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The first patient to arrive on the helipad is, in Margaret’s professional opinion, a doozy.
There is blood spattered all over the inside of the bubble, and when the orderlies remove it from over his head, Margaret can hear him gasping from twenty paces away. She turns on her heels and rushes to the pad, where he is counterbalanced with a dummy. There is a bus arriving in the compound, but she knows nobody on board can be as dire as this young man. Taking her commitment to triage seriously, she intends to have him seen first, and she will accompany him all the way through surgery.
Worryingly, he doesn’t seem to hear her reassurances that he’s going to be alright. His ears are ringing from the blast, and he tugs at them like a baby with an ear infection, unable to access the words for his pain. Or maybe he hears Margaret and doesn’t believe her, and he’s probably right. Margaret touches his dog tags to see his name, and his blood-type, too. She sees the stripes on his uniform sleeves, and the buttons have been preemptively undone by the field medic to staunch wounds underneath. There are punctures in his neck, which seem to be superficial, and then dark red blood oozing through his undershirt and the pressure bandages. She wants to treat him like a person, not just a patient.
“Corporal Harding, right?” Margaret asks him, but the words do not register. He stares at her, gasps, and coughs up blood in place of a reply. She wipes her face with the back of her hand. “We’re going to get you to surgery right away. Let me listen to your heart, try to take a deep breath. You’re going to be okay. Try to keep still, keep looking at me, I know you’re afraid. You’re going to be okay.”
Margaret trains her stethoscope over his chest. His heart is racing, of course it is. His right lung is straining, overcompensating, because his left is gurgling with fluid and likely punctured. When the jeep arrives with the gurney, she helps lift him, and tries to keep him still for the rocky drive down to the hospital tent. He loses consciousness, and Margaret digs through the messy first-aid kit in the jeep to start an IV in his arm, so he will be ready for surgery before they arrive. She has plenty of practice administering medications on the move, so the bumps in the road don’t bother her.
She’s relieved to see Charles at the first table, right by the door, so Corporal Harding will not need to wait any longer. Breathing has become increasingly difficult for him in the past few minutes, and his lips are tinged blue. Charles cocks his head at him, as Margaret unfolds the draw-sheet and hauls him onto the operating table with all of her strength. Knowing he has very little time to make a diagnosis himself, Charles looks expectantly at Margaret.
“Pneumothorax?” Charles asks.
“On the left,” Margaret nods. “Possible edema; I could hear fluid. And he’s been coughing up blood. I don’t think he can make it through an x-ray…”
All the while, she has been cutting him free of his uniform and the pressure bandages, anticipating the need to open his chest. She polishes his dog tags with alcohol, since they will soon become part of the field.
“He certainly can’t; I hope your diagnosis is correct,” Charles muses, stepping to the patient’s left.
They begin to administer blood, saline, and an opiate to dull the pain.
Margaret consults with the anesthetist, who is preparing the standard mask for the patient, until Charles intervenes. He leaves the bedside to rifle through the Mayo stand himself; Margaret gets anxious any time he leaves his domain and enters hers , where she keeps things organized for his benefit. She holds out his scalpel, and he declines it. In this moment, he is like a child wandering into the mysterious pantry only to raid the cookie jar, unaware anything else is stored inside. He never sets up the stands, nor touches them himself, and therefore has no idea why he can’t find the precise instrument he wants. Margaret wants to chastise him, but his gloves are not yet contaminated, so she has no grounds to do so. But after he emits an audible pout, Margaret asks him what in the world he’s looking for, knocking perfectly good lap sponges onto the floor and into his kickbucket.
“Ventilation equipment. Ten minutes ago, please, th’kyou,” he grumbles.
“I’m not a mind-reader, Major,” Margaret replies in kind, and finds what he wants on the draped storage shelf near the icebox.
She lubricates the tube and hands it to him.
“No?” Charles says brusquely. “You were masquerading as one a moment ago. He cannot breathe on his own, and the effort has already rendered him unconscious. Pray tell what good a low-pressure mask would do him? Now, hold him still .”
Margaret looks at the patient on the table, already unmoving and blue like a corpse, but if Charles is seeking an improvement, surely one can be made. She has that in common with him. Fetching a blanket - the poor man must be freezing - she tucks his arms in tightly at his sides, and leans over him to keep him still while Charles covers the patient’s eyes, tips back his forehead, and arcs the curved blade into his mouth, seeking his way down to the lungs. The incapacitated patient gags reflexively, splattering Margaret’s mask with blood. She feels some stinging in her eyes, and tastes metallic through the flimsy cotton mask, but she does not move from her post until the intubation is completed.
