Without Remorse by Clancy, Tom

‘Tell me what we have,’ the professor ordered curtly.

‘Shotgun wound, several pellets very close to the cord, sir.’

‘Okay.’ Rosen bent down, his hands behind his back. ‘What’s with the glass?’

‘He was in a car,’ Eaton called from the other side of the cubicle.

‘We need to get rid of that, need to shave the head, too,’ Rosen said, surveying the damage. ‘What’s his pressure?’

‘BP fifty over thirty,’ a nurse-practitioner reported. ‘Pulse is one-forty and thready.’

‘We’re going to be busy,’ Rosen observed. ‘This guy is very shocky. Hmm.’ He paused. ‘Overall condition of the patient looks good, good muscle tone. Let’s get that blood volume back up.’ Rosen saw two units being started even as he spoke. The ER nurses were especially good and he nodded approval at them.

‘How’s your son doing, Margaret?’ he asked the senior one.

‘Starting at Carnegie in September,’ she answered, adjusting the drip-rate on the blood bottle.

‘Let’s get the neck cleaned off next, Margaret. I need to take a look.’

‘Yes, doctor.’

The nurse selected a pair of forceps, grabbed a large cotton ball, which she dipped in distilled water, then wiped across the patient’s neck with care, clearing away the blood and exposing the actual wounds. It looked worse than it might really be, she saw at once. While she swabbed the patient off, Rosen looked for and got sterile garb. By the time he got back to the bedside, Margaret Wilson had a sterile kit in place and uncovered. Eaton and Marconi stayed in the corner, watching it all.

‘Nice job, Margaret,’ Rosen said, putting his glasses on. ‘What’s he going to major in?’

‘Engineering.’

“That’s good.’ Rosen held his hand up. ‘Tweezers.’ Nurse Wilson set a pair in his hand. ‘Always room for a bright young engineer.’

Rosen picked a small, round hole on the patient’s shoulder, well away from anything really vital. With a delicacy that his large hands made almost comical to watch, he probed for and retrieved a single lead ball which he held up to the light. ‘Number seven shot, I believe. Somebody mistook this guy for a pigeon. That’s good news,’ he told the paramedics. Now that he knew the shot size and probable penetration, he bent down low over the neck. ‘Hmm … what’s the BP now?’

‘Checking,’ another nurse said from the far side of the table. ‘Fifty-five over forty. Coming up.’

‘Thank you,’ Rosen said, still bent over the patient. ‘Who started the first IV?’

‘I did,’ Eaton replied.

‘Good work, fireman.’ Rosen looked up and winked. ‘Sometimes I think you people save more lives than we do. You saved this one, that’s for damned sure.’

‘Thank you, doctor.’ Eaton didn’t know Rosen well, but he made a note that the man’s reputation was deserved. It wasn’t every day that a fireman-paramedic got that sort of praise from a full professor. ‘How’s he going to – I mean, the neck injury?’

Rosen was down again, examining it. ‘Responses, doctor?’ he asked the senior resident.

‘Positive. Good Babinsky. No gross indications of peripheral impairment,’ Severn replied. This was like an exam, which always made the young resident nervous.

‘This may not be as bad as it looks, but we’re going to have to clean it up in a hurry before these pellets migrate. Two hours?’ he asked Severn. Rosen knew the ER resident was better on trauma than he was.

‘Maybe three.’

‘I’ll get a nap out of it anyway,’ Rosen checked his watch. ‘I’ll take him at, oh, six.’

‘Yon want to handle this one personally?’

‘Why not? I’m here. This one is straightforward, just takes a little touch.’ Rosen figured he was entitled to an easy case, maybe once a month. As a full professor, he drew a lot of the hard ones.

‘Fine with me, sir.’

‘Do we have an ID on the patient?’

‘No, sir,’ Marconi replied. “The police ought to be here in a few.’

‘Good.’ Rosen stood and stretched. ‘You know, Margaret, people like us shouldn’t work these kind of hours.’

‘I need the shift-differential,’ Nurse Wilson replied. Besides which, she was the nursing-team leader for this shift. ‘What’s this, I wonder?’ she said after a moment.

