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“Maybe that is why the muscles are so much more developed in the other leg.” They had puzzled on that the day before, but Red Hawk had stopped her from summoning the instructor. “We had a brave in our tribe who dragged one leg after a horse fell on him. The boys teased him.”
His stark comment forced her to look at him. Thick dark hair flopped on his wide forehead. Were he home on the reservation, she was fairly sure his hair would have been long and worn in plaits. Not that she really knew that much about the Sioux tribe, other than what she’d learned years ago from their friend Metiz, but long hair on the men seemed pretty standard. His square face and what appeared as sunburned skin set him apart from the others. This was the first comment he’d made about anyone back home. Maybe there was hope after all.
Together they excised to the bones, which looked nothing like the pictures they’d ever seen of a knee. Calcification made the components nearly unidentifiable. They looked at each other and nodded. She raised her hand to catch the instructor’s attention.
“What is it?” he asked.
“You might want to look at this knee.”
He made his way between the gurneys. “Excellent.” He clapped his hands. “Gather around here. We have an abnormality.”
Abnormality? Astrid mentally shrugged. In her mind an abnormality was something the patient was born with. She quickly jotted the word down to research later and stepped back to let their instructor take her place.
“What do you see here?”
“A knee that was injured severely,” Red Hawk answered promptly, “and the body built calcium around it to compensate.”
“Good. What had you seen on the body prior to this?” He looked to Astrid.
“Scar tissue on and under the epidermis.”
“Anything else?”
“Had I seen him walking, I’m sure he either favored or dragged this leg. Perhaps used a crutch or cane.”
“But since you couldn’t see him walking, anything else?”
Panic clawed at her throat. She took a deep breath. “The muscula- ture on the opposite leg was greatly increased, most likely compensating for the injury.”
“And you did not draw that to my attention?”
“No, sir.”
“In spite of the fact that all anomalies are to be mentioned?”
“I’m sorry, sir.” Red Hawk, this is your doing. If only she could melt into a puddle and slip out under the door.
Her breathing sounded loud in the silence, as if everyone else had turned to stone.
She’d learned her lesson from someone else’s previous error. Making excuses did not help. Just take the upbraiding and be more careful in the future was the gist of one of their study group’s late night discussions. The only one she’d been to so far. But then, she’d only been there for sixteen days, not that she was marking the days off on the calendar.
She glanced at Red Hawk from under her lashes to see him studying the floor, the sheet, looking at anything but her.
This isn’t fair, her insides screamed. But Pastor Solberg’s voice responded. “Who said life was fair? The sun and the rain, they both fall on the just and the unjust. As does the blizzard and the drought.”
“Have you anything to say for yourself?”
She shook her head. “No, sir.”
He looked around, catching everyone’s gaze. “What is the first rule of medicine?”
“Do no harm,” they all chanted back.
“And the second?”
The silence stretched.
Astrid searched through all the rules she’d learned. Did Thou shalt not kill apply here?
“Come now, you’ve seen it written on the boards before.”
Festina lente, make haste slowly, floated through her mind, but she’d not seen it on the board. But perhaps it had been on the board before she came. She’d have to ask someone else.
Their instructor shook his head. “I expect you all to have looked it up and be ready for an exam tomorrow.”
Astrid gulped. She knew all the material. Why did her stomach tie itself in figure eights?
“On the skin and everything below the knee.” He strode back to his desk and took his seat, glancing up to find them all staring at him. “Back to work. You’re wasting time.” He nodded at a raised hand. “Yes, Dr. Smith.”
“Does that include the knee?”
“I said everything below the knee. How would I test you on something you have not completed yet?”
The exhalation of breath was room wide.
Astrid stared at the malformed knee before her. Nothing in it matched any of the pictures or diagrams she had studied before. She glanced over to see Red Hawk following something—a nerve path?— that she couldn’t even see. What could she do? Think, Astrid, think. Ask the instructor for assistance? Ask Red Hawk if she could learn from his work? Run screaming back to her room? Throw her things in a suitcase and . . . ?
You promised yourself you would not think of leaving again. Choose to think of something else. The commands might as well have been shouted down a well, echoing but never working.
“You have fifteen minutes to clean up and put your things away. Make sure you clean your instruments thoroughly. Are there any questions?” Without even glancing to see if some hardy soul raised a hand, he returned to his writing, the pen scratching across the paper.
Knowing that the lab would be open in the evening for those who wanted more time, Astrid tucked her pencil into the slot for it and closed her writing pad. Taking her instruments to the sink, she washed them off with soap and water, and then washed her hands.
“Are you coming back tonight?” Red Hawk whispered.
She nodded. What else could she do?
“Good. Me too.” He covered their cadaver with the sheet and unlocked the wheels of the gurney to push it back to the assigned slot in the cooler.
When the bell rang, they filed out of the room without a word, walking slowly until the instructor went ahead of them.
“So what is the motto on the surgery hall?” one of the older women asked the others.
“First do no harm,” Astrid said.
“But then what could be the second?” They all looked at each other, shaking their heads.
“I was hoping someone else remembered it. That man makes me forget my name, let alone medical information.” There, she’d said it.
