Healer of Carthage (11 page)

“No.” Lisbeth wiped her mouth with the back of her hand. “I can’t go back.”

Cyprian grasped her elbow. “You will.”

She followed him to the wounded and her failure to defend the weak. She’d thought Mama’s disappearance had made her stronger, but she was mistaken. Taking care of Papa since she was five had made her hard. Tough and calloused were not the same thing.

She stood over Laurentius. What could she do for this boy beyond a cool cloth to the forehead? If his internal injuries matched his external bruising, she had nothing to offer.

Ruth appeared with a basket filled with rags, small pouches, and an assortment of wicked iron implements, including a long iron poker that glowed red hot. “Hold this, Caecilianus.”

The healer used a crude pair of scissors to cut Barek’s sleeve from cuff to shoulder. “The emperor has granted Aspasius his request for additional troops.”

“More soldiers?” Ruth held Barek steady. “Already they outnumber us two to one.”

Cyprian weighed in on the conversation. “Rome considers Carthage hard won. I’m sure the proconsul had no trouble convincing the emperor to commission his militia to protect the wealthy and the investments they’ve made in the restoration of this strategic port and its aqueducts.”

“Making war where there is no fight fills many coffers.” Lisbeth’s mother patted Barek’s good shoulder. “I’m sorry. This is going to hurt.” She poured brown liquid over Barek’s wound. His howl echoed in the hall. “Eradicating Christians is a cheap way to occupy bored soldiers.”

“Some believers say we must leave Carthage while we can.” Ruth caressed Barek’s hand. “Flee to the mountains.”

Murmurs of agreement swept through the pressing crowd.

The healer turned to the old bishop. “Is this true, Caecilianus? Will you give in to this fear and desert the sick?” She held the flask to Barek’s lips, but her eyes castigated the crowd. “I will not go.”

Caecilianus studied the poker, as if answers hid in the glow. His eyes traveled to his son, then to the crowd, and finally to Ruth. Anyone paying attention could see the love and sadness passing between them. “Believers, we will stay the course.” Solemnity swept across every face. “No matter the cost.”

“I have a daughter.” Numidicus pushed his way through the group. “What happened to these boys is a price we’ll all be expected to pay.”

“And they paid it gladly.” Mama’s glare forced Numidicus’s retreat. She returned her attention to the boy with the arrow. “Cyprian, snap this arrow shaft, but leave me enough to work with so I can get the head out.”

While the healer dug through a basket, Cyprian stepped into place beside Ruth. Uncertainty rippled in his tense jaw, but he set his feet.

The healer produced a handful of rags and a small cloth bundle. “Ruth, once I free that barb, you stanch the wound.”

“But, what if—” Lisbeth interjected. They all turned and glared at her. “I’m just sayin’, a millimeter either way, and that boy could bleed out.” From their pointed silence, she knew her medical opinion was obviously of no more value here than in Dallas, and rightfully so after her little temper tantrum. “Never mind.” She wasn’t a surgeon. Even if that arrow had sliced some major artery, what could she do?

“I’ll tend my patient,” Mama said, “and I’d appreciate it if you’d get busy tending yours.”

Lisbeth dropped her eyes back to Laurentius. She felt his pulse. Still unconscious and no change.

Cyprian wrapped his hand around the arrow shaft, and the
dogs began to whine. “I’ll be quick, Ruth, but hold your boy steady.” The muscles in his tanned arms flexed.

Crack.

Lisbeth cringed and looked up.

Cyprian fell back, holding a long portion of the jagged arrow shaft. Behind him, blood spurted from Barek’s shoulder.

“Press harder, Ruth.” The healer unrolled the cloth bundle, revealing a set of primitive surgical tools. “I’ll have to cut him open and try to stitch the severed vessel. I’m sorry, Barek. The pain will be great.”

The boy gave a wide-eyed nod.

“You’re going to operate without anesthesia?” Lisbeth shouted. “You can’t do—”

Mama’s sideways glance skewered her. “You have a better idea?”

She didn’t.

Suddenly, Laurentius’s eyes fluttered open. He grasped his chest. “Can’t . . . breathe.” Air leaked from his voice, draining the last of the color from his skin in the process.

Cyprian flew to the boy’s side and knelt beside Lisbeth. “Laurentius.”

