04/19/15

An Endless Array of Broken Men

Endless Novella

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Add this riveting piece of historical fiction to your library today!

A harrowing account of life on the front edge of a 19th century battlefield hospital…

For Josiah Boyd, hell is twenty-four sleepless hours, every one of them scalpel in hand, standing under a cross in a nameless church atop a dusty hill after a pointless battle. For too many good men, this is where the world ends.

The surgeons in this place work at their unpleasant task with a fever matched only by the fervor of those that have inflicted their wounds. This camp of wounded is filled with men of both sides and these men wait their turn with an eerie patience, as if their fate has already been decided and it is the duty of those present in this time and place to carry it out. As the surgeons part arms and legs from each in turn, the pile of disarticulated flesh grows at a hideous pace, now eight feet, now ten feet high. The men move on and off the tables with nary a word, except for the occasional groan that can’t be suppressed. Indeed, there is little to be said at such times, each participant in the drama knows his place and the universal language of blood speaks for all.

On this sleepless morning, Dr. Josiah Boyd is the embodiment of exhaustion. The blood and sinew that soil his front apron are now a full day old, and he hasn’t had so much as a latrine break in hours. The muck on the altar floor is two parts blood, one part shit from exploded bowels, and one part tobacco juice; Boyd spits frequently. This is a seething hell of broken bodies and rotting flesh.

Except for the ever present hum of flies (they are everywhere, a constant distress), it is mostly quiet; no sounds of battle breaking the dawn stillness, only an occasional random shot. Outside the church-turned-hospital, those who have survived the night await their turn at the surgeon’s table. They are a quieter lot now, having seen the two extremities of their fate in those that have gone before them.

They will live or they will die. It is beyond their making now…

˃˃˃ Won honorable mention in The Seventeenth Edition of the Year’s Best Fantasy and Horror (2003).

This short story was the impetus for my larger work, NOT ONE AMONG THEM WHOLE: a novel of surgeons and the wounded at Gettysburg. It is an intense story, a surgical thriller in every sense of the term, vivid in its depiction of the deep wounds inflicted on the surgeons at a battlefield hospital as they labor endlessly over the wounded in a time before germ theory or antisepsis.

“…resembles THE KILLER ANGELS and COLD MOUNTAIN, and its artistry rivals those great novels…a terrific achievement.” David Poyer, author of A COUNTRY OF OUR OWN and THE SHILOH PROJECT, on NOT ONE AMONG THEM WHOLE.

A short story of about 10,000 words, which is to say an hour or two of awesome reading. Perfect for the commuter: planes, trains, or automobiles.

 

This novella is available right now for Amazon Kindle

05/28/14

Not One Among Them Whole, Audacious & Intense

For these men & their charges, laudable pus will be the least of their worries.

An intense and audacious tale of battlefield surgery, distressed surgeons,
and the insanity of life & death in the Civil War.

“Engaging, heart-breaking, & absolutely fantastic. A terrific book.”
—D. Buxman, a top 1000 reviewer & Vine Voice at Amazon

“What I like most about this book is that everything and everyone has a shade. There’s no absolute bad or good, just human, heroic, cowardly, robust, vulnerable, impervious, venal and just plain terrified and confused raw pain that matches the emotional and twangy verbal tones of the recurring characters as we follow them through the travesty and glory that was Gettyburg.”
—From a review on Amazon

It is the summer of 1863, and the greatest battle ever fought on American soil is in full tilt. Southern Pennsylvania has become one great grinding stone and thousands of dead or dying are its grist. In this tilted landscape, reputations are made, careers are ruined, and men and women are driven to the brink in the wake of two armies intent on killing one another. Yet opportunity is everywhere…

For the privates and officers who fight the battle, it’s a kill or be killed world, with salvation or damnation just a bullet away…

For one undertaker in particular, the dead are a canvas, and his ability to make a body reflect the living individual is nothing short of uncanny. For Jupiter Jones, the burgeoning dead themselves are the opportunity…

And finally, for one teenage former slave, alive only because his father had the courage to bury him, opportunity comes in the form of a ten-year-old boy with a creel and only one shoe, who may or may not be a ghost…

In the summer of 1863, humanity itself is under siege. What happens amid the carnage and human flotsam of Gettysburg, Pennsylvania, will be unholy, unnerving, and all but unbearable, with only this certain: not one among them will escape unscathed.

Here, hell is in session.

And it’s the devil’s own day.

