The Moon by Night (17 page)

Dev and Cheney stared at each other.

Dr. White returned to Surgery 3.

Dev's jaw tightened with decision. “Go get Shiloh, Dr. White. Tell him to take off his boots, put on a coverall, and scrub his hands. Tell him all about the patient while he's getting ready. Run.”

Dr. White looked surprised, but she took off. Running.

Dev looked back at Cheney, and she saw that his face was troubled, that he was suddenly doubtful. Mrs. Green was still shouting in a monotonous panicky rhythm and was still struggling. But Cheney concentrated on Dev's face and words. In an undertone that the patient couldn't possibly hear over her own pitiful cries, Dev said, “You know, when a procedure goes bad like this, sometimes it's better just to try another day.”

“From the looks of it”—Cheney nodded toward the blood-soaked incision—“she may not have many other days, Dev.” Cheney's voice matched the quietness of his tone. “You did the right thing. Shiloh—he can do this. He can help.”

Slowly Dev nodded. He turned back to Mrs. Green.

Her struggles were lessening, and her screams were dying down into hoarse moans. Dev kept talking to her, but she seemed not to hear. Her eyes, wide and stark, darted around the room. There was no question that she was fully awake and aware.

Dev and Cheney kept holding Rebecca down, gently now, but warily in case she started struggling again.

The red spot on the bed grew bigger; Mrs. Green grew paler and weaker. A drop of blood splashed onto the floor…two drops…

The door banged open, and Shiloh entered the room.

For Cheney, time froze as she saw him striding in. In that moment, her mind grew strangely clear and preternaturally observant. She saw Shiloh not as the crazy-quilt of the past years of her connection to him, but clearly and objectively, as others saw him. As Dev saw him. As patients saw him.

He was tall and strong, larger than life. His face was determined, his jaw set. His blue eyes gleamed with alertness and intelligence. His stride was purposeful, his gaze quick and knowing. An aura of utter confidence surrounded him, and anyone observing him was sure that he could do whatever he purposed. Natural authority was integral to his entire attitude and demeanor.

Cheney blinked, and the spell was broken. Here was her husband again, and she was, perhaps, more relieved to see him than she had ever been.

He wasted no time with questions, just went to the supply table, pushed it forward enough so that he could stand where Mrs. Green could see his face, and began preparing the anesthesia. He said quietly, reassuringly, “Hello, Mrs. Green. You remember me, don't you? Yes, Dr. Duvall's husband. I have been my wife's medical assistant for years, and I can help you. Do you understand? I know what's happened here, and I can fix it. Do you believe me?”

Tears rolled down the woman's exhausted white face, but she was focused on Shiloh. She nodded weakly.

“Good. Now we're going to do this again, and this time I promise you—I
promise you
—that you'll just sleep sweetly, and when you wake up you'll be back in your room with your husband. Do you believe me?”

Again she nodded. More certainly this time.

With a great shuddering sigh—it obviously was an effort—she closed her eyes.

Shiloh placed the cloth gently over her nose and mouth.

She slept.

He looked up. “Hi, Buchanan. Hi, Doc. Y'all better get to it. This lady's in some deep trouble, I'd say. Okay, her pulse is strong but erratic, her temperature is slightly elevated, she's evidencing shocky tendency by the coolness of her hands….”

****

In the physicians' lounge, Dev threw himself into an overstuffed leather armchair, Shiloh collapsed onto the sofa, and Cheney sprawled, as ungainly as a teenager, beside him.

They looked at one another.

All of them were wearing white coveralls, and all of them had gory splotches and smears all over them. Shiloh looked glumly at his stocking feet. Earlier today he had been wearing bleach-white cotton socks, but now they were crimson. He'd even squished and made bloody footprints as they had walked through the hospital, heading directly for the sanctuary of the doctors' private sitting room. All of them had washed their hands at the carbolic acid stand in the operating room, but the strong yellow solution had been so diluted with blood that it had stained their hands a lurid orange.

Tiredly Dev rasped, “What on earth was
that
!”

“If you don't know, then we are in deep trouble,” Cheney murmured.

Shiloh was still staring at his feet. “You mean neither of you has ever had someone come out of the anesthesia early?”

