“I guess I’ll see you tomorrow night,” he said as he walked out to his bike. He put his helmet on and fired up the engine, then entered the clinic’s address into the GPS as he stretched — but no…he ran for the restroom off the lobby and made it just in time.
+++++
He pulled into the clinic parking lot a little before eight that evening, and he was shaking now, and he knew he was borderline hypothermic. The bike’s engine heat, and the heated grips on the handlebars, had been the only thing between him and death for the past two hours. Snow in September? In fucking Mexico? Well, mountains are mountains no matter where you find them, but having to stop every half hour to shit on the side of the road had only added insult to injury — and now he was near the end of his rope.
He just got the bike on the side-stand and made his way through blowing sleet to the clinic entrance and passed out just inside the door.
+++++
He felt the stinging pinch of the IV, heard the calm, reassuring voice of a physician giving orders to a nurse and he relaxed — until he remembered he was in Mexico and these people were speaking English! Had the DEA caught up to him?
He grimaced and opened his eyes, and he saw a youngish looking American girl drawing blood from a stick in his right arm and another, even younger girl looking at his EKG, then this girl turned and looked at him.
“Oh, you’re up!”
“Where am I?”
“Guachochi. At the Tarahumara Mission Hospital, and I’m Dr. McKinnon.”
“Shouldn’t you be, oh, I don’t know, in Glasgow, maybe?”
She smiled. “Med school in Mexico City, my public service commitment here,” she shrugged.
“UTMB Galveston,” he smiled.
“You’re a doc? Where at?”
“Minnesota. Taking a year off to do some riding.”
“Oh,” she said, her voice suddenly dull, flat, and comprehending. “Well, your core temp was 95.6 so I put some heat packs under your arms and I’m running Cipro wide open. You should be good to go in the morning.”
“Thanks.”
“What’s your specialty?”
“General surgery?”
“Really? I’ve got a kid with a hot belly and no cutter. Think you can do an appendix?”
“When? Now?”
“You should be hot to trot in an hour,” she said, knocking his knee with her clipboard. “And look at it this way…you do me a favor and I’ll do one for you.”
“You got a gas passer?”
“A nurse practitioner. Well, kind of.”
“What does that mean?”
“Oh, I don’t know. You’ll figure it out.”
He shook his head and looked at his watch; he’d been out for several hours — but he really was feeling a lot better. He shivered once and the nurse draped a hot blanket over him and he fell into a deep sleep…again.
+++++
The overhead lights weren’t the best but the instruments were clean and the OR was spotless, and he stood over the eight-year boy and checked off his landmarks for the incision, making a few dots with a marker on the boy’s belly before he swabbed betadine over the site.
Patty McKinnon had taped hot packs to his axial pits and inside his thighs and at least he wasn’t shaking now, so when the anesthetist, a girl from San Diego named Debbie Surtees, gave him the go-ahead he made his incision and dissected muscle to expose the kid’s appendix, and forty-five minutes later he closed the incision and just made it back to his bed before he passed out. Again.
He woke in the middle of the night and saw two bags of antibiotics and a bag of platelets running. “What the Hell?” he wondered.
McKinnon came in an hour later and when she saw he was awake she pulled up a chair. “Your white count is in the basement, Dr. — uh — Smith. And your right nut is as hard as a golf ball. Some of the cord, too.”
“Fuck.”
“My surgeon will be here tomorrow, and we should do an orchiectomy first thing in the morning.”
“All my stuff is over in Batopilas…”
“At the Lodge?”
“Yeah.”
“I know Martin. I’ll have ’em put your stuff in storage ’til we can run over and pick it up.”
“We?”
“You won’t be riding that bike for a while if you know what I mean.”
“We?”
“Yeah. We’ll treat you here, and you can work off your bill with the rest of the indentured servants working here.”
“I’ve got to be in Creel tomorrow morning.”
“That isn’t going to happen.”
“You have internet here?”
“If you don’t mind me asking, which cartel got to you? Sinaloa?”
He nodded.
“Quintana?” she sighed.
“That’s right. How’d you know?”
She chuckled. “Half the docs working in Mexico these days got sucked into their fentanyl operations. There used to be a shortage of doctors down here. No more.”
He nodded, if only because he’d already figured as much.
“I can get in touch with him if you like, but I’ll need to know your name, I think.”
“Trinity. Just tell him Trinity. He’ll know who you’re talking about.”
She looked away and shook her head. “Sooner or later you’re gonna have to trust someone.”
“I’m not there yet.”
“How long you been on the run?”
“A week.”
“Shit. No wonder…”
“Did you run an AFP?”
“Not yet. Our tech has to get supplies from Creel to run that one.”
“Sorry…it’s just a lot to wrap my head around.” He took a deep breath and shook his head. “I thought I felt something down there, like a burn, a pulled muscle kind of thing.”
“Probably the cord. We can decide on chemo after we look at the histology, but retroperitoneal radiation is probably warranted.”
“Uh-huh. Where? Not here, I assume?”
“No, not here. We do limited chemo, but I do mean limited.”
“So? Where?”
“I assume going home is out of the question?”
“Yup.”
“You could go to Creel, but…”
“Yeah…but no buts, please. Say no more. What about Mexico City?”
“Oh, yeah, of course, but there’s a good medical school in Chihuahua and the hospital has a decent radiology department.”
“What would you do, Patty?”
“I’d wait until I had the pathology report, ‘Gene.'”
He grinned. “You know, I was thinking when this blows over about heading over to someplace like Sudan or Ethiopia, joining MSF and maybe working over there.”
“Why?”
“Something about practicing medicine in the states, I guess. When I joined the group I was working with I was told we were a volume business, that the aim was to spend just enough time with patient to get a handle on the exact medical problem, then get ’em in and out of surgery as fast as possible. I guess within a year I felt like I was flipping burgers at MickeyDs. I didn’t know my patients, not at all. It was like go into the OR and see a patch of skin already draped, get in and get out and go to the next OR for the next case, then off to the office for exams before heading back to the hospital to finish my paperwork. Pretty soon I realized I couldn’t even remember one patient’s name from the last couple of years.”
“Flipping burgers,” McKinnon sighed, shaking her head in disbelief. “That’s good. I’ll have to remember that one.”
He looked out a little window and nodded. “I think I felt useless.”
“Do you have any idea how many times you say ‘I’ when you’re talking?”
He turned and looked at her. “What…a little too much narcissism for your taste?”
“Just curious,” she shrugged, “but was someone holding a gun to your head when you decided not to get to know your patients?”
“Yeah. The office manager was, and the partners sure were…”