“No worries,” Mason answered, looking at the ground.
Kalinski tightened his grip on Mason’s shoulder for a second. Matty and Dunlop joined them and they placed their arms around each other’s shoulders and bent their heads together as the helicopter lifted off.
“Is he gonna be OK, Ski?” Mason asked.
Kalinski closed his eyes and mouth against the swirl of dust kicked up by the rotors of the departing helicopter.
3
Amanda’s brow furrowed while she sought a less medical-sounding term for what she was about to write in a small notebook. Her train of thought was disturbed by a rustle from the bed. The patient was now awake, his gaze fixed on the fluids dripping into the line inserted in his arm.
She laid the notebook aside and gave him a cheery smile. “Hello, I’m Nurse Wilks. Can you hear me?”
His focus shifted to her.
“You can? Squeeze my hand for yes.”
His fingers twitched.
“Do you know who you are?”
His fingers tightened and relaxed.
“Where you are?”
A pause, and an increase in pressure on her hand.
“Do you remember what happened to you?”
His lips compressed into a thin line followed by a definite hand squeeze.
“Do you require a higher level of pain medication?”
There was no hand movement.
Under his unblinking stare, her free hand strayed to her throat. She twisted her neck as though to remove stiffness and in doing so broke eye contact.
In a hoarse rasp, he asked, “What signal . . . for no?”
She snatched her hand away from his. “Well, it certainly seems like we’re feeling much better, aren’t we.”
He coughed. “We’re feeling like—”
The sentence was cut short by the entry of Commander Gant. With him was a woman in civilian clothes who smiled at Amanda.
Goodness, Zanna, what the heck are you doing here?
There was no chance for small talk because Gant got straight down to business.
“How is he, Nurse?”
“His vital signs are stable,” Amanda replied. “He doesn’t seem agitated or disorientated and he also appears to know who, and where, he is.”
Gant moved to the patient’s bedside. “Good evening, Staff Sergeant Rivera.”
Rivera replied with a nod. He mumbled something and Gant bent closer to hear. “No, it was just you. Lowell suffered a head lac requiring sutures, but not serious enough to warrant a full MEDEVAC. He’ll be back on active duty by now. As will the other guys. They all passed the mandatory tests for anyone within a fifty-meter radius of a blast.”
Zanna smiled at Rivera and said hello, but he didn’t acknowledge her. His head sagged onto his chest and his eyes closed. Gant’s phone buzzed. He took it out and read a text. He excused himself but told Zanna to join him on morning rounds the next day.
Amanda waited until the door closed behind him and pounced on Zanna. “What was that about?”
“I was on my way to the gym and ran into Commander Gant. He said he wanted me to observe patients who’ve not yet started their PT programs. Do you think I should have followed him to find out more?”
Amanda laughed. “I’m sure he would’ve told you to if that was the case. You know what he’s like. He’s off on another mission now.” She became serious. “I need to step out for a moment too. Would you mind waiting until I get back?”
“Doesn’t he have any relatives?” Zanna asked. “I don’t mean that they should be here and not me . . . It’s just that people usually have someone with them by now.”
“Well, no one’s turned up yet.” Amanda tipped her head. “So, if you can spare a few minutes?”
Zanna waved the back of her hand at Amanda. “Go.”
Amanda blew her a kiss and left.
Settling herself in the chair by his bed, Zanna picked up Rivera’s ‘patient diary’. A familiar custom in the UK, Amanda introduced the diary to Gant, who’d immediately adopted its use. Zanna browsed through the pages where key events were recorded by caregivers all along his journey from Kandahar Trauma Hospital through his stopover at Landstuhl Regional Medical Center in Germany to his ultimate arrival here in California. Nothing about his medical treatment was included, just observations on whether he’d had a good or bad day, who visited, and who took care of him. On the page where visitors were asked to leave messages of encouragement, no family members were recorded, but there were a few get-well wishes from other Marines. She took the pen attached to the book and was about to write her own message when Rivera mumbled something unintelligible.
With sleep had come an easing of the tightness around his eyes and mouth, but it had not done much to restore color to his face. Even though his skin was deeply tanned, its current pallor conveyed his true state. He twitched and moaned softly.
Zanna laid down the book and moved to the edge of her seat. She took his limp hand in hers and, with a delicate touch so as not to wake him, she brushed an imaginary stray hair off his forehead. “It’s OK. You’re safe now.”
His breathing grew deep and regular.
* * *
Zanna waited for Gant to finish dictating some notes into his phone while they walked along the corridor to the next patient.
