Page 9 of Close Pursuit

This girl was too narrow-hipped and too damned young to be having babies, and the delivery had torn the crap out of her. She was bleeding heavily, and one supply he and Katie had not been able to haul in had been refrigerated whole blood.

Her uterus wasn’t contracting anymore, but it should be. She still needed to deliver the placenta. If even part of it was retained in the uterus, this girl would die, if not from blood loss, then from infection.

Placing one hand on her abdomen to stabilize the uterus, he reached inside her and prayed the placenta was sitting in the cervix. It wasn’t. Of course, it wasn’t. Everything that could go wrong with this delivery was.

“Give the baby to Grandma. I need you to inject two milliliters of fentanyl intravenously into the girl, stat.”

Katie’s eyes widened as she realized what was happening, but she nodded and moved fast, finding the powerful pain killer, loading it in a syringe, and locating a vein in the girl’s elbow. She inserted the needle and swore. She tried again, and he breathed a sigh of relief as he saw her thumb push the syringe’s plunger down.

The drug took effect fast, and he went back to work, stabilizing the uterus with his left hand while he reached into the girl’s uterus as gently as he could and manually detached the placenta from the uterine wall.

Even with the fentanyl racing through her system, she screamed in agony.

He worked fast, racing against time. The girl’s screams quieted. Not that he wasn’t causing her unbearable pain. She was merely bleeding out. Dying.

“Tell her to fight,” he ordered.

Katie leaned down to speak in the girl’s ear.

“Say it like you mean it,” he growled.

Katie raised her voice and demanded that the girl open her eyes. That she live for her son. While Katie tiraded like a drill sergeant, he fought like hell to do what he had to do.

It took about five minutes to remove the placenta and a few to verify it had come out intact. Finally. Something had gone right in this disastrous delivery.

He bagged the placenta and turned around to repair the external damage to the girl and stared in shock. Katie had an IV needle in her own arm attached with surgical tubing to a matching needle in the girl’s arm. Dark red blood flowed through it from Katie’s arm into the girl’s.

“How much have you given her?” he snapped.

“I’ve only been at it for about three minutes. I’ll give it another five minutes, and that should be around a pint of blood. I’m O negative, by the way. A universal blood donor.”

“That’s noble of you. But we’ll see dozens of patients the next few months. You can’t give them all blood. Next time, have a family member donate it.”

Katie managed to look both chagrined and defiant at the same time. He couldn’t fault her, though. It was a generous act. Even if it was impulsive and risky. She would need all her blood to carry oxygen at these high altitudes.

Katie’s transfusion did wonders to stabilize the girl’s vitals. He removed the IV from Katie’s arm, sterilized the needle prick, and bandaged it carefully. Then he settled down to the slow, meticulous business of stitching up the girl’s class four tear.

Although it took longer to do, he made sure all the stitches were internal and hidden. There mustn’t be any evidence of modern medicine, no sirree.

As he was finishing up and had just asked Katie to give the girl a massive shot of antibiotics to help ward off an infection, Grandma piped up. “How much longer? I must have her home by dawn.”

“She can’t move!” he exclaimed. “I just sewed her back together. I don’t need her running around, or walking for that matter, and tearing out all her stitches.”

Grandma looked alarmed but stubborn. “We must leave.”

Katie murmured in English, “We have to find a way to get her home.”

Sonofabitch. “Where do you live?” he asked Grandma in resignation.

The woman answered, “At the edge of Karshan village.”

“I’ll carry the girl to the Land Rover and drive as close as I can without being spotted. I’ll carry her on foot as far as I can,” he announced.

Katie replied, “None of it is safe.”

He rolled his eyes and scooped the girl up off the cot. The trip down the hill was an exercise in precarious balance, but he made it to the Land Rover without dropping the exhausted girl. He set her gently in the front seat and hastily took enough boxes out of the back for Grandma and Katie to have a spot to sit.

The drive didn’t take long. Thankfully, the family’s home was far enough outside the village that he was able to drive within a few hundred feet of it and find a stand of dead brush to park behind.

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