FORTY-SIX

When they returned to Union Grove just after sunset, Seth and Elam took the gunshot man directly to Dr. Copeland’s house. The doctor had been teaching his son and medical assistant, Jasper, twelve, how to tie trout flies, specifically this evening a buff caddis fly imitation constructed solely of deer hair: wings, body, and tail. The deer hair was hollow and, when it was tied off on the hook, little air pockets were created that made the fly unsinkable. It was also nearly indestructible. You could use one fly all season long, he told the boy, and he had. The doctor knew that the delicate work required similar dexterity as surgery.

When the rangers came to the door and pointed to the figure hunched in the saddle, the doctor rushed outside with a candle lantern and asked his wife, Jeanette, to prepare the lab for surgery. He gave the lantern to his son to hold while the three men undid the lashings and carefully lowered the man off the big black horse. The doctor had obtained an articulated operating table from Glens Falls Hospital, his employer in the old times, before it closed permanently. They brought the man inside and put him on it. Jeanette set up a complex array of candles and mirrors on adjustable wooden stands and fired the alcohol burner of the autoclave. Then she cut the man’s blood-stiffened clothes off with scissors while the doctor and his son changed into surgical gowns and scrubbed at the lab sink first with lye soap and then with full-strength ethyl alcohol. They cleaned off the patient with alcohol, put in a 110 millimeter plastic oral airway, inserted a rectal suppository of opium, the only anesthetic available, and proceeded to inventory his five wounds. The worst one had shattered his gallbladder, clipped part of his liver, and transited the pyloric canal of his stomach, finally exiting the right external oblique muscle. One lodged in the upper lobe of his right lung. One passed through his left upper trapezius muscle, missing the carotid artery and jugular vein by a few millimeters, and two had gone clear through the meaty part of his left thigh near the groin, apparently meant to unman him, but failing to.

“What a goddamned mess,” the doctor said, as he retracted an approach to the lung wound through the first and second ribs. His wife and son assisted as he dissected and entered each region, found the lodged bullet, sutured tissues and muscles, sponged out fluids, put in drain tubes, and sterilized the thoracic and abdominal cavities with alcohol as best he could. He had Jasper stitch up the outer layers, while he moved on to the next site. They finished in just over four hours. The patient’s blood pressure had gone as low as 72 over 40 but he was alive. They left him in place on the table, knowing that they would need more help to move him to a bed, if he lived through the night. The rangers had gone home, of course. Jeanette, too, had staggered back to the house in a pall of exhaustion.

“How do you like performing modern surgery in medieval conditions?” the doctor asked Jasper as they wearily took off their scrubs.

“You still have the knowledge,” Jasper answered. “That’s what matters.”

The doctor cranked his head and could not help smiling at the boy, despite his fatigue.

“You’ll be a better doctor than me when your time comes,” he said. “Say a prayer for our patient before you tuck in. Go on now.” He kissed the boy on top of his head and shoved him toward the door.

When Jasper left, the doctor went into the front room office of the old carriage house, poured himself three fingers of pear brandy in a pony glass, and stuffed some loose marijuana in a pipe he had carved himself. When he felt the mingled buzz come on, he returned to the lab, checked the patient’s saline and glucose lines, and took his blood pressure again. It had climbed a bit to 78 over 46. He sat on a stool beside the operating table sipping his brandy, only two of the twenty candles still burning, and calculated that the man had roughly a 15 percent chance of surviving his ordeal. Arduous as it was, the surgery itself wasn’t heroic. The doctor had seen much more complicated cases come through the Glens Falls Hospital emergency room in the old times: car and especially motorcycle crash victims, industrial accidents, shotgun wounds that just shredded people. The trouble, of course, was that he had no antibiotic medicines. The patient would be extremely fortunate to escape infection, or overcome it when it developed. Hard as people tried, and despite the persistence of knowledge about sanitary practice, the new times were septic times.