Preface: This is a sample from a passion project that I've been working on for about a year now, titled "Practicing Medicine." I am now almost finished with the 30-chapter first draft, and thought that now would be as good a time as any to recruit some folks who might be interested in helping me edit it. If you you have any interest in reading the full draft and helping me make it into something that is less of a mess, please PM me, check my profile for my contact info, or leave a review detailing how I can contact you.
Thank you.
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It was eight o' clock in the morning, and Sheriff McBain had just been shot.
There were no lights, no sirens. In fact, there were no outward signs of urgency anywhere, save for the urgent phone call I'd received just seconds ago, and my own accelerated heart rate.
It didn't take me long to change my shirt or pull on my boots. Even with my shaking hands, I moved with a sense of purpose, each action a step in an organized routine.
Pull off my shirt, put on a new shirt, put on my shoes, grab my glasses, disconnect pip-boy from outlet, clip on pip-boy, turn on pip-boy…
The black screen turned a vibrant green color as I clicked the power button, lighting up my otherwise dark room. These were the words on the screen:
PIP-OS(R) v1.0.3
COPYRIGHT 2075 ROBCO(R)
LOADER V1. 1
EXEC VERSION 41.10
32K RAM SYSTEM
16811 BYTES FREE
HOLLOWTAPE LOADED: "THE-SCIENCE-OF-UNCERTAINTY"
INITIALISING….
SUCCESS!
STATUS
Battery Level: (Optimal) 100%
Wireless Signal: (?)
Operating Temperature: 90F
HEALTH
Vitals: Strained, Within healthy range
Limbs: Intact
Blood Flow: Not Bleeding
CLIMATE
Current Temperature: 78F
Atmospheric Pressure: 753 mm
Background Radiation: 0.231 RAD
I couldn't read much, so I wasn't sure exactly what each of them meant, but I got the gist- I knew exactly what I needed to know.
Without pausing to think, I threw open my door and ran into the hallway, grabbing my long white coat off of a hook along the way. I slipped it on over my shoulders as I strode up to the front door, where my faded orange doctor's-bag lay on its side. Before I picked it up, I made sure to quickly button up my coat, and straighten my green tie, because appearances are everything. I hefted my bag up with one hand, and pushed the door open with the other.
It was hot outside, 97 fahrenheit and still climbing if my pip boy was telling the truth. Not that it mattered much; temperature rarely affected anything, and my patient was inside the air-conditioned Bison Steve's Hotel.
No more thinking- I started to sprint, skirting the corner of my neighbor's house and running out into the main square, my heavy bag swinging wildly in my aching right hand. As much as I wanted to have time to think, to stride up slowly and confidently like I'd been taught, I was on a timer. Depending on where the Sheriff had been shot, it could be a matter of seconds deciding whether or not he survived, especially if there was still a shooter in the area.
The Hotel was just up ahead now- the big "Bison Steve's" sign flickered eerily as I walked up to the double wooden doors, which had been propped open with two cinder-blocks. I felt the cool air wash over my skin as I stepped into the building, and tried to regain my composure. I cleared my throat.
"Alright y'all, listen up: I am a medic! I don't have a gun- please don't shoot me!" I shouted, which might have been a bad idea but it was all that I had planned for a possible active-shooter scenario. I didn't deal very well with confrontation.
The front hall and the reception desk were abandoned, but the lights were on. After deciding that further investigation would be a waste of time, I stepped through the next set of propped-open doors and into the dark hallway, where a pretty, blonde woman was standing, holding onto a wall-mounted telephone.
That would be Mrs. McBain.
"Oh my god, Isaac! Come here, quickly- I think my husband is dying!" I power-walked to catch up with her, then tried to keep up a comparable walking pace. It was kind of hard, given my height.
"Could you tell me what happened?" I asked. The words felt weird to say out loud- I'd practiced what I'd do in a real emergency, but now that it was actually happening, I couldn't believe that I was actually falling into my routine. I guess I didn't see any other option.