“Bag every five seconds, minimum,” Charles advises the anesthetist. “Don’t make me remind you. Margaret, now I’ll take that blade, and a rib-spreader, if you’d be so kind .”
His tone is aggressive in the interest of conserving time, a goal Margaret shares. Maybe if he spent less time making a mess of her trays– Margaret decides not to say this, but it’s satisfying to think it while she sneers under her mask.
At least he is working at a good pace today. They open the cavity efficiently, with Margaret pushing aside muscle and cranking apart the ribs. Charles peers in and asks for more light, which Margaret reaches up to adjust with a towel over her hand.
With each squeeze of the bag provided by the anesthetist, they watch the patient’s right lung fill with air and then depress again. Margaret is relieved to see her diagnosis was correct, even though the damage is serious. It means Charles can begin work immediately, rather than conduct an exploratory to locate the source of the problem. The gashes in his chest run deep - the shrapnel seems to have been removed in the field - and his left lung has been punctured in several places. Whether there is still debris inside, Margaret cannot tell, as the pooled blood is occupying a significant volume of the deflated lung. The sight prompts Charles to ask for a number of other specialty items, which Margaret tells him are on storage shelves and not the magical Mayo stand.
“I only have two hands, Major,” she insists, indicating that both of hers are busy holding the ribs apart. “All I have at bedside is suction, I can give you that to start.”
She locks the retractor in place with Charles’ permission, and then begins sponging up the bleeding in the pleural wall caused by the incision, following with a suction tube. Sometimes she hates how her job requires her to inflict pain, even if the ultimate goal is healing. She hates doing anything less-than-perfectly at all, and the patient certainly doesn’t need to lose additional blood today at the expense of her hands.
“I need hands over here,” she calls for help. “Klinger! Where’s Klinger?”
She knows that if she yells his name, he will come running. Sure enough, he arrives donning a mask and cap already, and fetches everything Charles barks for: a lavage tray, his cautery instruments, additional suction equipment, a chest-tube setup, and his needleholder primed with heavy silk. Klinger recites the list back and gathers all of the items from various places in the operating room, with a brief dash out to the supply room and back. He drops it on Margaret’s Mayo stand like a proud dog bringing back a ball, and Margaret thanks him by giving him another responsibility.
“Stay right where you are,” Margaret says. “Hold this.”
Klinger takes over with the suction while Margret is directed through the lavage procedure. It isn’t something they perform often, but Charles has it ingrained in his memory from his time in a proper thoracic unit, stateside. Alternating with the provision of oxygen, they flush saline through the holes in the lung to clear it of blood, keeping the suction in place. Charles asks to see the collection basin - cloudy and pink - then has Klinger empty it, so he can ensure the blood is not actively flowing into the lung. He hopes it has leaked in from the original punctures, and there is not more extensive hemorrhaging to be found. Once the saltwater flows without blood, Charles is not an unhappy shark so much as a relieved doctor, and he orders Margaret to take over with suction until the inside of the lung is thoroughly cleaned.
She has seen more than her fair share of horrific injuries in Korea, but there is something in watching the heart beat and the single lung struggle to fill with air, that undoes her. The pressurized oxygen comes whistling through the holes, sending more flecks of blood up into Margaret’s face, and she feels herself threatening to crumble. Letting a tear roll down her cheek is the only way to flush the blood from her waterline. She’s worried about him. His lips have become slightly less blue, but they look just as disturbing latched around the breathing tube. What if he doesn’t make it? Sniffling and unable to do anything to stall it, she swallows hard and focuses on the task at hand. Charles gives her a quizzical look, as much as possible from one garbed face to another, and thinks no further of it.
They witness his heart skip a beat, and Charles eyes the Mayo stand for epinephrine which he knows is actually kept there, but the arrhythmia corrects itself on the next breath.
“Where’s my cautery?” he asks, gruffly, at the same time Margaret finally sets down the suction.