 

“McDaniels’ fine Civil War novel is not the world of Robert E. Lee or Ulysses S. Grant or even Abraham Lincoln. McDaniels’ Gettysburg is a microcosm, a seething world of its own from which no player escapes.”
— P.B. Sharp, an Amazon Top 500 Reviewer

 

~ THE CHARACTERS ~

Ezra Coffin, a severely wounded Union soldier, has never seen his infant son, and perhaps never will…

Major Tom Jersey, a Confederate officer, awakens terribly mangled in the aftermath of combat, his only companions: the wounded enemy, without whom he can’t survive, and the ghost of his son—who may be his only means of escape…

Major Solomon Hardy, chief surgeon, who stands at the tables until his health fails—then watches over his own dying son…

Major Josiah Boyd, a gifted surgeon but a flawed man. His time behind the knife may cost him everything—and his patients even more…

Captain Tobias Ellis, his courage under fire makes him a hero, but he may just be the most flawed of all—and the most dangerous…

Liza Coffin, who isn’t eighteen, but already has been a homeless orphan, a mother, and perhaps now a widow too…

Jupiter Jones, showman extraordinaire, itinerant undertaker, and reader of the dead. His healing Oil, acquired from the equatorial coast of West Africa, may be the real thing…

And finally Cuuda Monk, a teenage boy and former slave, alive today only because his father had the courage to bury him when the end came. His visions of the boy with the creel may make him the sanest man in the land—and just may be the means to all their salvation…

It is the summer of 1863 and humanity is under siege. What happens next amid the carnage and human flotsam will be unholy, unnerving, and all but unbearable.

It is the summer of 1863 and everything is about to change.

Everything.

Forever.

Not One Among Them Whole, A Novel of Gettysburg, by Edison McDaniels

Click the book cover to buy the Kindle version from Amazon for just $4.99!

 ~An Excerpt~

Surgeon Josiah Boyd leaned toward the corner, pressed his tongue against his lips, and spat. Reflex mostly, something he did without thinking whenever the need presented, which was often. The gob splattered against the wall, joining the smear of juice already there. Assistant Surgeon Tobias Ellis gave little thought to the smear of tobacco, keeping his mind on the task at hand. Like Boyd, his hands and forearms were streaked with the blood of scores of men. They looked raw, almost skinned.

“Artery clamp.” Boyd stretched a palm out in waiting. 

Tiny, the surgeon’s helper, was a heavyset kid in his early twenties, though he looked younger. His experience put the lie to his appearance. He’d spent the better part of two years—the worst part of a lifetime—with the field hospital. He rummaged in the dirty water of the basin even as he held a chloroformed mask over the patient’s face. His fingers made quick work in the cool, blood pink water, finding the instrument by feel. He slammed the clamp into Boyd’s hand with a sharp smack and Boyd squeezed the clamp around the femoral artery as Ellis lifted the great vessel out of its bed, the thrum of the pulse fighting back from within. The clamp clicked as it locked, and the artery beyond the obstruction went limp. “Ligature,” Boyd said with a practiced calm.

Major Josiah Boyd was old for his thirty-eight years. His hair had thinned up top and he hadn’t shaved in days. He was of lanky build and sallow complexion, possessed of a long drawn-out face almost ghoulish in its particulars, with prominent cheekbones high under his eyes. His lower jaw had been twice broken (once by a horse, once by a man) and poorly set. It jutted obtrusively and his teeth came together at an angle somewhat off the expected, so that the whole of his face looked skewed. His hands were large and his fingers long and spindly like the legs of a great spider. They were economical in their wanderings across the surgical field however, with no waste of motion. 

The soldier on the table lay on his back. He was insensible to the workings both around and upon him, heavy under the influence of a chloroform-soaked towel. Boyd and Ellis worked quickly at their labors, their movements looking somewhat frantic at times. They had about them a look of resigned experience, showing both intolerable exhaustion and inordinate energy at the same time. They’d been working feverishly at one task or another since first light a dozen hours before. Their efforts had made not a dent in the line of men awaiting their services. At times, they worked so fast and the wounded spent so little time before them, it seemed they were cutting the same man over and over again.

Tiny passed the silk ligature and Ellis encircled the artery twice with it, just above the clamp. His fingers blurred with movement as he tied the thread and occluded the artery. He repeated the exercise on the thinner-walled vein beside it. Tiny retrieved a pair of scissors from the basin and slapped them into Ellis’s hand even before the man could ask for them. The assistant surgeon divided the vessels—artery and vein—below the ligatures and removed the clamp.

They had cut away the soldier’s trousers and filleted his thigh to the bone midway between hip and knee ten minutes before. Now, with the last of the muscle and flesh parted and only the bare thigh bone joining the lower leg to the upper, the amputation was complete in all but fact. Only the saw cut remained.

