12
I am a boiling bag of meat. Meat soup inside a fragile skin shell.
The fever is consuming me. I’ve had the flu, and my mum had pneumonia three winters ago. This is neither. This is bad. I’m sick, and scared.
Here inside the first-class cabin, the world around me flickers past in brief glimpses between sleep and foggy awareness.
The doctor’s face floats before me.
“Can you hear me, Harper?”
“Yeah.” My voice is raspy, barely audible.
“Your infection is getting worse. It’s coming from your leg. Do you understand?”
I nod.
“I cleaned the wound when you came out of the lake, but it’s gotten infected. I’m going to give you four ibuprofen, then I’ll return shortly and we’ll discuss next steps.”
I swallow the tablets and close my eyes. Next steps. That’s funny. Why? Oh, yeah, ’cause I’ve got a leg injury. At least the best bit of me is still intact.
Everything still hurts, but the fever’s subsided, and my head is clear. The world is back, and so is the doctor. She turns me to get a better look at my right leg and slides my jeans off. They come off as easily as if they were pajamas.
I’ve lost a good bit of weight. There’s a bright spot.
Dark fluid, black and burgundy, oozes through the white bandage that runs the length of my calf, from just below my knee to my right ankle. The skin around the bandage is puffy and red. I can almost feel myself getting sicker, just looking at it.
My limbs were numb at the end, in the plane, when whatever snagged me dug into my leg, and Nick pulled me free. Now it hurts. I can almost feel the heat rising from it, crawling up my body.
Sabrina stares at the bandage for a long moment, as if she’s a human X-ray machine and needs to hold still to capture an accurate image. Then she looks me in the eye.
“You have a severe infection originating at the laceration in your calf. Infection was a risk when you came onto the bank. I cleaned the wound as best I could and bandaged it. Those measures were insufficient. Now we need to make some decisions.”
I don’t like the sound of this.
“The next step is for me to clean the wound again and monitor it more closely. Normally you would have been getting antibiotics already, but our supply is very limited. Since your infection is one we can access, we have some chance of countering it without oral antibiotics.”
“I see.”
“If the infection is still advancing by the time the sun sets, we’ll have to take a more proactive approach.”
I nod, trying to conceal my growing nervousness.
“At that point, I will remove some of the flesh around the wound and sterilize the area a third time.”
She speaks at length in the same monotone, listing the risks in detail, using scary words like sepsis and gangrene. The long and short is, if I don’t get better today, she’s going to remove some part of my leg. Best case: my summer fashion choices will be limited from here on out. The worst case is . . . a good bit worse. Sabrina ends on the words “permanent loss of mobility.” Then she waits. I wonder what she wants me to say.
“Well, writers don’t get out much anyway. Haven’t played sports in decades.” So much for reactivating that gym membership when I get back to civilization.
“I’ve described your situation in detail because I believe every patient is entitled to know the details of their medical status and to be involved in the decisions for their care, when possible. And your situation is unique at present. Nick has been to see me regarding your care. He’s been quite insistent that you receive antibiotics immediately. He has enumerated certain . . . consequences, emotional repercussions for him personally and effects these might have on the well-being of the camp at large, should your health worsen.”
Nick Stone cares about me. Now there’s something.
Sabrina charges on. It sounds as if she’s reading a prepared statement, a speech she’s rehearsed a few times. “I’ve been saving antibiotics for cases of urgent need. My approach is simple: to prolong the lives of as many people as possible, to maximize the number of survivors alive when help arrives.”
That’s what it’s about then: Sabrina would rather see ten peg-leg survivors flown out of here than only five walk away whole. She’s right; their loved ones would agree. Speaking of, I bet my mum is worried sick.
Sabrina’s still barreling on, working up to something, by the sounds of it. “However, given Nick’s recent assertions, I face the dilemma of whether to administer antibiotics to you at this juncture, since not doing so endangers the wellbeing of the camp at large.”
“I see.” Again I wonder what she wants me to say. She’s put no question to me, yet she hovers there by my leg, silently prompting me. She’s not good at this part, the talking bit, that’s for certain.
“Normally at this point, you would be receiving inpatient care, likely IV antibiotics. All we have are oral antibiotics, and while they might help, I’m not certain they will be one hundred percent effective. As I said, I’d prefer to save them for patients where there’s no access to the infection—and, frankly, where they’re needed to prolong a life. For individuals with lower body mass, our limited doses will go further, have a more significant effect.”
Lower body mass. “Children.”
“Correct.”
I get it now. She needs a decision from me—and my help with Nick.
Lives and limbs are at stake, no matter who gets the antibiotics. I ask myself what decision I can live with, but it’s more complex than that. Down one road, I might not live at all. That’s the test, isn’t it? I can make a decision I can’t live with and save my own life or make one I can live with and risk death.
Sabrina’s looking at me, waiting.
I have a plethora of shortcomings. But if you ask any of my friends what single fault most holds me back in life, they’ll all tell you the same thing: decisions. Especially about my own well-being. Career decisions. Dating decisions. Where to live. Where to work. When it comes to making calls about my own future, I’m the worst. At least I’m quite capable of picking out an outfit and settling on where to eat (I sometimes find it helpful to state some positives about myself when facing a challenge).
My first instinct now is to panic, and panic about my panicking, until I suffer a full-blown breakdown. I mean, no pressure: what I say will only determine whether I lose life and/or limb or whether some cute kid down the aisle does. But as the seconds tick by, the panic never comes, only a clear, confident answer that fills me with a reflective calm. No second-guessing, no anguish. Weird. I’ll have to sort that out later, when a neurotic yet seemingly competent doctor isn’t crouching next to my rotting leg.
“I agree with you, Sabrina. Other people need the antibiotics more. When Nick comes back, I’ll tell him that you offered, and I refused.”
“Thank you.” Sabrina exhales and sits back against the galley wall, looking even more exhausted than before. I think this conversation was very hard for her.
I have to say, right now, what I’d really like is to be certain that Dr. Sabrina knows her stuff. I want to know that she sees my kind of injury quite regularly, that she’s remedied this sort of thing a hundred times.
I take a deep breath. “What sort of doctor are you, Sabrina?”
She hesitates.
“You see a lot of infections? Trauma? Do a good bit of wound care?” I prod, getting more nervous with each word.
“Not routinely . . .”
“Right. Well, then. What do you do routinely?”
“I work in a lab.”
Blimey.
“But I had extensive experience with trauma medicine during my medical school training.”
Blimey, blimey, double, triple, quadruple blimey. You know what I remember from university? Very. Very. Little. I nod as if she’s just related today’s weather forecast and tell myself that Sabrina Whatever Her Last Name Is just happens to be the number-one trauma surgeon in this makeshift hospital wing, that she is the very best medical care available at the present moment. Must have confidence in her.
She begins peeling away the white tape at the edge of the bandage. “Are you ready to begin?”
Who could say no to that? I mean, she works in a lab.