CHAPTER 9

           To place economic security in the hands of the government is quite literally a return to our medieval ancestry where feudal lords took responsibility for the economic survival of the serfs working their estates.

        —LANCASTER R. HILL, Climbing the Mountain, SAWYER RIVER BOOKS, 1941, P. 18

Lou estimated they were five miles from the lodge, assuming they had averaged ten minutes per mile over the uneven terrain. The concierge had warned him that cell phone signal strength in the mountains was spotty at best. After failing to get a dial tone, Lou checked the time. He had a new concern. It could take two hours to get back to the lodge and return with help—probably not much less even with an ATV. By that time there could be severe tissue damage caused by the tourniquet. The other potential danger was one he could not shake from his mind—severe shock and cardiac arrest.

Despite what Cap had said right before he stumbled and fell, he was never hot about making this run. Lou had talked him into it. Now there was no way he could allow him to die. The tourniquet had to be loosened as soon as hemorrhaging had clearly been stopped. Somehow, someway, Lou would get the man out of these woods without leaving his side.

“Listen, buddy,” he said, his voice managing to stay even. “This is going to be the tough part.”

“Do … what has … to be … done,” Cap answered, stopping between words to breathe.

With a few decent sips of water, and the bleeding slowed to an ooze, the physical evidence of shock had begun to ebb. As Lou had done with the tourniquet, most of the tools he needed to complete the next phase of the process would have to be improvised. Most medical schools and hospitals, Eisenhower Memorial included, offered a variety of continuing education classes on a regular basis. Six months back, Lou had taken a two-day wilderness emergency medicine course. Ironically, his decision to do so was inspired by his newfound passion for trail running. The class, taught almost exclusively by incredibly competent paramedics and specially trained EMTs, with a few ER docs sprinkled in, was well organized and terrifically informative. With two jobs and a kid, courses and lectures were often triggers for him to catch up on sleep. But fortunately, not that one.

Lou performed a quick, repeat physical. Cap was going to need all of his will and his strength just to survive the pain of what was about to be done to him. The exam offered Lou a whisper of confidence that his friend could endure what lay in store for him without slipping back into shock. Looking over the leg, the ugly bent angle, twisted like a wrung-out dish towel, the bone splintered and frayed at the edges, Lou questioned his own ability to inflict the required amount of pain. But the leg had to be straightened or the chances of saving it were negligible.

No matter how hard he tried to reason away the guilt, it kept gnawing at him. If only he had been less insistent. If only he could have been less exuberant.

If only …

Lou forced those thoughts to the back of his mind. For Cap’s sake, he had to stay in the moment, fully focused and committed to the process.

“I’ve got to straighten out your leg so I can splint it,” Lou heard himself say, his voice actually breaking between words.

Cap’s gaze seemed to sharpen. He eyes locked with Lou’s. There was no trace of doubt or fear on his handsome, bloodied face.

“You do what has to be done, Doc,” he managed.

“Actually, Cap, to do what has to be done, I’m going to need your help.”

Cap brushed the back of his hand across the damp bandage on his forehead.

“Tell me,” he said.

The misty rain had largely let up, but the world was still slippery and cool. To make matters more difficult, bugs had reappeared and were beginning to attack Lou’s face and naked back.

“Straightening and splinting your leg is a two-person production. Unfortunately, you’ve got to be one of those people. I’m going to get a couple of thick branches to be the splint. Then I’m going to tie the rope around your right ankle and loop it around that tree by your foot. When I say push, I’m going to need you to push your left foot against the tree with all your strength.”

“And you’re going to pull the rope.”

It was a statement, not a question.

Lou nodded. “If together we have the strength to do this, we’re going to pull the two segments apart and line them up the way they should be. Then I’ll keep the tension on by wrapping the rope around the tree, and you keep the tension on by pushing. Got it?”

“Sounds like fun.”

“When I get the rope tied around the tree, I’ll use our bandages and maybe your shirt to hold the splint in place. The setup will make sure those sharp bone ends don’t cut anything they haven’t cut already.”

“Got it.”

It sounded straightforward enough, but the truth was, Lou had serious doubts whether or not the two of them could pull it off. They had to overcome the tight spasm of the quadriceps group, the strongest muscle in the body. Just how strong Cap’s quad was would become clear in a few minutes.

Splint ’em where they lie, Lou thought, recalling one of the lessons from the course. Splint ’em where they lie.