“Capital saw,” Ellis said, and out of his side vision he caught Boyd turning to spit again. This time he had time to consider the action, something he’d seen Boyd do a thousand times in a dozen hovels just like this one. In the instant before the handle of the bone saw struck his palm, Ellis wondered at the incongruities of the man who was his direct senior. He had ‘good hands’. Goddammit that ain’t true, Ellis thought, he’s more than that, a genuine honest-to-God born surgeon. Ellis had seen a lot of men work the tables in his almost two years as an assistant surgeon and Boyd was, hands down, the best cutter out there. But it was also true the man had odd ways. Like his want to chew during surgery, which perhaps wasn’t all that bad, except it meant he was always spitting. And there was his habit of spacing out in the middle of an operation. He’d suddenly walk away from the table, turn his back to the room or go behind a wall, then reappear before too long as if nothing had happened. Except something had happened, Ellis would always think. At such times Boyd looked different. Certainly not better, and not worse (or probably not worse, he’d had occasion to think a few times—and how curious was that?). Just different. It showed most in his hands, which looked somehow, he tried to think of the correct word, revitalized? Was that it? Upon returning to the table, those hands, which had seemed worn and tired, would now be spirited and quick to perform. But it was Boyd’s eyes that bothered. Once the surgeon reappeared, Ellis always found those eyes…unsettling. As if Boyd’s eyes had developed an unpleasant ‘lag,’ a sort of disparity with his hands. As if the one had given to the other, Ellis suddenly thought. He swallowed hard then, tried to put that absurd notion out of his head. A fevered product of his own exhausted mind, he decided. After all, once a battle was joined and the bloodletting began, there was never enough rest.

Tiny put the saw in Ellis’s palm and he came back to the moment. He curled his fingers around it—they seemed to have conformed to it over the endless months of the war—and went to task on the soldier’s femur. Boyd held the meat of the leg out of the way as Ellis laid the business side of the saw against the lower end of the bare thighbone and began to run it back and forth. The blade’s teeth bit at the glistening bone with a gritty feel and flecks of ivory dust and crimson blood peppered the air as he worked. The sawing took more force than Ellis supposed it should and he made a mental note to have Tiny replace the blade before the next patient. When he’d about sawn through the whole of the femur, the remnant snapped with the pop of a dry twig and the leg fell away. Tiny stuffed a wad of lint against the bleeding stump as Boyd removed the now useless limb.

“Bone file.”

Tiny anticipated the request and passed it without hesitation. Ellis grasped the narrow, five-inch flat metal file and worked the roughened side against the sharp edges of the bony stump. When he was satisfied with its appearance and feel, no sharp edges to work through the skin later, he nodded at Boyd, who took a quick feel as well. “That’ll do,” the senior man said. Ellis handed the file back to Tiny and Boyd took up an amputation knife—its long, sharp edge might easily slice a ham—and carved away a bit of remaining muscle and flesh on the back of the thigh, until he was satisfied with the look and feel of the flap to lay over the stub of bone.

They continued to work largely in silence, with no idle chit-chat. Ellis removed the lint from the end of the sawn bone. Satisfied the wound was not oozing too much blood, the surgeons flapped the skin up and approximated the edges with several silk stitches placed an inch apart. Ellis dressed the incision with a plaster cap and Tiny fanned the man to purge the chloroform from his system. A quick whiff of liquor of ammonia served finally to bring him back to consciousness, where upon he began to groan. Judging the man was safely over the effects of the chloroform, Boyd dribbled a few drops of laudanum, a sweet concoction of opium and alcohol, on the soldier’s tongue to dull him to the agony of the hours to come. Ellis had seen its effect on men time and again. Some the laudanum slept, others it simply relaxed. Ellis himself had taken it once or twice to kill a headache. Its effect had felt something akin to salvation—removing him from the horrors of the field hospital and the tussle of war, albeit transiently. Good stuff, he thought, and dangerous. Too much of that could turn a man out.

A pair of stretcher bearers stepped forward and lifted the patient with only a bare afterthought of gentleness, grabbing him under his butt and armpits. The man’s grunts as they carried him outside to be deposited alongside the other unfortunates were lost in the chaos of the battlefield hospital. Boyd stood off to one side of the room, several men interposed between he and Ellis. Ellis watched as the surgeon put his hands out, looking at the trembling, blood soaked palms as if they might suddenly fall off. Another of Boyd’s odd behaviors. There followed a curious moment in which Boyd looked about, spotted Ellis, and slipped awkwardly out the back of the building. 

Another soldier was placed on the table. As Tiny pressed a cloth over the man’s nose and mouth and chloroformed him, Ellis probed the wound in his calf with a stiff finger, feeling for splinters of bone and the ball that had done the damage. The soldier winced, not quite under yet. As Ellis pulled his finger from the man’s innards, Boyd appeared at the side of the assistant surgeon and chuckled in an odd, not at all funny way. “The truth of the flesh,” he said, or something very much like it. Ellis couldn’t be sure. It was a small thing, but as Boyd called for a scalpel, it disturbed Ellis nonetheless and he had no idea why.

 

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NOT ONE AMONG THEM WHOLE is available for the Amazon Kindle & in trade paperback. Also available in other eBook formats. Now featured at the National Park Service bookstore at Gettysburg itself.

