The Ascent

'What happened, Nima?'

'I don't know, sir.'

'Nima, please...'

Nima thought about it. 'Not possible.'

'You can't tell me? Or you don't know?'

'Yes sir.'

Abe sighed. 'Ask his friends, Nima.'

Nima barked a question at the yakkies, then turned back to Abe. 'They say, this

man falling down. Shaking, shaking. I don't know.'

There was the suggestion of malaria again, but Abe discounted it. He would have to

look it up later in the big Physician's Desk Reference in his tent, but this just didn't

seem like malaria.

'Anything else?'

'No sir.'

Abe glanced up and around at the stark white eyes glowing in the smoke and gloom.

The shadows were too thick to show the stone walls and their dark faces were

invisible. But their eyes leapt out of the murkiness, peering and cryptic. Their

curiosity went beyond the ordinary voyeurism that attends any accident. These

yakkies had awe and fear written on them – it showed in their multitude at this early

hour and it sounded in their hushed murmurs and repetitious mumbles. Prayers, Abe

decided. Some of them were praying, and praying hard, non-stop. But why? He looked

down at his patient, and all he saw was 'some guy,' a creature like himself except for

the strange markings and hot delirium.

'Nima,' he started again, then gave it up. Abe admonished himself. It wasn't up to

Nima to provide answers. It was up to him, Abraham, their pretend-physician, to

solve the greater mystery of why this man lay unconscious and stretched out on the

ground. Always before, Abe had known his patients would move into the care of men

and women who knew more than he did and had technology he didn't. Once he

packaged and delivered them to the emergency room, his patients disappeared, and

he could quit thinking about them. But there was no other place for this Tibetan boy

to go, and no higher authority than Abe himself.

At the same time it touched him, Abe was also annoyed that these yakkies – indeed,

all of the men and women now gathered in the lap of this mountain – needed him, or

might need him, which was the same thing. He was not their answer to pain and

sickness, risk and death. He was just one more of them, a wanderer bearing his own

question mark.

They called him Doc for their own peace of mind and because they thought it would

flatter him, but Abe was embarrassed because he knew real physicians considered his

type wanabees and shake-and-bake messiahs. He was good at what he did, but a

paramedic is never a doctor, only at best the cowboy who first reaches the car wreck

or cardiac arrest or climbing victim and lays on the hands and manipulates the horror

and fear. Abe had saved people. He had been saving them most of his adult life,

sometimes even bringing them back from clinical death. But he no longer trusted his

motives, because at bottom what he did fed upon human beings at their most

vulnerable. He was needed by people who could not help but need him.

Abe had thought these thoughts too often to let them distract him. They came to

him as second nature, and he handled them with the same ease as he now handled the

boy's limp arms, palpating for fractures. He had a talent for treating his doubts as

background noise and getting done what needed doing.

He moved quickly, feeling for broken ribs, for deformities along the lower spine, for

pelvic fractures. The light shifted again, this time revealing yellowing bruises on the

boy's belly. But there were no distended areas, no unusual lumps or masses, not to

Abe's touch.

The rule was to assume spinal injuries with an unconscious patient. He hoped the

story of this boy collapsing on the trail was true, because anyone with cord injuries

might just as well die as be evacuated back across the Pang La and the corrugated

Tibetan roads.

Gently Abe pulled off the boy's shoes – he had no socks – and scratched his bare

soles with a pebble off the floor. To Abe's relief, each foot twitched. Abe got a distal

pulse behind each Achilles tendon and that meant there was circulation, more good

news.

Abe ran his hands down the bones of each leg, hip to toe: no gross fractures, no

dislocations. Then, with Nima's help, he slid off the Tibetan's quilted pants. His first

glance showed nothing out of the ordinary, but then the light – or shadows – revealed

more damage and once again he was scowling in puzzlement.

The flesh of both lower legs was ripped and torn and contused. Some of the wounds

appeared to have a pattern, some overlaid other wounds. His legs were like a canvas

of bad paints. Some of the marks were fresh and dark blue. Others showed green or

yellow, a month old. The overall effect was gruesome.

The yakherders against the wall muttered at the sight. Nima reacted, too. Abe could

feel the Sherpa withdrawing into himself. Nima still knelt beside him and held the

light. But his poise was gone, replaced by shock or fear or loathing. Something. For

whatever reason, his sense of command had drained off. Curiously, Abe felt himself

gaining strength from Nima's unnerving.

Abe took the light and bent close to the mysterious trauma on the boy's legs. He

pried open some of the lacerations for a cursory look and prodded at the terrible

bruises, investigating the clues. Abe had rescued – and when they were beyond

rescue, had bodybagged – climbers who had fallen from great heights and gotten torn

and shredded by their descent. Some of this boy's tissue injuries were consistent with

that, a bad tangle with old-fashioned gravity.

But some of these wounds were different.

'Damn,' Abe swore and pulled away, shocked.

His reaction alarmed Nima, who said, 'Sir? Sir?'

'These are animal bites.'

'No sir.' Nima categorically rejected the notion. 'Not possible.'

Abe didn't know what kind of animal, but he definitely recognized the puncture

wounds and lacerations.

'What's going on here?' Abe demanded. This was no ordinary camp accident. He

tried to piece together the injuries. Had the boy fallen off the trail and lain unconscious

while animals chewed at him? Or had animals attacked and driven him off some cliff?

Stranger things had happened.

'Very bad,' Nima murmured. 'Very bad.' Nima rocked back on his heels. He wouldn't

meet Abe's eyes.

Abe felt defeated, completely lost, like a traveler who wakes up in a dark forest. Abe

wanted a story to go with these wounds, as if that would somehow locate him in this

wilderness. But that was just laziness speaking. It was up to him to create the story

with a diagnosis. Wound by wound, he had to put in order this poor body.

Abe sighed. He was about to begin at the top again, with the boy's head, when