles of chianti and took the road to Florence. They passed a night in Pontedera. In Florence they left the jeep with a motor pool in front of the Palazzo Strozzi. They rode a train north into forested valleys. It was on the train to Bressanone that Rachel thought of roses: their ashes, she said, should lie side by side, his for a red rose, hers for a white, until with time they merged into one, a soft and delicate pink. It was a story she'd read, of two lovers, the final flowering of their passion. She could not remember their names now, it was something from very long ago, a book of tales from the library, illustrated: she might have been ten years old. Ben had wondered in teasing fashion if in fact it worked that way. Did the two roses mingle into one pink bush, or did their blooms tangle and intertwine, red and white, for eternity? There was no guarantee of pink, they decided. Who knew the outcome of such a thing? They would have their ashes interred side by side, leaving the rest to fate.

  They disembarked, rode west in a supply truck, then set off on foot into the mountains. He told her about the German he'd killed, the man's eyes, his legs in front of him, the twitching, rattling death. "I didn't think," he confessed.

  "It's difficult in a situation like that."

  "It didn't have to be that way."

  "It's done now," said Rachel.

  They were resting in a rock-and-timber hut where a rough-framed painting of a beneficent Christ had been hung in one corner. Ben sat back with Rachel against him, looking out at wooden ladders bolted to a cliff.

  "I wonder who he was."

  "That makes things worse."

  "I think about him."

  "Try not to, Ben."

  "Maybe he had a wife. A family."

  "It's in the past," said Rachel.

  That afternoon they came to a hamlet of Ladin homes and barns. They hiked uphill past potato patches and rested under a plum tree. A farmhouse stood open to travelers, and they presented themselves to the woman there, who wore a green apron and a hat of plaited straw and was busy lofting hay over racks. She led them through a low door, into a room made of pine boards. The floor had been painted in a floral pattern wearing away underfoot. They sat by a window in hand-hewn pine chairs, at a table painted in wildflowers—calendula and edelweiss—and looked out over long hay slopes falling away to the south. The woman brought a bottle of wine, diluted and chilled by spring water. She brought dumplings flecked with chives, polenta, and roe deer goulash.

  Ben told Rachel about the field surgeon who had saved Bill Stackhouse's life. "You were right," he said. "I should have been a medic. I should have listened to you."

  "This place is a dream," Rachel said. "A fairy tale or a dream."

  "You warned me. You tried to warn me."

  "There's green onion in the dumplings, too, mixed in with the chives."

  "I want to be like that surgeon," said Ben. "A person like that, a doctor."

  "I'm with you all the way," answered Rachel.

  NINE

  Ben opened his one good eye to a still and empty October morning in a motel room in Quincy, Washington. A nimbus of light, a gray corona, formed a halo at the curtains. The heater fan made a terrible racket, and outside, in the parking lot, someone was warming the engine of a car by repeatedly revving it. The air smelled of saffron, and from the bathroom the toilet sang. Ben felt mired from the marijuana, his limbs immovable. He couldn't rise with his war still in him, and he lay there feeling troubled by it as he had for fifty-three years. He'd returned home from Italy to the news that Aidan had died at Peleliu, hit in the neck by mortar fire. That fall, the apples rotted on the ground. Bens father sold ten acres to the Fisks before Christmas. In the spring, he sold the rest to a Wenatchee man, young and starting out, and moved into a cabin on the outskirts of town. He did odd jobs, hired on with the railroad. He moved to Spokane, then Yakima.

  Ben thought of the miracle of Stackhouse's heart: Bill had come away with a limp and a shoulder that ached in cold wea
ther; was retired from a position in sales at an office-supply company in Bethlehem, Pennsylvania; and had, to date, eleven grandchildren, photographs of whom he'd sent to Ben with letters over the years. Ben had seen him three times at reunions of the Tenth Mountain Division. They'd spoken at length about what had happened. Stackhouse was slowly writing his memoirs, so that his progeny would know about it, too.

  Ben thought of the hearts of other men and women in all their naked, exposed truth—muscles about the size of fists, pulsing at the center of living forms. The heart that was for poets and priests the seat of all things beautiful, the house of love, the host for God, the chamber of sadness, rage, discord, envy, despair, glee. Ben knew the heart as a muscle first, designed for the work of pumping blood, not so terribly intricate that it couldn't be duplicated. Parts of it were replaceable: a heart valve could be made from titanium, or lifted from a hog. In knowing the heart in this cold way, he had lost all innocence about it. It was not that he didn't believe in love, but first he was a scientist, a physician, and a man of reason. He had manipulated the hearts of human beings, and he thought he understood that when we speak of love, we speak of something transitory, something gone when we go. The heart, for Ben, was tangible—and nothing tangible remains.

  There were few things more depressing he could think of than to be alone in a cheap motel room, dying of cancer at seventy-three, the smell of fallow fields outside, gruff voices in the parking lot; a bleakness grew in him he couldn't face, couldn't abide or accept. He rose from bed, limped to the bathroom, and sat on the toilet with his head dropped between his knees, noting his thin and flaccid thighs, but nothing passed from his obstructed bowels except for a foul dark squirt of water that antagonized his hemorrhoids. An old man, terminally ill, thoroughly humbled on the toilet. An old man fallen from grace.

  He was driven out before eleven by hunger, and walked toward town with his hat pulled low, his hands deep in his coat pockets. The sun rode high and pale in the east, but a hard wind gusted from the mountains. A train whistled, gaining speed, churning toward the Rock Island crossing. The grit in the gutter rose and boiled whenever a truck flew past at high speed, and he was surprised once by the hiss of brakes when a freight truck slowed alongside him to turn at the Central Bean Company. To the south stretched a long row of mobile homes and trailers, some with windows broken and patched with duct tape and cardboard. In a packed-dirt yard of sparse weeds, a school bus dispensed kindergartners—the children of fruit pickers, Ben guessed—raising dust as they went. A mangy dog, yellow and slat-ribbed, came out to fend off Ben as he passed, stopping warily at thirty feet, its tongue spilling from its mouth.

 

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