The watch order was the reverse of the previous night.
…
“We are so getting rain today.” Marissa said as they were packing up after breakfast.
Dan looked at the sky. “Not that I don’t trust your joints, but even I can tell that. We didn’t have dew on the sleeping bags or blankets this morning, either.”
Marissa gave him a weak smile. “Thanks. I just hope it holds off until we can get to some kind of shelter.”
“Do you want to stick it out here for another day and try to build something?” Dan asked.
“No, absolutely not,” Marissa said. “Even a couple of miles further will be worth it, we need to keep making progress. We may end up at one of the underpasses tonight.”
Dan hugged her, making sure he didn’t squeeze too hard. “I agree, but I want to make sure we’re on the same page, that’s all.”
…
“The farms look awfully well tended,” Marissa said after about a mile. “I wonder how many people are pitching in to work the land.”
Dan was checking out the farmland around them and missed the shocked look of recognition on Marissa’s face when she saw the billboard ahead of them.
“That’s what it was!” She yelled, which snapped Dan’s head back around.
“What? What was?” He said.
“That’s why I’d heard of Kingston Springs. Hertzwell Farms,” Marissa said, “from the Farmers Market. They were next to the local honey guy and across from the free-range eggs people, remember?”
Dan gave her a blank stare.
“I’ll take that as a no.” Marissa said. “Then again, I went once a week and you came with me once in only a very long while.”
“I’ll take your word for it.” Dan said.
Marissa stopped her bike, which made everyone else do the same. “Dan, I trusted your gut back at the first town, on the first day, even though we didn’t agree on the underpass.” She said. “You didn’t feel comfortable trying to go in and barter, or trade, or whatever.”
Dan nodded, but squinted his eyes just a little, wondering where this was going.
“I need you to trust me on this.” She said. “I don’t know why, but I have a feeling, and I need you to back me one-hundred percent. I feel like we have at least a chance to barter for some additional food or goods with Mr. Hertzwell.”
Dan didn’t say anything at first, so Marissa kept talking. “Yes, that’s his name. He’s a third-generation farmer and I’ve been buying from him almost every week for the last three years. I think he’ll recognize me, and you mentioned you found the silver, and I think we could trade it for some fresh or canned food, and—I don’t know, we can discuss it with him.”
Dan took a deep breath and let it out slowly and then said “Ok. Which way to the farm? I’ll trust your instincts on this like you trusted mine. I’m putting one in the pipe, though. I believe that’s the correct term?”
Marissa gave a nervous laugh but nodded. “Yes, that’s right and frankly, it’d be silly not to.”
…
They followed the directions from the billboard and found that the town was fairly busy, which meant there was a bit of a welcome party for them. Guns were in evidence on all but a few hips, and both Dan and Marissa were sure those were simply in concealed holsters. Almost everyone had a rifle or shotgun, including the women.
The greeting wasn’t hostile, but it wasn’t exactly cordial, either. Luckily, Mr. Hertzwell was a member of the group. Unfortunately, he didn’t immediately recognize Marissa.
“I’m sorry, ma’am, I can’t say I recall meeting you.” He said, politely enough, but it wasn’t encouraging.
Marissa wasn’t deterred. She could understand that he might not immediately remember her; it was going on two months since he’d last seen her. It was now her job to remind him.
“Your booth was next to ‘How Sweet It Izz’, the local honey guy who had honey sticks five for a dollar. You were across the aisle from ‘Home on the Range’,” she closed her eyes for a few seconds and came up with the owner’s name, “Helen, that’s her name, sold free-range eggs and hormone-free chicken.”
Mr. Hertzwell was looking at her a little differently now.
“Next to her was the booth with the custom and handcrafted soaps. We used their bug spray exclusively because it didn’t stink and it worked better than the store-bought crap.” Marissa said.
“Yes it did. I just ran out of it and I’m really missing it.” He said in agreement.