The boy didn’t answer. His ragged breathing disintegrated into quick, shallow pants that mimicked a thirsty dog on a hot day.
Shortness of breath.
If the beating had broken a rib, Laurentius could have a punctured lung. Lisbeth’s senses recorded the observable symptoms.
Respiratory distress. Asymmetrical chest rise. The bluing of cyanosis
. She should do something. But what? Laurentius groaned, then lost consciousness again.

Fear flashed in Cyprian’s eyes. He put an ear to the boy’s dark lips. “Healer, this boy is not breathing!”

“I only have two hands”—Mama remained hunched over Barek, leaving Lisbeth to deal with Laurentius on her own—“and
right now they’re trying to keep the bishop’s son from bleeding to death. Lisbeth, Laurentius has a tension pneumothorax. Do something. Now!”

Lisbeth shoved Cyprian out of the way. She crammed the tips of her stethoscope into her ears and slapped the bell onto Laurentius’s chest.

“Breath sounds unequal,” she muttered, thinking through what to do next as she slid the bell back and forth along the midline. “I hear nothing over the left.”

“If his lung is punctured, every exhalation pumps air into his chest cavity.” Mama coached without looking up from her operating table. “Without an immediate way of escape, trapped air will compress his lungs, shift everything to one side, and affect the return of blood flow to his heart.”

A certain death scenario.

“What should you do, Lisbeth?” Mama prodded. “Think. Quickly.”

Lisbeth’s mind kicked into high gear, the drawings in her medical books flashing before her eyes. “Relieve the pressure inside the narrow space between the lung and the protective lining of the lung.”

“The pleural space,” Mama concurred. “Create a release valve.”

Lisbeth had observed a needle aspiration in the ER, but she’d never performed a procedure so dangerous. If she tried something this risky in these primitive conditions, she could kill him. “I can’t.”

“It’s the only way to help the injured lung reexpand.”

“But I don’t have the tools to relieve the buildup.” She glanced at the deepening shade of Laurentius’s lips. Doing nothing meant the kid would most certainly die.

“Improvise,” Mama ordered.

Lisbeth dug through the basket Ruth had placed between her and her mother. “Where’s a standard intravenous hollow needle
when you need one?” Her eyes shot around the room. Blood dripped from the wooden reed in Cyprian’s hand.

The shaft?
Approximately five millimeters in diameter. Kind of big, but the jagged end was narrow and, most importantly, hollow. It might work. Not the perfect solution, but the boy’s distended neck veins and her mother’s preoccupation didn’t leave her a whole lot of choice. She did not want this kid to die.

“Give me that shaft, Cyprian,” Lisbeth ordered. “Now!”

“This?” He presented her with the longer portion of the straight reed. “It’s filthy.”

“Break off the feathers.” She pointed at the healer. “Then rinse the whole thing with whatever she has in that flask.”

Doubt creased Cyprian’s face. “How will that help?”

The healer tossed him the flask. “Do what she says!”

Cyprian doused the serrated end of the hollow reed with a red liquid. “He’s dead.”

In the space of a few seconds, Lisbeth’s own heart rate had doubled. “He will be if we don’t do something.” Surging adrenaline increased the volume of her self-chatter. “Feel for the clavicle on the affected side.” She located the bony ridge running along the top of the boy’s shoulder. Then she ran her finger along the clavicle until she located the middle between the sterna notch and the bone’s insertion into the shoulder.

Satisfied she’d located the midclavicular line, Lisbeth proceeded, talking herself through the process. “Run your finger down the midclavicular line, pressing firmly until you locate the second and third rib.” She felt the rigidity of ribs, but just to be doubly sure, she started the whole process again, dragging her fingers slowly and counting out loud like a kindergartner. “Got it.”

“Good!” Mama shouted over her shoulder. “Now locate the hollow between the second and third rib.”

Satisfied the indention she’d found was the second intercostal
space in the midclavicular line, Lisbeth marked the spot with her left finger. “Without an X-ray, there’s no way to know if he has an injury to his major airway. If it’s worse than we think, this kid will need more than just needle decompression to fix the air leak.”

“Do it!” Mama ordered.

Lisbeth held out her right hand. “Give me that shaft.”

“It’s no use.” Cyprian placed the broken arrow stem in her hand. “Laurentius is with God.”

“He will be if you don’t get out of my way.” Lisbeth clutched the shaft. Keeping her eyes on the location she’d chosen, Lisbeth placed her thumb over one end of the hollow reed. “Now what?”

Mama glanced over her shoulder. “Insert the reed at a ninety-degree angle just over the third rib. Aim for bone.”

