Anything you have is okay.” The circle of people gathered around them began to close in. “You’ve got to back up!” Lou said firmly, applying gentle pressure. “Give us more room.”
Blood flowed from the wound in thick spurts. Hemostasis? Ice? Cleansing?
He evaluated the pluses and minuses of each maneuver.
Stop bleeding.… Get alignment.… Sterilize.… Protect any microscopic arteries that might still be intact.…
Lou made decisions while talking to the boy almost continuously. A single rolled apron had been placed under Joey’s neck, and stacks of towels were now elevating his legs from the knees down.
Lou rested the damaged hand palm down on a clean towel, gently adjusting the thumb into an anatomically correct position.
“Okay, Joey … listen to me now.… Everything is going to be just fine.… I’m going to help.…”
“Help me,” Joey answered back meekly. “Please help me.”
“Someone give me a scissors, please.”
Lou pulled one of the towels from the pile and cut off a long three-inch strip. Next, he wrapped the strip twice around the middle of Joey’s forearm and tied it off. The bleeding began to slow. To add torque, Lou slipped a wooden cook spoon under the strip and turned it until the bleeding began to slow even more. He made note of the time, 12:50. There may have been as much as two hours of wiggle room to keep the tourniquet on before there was tissue damage, but he had no desire to cut things that close.
“Here you go, Lou,” he heard Dennis say.
Lou’s heavy black leather bag materialized on the floor beside his knee. A number of states had enacted Good Samaritan laws to protect doctors who offered help in an emergency from being sued. But many of those laws were vaguely constructed, and some had even been challenged in court. As a result, there were docs who went out of their way to avoid involvement in trauma or medical emergencies-an aspect of his profession Lou had never been proud of. Instead, he had chosen to make himself better prepared. He carried a well-equipped medical bag in his trunk, and at one point, had actually participated on a committee that helped the airlines to design a sensible and useful emergency first-aid kit that could be placed on planes.
“You still with me, Joey?”
“Yes … I’m with you, sir.”
The physical evidence of shock had already begun to recede, and some strength had returned to the youth’s voice. Bleeding had been reduced to an ooze.
“I need that icy dishwashing soap now,” Lou called out.
Given that the ambulance would be there soon, there was little in Lou’s emergency bag that would be of major help. But there was gauze and a great splint-thumb-sized, three-quarters of an inch wide, pliable aluminum, backed with foam rubber. And just as important, there was a pair of shears that could shape it. Years had passed since he had put the splints and shears into his kit. Who knew?
He irrigated the wound, carefully wrapped the laceration, measured off a piece of splint well more than twice the length of the thumb and twisted it into a
“You’re doing great, pal,” Lou said to him. “You’re one tough customer, I’ll tell you that. You are really something.…”
Lou checked the youth’s blood pressure. One hundred.
He continued the stream of encouraging banter.
“You’re doing just great, Joey … just great.…”
“Out!.. Out! Okay, back off, everyone. Please.” Millie Neuland came rushing through the crowd. If she had aged since any of the dozens of photographs of her were taken, Lou could see no evidence of it. Gray, tousled hair, round wire-rimmed glasses, bright blue eyes, rouged cheeks, finely painted eyebrows, and a nearly perfectly round face. Her gingham dress, frilly half apron, and single strand of pearls completed the picture.
The quintessential grandmother.
Lou had begun wiping off the boy’s pallid cheeks.
Millie knelt next to him, mindless of the blood. “The ambulance is on the way,” she said to no one but Lou, a genteel Southern lilt in her speech. “If you’re not a doctor, son, you dang well should be. I’m Millie Neuland.”
“I guessed. Lou Welcome. I’m an ER doc at Eisenhower.”
“Lucky us. Oh, Joey! Can you hear me, baby? You got a doctor right here with you.”
Joey’s eyes fluttered open. “Hi … Ma.”
“Your son?” Lou asked.
“Might as well be. His name’s Joey Alderson. Been here at the restaurant for years. Looks twelve, but he’s near twenty-five.”
“Ma, I really messed up this time,” Joey managed in a hoarse whisper.
“How bad?” Millie asked Lou. There was emotion in her voice, but her tone was that of a woman used to being in charge and dealing with crisis.
“He put his hand under a knife that was chopping carrots. My father, the guy over there in green, and I were sitting just a few feet away.”
“How bad?” the restaurateur asked again, encouraging no mincing of words.
Lou glanced down at Joey, who appeared to have drifted off. “Reimplantation,” he said, sensing the word was one that the youth was unlikely to completely understand. “We have some wonderful hand surgeons at Eisenhower Memorial. I can make some calls and we can get him over there.”
“I don’t know you, and I don’t know any of the doctors at Eisenhower Memorial,” Millie replied, “but since you work at one of the big hospitals in the city, you might know that many folks out here consider a referral to there tantamount to a death sentence. We’re very proud of our hospital here. My restaurant is one of its biggest supporters. In fact, the surgical suite is named for me and this place. Joey’s a little … limited in some ways. He may frighten easily. The doctors at DeLand know him well. They know how to be sensitive to his needs.”
“I understand,” Lou said, now measuring every single word carefully. “The metropolitan hospitals in cities like D.C. all have the reputation you spoke about-mostly because people who are referred in are usually quite ill.”
From the distance, they could now hear the siren of an approaching ambulance. Lou knew that, assuming his concerns about DeLand Regional were on the mark, time was running out on his chances to get Joey Alderson into the city.
A frontal assault seemed to be his only option.
With the approaching siren getting louder, he met Millie Neuland’s gaze with his, and held it. “Millie, I promise to explain my feelings later,” he said, “but I have my reasons-very strong reasons-and I am begging you to allow me to bring Joey into Eisenhower Memorial.… Begging you.”
The woman, clearly nonplussed by the force behind Lou’s words, studied his face.
The siren, now in front of the restaurant, cut off. Moments later, they could hear the voices and commotion from the direction of the main entrance.
Lou felt his heart sinking. There was nothing more to say.
“Well,” Millie said finally, “if Joey’s going to be trucked into the city, then I’m going with him.”
CHAPTER 18
There was a time Kim Hajjar and her three closest D.C. friends met for drinks once a week. But more and more, their good intentions were being eroded by their professional lives. Their meeting spots seemed tempered as well. Gone were the margaritas at Chi-Chi’s and Scorpion Bowls down at the Hong Kong. The group of women now preferred quieter watering holes where they could commiserate about jobs, kids, husbands, or in Kim’s case, the dearth of quality men.