Marissa smiled. “And you,” Marissa pointed at Mr. Hertzwell, “your daughter had to take home one of the computerized babies for her Child and Lifespan Development class. She had to bring it to the Farmers Market one Saturday morning, and was so exhausted she was holding it while it was ‘crying’, and she was literally asleep with her eyes open.”
Mr. Hertzwell was chuckling at the memory and nodding. “At the end of that project her exact words were ‘This has got to be the best form of birth control ever!’ I do remember you now, I’m sorry I didn’t before. But didn’t you…” he stopped.
“Yes.” Marissa said.
Neither of them said anything more about the missing third child.
He cleared his throat. “Please, call me Craig,” As he stepped towards Dan and Marissa and the girls. “It’s alright, everybody, these folks are ok.”
…
“So,” Craig said, once they were off to the side of the street and out of the way. “What can I do for you folks?”
Marissa only paused for half a heartbeat before jumping in with both feet. “Well, Craig, first of all, this is Dan, my husband, and these are my daughters, Bekah and Jessie.” Marissa said, hoping that putting names to faces might help her cause even the tiniest bit.
“Pleased to meet you all,” Craig shook hands all around.
“I know that the situation isn’t exactly normal, but without going into our life story,” Marissa gave Craig an extremely abbreviated version of their need to get out of the neighborhood, and the fact that they were on the way to Natchez Trace.
“I won’t lie; we don’t have a lot to trade with, but…” Marissa said but was interrupted by Dan.
“I’m an EMT, if you have any medical issues, I’d be more than happy to do what I can in trade.” Dan paused. “Or…would you be willing to trade 90% silver?”
Craig had actually perked up a little at the offer for some medical treatment, but didn’t even blink at the mention of silver. He either had a great poker face or truly wasn’t interested.
“In general, in town we might have a need for the medical care, and it would come back around to me so that would be fine.” Craig said. “As for the silver, the world hasn’t recovered to the point that it’s useful for barter yet, but I might be willing to take some of what you have in trade. If I do, I won’t gouge you, and I won’t take all of it because I’m not that kind of person. I’d like to think that you were willing to come into town because you felt comfortable from having done business with me for years at the market for that very reason.”
Marissa smiled. “That pretty much sums it up.”
“Dan,” Craig said, “you said you were an EMT. What are you comfortable doing, medically?”
“How so?” Dan asked. “I can set broken bones and put in and remove stitches. I’ve started IVs and even performed emergency tracheotomies. I’ve delivered a total of seven babies, all of them successfully, I might add.”
“Any surgery?” Craig asked.
Dan blanched. “I’ve assisted in a couple emergencies, but, no, never anything primary as that is way outside of EMT stuff.” Dan took a deep breath. “What’s wrong, though?”
“Possibly appendicitis,” Craig said.
Dan closed his eyes. “How long?”
“Just about a day and a half, no more than that. Possibly a little less.” Craig said. “Your timing is really great on this one.”
“How have you been treating it?” Dan asked.
“Ant
ibiotics, metronisomething-or-other, Flagyl is the brand name.” Craig said. “It’s something that one of the folks in town had stocked up on and is supposed to be a broad-spectrum antibiotic that is good for appendicitis specifically.”
“It is, one of the better ones in fact.” Dan said. “Taking it orally is hard on the system since the appendix is actually a part of the large intestine. It’s possible that the antibiotics could cure it if it hasn’t ruptured yet. It could come back in a couple of years, though, and without a doctor or surgeon then it’s all over.”
Dan looked Craig in the eyes for a few seconds before he spoke again. “You don’t know me, you have no idea who I am or what I can or can’t do.”
“No, I don’t.” Craig admitted with a nod. “But the fact that you just admitted that to me tells me a lot about you, though. The man in question is the father of four, and I’m afraid that if we, if you, do nothing he will most likely die. The rest of us in town will pick up the slack and take care of the family because that’s how we do it out here, but if there’s a chance that something can be done then I think we have to try. If they are willing, will you give it a shot?”