It took five minutes of tromping through mud and old sodden leaves before Lou found a suitable pair of branches, each about a foot longer than Cap’s leg. One of them had a fork at the end, which was going to be helpful. Lou did not have enough ACE bandage to secure the splint in place, so he cut the backpacks and Cap’s shirt into strips that, along with some excess rope, would do the job.

But first, they had to straighten out his leg.

Lou glanced over at his AA sponsor, who mercifully appeared to have drifted off.

“Buddy, you got to get ready,” Lou said, gingerly securing the rope around Cap’s right ankle. Even the slightest movement of the leg induced a groan. This was going to be bad.

“I’m ready,” Cap said.

Lou released the rope and felt around the ground for a sturdy stick, which he gently slipped between Cap’s teeth.

“Here you go, pal. Just pretend you’re on a Civil War battlefield and bite down on this anesthesia machine when it hurts.”

“It already hurts.”

“I mean really hurts,” Lou said.

“Swell.”

“I got no whiskey like they had at Gettysburg, but I promise that if I did, I’d let you have as many swigs of it as you wanted.”

“Just do what you need to do.”

“Okay, this is it. Five … four…”

The rope tightened around Lou’s wrist as Cap preempted the countdown by jamming his foot against the tree. Lou gave the rope another wrap around his own wrist and wedged his foot against a boulder to help with leverage.

“Three…”

“This wasn’t your fault,” Cap said through the stick. “I wanted to come on this run.”

“Two…”

“Let’s do this!”

“One! Push, Cap, push!”

His gaze fixed on the fracture site, using all the strength he could summon, Lou pushed against the boulder and pulled on the rope. Cap cried out as he forced his good leg against the tree. After a few seconds, he spit the stick out and bellowed, the sound echoing off the canopy of damp spring leaves. Then, like a fast passing train, his screams stopped. His eyes were narrowed and utterly determined, as if he had crossed a threshold of pain tolerance. He was hyperventilating rapidly through his nose.

Lou felt his friend’s intensity, and called upon his own legs for more power. Finally, millimeter-by-millimeter, the jagged, bloodied bones began to slide apart. The spasm in Cap’s quad was lessening. Lou’s teeth were clenched as he ignored the nylon rope cutting into his wrists and demanded still more from his legs, which were themselves beginning to spasm.

The femur ends moved past one another and disappeared into the gash.

“More pressure, Cap. We’re doing it! We’re doing it! Force that left leg out straight.”

The man responded, and Lou sensed another few millimeters of movement. With the tourniquet still tight, there was essentially no bleeding. Maintaining maximum tension, he wrapped the cord several times around the tree. The femur fragments held.

“That’s it, baby! Keep the tension on. I’m going to set the splint now. You’re going to make it. You’re going to make it off the battlefield and we’re going to win the war. Then you’re going to go home and get elected the first black governor of Virginia.”

There was no response. Wide-eyed, Cap was staring straight up, awake and unconscious at the same time, but still maintaining the force necessary to keep his leg extended.

It took Lou several minutes to wrap the ACE bandages and nylon straps from what remained of his backpack around the sturdy branches he had placed alongside Cap’s leg. He then created another wrap around Cap’s foot with the remaining strips of backpack fabric.

“Looking good … looking good,” he said.

But there was more to be done. Undoing his shoelaces and knotting them together, he secured one end to the fork in the branch at the bottom of the splint, and pushed the other end up and underneath the nylon strips around Cap’s foot. This would hold the traction on the leg.

Cap’s eyes had closed, and for the briefest moment, Lou thought he might not be breathing. In fact, that was an issue. He had at last surrendered to the pain. His breathing was shallow, and his pulse, still without much force, had slowed to ninety. But he was no longer conscious.

“Nice going,” Lou whispered. “Damn, but you are tough.”

The rain had stopped completely now, and the sky had begun to brighten. Lou lay what few bandages he had across the wound, rocked back on his haunches, and examined the splint. Given the circumstances, it was about as good as it could get.

For several minutes, he caught his breath and debated between trying to claw his way back up the steep hillside to the trail, or building some sort of A-frame litter and heading down toward the river. It would be hard going—a few feet at a time over nasty terrain, but in the end, the thought of leaving Cap was unacceptable, and he opted for the litter, provided he had enough rope.

Naked from the waist up, and now starting to shiver, Lou stood, stretched, picked up the knife, and began casting around for some branches he could lash together—hopefully ones still on the ground.

It was at that moment he heard loud rustling coming from the dense woods downhill from them.

There was no chance it was the wind.