“I smell gasoline” Jack observed, “I’m going to disconnect the battery.” They wanted no source of sparks before they started the business of extricating Uli. Joyce affirmed his comment and turned to immobilizing Uli’s neck in a more stable manner with soft rubber covered foam blocks and tape. Jack pried open the hood of the car with a crowbar and cut sections out of the battery cables so that there would be no possibility of electrical sparks. He returned to Joyce, who had immobilized Uli’s head as best as she could. “It’s going to take a bit of time to get this door open, so I’m going in to further evaluate him” Joyce said. She got a big hammer from the tool kit, went to the rear of the car and smashed in what remained of the rear window and crawled in, trailing her medical kitbag.
The door to Uli’s side was deformed well into the drivers’ space, causing her to expect significant injury to the left arm, leg and probably the chest as well. Jack had gotten the prongs of a hydraulic device wedged into the seam between the door and door frame. The device, similar to a hydraulic jack used to lift cars for changing tires, could be operated electrically or manually. He deselected the electrical option for operation and selected the manual mode, no sparks wanted. Jack fitted the handle and began to pump the jack. The tortured metal began to groan as he pumped, the seam growing wider, the metal then squealed as he continued to pump, and finally gave way with a crack. Jack opened the door the rest of the way. Joyce said “O2 sat is up to 92, put his pulse is rising and BP decreasing (Classic signs of shock). I’m going to get an IV started”. Just then the two EMTs who had been looking at the driver of the other vehicle came over. “The other one’s gone” they said, and joined Jack and Joyce in getting immobilization boards under Uli in preparation for getting him out of the wreckage of the car.
They were led into the maze of wreckage, and to the side of what could be recognized as a commuter train car. Two firemen were working with a circular saw, just finishing an opening in the stainless steel side of the car. A section of the metal about a foot and a half square hit the tracks below with a clang. A woman’s knee was visible framed in the opening. Murph directed Karen to get in the car to monitor the woman and administer a fast acting anesthetic and narcotic. Karen took a smaller package from their bags, and followed their guide around the wreck to enter the car. Frank gave her a boost to help her enter through a window with its glass missing.
Without comment, Karl sorted through the bags and assembled a Gigli saw, betadine antiseptic, and esmark rubber bandage, a package of sterile surgical towels and sponges, and a large number twenty-one scalpel. He quickly doused the exposed knee with the betadine, opened the packages to make a small makeshift sterile field. Murph donned sterile gloves and handed another pair to Karl. Murph drew the rubber esmark bandage, a roll of rubber about four inches wide and four feet long, around the leg just above the knee, being careful not to get snagged on the sharp metal of the opening into the car. Then he tightened the tourniquet he had fashioned from the esmark and secured it with a Kelly clamp. Karl prepared the Gigli saw, a thin wire about a foot long with serrated teeth along its length, by attaching small handles to either end.
He gave the order to Karen to administer Propofol and Fentanyl. Anticipating this order, Karen had removed the syringes from her kit. She opened the IV drip wide and injected the Fentanyl, a powerful narcotic analgesic, and then the Propofol, a rapidly metabolized anesthetic. Propofol is metabolized so rapidly that it must be titrated, meaning that it is given in a continuous trickle after anesthesia has been established. Karen lightly flicked the woman’s eyelashes and noted the lack of a protective reflex response (an eye blink), a sign that anesthesia had been established. “GO!” She called out. She then began squeezing the IV solution bag to get as much fluid into the woman a quickly as possible. As soon as the bag emptied she pulled it off the line, spiked another bag and began to squeeze again. By increasing the volume of circulating fluid Karen would get the blood pressure as high as it would go, keeping the vital organs perfused and countering the effects of shock.
The whine of the gas turbine engine continued, with crunching and grinding noises coming from above, and the distinctive chop-chop sound of the blades grew quieter. “The transmissions gone” reported the copilot, and the chopper began a rapid descent. Without power to the blades, the Huey still made some lift from the blades in autorotation. This was due to the fact that they still had some thrust and momentum. Essentially, the Huey had become a glider. If they had been in hover when they were hit they would have fallen right out of the sky. Matt banked the Huey towards the source of the purple smoke figuring he could be sure of freindlies there. The Huey’s glide path carried them past the purple smoke into a running landing, the nose touching first, then the tail slamming into the ground. Fire broke out in the engine above the crew. Bandaid helped Gremlin to his feet, as they had both been flung out of their seats into the rear bulkhead by the force of the landing. Gremlin screamed in pain when Bandaid touched his left shoulder, the arm dangling uselessly. Bandaid slung the strap of the rucksack containing his medical supplies over his shoulder, helped Gremlin out the door, and grabbed one of the M-16s and a bandolier of magazines for the assault rifle. The magnesium-aluminum alloy of the Hueys skin and frame had started to burn with its distinctive blindingly white flame. Matt and Sonny were out of the chopper and had taken up positions facing outward, weapons at the ready.
As Bandaid and Gremlin reached the pilots all four of the chopper’s crew ran and took cover on a small knoll among the tall grasses. A squad of Gis came running from the nearby tree line, grabbed the four airmen, and raced hell for leather for the trees. The distinctive deep pounding sound and rhythm of a Chinese .50 caliber could be heard among the other small arms fire. “That’s the bastard that got us” said Sonny. The firefight raged around them, and then mortar rounds began to explode on the opposite side of the LZ. The Chinese .50 caliber was silenced. Bandaid diagnosed Gremlin with a dislocated shoulder, placed his foot in Gremlin’s armpit, took a grip on his wrist and pulled hard as Gremlin screamed. The dislocation was reduced. Bandaid took a triangular olive green bandage from his kit and immobilized the arm. Then he busied himself with the wounded. The second half of the longest day of Bandaid’s life had begun: He immediately had two more patients as well as the two they had come for. Later that afternoon Hueys with gunship escorts evacuated the four medivac crewmen and four additional wounded Gis. The two critical wounded they had been called in for had died, despite Bandaid’s best efforts. Their olive drab poncho wrapped bodies were reverently placed on the floor of one of the Hueys. Bandaid was reduced to a limpness of fatigue and delayed shock next to his patients in the other Huey.