"Well, the boys- Beagle and my husband, right, they were doing firing drills. But then the shooting stopped, and my husband started yelling, and when I ran in to see what happened, I found out that Beagle had shot him in the leg!"
And, there was the explanation. Here I was worried that I might be dealing with an active shooter! Though, the more I thought about it, the more I realized that an idiot with a gun might have been just as dangerous.
"Does he still have the gun?" I asked, approaching one of the four doors to what had to be the firing range. The familiar scent of gunpowder stung my nose as I cracked open the rightmost door, and peered into the massive, open room. I didn't see anyone, but then again, my vision was so awful that my patient was probably right in front of me. Mrs. McBain brushed through the doors.
"No, I made him to put it down." I nodded, took a deep breath, and entered the room.
As I stepped through the doorway, another smell hit me almost as hard as the first- a sharp, irony smell that hung in the air like some sort of leaking gas. I wasn't quite so intimately familiar with this smell, but I recognized it immediately; the acrid smell of blood on skin.
"Hey Doc, come on in-the Sheriff is lying over here," said Deputy Beagle, waving his pistol at me. I flinched.
"Put the gun down!" I shouted back, "I'm not going to do anything until-"
"Beagle! You put that thing down right now, or I'll shoot you myself!" Screamed Mrs. McBain. Beagle made a dramatic sigh.
"Fine. But, you know it was an accident, and it ain't like I'm gonna do it again." He tossed the gun aside. The cocked, loaded, cold-steel weapon hit the ground hammer-first, driving it into the firing pin and striking the cartridge.
The ensuing, "BANG!" was, no kidding, the second loudest thing I'd ever heard.
"Goddammit!" Beagle shouted, and Mrs. McBain screamed and dropped to a crouch. I just sat, stunned, staring at the dropped gun and trying to think again. It was like my mind was a machine, and someone had just shoved a flock of birds into the workings. Everything ground to a screeching halt.
"Isaac? Isaac, you alright sweetie?" asked Mrs. McBain, approaching me cautiously. I nodded.
"I'm okay," I lied. I kept nodding. "I'm okay, I'm okay, I'm okay…"
"You sure don't look okay," said Beagle, walking up uncomfortably close to me. I took a deep breath, pushed Beagle back several feet, and wiped away the tears that were making their way down my face.
"I'm alright! Where's the Sheriff?!" I looked around wearily. My eardrums were still bubbling, but I was starting to be able to hear myself think again. I had apparently dropped my medical bag on the floor, but it hadn't opened up or spilled.
"Jesus kid, can you not turn your head on your neck? Over there, sitting against the pillar!" snapped Beagle, motioning towards the wounded Sheriff with his whole upper body. I felt like yelling back, but that would be a waste of time. I gave him a quick nod, and strode over to the fallen Sheriff.
As I got closer, I could hear him muttering to himself, though I couldn't understand what about. Once I was sure that the immediate area was safe, I dropped to a crouch beside McBain, opened my medical bag, and pulled on a pair of nitrile gloves.
"Hello, Sheriff. Can you understand me?" I asked. He smiled at me.
"Hey! You're Isaac, the um, the Gambling-Place owner's son. Uh, Casino! Yeah…" He trailed off. I lowered him down to the ground, and started going over my ABCs, because apparently my mind was too busy to do anything but stick to its beaten-path routines.
He could speak, so his Airway was fine. I didn't have time to test his Breathing, but I assumed it was equally okay. The only problem, then, was with his Circulation- that would be the bleeding.
"Alright, Sheriff, I'm going to take your pants off. Tell me if it hurts much," I said, unbuttoning and unzipping his trousers. He just laughed as I pulled them off.
"Actually, I don't feel much of anything in my leg! Just like I got punched, and now it's burnin', sorta." That was good- it meant that the bone probably hadn't been fractured, and I wouldn't need any med-x. I always kept an emergency syringe of the stuff, but I was reluctant to actually use it on anyone.
