(+)14
2075 ROBCO(R)
LOADER V1. 1
EXEC VERSION 41.10
32K RAM SYSTEM
9131 BYTES FREE
HOLLOW TAPE LOADED: "THE-SPINY-BONE-SNAKE"
INITIALISING…
SUCCESS!
STATUS
Battery Level: 99%
Wireless Signal: (?)
Operating Temperature: 92F
HEALTH
BP: 120/90
SPO2: 98%
Temp: 98.5F
RR: 12
HR: 90
TIME
Day: 29 SEP. 2279
Time: 18:24
CLIMATE
Current Temperature: 85F
Atmospheric Pressure: 762 mmHG
It was late in the afternoon, and the sun was beating down on our backs. We had just exited the valley pass, and were currently going up the most painful uphill-road we'd done so far. Both me and Savanna had ended up taking turns riding on top of the cart after a while, because it had actually gotten really hot since we left. We drank up most of our water supply just to stay cool, but I still felt about as dry as a sack of flour.
"Are you sure that we have to stop in the village? Like, I know we need supplies and stuff, but can't we just go somewhere else?" Asked Savanna, holding on to the side of the cart for support. Gram turned around, and smiled all big and wide. His eyes were open too wide for someone who was facing the sun.
"What, you think I'm stopping there for the supplies? I really just wanna see that park one more time before I retire- reminds me of the old world." He closed his eyes for a moment, and sighed dramatically. "I can almost picture it- the green leaves, the rolling blue waterfall, the red rock hills…"
"And the vault with the "Don't Enter, The Plants Kill" sign in front of it," said Tandi. Gram glared at her.
"Oh, Thanks for ruining my train of thought, jackass." Tandi turned up her helmet.
"I ain't sorry. That shit looks like a death-trap to me."
"Well then we just won't go in the vault! Can't you indulge an old man with his little joys?"
"No- Whatever is in there ain't natural, and you know it!"
"Oh, well, neither am I!" groused Gram. Tandi crossed her arms at him. "Please, just lemme have this. You can even watch me with your rifle if you want- pop off at the first sign of movement, I don't give a damn! I just want to go there one more time before I settle down." He paused. Tandi hadn't budged. "Remember Kiev?"
Tandi sighed through her helmet. A strange, alien crackling noise came out.
"That is a low blow." She replied. She gestured to the armored space between her legs. "Right in the dick." Gram opened his hands expectantly.
"…And?"
"And, I don't want you to do stupid things like I did! But I will let you; I'm just telling you that you're a moron and this is a stupid idea."
"Fine by me. When you make it to my age, you get to be alright with a little bit of stupid."
The first watchtowers of the village were appearing around the bend, sturdy little buildings made of Joshua logs and uneven stones of various colors. The two towers were connected with a spiked log wall that effectively gated off the circular village area, which was already flanked on three sides by steep gray cliffs. The towers were empty, I noticed, and there only seemed to be one man standing guard. I couldn't see very well from this distance, but he was fiddling with some sort of weapon.
"Do you know that guard up there?" I asked, tapping Savanna on the shoulder and pointing at the guy who stood in front of the gate. She sighed.
"Yeah, I do. That's John. He's a good guy, but they really need to stop putting him on guard duty- if someone started shooting at him, I'm pretty sure that he would actually piss himself."
We kept moving in silence, until we were in shouting range of the open gates. I could see into the village now, and I have to admit, it was kind of charming; lots of little leather-and-hide tents, a big town hall with surprisingly ornate features, carved from various types of wood. And, in the center of it all, a massive pyre, where a few stray people were drinking and talking. Everyone was dressed in these quaint farmer-looking clothes, in lots of dull colors ranging from maroon to sky blue. All the men had beards, and all the girls wore these funny-looking white bonnet things.
"Hail, travelers! Step up to the gates, quickly now- there are raiders and cazadors abound out there!"
No one looked particularly concerned by that, but we still picked up our speed a little. Savanna and I walked ahead, while Gram, Tandi, and the cart trailed behind us. As we got closer, I was starting to be able to make out John's bearded features, and I realized that he was smiling- no, beaming, at Savanna. Even though he was holding a rifle, I didn't get the impression that John was very dangerous.
"Savanna, you return to us at last! How was your mission? And who is this?" He asked, holding his rifle with one hand and indicating me with the other. Savanna poked me in the arm.
"Well, things have been crazy since I left, but I'm happy. Oh, and, this is Isaac; he's a friend of mine from the caravan," she said, nodding back at the cart. John looked us both over, then gave me a conspiratorial wink.
"Friend of yours, eh? Well, he's a bit small and un-bearded for a husband, but I'm sure he makes up for it somehow," said John, stepping forward and patting me on the shoulder. Savanna groaned.
"John, I told you before- I'm not planning on settling down again!" For some reason, John didn't stop smiling.
"Well, that's alright- to each his own, I always say. But, there's a few people in this village who still wonder about you, and I think it would be nice if you said hello to them after all this time. A lot of them probably think that you're dead by now!" he replied, motioning towards the village beyond the open gates. Savanna nodded.
"Yeah, it's definitely been a while. How's Amos doing?" she asked. John, who had been beaming like a long-lost relative at a family reunion, stopped smiling immediately. He looked at me, then back at Savanna. It weren't a good look.
"Oh. It's, ah, It's funny you ask now. Amos been shot a couple of days back, so he was."
"What!? Oh my god- is he alright? Who shot him?" Asked Savanna. Her eyes darted around the camp as though she was looking for a culprit. John started fidgeting with his rifle, sliding the bolt in and out. By the time he spoke again, he had kicked all of his bullets out, and was just sliding the bolt back and forth in an empty rifle. This fact didn't seem to concern him.
