LITMIR.BIZ

      She arrived to find Andrea, a senior nurse who had specialist anaesthetic training, already in Theatre.

      ‘I’ll need you to assist,’ Andy said, as Ellie walked in. ‘There’s gear set out in the ante-room, and Tony will help you scrub.’

      Ellie took a deep breath. It wasn’t that she hadn’t assisted in operations before. It was part of their medical training, and they’d done a lot in Africa, but surgery had always made her feel anxious, as if she had no business having her hands in someone else’s body. It was impersonal, yet at the same time deeply moving.

      Shaking away the thoughts, she changed, scrubbed her hands and arms and held them up for Tony to slide on the gloves. He tied an extra apron around her waist, and she was ready.

      ‘Will you enlarge the wound you made earlier?’ she asked Andy as she took her place beside him.

      A quick headshake.

      ‘It was big enough, but I must have missed something.’

      The tightness of his voice told her how stressed he was—stressed because he felt he’d somehow failed the boy.

      ‘There was nothing obvious,’ she reminded him, ‘and you didn’t want to interfere with his bowel by poking around under it.’

      She paused then added, in a deep, terrifying voice, ‘Never touch the bowel.’

      Andy laughed. Her mimicry of a lecturer they’d had in third year had always been good, and the words took him back to when, as students, they and their friends had used the words in more earthy ways.

      It broke his tension and he opened the wound, holding it for her to clamp so he had a clear view.

      ‘Think about the barb,’ he muttered, and although she knew he was talking to himself, she understood what he was getting at. The barb could have pierced a muscle, tendon or even the bowel, and infection had developed in the second site.

      But there was nothing obvious. Lecturer or not, he was going to have to touch the bowel.

      He gently lifted the nearest coil of the large intestine, checking all around it for damage.

      Nothing.

      They irrigated the wound again, and closed it up, then all stood frowning at the monitor, which had no good news for them.

      ‘Hang on,’ Ellie said. ‘Didn’t someone say he was fixing a barbed-wire fence? Imagine what happened. The fence strainers broke, the loose wire would have flicked back, one barb would have pierced his skin. How far apart are the barbs on barbed wire?

      ‘Roughly a hand span.’ It was Andy who answered, catching on quickly to Ellie’s train of thought.

      So some things hadn’t changed…

      ‘That means the next barb would be here,’ he said, measuring across the boy’s abdomen with his hand.

      They all peered at the spot but there was no sign of damage to the skin, or any indication of infection.

      ‘Imagine him with clothes on,’ Ellie said. ‘Jeans, most likely, and low slung how the kids wear them these days. That barb would have hit the double layer of the pocket, possibly even a stud, so the next barb would be here…’ She used her hand to measure the distance, brushing Andy’s hand then glancing up, meeting his eyes above his mask—a flash of something as sudden and powerful as lightning flashing between them. ‘If the wire wrapped around him.’

      They found the wound beneath their patient’s left hip, a tiny pinprick of a mark, surrounded by swollen, angry redness.

      While Tony went for the portable X-ray machine, Ellie and Andy propped the boy on his side, careful not to touch each other after whatever it was that had flashed between them earlier.

      ‘From the size of it, it’s just an infection rather than another foreign object,’ Ellie said, and Andy nodded, although she could tell he was furious with himself for not checking more carefully earlier.

      She opened her mouth to say, ‘You weren’t to know,’ but Andrea beat her to it.

      Not that Andy would have found any comfort in the assurance. He prided himself on his physical examination of all patients, although earlier this morning the pinprick of a mark could have been all but invisible.

      The X-ray showed no foreign matter in the wound, but Andy opened it up anyway. Clearing out the infection already there would lead to a quicker recovery for the boy.