Once I was done removing the pants, I touched his leg- it was uncomfortably cold, and the pale skin of his thigh was starting to look sort of blue. I'd assumed shock, based on the bigass blood pool, but I could be dramatic like that. This was solid confirmation. I was going to have to work fast.
As I searched around in my bag for a tourniquet with one hand, I held up the Sheriff's leg up with my other, so that I could see the wound in the dimly lit firing range. The hole wasn't big, at least not the entry- just a red, penny-sized oval near the base of his thigh, surrounded by bruised skin and seeping out blood. Like a bloody little volcano.
The exit wound, on the other hand, was very big- a jagged hole in the back of the leg with flaps of skin hanging loose around it, leaking out a torrential amount of blood. The bullet, I noticed, hadn't actually come out all the way- the shredded orange head of the .45 ACP round was still peeking out of the exit hole.
Based on the entry and exit locations, and the amount of blood, the bullet had nicked or severed the femoral artery. I probably couldn't repair that with forceps and bandages alone. The best thing I could do would be to stop the bleeding, and get a stimpack as quickly as possible.
Of course, that presented a little bit of a problem: See, stimpacks are awful expensive, so carrying them around wasn't always an option. As of now, I didn't actually have any of them-things in my jump-bag. Most places around here had one in a box on the wall, but I didn't see any of those in here, and if there was one in the hall, I definitely would have noticed it. I cursed under my breath.
"Get me a stimpack," I ordered. I had finally found where I kept my pre-made tourniquets without actually looking in the bag, though if I had any sort of presence of mind, I would have been somewhat embarrassed at how long it had taken me. I slipped the tourniquet on over his leg.
"I'll fetch one from our kitchen!" replied Mrs. McBain, and I nodded in acknowledgement. Now that I had a stimpack on the way, all I had to do was keep the Sheriff from dying until I could apply it.
Easier said than done.
"Why are you squeezing me? You taking my blood numbers or something?" The Sheriff asked, as I fastened the plastic tourniquet and started tightening it. I tried to smile.
"I'm not taking your blood pressure, sir, I'm putting on a tourniquet. It'll hurt, but you'll bleed a lot less." Once I couldn't tighten it anymore, I took out another tourniquet, and fastened it above the first one, almost against the base of his thigh. It was a good thing that the Sheriff was thin, or I'd be having some issues on that front.
"What are you doing? He could lose his leg that way!" shouted Beagle. When I kept tightening the second tourniquet, Beagle smacked me in the back of the head- not so much to hurt me, as to get a reaction out of me. I didn't give one. "Hey, Isaac, I'm talking to you!"
"Stop it Beagle! Isaac is a good… he's a good kid," insisted the Sheriff, his voice growing weak. I finished tightening the tourniquet, and touched the Sheriff's ashen forehead. It was cold and sweaty.
"Could you try to talk with me, Sheriff? It'll help keep you from going into shock."
The Sheriff looked confused. He squinted up at me with teary eyes.
"Shock? You mean, the reason why it don't hurt? I'm pretty sure I'm already in shock, but I ain't- I ain't shocked, you know. Like, I know what's happened. I got my mind about me," he grumbled, pointing at his head conspiratorially. I removed a few packets of gauze from my bag, and started opening them up.
"No, I mean when your organs stop working cause they ain't getting enough blood." Finally, I finished packing the exit wound tight with gauze-bandaging. I started to wrap up the wound with a length of gauze.
"Oh. Huh. Well, you doctors ought to stop having so many words that mean- that mean different things," the Sheriff replied, his voice growing so quiet that I was worried he might have fallen unconscious. I stopped moving.
"Sheriff?" I asked. When he didn't respond, I reached into my coat with my free hand, and pulled out a small metal tinderbox full of a reddish powder. I waved it under his nose.
"Wake up, Sheriff!" I shouted. He started coughing and looking around wildly.