"Well, he is alive. Sort of."
"Sort of?" I asked. John continued to look uncomfortable.
"He ain't moved much since he been shot. I heard they been feeding him through some sort of tube," he explained. I grimaced
"Well, that's gonna be an injury to the spine, probably. I hate those things a lot," I said. John looked confused as I mentally recalled my last experience with one of the ridged menaces. Poor, poor Tyrone.
"The… What?" he asked. I pointed at my back.
"The spiky-bone-snake that runs from your butt up to your neck. It's kinda important if you want to stay alive, on account of it letting you move all your limbs and stuff," I said. I ran a finger along my own spiky-bone-snake, and John seemed to understand that.
"Oh," he said. He scratched at his bone-snake with one hand, and limply clutched his empty wooden rifle with the other. Savanna looked at me pleadingly.
"Isaac, I know that you don't like spine stuff, but…"
"I'll see what I can do," I said. And I meant it, but the words still tasted like battery acid in my mouth. "See what I can do-" what kind of promise is that?
"Be you careful. His mum is watching him like a hawk. I ain't sure she'll let you near him," John warned. Savanna set her jaw.
"Oh, I'll deal with her. Where are they?"
"In the medicine tent by the campfire," he replied, gesturing towards one of the brown blobs that sat in the huge clearing. Savanna grabbed me by the arm and started stalking forwards. My heart leapt up into my chest.
"Savanna, are you sure we shouldn't, like, sit down first? His condition sounds pretty stable, and-"
"Isaac," said Savanna. She tightened her grip on my wrist. "Amos is my brother. He wasn't always close to me, but I love him, and I trust you enough that I want you to help him. Do I have to explain to you why I need you to do this?"
Yes, I wanted to say, because, truth be told, I wasn't entirely comfortable with the idea of any sort of surgery; Spinal surgery was so far outside of my usual practice that I might as well just shoot him and hope for a similar result.
But, she was looking at me with those big, hopeful eyes, and she'd implied that she thought I was a good doctor, which made me oddly proud. I mean, she wasn't entirely wrong- after all, I had done some pretty crazy stuff in the past few days. I'd sealed a severed femoral artery with a hemostat, some fishing line and a hook. That was pretty cool, right? And then there was the Deathclaw attack, where I'd managed to set up a makeshift hospital and save two critical patients.
In just a few seconds, the moral implications and worries that had been clouding my mind faded away, and were gradually replaced by clouded visions of the few things I'd managed to get right in the last few days. Like that one time where I'd heroically sliced Tandi open with a steak knife! Not my cleanest work, but I had been racing-the-reaper with a rusty tricycle on that one, so I couldn't really be held accountable for the mistakes, or the entirely avoidable trauma I caused...
I was grinning now. "Oh, of course I get it! I was just gonna say that I should really grab some stuff before I start cuttin' up this brother of yours. I'd hate to be responsible for another broken spine!" Savanna's jaw went slack.
"...Oh. Oh! Um, okay. I'll… I'll just, wait outside the tent for you, then." She was staring at me with this look that I couldn't parse. That sort of thing would normally worry me, but I was way too busy savoring this rare ego trip to notice or care. She said that she trusted me! Ain't that a glowing endorsement?
Savanna was really good at that; she just had this inexplicable way of hijacking my whole stupid goddamn brain. She wasn't even trying to, I don't think, but whenever she asked me to do something, or looked like she needed help, all bets were off. Because she made me feel good, made me feel like I was worth something; Even if I needed to shift my whole outlook to accommodate her, I'd do it in a heartbeat.
You know, now that I think about it, I'm thinking that maybe, I might have had a little bit of a crush.
-Break-
I had never worked in a glowing red operating room before; The light of the setting sun through the thin animal-skin tarp had painted the whole tent in the shade of fresh blood, and it felt cramped, visceral, dangerous. Walking in through those tent flaps, I felt like I was climbing down the throat of a beast.
"What's the situation?" I asked. There were two large, shirtless, and utterly identical men crammed into the tent beside the patient, a short guy with brown skin and frizzy black hair. He was lying comatose on a sturdy wooden table, staring up into the leather ceiling. Although I didn't notice it at first, there was a tiny old woman kneeling beside him, staring at us with puffy red eyes. The air smelled like shit and incense.
"Savanna…" said the little old woman, very quietly. Savanna gave her a short glare, and the old woman covered her face and looked away. The twins didn't seem to notice.
"Well, me and my brother Jacob were out mining iron with Amos, two nights ago now. It was dark, kind of spritzing. We were talking about the rain, when suddenly the iron ore started sparking and Amos fell over, rutsching all over the ground, then went all stiff. Wuntz, we thought he was dead, but we carried him back anyways, thinking it would be easier on Anna…" Said one of the two men, accentuating his A's in that funky sorta way they spoke in. He looked sympathetically at the old woman on the floor.
"Of course. Was he shot more than once?" I asked. The twin who hadn't spoken yet, Jacob, nodded.
"Aye, in his arm and the chest. Miss Kauffman did her best patching the holes, God bless her heart, and Eli here gave him Stimpacks, but it wasn't enough; We used our Stimpacks until they were all, and he didn't get better. He's only been lying like this, moving nothing but his head and sometimes one of his arms, not speaking none. It wonders me if maybe he ain't got his back shot."
"That's what I was thinking. Has he vomited at all?" I asked, bending over and listening to Amos's breathing. It was even but weak, so I opened up his airway with a jaw-thrust and peeped down it with my dim pip-boy flashlight. The twins didn't answer my question, just looked at me funny.
"Did he Kutz when they shot him?" asked Savanna, highlighting the foreign word condescendingly. Both of the twins shook their heads.