05/26/14

The Bottom of the 5th — An Excerpt

A touching story of a little boy and the miracles surrounding him on opening day of the Little League baseball season. An inspirational story of what it means to live life to its fullest…

Click the image to buy THE BOTTOM OF THE 5TH for the Kindle, Just 99¢

Click the image to buy THE BOTTOM OF THE 5TH for the Kindle, Just 99¢

The Bottom of the 5th
A short story by Edison McDaniels

 

I had me a son once.

His name was Cooper and he was a special child, all a parent could want. The boy had dark mulatto skin, lighter than mine, and dense black hair that curled naturally into tight little twists close to his scalp. A smart kid, mature for his age, but funny too. And well-liked, with a natural gift for getting on with others. Like our neighbor Sam for instance, a old blind man. Cooper used to take the Sunday paper over to ‘im. He and Robbins—that’s my wife, Robbins with an ‘s’—would get home from church around 11:30 I guess. Cooper would grab a quick sandwich, then head over to Sam’s place and read to him for a couple of hours. I asked him once if there wasn’t something else he’d rather be doing with his Sunday afternoons.

“Like what?” he asked, like the thought had never occurred to him.

“I don’t know. Like playing ball or going to a movie maybe.”

He gave me a quizzical look. “Why would I wanna do that? Sam’s got more stories than any old movie and I can play ball anytime.”

I remember that conversation because it was the only time I ever heard Cooper put anything before baseball. He loved the game, was born to it. Spent hours playing it too. The boy couldn’t wait to get home in the afternoons to throw the ball around, even if it was just against the side of the garage. He wore a hole in the stucco there. Twice.

He was a good kid, the best as he once said to me. Truth is, the boy really only had one vice, and even that wasn’t so bad. Not in hindsight anyway. He was a thumbsucker. Did it without even thinking about it I’m sure.

Yeah, he was a good kid.

And then he was gone.

If you’ll sit a spell on the bleacher here alongside me, I’ll tell you about it. Not ‘cause he’s my son either, but because it’s worth hearing. First though, I have to tell you about opening day, about how he quit sucking his thumb.

And about the bottom of the fifth.

 

Cooper turned nine years old that Saturday, opening day. We arrived at the field a bit early, probably on account of him being so excited. Baseball did that to him. The day itself was perfect, like it was made for baseball. The sky was a cloudless deep blue—smog was still a thing of the future back then. Just a bare hint of breeze in the air, enough to carry the ball toward the fences I guess. What you’d call a hitter’s wind.

Roscoe Field the place was called. Built tight against one of those perpetually brown Southern California hillsides, so close the right field was thirty feet shorter than left. To fix that, they put a twenty foot high wall in right field where it dug into the mountain. There aren’t many ten year kids what can hit a ball both that far and that high for a homerun, but I saw it once—a feat I’ll describe for you shortly.

The outfield grass that spring day was the greenest I ever remember seeing it. The air was redolent of a just cut lawn, like honeydew and lilac it was. I can’t never smell that now that I don’t go back to that day. The snack bar, just a shack really, had its usual worn coat of paint. Fluorescent yellow, god knows why. The players sat on telephone poles laid in the dirt along first and third. Not fancy, but it worked. The backstop was a patched mess of rusty chicken wire and every time a ball hit it, those of us in the bleachers flinched at the possibility it wouldn’t hold. It always did though, except once. I’ll get to that too, presently.

There was the usual opening day carnival atmosphere, something I always liked but Cooper could have done without I suppose: balloons and firecrackers, a pony ride, the usual fire truck for the baby kids to climb on. Even a few carnival-style games and a kiddy slide. The teams joined up in the outfield and was introduced, followed by a few short but still too long speeches. A recorded version of the star spangled banner hissed over the loudspeakers and the Junior ROTC paraded the American flag across the infield.

When I saw him not long after the ceremony, it was obvious Cooper was bored, though he never woulda said so.

“When do the games start?” he asked.

“Cooper, you know how opening day is. Won’t be long now.”

“I just wanna get playing, to heck with all this other stuff. That’s for kids.”

Watching him standing there with his thumb in his mouth, I couldn’t help but chuckle at that. “And what do you suppose you are, champ?”

“A ball player, dad. I’m a ball player is all.” He said this with such conviction he must have thought it obvious to all.

“A ball player? Okay, sure. Tell me something though, Mr. ball player.” I hesitated a moment, perhaps afraid to burst his bubble. “You plan to suck your thumb out there?” I pointed through the chicken wire, out toward the pitcher’s mound.

“Naw, that’s not something ball players do,” he said, realizing he was doing it then. He took his thumb out and rubbed the slimy digit on his pants. As he did so, I saw it was wrinkled and pristinely clean compared to his other fingers. When he smiled up at me, his teeth bucked out expensively and I could imagine them costing me a fortune some day. He smiled and jogged off toward the carnival games despite himself.

