This chapter contains some medical surgery. Obviously, as said before Archie wouldn't have survived the trip without some means of lifesaving surgery, so to make things more believable; this is how he lived through the trip to Kingston. (at least in my own version of the story)
December 1800
Katryn's advice was not what I was hoping for. She and Davey both told me to ask Archie or Horatio or just use my best judgment. I need some help . . . God, I can't do this myself.
I can't seem to express what I'm feeling. Katryn said when she gets that way, when something inside gets packed in and needs to be let out, she sings. Here is not the place to sing, if I want to keep my cover. But I can write out what I cannot sing out loud.
"Wise man said, 'Just walk this way; to the Dawn of the Light.
The wind will blow into your face; as the years pass you by.
Hear this voice from deep inside. It's the call of your heart.
Close your eyes and you will find passage out of the dark.'
Here I am. Will you send me an Angel?
Here I am. In the land of the Morning Star.
"Wise man said, 'Just find your place; in the eye of the storm.
Seek the roses along the way. Just beware of the thorns.'
Here I am. Will you send me an Angel?
Here I am. In the land of the Morning Star.
"Wise man said, 'Just raise your head; and reach out for the spell.
Find the door to the Promised Land. Just believe in yourself,'
Hear this voice from deep inside. It's the call of your heart.
Close your eyes and you will find the way out of the dark.'
"Here I am. Will you send me an Angel?
Here I am. In the land of the Morning Star.
Here I am. Will you send me an Angel?
-Hannah White Eagle. (Send me an Angel by the Scorpions)
Hannah closed her eyes as she closed her journal. If only life were so simple that an Angel could step in and save the day. But in this place now, she had to be the Angel . . .
With this thought, she put her journal back into her trunk, and locked it, before grabbing her medical supplies bag, and leaving the room, headed back to the sick berth.
Archie looked up as the nurse returned. His chest was starting to hurt again, sharper and more pronounced this time. The dressings over the wound were now dark red, where blood had seeped through. It was getting harder and harder to breathe, even with the mask. Fear had tightened in his chest and he knew that this was not normal. This was something serious.
She seemed to notice his predicament immediately, and as he could see from the look in her frightened eyes, his feeling had been correct.
"How long has he been this way?" She asked the fear showing in her voice.
"Not long." Bush assured her, watching the nurse help Archie to sit up.
Realizing he was drenched with sweat, Hannah quickly saturated a cloth with water from the bucket between the two hammocks, and placed it on his forehead. "Hold that a minute." She ordered, as she put on her gloves and removed his bandage. She could see the air escaping through the blood, bubbling up every time he breathed in and judging from the blood running from the corner of his mouth, his lung was going to collapse, and it was obvious he was in the early stages of Respiratory Failure. There had been too much bleeding from the injury. Too much blood in the injured lung.
Hannah bit her lip as she realized she was going to have to drain the blood and try to keep the lung from completely collapsing; a procedure she had never before performed on her own, and only assisted on once in her entire career.
Not meeting Kennedy's gaze, Hannah flagged down one of the loblolly boys. "Go get Mr. Hornblower now!" She ordered. "I'm going to need some help here."
"What is it?" Archie asked, breathless.
"Don't talk." Hannah commanded. "And keep that mask on, or I'll have to shove a breathing tube down your throat."
Archie stared at her, now very frightened. Was it as bad as that?
"You're losing air as fast as you're taking it in." She explained, a little softer. "I'm going to have to drain the blood in the lung or it's going to collapse completely. You just don't talk and concentrate on breathing through that mask."
Across from them, William was watching, his face pale. This was something he'd never even heard of being done.
When Hornblower showed up, Hannah explained the situation to Horatio as best she could.
"I think perhaps we may need Dr. Casse." Horatio spoke up, swallowing hard.
"Will." Hannah called out, not looking away from what she was doing.
"What can I do?" He asked, sitting up, as best as his own injury would allow.
