A Measure of Mercy (22 page)

“In other words, you froze. Or have you always had a problem with written tests?”

“No, sir.”

“You have not only assisted, but according to these files, you were the primary physician on several cases from birthing babies to setting broken bones and removing a bullet. You have had more medical experience than anyone your age I’ve encountered before.”

“Thanks to Dr. Elizabeth, er Dr. Bjorklund. She wanted to make sure I was trained sufficiently not to embarrass her when I came here.”

His eyes crinkled again. “That sounds like Dr. Bjorklund all right.” He stared into her eyes. “Do you usually panic when under duress?”

“No, sir. Just since—”

“Dr. Bjorklund, your dissection class is about to start.” A voice came through the open doorway.

“You go on. We will continue this discussion later.” He stood and picked up the stack of charts. “In your spare time, you will want to acquaint yourself with all these patients. We have two surgeries tomorrow morning, starting at seven. One a muscle repair and the other abdominal. And I am on call for the ER, so you will be too. Go and breathe deeply so you do your best on this exam. Dr. Franck is a stickler for punctuality, as well he should be.”

“Yes, sir. Thank you, sir.” Astrid hurried up the stairs and down the hall. Running was not appropriate, but it sure would be helpful.

This time she would not succumb to the fears that rode her.
I
have a heart of love and a sound mind.
Where did that come from? Of course, from one of her memory verses from Sunday school.
For
God hath not given us the spirit of fear; but of power, and of love, and of
a sound mind.
She prayed as she entered the room,
Lord God, I most
certainly do need that sound mind. Please keep the fear away.

She took her seat just before Dr. Franck turned from the blackboard. “Good of you to join us, Dr. Bjorklund.” The slight twist he put on her title made her swallow. She swallowed again and sucked in a deep breath.
Sound mind, sound mind, sound mind.

He removed the cloth he’d draped over the other blackboard. The list of ten questions made someone groan. At least it wasn’t her. She read down the list. Yes, she had studied all that. Yes, she had seen it all on the cadaver too. Now to write.
Please, Lord, I know this might
not be important to you, but it is to me. Please help.

She paused a moment before her pencil hit the paper. Had she prayed like this before the other tests? Her mother would say God was trying to teach her something. But what? More lessons? She made herself breathe deeply and leaned her neck from side to side.

Once she began writing, her pencil flew across the paper, the words pouring from somewhere inside faster than she could write them down. She finished the test, including the question titled for extra credit. When she reread her answers, she could hardly believe it. She sounded just like the textbooks. Had she really memorized all the information like that? She made a couple of small changes and stood to take her exam paper to the instructor. As she walked up the aisle, his eyebrow rose. He took her paper and glanced down through the answers, nodding as he went. “You are dismissed, then, Dr. Bjorklund, for today.”

One of the other students brought her papers forward. He glanced down. “You might want to work some more on question five. You have plenty of time.”

“Thank you, sir.” The young woman returned to her seat.

Astrid forced her feet to walk sedately back to her chair. She picked up her things and walked out the door. In the hall the skip and jump burst loose, and she added one spin to the dance. Finally a good test.
Thank you, God.
She said it again in a whisper. Had she been at home, she would have gone out and shouted to the blue bowl of North Dakota sky.
Thank you, God
. He did listen to her prayers after all, not just her mother’s. She started down the hall, refusing to get trapped again in questions about the death of Vernon and the baby. Perhaps there were indeed no answers there. Like her mother often said, some things we’ll only learn in heaven.

Glancing at the watch she wore pinned to the chest of her apron, she hurried back to her room and sank down on her bed to read her mother’s letter.

My dear daughter,

How I miss you. How we all miss you, including Inga, who asks when Tante Asti is coming home. I know you are up to your eyebrows in work there. I hope you are learning all that you can and that when you write, you will take time to sleep more than to write to us. We are all praying for you.

It looks like harvest will begin next week. As always now we are praying that the rain will hold off. And as always, your far is restless for it to begin. He says that the sooner we start, the sooner he can get home again. I wish he would let the younger men do it all, but you know your far. If I said that to him, he would be mortally offended. So I pray and rejoice that he is so much improved. He still tires more easily than he used to, but he is healthy, and that is all that matters.

The girls had a party for Grace before she left for New York. I wish she could have stopped in Chicago to see you, for both your sakes. The girls all said they miss you and are sending prayers up for you.

Inga got Carl in trouble again. He tries so hard to keep up with her. That’s like a spring breeze trying to keep up with a tornado.

Anna is pulling out of her depression. She and I talked again the other day, and I told her what I had experienced all those years ago. Why is it that so often a good cry and a shoulder to cry on are as therapeutic as most medications? I know that getting her out in the sunshine was the first step toward healing.

Mr. Landsverk came for dinner after church on Sunday. He is doing well with the windmill business. He and Trygve are talking of building a little house on wheels like the cook shack for when they go beyond the range of returning home at night. He received a letter that his mother died, and I know that was a shock for him.

I better close now. The bread is ready to be punched down, and Freda is out picking beans again. We are having a bumper crop, for which I am so thankful. I think we’ll do leather britches again. We didn’t have enough last year. I’m going to let the last pickings dry on the plants so we have more dried beans too. God is blessing us with such bounty. I know He is taking care of you.

Love always from your mor

Astrid wiped at the tears that trickled down her cheeks. Instead of going down for the stack of reports, she took out pencil and paper. Even just a note would be better than waiting for time to write a letter.

Dear Mor and all those I love in Blessing,

Please share this, as my time to write is nonexistent. I finally took an exam that I didn’t panic over. I did like I used to at home. Thank you for your prayers, and I am thanking God that He answered mine.

I was asked to assist Dr. Whitaker. Elizabeth will be thrilled with that news. I am astounded, considering my bad scores and mistakes. The thought that a mistake on my part could endanger another person’s life didn’t used to plague me like this. I didn’t think about it. I just did what I knew needed to be done.

I need to go read charts. I love you all and am so looking forward to returning home to Blessing and seeing you.

Dr. Astrid Bjorklund.

P.S. I love signing my name that way. Is that prideful? I hope not.

She’d just finished putting a stamp on the addressed envelope when a knock came at the door. “Yes.”

“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

T
he 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.”