de problème,” Luke said.
The patient left the room and Luke turned back to her. “You ready to go and help the patient in the lobby now?”
“What just happened here?” She watched as Luke began to grab suturing trays, gauze and a bolus for an IV. “What’s going on? Why are you stealing my supplies?”
He groaned and grabbed her hand. “Come on. I need another doctor’s help with this.”
Sarah didn’t really have much of a choice as she was dragged from her clinic. The other patients watched her leave, just as confused as she was at the moment.
“If this patient needs another doctor, why didn’t you get your brother to help you?” Sarah asked.
“There was no time to take this man to town.” Luke pushed the button on the elevator, not looking at her, but watching for the door to light up and open.
“What’s wrong with the patient?” she asked.
“Have you ever seen a mauling?”
Sarah gasped. “Did you just say a mauling? By what?”
Luke glanced at her. “A bear.”
She shook her head. She’d seen pictures in textbooks when she was a resident. As a trauma surgeon you had to be prepared for everything, but she’d never actually encountered one personally. She was aware of the damage that could be done. Her stomach twisted in a knot at the very idea, but they were in bear country. It was to be expected.
The elevator arrived and they got on. It was a quick ride down to the lobby. When the doors opened everything was in chaos and Sarah could see a trail of blood from the door to a boardroom down a darkened hall.
“I don’t get it,” Sarah remarked as she fell into step beside Luke.
“What don’t you get?” he asked.
“Bears hibernate. It’s January.”
Luke sighed. “No, not really. It’s called torpor. It’s like hibernation—they can be woken. This idiot was fool enough to stumble on a bear’s den and, instead of leaving the bear well enough alone, he crawled inside to get a picture. Thankfully, people were with him.”
“Idiot is right.”
He nodded. “If you haven’t seen a mauling before, prepare yourself.”
She nodded. “I’ve seen worse stuff in the ER.”
“Possible disembowelment and bite marks?”
“Yeah. A car can do damage to a patient, too. I’m ready.”
A small smile played on his lips, but just briefly. It was almost as if he was impressed that she didn’t shy away or that she wasn’t squeamish at the prospect. It scared her. It was something she was completely unfamiliar with. It was something she was a little terrified about herself since moving from Manhattan to a remote town in northwest Montana, but this was her job. She was going to help Luke any way that she could. It was the trauma surgeon in her.
“Did you bring enough supplies down?” she asked.
“We’ve got enough supplies in here. We have to get him stabilized before the air ambulance gets here.”
Sarah nodded. “Okay.”
She walked into the room and tried not to gasp. The man was in bad shape. There were deep lacerations to his arm, his legs and torso, but his face was really bad. She could see teeth marks, deep gouging all over; she could see bone on his arm and the bandages on his abdomen were already soaked through, which tipped Sarah off that this guy would need packing if he was going to survive the trip to the nearest hospital. The way his abdomen was distended, she knew from her trained eye he would suffer from compartment syndrome sooner rather than later and that could be fatal if not controlled.
“Buddy, I’ve brought another doctor here to help me.” Luke spoke to the man. “Just take it easy.”
The man just moaned.
“I’m surprised he’s lucid.”
“Me, too,” Luke said. “I did give him a shot of morphine in the field when I found him, but he’s lost a lot of blood.”
Sarah nodded and pulled off her white lab coat. “Gloves?”
Luke gestured in the direction of the sideboard, where a box of rubber gloves was waiting. She slipped on a pair and then grabbed a pack of gauze.
“I need you to hold him down—I’m going to put in a central line,” Luke told her.
“You’re going to put in a central line here?”
He nodded. “No choice. Look at his arms, and his veins are chunky. The bear did damage. Lots of damage.”
“Sure.” Sarah leaned over and held the man down. She looked down into his dark eyes, full of confusion and fear. “Don’t worry, sir. We’re going to get you patched up in no time. Soon you won’t be in so much pain. I promise.”
“Hold him now for me,” Luke said.
“I’ve got him. Just do it.”
Luke inserted the central line quickly and efficiently. She couldn’t remember the last time she’d seen someone put in a central line so fast before. She was impressed. The patient barely flinched, but that could be because maybe some of the fight had gone out of him, or it could’ve been the morphine.
Once he was hooked up to a drip, he passed out and Luke went about stitching what they could to help control the bleeding. Sarah packed his face and set a broken bone in his arm. They didn’t say much to each other; there wasn’t much to say, really. They were both totally focused on their patient.
The last time they’d worked on a patient together, they were at each other’s throats. This was different. It was nice. Comforting almost, as if she’d been doing this with him for a long, long time, and she couldn’t remember the last time she’d felt such a familiarity with another surgeon before.
“He has extensive damage to his abdomen. There is nothing I can do here.”
“Pack him?” Luke asked.
She nodded. “No choice. If I start poking around to find the source of the bleeders I could do more damage. His body needs to rest before repairs. Does bear saliva have an envenomation? You know, like the wolverine or Komodo dragon?”
“No, but the saliva often carries staph or strep, which can lead to infections and organ shutdown.” He frowned and seemed upset for a brief moment. “Either way he’ll need a good course of antibiotics, tetanus and rabies. Though rabies from bear bites are rare.”
“Why is that?”
“The injury rate from bear attacks in North America is like one person per couple million. Of course, that report by S. Herrero is from 1970. It could be different now.”
“Wow.”