Dan couldn’t make this decision on his own; if things went badly it could go badly for the whole family. He looked at Marissa and she nodded.
From behind him he heard Jessie ask, “Can you help that man, Daddy?”
“I don’t know, honey,” he said, “but I think I have to try.”
…
“I have to ask,” Dan said, after some additional discussion with Craig before meeting the family and the man he was going to be potentially operating on, “where are the other doctors from town? I mean, in a town this size I would expect at least two or three.”
Craig shook his head, “You have a good question and a perfectly valid point. We have three Family Practices after all, and an urgent care. The problem is that none of them lived in town.” Craig pointed towards one of the buildings ahead, which looked to be getting more attention than the rest. “That’s actually where we’re going. Dr. Mitchell actually used what gas he had in his hybrid for the first two weeks to come into town and treat a couple of folks who were in a bad way. He also handed out what samples of medications he had locked in the office to people who had prescriptions that were running out.”
“Yeah, Dr. Mitchell was a good guy, and I don’t blame him one bit for not being able to keep coming back like he was.” Craig said. “He had a wife and a young kid he needed to look out for. The other doctors and nurses, and everyone else, well…Dr. Mitchell is the only one we’ve seen in two months.”
Dan decided not to ask any more questions about the health of the town. He didn’t want to get sucked into staying here. Then again, sticking around might not be all that bad, assuming they were offered a chance to stay.
“We set Jay up in the clinic. We figured we could keep things cleaner here.” Craig said.
Dan nodded. “Good call, most likely. Hopefully they’ve got a recent copy of Grey’s Anatomy.”
Craig raised his eyebrows.
“The book, not the TV show.” Dan said. “If I’m going to be performing surgery I’m going to need to brush up on a few things. I know where the appendix is, and I know, generally, what’s in front of it and what I shouldn’t cut getting to it, but in this case ‘general’ isn’t going to be good enough.”
“Gotcha,” Craig said. “Well, the Doctor’s offices were back here, so let’s try there first.”
…
“So, here’s the first problem I see,” Dan said four hours later, “and I’m not saying no, I’m just pointing a few things out. Typically, this is done under a general anesthetic—of which we have none.”
“Secondly, we’re going to need a local anesthetic,” Dan looked at Marissa, “of which I haven’t found any that the Doctor left behind either.”
“Lastly, well those are actually my two reservations outside of I’m scared to death to do this.” Dan said. “Can I do this? Yes. If I do this without a general, will Jay hate me in the morning? Hell yes! Will he survive? If I don’t cut anything vital during the surgery and I can tie up anything non-vital right away, I give it an 80-85% if he makes it twenty-four hours. 95% if he makes it forty-eight hours.”
“What’s really your biggest concern, Doc?” Jay’s wife, Denise, asked.
Dan smiled a little at that. “Well, thanks, but I’m not a doctor. The biggest concern is going to be infection after the surgery, internal as well as external. He’s on a good antibiotic, but its oral, and that’s rough for abdominal surgery—especially when the intestines are involved since that’s partially where the medication is absorbed.”
Dan went on, “That’s not why I’m concerned about infection though. Infection is always the biggest concern after any abdominal surgery. There’s always the chance of not completely closing the intestine and that would be bad. Any leakage and, well, it would be bad.”
“If you’re still up for it then, please, by all means try,” Denise said.
“And while we don’t have any type of general anesthesia we do have some Novocain from the Dentist’s office.” Craig said. “We figured he wasn’t using it and it might come in handy elsewhere at some point.”
Dan said a little prayer of thanks for not having to make the choice between his wife and Jay, or having to put a man through surgery with nothing but several stiff shots of 150-proof whiskey…which would really play havoc on the bleeding.
Chapter Sixteen
“Valium!” Dan said. “Why didn’t I think of that?”
“Because you were too worried about killing the man?” Craig said.