When I caught up with him again a half hour later, his thumb was back in his mouth.

 

I remember that Saturday as if it was yesterday: the luxuriant green of the grass; the chirping of birds in the nearby trees; and the giggling of a couple of little girls sitting behind me in the stands. There was a pair of outside handball courts on the other side of the park, and I can even remember the sound of a rubber ball splotching against the cement walls there over and over again. In the quiet morning air, that sound seemed to echo forever. I also remember wishing Robbins could be there, but she had volunteered to help out at a pancake breakfast at our church that morning. Robbins was a nurse, and I later found out she saved a life that day, doing CPR when one of the older parishioners collapsed. Turned out she was the only one there what knew how to do it. She saved that man, I mean really saved him. Edelman was his name and he became the poster person for CPR across the Southwest after that. Saving his life probably saved countless others. Considering everything else that happened that day, that thought always comforts me.

Standing out on that field, playing third base as usual, I gotta say Cooper looked like a baseball player. That may sound like a father’s pride talking, but it really ain’t. Back in those days, every kid got a complete uniform: hat, shirt, pants, stirrup socks. He had his pants fixed just so, with the elastic band of the cuffs turned in just below his knees. He wore white socks with blue stirrups layered over them. There was even a batting glove sticking out one of his back pockets. He was very particular about his cap and had shaped and curved the bill of it the way ball players will do. He wore it well up on his forehead, never down over his eyes. His team sported light gray jerseys that buttoned up the front, the word ‘Dodgers’ embroidered diagonally in the classic script of the big league team. Cooper wore number three, same as Willie Davis, who played center field for LA. The shirt had blue piping that seemed somehow to complete the illusion of greatness each kid longed for.

I can remember that game as if it was played this morning, not twenty-six years ago.

Want to read more? Click the image below to buy THE BOTTOM OF THE 5TH for the Kindle. Just 99¢.

 

Click the image to buy THE BOTTOM OF THE 5TH for the Kindle, Just 99¢

Click the image to buy THE BOTTOM OF THE 5TH for the Kindle, Just 99¢

 

05/26/14

Juicing Out — An Excerpt

A surgeon must make the most difficult cut of his life—or die trying. A steep descent into the ordered but claustrophobic mind of a surgeon as time runs out on his most significant patient…

JuicingOutCover2

Click the image to buy JUICING OUT for the Kindle.

Grab this tale of surgical suspense! 

Sam Vogel is a brain surgeon, one of the best. He’d better be, because on this night he’s going to be taken to the very brink of his skills and endurance. And before it’s over, he’ll know exactly what sort of stuff he’s made of. Literally.

˃˃˃ A far surpassing tale of surgical suspense that will leave you breathless. And pale.

This is one of those stories that pretty much wrote itself. The idea came to me in my exhaustion one night. It sat in my brain, worming its way around like a parasite of some sort until I had to write it down after a few weeks. I’m glad I did. I think it’s pretty good and I’m betting you’ll think so too. Fair warning though, it’s intense. Jesus Mother Mary intense. 

And it’s a novella, about 16,000 words. Which is to say several hours of awesome reading. Perfect for the commuter: planes, trains, or automobiles.

An excerpt from JUICING OUT
by Edison McDaniels, MD

The sound was piercing, high pitched, and shrill, but quick and elusive the way a chirp is at once there and not. Irritating too, the midlife equivalent of that old elementary school trick of dragging one’s fingernails across a chalkboard. That chirp was a curiously instantaneous sound, lasting, I came to think of it as defining, an instant. And that instant came again (chirp), and again (chirp), and again (chirp). I timed it later—not because I wanted to but because I had no choice—and found it to be exactly thirty seconds. Oh sure, sometimes it seemed shorter, like maybe only fifteen or even ten seconds had elapsed since the last chirp, but then I would watch the second hand of my timex jerk forward and when the counting was done the interval would be those same goddamn thirty seconds. No sir, that lousy smoke detector was never off by so much as a tick. 

I guess maybe it was my sanity that was off.

But that all came later. Just then, at o’dark thirty on that lousy morning, all I knew was that that little birdie of a smoke detector was driving me nutso. I had been up for the better part of two days and I should have been sleeping. My body needed it and I certainly wanted it. A half hour before I hadn’t even bothered to undress. My butt hit that mattress and I fell back like some sort of boneless waif. I was probably asleep before my head even hit the pillow. But some sounds are designed to be heard no matter what, even through a dead sleep—especially through a dead sleep as it turned out—and that smoke detecting little birdie chirp was chief among them. Once it started up, no power on earth seemed capable of canceling it.

If I’d have had a shotgun I’d have blown that goddamn birdie off the ceiling and out of my life. But I didn’t and so began the trouble.