"Ah, Jesus Christ, what the hell is that smell?" I slipped the box back in my coat.
"N-H-Four, sir! It's supposed to keep you awake!"
Of course, it wasn't doing a very good job. Before I was even done speaking, the sheriff was already drifting off again. I grabbed him by the shoulders and shook him vigorously.
"Sheriff, don't you fall asleep! If you fall asleep, you're gonna die!" I shouted, pressing my sweaty forehead up against his. His eyes fluttered.
"You know, I like your voice! It's like, you talk like a teacher, but then you got the whole cowboy accent going on, so it's sort of funny…" muttered the Sheriff, his head hanging limp on his neck. I let him drop, and focused on applying pressure to the wound again.
"Hey, Isaac?" I turned around. Deputy Beagle was standing above me again, clasping his hands together. I wasn't good at reading emotions, but I could tell that he was feeling sick. He had spoken so quietly, which was strange considering how loud he'd been before. "Isaac, Is he gonna die? I thought that getting shot in the leg didn't kill people. Why's he acting like that?" I sighed.
"I sure hope not. But, there's a big red-pipe in your leg, and if gets hit, you bleed a lot. If I don't get a stimpack soon, there's nothing I can do."
As if on cue, Mrs. McBain came rushing into the room, her dress bunched up and full of miscellaneous medical supplies. Among the heaps of things I already had, I could see a stimpack poking up.
"Isaac! I brought a bunch of things, I don't know what'll help and what won't, but-"
Suddenly, Mrs. McBain stumbled, and her makeshift pouch came unfurled as she threw out one hand to catch herself.
Oh shit! I dropped everything and ran towards Mrs. McBain, interposing myself between the unsecured, falling medical supplies and the floor. Packaged Band-Aids, bottles of pills and ointments, a pair of scissors- it all went tumbling over me and I didn't care, until suddenly I saw the old, fragile stimpack teetering on the edge. By now, Mrs. McBain was trying to recover, but she was only making matters worse. The supplies were spilling out both sides now, and she was getting dangerously close to just dumping it all on top of me.
The stimpack. That was the focus. I shot out my hand to try to grab it, but I only succeeded in tipping it off it's balance point, causing it to tumble back into the pouch.
I stood up, and all the supplies that had landed on me spilled back onto the floor.
"Mrs. McBain, don't move-" I started, but she had already slipped and let go of other side of the pouch. I cringed outwardly as it all went spilling on the ground.
"The stimpack-" I looked down, and found that through some unchecked reflex, I had caught it on my outstretched thigh. I blinked.
"Huh," I said, and snatched the needle off my leg. I rushed back over to the Sheriff, who was now unconscious. Beagle was sitting beside him, squeezing both sides of the wound and muttering to himself.
"Sheriff, you can't die- I'm, I'm just a deputy, if you die I'll have to handle this whole town myself, and I- I can't do that! Please, please be okay, please-" I fell to a crouch beside Beagle and the Sheriff, stimpack in hand. Beagle was crying.
"Am I- am I doing this right?" He asked. I nodded.
"You're doing awesome! Just keep doing that while I get a stick," I replied, searching for a place to put the needle. After a few tense seconds, I lifted up his leg, yanked off the bandage, tore out all the gauze, and probed for the white, deflated husk of his split femoral artery among all of the spilled fat and muscle. It was barely visible among the gory chaos of the exit, but I knew it when I saw it- despite the tornequit, the top end was still pulsing out bright red blood with each passing heartbeat. I took my forceps out my bag, and clamped the split ends together.
'Moment of truth, Isaac,' I thought, as I injected the shimmering red liquid into the artery, then clamped the two ends of the exit-wound together with the forceps and ran the stimpack along the seam. Once his thigh had sewed to my satisfaction, I repositioned my needle and injected the rest of the stimpack into the tiny-little entry wound, to solve any of the leftover internal damage.
