Two weeks into the New Year, a nurse stuck his head into the treatment room where she and Kincaid were putting the finishing touches on a laceration and said, “Boss, just got word from an advance scout. Hank and them’s coming in hot. Found someone in an old barn up by Oren.”
“We know how bad?” asked Kincaid.
“Sounds septic. Wound infection, looks like a bite.” He paused. “Boss, they say he’s a Spared.”
At that, she almost gasped. Her first thought was that Tom had been bitten. Could it be? No, it couldn’t be Tom; too much time, nearly two months, had passed.
“Get me a gurney for out front, and get a tech in here now. I’ll be right there,” said Kincaid, and then to her: “Go on, finish up. We don’t got all day.”
“Sorry.” She concentrated on that last stitch, then tied and snipped. She did it all calmly enough, but her heart was trying to break through her ribs. She reached for a packet of gauze bandage, but Kincaid was already stripping off his gloves. “Leave it, leave it,” he said. “I need you with me.” He snapped his fingers at a tech, pointed at the patient, and was out the door with Alex on his heels.
Dashing down to the lobby, they pushed out through the double doors as first a single rider thundered down the approach road, followed an instant later by a horse-drawn flatbed sleigh. A man she didn’t know, but who must be Hank, was handling the horses; Alex spotted two boys in the sled. With a little stab of surprise, she recognized Greg. What was he doing here? He’d gone out with Chris.… All thoughts of that vanished when she realized that Greg was doing CPR.
“Whoa, whoa!” Hank shouted, as the horses charged around the breezeway. He pulled back on the reins hard enough that one of the horses reared in protest. “Whoa, easy!”
The two horses stamped and jolted to a shuddering halt, and then Kincaid was dashing for the sleigh, hoisting himself onto a runner. “What do we got? How bad is he?” Then he got a good look and said, “Oh Lord.”
Heart jamming into her throat, Alex crowded in beside Kincaid and then didn’t know whether to sob with relief or fury.
It was not Tom. Of course, it wouldn’t, couldn’t be. The boy was young, no older than eight or nine. And Greg had ripped open the boy’s jacket and shirt to do CPR, so she could see the birdcage of his ribs and the knobs of his shoulders. His eyes were closed and sunken, and he was deathly pale, his lips almost blue. The right leg of his jeans was shredded and oozy, and the smell was overpowering. Her breath thinned as she caught his smell: rotting and fetid.
“Found him by his lonesome in a barn. Arrested on the road,” Greg said, without breaking stride. He was sodden with sweat, breathless from exertion. “Been at this about … four-one-thousand, five … go.” At his signal, the other boy who’d preceded the sleigh up the road—she thought his name was Evan—squeezed an ambu-bag, forcing air into the unconscious boy’s lungs. Greg ducked his head into his shoulder to smear away sweat. “Ten minutes now.”
“Ten minutes too long,” Kincaid said. He turned as Paul, an elderly male nurse with a permanent beer belly, rattled up with a gurney. “I got this, Paul. I want IVs set up, large bore, and get me a CVP line—”
“I don’t know if we got one, Boss. We’re so low—”
“Find me a damned line, Paul! Don’t you show your face without one—you got that? And get out the crash cart, whatever you can scrounge. Move it!” As Paul hurried back inside, Kincaid wrestled the gurney alongside the wagon, butting it in place with his hips. “All right, people, bells and whistles on this one. Let’s—” He paused, a curious expression creasing his weathered features.
Hank, who’d already leapt down to help move the injured boy to the gurney, looked over at Kincaid. “Doc, you okay?”
“Yeah, just a sec. Greg, hold up there, let me check for a pulse.” And then Kincaid stared right at her, grabbing her eyes, and she read the question as if he’d spoken it aloud: Is it safe?
It was a question she knew would come eventually, one they’d never asked before.
“Is there a pulse?” said Greg.
Kincaid didn’t answer. She knew she couldn’t afford to be wrong. The dead-meat stink was unmistakable, but it was also different: gassy and almost sweet.
“Doc?” Hank asked.
Dead meat, yes; that’s infection, not the Change. She gave Kincaid the barest of nods.
“I’m not getting anything. Greg, keep on those compressions. All right, let’s go,” Kincaid said. “Move him on three. One, two …”
Straddling the gurney, Greg continued CPR all the way to the treatment room as Evan trotted alongside with the ambu-bag. She and Paul started the IVs, and Paul had found a CVP line somewhere that Kincaid now threaded into the boy’s subclavian vein.
“This is the last of the bicarb,” Paul said, handing Kincaid a syringe. “You sure you want to—”
“Can’t think of a better time. Push that on in there.… We got atropine? All right, hold on.… Greg, stop compressions.” Eyes closed, Kincaid listened through his stethoscope, then said, “Hold on, I think … Paul, push that atropine in.”
They waited. Greg was panting, the sweat running in rivulets down his neck. Paul glanced at a stopwatch. “Fifteen minutes, twenty seconds, Boss.”