Of course, it’s important to get the patient taking in more than fifty percent of the oxygen he needs to survive, and they cannot do this while the left lung still has holes in it. She plugs in the galvanized forceps, unwinding the cord carefully between the shifting feet of the rest of the crew, and hands the instrument to Charles, who promptly switches the heating mechanism on. This overwhelms the generator, and the overhead lights flicker and dim, and the readings on the ventilator go haywire. The anesthetist continues bagging manually, as calmly as she can, while Margaret finds Charles a flashlight. She holds it up over the cavity and plugs one of the larger punctures with her finger in the interim.
“See why you can’t play with your fancy toys, Charles?” Hawkeye teases, from two tables over. He keeps his tone light by willpower alone; the crew need hope as much as the patients need surgery.
“I don’t know about you, but I can’t see anything ,” BJ chimes in.
Klinger volunteers to go resuscitate the generator, and to sit with it until Winchester’s delicate operation is complete, however long it may take. He gives an animated salute as he runs out the door and wishes the team well in his absence.
The interruption agitates Charles, who is left with the useless pair of cold forceps in his hand. As the lights start to hum again and the needle on the ventilator returns to its normal position, he watches the tips of the instrument until they glow. Then he pinches together the sides of each little tear in the lung to singe the ruptured capillaries into submission, sealing the mucosa to improve circulation. Margaret peers in to watch, too, fascinated with how her diagnosis is being resolved.
Charles asks for his needleholder to begin mending fascia, and Margaret passes over the one Klinger left on the tray, already threaded. Something feels off about it, perhaps it is a gram or two shy of its regular weight, and she hopes Charles will not notice, but she knows he will.
“This isn’t mine ,” he says, after looping a single stitch with it.
He is fussy and particular about minutiae that don’t really matter , in the grand scheme of things - but since they are in the operating room, Margaret defers and apologizes. Details are important, here. The lock on the instrument is out of alignment, and pinches between his fingers each time he applies pressure, but he carries on.
“I can only apologize, Doctor,” Margaret says. “I can find yours, and–”
“Don’t waste your precious time,” Charles sourly replies. “Be thankful my hands are steady, or you could be spending several hours fishing the needle out of this pleural haystack, aheh. Demagnetized nightmare .”
He flicks his wrist up again violently, cutting the line when he is through with it, and purposely dropping the holder so it clatters into the bucket of used sponges. Margaret will need to rescue it later, so it will not end up in the trash.
“Charles is known for his magnetism,” Hawkeye deflects the tension. “Sorry, that must be mine .”
“Who says you aren’t magnetic, Hawk?” BJ’s voice follows.
Charles continues closing in silence, only offering beleaguered sighs or passively affirmative hums as Margaret looks back and forth between his eyes and the open wound to decide what to give him. He is intently focused on his work, to the point even Margaret’s questions annoy him, even though they are necessary. She tries to get by silently, anticipating his needs, and eventually the rib-spreader is removed and the skin is sewn together again, and the chest-tube is placed to equalize pressure.
“He never heard me, when I said he was gonna be okay… do you think he will?” she asks, quietly. The chest-tube burbles as Charles sutures around it.
Once he’s finished, Charles glances up.
“Hmm? Of course he will, Margaret,” he says. “Your adherence to triage was impeccable , your diagnosis correct, you responded swiftly and brought him to the physician best qualified to treat him.”
Relieved, Margaret sniffles again, then realizes she can peel off her gloves and provide aid with the back of her wrist, or perhaps her hand if she can make time to go rewash it. A pair of orderlies arrive with a gurney to transport Corporal Harding to Post-Op, and Margaret gathers more medicated fluids to be administered there, tucking the bottles into the bedroll on the gurney. Charles instructs them not to move the patient until he is cannulized and on the support of a portable oxygen tank, set to the highest possible output. The anesthetist ceases to produce each breath for him manually, as Charles carefully removes the tube from his throat and swaps it for far more pliable, gentle tubing in each nostril. Margaret listens to his breathing with her stethoscope and offers it to Charles, still wearing his contaminated gloves, who trusts her verdict and declines. She appreciates that.
With Harding transferred out of OR, she moves to the Scrub Room to change her mask. Charles notices the blood on the front of her present one, and recognizes immediately a lack of strength within himself; if a patient’s blood had come in contact with his eyes and mouth, he would have stormed out of the room and only returned under duress or heavy bribery. Wistfully, he watches her turn the corner, and stands there with his bloodied hands held forward in waiting.
