Sunday, September 11, 2005

For One Life 20/38

For One Life

By M. Blais and J.D.

Chapter 20

Claire had apparently fallen asleep, as she was silent so long, and an hour passed.  The tent flap moved, quietly, and William stepped in, his hair a little windblown, and he was squinting in the change in light.  With the rustle of the flap as it opened, Luka glanced up.  Seeing William, he slipped the picture he still held in his hand, back in his pocket.  The older man's eyes went immediately to Claire, then to Luka, and he stepped all the way inside, letting the flap fall back down.  "Still asleep?" he mouthed, gesturing to his daughter.

"She was awake, said she was dizzy.  Her one eye is slow to the light, too."  He kept his voice low so as not to wake Claire as he updated her father.

William nodded, and stooped over Claire's form, moving her hair out of the way a moment so he could see her face.  He touched her cheek, which she didn't respond to.  "Did she say she was in a lot of pain?" he asked, curiously.

"Some.."  Luka reached for the bottle of pills and held them up. "She wanted to take these..I thought she should wait for you to okay it."  As he spoke he forced himself to sit back up, then eased his braced leg off the cot again.

William straightened, rubbing his index finger and thumb together.  "She's been crying," he observed, before taking the bottle and checking the label.  "Yes, I'd like to keep any drug interactions to a minimun."

"I didn't know, I should have had someone go find you."  He mentally chastized himself for not doing just that.

William shook his head.  "Sounds like you did just fine.  You checked her eyes and all....that, plus she awoke on her own.  All good signs." He set the bottle aside.  "How are you feeling?"

"My knee is throbbing, but I can handle it."

"Are you sure?"  William smiled, touching the bottle with his fingers.  "You can take a few of these, if you want.  No more than two, however."

Luka waved his offer off with a shake of his head.  "Better save them for someone who really needs them."

"You may be that person," he pointed out, pulling his stool over.  "Still coughing?"

He nodded. "Some."

"Here, let me see the leg....about time for some rewrapping, considering movement and all."

He eyed first William, then Claire before reluctantly pushing himself to his feet, keeping his weight on his good leg as he unfastened the belt, then his jeans. After easing them down, he sat again, pulling the thin blanket across his lap once he was settled.  William helped him when necessary, as Luka braced his hands on the cot, then drew his lower lip between his teeth in anticipation of uncovering the pained knee.

William slid his fingers under the wrappings and started to unwind them around.  "Is the movement any less stiff now?"

"Hard to tell with the splint...I just know the knee is hurting.  Just thought it was from all the walking and everything."

William removed the two makeshift boards, setting them aside. After all that time bandaged, they were bent a little outwards. Setting them aside, he took off the remainder of the wrappings until it was completely exposed.  Luka let his eyes drop to the knee, regarding it critically as he waited for the man to comment on it.  William placed his fingers on either side of the knee, testing the ligaments. "What do you think?" he asked.

There was a quick intake of air with the initial touch, even though he thought he was ready for it, and then through clenched teeth he offered, "Not so bad."

William smiled.  "Your face doesn't say that."  He took Luka's hand and placed the fingers on either side of the knee.  "Here...feel for the ends of the ligaments.  Then feel for the knotty tissue where they were originally attached.  See how there is growth there?"

He swiped his tongue across his lips, then watched and did as asked.  "Yeah..."

"You can tell when something needs surgical help on joints by learning the feel of these ligaments, and the cartilage around them."

"It'll be okay?" Despite efforts to conceal it, his voice betrayed him, wavering slightly with residual fear as he questioned the man.

William nodded.  "It's already reattaching, and as far as I can tell, no more than a few centimeters from the original site.  Now, to speed the new growth, that's why we keep it wrapped so tightly, and restrict movement."  Luka nodded, wincing slightly as he fingered the knee himself, trying to note the differences that were being pointed out to him.  William drew two new flat sticks from his bag.  "You should practice on yourself like you a real feel for it."

"The swelling still looks pretty bad..." Luka couldn't overlook the fact that one knee was almost double the size of the other.

William shook his head.  "It's misleading.  You see, a knee is almost all bone...not much around it but the ligaments.  All swelling looks bad on the knee.  The same swelling you wouldn't notice as much say....on an arm, maybe a shoulder."

He offered a nod of understanding even though he was having his own doubts.  "Okay..."

"Ready for rewrap?"

Luka drew a breath, then took hold of the edge of the cot.  His hands tensed slightly for the anticipated pain.  "Yeah."

"Do you want to try doing it?"  William chuckled.  "I don't usually encourage self-treating, but you are a student.."

"I guess..."  He released the his hold on the cot with the acceptance.

"Come now, some enthusiam.  Not often you get to see a good ligament tear out here."  His face was serious, but his eyes twinkled.  Luka raised his eyes to the older man, not quite sure how to take the teasing, and William added, "Take your lessons where you can find them, Luka.  Remember that."

"Yeah..."  He took the offered bandage and drew a breath before beginning to wrap the knee again.

"Wait, wait.."  He held out the two sticks.  "Make sure these anchor it."

"Right...I forgot.." He set the loose end aside and tucked one of the sticks between the layers only to repeat the action with the second. He drew a slight breath with the added pressure but didn't seem to be cutting himself any slack on the tightness of his wrapping despite it.

"Slowly.....make sure it has room to circulate, and let the swelling ease.."

He nodded, loosening the last couple rounds before finishing.

", test the give with your fingers."

Luka lifted his eyes from his task to the elder doctor, looking a little puzzled.  "Give?"

William slid his fingers barely under the wrap.  "Pull on it...see if it moves.  If it gives.  See?"


"We're going to change the dressings on the bullet wound next."

