Healer of Carthage by Lynne Gentry Page B

“I’m just sayin’, a millimeter either way, and that boy could bleed out.” From their pointed silence, she knew her medical opinion was obviously of no more value here than in Dallas, and rightfully so after her little temper tantrum. “Never mind.” She wasn’t a surgeon. Even if that arrow had sliced some major artery, what could she do?
    “I’ll tend my patient,” Mama said, “and I’d appreciate it if you’d get busy tending yours.”
    Lisbeth dropped her eyes back to Laurentius. She felt his pulse. Still unconscious and no change.
    Cyprian wrapped his hand around the arrow shaft, and thedogs began to whine. “I’ll be quick, Ruth, but hold your boy steady.” The muscles in his tanned arms flexed.
    Crack.
    Lisbeth cringed and looked up.
    Cyprian fell back, holding a long portion of the jagged arrow shaft. Behind him, blood spurted from Barek’s shoulder.
    “Press harder, Ruth.” The healer unrolled the cloth bundle, revealing a set of primitive surgical tools. “I’ll have to cut him open and try to stitch the severed vessel. I’m sorry, Barek. The pain will be great.”
    The boy gave a wide-eyed nod.
    “You’re going to operate without anesthesia?” Lisbeth shouted. “You can’t do—”
    Mama’s sideways glance skewered her. “You have a better idea?”
    She didn’t.
    Suddenly, Laurentius’s eyes fluttered open. He grasped his chest. “Can’t . . . breathe.” Air leaked from his voice, draining the last of the color from his skin in the process.
    Cyprian flew to the boy’s side and knelt beside Lisbeth. “Laurentius.”
    The boy didn’t answer. His ragged breathing disintegrated into quick, shallow pants that mimicked a thirsty dog on a hot day. Shortness of breath. If the beating had broken a rib, Laurentius could have a punctured lung. Lisbeth’s senses recorded the observable symptoms. Respiratory distress. Asymmetrical chest rise. The bluing of cyanosis . She should do something. But what? Laurentius groaned, then lost consciousness again.
    Fear flashed in Cyprian’s eyes. He put an ear to the boy’s dark lips. “Healer, this boy is not breathing!”
    “I only have two hands”—Mama remained hunched over Barek, leaving Lisbeth to deal with Laurentius on her own—“andright now they’re trying to keep the bishop’s son from bleeding to death. Lisbeth, Laurentius has a tension pneumothorax. Do something. Now!”
    Lisbeth shoved Cyprian out of the way. She crammed the tips of her stethoscope into her ears and slapped the bell onto Laurentius’s chest.
    “Breath sounds unequal,” she muttered, thinking through what to do next as she slid the bell back and forth along the midline. “I hear nothing over the left.”
    “If his lung is punctured, every exhalation pumps air into his chest cavity.” Mama coached without looking up from her operating table. “Without an immediate way of escape, trapped air will compress his lungs, shift everything to one side, and affect the return of blood flow to his heart.”
    A certain death scenario.
    “What should you do, Lisbeth?” Mama prodded. “Think. Quickly.”
    Lisbeth’s mind kicked into high gear, the drawings in her medical books flashing before her eyes. “Relieve the pressure inside the narrow space between the lung and the protective lining of the lung.”
    “The pleural space,” Mama concurred. “Create a release valve.”
    Lisbeth had observed a needle aspiration in the ER, but she’d never performed a procedure so dangerous. If she tried something this risky in these primitive conditions, she could kill him. “I can’t.”
    “It’s the only way to help the injured lung reexpand.”
    “But I don’t have the tools to relieve the buildup.” She glanced at the deepening shade of Laurentius’s lips. Doing nothing meant the kid would most certainly die.
    “Improvise,” Mama ordered.
    Lisbeth dug through the basket Ruth had placed between her and her mother. “Where’s a standard intravenous hollow