"Pull the radio out of my pocket and pray we can get a signal down here." Hannah ordered. "Push down the red button and speak into the radio. Just say you need Katryn now."
William did as he was told and uncertainly he spoke into the little black box.
"This is Jesse, Kat's in surgery! Who the heck is this?" His static filled voice replied.
"Hold it over here and punch the button again." She told Bush, who complied. "I need some help, Jess! The lung is collapsing and I'm looking at Hypoexemic Respiratory Failure!"
"Oh boy, can it wait until I can get there?" Jesse responded, already sounding as he was packing a bag.
"Can't wait." Hannah returned. "He's losing air faster than he can take it in."
Jesse sighed. "Okay, he's gonna need a tube thoracostomy. You need to get iodine over the site, dump it on him, if you have to, pull out the sterile drapes on either side; and you may want to knock him out. Put him on IV while you're at it, I'm on my way over now. Once you get him out, intubate him." As he spoke, he was already on the move. Between his directions, they could hear him running and shooing people out of his way.
"Got that." Hannah replied, pulling a vial out of the bag. Fortunately Jesse had seen to it that Hannah's medical gear included a laryngoscope and the endotracheal tubing.
"Leaving the radio on the ship." Jesse announced. "I'll be there as fast as it takes to row that far."
"Copy." Hannah replied, motioning for Bush to put the radio back into her bag, as she tied a rubber band around Archie's upper arm.
"What on earth is going on here?"
Hannah and Horatio both groaned. Of all the times for Clive to come back. "Oh nothing, just keeping his ass alive for another couple days." She managed to remark, uncapping a needle with her teeth, as she felt for a vein in Archie's wrist, and swabbed it with alcohol.
Clive sighed. Hannah knew what he thought. He thought they should let the man die and stop drawing it out. But he didn't know they were planning to save him either.
As soon as the IV was in, and the tourniquet removed, Hannah injected the anesthetic. "Go to sleep and we'll take care of it." She assured Archie, who was now drenched in sweat and gasping for air.
Archie sighed and after a moment, his eyes closed.
"I'm going to need someone to bag him." Hannah informed the group around her, as she started the intubation process.
Horatio stared in shock, as the nurse forced a tube down his friend's throat. "It's in." She went on, hooking something that looked like a plastic bubble, and another oxygen tank.
Looking up at Dr. Clive, she motioned him over. "Count one, two, three, and squeeze, and don't stop."
"What exactly does it do?"
"Basically, you're breathing for him." She looked at Hornblower. "You! Get on a pair of gloves!"
In the minutes it had taken for them to accomplish this, they were interrupted with the arrival of Lt. Buckland, and a good portion of the crew, who had followed Jesse as he'd boarded the ship, carrying an EMS bag, and ran down to the sick berth, not stopping to explain anything. The only thing they could get out of him, were two distinct words. "Medical Emergency!" As he ran through the ship, pushing anyone in the corridors out of his way.
Those who had never met the mohawked Indian were staring in shock, as they made way for him.
Horatio looked up, relieved. He knew Jesse had worked in an Emergency Room so he was well prepared for any emergency. What concerned him was the fact that Jesse still had one bandaged hand. The scarring on the side of his friend's face surprised him slightly, but he remembered Jesse had been injured in the explosion.
Jesse took one look at Archie, then looked over at Hannah. "Respiratory Failure's not his only problem, I see." He spoke up, noting the bluish color of Archie's lips and around his eyes. Pulling out his stethoscope, he checked his friend's breathing. "We've got abnormal breathing sounds in both lungs; he's cyanotic and coughing up blood." He announced.
"Pulmonary embolism?" Hannah questioned. She had suspected and yet, she had been dreading it.
"More than likely. Help me get this on." He ordered Horatio, holding up a glove. "Hannah, you're going to have to be my left hand here and we've gotta move fast or we're going to have a respiratory arrest to deal with."
