Wounds - Book 2

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This book is a work of fiction. Names, characters, places and incidents are products of the author’s imagination or are used fictitiously. Any resemblance to actual events or locales or persons, living or dead, is entirely coincidental.

An
Original
Publication of POCKET BOOKS

POCKET BOOKS, a division of Simon & Schuster, Inc. 1230 Avenue of the Americas, New York, NY 10020

Copyright © 2005 by Paramount Pictures. All Rights Reserved.

STAR TREK is a Registered Trademark of Paramount Pictures.

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http://www.startrek.com

Chapter
1

S
o, contestants, today’s puzzler. Given the opportunity to whack off some poor guy’s leg without anesthesia, would Elizabeth Lense rather:

• a)
  chow down on a bowl of wriggly gagh chased with shots of piping hot bahgol while simultaneously squatting naked as a jaybird with Tev in a mudbath and being tortured with Klingon painstiks;
  
• b)
  have Captain Gold as her therapist forever because there’s no way in hell she’s going to be anywhere near normal if she ever gets off this dustball of a planet;
  
• c)
  gladly go anywhere in the known universe with Julian Bashir while he gabs on about being a Remarkable Frontier Doctor;
  
• d)
  all of the above;
  
• e)
  What, haven’t you been listening? Julian Bashir is dead; Lense is stuck somewhere hell and gone; people are trying really hard to die right and left; and you’re worried about some dumb stupid game? Get out of my way.
  

Blood drizzled in a sludgy brown stream, soaking thin linen thrown over a makeshift surgical table, a wood pallet balanced on twin stacks of flat rocks. The wound site was a mess: a gory crater of pulverized bone and blasted flesh midway below the right knee. There was no way in hell Lense could save that leg.

You know, d is pretty damned attractive.

“Okay, okay, hold him still,” Lense said. They were nine in all: Lense and the patient as well as the seven others she needed to hold her patient thanks to that lack of anesthetic. To Lense’s left, Mara controlled the leg from the knee down, and Saad stood to Lense’s right. The leg was flexed at a right angle and Saad pulled down on the knee until it canted fifteen degrees from horizontal.

Reeling in a deep breath, Lense spread the fingers of her left hand over the man’s inner thigh. His skin jumped and his head snapped up, and his knee wobbled as he strained to kick free. “Please,” he said. His teeth were bared in a grimace of fear and pain, and he was sweating so much his gray-blue skin shone as if oiled. “Please, please, please, don’t take off my leg, please don’t take my leg, please, don’t—”

“No, I’m sorry, got to do this, just hold on,” Lense said, and then simply whipped her scalpel over his skin. The knife bit through skin, slashing open his thigh and cutting fat, fascia, and muscle in the first pass.

The man let go of a high, keening shriek. Chocolate-brown blood spurted from severed veins and arterioles, and he bellowed with pain. The pallet shifted, and she heard the squawk of wood grating on stone.

“For God’s sake, hold him!” she shouted. Last thing she needed was to cut herself, or send the blade through the artery before she was ready. “All I need is a couple more minutes!” This was a lie; she needed a lot more than two or three minutes. There were muscles and tendons to cut; nerves to suture to muscle; an artery to find, clamp, and then tie off so he wouldn’t bleed to death—to say nothing of sawing through bone. And that was just to get the leg off.

“Hurry.” Saad, at her right elbow. He was a big man, easily two meters tall and muscular, but even he was struggling. “You must work faster, Elizabeth.”

She slashed through muscle and fascia. Talked herself through it:
Okay, coming across the top now; there goes the semimembranosus, and then I got to be careful because of the sciatic nerve; got to cut that fast and then tag it so I can suture it to the short head of the biceps femoris; yeah, that’d be best….

She tagged the sciatic nerve, then clamped and tied off the saphenous vein. (Were these the right names for here? Probably not. But with some significant exceptions—the heart, the left lung, a thick sternum, their very large spleen and thymus, and their queer blood—this species’ anatomy was virtually identical to humans’. Lucky her, she’d had plenty of casualties to practice on, do a couple half-dozen autopsies to get the anatomy down.) She was drenched in sweat; the back of her khaki tee was plastered to her shoulder blades and the front spattered with blood that came fast and brown. But no pumpers, thank Christ, though the femoral artery wasn’t too far away now.

Trickiest part; got to clamp it off and make sure you got plenty of artery there or else it’ll retract….

She made her next cut and saw the femoral artery now: a fat, bluish-brown, pulsating tube wedged close to the bone medial to the knee and between two large thigh muscles. The tube throbbed a rapid staccato, her patient’s heart rate ramping up with fear and pain. He was still screaming and trying to kick, and she kept praying that, please God, he’d pass out because this was insanity, she was out of her goddamn mind….

First proximal, then distal, because if the artery tears, at least you’ve got control of the business end of things.
Clicking open two arterial clamps, she gently eased the teeth of one around the artery at a point closest to the hip and then snicked a second clamp shut two centimeters distant. She was already thinking three steps ahead:
Tie off the artery, then get rid of the rest of the tissue, cut the bone.

So what happened next probably occurred because she wasn’t focused, wasn’t reading how his few intact muscles kept jerking and twitching, wasn’t listening to how much he screamed because
everyone
screamed. So Lense slit the artery in two—at exactly the wrong moment.

“Stopstopstopstopstopstop!”
he shrieked. The thigh above the cut bobbled, and Lense flinched, her scalpel snagging in the handle of the proximal arterial clamp.

“Hell.”
Can’t lose the artery, can’t lose it.
Then she heard a warning yelp from Mara and looked up just in time to see her patient’s left foot angling for her face.

“Jesus!” Lense ducked but not fast enough, and the blow caught her left temple, slamming her back. She went down hard; her scalpel skittered over rock, and she lost her grip on the clamp.

