Patriots

by James Wesley, Rawles

  He had a big revolver pointed right at her head. She just froze there. The other guy walked up to my door, and leveled a Mossberg riotgun at me. What was I supposed to do? I was thinking we were history.

  “The next thing I knew, the guy with the shotgun ordered me out of the cab. Then, he had me open my flight jacket and he pulled my .45 out of its shoulder holster. He put that in their car. Then, like a fool, he turns his back and starts rummaging around under the seat without finishing searching me. I figured that this was my one and only chance. I pulled my little AMT Backup .45 out of the inside pocket of my flight jacket, and shoved the barrel right up against the back of his head. Now, I had the drop on him. I told him to verrrry slowly put the shotgun on the seat of the truck and back out, again, real slowly.

  At this point, his partner started getting panicky. He didn’t know whether to take a shot at me, run, or what.

  “Next thing, I ordered the guy on my side of the truck face down on the pavement, keeping one eye on his fidgety partner. I gave the guy a quick frisk.

  All that I came up with was a Bucklite pocketknife. The other guy just stood there kind of shaking. Finally, he says, ‘Drop the gun and let him go, or I’ll shoot the girl.’ Real original line, huh? Then I told him, ‘No, you drop your gun, you half-wit, or I’ll shoot both you and your partner. Unlike you, I know how to use a gun.’ At this point, he goes into a real panic. He points his gun at me, then back at Rose, then back at me. He was shaking like he had spent too much time in a meat locker. This guy obviously had a room temperature IQ, and no nerve whatsoever. Throughout all this, I had my pistol pointed at the back of the head of the guy on the ground. It was the old Mexican standoff.

  “The next time he switched to pointing his gun at Rose, I leaned my forearms across the hood of my rig and lined up the sight rail on his chest. Then, when he looked back at me, his eyes got as big as saucers and he started backpedaling. As soon as the muzzle of his gun swung away from Rose and toward me, I gave him the ‘double tap.’ I hit him once in the chest, and the second shot grazed the top of his head.

  “When he heard my shots, the guy on the ground tried to get heroic, and jumped up at me. I emptied the four rounds left in the magazine into him. The last shot was right into his face. The whole back end of his head exploded. I guess I was on autopilot at that point.

  “Then, I realized that the other guy—the one with the revolver—wasn’t yet one-hundred-percent dead. He was sitting on the ground gurgling and waving his gun around. He started pulling the trigger. By pure chance, one of the rounds hit Rose. Before I could put in a fresh magazine and line up the sight rail on him, his revolver was empty. He kept clicking on fired chambers, with the muzzle pointing sorta randomly. After another few seconds, he collapsed.

  “I grabbed my medic’s bag and got to Rose as soon as I could. I saw that it was a through and through wound, saw it wasn’t a major hit, and applied direct pressure. I got sterile bandages on both sides of the wound as soon as I could, and then got her into the truck. I picked up both of their guns and threw them on the floor of the passenger side of the truck. Then I went and got the full-sized Colt .45 they had stolen from me and put it back in my shoulder rig. I just left their bodies and their car where they were.

  “Because we were only about an hour away, I figured my best bet was to beat feet up here. It was hard to believe, but Rose didn’t go into complete shock. She was coherent until just before we went through Bovill. Then she passed out. Up until then though, she was able to monitor the amount of bleeding, and put pressure on the top of the exit wound dressing with her right hand. Luckily, Dan had once described how to find your place to me, so I didn’t waste a lot of time looking for it.”

  By now, Mary had pulled the instruments she thought that she’d need out of their sterile wrappers. “What’s her blood type?”

  Jeff replied, “I don’t know, but she keeps a donor card in her wallet—in her purse out in the truck.” Trasel sprinted away to look for it. Mary estimated that Rose had lost at least two or three pints of blood. She then checked Rose’s pulse, respiration, blood pressure, and pupils. Speaking to those gathering in the room like a group of surgical interns, she pronounced, “She’s pretty well out. Her pulse is rapid at 115, but her BP is a bit on the weak side—110 over 40. That may sound strange, but I’ve heard that that isn’t unusual in cases where someone has lost a lot of blood.”

  An impromptu surgery room was set up in the kitchen. The kitchen table was used as the operating table. Lisa washed the table down with half the contents of a bottle of denatured alcohol, while T.K. put on a five-quart stockpot of water to boil. Jeff returned, reporting that Rose had indeed been carrying a blood donor’s card. As it turned out, the only other person at the retreat with Rose’s blood type, A negative, was Dan Fong.

  Mary prepped Rose’s arm. Jeff helped her hang a colloid IV bottle from the light fixture above the dining room table. She left the roller clamp on the IV tube in the wide-open position, providing a rapid drip.

  • • •

  Fortunately, Mary had learned how to give transfusions from a surgeon at the hospital where she formerly worked in Chicago. The surgeon was curious to know why she wanted to master an obsolete technique. She explained that she thought it might come in handy if there was a major disaster and the hospital’s supply of whole blood ran out. He winked and said, “Oh, so you’re one of those survivor types.” The surgeon was very precise in his instructions. He also gave her a complete description of the equipment needed. “None of the large companies make traditional person-to-person transfusion sets anymore,” he explained. “Everything is geared to working from bladder-packed units of whole blood, plasma, or solutions like Ringer’s lactate like the paramedics use.

  However, all the tubing connectors are modular, they use the same fitting as a Luer lock. You can even set up a piece of tubing with needles at both ends for a direct transfusion if absolutely necessary.” He instructed that it was generally better to collect blood for transfusion, rather than making a direct transfusion.

  “There is too much risk of losing track of how much is coming out of the donor if you don’t take out measured units. Donors have gone into shock and died from giving too much blood in direct transfusions. It happens a lot in Third World countries where they do direct transfusions.”

  Soon after her conversation with the surgeon, Mary added six disposable sets of transfusion rigs to her mini-surgical kit. Although she had long hence memorized blood type compatabilities, for everyone else’s benefit, she typed up “cheat cards.” The rules were generally accepted for packed red blood cells from blood banks, but could be used for freshly donated blood in an emergency. She photocopied and laminated them, and put them in each transfusion kit. They read:

  O+ can receive [O+ and O-] and can give to (O+, A+, B+, AB+)

  O- can receive [O-] and can give to (all blood types… universal donor)

  A+ can receive [A+, A-, O+, O-] and can give to (A+, AB+)

  A- can receive [A-, O-] and can give to (A+, A-, AB+, AB-)

  B+ can receive [B+, B-, O+, O-] and can give to (B+, AB+)

  B- can receive [B-, O-] and can give to (B+, B-, AB+, AB-)

  AB+ can receive (all blood types… universal recipient) and can give to (AB+)

  AB- can receive [AB-, A-, B-, O-] and can give to (AB+, AB-)

  Mary taught a class to the group members on basic transfusion techniques. In the class, she stopped just short of starting an actual transfusion, but she showed how to position both the donor and the recipient, how to set up and monitor the flow of blood, and demonstrated how to “prep” an arm or leg artery on two group members.

  • • •

  Both Dan and T.K. had their arms prepped to give transfusions. T.K. was the group’s only type-O negative universal donor. Dan was positioned on the couch. Mary then loosened the catheter cap and inserted the end of the tubing to start the flow of blood down to an empty bladder pack on the floor. By that time,
the IV that was connected to Rose was nearly empty, so Mary replaced it.

  She said tersely, “I’m going to put another unit into her, again at a rapid drip, while we are drawing Dan’s blood.” Mary continued to check on Rose’s vital signs in the next few minutes while Dan was giving his first unit. She noticed that Rose was drifting in and out of consciousness. Soon, Dan’s first donor bag was full. She waited until the second bag of colloids was nearly empty, and replaced it with the unit from Dan.

  Then she dashed across to Dan and started to fill a second bladder pack.

  “Let me know if you start to feel dizzy at all, Dan. We’ll be drawing you down this second unit.” Next, Mary prepared a heavy dose of Ketalar, a disassociative general anesthetic. The dosage was based on a table included with each bottle.

  She adjusted the dose based on Rose’s body weight of 120 pounds, and her already semiconscious state. She judged that with this dose Rose would be fully unconscious for four hours. Mary introduced the Ketalar into the flow of transfused blood coming from Dan, using a small bladder of saline linked to the T-connector positioned just below the unit of Dan’s blood.

  After about fifteen minutes, Mary cut off the supply of blood from Dan, and had T.K. take Dan’s place on the couch. She slowed the rate of flow from the unit of Dan’s blood to Rose, using the roller clamp, explaining, “We don’t have an unlimited supply of blood, so we’ll hold off on the transfusion until after I get started with the exploratory.”

  Washing her hands once again, Mary donned a surgical mask and a pair of sterile gloves. The mask wasn’t necessary, but since she had them handy, she used one. “Ninety-nine percent of the risk of infection comes from my hands and the instruments. But it doesn’t hurt to add a bit of insurance with a mask.”

  She then gingerly removed Rose’s bandages, sodden with half-clotted blood.

  “I’m going to probe the entrance end of the wound first.” Thirty seconds later, she declared, “It looks clean. The bullet didn’t hit anything major on this end.”

  Mary then shifted to the top of her shoulder. “There’s a lot of blood-shot here,” she mumbled. To T.K., Mary’s last sentence sounded more like something someone quartering a deer would say.

  “I’m going to have to debride quite a bit of this muscle tissue. If the wound channel is this large after collapsing inward, the temporary channel must have been enormous when the bullet went through. There are also some bone fragments from her scapula. It’s really trashed. What did she get shot with, anyhow?”

  “A .357 magnum. And boy, am I pissed,” Jeff replied.

  Mary set down the dull probe she had been holding, and picked up a number four curved scalpel. After resuming the transfusion from Kennedy, she began slowly and carefully cutting away some of the most badly damaged tissue.

  A few minutes later, Mary spoke again. “Ah haaaah. I see our culprit now.

  An artery less than two millimeters across, but just a bit too big to clot closed by itself. I’m not skillful enough to rejoin it, so I’ll just have to suture it off, and hope that nothing goes necrotic. Supposedly a fairly safe bet with arteries this small. The Good Lord was prescient and provided a dual supply to most areas of our bodies. Some of the smaller veins and arteries can be sacrificed and there is still a supply. You can’t do that with anything major like the femoral or sub-clavian arteries, but it is allowable with the smaller ones.”

  As she spoke, Mary picked up a “derf ” suture needle holder and clamped a pre-threaded 3-0 absorbable suture into it. The suturing took an unnerving twenty minutes. “This is a real pain,” Mary groaned. “It would be a lot easier if this little artery would stay in place and if it weren’t spurting blood.”

  When the suturing was completed, Mary asked T.K. to remove the clamp from the transfusion tubing, resuming the flow of blood. By now, Lisa had replaced the second bladder of blood from Dan with the first one from Kevin, tapping on the tube with her fingers repeatedly to force some air bubbles in the tube up to the expansion chamber. After a couple of more minutes of probing around, Mary asked, “Okay, now I’m going to have to do something with what’s left of her scapula. The only thing is, I don’t know what to do. I’ve removed the loose bone fragments, but that still leaves a really rough edge. Any suggestions?”

  There was silence for a few moments, then Dan spoke up, “Couldn’t we just file the edge of it smooth?”

  “Yes, I suppose so,” Mary replied, “but I don’t have anything like a file in my bag of tricks. The only thing that comes close is my bone saw, and that’s way too big for this job. What I need is a miniature version of a machinist’s flat file.”

  Dan then offered with his characteristic smile, “I’ve got a set of Swiss pattern files in my gunsmithing box. You can take your pick from all sorts of profiles. I’ll go get them.” While Dan was gone, Mary again checked Rose’s vital signs.

  Less than ten minutes later, Dan pulled the chosen Swiss pattern file out of the boiling water, using a huge pair of obstetrics forceps to reach down to the bottom of the stainless steel stockpot. Dan handed her the file using the forceps. Mary nodded and enunciated, “This should do the trick.” She shook the file in the air to help cool it. After five minutes of judicious filing, more probing, a second look at the sutured artery, some irrigation with saline solution, and some swabbing, Mary was almost done.