“Certainly not,” Dev huffed. “You mean you've seen such a…a…sideshow before?”

“Well, yeah, I'm sorry to say, Buchanan. We started running low on chloroform in '62, so we started skimping on it real early, and men would hardly go under for more than five minutes at a time. Then from '63 to '65 we didn't have a sign of chloroform in the field. Or morphine. Or laudanum. Finally we even ran out of whiskey.” Shiloh had fought for the Confederacy in the War between the States.

Both Dev and Cheney looked startled, then horrified. “I couldn't do it,” Cheney said in a guttural voice. “I wouldn't.”

“Sure you would,” Shiloh said mildly. “True, about half of the men died from shock. Of those left, about half died from gangrene. But you still saved a few. You'd do it, Doc. You'd just grit your teeth and stop your tears and do it.”

A long silenced ensued.

Then Dev said thoughtfully, “You know, we've only been using anesthesia for twenty years now. I knew physicians in England, older men, who had practiced for years without it. But they always said what a blessing it was, both for the patient and the surgeon. In fact, anesthesia is the only reason that the field of surgery is growing so prominent in medical care today. Those old men would shudder when they told us how they would have to work fast—horribly, mercilessly fast—and that was all that counted. One thing I did learn today—I can now see why the best surgeons did indeed used to be butchers.”

“I am going to pray every day for a long, long time that it never happens again,” Cheney said with a slight shudder. “And I have to know why it happened this time.”

Both Dev and Cheney turned speculatively to Shiloh. But without any sign of discomfort he said, “Yeah, that's a mystery to me. I saw the cloths she had used before—you know, of course, that chloroform leaves a stain that kinda shows you how much of a dosage was on it—and it looked right to me. In fact, I gave the patient about the same amount initially. About fifteen minutes later I added another drop, but that was more because we were all so spooked than because I was convinced she was coming out from under.”

Dev listened carefully and respectfully to Shiloh, then he said, “So in your opinion, Irons, the dosage given to the patient was correct.”

Shiloh thought for a few moments, then nodded. “Yeah. It was.”

“Did the chloroform seem all right to you? I mean, it didn't look or smell weakened or corrupted in any way?”

“No,” Shiloh answered. “That's the first thing I thought of when Dr. White was telling me about it while I was getting duded up. It looked and smelled fine.”

Dev relaxed, drumming his long sensitive—and orange—fingers on the fat rolled arm of the chair. “Then there's only one answer, and that's that the deviation was in the patient. She must have had an idiosyncratic reaction.”

“Huh? What's that mean?” Shiloh asked unselfconsciously.

“Sometimes people have peculiar reactions to prescriptives or chemical substances or even botanicals. It can be a minor nuisance, such as not being able to drink milk without it making you ill, or it can be a major problem, such as Rebecca Green's unbelievably high tolerance to chloroform.”

Shiloh frowned. “But, Buchanan, if that was the reason, wouldn't the dose I gave her have done the same thing? I mean, if her—uh—idiot's whatever was that a regular dosage of chloroform only drugged her into unconsciousness for say five minutes, then wouldn't she have awakened after I administered the third dose?”

“Good question,” Dev answered, “one I don't know the answer to.” He turned to Cheney. “What do you think?”

Cheney had been watching Shiloh, thinking about how wonderful it was for the three of them to be here, discussing a patient, with a brilliant physician like Dev showing so much respect for Shiloh, who was not even a trained nurse. It was so much like the days when she and Shiloh had been a team. She missed it so much it gave her a lump in her throat. But fiercely she reminded herself that Shiloh had no wish to be a part of this world; he was merely doing what was probably a distasteful duty because he had been at the scene and was needed. Much like he would certainly attend a carriage accident that happened right in front of him.

With an effort she disciplined her thoughts to give a coherent reply to Dev. “I don't know about the idiosyncratic reaction theory either. We don't know enough about such aberrations to know if they are consistent. Consistent aberrations.”

“Too true. Today we saw that Rebecca Green will not be anesthetized by the normal adult dosage of chloroform,” Dev stated. “But would she have identical idiosyncratic reactions in, for instance, twelve incidents? Or would the idiosyncratic reactions vary themselves?”