"Oh, no. He has shat himself, but we changed his clothes," said Eli. I nodded absently and pulled out my utility knife. One of them flinched, only to let out a sigh of relief when I pressed the knife against the edge of Amos's faded flannel, and slowly sliced it down the middle. He was positioned belly up, which would at least make getting his shirt off easy. I'd still have to roll him over to examine his spine.
"Miss Mary Kaufmann Is gonna kill you for that," said Jacob, motioning towards the patterned lump of denim. I didn't know much about clothing, but the quality of the make was pretty close to my own coat. I grinned.
"This the same gal who fixed the artery? She did a good job." I touched Amos's sutured radial artery with my middle and index fingers, ran it along the wound. The bullet had clearly gone in and out, completely splitting the artery and fracturing the radius along the way.
"Should we bring her here?" asked Eli. I gave him a thumbs up.
"You read my mind! Don't suppose you want to spike me a bag of saline, too?" I was met with blank stares. Still grinning to myself, I shooed the two men away; It had been worth a shot. I turned to the old woman- Amos's mother, Savanna's mum- and motioned for her to stand. She started shaking her head.
"You should probably get out of here too, ma'am. I know that he's your son, but I-"
"No, NO! Why should I let you near him? I've never met you- how do I know you aren't going to do something horrible to him!?" she demanded, leaning forward and stabbing me in the chest with a bony, accusing finger. I tried to put my palm on top of her hand, but she swatted it away.
"Get out of his way, mum. He's a doctor," said Savanna, with none of her usual patience or sensitivity. I put out a hand and started to tell Savanna to back off, but the old woman spoke before I could.
"I don't care if he's a doctor- will he hurt my baby? How do I know he won't do some awful experiments?" she asked, her wrinkled, tear-streaked face drawn up in anguish. I put a hand on her shoulder.
"Honestly ma'am, I'm not sure what I'm gonna do. I still need to figure out what exactly is wrong. If my guesses are right, though, he is gonna need surgery."
"Does it involve computers? Machines?" asked the old woman. I looked down at Amos;
He probably had some C-Spine damage, which would mean open spine surgery, performed with no drugs except for Morphine, MED-X and Stimpacks. It sounded like Amos had been attacked by rifle bullets, and I wasn't seeing the telltale signs of a recently-healed exit wound, so there was probably a big-ass chunk of metal lodged directly in his damaged c-spine. Because they'd Stimpacked the wounds, (which somehow didn't count as a breach of code?) even finding exactly where the bullet was lodged would be awful tricky without consulting the pip-boy. Once I found it, I'd have to work carefully to take the bullet out and apply MED-X to the damaged section of the spine, followed immediately by a Stimpack around the site of surgery.
To top it all off, if I didn't work fast enough, he would probably die from infection because of all the nasty bacteria invading his exposed spinal column, a possibility that I didn't even want to imagine. Stimpacks kill early-stage infection, but they don't do much for septic shock, and I wasn't sure that they'd do anything for intramedullary abscesses either. Stimpack treatment tends to fall apart in regard to structures made of things other than soft tissue and cartilage.
"Almost certainly," I concluded. The woman let out a shaky sigh.
"This goes against everything I've ever believed. Technology is what brought us so low, and nothing good can come from relying on it now. It's a blight on this Good Earth," she said, stroking her son's arm as she spoke. She didn't sound very sure of herself.
"If I'm the one doing the surgery, I don't think that God would fault him for it. My choice, my sin."
"But it would be mine too, because I'd be letting you! I want my son back, but I haven't followed God's teachings this long to abandon them when they become inconvenient!"
Everyone was silent for a moment. Savanna looked furious, but she didn't say anything. In that moment, Amos must've been the only person in the room who wasn't holding their breath.
"Would Amos want to be saved?" I asked, eventually. The woman didn't hesitate before nodding.
"Oh, Of course he would! Amos was never a believer. I tried so hard to reach him, but he's just like his father… Faithless, worried only about this mortal plane," she said, glaring at her son through the tears. I lifted my hand off of her shoulder.
"Then there's nothing that you could do to stop me."
I stood up, and got back to assessing Amos. I removed my pip-boy and placed it next to Amos to see if the old woman would react, and she didn't. For her part, she just silently pulled herself to her feet, kissed her son on the forehead, and shuffled on out of the tent. Savanna kept glaring at her until she had left the tent, and for a while after she was gone too.
That left me, Savanna, and Amos.
"You didn't have to be so mean to her," I said, grabbing a coyote pelt from off the floor and wrapping it around Amos's neck. I rolled him onto his front, and began to unwrap the pelt and position it under his face. Turned his head on his side too, just to make sure he wasn't rebreathing too much of that Co2.
"You don't know her, Isaac. Since the day I got adopted into the tribe, Mum's been ashamed of me. She'd never say it, but she's ashamed of Amos too. 'Too much like his father…' The hell does that even mean?"
"He was a scientist, right? She probably just found it hard to justify his ideas within her worldview," I replied. I pulled off Amos's slashed shirt by the hem, and tossed it aside; Too many loose, non-sterile threads to be of any use as a bandage. Its size was good, but I'd honestly rather deal with using five yards of thin gauze than the nasty infections that could result from leaving fabric in non-stimpacked wounds.
"Yeah, exactly! She's a small minded bigot, just like everyone else in this goddamn tribe. They live off of fear, and it's never fear of anything smart- No, they like to ignore the real problems in favor of some imagined "technological" threat, which they solve by making some stupid rules so that they can feel like they're doing their part in preventing it. Like, who the hell decided that calculators are, "Forbidden Technology," but guns and moonshine stills aren't?"
"Someone who knew how to have a good time, clearly."