“Thank you, Commander.”
He raised an eyebrow.
“I mean for allowing me to see the patients and the extent of their injuries so soon. I don’t meet them until they’re due for physiotherapy. I can see now just how far some of them have already come at that point.”
“The patient we just saw came in last night. It will be a while before he’s in the gym, but we get them started in their rooms as soon as possible. Good for morale.” Gant stopped outside another door. “Ready for the next one? You met him briefly yesterday.”
Zanna squared her shoulders. “Once more unto the breach and all that.”
They entered the room and Gant stood at the foot of the bed silently observing Rivera. Oxygen was still being administered via nasal cannula, and other tubes were delivering—or removing—various fluids.
Rivera’s eyes slowly opened and he took in the three people watching him. He hitched a thumb at Zanna. “Psych eval, sir?”
“Do you think you need one?” Gant replied.
“No, but I’ll get one anyway.”
“When it’s time for your psych eval, I will conduct it myself.”
Rivera picked up a glass of water from the bedside table.
Gant ignored Rivera’s brusque comments. “Ms. Carpenter, like Nurse Wilks, is from the UK and here on a workplace exchange program for a few months.”
Rivera scowled and after taking a drink—his voice stronger now—he addressed her directly. “This place? Being taken over by the Brits?”
Zanna stepped closer to the bed, tapping the side of her nose. She adopted an exaggerated upper-class English accent reminiscent of old black and white British war movies. “Shhh. Yes, we’re both undercover agents. We’ve been sent over here to recce the lie of the land and take a squizz at what sort of opposition your ground-pounders might put up against our sneaky beakies should the time come for us to reclaim our old territories.”
The tight lines around Rivera’s mouth gave way to something approaching a stifled grin and crow’s feet appeared at the corners of his eyes. Eyes as dark and earthy as rain-dampened loam.
She offered her hand, “My name’s Zanna Carpenter, by the way. I’m a physical therapist.”
“Domingo Rivera.” His warm voice pronounced his name with a marked Spanish lilt; the inflection soft on the ‘Ree’, accenting the ‘veh’ and fading away into ‘rah’.
She replayed the way he said his name until a movement in her hand brought her back. “Yes, your right grip is excellent. May I see how the left compares?” He complied. “OK, now take both of my hands in yours.” He did so. “Grasp them a little more firmly.” He widened his eyes and began tightenin
g his grip. Zanna squeaked, then laughed. “Okaaaaaay, that’s fine.”
“Excuse me,” Gant said. “I’m due in the OR in an hour and still have rounds to get through.”
“Sorry.” Zanna laughed, mouthed an ‘oops’ to Rivera, and stepped out of the way.
“Good to see you looking so much better,” Gant said. “Whoever treated you in country did a fine job.”
“I had a good team, sir.”
“That you did, Marine. That you most certainly did. Now, let’s take a look.” He pulled back the sheet covering the cradle over Rivera’s legs. Zanna and Amanda moved in closer.
Rivera sat forward, his eyes widening at the sight. “Shit . . . sir.”
Gant raised an eyebrow. “You were expecting better, maybe?”
“I thought it was gone.” He settled back into his pillows with a guttural sigh. His right leg was undressed. The livid, raw wounds were still open in two places, but the color of the flesh indicated they were healing well. There were sutures, and pockmarks from shrapnel, but most prominent was the eighteen-inch metal bar attached to the side of his lower leg. Thin pieces of metal resembling long screws extended out of it, and into his bones.
“Wiggle your left toes for me,” Gant said. “What do you feel?
“Pulls a little in the thigh.”
“Good. Now, try moving the right ones . . . gently.”
With the slight movement of his foot, Rivera’s already ragged complexion paled to an even more ghostly appearance. His jaw clenched and he bared his teeth, causing wrinkles at the outer edges of his eyes.
“You’ve suffered a Grade Three comminuted compound fracture of the tibia and fibula,” said Gant. “Most of the soft tissue damage has been repaired. I’ve inserted screws above and below the fracture to stabilize and align the bones. We can adjust the screws manually as the bones knit to keep the alignment true. In time, I’ll replace the external fixator with an intramedullary nail through the tibia to preserve the fracture biology.”
Rivera’s breathing became easier. “Which means?”
Gant rolled his lips. “In layman’s terms, it means your leg’s a mess. Right now, it has a temporary structure holding the broken bones together. As they begin to knit, I will remove that scaffolding and replace it with a titanium rod inserted into the bone marrow canal of your tibia.”