 

Six hours before, I had just finished my third crani and seventh operation in thirty-six hours. I crack heads for a living, as in brain surgery, not bouncing. It was already going on eight in the evening and I was looking forward to mashed potatoes and a chicken-fried steak at the Hungry Peddler followed by some quality time with my pillow. My week of call had less than twelve hours left. Better yet, I had a week of vacation to follow, though I hadn’t planned much aside from driving over to Minneapolis to see my daughter and her family. I had left that idea open though, maybe I would show up and maybe I wouldn’t, so they weren’t expecting me at any particular time. 

My third crani had been a teenager named Junious Flagg. He should have been in school but was out joy-riding with his buddies instead. He arrived smelling of whiskey and I later heard the cops found two empty bottles of Night Train on the floorboards. I guessed he’d had his head out the window, maybe in his cheap whiskey stupor he’d actually been trying to climb out I imagined, when his buddy spun out on the shoulder of the road and Junious took a stop sign to the face. He’d come in seizing, his lips and fingers hypoxic blue and arms and legs flailing like some version of the horizontal funky chicken. One side of his face was hard to look at, a red pulpy mess. But the far bigger problem for him was the clot I saw pressing his brain inward on the CT. We went to surgery on the spot, without bothering to pass go or collect $200. Two hours later, after removing a fair portion of his skull and sucking out the clot along with several good sized pieces of wood, I gave his brain only a fair chance of ever allowing him to wake up. His face was at least covered with skin again, though if he lived he wasn’t going to be impressed with his new look. I was getting him tucked into the ICU when another call came.

‘Another call’ turned out to be a major trauma alert to the ER. One of those all hands events, choreographed chaos. The patient hit the door, another young man, and was whisked straight to the trauma bay. He wore international orange and was awake and talking, though what he was saying was anybody’s guess. His speech was thick and mostly unintelligible, like he had marbles in his mouth. That wasn’t the most of it though. Wrapped around his head was a thick and bloody bandage of a sort I hadn’t seen in all my twenty years of practicing neurosurgery. It looked for all the world like an adult diaper.

It was. I confirmed this a short time later in the OR. Just then though, I was trying to figure what had happened and what needed doing to save his life. The rapid beep-beep-beep of the heart monitor filled the room. Somebody hollered “100/60” and I saw a nurse pull a pair of shears from her smock and start cutting his clothes off. It was done fast and was followed quickly by an intern sticking a finger where the sun doesn’t shine. “Good tone, no blood,” she said to nobody in particular, then went to work sliding a catheter up the shaft of his manhood.

The patient didn’t particularly appear to like this, but then again he probably didn’t like much of what happened over the next several minutes. A lab tech stuck a needle in his arm and blood dribbled from it onto the floor. An IV was started. His arms and legs flailed and at one point he kicked one of the orderlies holding him down. I stepped in and shined a light in his eyes, which were both reactive, and he squenched them closed in the next instant. He opened them again, seemed to gaze at me with a sort of distant, languid look.

“You got what you need, Sam?” somebody asked me.

“What’d you say happened here?”

“Don’t know for sure. He was out in the woods, deer hunting by the looks of him, and was found on the wrong side of a ridge by his buddies.”

“A deer stand diver?” Every year we saw a dozen or more folks who’d fallen out of a deer stand, maybe because it had rotted in the off season, or they had fallen asleep with boredom, or, and this was the grand winner in terms of numbers, because they had mixed guns and alcohol. One year I had a guy who had dropped his shotgun over the side in his beer stupor. It blew the top of his head to smithereens when he peered over the edge just in time to see it striking the ground.

“Not so far as we know.”

“The diaper?” I asked.

“His buddies carried him out. Drove him to the local ER I hear. I guess they used what they had.”

I thought about asking if they were hunting in diapers, but I let it go. “His head?”

“Nobody knows,” he looked at me, asked again, “You got what you need?”

“Yeah, sure. He’s combative and we need a look under that diaper.”

“We’ll get him over to CT as soon as he’s tubed.”

He was tubed, paralyzed, and in the scanner inside of five minutes. I stood with the other docs looking at the monitor as the machine scanned through that diaper. His head was a small ball in the middle of the wad. As the pictures revealed themselves, there was a collective “holy shit,” followed by several loud whistles. To a person they turned to me.

“Anybody think he looks like a deer?” I asked.

Somebody chuckled. The trauma surgeon, Joe Gap was his name, said, “Somebody must’ve thought he did.”