More time passed in silence. I knew it wouldn't matter, but I loosened and removed the tourniquets to feel like I was doing something. My ears were ringing, blood was soaking into my pants, but I barely noticed- all that mattered now was if he was going to live, or if he was going to die. I was just going to have to have faith now, since all of the important healing would be inside.
"Is it working?" asked Mrs. McBain. I checked the Sheriff's pulse, noticed that some warmth had returned to his skin...
Vitals are strained, but normal, I thought. I sighed with relief. "It's working. I definitely hit the artery." A few more seconds passed. "I don't think he went pulseless or entered irreversible shock, so his brain should be fine, if you're worried about that. He might need therapy for the leg-" I started, but then Mrs. McBain wrapped her arms around me and pulled me into a tight hug. Once I was over the initial shock, I hugged her back.
"I… thank you?" I murmured, trying to understand why she hugged me. Mrs. McBain laughed.
"You saved my husband, Isaac! You saved his life."
I nodded, and tried to free myself from the asphyxiating hug. Unfortunately, Mrs. McBain was stronger than me. "I don't even know how to thank you. Do you want caps? We- well, you know we aren't rich, but we have some hidden under-" she started. Still struggling in vain to free myself, I shook my head.
"No- no, Mrs. McBain. I don't want caps. Just promise me that you'll keep a close eye on your husband over the next few weeks. He was just shot, and he'll need help getting back to normal. He's gonna need lots of fluids on account of the stimpack." That first part was a white lie. I would have loved caps, considering how much I was hurting for supplies, but I wanted to establish that I didn't charge for my services.
"Oh, but I can't just let you go like that- look at you, you're all filthy!" said Mrs. McBain, finally releasing me from the hug. I stumbled backwards, and fell onto my rear. "Why don't you come over to our house- You can clean off, get those clothes washed, and I'll get you some lunch. After all, you wouldn't want to go home to Penny looking like that!"
Well, I couldn't disagree with her on that count. Mom wouldn't be very happy if I tracked blood in the house.
"Alright," I said. The ringing in my ears was almost gone, and I was starting to be able to think straight again. I noticed that Beagle was offering me his hand.
"Um- yes" I said, allowing him to haul me up to my feet. He looked at me with an expression that was impossible to parse.
"Thanks, Isaac. I know that this is my fault, and that I'm not always nice to you, but I- I really do appreciate what you did. I don't know what I would have done without the Sheriff." I smiled, and this time it was a real smile. Beagle smiled back at me, and it almost made me forget how much of a prick he'd been when I was a kid. Almost.
"Water under the bridge, Beagle. Just don't shoot the Sheriff again and we'll be fine," I replied. I thought about winking, but I once made a girl run away from me when I tried to wink at her, so I held off.
"Isaac, sweetie-" I turned around. Mrs. McBain was standing in the doorway. "I'm going to be at my house. Why don't you go get your stuff and meet me there? I'll leave the door unlocked."
I almost agreed, then I remembered the Sheriff. He was stable now, but it would be irresponsible to leave him without a plan for his continued care.
"What are we going to do about Mr. McBain?" I asked. Mrs. McBain looked at Beagle.
"Beagle, seeing as how you're the one who shot him…" she started. Beagle put his hands above his head.
"I'll handle it, ma'am. What should I do?"
"Let him lay down- try to get him on a mattress, if you can. Give him lots of water. He's going to be in a lot of pain, so we'll have to give him morphine when he wakes up. I brought IV's with me…" I said, assessing the situation carefully. Mrs. McBain started to walk away.
"You two do what you have to, I'm going to go get the house ready for him. Take your time- that's my husband you're dealing with!" she said in a mock-stern voice, and disappeared through the doorway. I looked at Beagle.
"He didn't hurt his back, right?" I asked. Beagle shook his head. "Good. In that case, I'll grab his legs, you grab his arms- let's take him over to one of the cots over there."
Beagle nodded. We both grabbed our respective extremities.
"Alright. Three, two, one-"
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