“I’m glad he’s unconscious, because this is going to hurt.” Lisbeth took a deep breath and jabbed the sharper end of the shaft through the tight skin on Laurentius’s chest. He didn’t even flinch. “I’ve got bone.”

“Good. Now walk the shaft over the rib to avoid the artery and nerves that run inferior to each rib.”

Satisfied she’d cleared the rib, Lisbeth slowly advanced the reed deeper into his flesh, listening for penetration of the pleural.

Pop.

“Got it.” She released the seal her thumb had formed over the exposed tip of the shaft. Immediately, air swished out through the reed.

Laurentius took a deep breath. His eyes fluttered open, muddy green irises with the telltale white Brushfield spots of his syndrome. Lisbeth filled her own lungs in relief.

“He lives?” Cyprian directed his confusion at Lisbeth. “He lives.” The crowd gasped, then pressed in close.

“That he does!” Lisbeth whispered into Laurentius’s ear. “Just breathe, buddy.”

With each completed breath cycle, the left side of Laurentius’s chest slowly expanded, gaining symmetry with the right side.

Lisbeth rocked back on her heels. Manually manipulating the occlusion, she watched a pinkish glow drive the gray from the boy’s puffy cheeks. “Feel better, buddy?”

Laurentius put his hand around hers, the one she was using to steady the shaft in his heaving chest. A guttural sound croaked from his small mouth. She made out a “thank you” from his breathy Latin.

Lisbeth wiped at unexpected tears. “Easy as poking a straw through a plastic lid.” Pleased at how quickly his breathing seemed to be leveling out, she looked to her mother for further instructions. Cyprian, Ruth, and Mama towered over her, their eyes glistening.

“He lives!” Cyprian knelt beside Laurentius and took his hand. “Good to have you with us again, little man.”

“Good work, Lisbeth.” Mama’s praise felt like a 14G needle releasing the pent-up anger in Lisbeth’s chest.

Laurentius struggled to sit up.

Mama knelt beside him, her hands covered in Barek’s blood. “Stay still, Laurentius.” She addressed the crowd. “Step back, and let her patient get some air.” She found a bone needle in her basket and quickly threaded a coarse string through the tiny hole. She was left-handed, Lisbeth noticed. Like her. “You must lie very still, Laurentius. I’m afraid this will hurt.” She slid the bone needle into the raw flesh and the boy yelped. With a few quick flicks of her wrist she secured the chest tube with a perfect purse-string suture. Mama glanced at Lisbeth. “We make a good team.”

Before Lisbeth could refute the assumption that they were a team, Cyprian demanded, “Who are you?”

She had no intention of telling this clod anything. “I guess I’m your whore. You paid for me, remember?”

Cyprian turned to Magdalena. “She brought someone back from the dead. How can this be?”

Fear rumbled in the mob, and voices called out, “
What
is she?”

Mama smiled. “She is the answer to our prayers.”

11

T
HE PUNGENT ODOR OF
cauterized flesh lingered in the atrium long after Barek’s screams dissipated.

Questions from the crowd poked Caecilianus from the shock of Mama’s claim. He rose from his prayers and, with a pronounced air of authority, repeated Mama’s crazy idea that God had sent another healer. A better healer with new and better ways.

Lisbeth felt the satisfaction of delivering successful care evaporate as the people pushed in to touch her. She was not their healer. If Mama wanted people to think she was magic, that was her business. Dispensing a few medical tricks here and there had probably kept the woman alive through the years. Although a part of her was grateful to learn her mother was alive, Lisbeth had no intention of mastering two-bit sleights of hand. Mama could stay here and slap Band-Aids on wounds that would never heal, but she was leaving Carthage.

Getting back in the saddle had not removed her regret, but it had surprised her to learn how much she actually wanted to be a doctor. Not for Mama. Not for Papa. But for herself. Going home to face her mistakes and take care of Papa were the right things to do.

Cyprian mingled among the excited believers, herding them toward the door. “There’s nothing more any of you can do here
tonight. Return to your homes in the cover of darkness. Pray and fast until you receive further word.” He asked Caecilianus to speak a blessing over the agitated group and instructed Naomi to bag the leftover bread for distribution.

Parents reluctantly gathered their children and circled around the old bishop. After the preacher’s lengthy prayer, families filed through the garden. Naomi doled out bundled scraps as families ducked out the back gate.