All business, steely-eyed, Margaret returns with clean garb, and peels off Charles’ gloves for him while he asks for their next patient. Colonel Potter turns down the request.
“We’ve got it under control,” Potter urges, but kindly. “The only cases waiting in the wings are superficial; your boy was a doozy . Why don’t you two head outside and cool off? If he takes a turn in Post-Op, we’ll holler.”
Charles and Margaret look at one another. She moves to collect a sponge from the messy table, and Potter tells her not to worry about it. So the two of them shed their gowns onto the table and stagger out the side door, into the sun.
They don’t know whether they are supposed to remain together on this mandated excursion, or if it would be preferable to go their separate ways. Charles doesn’t particularly like spending time outdoors in Korea, where the trees and the animals are foreign to him. Margaret ends up a few paces ahead of him, and he ducks his head in the interest of following her inconspicuously. She always seems like she knows where she’s going.
They pass the generator, penned in like livestock, straining itself to provide power to the operating room. Klinger is sitting sideways on the fence, sweet-talking it, and he whips his head around to see the Majors as they pass.
“You’re done with that case already ?” he asks, wide-eyed. “Uh-oh… don’t tell me he didn’t make it?”
Klinger looks at the pair of them, slouched shoulders and bloody scrub shirts, and isn’t optimistic.
“He’s in Post-Op,” says Margaret.
“How ‘bout that,” Klinger marvels at them. “The dream team does it again.”
“The ‘dream team’ has been banished from the OR,” Margaret quips back.
“One can hardly be banished from prison,” grumbles Charles. “We were instructed to cool off . Of all the childish impositions–!”
“I’m walking to the river and back, and then I’m sitting with Corporal Harding, and if Colonel Potter doesn’t like it–” Margaret loudly proclaims, “– too bad ! Knowing that poor boy isn’t going to turn and die on us is the only thing that would make me feel better right now.”
“I might have something,” Klinger chirps, rising from the fence and digging into his jacket pocket, holding up one finger to stall them. “You’re going to the river, right? Here, take a look.”
He produces a drawstring sack - alluring in the sense that it is purple and velvet, instead of drab canvas - and from within, a small rock, which he displays atop his flat palm.
“Would you like us to stone you?” Charles asks.
“I got ‘em from Mr. Shin,” Klinger explains, clarifying very little. “They’re perfect for skipping, look how smooth they are! He said what you do is say something you’re afraid of, then you skip it, and your fears evaporate before it drops into the water.”
Charles grins and gives an airy chuckle through his nose, and he looks at the perimeter rocks, the little pebbles surrounding the generator, the uneven dirt everywhere…
“A contrived superstition,” he says. “A scheme enticing you to spend your meager wages on… mere gravel , and you fell victim to it.”
“Ah, you may think so, Sir,” Klinger says boastfully, “but these are genuine pagoda stones, they really work! You remember last week, we had boiled-chicken-and-raisin sandwiches twice in a row for dinner? I knew we still had a crateful of raisins in the kitchen, I was afraid we were gonna serve ‘em again - and it was my turn on KP, the guys woulda killed me! So I went out to the slush-pond by the garbage dump, squeezed one of these little babies in my hand, whispered ‘boiled-chicken-and-raisin sandwiches’ to it, and threw it in the puddle. Next day, sure enough, we got surplus hamburgers, you remember?”
“That’s just about the stupidest thing I’ve ever heard,” Margaret says. “What the hell, why not?”
She is already pointedly walking away from him, but laughs at the story over her shoulder. Charles does the same with his hands buried in his pockets, and says he wishes Klinger’s mysticism had anything to do with the food supply. Klinger tags along with the drawstring bag tied around two fingers, swaying to and fro.
Onward they trudge to the river. The orphanage is visible in the distance on the opposite side. Sometimes the locals bathe or do their laundry in the flowing water. Margaret has overheard some of the men talking about fishing trips to it, though she never sees them return with a catch. Charles has to admit the prolific aspen trees lend the scene a certain amount of serenity.
Klinger sits against the trunk of one, though it is neither thick enough to support his weight, nor are its leaves plentiful enough to offer shade. The corporal is good at playing pretend, and Charles could use a few lessons.
“Nice to get out of the city, right, Major Winchester?” he asks.
“I’ve been out of the city for nearly a year; I’d rather like to be back in it .”
