Cancer abandoned his two Minimal patients, moving to assist with the new casualty.
The next incoming patient should have been the first one into the mosque—a man in his sixties with a missing hand, being escorted by two villagers. They’d ratcheted a belt around the man’s forearm in an attempt to save him, and the stump at his wrist was, at first glance, bleeding remarkably little.
They probably thought their impromptu tourniquet had succeeded, but Reilly knew better. He recognized at a second’s glance that the radial and ulnar arteries had simply shunted themselves, retracting inside the wrist. It was clear from the volume of blood on his forearm that the wound had bled profusely before that occurred, the remaining hemorrhage mitigated only slightly by his elevation of the cut, the application of a belt, and a one-handed attempt to maintain pressure by clasping his wrist.
But with the minutes that elapsed between now and the man’s amputation in the soccer field, Reilly knew that the pendulum was about to swing the other way, with the severed veins undergoing vasodilation and causing him to bleed out in the next ninety seconds or less if left untreated.
As if there wasn’t enough urgency in the situation, Tolu arrived beside him and translated their words. “Last casualty. This is the village elder.”
No further explanation was needed—as a man of great influence in this limited sphere, the victim warranted an otherwise unprecedented level of care by the senior medic on scene, least of all for his ability to inform and influence the greater strategic situation at hand. The fact that he’d waited until last to enter the mosque was a well-intentioned move, but one that could nonetheless cost him his life.
Reilly responded accordingly, making the decision to personally treat this elderly Nigerian out of consideration for both the broader implications and medical necessity.
The medic ripped a tourniquet from the front of his kit and applied it to the man’s mid-forearm in an attempt to preserve as much of the radius and ulna bones as he could— who knew if prosthetics were possible in this part of Nigeria, but Reilly would treat him the same regardless. Then he wrenched the windlass in a series of clockwise turns until it was impossible to tighten it any further as he spoke to Tolu, who attempted to relay the words.
“He says that—”
“Get his escorts out of here,” Reilly ordered. And while Tolu translated that instruction and the two men gradually complied, the village elder continued speaking with a renewed sense of determination.
The medic ignored him, securing the windlass in place as the elder continued chattering urgently. Finally Reilly resorted to telling Tolu to translate seven simple words.
“Tell him to shut the fuck up.”
After securing the windlass, Reilly dipped into his personal aid supplies to recover a wad of Kerlix and stripped it from its wrapper, pressing the gauze atop the stump with care. The bizarre truth about such amputations was that shards of exposed bone could slice your hand apart as easily as a razor, and with two million Nigerians living with HIV, Reilly was cautious while holding the gauze in place. He used his free hand to unroll an Ace bandage and wrap it over the dressing to hold it in place.
Once complete, Reilly finally stripped the belt from the man’s arm, tossing it aside.
“One Immediate,” he shouted, pointing the village elder to Worthy and Cancer, where he’d await transport while having his vital signs continually assessed. But the man was speaking more insistently now, each ragged word coming across as gibberish to his savior—though not to Tolu, who insisted on translating the man’s words.
“He says there is still a rebel.”
“What?”
“One of the invaders. He is alive...and hiding among the people.”
Reilly was silent for a moment, processing that information with the feeling of a hot coal simmering in his gut. Most of his combat time had occurred with an almost clinical sense of detachment—he was there to do a job, and took no pleasure or sorrow from the act of killing.
But the effect of warfare on innocent civilians was a hardship he’d never grown accustomed to, and the man’s comment elicited a peculiar sense of rage in the normally easygoing medic.
He gave the man a reassuring attempt at a smile, then replied in a low tone, “Can he assign someone to point him out to us?”
Another exchange before Tolu responded, “Yes, one of his men can do this. But he is afraid his people will be punished—”
“Believe me,” Reilly cut him off, his expression hardening, “once we get ahold of the bastard, revenge will be the furthest thing from his mind.”
35
Ian felt a knot of dread forming in his stomach as he stepped outside the mosque with Tolu, responding to David’s request that both men help him in the upcoming proceedings.
The casualty situation was, by now, well in hand—Reilly had released the two Minimal patients, while the Delayed casualty with a broken humerus had moved to the village’s ambulatory vehicle, which only needed the three Immediate patients to arrive before setting off for the nearest hospital. Those latter three were now receiving Reilly’s direct care before being moved; the Expectant casualty with the shattered skull had, by then, expired.
As would the man Ian located to his left, he suspected.
David and Cancer were practically dragging the restrained captive through the streets—he looked to be in his mid-twenties, and had taken the precaution of stripping his fatigue shirt before trying to hide among the populace.
Now he was in camouflage pants and a sweat-stained T-shirt, hands flex-cuffed behind his back as the team leader and sniper alternated between shoving and kicking him from behind as they made their way down the street. Ian took a moment to try and assess how cooperative the prisoner would be, only to come up uncertain—he was bleary-eyed, head hung as he struggled to maintain his footing.
David and Cancer dragged the captive into the alley beside the mosque, and Ian tapped Tolu on the shoulder with the words, “Let’s go.”
They arrived in time to see David push the captive into a stone wall, pinning him against it with a hand on his neck as he said, “Cancer, go help with the casualties.”
The sniper objected, “Boss, I can—”
“Go,” David insisted, waiting until Cancer departed before nodding toward the prisoner and asking, “He drunk, or what?”
“Tramadol,” Ian replied. “It’s an opioid painkiller, and they mix it with alcohol and every other drug they can get their hands on. Bad guys use it to numb themselves to killing, and the civilians use it to cope with the violence. Half the region is addicted.”
“Will he be able to talk?”
Ian paused before providing an honest reply.
“Yeah. He will.”