  Meanwhile, Lisa finished taking the second unit of blood from Kevin, and capped his catheter, taping it securely in place.

  Seeing this, Mary half-shouted, “Both T.K. and Dan should go lie down and start drinking fluids, pronto. I think that there are still a few bottles of Gatorade in the pantry. Let’s leave them prepped, in case they have to donate again. If absolutely necessary, they could each probably give another half unit tomorrow, if they take it easy. Let’s pray that Rose doesn’t start bleeding again.”

  Next, Mary opened a bottle of saline and soaked several small rolls of gauze.

  She looked up at Lisa, who was standing by her side, and declared, “I’m going to leave this wound open for the next few days. I’ll just pack it with this damp gauze. It would be a mistake to stitch her up prematurely. At this point drainage is much more important. We’ll watch her wound closely the next few days. I expect in a few days we’ll close the entrance side and a day later, the exit side, but even then I’ll probably want to leave a drainage tube in. Final closure won’t be done for about a week.”

  Only when Mary glanced up at the clock did she realize that nearly three hours had gone by since she had started scrubbing up. After checking Rose’s vital signs once again, she said resolutely, “Well, that’s all I can do. She should make it though. The damage wasn’t too great, and I didn’t have to try anything fancy. Thank God for Colonel Fackler.”

  “Who is he?” asked Jeff.

  “He’s the surgeon who wrote the chapter on gunshot wounds in the NATO Emergency War Surgery manual. I wouldn’t have had a clue how to perform that operation if it weren’t for him.” With that, Mary pulled off her gloves and went to take a nap. She was completely spent.

  • • •

  The first addition to the group after it was started by Todd and T.K. was Ken Layton, a lanky, red-haired man with an infectious smile. He was an acquaintance of Tom’s. T.K. first met Layton through a Catholic “young adults” group.

  Ken was of interest because he was an automobile mechanic. Although he had the necessary acumen, Ken had shown no interest in pursuing college when he graduated from high school. Instead, he immediately started working full time as an automobile mechanic. Turning wrenches was Ken’s idea of fun, and he certainly was good at it. By the time he joined the group, Ken had changed jobs twice, and was making $58,000 a year. By 2009, Ken was earning $98,000 a year as the assistant manager of a shop specializing in off-road vehicle repairs and modifications.

  The next recruits into the group were Mike Nelson, a botany major at the University of Chicago, and his girlfriend, Lisa. Mike had met Lisa by chance at the uni
versity’s Regenstein Library. As Mike was walking through the stacks, he noticed an attractive young woman who was sitting at a study carrel reading Musashi’s A Book of Five Rings. He soon struck up a conversation with her about martial arts. For Mike, it was love at first sight.

  Lisa was a graphic design major with interests that ranged from backpacking to tae kwon do, to sport parachuting. Lisa was of average height, with dark brown hair and unusually heavy eyebrows. She joined the group a few months after she and Mike began dating. Lisa was a talented airbrush artist. Over several years, she painted camouflage patterns on most of the group members’ long guns, to match their camouflage uniforms. She put three coats of clear flat lacquer over the camouflage paint, to keep it from chipping or wearing off. Initially, Lisa approached the group as just another one of her many hobbies. Later, it became an all-consuming passion that overwhelmed most of her other interests.

  Upon getting his Bachelor of Science and Master of Science degrees, Mike Nelson was unsuccessful at finding any position relating to botany. The only positions that he found available were low-paying GS-5 pay grade jobs as forest survey assistants. Out of desperation, he ended up taking a job as a Chicago police officer. He graduated second in his class at the police academy. Curiously, Mike found that he genuinely enjoyed police work. Like most newly hired officers, Mike was assigned night patrol duty. However, unlike the majority of his contemporaries, Mike enjoyed the assignment. He later volunteered to continue night shifts, and even asked for assignments in Chicago’s rougher neighborhoods.

  Mike told the other group members that his attraction to police work was the adrenaline rush of stressful situations. He said that the “fun” part of his job was getting into “a worst case do-or-die survival situation every other night.”

  Meanwhile, Lisa found a job as an artist with a large architectural design firm.