Porthos gasped in pain when his fellow Musketeers removed him from the horse. White-hot agony flashed through his lower chest at being manhandled before he suddenly went limp in his rescuers arms.
"I am Eriq Fontaine, Steward of Château de Blois," the steward announced as he approached the group of Musketeers. The man snapped his fingers, ordering the servants to help get the wounded men inside. "Take the wounded men upstairs to the bedchambers on the second floor; I will call for the physician."
Aramis knelt beside Athos lying unmoving on the ground. He gently turned him onto his back, cursing at the blood-soaked handkerchief and the smearing of blood across the front of his doublet from the injured arm.
The marksman instantly went into medic mode; he peeled back the bandage from the wounded arm just as Marceau approached to carry Athos inside for treatment. "I'll take good care of him, Aramis, I promise," the Musketeer assured when the medic wouldn't let go of his friend.
"You need to let him go, son," Captain Tréville urged. "Marceau has to get him inside now. . . Aramis?"
Aramis released his hold and nodded to the Musketeer as the burly man scooped Athos into his arms then carried him away. The medic tried to stand but fell to his hands and knees as his ribs shifted.
Aramis' head drooped as he tried to choke back the gasp of pain. He rocked forward with his hands on his knees then straightened upright, hoping it would take the pressure off his ribs. His shaking hand cradled the injured ribs as though trying to seep the pain from his chest into his fingers.
Captain Tréville knelt beside Aramis and put a hand gently on his shoulder. "Are you alright, what happened?" he asked. "You were supposed to be on leave in Orléans with Cécile."
"So many questions, Captain," Aramis chuckled lightly, wincing at the pain it caused. "Now you sound like me," he scrunched his eyes closed tightly against the pain throbbing in his chest.
"Are you able to walk on your own?" The captain looked around to see that all the wounded were inside now but the medic.
Aramis nodded but found that he couldn't rise. Captain Tréville and René each took an arm and lifted the medic to his feet; the trio slowly made their way to the second floor of the château.
It was a long, slow trek upstairs to the bedchamber where the Musketeers were directed to sit Aramis down on the edge of a large bed. The marksman's face glistened with sweat; droplets ran down his forehead, plastering his hair to his sticky face. "Where are the others?" he wearily asked Tréville.
"I'll go check on them," the captain replied. "Stay with him, René; I'll be right back."
Tréville wandered down the hall and came to the room with Athos lying unconscious on a large bed, his torn and bloody left arm hung limply over the edge. The captain froze in his tracks as he watched the blood drip from his Musketeer's fingertips to the floor. "Oh, Athos. . ."
Turning to the doorway, the steward smiled reassuringly. "We will take good care of him, Captain."
Captain Tréville nodded then turned to continue his search for Porthos and d'Artagnan in the remaining rooms of the left wing but found them empty. Turning back the other direction, the captain began checking the rooms in the right wing; he grew increasingly more anxious when he couldn't find his Musketeers.
Finally, Tréville heard voices and walked into the room to find d'Artagnan lying motionless on the bed as two servants removed his boots and weapons. "Oh no, I need to find Porthos," the captain said as he left in search of the large Musketeer.
Across the hall he found the wounded Musketeer: he breathed a sigh of relief after he spotted Porthos' boots neatly stacked together on the floor beside his clothing and weapons. The captain retrieved the right boot then put his hand down inside, feeling around for the loose leather edge of the insole.
Lifting the still-warm leather insole, his fingers found the envelope; the captain closed his eyes as a flood of relief washed over him. He fell into the chair beside him with the boot still in his grasp. "Thank God," he muttered under his breath.
"Captain, I am afraid the château physician is away with Duke Gaston and is not available," Steward Fontaine announced at the doorway. "I have sent for a nearby physician, but it may be a while longer before your men get the necessary treatment. Our chamber maids are skilled nurses and can tend to your men until the physician arrives, if this is satisfactory?"
"Yes, it will do in the meantime," Captain Tréville nodded. "However, Porthos will be requiring surgery, as will Athos on his arm, and d'Artagnan on his shoulder. Is this other physician skilled in surgery?"
"I am not so certain of his surgical skills, Captain," Steward Fontaine answered honestly.
"Very well, thank you," the captain nodded, disappointed at the news. His men needed a surgeon, not a village doctor who may—or may not—know what he was doing. This isn't acceptable at all. I better go see Aramis and let him know.