I hadn't heard that voice before. Slowly, I turned to face the new figure who was standing between the tent-flaps. She was a little bit taller than me, with wispy blonde hair that went over her eyebrows, and a small, pointed face. She was wearing an unpatterned blue dress, and that weird white cap thing on the back of her head.
"Mary," said Savanna. I was starting to get to know Savanna's tones, and while it was still an inexact science, I didn't get any warm, fuzzy feelings off of that one.
"Oh, hallo! I never thought I'd be seeing you again, Savanna," said Mary, smiling in a way that reminded me of one of my own incompetent smiles. Savanna didn't smile back.
"Trust me, Mary, the feeling is mutual."
Alright, so, we've got some tension in the operating room. Not really optimal, but at least they ain't fighting! I can work with this!
"Well, Savanna, I'm glad to see you too. How have things been out in the festering wasteland? I can't imagine that you've been doing well without poor Saul," replied Mary, holding her hand over her heart. That sounded like a real nice thing to say, but based on the look that Savanna had, I don't think it was.
"Yeah, I am doing well, actually. In fact, I'm not just doing well, I'm doing great! I've even made some real friends since I left- you know what I mean? Like, friends who aren't just pretending to care."
Oh, that doesn't sound good! I clapped my hands together.
"So! I'm sure that it's real nice that you two finally get to see each other again, but there'll be plenty of time to catch up after the surgery. Now that we're all here and situated, let's review our situation right-quick!" I said, trying not to be too obvious while I plowed directly through the layers and layers of social facsimiles. The two glared at each other for a couple of tense seconds, then looked at me expectantly. I couldn't fool Savanna, but I was pretty sure that I could just pull the autism-card on Mary if she started asking about my apparent social blundering. For now, I was just going to have to keep them distracted with work and instructions, so that they couldn't possibly have time to provoke each other in my emergency room.
"…So, here's the deal: we've got a relatively stable, paralyzed patient with a serious spinal injury and foreign body intrusion, possibly through the really important part in the middle. All his automatic stuff is working fine-ish, but people keep telling me that he hasn't done much moving in the past two days. I have some guesses about what that is, but I ain't about to jump to conclusions. Probably, it's just the body trying to keep him from hurting himself anymore, so that's what I'm gonna go with until I have reason to think otherwise."
"Otherwise?" Asked Mary. I nodded.
"Yeah. There's some nastier possibilities, but we'll see about those when the time comes." She looked like she was going to keep pressing the issue, so I decided to continue before she could talk again. "-Anyways, we're gonna need to find the injury, open it up, get the bullet out, and treat it with MED-X. Savanna, I'm putting you in charge of sterilizing my surgical stuff. You know how to get Hydrogen-Peroxide as gas, right?" I asked. Savanna scoffed.
"Duh. I mean, the stuff that you've got is 3%, so I'll need pretty much all of it, but isolating the H2o2 gas from water vapor shouldn't take long."
I nodded. "Good. Of course, that's the easy part- after that, we're gonna need to scrub this entire tent of bacteria, and I still haven't got any idea how the hell we're gonna do that. Either of you got any ideas for that?" I asked. Mary smiled and raised her hand.
"Yes, Mary?" I said, bracing myself for what would probably be a really stupid idea. I might not have shared Savanna's hatred of the little Amish tribe, but I didn't have much faith in their medicine. If Mary noticed my lack of enthusiasm, she didn't show it.
"Well, I ain't sure if you noticed, but this tent's already clean. You see all those candles?" asked Mary. I nodded. I did see those candles- smelled them too. I was already planning on how to dispose of them. "Well, those ain't just for the pretty smell and the romantic atmosphere. The fumes kill airborne disease, and we keep the table rubbed down with alcohol. The only dirty thing in here is the hides, which we treat every week. But, you don't have to put that under him if you don't want to."
I gave her a blank stare. "Oh," I said, eventually. I stared at one of the dripping wax-candles, and started squinting at it as if it would reveal some hidden magic. It didn't. I just found myself getting more and more confused as I tried to sort through all the ways that a bacteria-killing candle might work. Was it an ancient art, or some of that Good-Christian-Magic that people were always trying to get working properly? I kept squinting at one of the candles, waiting in vain for my mind to come up with some coherent explanation for what had just been revealed.
"We're old fashioned, ausländer, not stupid," said Mary, smirking condescendingly. Savanna and I looked at eachother, and Savanna shook her head and mouthed something impolite. Still wracked with intense, unshakable confusion, I adjusted my glasses and pretended that I didn't hear her.
"Well, uh, thanks for that, Mary. I guess that leaves the procedure, which I think we're gonna go over in, "real time." I'm better at showing that I am at explaining, you know?" I pointed to the tent flaps. "Savanna, you should go sterilize my stuff. I'm gonna go get the other supplies out of the cart. Mary, you've done all the most impressive work on Amos so far, so I'm just gonna leave you to watch him for a minute. Do you think that you could shave the back of his head for me?"
"Yes, but I need to fetch a pail of warm water. How about I do this, and Savanna can clean your knives when I get back?" said Mary. I shrugged.
"Good enough for me. You got any input, Savanna?" Savanna stared at me, then at Mary, and then back at me. After a tense pause, she nodded.
"Okay."
"Great! I'm heading out to the cart. See you guys soon?"
"Oh, definitely!"
I gave Mary a quick little thumbs up, and pushed my way past the tent flaps, out into the warm twilight air. It was getting dark now, so I took a mental note to grab myself a flashlight and some duct-tape from the cart; I couldn't imagine performing spinal surgery in the dark.
