Josh hovered over his mother’s body, the blood pooling on the floor beside her bent arm. He couldn’t move, let alone breathe. What did he do first? Think.
He checked her pulse as she lay sprawled on the floor. She had one. A gash in her forehead oozed blood. He stood rubbing his face with shaking hands.
He sank to his knees, eyes closed. “Calm. Focus.” He ran his fingers over her right arm, her legs, and torso for other breaks or cuts, found a cut behind her left ear. Concussion and a broken arm were the big problems. He brushed his fingers down the bicep of her broken arm. She moaned as he reached the break. He froze, a boulder sized ache in his belly. He didn’t want to hurt her, but this would hurt.
“Mom.” He knelt by her side, but she didn’t open her eyes. He gritted his teeth and lifted her sleeve to reveal jagged bone protruding through her skin and blood, lots of blood. His head swam, and he gulped air. He drew his phone from his back pocket. No bars? No 911.
No. No. No. No. It was fully charged. This couldn’t be happening.
He scanned the floor for her phone, but she’d brought his father’s papers, not her purse. He moved to the desk and picked up the landline Grandpa refused to disconnect. Silence. A chill settled in his chest. He was on his own, and mom needed more medical attention than he could give. His mind raced.
Think, compound fracture—what should he do?
He panned the flashlight around the dark basement, looking for an answer, revealing only dust and cobwebs. He pointed the light into the kitchen area over the cabinets and sink. He checked the worktable.
He needed a pillow to elevate her head, that would help. He lit on the overstuffed couch in front of the fireplace. He’d stabilize her arm, stop the bleeding, then move her to the couch.
His beam landed on a stack of wood by the fireplace. He’d start a fire, too, later. He shone the light into every corner of the basement. Bingo. He snatched a cushion from a chair and, lifting Mom’s head, slid the cushion under her.
Now for her arm. He glanced at her sleeve stained red from wrist to elbow. These mistakes weren’t supposed to happen. The plan was to start a fire, to stay warm and heat food cooked over the flames. He wasn’t prepared for compound fractures. This wasn’t part of the plan…
He sat back on his heels, shoulders slumped. His lack of medical training sank like a wedge in his chest.
He inhaled through his nostrils and exhaled. Calm. Focus. He knelt over mom and lifted her sleeve. The skin bulged where white bone broke through her skin. He closed his eyes and sank back on his heels. His gut churned.
He needed more light. He moved to a cabinet, found matches in a drawer, and lit a couple candles. They illuminated the papers mom had dropped and a red cross hanging above the sink. Red cross.
The first aid kit, Uncle Carl’s cheesy birthday gift, but Josh appreciated it now. It might not be 911, but the Emergency Medical Manual was priceless.
He opened the kit and took out the EMM, searched for “Compound Fractures” in the index, and flipped to page 230: “An injury where broken bone pierces the skin, causing risk of infection.”
Infection? No. Please. He read the list:
“1. Stop bleeding.”
He reached out and lifted the sleeve. The blood was coagulating. Coagulating was good.
“2. Splint the break. 3. Look for swelling.”
Her hand wasn’t swollen, which meant no blood vessel was broken. His neck muscles pinched, and he rolled his head from side to side to release his tension. Being a doctor was stressful, especially when he wasn’t one.
“4. Call 911.”
What? He turned the page. It said nothing about what to do if he couldn’t call 911.
“Splint over the break.”
He could do that, but what could he use? Grandpa’s desk under the stairs.
Tugging open the drawer, he grabbed two wooden rulers. The length should work. They clattered in his hands. A moan came from the floor, and a sharp pain shot through the center of his gut.
He stepped over Mom, filled a large bowl at the kitchen sink. A moan came from the floor. Mom was grinding her teeth. He wiped his brow. This would hurt him as much as her.
He reached for a bottle of ibuprofen for inflammation and acetaminophen for pain. Should he give it before or after? He’d wait until she woke.