Captain Treville removed the letter from Porthos' boot and tucked it safely inside a pocket of his doublet before heading back to the left wing to inform Aramis of the grim news.
~§~
"I'm afraid the news isn't good right now," the captain reported to Aramis as he sat at his bedside.
"What's wrong?" the medic asked, his eyes growing wide with worry. "Has something happened to one of my brothers?"
"No, nothing has changed with their condition," Tréveille replied. "The château's physician is away with the duke; Steward Fontaine sent for the village physician, but it doesn't sound like he's a skilled surgeon."
"Dammit, they need a surgeon, Captain," the medic groaned. "What are we going to do?"
"The steward said the chamber maids are skilled nurses. . ."
"They need more than just a nurse, especially Porthos," the medic interrupted with a frown. Aramis suddenly snapped his fingers as a thought came to mind. "Captain, can you call for the steward? I have an idea."
The captain later returned with Steward Fontaine. "Monsieur Aramis, you requested to see me, what may I do for you?"
"Steward Fontaine, do you have a trusted messenger or courier?"
"Yes, of course," answered the steward. "Our messenger, Luc, is trusted with the duke's personal correspondence."
"Do you think Luc can deliver a message from me to a nurse in Orléans?" Aramis inquired. "This nurse knows two very skilled surgeons who might be able to help—if they are available to come."
"Why yes, I will have Luc deliver the message for you as soon as it is ready," Steward Fontaine offered.
"Considering how late it is already, will Luc be able to stay overnight in Orléans and return tomorrow?" Aramis asked.
"Yes, of course."
"Seeing that the surgeons will not be coming until tomorrow, I would like Aramis to assist the doctor until our own physicians arrive—if he's up to the task?" Captain Tréville looked to the medic.
"I'll do it, Captain," Aramis agreed. "I wouldn't trust my brother's care to some unknown, unskilled village doctor; I'll be alright."
"Is this arrangement agreeable to you, Steward Fontaine?" Captain Tréville asked.
"Of course, Captain," Steward Fontaine agreed. "These are your men; I understand your concern for their welfare."
"We should be able to patch up d'Artagnan's shoulder well enough to hold him over until the doctors arrive tomorrow," Aramis informed the captain. "I'll have to take a better look at Athos' arm to check the damage before I can determine anything further. However, Captain, I know that I lack the skills required to help Porthos with his chest wound."
"We'll do the best we can, Aramis, until the doctors arrive." Captain Tréville clapped his medic on the shoulder reassuringly.
"I'll send for my messenger right away while you prepare the letter." Steward Fontaine turned, then left the room.
Aramis began writing the letter to Cécile explaining their dire situation with three wounded Musketeers with no skilled physician to help. "I just pray to God one or both doctors can come here tomorrow, or we're in trouble," the medic said grimly as he handed the letter to his captain.
"Are you sure you're well enough to work on the others, Aramis?" Tréville asked, carefully observing his medic. "I know you are hurt; not getting yourself tended to will only worsen your condition."
"I understand, Captain, but they need me right now." Aramis dismissed the captain's concern. "Besides, Cécile already tended to me earlier in Orléans."
"You still have to explain to me what happened and how you ended up with Athos—though it can wait for now." The captain cut off the conversation and helped Aramis to his feet at the announcement of the village doctor's arrival.
"Please, Captain, make sure the messenger gets that letter," Aramis sighed. "I'll go see if this village doctor is any good."
The first patient the physician and Aramis visited together was Porthos, as his condition was the most serious. "Nurse, I want you to get the ointments out from my bag, as well as the bandages, salve, needle and thread," the doctor instructed one chamber maid. "Mademoiselle," he instructed another, "if you wouldn't mind, we need clean cloths and towels, and plenty of hot and cold water."
"I will have the servants bring the water." Steward Fontaine nodded as he left to fetch the servants.
"So, I am told that you are the regimental medic for the Musketeers," the doctor glanced at Aramis. "Are you skilled in stitching and treating serious wounds?"
"Yes to both questions, doctor," Aramis replied. "I have had my share of tending to wounded Musketeers with varying injuries, from very routine to very serious."
"Very well, you will be my assistant," the doctor nodded. "I hear there are two more men besides this one who need attention?"
"Yes, d'Artagnan and Athos."
"Tell me, briefly, about their injuries," the doctor requested.
