Surgery

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“Charlie!” Jonas shouted as he brought the truck squealing to a stop.  “The Boss is hurt!”

Andy and Brian ran over to the truck and gingerly laid Nyko down on the concrete.

“What happened,” asked Andy.

“Stabbed in the gut,” said Jonas.  “I blasted the fucker’s head off and drove here.”

“How long ago,” asked Andy, noting the volume of blood covering Nyko and the inside of the truck.

“Took about half an hour to get back here.  Is he going to make it?”

Charlotte came running through the door carrying a backpack.  She laid it down next to Nyko and got to work.  Even unconscious, he was holding the sponge, now completely ineffective and full of blood against his abdomen.   She peeled his arms back and gingerly removed the bandage.

“Andy, open the bag.  Get me the purple gloves.  Don’t open the package.  Jonas, rip open another compress.  Brian, find the clamps. I need at least two pars.”

Charlotte pulled a hair band off of her wrist and tied her hair up into a bun.  Andy handed her a pair of gloves, which she slipped on.  Jonas and Brian both dug furiously through the backpack of medical supplies.  “I don’t see any clamps,” Andy yelled.  Panic was plain in his voice.

“Roach clips, dude.  Find me the roach clips.  Don’t touch them or open them,” Charlotte said calmly.  Brian quickly laid two plastic wrapped clamps on Nyko’s chest.

“Now the tricky part,” she said, plunging her finger into the hole and feeling around.  “Feels like his small intestine is perforated.  She added a second finger and continued to feel around, spinning her hand back and forth inside Nyko.  Seconds later, she pulled her hand out, bringing a section of his small intestine with her.    A small cut, less than an inch long was plainly visible on top of the loop of bowel protruding from the wound.

“Brian, I need you to go get Taylor.  She’s with a client, room four.  Tell her it’s an emergency, and we’ll double his credits for the trouble.  Tell her to grab two gallons of distilled water, put them in a big pot, and this part is important, Brian.  You with me?”

“Yeah, what,” he replied.

“Add half a cup of salt, not iodized, if she can find it, but iodized is fine.  Speed is the key.  Tell her to get warm the water, dump in the salt and stir like hell until it’s all dissolved.  As soon as it’s dissolved, bring me the pot.”

“Got it,” said Brian, running off to find Taylor.

“Andy, find me a towel, they’re folded up in plastic, and a suture pack.  Curved needle and thread. Should be in the side pocket.”

Andy wordlessly laid out the requested items, and Charlotte continued giving directions, while pinching the section of bowel closed.  “Lay out the towel on his chest.  Then open the sutures and clamps.”

When he was done, Charlotte locked a pair of the scissor-like clamps over the cut in the bowel, and tucked the intestine back inside Nyko up to the clamp.  She took the needle and wove the thread in and out of the intestine at impossibly small intervals, up each side of the cut.

“Ain’t you gonna sew it together?” Andy asked, watching.

“Yes, but the intestine is very soft.  I’m worried that the string will pull through the meat of his gut and it’ll tear open.  By running the string up each side, I’m creating something to spread the load of each stitch.  I don’t want to have to open him back up to do this again.”

“Where’d you learn all this?”

“Books, mostly.  I had some practice before all this shit, my boyfriend was a bouncer, I used to sew him up once a month.”

“You ever had to sew up someone’s guts before?”

“Nope.  First time, I don’t have any idea if I’m doing it right, I’m just trying to think things through and do the best I can.”  Charlotte wiped her face on her sleeve.

The stitching took about fifteen minutes.  She was making them as small as possible to make sure the intestine sealed.  She was on the second to last knot when Taylor and Brian returned, carrying a huge pot of water.

“How hot is it,” asked Charlie as she started on the final stitch.

“Feels like bath water,” said Taylor, sticking her finger in the water.

“Please don’t put your finger in it again.  Is it as hot as a hot tub?”

“I’ve never been in a hot tub,” answered Taylor.

“Andy, there’s a thermometer in the bag, for taking people’s temperature.  Put it in the water and tell me how hot it is.”  Charlotte worked quickly to finish the last stitch.

Andy picked up the thermometer, shook it twice like he’d always seen his mother do, and dropped it into the pot of water.

“Fucking Christ, really?” Charlotte asked.  “How are you going to read it at the bottom of the pot?”

“Shit.  Sorry, Charlie,” Andy replied.

Charlotte finished the last stitch, unclamped the intestine and pushed the contents of Nyko’s bowel back and forth to make sure the wound was completely sealed.  Charlie tucked the length of intestine back inside Nyko’s gut.

Next, she stuck her gloved pinky in the water.  “It’s fine.  Get ready to pour.”  She put her hands flat on Nyko’s stomach, thumbs together and index fingers together, with the wound in the diamond formed by her hands.

When she pressed down, air bubbled out of the wound, emitting a foul odor.  “Jesus, that’s the worst fart ever,” said Brian, trying not to gag.  Charlie pressed down over and over, trying to get all the air and fluid out of Nyko’s abdomen.

“Okay, pour,” she said.  “Right in the hole.”  She worked the wound back and forth as they poured, working the saline solution down into Nyko’s abdomen and watching as it rinsed away the filth.  “Stop,” she said calmly, and resumed pressing on his abdomen, expelling the now pink saline solution.

She pressed and pressed, until nothing more came out.  “Okay, pour again.”

They repeated this process until all the solution was gone, and then Charlotte sewed up the abdominal wound.  At the very end, she cut a piece of tubing and sewed it into the hole.  “That’s a drain, for puss and stuff to run out.  I don’t know if that’s the right thing to do, but it’s done now.  He’s going to need a bunch of antibiotics, but I don’t really know what to give him or how much.”

“We have some in inventory, but it’s getting pretty old at this point,” said Andy, who knew every single item in the shop.

Charlotte sat back on her heels.  “I’m worried about giving him anything by mouth and putting pressure on the stitches.  Do we have any IV bags?  He’s going to need a lot of water to make new blood to replace all he lost.”

Brian looked at Charlotte.  She was wearing shiny black chaps with a matching thong and string bikini top, and rubber gloves.  She was covered in blood.  The knee of one of her chaps had a hole in it from the warehouse’s concrete floor.  “You just know how to do all this?  I had no idea what to do.  I don’t even know what to say.”

Charlotte looked up at Brian and smiled at him.  “I like surprising people.  Just because I make a living shaking my ass doesn’t mean that’s my only asset.  The truth is, like I said before, I have no idea what I’m doing.  But someone had to do something.  Nyko was going to die.  He is probably still going to die, I just hope I made things better, and didn’t do anything to make his situation worse.  If I hadn’t been certain he was going to die either way, I wouldn’t have tried anything.”

Charlie laid her hand on Nyko’s forehead.  “Now, we have to move him to a bed and keep him warm.  He’s got a lot of recovering to do.  Once he’s moved, find me some antibiotics and IV bags.  If we don’t have any IV bags, go get some.  I don’t care how many credits it takes or what you have to trade for them.”

“Yes Ma’am,” replied Andy and Brian together.  Several of the other men who’d been standing around looked to Charlotte for orders.

“Find something we can use as a stretcher.  I don’t care if it’s a couple of pieces of wood.  Do something!”  Charlie walked out of the warehouse.  “I’m going to get a shower and change clothes.  He better be safely in his bed when I get back in five minutes.”

She passed through the door and started peeling her clothes off as soon as she was in the hall.  Warm water was pouring over her head when the tears started.  Nyko’s right hand allowed herself a few minutes of grief before turning the water off and starting her vigil at her boss’s bedside.

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