Chapter 4

CHAPTER 4

Later, he couldn’t quite remember how they bulled their way through, only that the sergeant corralled two other Marines and, together, they formed a wedge and rammed their way through the throng, slipping and sliding on something on the ground. Not blood, but something hard and round: ball bearings from the bomber’s vest.

“Doc!” Driver’s face twisted in a kind of agony. Clapping a hand to John’s right shoulder, he reeled John in the final few feet. “You gotta do something. You gotta help !”

He took in the scene at a glance: Flowers on one side, hastily pulling body armor away from Harris, who was one his back in an enormous brick-red puddle growing larger by the second. The man was semi-conscious: eyes fluttering, pulling air in through an open mouth, but his skin was bad, already going a sickly color like Silly Putty. A tourniquet was cinched high around his right thigh. Immediately below that, a gory dagger of bone jutted from where the sharp edges of that broken femur had ripped through muscle and flesh.

“John!” Roni was on her knees. Her hands were gloved in scarlet, and more blood had soaked into her sleeves. There was even a drippy arc just under her chin, probably from the artery she was working to clot off with a hemostatic dressing. “I need another pack,” she said, the fingers of her right hand working the gauze from a HemCon dressing into a powerball. She’d either cut or ripped open Harris’s left pant leg up to his crotch: a bad sign. He could see at a glance that the still-spurting wound was too high for a tourniquet. The only way to keep Harris from bleeding to death was to work lengths of HemCon into plugs and stuff those into the wound, packing that with as much HemCon as possible.

“Femoral artery. I can’t get it to stop.” Still applying pressure with her left hand, she formed yet another plug with her right as arterial blood continued to pump and bubble. “I tried clamping it, but the tear’s high up, and it’s too slick. I’ve always used two HemCons, but I just can’t get it to slow down enough to?—"

She left the rest unsaid, but he knew what she was thinking. For Harris not to bleed out.

The problem was twofold. Arterial walls are lined with muscle, which makes sense given that an artery must hold up under a lifetime of blood continually being forcefully pumped from the heart. The problem with muscle: the fibers are designed to stretch and contract. Severed, they often retract, pulled back, the way a rubber band will if it snaps. Sometimes, that even clamps off a bleed. As an intern, John once had missed a bleeder in a kid’s arm that had done just that. The kid was smart, though, and came back to the ER within a half hour after his arm started to really hurt because of the blood pumping out of the severed artery that had first pulled back but had subsequently relaxed.

The problem with the femoral artery is that it is both relatively large and emerges close to the groin. When cut in two, the artery can retract so far into the groin that trying to stopper the flow of blood in such a large gap is like putting a pebble in front of a sluice gate.

Plus, as Roni said, blood is slippery.

“I’ve got plenty.” He’d already dug the packet from his bag. We need an ambulance, like, yesterday. They also needed a stretcher. A glance over his shoulder revealed the sergeant already talking into his mike. The sergeant caught his look, gave him a thumbs-up then spread his hand like a cop stopping traffic.

Help on the way. Five minutes. Which he worried was four minutes too long. But they couldn’t move Harris, not yet, not until they got control of the bleeding.

“How are your hands, Roni?” he asked, teasing out a tongue of gauze. “Tired? Want me to take over? ”

“No, I’m fine.” She held out a hand for the QuikClot. “I can keep?—”

Harris suddenly gasped, a long, thin inhale as if the man were trying to suck air through a flimsy straw. His nostrils flared; the cords on his neck went taut. The whites of the man’s eyes showed as they rolled back in their sockets. Arching, Harris’s mouth opened wide—and John couldn’t help thinking of a suffocating salmon flopping on a deck.

“Keep him still!” Roni barked at the same moment Meeks sang out, “Got a chest wound here!”

Driver cursed. “We need to get him more help, man, we need to?—”

John paid no attention. Scuttling to Meeks, he said, “Back off. Let me see.”

He saw at once what was wrong. If he’d any doubts, the shift in Harris’s trachea from the middle of his throat to the right was a dead giveaway.

A ballistic vest will protect a man’s chest and back and most of either side, but there are gaps: several inches, in fact, below either armpit. Just enough space for a ball bearing whizzing through the air at a thousand feet per second.

“Sir.” It was the sergeant. “Ambulance crew on the way. But, sir, I gotta go. There are other Marines?—”

“Go.” Ripping open Harris’s shirt, John found the entry wound almost at once: a fleshy oblong hole about the size of a large peanut M&M. “Thanks for getting me here.”

“No problem. Good luck, sir. ”

I hear that. Even as John slapped on a loose bandage to act as a flutter valve and keep more air from entering into Harris’s chest, his mind was already leapfrogging ahead to next steps—none of which they could take until Harris was on a gurney or table, someplace where John could crack his chest and track down the ball bearing that had smashed through skin and bone and gristle. There was no good chest wound one could have, only those that were slightly better than others because they missed arteries or the heart.

Given his wounds, Harris would need all the luck John and Roni could muster.

He didn’t get it.