"Well, d'Artagnan was with Porthos." Aramis motioned with his head to the large Musketeer on the bed. "They were both severely tortured and they each have multiple lacerations over their torsos from being whipped. They were both found being stretched on the rack when we rescued them; I didn't find any breaks or dislocated joints in their arms or legs though. D'Artagnan has a gunshot wound to his right shoulder—in and out, clean—but it hasn't been treated since it happened. Plus, he has shallow knife cuts to his torso and shoulder.
"And Athos?"
"His left arm was shredded with a torture device, a cat's paw." Aramis shook his head with disgust. "He also has a severe cough; he's developing bronchitis. . ."
"And how do you come to this conclusion?" the doctor interrupted. "Since you are not a doctor."
Aramis was stunned at the rudeness of the doctor; he took a moment to breathe deeply before answering. "Athos suffered from a serious case of catarrh during the outbreak in Paris recently. The physician who treated him said that his lungs were probably scarred and he would most likely develop future bronchial infections. He also said that his stubborn cough could last for weeks, and if he wasn't careful, the cough could mutate into bronchitis or possibly pneumonia."
"Well, we have ways of treating the cough, if necessary," the doctor said, appearing unconcerned. "The injury to the arm may be more severe than I can mend, if a cat's paw that was used on him. Those devices have a tendency to tear ligaments, tendons and muscle; I cannot mend that kind of injury. He will probably require amputation."
"What? The hell you say!" Aramis exclaimed in horror. "You haven't even looked at his arm and you're already talking amputation?"
"For severe injuries—as will occur with the cat's paw—amputation is always the easiest and quickest treatment, if it means saving his life. A man can live without an arm."
Aramis released a huff of breath, thoroughly appalled at the doctor's flippant attitude. "You don't know Athos," he muttered. "Being a Musketeer is everything to him and to lose that. . . well, he'd rather die."
"Well, he just might get his wish if the injury is severe enough to warrant amputation and we don't do it," the doctor shrugged.
Aramis scrubbed a hand over his face and shook his head. God help me and give me strength; I want to strangle this doctor with my bare hands. Molyneux and Berteau cannot get here fast enough. The doctor's apparent lack of bedside manner nauseated the medic.
"Let us focus on tending to this man before we worry about the others, shall we?"
"Yes, I agree, doctor," Aramis replied, trying to maintain his temper.
The servants and nurses arrived with the medical supplies requested, filling the room with activity. Everything was on hand to begin treatment on Porthos so the healing duo began treatment, though not very cooperatively.
"He has a deep laceration on the back of his head," the doctor observed. "It appears he was hit with a hard object, probably has a concussion. It may be too late to try to stitch up the wound."
"We can still try. . ."
The doctor ignored Aramis and continued his examination. "It also appears that he may have a cracked rib here, just above where the stab wound is located," the doctor said as he felt along the ribs with his fingers. "It is possible the knife glanced off a rib and therefore he has no severe internal injury."
Well, that's got to be the most ignorant thing I've heard the doctor say yet. Where did they find this doctor?Aramis shook his head with disagreement. "Perhaps, but Porthos was complaining of pain between his shoulder blades, which is a sign of damage to his diaphragm."
"Are you the doctor or am I?" the physician snapped, causing everyone in the room to stare in shock.
"Doctor, if we are going to work together you have to accept my input, whether you like it or not. I know the medical history of each of these patients; I know their specific injuries, symptoms and how they received their wounds. So, please give me some credit," Aramis snapped.
"Fine, if credit is deserved," he deadpanned, "but we shall see."
Aramis held his tongue. In fact, he was biting his tongue to keep from lashing out at that insulting comment; this was not the time or place to argue. The medic swallowed his pride and focused solely on helping his friend- though inside he was furious.
The doctor continued with his examination on Porthos, ignoring Aramis. "It looks like none of these cuts are infected, which is very good. I will apply a salve mixture of chamomile and juniper for the cuts which will help prevent infection and aid in healing."
For several long minutes Aramis and the doctor tended to their ministrations on Porthos in relative silence. Aramis was still fuming at what the doctor insinuated about him. What an arrogant arse—how dare he!
The two healers worked separately, keeping out of each other's way, as each cleaned, stitched and applied salve over the large Musketeer's wounds. Together, they treated the superficial wounds but the doctor deliberately side stepped the more serious wound to the chest.