“I got something,” said Kincaid, glancing at his watch now and counting under his breath. “Paul, get me a BP.”
“Sixty over thirty, Boss.”
“All right, that’s not great, but it’s not terrible. This boy might make it after all.” Kincaid snapped on a pair of gloves. “Let’s see what we got. Alex, I need your hands—glove up.”
The stink that pillowed from the boy’s left thigh smelled of rot and was bad enough that even Kincaid winced. Someone had tried to bandage the wound, but the wrappings were soggy and stained green and yellow with pus. Alex felt her stomach turn over as Kincaid peeled away the oozy gauze wraps. Pus, yellow-green as snot, puddled in the open wound, and the shredded flesh along the wound’s margins was black. Thin red streaks coursed the length of the boy’s thigh to his knee and radiated to his crotch.
“Seventy-five over forty.”
“All right,” Kincaid said as he began sponging away the mess with gauze pads. On the gurney, the corners of the boy’s eyes twitched, and then he let out a low moan. “I know,” Kincaid murmured as he worked. “I know it’s bad, son. I’m sorry, I know. You just hold on there.”
“That’s good, right, Doc? His pressure?” asked Greg, arming away sweat.
“Well, it’s not bad. You boys catch a name before you hightailed it outta there?”
“Naw. Like I said, he’s been out of it.”
“Okay. Alex, draw up a couple fifty-cc syringes of saline and irrigate the hell out of this, would you?”
Alex was glad for something to do. As she pulled up the fluid, Greg said, “You can save him, right?”
“We are certainly going to try. He might lose that leg, but one thing at a time. Greg, get yourself into some dry clothes before you catch your death. How’s that arm of yours? Either you boys hurt?”
“Naw, everyone got out okay, Doc,” said Greg, flexing the arm where he’d been wounded three weeks before.
“Good, I didn’t want to be patching you up again. What about the others?”
“They’re about a day behind.”
“All right. Now you two get on out of here and let me work. Paul, get me a surg kit; we’re going to be doing some cutting here, and I want some Cipro in him right now.”
Paul pulled a small glass vial from a mostly empty med cart. “Boss, that’s the last of—”
“The last of the Cipro, I know. Just do it, Paul. Alex, you can stop irrigating. Cut away the rest of his clothes, so I can see what I’m doing.” Kincaid glanced at her over his mask. “Let’s just hope this poor boy stays out.”
As Kincaid cleaned and debrided the wound, she worked a pair of heavy surgical scissors through the boy’s pants, cut those away, and then attacked what was left of his shirt. Slicing through flannel, she suddenly recoiled. “Oh, gross.”
“What?” asked Kincaid.
“I think …” The boy had another large bite wound, raw and weeping and filled with what looked like white rice—and then the rice moved. “I think they’re maggots.”
“Really?” Kincaid took a long look and then nodded. “Excellent.”
“Excellent?” Alex goggled at him. “What’s good about maggots?”
“Because they eat the dead stuff and leave healthy tissue behind,” said Kincaid. “See the margins there? That’s all viable tissue. Alex, see if you can scoop a couple dozen of those little guys onto some gauze.”
“Sure,” she said faintly, not at all sure she wouldn’t pass out. She couldn’t get rid of the image of flies buzzing over the boy’s wounds, landing and laying eggs.
And then she thought, Hey, wait a minute.
“You want some help?” asked Paul, although he sounded like he’d be just as happy if she refused.
She did not disappoint. “No, I’m good.”
“Oh, we are going to give you bad boys a regular feast,” Kincaid said. “Warm you maggies right up.”
“They look pretty warm to me,” said Alex. “They’re moving all over the place.”
“He is the only person I know who would get excited over a bowl of maggots,” Paul observed as he pumped up the blood pressure cuff again. “Ninety-five over sixty-two.”
“I like the sound of that,” Kincaid said. “Paul, get us another catalytic heater in here and then see if you can scrounge us up a plastic container and an apple.”
“You want to eat?” asked Alex. “Now?”
“Eventually.” He winked at her over his mask. “Apple’s for the maggies. Old fishing trick. The maggies’ll keep somewhere cool and dark for a couple weeks.”
“We could start our own maggot farm,” said Paul.
“That is a very good idea,” said Kincaid. “We find somewhere warm enough. Flies’ll die otherwise.”
“I was joking.” Paul rolled his eyes. “Be right back. Boss, I hope you and your maggies will be very happy.”
“Oh, we will,” Kincaid said, “we will.”
Great, now she’d be babying maggots for the foreseeable future. Alex thought it would be a really long time before she looked at rice the same way again.
Presuming, of course, she ever saw rice again.
“That’s it,” said Kincaid. After peeling out of his gloves, he dragged the mask from his face and sighed. “Wish I hadn’t had to cut away so much tissue to find healthy muscle, but can’t be helped. Between me and the maggots, though, those wounds might just granulate in. They won’t be pretty, but if he’s lucky, he won’t lose the leg.”