“Elizabeth!” It was Saad. He’d caught hold of the patient’s left leg and was forcing it back, passing it off to the men opposite. “Elizabeth, the
artery!”

Cursing, Lense grabbed his proffered hand, clawed her way back to her feet. Her head throbbed, and tears stung her eyes. Her vision was blurry with pain, but she could see well enough and then wished she couldn’t. A geyser of blood jetted over raw muscle and bare bone, but the elastic artery itself had snapped back into muscle and was nowhere in sight.

“Oh, no no no no!” She tried fishing for the artery with her clamps, jamming the curve of her instrument into bloody meat. But there was nothing to snag and so much gore Lense couldn’t see worth a damn. “Hold him,
hold
him!” Quick as lightning, she slashed away at the remaining tissue right down to the bone. She was sloppy about it; her scalpel scraped against nerve-rich bone and the patient flopped and wailed in agony. Then, mercifully, finally, he fainted.

The sudden quiet rang as a high whine in her ears. The only sounds were ragged breaths and the drip-drip of blood pouring into and overflowing from a thick lake on the pallet to patter in rivulets onto rock with a sound like rain on tin.

“Okay, okay, just a few more seconds,” she said, lying through her teeth. She abandoned the clamp, squirming her naked fingers into warm muscle until she felt blood spewing with every beat of her patient’s heart. Grunting with effort, she tried tweezing the artery between her thumb and forefinger, pushing and tearing through thick muscle.

If I don’t get it this time, either I cut away more muscle or that leg comes off right now.
She concentrated, closing her eyes; then, her breath snagged in her throat. “Got it, got it,” she said, her teeth clenched hard enough to hurt. “Just another sec, just another—” But then she felt her blood-slicked fingers slip and the artery pulled back like a taut elastic band snipped in two.

“Damn!” She huffed out a breath, then dug out a thin coiled wire strung between two metal handles. “Got to cut the bone, get more maneuvering room,” she said, whipping one end of the wire beneath the nearly-severed leg. “Otherwise, I’ll have to cut away more meat.”

Or he’ll just bleed and die; supply will peter out and his pressure will hit the basement; and there’s no way in hell that’s happening on my watch, not on my watch!

She palmed the metal handles of her saw: a very fine, very tough wire. (Admiral McCoy, guest-lecturing a history of medicine course, talking about how the principle behind this kind of primitive saw, a Gigli, proved what Thugee assassins had known for centuries—that garroting with razor-thin wire almost always resulted in decapitation.) The saw made a buzzing sound like sandpaper over stone; but she had no lubricant for the saw, and friction and thickening blood made the wire heat, then snag and hesitate. She struggled, the saw giving in grudging fits and starts.

“Let me,” said Saad, and then he simply jerked the handles from her and bent to the task with a will. His shoulders strained, but he moved fast; the saw zipped through the bone in less than sixty seconds.

“Thanks, okay.” She was already crowding in just as the leg came free. She pushed the disarticulated limb aside; it dropped to the rock with a sodden plop but she ignored it because that was dying meat and in the way. She grabbed up a linen and swabbed, but the linen was saturated in seconds and blood still jetted from the severed artery. However, she now had a marginally better view, looking at the stump on end, like a rump roast sliced in two: bone and its circle of bronzed marrow a little off-center, slabs of glistening raw muscle, and the spurting tube that was the artery, wide and fat, held open by the pressure of blood being forced through.

One more time.
She watched the geyser pump, the blood chugging like oil. A quick nod to Mara, who sponged the area clear and then Lense was plunging the clamp deep into the muscle, forcing the tough tissue back, spreading the clamps as wide as they would go—knowing she was going to grab meat, too, but not caring—then jammed them together, hard.

For a second, she didn’t know if she’d hit the artery or not because there was still so much blood—on the stump, splattered on her and Mara and Saad, pooled on the pallet—she couldn’t see, and her boots squelched in coagulating muck. But the pumping had stopped. She held her breath for five seconds, then ten. Her eyes clicked over raw muscle; she registered ooze from small vessels. But no spurts, no more geysers.

“Okay,” she said, releasing a long breath. She felt queasy. Because she was out of her league, and knew it. “Okay.”

“Okay? This is all right with you? You call this
mercy?”
Saad’s tunic was sheeted with blood. He was panting; gore slicked his hands, and he held them up for Lense to see.
“This
is your mercy?”

Her cheeks burned with shame. She opened her mouth then closed it.

Saad stared at her a second longer. He was so enraged, he trembled. “Elizabeth, whatever you think of our customs,
this
is blood on my hands, this is—” Then, whirling on his heel, he hooked his thumb over his shoulder, and one of his men stepped up to take his place.

Lense found her voice. “Blood on your hands…and it wasn’t before?”

“Not this way.” Saad’s lips had compressed to a thin dark line, like a crack in stone. “Because I never made my people
beg.”
He stalked out, and Lense heard the echoes of his footfalls several seconds after he was gone.

Mara plucked up a length of teal-colored suture threaded through a needle between the jaws of a clamp. “He’s right.”

“Thanks,” Lense said tersely. She took the needle but she couldn’t look Mara in the eye. Her face flamed with anger, embarrassment. “I know that.”

“Something has to give. We can’t keep on like this.”

I know that, too
. Lense squeezed her eyes tight. She tried counting to ten and made it to three. “So what do you want me to do, huh? Give up? Stop trying to help? We have virtually no
equipment!
But if there’s even a
chance…!”

“For what? We still lose men, or they stay alive long enough to die of
complications,
as you call them. So, is this for them, or you?”

Lense had no answer for that. “Fine, whatever. Let’s just give this guy a nice scar.”

“A scar,” said Mara. “And here you were so worried about fitting in.”