"Alright, we are done here," the doctor said. The older man walked away to pack his supplies in his medical bag. "We need to move on to the next patient; the nurses can tend to the bandages.
"But. . . we are not done here," Aramis protested. The medic was stunned, almost speechless.
"We've done everything that can be done for him," the doctor said as he left the room.
"This is not right," Aramis shook his head angrily. Having no choice, the medic followed behind the doctor to d'Artagnan's room; he winced as the pain in his ribs flared again.
~§~
Upon examining d'Artagnan's wound, the doctor shook his head. "Yes, I see the similarities of the injuries," the older man stated as he stared at the Gascon's torso. "Ah, yes, I see the gunshot wound." The doctor partially rolled the patient to get a better look at the exit wound. "It is a clean shot; there should be no permanent damage to the shoulder."
"We need to stitch up the wounds to his shoulder, both the gunshot and the stab wound," Aramis stated. The Musketeer was not taking any further chances with this doctor's rush to finish.
"If you feel the need to stitch him up, you may do so."
Aramis opened his mouth to protest but quickly shut it again. Where did the steward dig up this guy?
"While you stitch his wound, I will tend to these smaller lacerations and cuts," the doctor added.
"D'Artagnan has a gash that needs stitching here on his temple also, doctor"
"Yes, you can take care of that as well," he replied dryly. The doctor continued tending to the many lacerations on d'Artagnan's skin, washing each cut with wine.
Aramis took a deep breath to calm his nerves before beginning the tedious work on the shoulder wound, washing it thoroughly with brandy. The medic was glad d'Artagnan was already unconscious so he could scrub the wound clean without worry of severely hurting the young man. I hope infection doesn't set in like it did with Athos in Chamarande. Wouldn't you figure, just like Athos, d'Artagnan also has a shoulder wound.
Aramis asked for a nurse to assist him as he began the finely detailed stitching of the ragged shoulder wound. He worked carefully and precisely, placing the stitches close together to promote faster healing and with less scarring. "Pull the skin together tightly and hold," the medic instructed the nurse as he continued pulling the needle and thread through the jagged edges.
Once finished with the gunshot wound, Aramis began stitching up the knife wound. The shallower knife wound was easier and faster to mend as the wound had clean, even edges from a sharp blade. Finally, Aramis stitched up the gash on d'Artagnan's temple; he winced at the thought of his friend getting bashed in the head. He was probably backhanded with a pistol.
"We need to turn him over so I can stitch up his back," Aramis stated as he wiped the sheen of sweat from his face. The medic stretched his back, wincing as sudden pain lanced through his chest. "Damn," his breath hissed noisily through clenched teeth.
Aramis waited—all the while being ignored—for the doctor to finish so they could turn the Gascon onto his stomach and begin treating his back. At the sight of d'Artagnan's tortured back, the nurses gasped with shock then burst into tears.
The two healers ignored the gasps as they began their ministrations to the terribly damaged back without further conversation for the next hour or more. While Aramis stitched the shoulder wound, the doctor tended to the angry lacerations criss-crossing over the skin on d'Artagnan's back.
"We will leave the rest of the application of salve and ointment, as well as bandaging the wounds, to the nurses," the doctor informed the team. "Let us move on to the final patient."
The medic shook his head at the doctor's rush. "It would be a good idea to leave him on his stomach for now," Aramis instructed the nurses. "Can you handle the remainder of the treatment without us?"
"Yes, we'll be fine," a nurse replied. "Don't worry, we'll take good care of d'Artagnan and finish his treatment properly. You better go and catch up with the doctor before he throws a fit."
"Have you worked with this doctor before?" Aramis asked with disgust. "Is he always this rushed with his patients?"
"I've worked with him before," replied a pretty nurse with red hair. "Yes, he is always in a hurry to finish and get home. He doesn't care about the patient; he just wants to collect the paycheck."
"Medic, where are you?" the doctor bellowed from down the hall.
"Told you," the first nurse chuckled.
"Don't let him get to you, Monsieur," said the pretty redhead. "He's like this with everyone, trust me."
Aramis nodded then quickly ran after the village doctor, heading toward the final patient—Athos.
The doctor picked up the Musketeer's arm, causing Athos to moan in pain at the touch. He turned the arm one way and then the other, all the while nodding his head and muttering to himself. "These wounds are not as deep as the others I have seen from the same device."
Is he disappointed at that fact? "Athos was wearing a leather doublet when he was injured."