“Interesting from a theoretical standpoint, Dev, but I'm still not totally convinced that hers was a true idiosyncrasy,” Cheney said.

“You're not? Why?”

“Because she was not, in my opinion, sufficiently sedated before the surgery,” Cheney answered carefully. “No, don't start defending yourself, because I did agree with your inquiries, and I would have done the same thing. I would have given her an additional dosage of absinthe, but even though she obviously was still apprehensive, I doubt very seriously that I would have given her more narcotics. It's only in hindsight that I think she might have just been in a state of such high apprehension initially that it might have negated the effects of the chloroform.”

A heavy silence weighed on them for a few moments. Then Shiloh asked, “Buchanan, I've been meaning to ask you if this absinthe you give your surgical patients is the same liquor that people get in taverns. I've never seen it here, but in New Orleans they have Absinthe House, and it's roaring on Saturday nights.”

“No, it's my own concoction,” Dev answered. “I use an opium tincture in mine, along with the anise and wormwood. It's a potent, dangerous drug, not a party drink. I just call it absinthe because that's the base.”

“So did anyone check the absinthe?” Shiloh asked.

Cheney and Dev looked at each other, dumbfounded.

“Just askin',” Shiloh drawled, “and what in the world was all that about the sutures? That poor little girl was talking so fast I could barely make out every other word. I kept hearing
catgut,
but I sorta blocked it out after I figured out that the problem was with the anesthesia.”

“That's a problem,” Cheney muttered. “I am going to speak to Mrs. Flagg about that, Dev.”

“Uh-oh,” Shiloh said under his breath.

“Cheney, leave the woman alone,” Dev said. “She feels bad enough about this whole thing, and the worst trouble wasn't her fault. Anyone can get a bad batch of catgut.”

“Shiloh always checked mine to make sure that they were usable,” Cheney said stubbornly. “And he checked my whole stock each month.”

“He did? You did?” Dev turned to Shiloh, impressed.

“Yeah, I did,” he said easily. “It's probably a good idea, Buchanan. That whole thing with the catgut, it must have just made you and the doc more tense. That's not good for the patient either. Poor Rebecca Green! Sounds like she had too many fronts in the battle for one cold dark morning.”

Abruptly Cheney jumped up. Stiffly she said, “Well, you don't have to worry about her anymore, Shiloh. I'm sure you have things to do. Dev? Why don't we let Shiloh go? With our thanks, of course.”

Of course both men had jumped up when Cheney did. Shiloh looked bewildered and so did Dev. But Shiloh gave a little shrug and said, “No thanks needed, Doc. It was kinda good to get back in the saddle again.”

“I'm sure,” Cheney said dryly. “Anyway, I'm going to wash up and change my coveralls. I'll see you tonight, Shiloh. Are you coming, Dev?” She whisked out of the room.

Dev looked up at Shiloh. “What'd you do?”

“Dunno,” he said with a sigh. “Sometimes I think the doc has that thing, that idiot's reaction, to
me
.”

Shiloh came into the house and took the stairs two at a time up to the master bedchamber floor. Jauncy was on his knees in the bathroom scrubbing the tub when he heard Shiloh come in. He hurried to get his sleeves rolled back down and his modest black suit coat on before Shiloh saw him, but Shiloh bounded past the bathroom and said, “Hey, PJ, give me a hand with my boots, huh? My socks are sopping wet, and it's gonna make it tough to get 'em off.”

Jauncy followed Shiloh into his dressing room. His boots were filthy, what with the snow and mucking about at Roe's before Dr. White had come running and shouting to fetch him. “Sorry about the state of my boots, but I just gotta get them and these sticky cold socks off and wash up,” Shiloh said, sitting down on an armless side chair and sticking out one foot. Jauncy promptly turned his back to Shiloh, reached down to get a good grip on the boot, and pulled. It took a few minutes of grunting exertion, but finally he pried the boot off.

Slowly he turned around, still holding the filthy mud-caked boot in one hand. His eyes were round as he looked down at Shiloh's sopping crimson sock and the blood-soaked hem of his denims. He swallowed hard. “Is…is…would that be blood, sir?”