‘Hmph?’ Rosen walked around to her side of the table while the rest of the team did its work.

‘A tattoo on his arm,’ she reported. Nurse Wilson was surprised by the reaction it drew from Professor Rosen.

The transition from sleep to wakefulness was usually easy for Kelly, but not this time. His first coherent thought was to be surprised, but he didn’t know why. Next came pain, but not so much pain as the distant warning that there would be pain, and lots of it. When he realized that he could open his eyes, he did, only to find himself staring at a gray linoleum floor. A few scattered drops of liquid reflected the bright overhead fluorescents. He felt needles in his eyes, and only then did he realize that the real stabs were in his arms.

I’m alive.

Why does that surprise me?

He could hear the sound of people moving around, muted conversations, distant chimes. The sound of rushing air was explained by air-conditioning vents, one of which had to be nearby, since he could feel the moving chill on the skin of his back. Something told him that he ought to move, that being still made him vulnerable, but even after he managed a command to his limbs to do something, nothing happened. That’s when the pain announced its presence. Like the ripple on a pond from the fall of an insect, it started somewhere on his shoulder and expanded. It took a moment to classify. The nearest approximation was a bad sunburn, because everything from the left side of his neck on down to his left elbow felt scorched. He knew he was forgetting something, probably something important.

Where the fuck am I?

Kelly thought he felt the distant vibration of – what? Ship’s engines? No, that wasn’t right somehow, and after a few more seconds he realized it was the faraway sound of a city bus pulling away from a stop. Not a ship. A city. Why am I in a city?

A shadow crossed his face. He opened his eyes to see the bottom half of a figure dressed all over in light-green cotton. The hands held a clipboard of some sort. Kelly couldn’t even focus his eyes well enough to tell if the figure was male or female before it went away, and it didn’t occur to him to say anything before he drifted back to sleep.

‘The shoulder wound was extensive but superficial,’ Rosen told the neurosurgical resident, thirty feet away.

‘Bloody enough. Four units’, she noted. ‘Shotgun wounds are like that. There was only one real threat to the spine. Took me a little while to figure how to remove it without endangering anything.’

‘Two hundred thirty-seven pellets, but’ – she held the X ray up to the light- ‘looks like you got them all. This fellow just got a nice collection of freckles, though.’

‘Took long enough,’ Sam said tiredly, knowing that he ought to have let someone else handle it, but he’d volunteered, after all.

‘You know this patient, don’t you?’ Sandy O’Toole said, arriving from the recovery room.

‘Yeah.’

‘He’s coming out, but it’ll be a while.’ She handed over the chart which showed his current vitals. ‘Looking good, doctor.’

Professor Rosen nodded and explained further to the resident, ‘Great physical shape. The firemen did a nice job holding up his BP. He did almost bleed out, but the wounds looked worse than they really were. Sandy?’

She turned back. ‘Yes, doctor?’

‘This one is a friend of mine. Would you mind terribly if I asked you to take -‘

‘A special interest?’

‘You’re our best, Sandy.’

‘Anything I need to know?’ she asked, appreciating the compliment.

‘He’s a good man. Sandy.’ Sam said it in a way that carried real meaning. ‘Sarah likes him, too.’

‘Then he must be all right.’ She headed back into recovery, wondering if the professor was playing matchmaker again.

‘What do I tell the police?’

‘Four hours, minimum. I want to be there.’ Rosen looked over at the coffeepot and decided against it. Any more and his stomach might rupture from all the acid.

‘So who is he?’

‘I don’t know all that much, but I ran into trouble on the Bay in my boat and he helped me out. We ended up staying at his place for the weekend.’ Sam didn’t go any further. He didn’t really know that much, but he had inferred a lot, and that scared him very much indeed. He’d done his part. While he hadn’t saved Kelly’s life – luck and the firemen had probably done that – he had performed an exceedingly skillful procedure, though he had also annoyed the resident, Dr Ann Pretlow, by not allowing her to do much of anything except watch. ‘I need a little sleep. I don’t have much scheduled for today. Can you do the follow-up on Mrs Baker?’

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