As has become common, the ugly reality of my situation was finally starting to set in, and way too late for me to do anything about it. I was now committed to performing an open-spine surgery, in the middle of Hillbilly-Hell, with a largely improvised procedure and tools. Back before the war, they'd use a robot to do this surgery- I was doing it with my hands. And, seeing as how the surgery was on Savanna's brother, she'd probably never forgive me if I screwed up. I thought back to what had happened to poor Tyrone, how my mistake had been so life changing that he wouldn't even let me try to fix him… I hadn't dreamt much in the last few days, but I had, on more than one occasion, woken up in the middle of the night, thinking of that face that he'd made when I walked into the room; the only time that I'd been able to read a complete stranger's expression perfectly, because there had been nothing hiding under it.
If I messed up here, Amos wouldn't be able to make any sort of face at me, because he would be dead. Savanna would still be alive though, and she would probably look at me with the same kind of disgust that Tyrone did, and then I'd have two people in the world who hated me more than anyone else- Three, if I counted Tandi's hovering disposition after the cardiac-tamponade.
I didn't like that thought much, because having Savanna as an enemy would mean that I couldn't make dinner with her anymore, or do alcohol-fueled scientific experiments at three in the morning, and that wouldn't do! I pressed my fingers against my temples, and closed my eyes. A purplish yellow light lingered under my eyelids. I took deep breaths, tried to calm myself…
A life is hanging in the balance. If I mess up, someone's gonna die. Nothing else about this has any right to worry me- I do this all the time. I opened one eye to squint at the rocks on the ground. There weren't any interesting rocks, so I closed it again and kept doing deep breaths until my breath stopped being shaky. Once I was sure that I wasn't gonna start hyperventilating, I let my natural breathing take back over, and began the short trip to the cart. I felt a little better, though my bowels were still knotting themselves with anxiety.
I better be getting a fucking date out of this.
-Break-
"Are we ready?" I adjusted my improvised surgical mask that was really just a period-pad that had been taped over my mouth and nose. My voice was confident, but my words rang hollow. I'm sure as hell not ready. How can I expect them to be?
"Well, whenever I do anything important, I like going over each step, to make sure of not missing. Have we done everything?" Asked Mary. I bit my lip. Head shaved, instruments sterilized, skin around incision-site rubbed with PVP-I, vitals taken on pip-boy, intubated via endotracheal-airway, Glasgow coma score taken at an 4, bullet marked with masking tape, flashlight taped to ceiling at a good angle… I didn't have a routine for surgeries yet, but I'd gone over things like this in my head before, and my list was looking promising so far. Morphine administered as anesthesia, Area around incision-site isolated with sterile dressings. All operators masked, ran out of gloves, made Savanna some gauze-pad mittens…
"Yeah, I think so. I'm just gonna go for it," I said. Before I could change my mind, I grabbed the makeshift Steady inhaler off the side table, and pressed the tube between my lips. Savanna handed me a cigarette lighter, and I hit the switch and pressed it against the heating agent, letting the little orange flame turn the crumpled aluminum foil a sickly shade of black and yellow. Little black bubbles were starting to form in the empty sarsaparilla bottle that served as the chamber, which was quickly filling up with a purplish steam.
"Oh, that is disgusting," muttered Savanna, as I sucked in a cloud of the foul-smelling gas. I took a second to swallow the vapor, which tasted almost as bad as it smelled, and grinned.
"Yeah, this is some nasty stuff! Not good for your nervous system, either." I curled and uncurled my fingers experimentally. Perfectly steady.
Once I'd gotten over the novelty of being able to properly control my fine-motor movements, I laid the steaming inhaler down on the little aluminum side-table that we'd brought over, clamped off the tube, and examined the assorted instruments. These were the tools that were sitting on the table:
+A small bone chisel, which was basically just a specialized knife.
+A pair of tissue forceps, which looked like scissors with beetle-jaws at the end.
+Two pairs of Dissecting Forceps, which looked like pointy nail clippers.
+A pair of big tweezers that father kept trying to call "DeBakey forceps."
+Five mismatched lancets with slightly different blades. A couple of them looked like miniature spears, whereas the rest were more glaive-like.
+My trusty utility knife.
+One NCR-Issue stimpack, courtesy of Gram.
+My eon old emergency MED-X solution, with the bright purple tubing along the side.
+A couple of Curettes, just aluminum spoons with real tiny scoops.
+A pair of needle-nose plier-looking things that I didn't know the name of.
All of the instruments were sitting in a surprisingly shiny steel baking-tray that Savanna had found in the kitchen, and sterilized alongside the blades. One by one, I picked them up, tested them in my hands, and set them back down. I was still a little bit shaky with the larger instruments, so I picked up the steady inhaler and took another drag from the thin plastic tube. The liquid wasn't bubbling no more, but there was enough leftover vapor that I didn't have to heat it again.
"Alright, now I'm ready. Mary, Savanna, you two have got all the names down, right?"
"Yep," said Savanna, through her improvised period-pad mask. Mary nodded silently.
"Alright then- Savanna, hand me the primary lancet. Mary, get ready to swab the skin under the tape with PVP and alcohol. I'm gonna make the cut," I said. Inside, I was screaming. This is it, I thought, the point of no return! No fuck-ups from this point on.
I took the #30 black lancet from Savanna, and pressed the blade against the little blue strip of masking tape that marked where the bullet laid- near the bottom of his c-spine, between the damaged c6 and c7 sections. I pulled it off in one quick motion, and stepped out of the way as Mary cleaned off the residual adhesive and rubbed the newly exposed skin with the orange PVP-I dust. As soon as she stepped out of the way, I gripped the lancet between my fingers like a pencil, and plunged the blade into the spot just above the site of the wound. I held my breath as I waited for the blood to come.
After a few seconds of tense silence, a steady stream of bright-red blood began to seep from the incision, running along the edge of his right scapula and staining the gauze that we'd used to isolate the site. It wasn't much, but a little bit of blood goes a long way.