The scan showed several large bullet fragments in the back of his head. His skull had been fractured by the impact and pieces of bone and lead were laced throughout his occipital lobes. Something large and metallic was stuck near the bony prominence at the back of his head. There was no way it hadn’t lacerated the transverse sinus, the big mofo as far as veins in the head go. I looked through the leaded glass at the man laying in the CT scanner, at that stupid looking wrap on his head. Did he look paler than he had in the ER? I had a pretty good idea there must have been a shitload of blood spilled in those woods. Jesus Mother Mary, I thought, and was suddenly glad I hadn’t opted to unwrap that diaper before scanning him. I was shocked they’d gotten him this far alive. This guy owed his life—or the last hour of it anyway—to whichever of those hunters had a problem holding his bowels so severe he’d opted to wear an adult diaper into the woods. I couldn’t believe he hadn’t bled to death out in those woods. I couldn’t believe he’d arrived here talking. Most of all though, I couldn’t see how he was gonna leave here in anything but a body bag. “Shit,” I said, “tell the OR we’re coming. And tell the blood bank I need a half dozen units of O neg. And tell ’em be quick about it.” I turned to Joe. “Can you give me a hand?”

He nodded, “but just remember, I ain’t no brain surgeon.”

 

While they moved my patient down the hall and up the elevator two floors to surgery, I made my way back to the ER. I always try to at least meet the next of kin before operating, especially when the next time I talk with them might be with a priest beside me.

His significant other was in the waiting room I was told, but I found her outside smoking a cigarette. It was cold outside, but you couldn’t smoke in the hospital and there was probably nothing she needed more in that instant than a cigarette. That’s a truism I’ve discovered over the years. I watched her through the glass for a moment. She stood beside a pole (in the spring or summer I thought she’d have been leaning against that pole, but not in the dead of winter; that pole would have burned her bare skin). She held a cell phone in the same hand as the cigarette, but she wasn’t using it just then. I saw she wasn’t wearing a sweater and had her shoulders hunched against the cold. She seemed alone in her misery.

I stepped forward and the doors slid apart. I said “excuse me” and she turned around. She was maybe thirty pounds overweight, the couch potato zone I thought, still a few pounds shy of true obesity with its diabetes, heart disease, and back problems. She had an unflattering ruddy complexion though; not the picture of health. She had the look: she’d been crying and there were rings around her eyes of a sort almost exclusively reserved for those who don’t know if a funeral or a hug is in their future. A wad of kleenex was balled in her off hand. She looked decidedly blue collar in a slightly frayed white maid’s uniform. A name tag pinned over her left breast, above her heart I guessed, said Howard Johnson’s on the top line and Josie in large letters below it. I held my hand out, I like to touch folks (I read somewhere how it makes the interaction more heartfelt for them), and she stuck the kleenex in her pocket after a moment of hesitation and took my hand in hers. 

“Is he…” Her voice had a smoker’s phlegmy rattle.

“No,” I said quickly, maybe too quickly I thought afterwards, on the way up to the operating room. “But it doesn’t look good.”

“He gonna make it. Has to, that’s all. Has to.”

Saying it doesn’t make it so I thought but didn’t say. “Why don’t we go inside.”

She took a last drag on the cigarette and stubbed it out under her shoe on the icy sidewalk.

When we were seated in the privacy room, I said, “My name’s Sam. I’m a neurosurgeon.” I paused. Nobody is ever happy to see a neurosurgeon and the realization can come as quite a shock. “He’s hurt real bad.”

“Neurasurgeon. That a brain surgeon, right?” Her eyes loomed large before me, but they never actually looked at me. Like she was afraid to make eye contact. Or maybe she was just overwhelmed. Maybe she was used to taking her cues and getting her words from others. Mostly men I thought. I thought too how those eyes had a hard edge to them. One of them had a tinge of blue beneath it, like an old bruise.

“Yes ma’am. Just now I’ll be taking him into surgery, the back of his head…” I indicated my own head with my hand, “…it’s busted up pretty bad.”

“What you think, Dr. Sam? Does most people what have a busted up head make it? Or does they go to ground?”

I had never heard that term before and there must have been a quizzical look on my face.

“That how my grammie used tuh say it. You think he’ll go to ground, Dr. Sam?”

“Actually, it’s Dr. Vogel, Sam’s my first name. May I call you Josie?” I didn’t wait for an answer, there wasn’t time. “And I don’t know if he’s going to ground.” But there’s a damn good chance of it, I might have added but didn’t.

“He cain’t go to ground. Bobby, he drinks some but he ain’t no bad guy you know. He hardly ever do me when I don’t want it. I know he love me.” She almost looked at me then, and I thought Who gave you that shiner Josie? Did Bobby—your ain’t no bad guy man—do that? 

“I ain’t never had no one to love me before. I know something about bad guys and he ain’t one.”

I thought she probably did know something about bad guys. Looking at her, I thought maybe she could write a book about bad guys. I said, “I’ll do my best.” But don’t expect too much, cause that’s a big ol’ bullet somebody put in Bobby’s head, bad guy or no.

She bucked up then, and nodded at me. She looked in that moment like she had seen life at its worst and this wasn’t it. She looked like she had faith in me.