Charles finds a boulder to sit on, remarking that a rock this size would have cost Klinger a fortune . Klinger gets up again and provides each Major a single stone from his bag as pittance. Margaret sits down in the dirt.
“Have you ever skipped rocks, Major Houlihan?” Klinger continues.
“Of course I have,” she replies. “With my father, when I was little. We lived on Base in California, right on the ocean.”
She bends her legs and scrapes the dirt around with her boots, restless.
“This one’s for your patient, if you have no objections,” Klinger says, showing his chosen stone to each of them. He squeezes it tight in his hand, recites his fear in the form of, “the kid in Post-Op doesn’t make it,” and then flicks his wrist and flings it onto the surface of the stream. It skips along four times before it sinks, and Klinger triumphantly dusts his hands and promises the others, on this basis, their patient will be just fine .
Charles watches the rock as it seems to float across the water, and while he ultimately denies himself the opportunity to laugh aloud at it, the notion does cross his mind. How utterly silly, a thing known for its weight appearing to be weightless.
Margaret opens her fingers to peer at the stone she was given. She’s been squeezing the life out of it, needing to work out her frustrations one way or another. If it were a lemon, at least they’d have juice, and she’d have pulp and pith to scrub out from between her fingers, and Charles probably would’ve winced at the squelching sound. She nods curtly to calm herself. Thankfully it’s just a rock, and she can’t hurt it by being overzealous.
“So it isn’t like birthday candles,” she gleans from Klinger, who gives her a smile, “I mean, you’re supposed to say it out loud?”
“Yeah, sure,” Klinger says gently. “Rocks can’t hear too good, I guess. Go ahead, Major. Just be careful to say what you’re afraid of, not what you want to happen. I almost told one of ‘em I wanted to go home!”
Margaret takes a slow, deep breath.
“I’ll forget how to perform my duties as a nurse under pressure,” she says stoically.
The thought makes her shiver, but she does not allow this to upset her aim. She pitches the rock forward and watches it skip thrice before splashing downward. Then, for good measure, she scoops up another rock indiscriminately from the dirt, and tosses it. This one follows the same pattern as the first.
“Stacking your odds, very smart,” Klinger says, pointing at her.
Margaret could dump a whole wheelbarrow of rocks into the river, and it wouldn’t make her feel any better about the day’s session. She let Charles’ agitation throw her off course, and she wonders why she didn’t stand up for herself. Would it have made any difference in their patient’s prognosis? That’s all she’s worried about.
That’s all Charles is worried about, too, in his own way. The others’ eyes shift to him, as he sits on the boulder with his legs daintily crossed in front of him, taking in the crisp air and the sight of the rippling water. He turns the rock over in his hand, soothed by the motion to the point he does not want to part with it, he does not want to part with it at all.
“I fear Major Houlihan will rightfully take offense to my boorish behavior, and decline to work a case with me ever again,” he recites the mantra and throws the rock too softly. It sinks immediately. He gulps and realizes he’s playing along with Klinger’s superstitious game. “That… doesn’t bode well for me, then, does it?”
Margaret gives him a pleading look, waiting for him to say more. Tentatively, his eyes meet hers, and then he bows his head. He is unable to do things like this in front of a crowd, least of all in their prison-cell of an operating room, but the river calms him and reassures him, because it never goes anywhere, and yet it flows.
“I’m deeply sorry , Margaret,” he says. “If I ask the impossible of you, it’s because you spoil me by bringing it within my grasp. Truth be told, I’ve never worked with a nurse of higher caliber here or anywhere in Boston - you’re efficient, dedicated, an advocate for your patients - and I hope my temper did not sever… our connection.”
She laughs a little in spite of herself. There is no longer a stone in her hand to squeeze, she wonders if Charles will let her use his hand, but she isn’t about to ask. Oddly enough, he offers it anyway, and she gives it a skeptical look before she takes it. He’s standing and helping her up from the dirt, that’s all, so she tries not to squeeze too hard.
“I love watching you work,” she admits, brushing dust from the back of her uniform. “Sometimes it’s so seamless, I forget I’m working too .”
He tips his head to the side and makes a vaguely affirmative sound.
“Ah, thank you,” he says.
“But if you don’t think I’m gonna teach you how to skip a rock the right way, Mr. Steady-Hands, you’ve got another thing coming,” Margaret feigns a threatening tone. “Have round two ready for us, Klinger, we’ll be right back.”