Scissors. He stuffed them in his back pocket and carried the pot of water to Mom. She moaned, and her eyes fluttered open. He elevated her head and fed her the pills with sips of water. She fell back on the cushion, and he lifted the fabric of her sleeve, cut it open with shaking hands revealing the full extent of the damage—the grotesque lump, the angle of the bone. He leaned back on his heels and rubbed his hands over his face as though that would wipe away the image.
So much blood.
Get a grip. He poured antiseptic over the wound on her arm. His mother’s eyes rolled back in her head. He placed a towel under her arm and swabbed the wound with gauze, then more antiseptic, then more swabbing. She glared at him, her gaze boring into him. She hadn’t spoken yet, and the silence left him hollow.
“It’s broken.” He returned her steady gaze. She nodded.
She pressed her eyelids shut. “I can’t feel my fingers. Compound?”
“Yes.” His voice cracked, and he cleared his throat. Did she know he couldn’t reach 911? “I’ll splint it, but the bones are exposed. I might have to set it if I can’t get ahold of 911.”
She frowned but nodded, clamping her jaw, her teeth showing. He took hold of her hand and her elbow, his shoulders tense.
“Is it a clean break?” she asked.
He couldn’t answer. She remembered more from the first aid course they’d taken together than he did. She understood what was happening, blood loss, bone fragments, shock, and infection.
“You are the calm in this chaos.” Her voice hummed low and steady. “You can do this.”
No, he couldn’t do this, but he had to. “When the power comes back on, we can call for help.” He crossed his fingers behind his back.
She eased back on the pillow. He swiped his brow with his sleeve, picked up the rulers, and placed them on her arm. The bones clicked, and she cursed under her breath. He winced and dropped the rulers. She never swore. Her arm started bleeding again. He poured more antiseptic over her arm and laid a gauze pad over the wound. Splinting could wait.
He wanted to comfort her. Instead, he held her arm as still as he could. She’d fallen unconscious again, and he almost joined her.
“Hang in there, Mom,” he whispered.
The wind blasted through the rooms upstairs. Another window broke, but the crash didn’t faze him. He opened the EMM, and reread page 234, Splinting.
Lifting the rulers, he placed them against her arm. He wrapped, and she winced, even unconscious. Why weren’t his fingers ten inches longer? Why hadn’t the power come back on yet?
She moaned again, and he fumbled the bandage. She opened her eyes and tried to smile through her clenched teeth.
“Sorry.” He pressed his fists against his rolling belly.
“I know.” Her eyelids slipped shut.
He pressed his hand over his mouth. Doctors didn’t puke on their patients. He stared at the bandage in his other hand. If he didn’t finish now, she’d only be in pain longer. He swallowed and continued wrapping.
He pressed the wrap on the end to fasten it then pushed himself onto weak legs. Mom tried to sit, but slumped back with a gasp, cradling her arm.
He dragged his finger down the index of the EMM for Head Injury. Page 126: “Call 911 if the person loses consciousness, even briefly.”
Why did it always say, “call 911?” Wasn’t there any useful information in this book?
He took the EMM out, laid it on the floor, and opened it. He read the list for head injuries.
Breathing— she was.
Pulse—strong and steady.
Bleeding—a towel.
He worked as fast as he could without applying too much pressure or bumping Mom’s arm. For such a small cut, it bled a lot. She lay still, eyes closed, pulse regular. He, on the other hand, couldn’t seem to get enough air.
“I’m going to get ice. Don’t move.”
“Really? No laps around the basement?”
Humor was good. He headed to the freezer, grabbed an ice pack, and carried it to her. With great care, he placed the pack on her head. The blood was starting to dry on the floor and in her clothes, drying on his hands and arms, Mom’s blood.
She grimaced but let the ice pack rest on her head where he placed it.
“Mom?” The wind rumbled above them like a locomotive.