 

A few minutes later, I was standing in the operating room looking down on Bobby. I knew there was gonna be a bloodletting like nobody’s business as soon as I unwrapped that diaper. Normally, I’d have called my partner to assist me on something like this, but there wasn’t time. Joe was right in that he wasn’t a brain surgeon, but he was a damn good trauma surgeon and wouldn’t faint when things turned to stool.

They turned to stool in a hurry.

I put on a pair of gloves. We had just moved him off the gurney and onto the OR table, his skin felt cold and clammy, when the assault began. “Pressure’s dropping,” one of the anesthesiology folks said. I glanced over his direction and saw six people, each doing their damnedest to keep this guy breathing. “We don’t have any blood yet?” I asked. We turned the guy up on his side and propped him there with a pillow. I positioned an orderly at the man’s back. “You don’t move,” I said. “Pretend you’re a seatbelt.”

“No blood yet,” one of the gas passers on the anesthesia side of the table answered, “even O neg takes some time.”

I turned to Joe, who turned to the circulating nurse, a young beauty named Alyssa. “Get on the goddamn phone and tell them send whatever they got. Tell them he ain’t picky.” By he he meant Bobby of course.

I looked down at the diaper and saw a new flush of red seeping out from somewhere near what had to be the back of his head. The rapid beep-beep-beep of the monitor suddenly hiccoughed, Bobby’s heart had dropped a beat or two under the strain, then became steady again. “How long?” I asked Alyssa, who was standing on the other side of the room and must have read my lips. No way she could have heard me in that confusion.

“Maybe ten minutes.”

Joe mouthed a reply back. “He’ll be dead in five.”

It was Shock 101, first year med school stuff. Bobby was losing blood, the so-called effective circulating volume. I thought he had arrived to the ER having already lost a good bit of the red stuff, maybe a quart. It couldn’t have been much more than that. He had been confused, maybe a little pale. But he had been awake and his heart rate, although fast, hadn’t been skipping beats. He’d been in Class I shock when he hit the door, which by definition in a guy his size worked out to a quart of blood, about 15% of his effective circulating volume if I had my figures right.

He was damn sure beyond that now. The tracing on the monitor showed Bobby’s heart was doing periodic back flips, meaning it was having trouble keeping up with demand. The folks at the top of the table were trying hard, breaking a sweat and dancing like there was no tomorrow. They were giving him salt water in the absence of blood—which meant they were giving him volume but no life saving red blood cells, a trick that would buy a few minutes tops. Pretty soon Bobby would start bleeding water and before too long he wouldn’t even bleed that. 

I had seen that once before, bleeding water. A little baby I worked on as a resident in training. That poor kid had been shot as well—his father had blasted away the top of his head with a shotgun—and we couldn’t begin to stop the bloodletting in that case. “Looking pretty thin down here,” I hollered when the stuff coming out his wounds was no more than pink salt water. That baby’s heart stopped, started, stopped and started a dozen times before it finally gave up the ghost and we pronounced him. I could have read a newspaper through the watery stuff coming out his veins by then.

Bobby’s heart wouldn’t last that long. He had probably lost a quart and a half of blood, maybe even two full quarts, by then. Half a gallon of milk. He might survive losing a third quart—though he’d probably have a stroke and speak gibberish for the rest of his miserable life—but he damn sure wouldn’t live to shoot another deer if he lost a fourth, which would bring him up to the magic and lethal number of forty percent blood loss. Everybody goes to ground at that number.

He looked pale. Like instead of a bullet to the brain he’d taken a vampire to the neck. His blood pressure was ninety over thirty one moment and sixty over fuck the next. If he had been awake and not anesthetized, he’d have passed out. He would have fainted and never awakened. Yes sir, he looked like a forty percenter to me.

Bobby, he drinks some but he ain’t no bad guy you know. He hardly ever do me when I don’t want it. I thought Bobby’s days of doing her were just about over.

I stole a glance at the scrub tech. She was frantically trying to get the instruments laid out and ready. I glanced at the table, saw a scalpel and a mess of hemostats, scissors, clamps, and sponges. I thought it probably wouldn’t be enough. I thought it had to be enough. Jesus Mother Mary. You wait any longer, I told myself, you’ll be operating on a cadaver.

“I can’t wait,” I said. “Help me with this, Joe.”

Together we unwrapped the diaper and the crown of his head came into view. He was mostly bald, middle-aged or better I thought. I hadn’t asked his age in the confusion, not that it mattered much now. His age would be on his tombstone after all. No confusion about that.

The skin at the back of his head was torn and bruised. I saw that much. Then Joe pulled the diaper off the hole in Bobby’s skull and the damn burst wide. A sea of dark blue, almost black, blood. For an  instant, it poured out like somebody had diverted Niagara freakin’ Falls into that broken head…

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