"Made the first stab, now I'm making the cut. Savanna, ready with the tissue forceps. I'm gonna open up a little hole in his back, and we're gonna hold it open in the middle with those. You know how to lock 'em, right?"
"Yeah. I figured it out while I was cleaning them."
"Good. I'll give you a signal…" I tried not to wince as I ran the lancet through Amos's oak brown skin, skimming over the spine and cutting through the many layers of muscle that ran across his cervical column. Sections c6 and c7 look more like bits of the t-spine than they do sections of the c-spine, because the two "tails" that are normally characteristic of c-spine segments start to merge into 1 wider tail starting at c5. The final cut was to be from c4 to t6, (The pip-boy had indicated possible damage up to t5, and I wanted to be on the safe side) so I had to go slow and move my blade upwards to accommodate for the gradual shift of shape. Once I hit the base of t6, I flicked Savanna in the arm with my left hand.
"Forceps!" I hissed. Savanna swept past me, and carefully placed the hooked tips of the forceps into the middle of the incision, right at the height of the t-spine. I stood by, watching warily as she slowly opened up the forceps, spreading the slit of skin and muscle and exposing the bloody spinal column underneath. It was mostly just reddish meat, but apparently I'd made the cut deep enough that the crests of the spine itself were just barely exposed. I sighed with relief. Step one, down.
The damage was immediately evident; section t5 was fractured in a single place, c5 and c6 were fractured in multiple places, and the spinal cord was unmistakably severed under c5. A misshapen copper-coated bullet, with the entire upper half folded in on itself, was jammed just between c5 and c6. It glinted in the white glow of Tandi's flashlight.
"What's that rutsching thing in his back? Oh, lord, is that his…?" Started Mary, hovering over Amos on the other side of the operating table. I nodded.
"Yep. That's his heart alright." All three of us stared solemnly at the pulsating little spot for a while, where little bubbles of blood were rising up and down with each pump. "You're seeing the tissue behind it expanding. I didn't expect to see that, but I guess you see something new every day!"
"It's beating pretty slowly," observed Savanna, locking the forceps into place. I put a hand on her shoulder, and she stepped away from Amos, trading places with Mary and allowing me to step up and examine our handiwork. It wasn't bad- the diamond-shaped cavity was extremely large, but we appeared to have located all three of the wounds, and we'd be sealing it shortly anyways. My incision hadn't hit any of the little arteries that ran along the spine, which I was pretty sure meant that I was some sort of god, because there are a lot of those things. The c5 and c6 wounds would require some thoughtful operating, while the t5 wound was a simple, minor fracture, probably from falling on the way down. I decided to start with that one. I still had my lancet, so I quickly sliced through the two-odd-layers of muscle that sat atop the t5 plate, and removed the chunk with my fingers. I didn't manage to avoid the arteries this time, but, thankfully, it appeared that these ones weren't gonna bleed much. They sprinkled with each beat of the heart, but the blood loss wasn't bad enough to amount to anything significant. I set down my lancelet on the side table.
"Need MED-X and pliers. Pliers first, I'll signal for med-x," I said, holding out my right hand to accept the plier-things from Mary. I gave them one quick, experimental squeeze, then got right to work digging through the meat around Amos's damaged t5, which had been split just to the right of the long, thin tail. After a few seconds of squelchy searching-and-prodding, I managed to get one head of the pliers on the right main tail, and one side on the flat side of the t5 segment. Once I was sure that they wouldn't slip, I relaxed my grip, and allowed the pliers to bring the fractured segment back together. I was still holding them in place, but I was pretty sure that they weren't going to move.
Though I was sweating profusely from my forehead, I pulled down my mask, and smiled at my fellow operators, because they were looking nervous.
"First section is about to be fixed, guys! Get ready to hand me the med-x!" I took one last look at the pliers, released them, and started to pull my mask back up. Obviously, the pliers stayed right where I put them, because I am a master surgeon who can do no wrong.
Well, that was what happened in my head. In reality, I must have put the pliers on a slippery section, because they went "SNAP!" and flew up out of his back the second that I released them. My jaw dropped and my mouth shot open as I scrambled to catch the things, groping wildly for a rubberized grip or metal head, or…
I looked down in the wound, and failed to spot any needle-nosed pliers, so I checked my hands; not there either. Savanna and Mary were looking at me funny, and I started to ask them why, only to realize midway through my muffled sentence where the pliers had ended up; In my mouth. I'd caught the things between my teeth.
"Ah. Ehm. Ca' so'one gra' thoshe for meh?" I asked, because I didn't want to get slobber on my sterilized (and currently bloodied) gloves. Savanna gave me an angry look.
"Please don't put those back inside Amos," she said, grabbing the pliers from between my teeth with her gauze-pad mittens. I nodded.
"Yeah, thas prob'ly a good idea. Ah goddamn, now my jaw hurts…"
"Watch your mouth, Auslander! We need the lord on our side for this operation!" Said Mary. I managed a weak laugh.
"Ahahaha. Ah. Yeah. Um, I think that maybe all the forbidden technology has already ruined our chances of divine intervention, so I ain't gonna stress about it right now." There was an awkward pause. I stared at Amos's open wound, then at the operating table, then at the presumably-infected pliers. I cleared my throat. "So… We got anything else we could use, now that the pliers are contaminated?"
"Just take off the rubber parts! If you're having trouble holding it that way, wrap it with gauze," suggested Mary, grabbing an unopened pack of gauze bandaging from the table. I nodded and pulled my mask back over my mouth.
"I like the way that you think, Mary! Savanna, hand her the pliers, and- oh, let me see that," I said, snatching the pack of gauze from Mary, who was struggling to get through the plastic wrap. I couldn't open it along the seam with my slippery wet gloves, so I just held it in one hand and tore it with my teeth. Once I'd torn it a few inches, I handed it off to Mary, who was now holding the pliers in her other hand. She looked mystified.