Hannah quickly moved to the other side, where Jesse needed her, letting him take over. "I was afraid of that."
On the other side of the room, the group was staring. "What did he just call him?" Buckland asked, quietly.
"I knew it." Hobbs murmured. "It seems Mr. Nurse has been deceiving us, as the Surgeon did."
"Belay that!" Horatio ordered, before he turned back to Jesse. "Exactly what is his condition again?"
Jesse sighed. "The bleeding from the lung injury is causing clotting in the lung. If we don't get the blood out, the lung will collapse and he'll go into cardiac arrest." He paused. "Meaning the heart will stop."
"Do you wanna give him heparin?" Hannah asked, uncertain.
"I'd like to avoid that for the moment." Jesse answered, shaking his head. "If we thin his blood he can bleed out through the wound itself. Let's just see how much blood we can drain from the lung first. If we can't stop the clotting; then we'll thin the blood. Thirty-two french tube."
Hannah quickly pulled the packed tubing out of the bag.
"But what is the point to this?" Buckland questioned, as he watched the pair work just above the hole in Kennedy's lung. "The man is dying. Can you not just let him go?"
Without looking up. "This man is a witness to a crime." Hannah reminded them. "Where we come from, you try to keep the witness alive long enough to testify what he saw!"
"Nonsense." Buckland retorted. "Kennedy is not fit to stand up in a court marshal."
"Why don't you let him decide that?" Jesse returned, and then looked at Hannah. "Rib spreader."
On Jesse's left side, Hannah assisted him and together they inserted the chest tube into the open cavity.
Clive, still squeezing the bag, as he'd been told, could not believe what he was seeing. They had used the wound in Kennedy's chest to drain the lung of blood, and now it seemed they were patching the hole itself. His expectations of Kennedy's condition were beginning to change and he began to see a possibility that the young man could actually survive this.
It was obvious they wanted him to give a testimony, but from the looks of things, this was more than just keeping him alive a little longer. If he didn't know better, he would say they were actually trying to save his life, rather than just prolonging it.
But for what reasons?
Katryn looked up as Jesse entered the sick berth, roughly an hour and a half later. "How is he?"
"We got a temporary fix." Jesse informed her. "He'll live to Kingston, but if you don't get in and repair the damages completely, he'll die in less than a month anyway. We bought him some time."
"That's all I need." Katryn replied. "We're a day or two from Kingston now. Did you leave the chest tube in?"
"Yeah." Jesse replied flopping into a chair. "Just in case he gets any more fluid buildup in the lung. I can take it out when they reach Kingston."
Katryn nodded. "Good move."
"Another problem, though."
"Yeah?"
"I blew Hannah's cover." Jesse confessed. "I used her first name during the surgery. They all know she's a woman."
Katryn sighed. "It's only another day." She answered, after a moment. "Kennedy will get through with the patch, and Hannah can come back tomorrow before they sail into port."
"So all we have to do is fake his death, and switch the bodies." Jesse put in, yawning. "How's Conrad?"
"He's fine." Katryn assured him. "Allyssa was better than she thought she was. She's going to be one good doctor someday."
"I'll bet she was glad to hear that." Jesse responded, with a smile.
"Oh yeah." Katryn answered, grinning. "She's thinking of going into Surgery. I told her I'll make sure she gets a recommendation from me."
"And she was even more glad to hear that."
Katryn shrugged. "I think she may just loosen up now."
Jesse looked impressed. "It's about time." He remarked. "That one definitely needs to learn to lighten up."
Katryn rolled her eyes. "She's a Medical Student, Jess. They're all like that." She pointed out. "I know I went through it."
Jesse shrugged. "I dunno." He retorted, thoughtful. "I was always told to take things more serious."
Katryn raised an eyebrow.
"I think it was the hair, mainly."
"Yeah, I can see how the doctors would take that." Katryn quipped.