“I still can’t feel my fingers.” His mother’s thin voice was barely audible over the storm. He leaned on the arm of the couch.
“Why was I in such a hurry? I panicked.” She glanced around the room, books and papers still scattered at the foot of the stairs. “No electricity?”
“No. Does anything else hurt?”
“Just give me a day, and I’m sure everything will hurt, but for now, just this.” She pushed the ice pack off and touched her fingers to the bump on her head.
“Ah.” She reached up, and he grasped her hand and placed it in her lap. He shook out a wool blanket from the back couch and covered her. A bloodstain grew through the gauze on her forehead. She squeezed her eyes shut. He swallowed hard. Even in the dim glow from the candles, her face glowed white as her blouse. Shock, page 26.
“You need a real doctor, Mom.”
“You’re all I need.” She gave him a nod, and the corners of her mouth lifted. “I guess I won’t be arm wrestling anytime soon.” She cradled her arm and shut her eyes.
She was putting him at ease, being Mom, but her words were exactly what he needed right now. “I want to get you onto the couch and elevate that arm.” He calculated the distance of the couch to where she lay, ten feet “Okay, but I don’t feel so good.”
Nausea. Concussion, page 131. He drew a scarf off the back of a chair and tied the corners to make a sling. He slipped it over his mother’s head and, with steady movements, lifted her arm. He gripped her elbow to cause the least amount of pain. She lifted her arm a fraction.
“Agh.” She hugged her arm to her chest, her breath quick and shallow.
He jerked away, jiggling her arm. She ground her teeth and hissed air over her clenched teeth. She shot him a glare that startled him, but with her help, he slid her broken arm into the sling. Sweat beaded her forehead, her gray face pinched.
“Get me to the couch before I pass out or puke.” She cradled her arm. “Or both.”
He pushed to his feet and helped her sit. Her moan hung in the air between them. She got to one knee, panting, her teeth gnashing together. She nodded, and he placed her good arm over his shoulder.
Calm. Focus.
He shuffled her around the old kitchen chairs to the couch, half carrying, half guiding her to the couch. It was a hide-a-bed, but the bed would have to wait. She needed to lie down now. He eased her onto the cushions. She groaned.
“Okay?” he asked.
“Mm.” Her thin face was grayer, but she no longer panted or ground her teeth.
“I’ll mix some Rejuvelyte.”
“I could use the electrolytes.” She gripped the bicep of her broken arm.
He placed his hand on his abdomen. Was he calm in the midst of chaos, really? He glanced at the blood on her forehead, and his calm evaporated.
Tears glistened on her cheeks, and a frown drew her eyebrows together as the candlelight flickered. Josh glanced away, not sure what he should do. She worried about him, and he worried about her. What a pair. But if infection…?
He wiped his face with both hands and stood his full six feet two inches. He wouldn’t let that happen. They’d prepared for everything, food, water, shelter, everything, but not a compound fracture.
Where was Dad now? Stuck downtown at the conference, most likely. Dad had a plan for any emergency, and Josh did, too, but he’d never had to do it all alone. Mom lay on the couch, pale and still. He had to face facts. The longer the phone was out, the more likely infection became.
The wind howled outside. Could this be El Primo? Would it go on for days? He wanted to yell, but that wouldn’t help. His other option was to crawl into a ball in front of the fireplace. That one might work, but right now Mom needed him. Focus.
He ran down the emergency list: start the generator, check the radio, keep the water pump running, start a fire. He knelt by the fireplace, wadded paper, and stacked kindling around it. The paper lit with one match, and the kindling began to snap. He added larger pieces of wood, and the room filled with light and grew warm. She seemed to doze, and his nerves settled. He poked the fire and laid another log on top.
“Cozy,” Mom mumbled from the couch.
He spun around. “You’re awake.”
She managed a small grin. “Can’t sleep. How are you doing? Any news on the radio?”