"Did that not hurt?" She asked. I shrugged.
"I dunno. I didn't feel nothing."
After a few seconds of tinkering, Mary handed me back the pliers, now freed of their rubber grips and contained within some tightly wrapped gauze. I squeezed them experimentally.
"Huh- The grip is actually pretty good. Thanks, Mary!"
"You're very welcome… Isaac, right?" She asked. I nodded.
"Yep. You guys got an Isaac? Y'all really love your old-testament names, so I wouldn't surprised," I replied, hunching over Amos and getting my pliers back into place. My confidence was still shaken from the last attempt, but at least I knew what not to do now. I continued to search for a good spot, scraping over the smooth bone with the twin metal blades.
"No, but we used to. Know you what the name means?" She asked, in that weird word order that I was quickly getting sick of deciphering. I shook my head. "It means, "laughing one." Our Isaac told me that when I was little."
"Interesting," I said. Mary nodded sagely.
"Yes, very interesting."
I grit my teeth in anticipation as I prepared to release the pliers once again. Slowly, millimeter-by-millimeter, I let off on the grips, until I was absolutely completely and utterly sure that they would not move. Once I was finally confident, I thought about releasing them, then thought better of it and decided not to. Instead, I held them right where they were, and grabbed the Med-X off the table with my weird left hand. I'm pretty sure that I'd planned to signal for it and have someone grab it for me, but I was, "in the zone," so to speak. As long as I could stay focused and stay calm, I'd be like an artist at work.
A third rate, drugged-up abstract artist, that is. A real Jackson Pollock.
"Injecting the MED-X. Someone, get ready with a Stimpack." Without thinking much of it, I clasped the fragile MED-X syringe between my two pointing fingers on my weird hand, switched it off to the space between the pointer-fingers of my dominant hand, and then switched my grip on the pliers to my left hand; I wanted to make sure that I was performing the injection with my better hand, because this was where I had the smallest margin of error. I had to hit the spinal cord first, in case it was damaged, and then go on to the actual bone. I held my breath, and slipped the MED-X syringe under the t-5 plate, stabbing the tiny needle through the articular capsule and into the spinal cord, where I released a minuscule amount of the stuff, and then drew the needle out immediately. Amos's heart was still beating through his spine, so I decided that I must not have killed him yet. I moved on to the fracture.
The fracture was easier. Since I'd pressed the fractured sections back into shape with the pliers, all it took was a hot-glue-gun style drip of MED-X along the seam of the fracture, and I was done! Although it was impossible to tell from the surface, the injured bone was now fusing itself back together, rebuilding a thousand little connections as the clear healing solution trickled down through the fracture. After twenty seconds, I released my grip on the pliers, which actually stayed this time, and placed the syringe back on the table. I decided to leave the pliers in place until I needed them again, but I knew from experience that MED-X reconstructs bones even faster than Stimpacks reconstruct flesh. Its work would be done in under a minute.
BAM! Step two, down! I could have giggled. I didn't, of course, because I was performing a spinal procedure, but I could've!
"Alright boys- er, girls, I'm feeling good about this! Let's get this bullet out, and finish up in time to eat a nice, celebratory dinner!" I cried, cracking my knuckles and grinning maniacally. Then, I thought about that last part for a second, and thought of a better way to say it:
"Hey Savanna, if I don't screw this up, wanna have dinner together?"
Savanna raised an eyebrow at me. "Well, sure. But, don't we have dinner together most nights?"
I sighed. That wasn't what I meant.
"No no, I mean, like, a dinner date. With candles and all the works."
Mary gasped and covered her mouth with her hands, which was unnecessary given the mask. Savanna went completely rigid, then yanked her mask off and looked at me like I was an insane person. I looked away.
"What- Isaac! W-why the hell…?" Her face was starting to turn red. I wondered if maybe I picked a bad time to say that, what, with her paralyzed brother laying on an operating table with his back hanging open. It stung and all, but I could see where I'd gone wrong. I began to regret my decision.
"I'm sorry, that wasn't very good timing," I admitted. Savanna closed her eyes, and let out a deep breath. Mary continued to look uncomfortable, which these Amish folks seemed to be really good at. She pressed her fingers against her nose.
"Oh my god. After the surgery, Isaac. Ask me again after the surgery," she said, and I nodded; I could live with that.
"Okay. Why don't you put the mask back on, and calm down a little. Mary, hand me them tweezers- I think I'm going for the bullet."
I pushed all of the emotions I was feeling out of my head as I grabbed the "Debakey Forceps," (Read: Tweezers) from Mary, and tested the clamping mechanism, weighed it between my fingers. Once I was sure that I had it down, and that I wasn't going to let my tumultuous feelings screw me up, I hunched down over Amos again and started to lower the tweezers into the space between c5 and c6. Up above me, the flashlight flickered on and off, briefly casting the tent between dim, concentrated light and absolute darkness. I didn't mind, because I'd already found my target; he was a slippery little bastard, to be sure, but I was pretty sure that if I could get 'im loose of the surrounding tissue, it wouldn't be that hard to get him out. He wasn't stuck in a bone, just lodged between two of them.
I started working at the muscle that the bullet was lodged in, right between c5's right Ligamenta Flava and its right Articular capsule. At first, I tried digging at it with just the hooked tweezers, but it quickly became clear that this wasn't gonna work. Not bothering to signal or ask, I set down the tweezers and picked back up one of the assorted lancelets, and got to work removing the remaining layers of muscle from around c5 and c6. It was a gruesome process, with lots of little arteries sprinkling and dripping as I carved through them, but it had to be done. Once I had etched a line around the block of tissue that needed to be removed, I set back down the lanclet and picked back up my tweezers.