"All right..."  He swallowed then eased himself back onto the cot, stretching the leg out flat on it.

"I want your help on this one too."  William unwrapped the bandage a little faster on this one.  Luka complied silently, aware of how it had looked only a few days earlier.  William leaned forward, peering at it a little.  Casually, he took a pair of gloves from his bag, and handed one of the two to Luka.  Then he slipped the other one on his own right hand.  The younger man took the glove, not sure what he had in mind, then pulled it on.  "Alright now...with an entry wound--"  William started, before he was interrupted by a faint moan from the other cot.

At the sound Luka shifted his attention to Claire, then back to William.  "See to her."  Even as he spoke, he reached for the blanket to cover himself modestly.

William nodded.  "Don't rewrap that yet."  He rose and went to the other cot, as Claire rolled over onto her back.

Luka nodded, though he did drape a piece of the bandage on the wound to shield it from the blanket contact.

William perched on the edge of her cot, as she started to sit up, blinking.  "Hang on there," he murmured, pushing her back down.  "Let me look at you."

"Poppa?" she asked, her voice rough.

With William to the other side of the tent, Luka lay back, closing his eyes with a sigh as he gave in slightly to the pain he had been trying to avoid acknowledging.

"How is your head?"

Claire groaned.  "It feels like someone was beating on me as I slept...sure it wasn't one of you two?"

"I prefer to wait until you are awake to pick on you, thank you very much," William said, archly.  "Open your eyes."  Luka did the same as Claire was ordered to, opening his eyes as he turned slightly to his side to watch them.  He managed no more than a muted groan to mark the effort.  William gently put his fingers under her chin, tilting her head back as he looked into her eyes critically.  Her lips tightened automatically, but she let him check, even following his finger when he asked with her eyes.

Releasing a cough before speaking, Luka propped himself up on his elbow to ease it.  "Any change?"

"Some," William said, slowly.  He moved his hand to test the bruise on her forehead.  She closed her eyes tightly as he touched it.  "Good....seems like any internal swelling has started to ease."  Leaning over the side of his own cot, Luka snagged the discarded jeans from the floor.  William diverted his eyes a moment, catching the action from the corner of his eye.  "Hey, I'm not done with you yet."  He smiled at Luka.

"I know."  He fished his picture from the pocket, then sat up enough to toss his jeans to the foot of the cot before leaning back on one arm again.

Claire reopened her eyes.  "Can I please have something for my head now?"

William sighed, leaning back.  "Any dizziness?"

She started to shake her head, then stopped.  "..No."

"Any nausea?" William continued to question his daughter as he worked.

She started to sit up, watching to see if he'd stop her. "No.."

"Hmm."  William rubbed at his jaw with his ungloved hand, then said, "What do you think, Luka?"

"She said she was earlier." He pointed to the bucket by the bed.

"True...let's give it a few hours, Claire," William said, trying to be sympathetic.  She sighed, her shoulders slumping, as she rubbed her head with her hand.  "Alright, back to wound number two," he said, almost cheerfully, scooting his stool over to Luka's cot.  "Between the two of you, I'm getting a lot of work," he added.

Luka lay back himself, only to start coughing with the position  then forced himself back to the semi-upright compromise.  It seemed as if he could never get comfortable.  "I can go back to the medical have enough to worry about here."

"Is that what you want?" William asked, testing his glove again and leaning over the cot.  "It shouldn't be about Claire...she's going to be fine, I think."  He gave his daughter a smile.

"I don't want to make anymore work for you."

William made a tsking noise.  "So you'll make me walk all the way to the medical tent?  Not very nice for one of my assistants.  Let's see that leg."  Obediently, Luka rolled back onto his back, and pulled the blanket aside, a cough immediately following the action as he was once more flat on his back, like clockwork.  William leaned forward, examining the edges.  "Do you mind if Claire sees it as well?"

He boosted himself up on his elbows to watch, easing his breathing before answering.
"No.."  Modesty accompanied his permission and he arranged the blanket so it would cover a bit more skin as he agreed.

"Claire."  William said it like an order.  She rose from the cot, pushing her hair back.  Carefully, she sat on the edge of his cot, using her hands to steady herself.  "What do you see here?" he said, his gloved fingers pressing at the wound.  Luka drew a breath in with the pressure despite the effort not to.  She had to blink a few times to clear her vision, then narrowed her eyes to focus them.  "Exit bullet wound," she said, her voice rusty.  She cleared it after a moment.

"Luka?  What would you look for in a wound like this?"

He wet his lips, the flicking of his eyes an indication of his searching for a word.  When he didn't find it he offered "infekcija" in Croatian before switching back to English.  "If the wound wasn't kept clean...or ulomci," he shifted momentarily to Croatian again, "were left behind."

William nodded.  "You have to check for infection, yes, and if any pieces were left.  But largely in a bullet or knife wound, there won't be.  A shrapnel wound, yes."  He carefully set his fingers at the puckered edges and pressed, lightly.  "But an infection isn't always visible.  You need to learn how to feel for things like tissue degeneration, or too soft flesh underneath."

The gasp was unavoidable, as was the tensing of his muscle at the man's touch.  Claire lifted her eyes to Luka's face. "Poppa, careful," she murmured.

"It's okay..." Luka drew a couple deeper breaths then nodded for William to go on even as his voice betrayed him.  His compromise to himself was a tightening of his hands in the bedding where they might not notice.

"See how the thigh muscles tense?  That's means they have not been compromised by the wound."  Claire dropped her eyes again to the wound as William spoke.  "Now, as long as there is no bleeding, and no infection, the tissues will knit just fine in time."

Further instruction was interupted as there was a rustling at the tent door, and William turned to look.
To be continued...

No comments: