Sugical Interventions

[xylophonefairy†]

((Helen Wilson continues from In Honesty, We Didn't Plan This Far

Also, I think this is going to overlap with Confessional somewhat, which I'm really sorry about! And it's really long.

And don't try this at home.))

Bent almost double, Helen staggered towards the infirmary that loomed suddenly in front of her. Squinting over the tops of glasses that had slid down her sweating nose, myopic eyes tried to locate the door. Detecting a blur that was somewhat darker than the rest of the whitewash building, possibly door shaped, she stumbled towards it. She had lost Leila in the woods, having run more quickly than the girl's still quite recent injuries were able to keep up with, and after a brief exchange, they had parted ways. Now she was wishing that she hadn't, taking out her own appendix was starting to seem like a ridiculously impossible task.

Why did you come to the hospital?I think I might have appendicitis.So, why did you come to the hospital?I want you to treat me for appendicitis.You can't be the doctor AND the patient!Well, it looks like I'm going to have to be! Banging the door crudely with a wrist, it swung open easily and Helen somehow managed to get herself into the hallway. Pausing by a map detailing the infirmary, her fuzzy mind worked out a route from the red dot that said You Are Here! to the biggist room marked operating theatre. In fact, it was only down this corridor... Having stopped, it was hard to start moving again, when every step felt like someone was trying to kill her: a well aimed knife blow to the right iliac fossa. Someone was gabbing her insides and twisting them, daring her to cry out and ask them to stop. This was what morphine was for, oh if only she could find morphine. Best she had were a couple of tylenol somewhere at the bottom of her bag.

Pushing herself off the wall, Helen managed to stumble her way to the Theatre. When she got there, she stopped short, almost throwing up at the sight of two bodies on the floor, covered in a sheet. She was grateful to whoever had done that, people had stopped respecting the dead when there were so many of them. Still, as flies buzzed around the bodies and they gave of a rank smell of decomposition (they must have died days ago), she knew she couldn't stay there. That was when her eyes caught the sign on a door to the right or where she came in. A brushed metal plate read Pre-Op. Struggling over to it, she glanced in. It was similar to the operation room, only smaller, and more importantly, empty. It looked like it had hardly been disturbed, probably because there didn't appear to be a great deal in there. Looking around the theatre, Helen was filled with a sudden surge of adrenaline. If she was here, that meant that this was going to happen, that she was going to do this.

Right, equipment. She looked around, and went through the motions of preparation for surgery, even if all her preparations were guesses. Snippets of information from TV programmes and documentaries. There was a tray on a wheeled table, that she covered with some green paper from a huge roll off to one side. A marker pen. A new scalpel, still in a sealed pack from a drawer. A retractor. Liberal numbers of gauze swabs, each individually wrapped. Hastily, she threaded a needle with black thread, ready for stitches. A dusty bottle of iodine solution to clean the area with. Some cotton wool to spread the iodine with. Everything in this place looked old, she wondered who had used it last. Were they still alive.

"One of the things I never understood," Helen said out loud, realising quickly that talking was painful, but wanting to speak. She was acutely aware that her time might well be limited, and there was so much she had to say first. "Where are all the people who used to live here? They can't have gone that long ago, there was a computer." The memory of the computter made her smile fleetingly. They had done so much with that computer. "Don't they recognise their homes and their hospital? Their beach and harbour? All this stuff, it's so familiar and I've only been here for nine days. Why don't you speak up? Why don't you tell anyone where we are?" She broke off, wiping her eyes with the back of one hand. The adrenaline that had first coursed through her body when she'd entered the building was ebbing away, although adrenaline migh be a good idea. Rooting through cupboards, she found one with medications in, and appraised them. There was a pre filled syringe of adrenaline that went on the tray with the rest of her equipment. A bottle of amoxicillin, that bright yellow, banana flavoured suspension that had been a marker of childhood infections. Puffing out her cheeks in thought, she took the bottle and cracked the lid with an ease that should have warned her off. Helen took a couple of gulps, in the vain hope that it might help to prevent a post operative infection. She would almost rather die from the appendicitis than live a couple more days, in agony with some flesh eating staph infection. There was also a pre filled syringe of lidocaine, which she took. Anything to make this easier.

With everything she would think of ready, Helen turned and leaning heavily on her tray table, struggled into the preparation room. It was relatively clean looking, though she couldn't be sure. There was a bottle of a disinfectant of some kind that she sprayed liberally everywhere, including the bed and her hands and all the equipment on the bed. Climbing onto the bed, she pulled the tray closer to herself and set her bag (which had also been attacked with the disinfectant) on a table to her other side. Somehow being nearer her things, things that reminded her of home, made this seem easier. Safer. Looking up at the ceiling, a fluorescent light flickered a couple of times. It was alarmingly similar to her dentists office at home; the light always needed changing. Looking down, Helen gingerly lifted up her top, exposing a a flattish abdomen, slightly swollen on the right hand side. She shimmied her jeans down slightly, underneath her hips, letting the area be completely free of coverings. Closing her eyes, Helen tried to remember what she knew.

If she'd been more religious, she might have seen it as an act of God. This was the only thing she had any knowledge of how to do, the only surgery she'd had any exposure to. After her Dad's near death experience with appendicitis a few years previously, she had developed an interest, and looked into it. But that was months and months ago; she'd never thought that she would need to use the information before she was taught it for real.

"The incision is made at McBurney's point, two thirds of the way between the umbilicus and the ASIS". Gently, she felt her belly button and the prominence of bone in her pelvis, guessing fairly accurately what was two thirds of the way between. With a shaking hand she drew a line with the pen, letting out a small moan as the release of pressure caused a shockwave of pain reverberating throughout her body. Chewing furiously on her lip, she paused then, and reached into her bag for the ipod that had almost-but-not-quite run out of battery several days previously, when she just met Dave, Isabel and Charlie. And that was how she'd started that conversation, the one that had gotten her through the next week. Without them, Helen knew she would have died of boredom a long time ago. Shakily, she managed to fumble her way to shuffle mode.

The first song that came up was a slightly obscure eighties single.

Pray God you can cope.
I stand outside this woman's work,
This woman's world.

Grasping the iodine bottle, she tipped it against the cotton wool, and spread some around her abdomen. Not enough. She did the same thing, but this time her hand slipped, and an entire bottle of iodine solution splashed and flowed over her stomach, jeans, white tee shirt, and all over the bed and floor, and the glass bottle smashed just to her right.

Ooh, it's hard on the man,
Now his part is over.
Now starts the craft of the father.

Reaching over with her right hand, she transferred the retractor to her left hand, and balanced several gauze swabs on her left breast (which had managed to avoid the worst of the iodine) so that they were easily grabbable. Her right hand took up the lidocaine syringe, which, after ten deep breaths and a lot of self argument, she jabbed into her abdomen right where she was about to cut. In the couple of minutes while she waited for the anaesthetic to take, Helen stared at the ceiling and played conversations in her mind, as Kate Bush's soft voice lulled her into a memory of sitting in the kitchen as a kid, and the same song playing on a CD player while her Mom talked her though cooking lasagne.

"Cut the muscles along the line of their fibres. Firstly, external oblique, fibres go that way," she motioned from her side to her groin. "Internal oblique, fibres go the other way."

I know you have a little life in you yet.
I know you have a lot of strength left.

Tapping her belly, she felt no pain, and picked up the scalpel in trembling hands. It glinted menacingly in the bright lights of the room, the sun that managed to come in through the small, open window. You have to do this. You WILL die if you don't do this!

You have to! You have to! You ha-

She made the incision. The blade cut through her skin after a pause, and immediately, blood seeped from everywhere. Wide eyed in panic, she grabbed a handful of the gauze swabs that were on her chest and stuffed them haphazardly into the wound. After a couple of seconds the bleeding eased, and she slowly, warily, removed the swabs. There was a thin layer of fat (and people always said I was so skinny!), and underneath it muscle.

I know you have a little life in you yet.
I know you have a lot of strength left.
I should be crying but I just can't let it show.
I should be hoping but I can't stop thinking.

Cutting through the muscle was even easier than the skin, like cutting through water. Fresh blood oozed from capillaries, but she didn't have time to worry about that. External Oblique. Internal Oblique. There was another muscle underneath them. A third muscle? Helen racked her brains, trying to remember what it was called, but it was futile. She was clouded up on pain medication, local anaesthetic and adrenaline. She hadn't even felt anything yet. It didn't matter what the muscle was called, she could see that the fibres were running vaguely horizontally, and sliced through them that way. Butter. That's what cutting through muscle feels like. Soft butter. And she'd barely felt any of it, even though the scalpel was cold against her insides. The retractor held everything away, leaving a neat hole in her abdomen, through which her insides pulsed.

There was stuff underneath. A weird gooey mixture of fat, connective tissue. She touched something stringy looking and immediately pins and needles shook her right leg; she shuddered violently, shivers running up and down her body in realisation as to how easy it would be to mess this whole thing up. One wrong cut, and she would be dead for sure. Blinking the tears out of her eyes and they formed, she stared at the boring white ceiling, and made a vow that this wasn't going to be the last thing she ever saw.

Of all the things I should've said, that I never said.
All the things we should've done, that we never did.
All the things I should've given, but I didn't.

Oh, darling, make it go,
Make it go away.

Calming down, she put the scalpel precariously on her stomach and started to feel around in the wound for her appendix, barely managing to stifle out a cry. She became vaguely aware of voices somewhere else in the building, and clamped well bitten lips together. Then, there was another voice. It cut through everything else, cut over the other people in the building wherever they were, and at the same time it cut deeper than the scalpel had.

"Hello, students of Bayview Secondary School. My name is Jaxon Jeremiah. I'm here with a group of people who can get your collars off and take you home, on one condition: that you have not been murdering your classmates over the past week. If that describes you, and you want a lift, come to the beach as quickly as you can. We won't be here for long.

"If you've been playing, I'm sorry, but you're too much of a risk. We're armed, and we will not hesitate to open fire and send you away. All I can suggest is that you hold out and hope we tear this game to the ground. Should that occur, we will come back for you too."

They were here! They had done it!

No, that's not fair! That's NOT FAIR! Suddenly, she remembered. They had all died. First Ethan, who came up with the plan. Feo, who set it all up. Roland who transmited the message. Winnie and Dave, people she'd been with for days and been through so much with. Her team. This is OUR victory. And they all went and fucking died. It's not fair!

Give me these moments back.
Give them back to me.
Give me that little kiss.
Give me your hand.

Then Helen remembered the gaping hole in her abdomen. Right, surgery, yes.

The new leaf of adrenaline that the announcement had brought dulled the pain she felt as her gloved fingers covered themselves in blood as she tried to find her appendix. Truth be told, it wasn't that hard to find. With some distaste, she located something that she could only describe as halfway between a slug and a pickle, and with a short cry her trembling fingers detached it from the underlying tissue. Picking up the scalpel again in her right hand and taking a deep breath, she sliced it off in one swift motion.

She felt nothing.

Throwing the grotesque appendix to one side, suddenly disgusted by it, Helen felt a strong desire to be done with the whole thing. Which, she now knew was actually an option. What was next? Right, suturing! She'd found a suturing needle in her run around of the operating theatre, and threaded it with an attractive looking black cotton. It was her first time with a suturing needle, but she had a pretty good idea how it worked. And so, removing the retractors with a cry, that was the first pain she had really felt as the tissues came colliding back together, she picked up the sutures, blinking her tears away again. Crap, that hurt!

I know you have a little life in you yet.
I know you have a lot of strength left.
I know you have a little life in you yet.
I know you have a lot of strength left

Sewing everything up. The hole left by her appendix. The muscle she didn't know the name of. Internal oblique. External oblique. Fascia. Skin.

There was a heavy pause. Suddenly, she realised that she was done. She waited a few minutes, a short recovery time. Sitting up, that was painful, but she needed to get to the boats. Covering the wound with five layers of gauze and strapping them up with that tape that looked like a band aid. With a frown she realised she didn't know what that was called either. So much I have to learn! When I get to Stanford. Which I will. Just need to get to the boats...

I should be crying, but I just can't let it show.
I should be hoping, but I can't stop thinking

Of all the things we should've said,
That were never said.
All the things we should've done,
That we never did.
All the things that you needed from me.
All the things that you wanted for me.
All the things that I should've given,
But I didn't.

Oh, darling, make it go away.
Just make it go away now.

((Helen Wilson continued in The Cavalry Arrives))