With color now returning to his face, Rivera nodded his understanding.
Gant continued his explanation. “This method is indicated in your case, and because it has the advantage of sharing the load with the bone rather than entirely supporting it, you will be able to bear weight on it much sooner.” He scratched his chin. “However, it is still going to be a painful process.”
“Pain is just weakness leaving the body, sir.”
Gant shook his head. “Parts of the wound have been left open for drainage. There are antibiotic beads in place that will resorb as the bones heal. I see from your report that Kalinski got them in right away too. Those beads will continue to do their job while the wound is healing, but there is still a risk of infection.” He moved from the foot of the bed to Rivera’s side and he included the women in the next part of his explanation. “Normally, the injury is packed with gauze in country and it remains untouched—unless more gauze is added—until the next repack in Germany. By which time infection can have gotten a good hold. You were damn lucky to get that particular plane when you flew into Germany.”
Rivera cocked his head.
“It was one of the flights where the Air Force MEDEVAC Teams are trialing a vacuum pump that keeps the wound drained of fluid without the need of conventional packing.”
“How did I end up here?”
“I was in Germany, embarking a flight back to the US when I heard you were inbound from Afghanistan. I couldn’t rearrange my schedule—though I tried.” He ran a hand over the back of his head. “But you responded well to treatment and two days later the surgeon in Germany sent you on to us so we could get down to the business of putting that leg back together.”
Rivera nodded.
“I’m prescribing a relatively new therapy; AV Impulse Pads that will maintain the circulation in your legs while you’re laid up in bed.”
Rivera remained quiet for a moment, then asked, “How long?”
“How long for what?”
“Till I’m back.”
“Back where?”
“You know what I mean, sir.”
Gant stiffened. “Staff Sergeant, you’ve suffered a serious trauma to your right leg. An injury from which some people might never regain full function.”
“I’m not ‘some people.’”
“I’ve ordered a new MRI. After I evaluate the images, we’ll discuss where to go from here.” He checked Rivera’s notes on Amanda’s mobile station. “Nurse, I am amending the order for pain meds. Make sure it is administered before he goes for the scan.”
Rivera extended his arm and the two men shook hands.
“Hang in there, Ding,” Gant said. Striding for the door, he addressed Zanna. “That concludes your rounds for today.”
Zanna thanked him. I hope that means you’ll allow me to accompany you again sometime.
Rivera lay back on his pillows while Amanda injected the painkiller into the catheter in his arm. The door opened and Petty Officer First Class Raul Garcia entered.
“I’m here to wheel him down to Radiology,” he said.
“Hey, you guys,” Zanna said. “Did Commander Gant not mean an X-ray? Surely he can’t have an MRI with an external fixator?”
The thirty-something, wiry Latino squinted at Zanna. “All the fixings we use are tested to withstand exposure to MRI. They’re not ferromagnetic, so they don’t heat up or vibrate,” he arched his brows, “unduly.”
“What about that necklace?” Zanna asked. “Does it need to come off?”
“Yes,” Raul replied. “Good thing he doesn’t know that’s had to come off each time he’s gone into surgery or for X-rays. I bet he’s never taken it off since the day he was given it.”
Amanda fiddled with the complicated knot to the paracord around Rivera’s neck, on which was strung the business end of a bullet. “I can think of more romantic tokens of affection to give the man in my life.”
Raul rubbed an eyebrow. “It holds a special meaning for him.”
Rivera seized Amanda’s wrist. She gently pried open his fingers and tried to untie the cord again. He made another feeble attempt to grab her which she deflected. He mumbled in Spanish.
Raul winced. “Hey, ’mano. There’s no need for that.”
“What did he say?” Zanna asked.
“You really don’t wanna know.”
“I gathered it wasn’t very complimentary,” Amanda said. She addressed Rivera. “If you don’t let me undo it, I will have to cut it off.”
“Wait,” Zanna said. “That looks like a sliding knot.” She stepped in and moved the knots along the cord to lengthen the necklace. She held Rivera’s faltering gaze. “I’m going to slip this over your head, OK? No one’s trying to steal it, but you can’t wear it during an MRI.” She placed her hand behind Rivera’s neck and gently lifted it just enough to allow her to remove the thong. He still reached for it, but weaker now the drug was taking effect. She took his flailing hand in hers. “Listen, is it all right for me to give it to Petty Officer Garcia? Let him look after it?” That quieted him, but he kept his eyes on her until he finally drifted off into another drug-fueled sleep.
Honor Courage Commitment Page 2