It took a couple of tries, but, before long, I had extracted the two layers of muscle and moved them off to the side, where I could keep it until I was ready to graft it back on at the end. The bullet was clearly and fully visible now, lodged firmly in the connective material between c5 and c6. The fractures were more visible now, too, and they were nasty- c5 and c6 had been utterly shattered by the bullet's impact. Based on the location of the bullet, the corresponding section of the spinal cord had most likely been completely vaporized.
"Lovely," I muttered, moving my tweezers to get a grip on the dented front end of the bullet. I had to dig through some connective tissue, but I got both ends of the tweezers around the big copper shell fairly quickly. Just based on the position, I knew that I couldn't get it out on the first go, so I decided to focus my efforts on loosening it up, and getting it to a less difficult position. I spent two silent minutes tapping it, prying at it, tweaking it up and letting it fall back down.
Then, in one sudden, inspired moment, I clasped the tweezers around the bullet and yanked it out.
Everyone watched in silent shock as the shiny, blood-coated bullet came out with my tweezers, then slipped from my grip and tumbled through the air, striking the tray of surgical implements with a loud, "PLINK!" before falling silently onto the ground. The proverbial dust settled without a sound, and we all shared a moment of amazement.
"Was that the bullet?" asked Mary. I nodded sheepishly.
"Yeah. Anyone want to get it?"
"I'll grab it," said Savanna, hunching over and placing her hands on the coyote-pelt that the bullet had fallen onto. After a few seconds of searching, she turned around and presented us with the slick, glinting bullet, holding it in her white gauze-pad mittens like a baby-tooth that had just come out. I started laughing.
"Well sweet baby Jesus, we did it! We got the bullet out!" I turned back to Amos. Despite having the bullet removed, he still wasn't looking very good, which reminded me that I wasn't done yet. I was practically spilling over with emotion now, but I'd have to put it away one more time before I could really celebrate; I still had to fix the fractures, and repair the muscles, and the connective tissues…
In short, I still had a lot of work to do. So, I stood back up, set down the tweezers, and removed the pliers from the fully-healed t5 section. C5 was more-or-less shattered, but I still wanted to at least attempt to bring the pieces back together before I applied the MED-X. That would reduce the chance of deformation, which would, in turn, greatly improve poor Amos's long-term outlook. I'd already removed all of the obstructive muscle-tissue from section c5 to get the bullet out, so all I had to do was place one end of the pliers on the outermost right edge of c5, and the other end on the outermost left edge. Once I released pressure, the pliers sort-of kind-of not-really brought the pieces back together-ish, scrunching them up like a jigsaw puzzle that was missing pieces.
It'll have to do, I decided, and grabbed the MED-X with my off-hand. First came the vaporized section of the spinal cord, which I repaired by slipping the syringe through the already-damaged Ligamenta Flava of the c5 section. As an afterthought, I moved the syringe up and repaired the section under c6 as well, slipping through the corresponding Ligamenta Flava and injecting a couple of small drops into the spinal cord. I don't know how necessary this was, since the cord-damage was focused directly under c5, but I did it anyways because I like to be thorough.
Once I was done with the spinal cord, I moved on to repairing the c5 fracture, which I'd recently squished together using the pliers. Since I still had plenty of MED-X left, I applied it liberally to the fracture lines, using about half the syringe (Somewhere in the range of 400 caps) worth of the stuff on that section alone. My wallet didn't appreciate the move, but it did speed up the process immensely- immediately, I could see the fracture lines closing and the broken pieces shifting themselves back together, making a bit of a hissing noise and filling the air with a chill that permeated through my rubber gloves and into my skin. Once the spine had stopped moving and the reaction had stopped sucking away heat, I removed the pliers and applied them to c6, which had been split clean in half.
I smiled with satisfaction as the pliers brought the two separated sections back together, so perfectly and thoroughly that it almost looked like it hadn't been fractured in the first place. The only evidence that it had ever been injured was the thin line running through the two-pronged fin, which I sealed using just a few drops of MED-X. The stuff worked like Wonderglue, and soon section c6 was stable enough to hold together without the pliers.
"The spine is all fixed up now! Someone get me a Stimpack, I've got a whole bunch of shit to seal," I said, setting the half-empty MED-X syringe down on the metal tray. Mary started to grab for the Stimpack but Savanna beat her, and handed it to me before Mary could process her defeat. I gave her a nod of acknowledgement and began the sealing process, starting with the t-5 section and moving up. This process was a lot less surgical than the rest, because I basically just packed the damaged meat back into place and applied Stimpack-fluid to it until it looked normal again.
Once I'd fixed all of the secondary incisions and tissue damage, I squirted some Stimpack fluid into a gauze bandage and wrung it out over the cavity, to disinfect the site and heal any miscellaneous damage. I did a quick double-check to make sure I hadn't missed anything, checked his HEALTH status on the pip-boy to confirm that I hadn't missed anything, then removed the forceps and sealed the primary incision using the rest of the Stimpack. Over the course of about thirty cold seconds, the massive cavity through Amos's back stitched itself back together, and after about a minute it looked almost as good-as-new, though the skin was discolored and split along a seam. Amos's eyes fluttered as the incision finished sealing up, and I heard him let out a grunt of pain through his throat-tube and shift his weight a bit as his newly-repaired nervous system "rebooted" itself on the spot.
Patient responsive. Steps three, four, and five, down for the count!
Shaking with barely contained glee, I tore off my mask, and looked at Savanna right in the eyes. I saw her shoulders sag, with what I could only imagine was a mix of both great relief and utter defeat. I smiled at her.
"So, Savanna, how 'bout that dinner?"