Karl cut away Uli’s clothes to expose his chest and abdomen, and then poured an iodine solution over all of it. Karen, gowned and gloved was setting up her sterile table with the instruments needed for surgery in the abdomen and chest. The table would not be counted as usual for surgery to save time, and the full body CAT scan would reveal if anything was left behind, as it could be removed later when the immediate crisis had passed. Murph pulled out the Heimlich valve from between the ribs, used a scalpel to slightly enlarge the incision, and pushed in a chest tube that had a sharp metal spike through it, called a trocar. As soon as he felt the trocar through, Murph removed the trocar, pushed the chest tube in to the depth his experience told him would be sufficient, but not too deep, connected it to the pleurevac, and then connected the pleurevac to suction. The pleurevac provided a space for the collection of fluid and air from the chest, and a water seal that kept the suction at a regulated level, and also prevented back flow into the chest if the suction was disconnected or discontinued. It began to bubble.
Nan sewed the tube to Uli’s skin with a suture to prevent it from being accidently pulled out. Steve, the ultrasound technician that Karl had summoned began the FAST scan with a probe that had been placed in a sterile plastic cover. Murph watched the screen of the ultrasound machine along with Steve. Starting with the left lower quadrant, Steve worked the probe so as to miss nothing, then moved on to the right lower quadrant, then to the right upper quadrant, and finally to the left upper quadrant. “There!” he and Murph exclaimed in unison. The scan showed a ruptured spleen and a large collection of blood called a hematoma. Murph quickly applied a disinfectant hand cleaning solution to his hands, worked it in and held out his hands and arms to Karen for gowning and gloving. Chloe and Nan had finished drawing multiple tubes of blood, which Nan took to the stat lab. Chloe turned to assisting Kurt.
“In any case, come and sit that I can examine you.” Uli sat in the chair Aesculapius had placed behind him. Mumbling to himself, Aesculapius removed the bandages and dressings. He flexed and contracted Uli’s joints, thumped his chest and back, put his ear to Uli’s chest, felt his pulses at several places and passed his hands over all the injured areas. The snake extended its head and its tongue flicked at Uli. Almost immediately, Uli began to feel better. Looking at himself, he found all his cuts and bruises healed. Aesculapius nodded his satisfaction, and took a small vial which he held out to the snake. The snake put its fangs over the edge of the vial and a few drops of an amber fluid collected in the vial. Aesculapius added some clear fluid from another vial, swirled it around to mix the now cloudy fluid and then handed the vial to Uli. “Take two drops of this every morning with some wine and see me again in a week.” With that he turned and walked out the door, the staff swinging in time to his sprightly gait, trailed by the servant.
She was barefoot, dressed in jeans and brightly colored blouse, with a heavy looking silver and gold necklace and wide silver bracelets, looking as if she had stepped out of the pages of a J. Crew catalog. “Help yourself and come sit with me” she said. Uli realized that he was starving, and heaped a plate with eggs, bacon and a thick slab of fresh baked bread. He filled a second plate with cantaloupe, strawberries and chunks of pineapple. He sat down across the table from his hostess. “My name is Ulrich Steiner, but you can call me Uli, and I am extremely grateful for all that you and your servants have done for me. From a comment that Aesculapius made, I take it that I am in some alternate world to my own.” Placing the heavy hand blown glass that she had been drinking from on the table, the woman replied to Uli “I am Calypso, and to follow your world’s custom of using informal names, you can call me Callie. This is my island, and indeed you are in, as you said, an alternate reality. I have had visitors here from many different worlds, including your own. Usually, my visitors have been sent here directly or indirectly by one or another of the gods, and it usually falls to me to help them get on with their quests. Once in a while, a visitor just happens to get here by random chance, but you do not have the aspect of one of those.” Uli looked at her eye to eye and replied “I can’t say whether I came here by design or by chance, but as pleasant as your island and your hospitality are, I would get back to my own world”.
Then perhaps you are a Byronic hero.” Uli regarded Calllie with curiosity “What in the blazes is a Byronic Hero?” “They usually display a combination of the following traits: “Arrogant, Cunning, Disrespectful of rank and station, distasteful of social norms, jaded and world weary, they have a troubled past, are mysterious and charismatic, self destructive, seductive or sexually attractive.” “That sounds like an anti-hero” remarked Uli. “Anti-heroes are altogether different” said Callie “they are conspicuously contrary in character to a hero. They are selfish, cynical, moody, prone to violence, lack physical prowess, but often pursue noble motives by bending or breaking laws and social norms. For them the end justifies the means.” “No I don’t think I am any of those” Uli said. “Then there is the Picaresque Hero” Callie said. “The picaresque hero is often of lowly caste or class who lives by his wits in a corrupt society, confounding his foes of superior station with clever stratagems to humorous effect.” “No,” said Uli, I don’t fit that bill either. That sounds a lot like Huckleberry Finn.” Callie replied “I know this Huckleberry fellow. He passed through here some years back with a ship’s captain named Twain. They were a very entertaining pair.” Uli stared at Callie in amazement.