"Ah, that explains why the device did not shred his arm further. However, the muscle damage could be quite extensive nonetheless," he reported dryly. "I would still highly recommend amputation."
The Musketeer lieutenant stirred at hearing the doctor's final prognosis and instantly began to panic. "No, don't amputate my arm," he pulled his arm away. "Aramis, help me; I need to get out of here." Athos tried sitting up, but was held down by the doctor and Aramis.
"You're not going anywhere, young man," the doctor said as he fought against the Musketeer. "We need to take care of this arm."
"Athos, stop fighting us," the medic ordered loudly. "Athos, it's Aramis, stop fighting. No one is amputating your arm—stop it!" Aramis shook his brother by the shoulders to break through the panic; as the Musketeer became more aware, the fighting became more intense.
Captain Tréville ran down the hall at hearing the commotion and hurried to the room to assist. "What can I do to help?"
"Captain, I can't hold him down!" Aramis yelled as the wounded Musketeer struggled against the hands holding him. "Thanks to sawbones here mentioning amputating his arm, Athos is in a semi-conscious panic."
"Athos, listen to me," Captain Tréville whispered soothingly near the Musketeer's ear. "Aramis is going to take care of your arm and stitch it up like new. I won't let anyone amputate your arm, I promise; you need to stop fighting us and let us do our work." Tréville stroked Athos' hair and tenderly moved the sweat-soaked strands from his eyes.
"Athos, no one is going to take your arm, I promise you," Aramis whispered to his friend.
"Don't let him touch me!" Athos' eyes shifted wildly from the captain to Aramis.
"Son, no one is cutting off your arm," the captain reassured. "I'll have Aramis take a look at it instead of the doctor, but only if you cooperate and let us do our work."
Athos looked from the captain to Aramis, then nodded.
"Do you want something to dull the pain?" Aramis asked. "This is going to be painful, Athos; I would recommend taking some wine."
"No," Athos shook his head. "Just get on with it, dammit." The Musketeer closed his eyes; he gritted his teeth and steeled himself in preparation for the coming agony.
"I am going to clean the wound first by washing it out with wine," Aramis warned in Athos' ear. "Are you ready?"
Athos nodded, without opening his eyes.
Aramis glanced at the captain and then the doctor before taking the bottle of brandy and pouring it liberally over the wound. The wine splashed over the arm and into a catching pail below as Tréville held tight to the Musketeer.
"Dammit… damn!" the Musketeer cursed, his breath hissing through his teeth. Athos gasped and writhed at the sudden onslaught of fire burning up and down his arm; he tried pulling free but the captain's firm grip was too strong.
One more pass of the wine and Aramis began cleaning out the dirt with a sharp pair of pincers, causing Athos to scream out in pain. His chest heaved, triggering a coughing fit that erupted from deep within his chest. "Oh God, stop please . . ." Athos wheezed between coughs.
The panicked Musketeer attempted to roll onto his side to escape the flurry of arms holding him prisoner, but the strong hands held firm. The tense and writhing body suddenly went limp under the strong hands and he sagged as his head lolled to the side. Athos mercifully lost the fight to stay conscious and fell into blissful oblivion.
A/N:
The diaphragm was recognized as a distinct anatomical structure in the earliest Greek writings. Homer, in the 9th century, describes, with astonishing precision, wounds suffered by Greeks and Trojans on the field of battle, using words which designate the respiratory and digestive system, larynx, trachea, bronchi, lungs, thorax, and diaphragm.
In 1579, Ambroise Paré, made the first description of "diaphragmatic rupture," with a French artillery captain who had been shot eight months before his death from complications of the rupture. Using autopsies, Paré described diaphragmatic rupture in people who had suffered blunt and penetrating trauma. Reports of diaphragmatic herniation due to injury date back at least as far as the 17th century.
The diaphragm is a muscle across the bottom of the ribcage that plays a crucial role in respiration. If the diaphragm is damaged, patients often complain of pain between the shoulder blades. Signs and symptoms of damage include: chest and abdominal pain and difficulty breathing. When a tear is discovered, surgery is needed to repair it. Most modern-day diaphragm injuries occur due to stabbings, car accidents and gunshot wounds.
Between 50 and 80% of diaphragmatic ruptures occur on the left side. It is possible that the liver, which is situated in the right upper quadrant of the abdomen, cushions the diaphragm.