“Is he going to make it?” asked Alex.
Kincaid’s mouth set in a grimace. “If things were even halfway normal, I’d say only fifty-fifty. He’s already arrested once, and he’s septic. Fluids’ll help, but we only got a couple more bags and no more antibiotic. If his blood pressure falls again, I got nothing left to give him.”
“Maybe it won’t,” said Alex. “Maybe you got to him in time.”
“Maybe. Be a damn shame, all this effort and risk for nothing. Just got to hope for the best.” He looked behind Alex. “Greg, take this girl home before she passes out.”
“Just waiting on you, Doc,” said Greg from the door.
Night had fallen hours before. Now she glanced at Ellie’s watch and saw that Mickey said it was pushing ten. Untying her mask, Alex said, “Have you been there the whole time?”
“All”—Greg checked his pocket watch—“six hours and twenty minutes.”
“And it’s way past my bedtime,” said Kincaid. He looked as if he was going to fall down, and when he dropped into a chair, he let out a long groan. “Many more nights like this, and I’m going to be old before my time.”
“You need to rest,” Paul said. A huge butterfly splotch stained the chest of his scrub top, and a sheen of sweat glistened on his ruddy scalp. “We’re not kids anymore.”
“I heard that,” said Kincaid.
“You should get some sleep,” Alex said. She was dead tired and she could smell herself. “I can watch him for a while. All I need to do is wash up a little bit.” When Kincaid opened his mouth to protest, she said, “Come on, if something bad happens to you, we’re screwed.”
“She’s got a point,” said Paul.
Kincaid grumbled some more but eventually gave in. “I’ll bed down here. You come get me in four hours,” he said as Paul ushered him out. “Don’t you forget.”
“I won’t,” she said, and then after he was gone: “Maybe.”
“You really do look beat,” said Greg, who looked only marginally better than she felt. “You want company?”
“I’m fine,” she said, and then ruined it by yawning. “Look on the bright side. You won’t have to come get me in the morning.”
“I’ll bring you a change of clothes. Chances are Doc is going to let you knock off tomorrow, though.”
“Yeah, well.” She glanced at their patient, whose color was only a little less white than his sheets. His dark hair looked artificial, like something penned in with a Magic Marker. Then she began to gather up soiled instruments. The plastic garbage bags were overflowing with soiled and bloodied gauze and the remnants of the boy’s clothes. “Let’s see what happens. You should go home.”
“I’m gone.” Greg tipped her a wave. “Just don’t tell Chris.”
Now what, she thought, as she began tidying up the treatment room, would I tell Chris exactly? Oh, bad Greg left me all by my widdle wonesome?
She had thought of Chris, too, and often. Not obsessively, not the way she had with Tom—but that had been different, hadn’t it? She wasn’t sure now what she’d felt with Tom, but they’d fought together and he’d been hurt, maybe dying, and she’d been on a mission to save him.
Yeah, like, fail.
She took the boy’s blood pressure, noted his pulse, checked his IVs. Then, gathering up a tray of soiled instruments, she dumped them in alcohol before crossing the hall to retrieve their makeshift steam sterilizer. She carried the sterilizer outside, set it on a small propane stove, and lit the stove. While she waited for the steam to build, she washed the instruments, then placed them in the sterilizer. It would take about twenty minutes of steam to disinfect the instruments, heat being their only …
Heat.
Heat.
Staring down at the tiny ring of blue flame, huddled in her scrubs and a thin yellow nurse’s gown, she frowned. Something about heat had been bothering her for hours. But why?
Kincaid’s words came back: Flies’ll die in the cold.
That was right. Flies died in the cold. Leave a dead anything out in the cold, and there would not be blowflies, not in winter. She had seen no flies in Honey’s stable at all, not even four weeks ago. She’d seen more than a few dead bodies on the road, but no flies. And at the gas station, dead Ned …
“No flies,” she murmured. But the boy had maggots. Maggots could only come from flies, but if they’d found him in an abandoned barn, how had he stayed warm? What would’ve warmed up the barn enough so flies could live in winter?
Okay, maybe the boy had started a fire. No, that couldn’t be it. That boy was out cold when they brought him in; he was just the other side of dead. Hell, he had been dead.
Which meant that someone else started the fire. Someone else kept the boy warm. There had been someone else, maybe more than one person.
But Greg had said, Found him by his lonesome in a barn.
No, Greg. Not hardly. And they’d been nearer Oren … what were they doing there? They’d been on their way to Wisconsin, unless there’d been a change in plans. Hadn’t Chris been up to Oren already? Right; that’s where he’d gotten the books. So Chris had been there not long ago.
Kincaid: Either you boys hurt? You boys get a name?
If Kincaid was worried about that, he must’ve figured there was a fight. Getting a name, though, suggested not only other people but … a conversation? Or—oh my God—a trade? Something worse?
Because Kincaid knew: they hadn’t just found this kid; they hadn’t rescued him.
They’d taken him.