“Well, yeah, there was that.” Dan said. “Ok, I have to look something up. I can’t remember if it’s a vasodilator or a vasoconstrictor.”
“A what?” Craig and Marissa said at the same time.
“I can’t remember if it opens or closes the arteries and veins.” Dan said. “I think it opens them up but I’m not sure, and the last thing I want is to give him something that is going to make him bleed to death during surgery.”
Dan stopped as he was walking back towards the Doctor’s office. “Which brings up something else altogether, anyone know what Jay’s blood-type is?”
“Geez, let me go find out.” Craig said.
Marissa came up behind Dan and gave him a hug while he was looking up the information in the Physician’s Desk Reference. “You’re really doing a good thing here, Dan. I’m sure you’re going to do fine.”
“I’m glad someone is, because I’m scared out of my mind.” Dan said.
“As you should be,” Marissa said. “This is like the final exam to end all finals, but that doesn’t mean you aren’t going to do a great job. Do you think anyone here has the same blood-type as Jay?”
“I hope so, because if not we’re going to have to call this whole thing off.” Dan said. “We simply can’t do it without at least some blood. He’s going to bleed, and without putting it back he will die. I can’t believe I didn’t think of it before.”
“You did think of it before. Before you started the operation, and that’s what counts.” Marissa said.
Dan sighed. “Ok, you win. I’ll be more positive about this.”
…
“Jay is B-Negative, and we have two other people in town who are as well.” Craig said. “Both swear up and down that they have clean bills of health, and Jay and his wife have both agreed to accept whole blood from both of them.”
“Ok,” Dan said. “I’m going to go ahead and take a pint from each and we’re going to need a place that we can keep it cool. We have all the sterile equipment here. If we don’t need it I can give it back to each of them, but I doubt that will be happening.”
“The doctor left saline and lactated ringers here so we’re good to go for that, and I’ll start with saline to keep his blood pressure up.” Dan said. “Speaking of which, I’m going to need some assistants in the operating room. At least five, who aren’t squeamish, and
can follow directions without questions.”
…
“Jay, I’m Dan Clark. I’m going to be performing your appendectomy in a few minutes.” Dan said after he walked into the room.
They’d decided to introduce Dan after Jay had taken the Valium and was feeling ‘good’. It had turned out that the Valium would work fine, and Dan would be ok as long as he waited about a half hour to forty-five minutes after things kicked in to begin the surgery. He would be using liberal amounts of Novocain to keep things numb locally.
“Hey, good to see ya Doc,” Jay said with a bit of a slur to his speech. “I’m afraid I might sleep through the whole thing, though, whatever you gave me,” Jay interrupted himself with a jaw-cracking yawn, “wow, really good stuff. First time I’ve been out of pain in a couple days.”
“That’s just fine with me, Jay.” Dan said. “I understand that your wife has already talked to you about this, but for your safety…”
“Oh yeah, I know, you gotta tie the wrists and the ankles down.” Jay said, and yawned again. “Totally understand.”
“Alright then,” Dan said. “One last thing, I’m going to start your IV and then we’ll move you into the other room.”
…
Dan was soaked when he walked out of the makeshift operating room almost three hours later.
“Is he going to make it?” Denise asked as soon as the door opened.
Dan was glad he’d taken the smock off before he came out. “I don’t see any reason for him not to.” Dan said. “The appendix hadn’t ruptured yet, almost definitely due to the antibiotics, but I don’t think they were going to fix it either.”
Dan looked around for Craig, but he wasn’t anywhere to be seen. “Could I get a glass of water? We ran out in there about twenty minutes ago and I’m parched.”
Denise went to get him a glass of water from the jug they had in the next room and a few seconds later Craig came in with Marissa and the girls.
“So, what do you think?” Craig asked.
“I think I’m going to get asked that question a lot over the next half an hour.” Dan said. “But I think he’ll be ok.” Dan held up his hand to wait until Denise came back in and Craig nodded. When Denise came back with the water, Dan went on.
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