“Oh, me too. He glares at me, and I—”
“He doesn’t know how to smile,” someone added.
“As if he is doing us a favor by permitting us to sit at his feet and learn from his sculpted lips.” The derision on the first woman’s face matched the spoken words.
The jumble of comments as they made their way down the hall and stairs made Astrid smile. For the first time she felt part of the group, even if she hadn’t been able to remember at the right time. She wasn’t the only one feeling so out of sorts.
As they went their separate ways, she headed for the room she shared with one other woman—Elyse by name, Dr. Davidson by title. Elyse would graduate in May, with one more rotation after this one. They hardly saw each other because Elyse worked the night shift on the obstetrics floor for this rotation.
“Dr. Bjorklund!”
Astrid stopped in the act of opening her door at the call. “Yes?”
“We have an emergency surgery, and you’ve been ordered to scrub up. Operating room four.”
She started to ask a question but nodded instead. “I’ll be right there.” She set her books on the table she used as a desk and hurried down the stairs, her hand slick on the stair rail. She’d observed several surgeries and birthings, but this was the first time she had been ordered to scrub. Would she be assisting or observing or what? The questions kept time with her feet slapping the stairs.
In the scrub room she soaped her hands and arms, standing next to Dr. Whitaker, who was doing the same.
“Glad you could come.”
“Thank you, sir. What are the symptoms?” She b
linked. Was she being too forward?
“Elevated temp, pain, and tenderness in the lower right quadrant.”
“Appendicitis?”
“Looks that way. Hope we get it before it ruptures.”
“Yes, sir.”
“Have you done one like this before?”
She shook her head. And I’ve not gotten that far in anatomy either. But in her mind she could see the diagram of the little thumblike organ. If enlarged with infection it could burst and send peritonitis throughout the patient’s abdomen. “No, sir.”
“Ever opened or closed?”
“Yes, sir. Both. But not with this diagnosis.” She dipped her hands into the carbolic acid and let the liquid run down her raised arms. One of the nurses held a surgical apron ready to drop over her head. She turned so that the strings could be tied. Another pulled a white cap over her hair, tucking in the strands of hair that fought to fly free.
“Just do what I tell you.”
The internal butterflies banged against her rib cage instead of flying in formation. She’d not been in an operating room like this other than on tour and observation.
“The patient is ready, Doctor,” the head surgical nurse said, intoning the vitals.
“Good.” He nodded to the nurse holding the ether cone. “Proceed.”
Later, when he dropped the swollen but still intact body part into the basin, he caught Astrid’s gaze. “Would you like to close?”
She agreed to, well aware what a privilege he was giving her as new as she was. Why was he? Her work to this point hadn’t been of the quality to attract his attention. Dr. Morganstein had told her she would be starting with simple things like broken bones and repairing injuries. She stepped forward, staring into the open incision. Her mind flipped back to the day she’d fought to clear all the debris from Vernon’s abdomen. This was far different; all the organs were lying where they belonged, the blood flowing in the proper vessels, not leaking like a sieve. She took a deep breath, exhaled, and took the threaded needle the nurse offered her. At least she could sew a fine seam, thanks to her mother and all the hours of practicing ties and knots.
“Make sure you don’t pull the sutures too tight. You get more scar tissue that way. Adhesions can be very painful and sometimes necessitate further surgery.”
“Yes, sir.” She closed the peritoneum, then loosened the retractor so the muscles could return to their proper positions. Working through each derma layer, she was able to forget the doctor and nurses who were watching her, as well as the students likely observing in the balcony above. Her knees were shaking by the time she tied off the last suture and stepped back. At home she would have done the dressings too, but here there were other staff members to do that.
“You did well.” Back in the scrub room, he dropped his mask so she could see his smile. “I could tell you’ve applied a fair number of sutures before.”
The simple compliment made her eyes burn. “Thank you.” Thank you, God. Thank you, Mor. I finally did something well again. And she’d been correct in the diagnosis.
“You remind me of Dr. Bjorklund. You have that same fierce dedication she had.”
“Still has. She made sure that I studied all the basics, including all her texts from here. She’s a hard taskmaster.”
“Yes, well, we’ll see how much more we can add to your fund of knowledge and experience.”
Astrid thanked him again and returned to her room to change clothes. She was soaked from the skin out, not realizing until they were done how hot it had been in the operating room. Outside, Chicago broiled in a summer heat wave, making the hospital much like a kitchen during canning season. If only she had time to take a shower. But a sponge bath would have to do. Her stomach grumbled, reminding her that breakfast had been hours earlier.
She had another class in twenty minutes. She scooped up the letter standing next to her lamp and tucked it into her pocket to read while she ate. At least there would be bread and cheese or something set out in the dining room for those who couldn’t make the scheduled mealtimes. Guilt nagged her down the hall. She’d not written home since the first letter to let them know she’d arrived safely. How would she ever fit in everything she had to do to finish this rotation in six months? Why had Red Hawk let her take the blame for his mistake? More importantly, how was she going to work with him without confronting his perfidy?