She would ask that. “No electricity, no radio.” He combed his fingers through his hair. “No phone, no 911. I can’t get to the generator until the storm dies down. I know how to do all this, but not without Dad. It’s too much.” Josh paced between the floor and the couch.
“You’re doing fine. We’re safe and warm and there’s light.” She adjusted herself on the couch. “Think of Uncle Carl. He’s probably up to his eyeballs in emergencies, running his ambulance.”
Uncle Carl would know what to do. Would he come? Josh shoved his hands in his pockets. A loud crack split the air. In two steps, he was at the black window, peering into darkness. Lightning? A dull thump added to the blare of the wind.
“Must be a tree.” He moved to his mother’s side and adjusted the blanket over her small form. “That was close.”
“Sounded like the old apple tree,” she said.
“No.” He stood and paced the floor. Not that tree, the one with the tire swing and crunchy, sweet apples in August.
“It’ll be okay.” Her teeth chattered.
Shock? He reached for the EMM.
Page 26: “Elevate the legs and feet slightly.”
He put a cushion under her calves. She pressed back into the pillows.
“Your fa—” she mumbled.
“He’s fine.”
“But these winds are off the charts. He wouldn’t have left us here if he’d known.” Was she in so much pain she couldn’t think straight?
What could Josh say to comfort her? Lie? Trees fell and winds blew through the house, leaving every muscle he had tensed and his concentration scattered. This was the worst storm he could remember. The hands on the clock above the sink pointed to 6:03 pm. She had fallen at 3:27, and the winds hadn’t died down at all.
He adjusted the ice pack on her head. It was thawing fast.
“How long does it take to walk from the U to Cedarville?” he asked.
She didn’t reply. She lay so still he leaned in to check her pulse. She twitched but didn’t open her eyes. No one had ever died from a compound fracture. It was the infection that killed them. She needed antibiotics—the real stuff, not antiseptic ointment.
She dozed, and he paced, his fingers itching for his violin. Why hadn’t he grabbed it? Because he’d chosen his dad’s books instead. He needed the motion of drawing the bow over the strings, the melody to fill the air with soft notes.
Gusts of wind blasted through the house in a steady rhythm, like waves hitting the shore. The steady roar lulled him into a memory. He and his dad had been in the barn repairing one of the weather stations. It brought heat to his cheeks. He should have paid closer attention.
“Dad?” He had loosened a screw but kept his dad in view to gage his expression as he worked. “About that new laptop. Mine can’t even run the calculator for my precalculus class.” He owned the calculator, but his laptop was eleven years old, and he wanted a new one.
Dad grunted and stood his full six feet three inches. “Use your brain.”
“Brain?” He bit his lip. Too late.
“You know. That gray matter that sits between your ears. Use it or lose it.” He pounded on a metal leg in a vise, inspected it, and blew off metal chips. “Besides you need to practice working out those problems on paper for later when you’re in the field. Pens don’t use electricity.” His dad screwed a bracket onto the metal leg, avoiding eye contact. The conversation was over.
But Josh couldn’t let the argument drop. “Dad—”
“Look, when the electricity goes out, what will you do then?”
“But the electricity always comes back on.”
“When El Primo hits, monster storms will come one after another. We won’t be able to repair the damage and restore the electricity fast enough. It will take months, maybe years, to recover and rebuild.”
Dad turned back to his weather station, and Josh didn’t get the new laptop, not until Christmas.
Now the electricity was out, and if this was El Primo, he could only guess for how long. They’d rely on the solar panels if he could even repair the circuit. At least his grandpa had installed them in frames on the ground and not the roof. Grandpa had always believed in his son and prepared for the worst.
Josh stared into the flames in the fireplace. He’d have to keep the fire going, but when would he sleep? He glanced at the couch. The steady rise and fall of Mom’s chest were a comfort as debris hit the walls and roof in constant thumps and bangs. He placed the back of his hand on his mother’s forehead, and his belly tightened into a knot.
Fever, page 80.