still beating,
fast and faint. Despite his improvised tourniquets, blood was oozing from the savaged stumps of the legs.
ABC,
Hatch recited under his breath:
airway, breathing, circulation.
He opened the man’s mouth, cleared out mud and vomit with a hook of his finger, then rolled him on his left side, squeezing
him into a fetal position. To Hatch’s great relief a thin stream of water came from the man’s mouth, along with a sigh of
air. Hatch immediately began a stabilizing pattern: a ten count of mouth-to-mouth, then a pause to tighten the tourniquet
around the left leg; ten more breaths; a pause to tighten the other tourniquet; ten more breaths; then a pulse check.
“Get my bag!” he yelled at the stunned group. “I need a hypo!”
One of the men grabbed the bag and began rummaging through it.
“Dump it out on the ground, for Chrissakes!” The man obeyed and Hatch fished through the scatter, pulling out a syringe and
a bottle. Sucking one cc of epinephrine into the hypo, he administered it sub cu in the victim’s shoulder. Then he returned
to mouth-to-mouth. At the five count, the man coughed, then drew a ragged breath.
Streeter came forward, a cellular phone in his hand. “We’ve called in a medevac helicopter,” he said. “It’ll meet us at Stormhaven
wharf.”
“The hell with that,” Hatch snapped.
Streeter frowned. “But the medevac—”
“Flies from Portland. And no half-assed medevac pilot can lower a basket while hovering.”
“But shouldn’t we get him to the mainland—?”
Hatch rounded on him. “Can’t you see this man won’t survive a run to the mainland? Get the Coast Guard on the phone.”
Streeter pressed a number in the phone’s memory, then handed it over wordlessly.
Hatch asked to speak to a paramedic, then quickly began describing the accident. “We’ve got a double amputation, one above,
one below the knee,” he said. “Massive exsanguination, deep shock, pulse is thready at fifty-five, some water in the lungs,
still unconscious. Get a chopper out here with your best pilot. There’s no landing spot and we’ll need to drop a basket. Hang
a bag of saline, and bring some unmatched O negative if you have it. But get your ass out here, that’s the most important
thing. This’ll be a scoop and run.” He covered the phone and turned to Streeter. “Any chance of getting those legs up in the
next hour?”
“I don’t know,” Streeter said evenly. “The water will have made the pit unstable. We might be able to send a diver down to
reconnoiter.”
Hatch shook his head and turned back to the phone. “You’ll be flying the patient straight through to Eastern Maine Medical.
Alert the trauma team, have an OR standing by. There’s a possibility we may recover the limbs. We’ll need a microvascular
surgeon on tap, just in case.”
He snapped the phone shut and handed it back to Streeter. “If you can recover those legs without risk of life, do it.”
He turned his attention back to the injured man. The pulse was lousy but holding steady. More importantly, the man was beginning
to regain consciousness, thrashing feebly and moaning. Hatch felt another wave of relief; if he’d stayed unconscious much
longer, the prognosis would have been poor. He sorted through his kit and gave the man five milligrams of morphine, enough
to give him some relief but not enough to lower his pulse any further. Then he turned to what remained of the legs. He winced
inwardly at the raggedness of the wounds and the shattered ends of bone; the dull blade of the ax was nothing like the nice,
neat saws of the operating room. He could see some bleeders, especially the femoral artery of the right leg. Sorting among
the refuse of his medical kit, he grabbed a needle and some thread and began tying off the veins and arteries.
“Dr. Hatch?” Streeter asked.
“What?” Hatch replied, head inches from the stump, using tweezers to fish out a
fast and faint. Despite his improvised tourniquets, blood was oozing from the savaged stumps of the legs.
ABC,
Hatch recited under his breath:
airway, breathing, circulation.
He opened the man’s mouth, cleared out mud and vomit with a hook of his finger, then rolled him on his left side, squeezing
him into a fetal position. To Hatch’s great relief a thin stream of water came from the man’s mouth, along with a sigh of
air. Hatch immediately began a stabilizing pattern: a ten count of mouth-to-mouth, then a pause to tighten the tourniquet
around the left leg; ten more breaths; a pause to tighten the other tourniquet; ten more breaths; then a pulse check.
“Get my bag!” he yelled at the stunned group. “I need a hypo!”
One of the men grabbed the bag and began rummaging through it.
“Dump it out on the ground, for Chrissakes!” The man obeyed and Hatch fished through the scatter, pulling out a syringe and
a bottle. Sucking one cc of epinephrine into the hypo, he administered it sub cu in the victim’s shoulder. Then he returned
to mouth-to-mouth. At the five count, the man coughed, then drew a ragged breath.
Streeter came forward, a cellular phone in his hand. “We’ve called in a medevac helicopter,” he said. “It’ll meet us at Stormhaven
wharf.”
“The hell with that,” Hatch snapped.
Streeter frowned. “But the medevac—”
“Flies from Portland. And no half-assed medevac pilot can lower a basket while hovering.”
“But shouldn’t we get him to the mainland—?”
Hatch rounded on him. “Can’t you see this man won’t survive a run to the mainland? Get the Coast Guard on the phone.”
Streeter pressed a number in the phone’s memory, then handed it over wordlessly.
Hatch asked to speak to a paramedic, then quickly began describing the accident. “We’ve got a double amputation, one above,
one below the knee,” he said. “Massive exsanguination, deep shock, pulse is thready at fifty-five, some water in the lungs,
still unconscious. Get a chopper out here with your best pilot. There’s no landing spot and we’ll need to drop a basket. Hang
a bag of saline, and bring some unmatched O negative if you have it. But get your ass out here, that’s the most important
thing. This’ll be a scoop and run.” He covered the phone and turned to Streeter. “Any chance of getting those legs up in the
next hour?”
“I don’t know,” Streeter said evenly. “The water will have made the pit unstable. We might be able to send a diver down to
reconnoiter.”
Hatch shook his head and turned back to the phone. “You’ll be flying the patient straight through to Eastern Maine Medical.
Alert the trauma team, have an OR standing by. There’s a possibility we may recover the limbs. We’ll need a microvascular
surgeon on tap, just in case.”
He snapped the phone shut and handed it back to Streeter. “If you can recover those legs without risk of life, do it.”
He turned his attention back to the injured man. The pulse was lousy but holding steady. More importantly, the man was beginning
to regain consciousness, thrashing feebly and moaning. Hatch felt another wave of relief; if he’d stayed unconscious much
longer, the prognosis would have been poor. He sorted through his kit and gave the man five milligrams of morphine, enough
to give him some relief but not enough to lower his pulse any further. Then he turned to what remained of the legs. He winced
inwardly at the raggedness of the wounds and the shattered ends of bone; the dull blade of the ax was nothing like the nice,
neat saws of the operating room. He could see some bleeders, especially the femoral artery of the right leg. Sorting among
the refuse of his medical kit, he grabbed a needle and some thread and began tying off the veins and arteries.
“Dr. Hatch?” Streeter asked.
“What?” Hatch replied, head inches from the stump, using tweezers to fish out a
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