* * *
ASTRID FELT THE crinkle of her mother’s letter, still unread, when she hung her apron on one of the hooks on the wall. She pulled it out and puffed her cheeks in a sigh. How could she be so tired she didn’t even have the energy to read a letter from home? Moving quietly so as not to disturb her roommate, although Elyse was sleeping so hard a fire bell wouldn’t penetrate, she slipped her nightdress over her head and tiptoed out the door, down the hall to the community washroom. There she slit the envelope open and removed the two sheets of paper, covered front and back with writing.
“Oh, Mor, I can’t do this.” Without reading a word, she stuffed it back in the envelope, used the necessary, and returned to her room. Her eyes ached from the formaldehyde, and her legs hurt from standing at the gurney for so long. But she knew the cadaver’s leg and foot from the knee down. Red Hawk had not appeared, so she’d used his side for her study. Surely she would dream of bones and muscles tonight.
16
BLESSING, NORTH DAKOTA
Joshua slipped the guitar strap over his shoulder and strummed a couple of times, then adjusted the tuning pegs and fingered the strings again. That sounded better.
Jonathan Gould hit a C chord on the piano, and Joshua tuned again, right along with Lars on the fiddle. When they were in agreement, they nodded to Pastor Solberg on the gut bucket, and the four started off the fall dance with “Blow Ye Winds, Blow.” Blessing folk continued to arrive at Andrew and Ellie Bjorklund’s barn, both on foot and by wagon, leaving their covered dishes at the tables set up for that purpose and joining the dancing.
Joshua wished he could quit watching the newcomers, always thinking how much more he would enjoy this if Astrid were there. If he’d been afraid he’d lose interest in her with her gone like this, he now knew without a doubt that she was the one for him.
Jonathan was in the same boat. Here he was getting ready to leave for Fargo in a few days, and Grace had already gone back East. She’d been offered additional teacher training and was taking advantage of it.
Pay attention, he told himself when he missed a beat. But all he could think of was whirling Astrid around, holding her in his arms for a waltz, enjoying her laughter. One of the many things he loved about her was that she knew how to enjoy herself. And help others around her have a good time too.
Sophie, or Mrs. Wiste, caught his eye and gave him a tiny wave. He nodded and smiled back. No one could resist smiling at Sophie. The way Garth smiled down at his wife made Joshua wish for Astrid even more.
Watching Mr. and Mrs. Bjorklund dance by, he knew he wanted to be like them. Both showed glints of white in their blond hair and encroaching lines on their faces, but it was obvious they loved to dance and they loved each other. Think on something else, Landsverk. All this seeing love is making you jealous. He glanced over to the table with the tub of punch. Some of the younger children were pouring and giggling. Interesting that over in the fenced-off corner, the cousin Anna was watching over the little ones who were still awake. He didn’t see her husband anywhere.
When he saw Gus and Maydell two-step by, he almost chuckled, remembering a previous dance when she had sort of forced Gus into a marriage agreement. Last he’d heard, the wedding would be after harvest. Everything here revolved around the farming calendar. Tilling, planting, haying, harvesting . . . a fight all the time to keep the weeds down and praying for the right weather. Even if he didn’t want to farm, when one was working with farmers, the same seasons applied. He thought about Hjelmer’s house and how there would be so few to finish the interior when harvest took the bulk of the men away.
&nb
sp; “Let’s take a break after this number, shall we?” Lars suggested a few tunes later. “I’m drier’n a water hole in August.”
“Sounds good to me.”
Lars raised his voice. “This is the last dance for a while, folks. Maybe the ladies would like to open the food table about now.”
“You could have given us a warning,” some female called back.
“Why, that would be too easy, now, wouldn’t it? All right, we will play one more number so you have time.” He glanced to his fellow musicians. “ ‘Little Brown Jug’?” At their nods, he tapped his foot four times, and away they went again.
Since the people let the musicians go through the line first, Joshua had a plateful of food in his hand when the elder Mrs. Valders stopped beside him.
“I’m sorry to hear about your mother,” she said.
Surprised, he nodded. “Thank you. She would have enjoyed a party like this.”
“We are fortunate to have so many good musicians here in Blessing. Dr. Bjorklund is very talented on the piano too. I think she was relieved when Mr. Gould volunteered to play.”
“Oh, really?” The things one learned at a party.
“Well, I’d best see to making more punch. Hot night like this, everyone’s extra thirsty.”
“That’s for sure.” He raised his cup. “I really appreciate my share.” He took his plate over to where benches had been set up and sat down to eat.
Toby sat down beside him, his plate heaped. “You heard from Hjelmer?” He picked up a piece of fried chicken and took a bite. “Ah, Thelma over at the doctor’s sent this chicken.”
“How do you know that?”
“She makes the best fried chicken in town. Mrs. Sam from the boardinghouse comes a close second. Don’t know what they do different from the others, but they do. Mrs. Bjorklund makes the best bread. Just ask Thorliff.”
“Back to your question. Nope, I haven’t.”
“Figured you would by now. Penny said anything?”
“About what?”
“If he’s sold any more windmills. I figured you’re about done with the one south of here.”