oocmy apologies for the length. It turns out it takes no short amount of time to write about an amputation 
"First things first, get me a hot iron going so I can set about closing the vessels when it's that time. I need a fine point so I can be precise, okay?" He actually missed doing this, even though that was kind of sick. People had to be so terribly wounded for the former doctor to have to really push himself. He improved through others misery, as was the life of a doctor.
There was a lot of work to be done, and not nearly enough time, so he'd have to get to work. The poor knight wouldn't even know what happened. The fevers had already began to take him, and if the dead flesh wasn't removed, death would take him soon enough. "Go and get someone to help us hold him down while you're at it. The last thing we need is this guy thrashing about. If there's something to tie him down, we'll want that, too."
Orion sighed as he looked down at the soon to be former knight. It would be a horrid thing to wake up to, but when it came to life or limb, Orion chose life. It was a hard call to make, but at least he had a chance at picking up the pieces of his existence rather than ending it. ”How’s everything going?” Orion turned and glanced back at the farmhand. While she didn’t have it near as bad as the knight, he still felt quite bad for the woman. She never could have expected that this is what would be meeting her when she got up the previous day. The knights kept the outpost safe so that they could go about their business and work. She was just a simple farmwoman, raising crops and taking care of her family. These horrible beasts were supposed to be kept at bay.
”It’s coming along, Ser. The iron is heating, and I’ll go see about getting someone to help us.” She was exhausted, that much was clear enough, but Orion needed her help more than anything. There were so many tents with so many wounded and there weren’t nearly enough healers at the outpost yet. He and Septimus had been some of the early responders.
”Thank you,” Orion said, forcing himself to flash a smile at her. ”You’re doing great.” Another thing he’d learned in the past was that berating your people hardly got anything done. It didn’t inspire confidence and didn’t lead to good work. He was lucky that his attitude hadn’t cost someone their life.
The squire checked his surgical tools again and again, making sure that everything was there and in proper condition. They’d all been wrapped up neatly in cloths for so long, he’d almost forgotten what they looked like. The steel tools all felt so fragile in his hands when compared to the steely swords and shields he’d spent bell upon bell learning to wield. He felt, however, that the surgical tools were just weapons of a different kind. It was the only power he had in a battle against death, after all.
Orion fought off his nerves as the woman returned with a rather muscular civilian. He’d hoped for a knight, and should have specified it, but there was no time to fret about it. He’d make do with what was available. ”Hello, I’m Orion Michaels. Thanks for coming to help.”
The woman smiled and patted the man on the back. ”He’s my son. Strong as an ox, but he took a fall when he was younger. Doesn’t talk much, but he works the fields like no one else.” The farmwoman looked up at her son, smiling. ”Alright, boy. Hold down that man like I asked, alright.” The hulking man strode over behind the cot the knight lay on and held down his shoulders.
”Got these leather straps, too. Normally used for tying down hay bales, but should work just as good on a man.” She handed the straps over to Orion, who grasped them in his hands.
”Thanks again. I’d not be able to do this without you.” Orion knelt down by the cot and fed a strap under it to the woman who was residing on the other side. She took it and ran it across the man’s thighs and then returned it to Orion, who took it and cinched it down to keep his legs in place. They then did the same for the chest, securing him tightly to the cot. After he was satisfied that the man wasn’t going to be able to move, Orion set about dragging a table over to set the man’s arm on. It was rudimentary equipment. He’d never missed the Soothing Waters as much as he did at that moment. If he were there they would have actual tables to operate on, rather than a mishmash of whatever they could scrap together.
I wonder if this is what all of my medic experience will be as a knight.. He knew that this was the reason he was here. Orion could learn the sword all he wanted, he could learn to shoot arrows out of the sky with his bow, but it wasn’t his purpose. He was recruited for his medical knowledge, plain and simple. Everything else was a rather drawn out formality.
”I brought some booze along, just in case, Ser.” She gave the doctor a toothy grin, handing him the glass bottle of a clear liquid. ”It’s good stuff. I use it when my boy hurts himself. Shuts him up and cleans out the filth if it’s a wound. Figure it could be of some use here.” She managed to get a full grin from Orion with that one. ”Ahaha, thanks. I’ll have to take a sip of it once this is done, too. Let’s get some of it down the guy’s gullet. Hold him up and we’ll get this guy so drunk he won’t realize that his arm is gone.”
It was a surprisingly difficult task. The bulky farmer held him up, Orion forced his mouth open and the little farmwoman poured. The man was in and out of consciousness, so a good bit of the alcohol didn’t make the mark. Once they’d gotten a fair amount down his throat, however, they could actual move about proceeding with the amputation.
After they gave him time to get drunk, that was.
It wouldn’t do them any good to have wasted all that perfectly delicious alcohol if they went at it right away. This led to several awkward chimes of standing around waiting. With more patients to see, it was almost criminal to waste this kind of time. He thought about running to another tent and trying to start work there, but attention divided in such a manner would likely end up in more dead than people saved. Orion did take advantage of the time to get better dressed for such a surgery. Or rather, he decided that full plate wasn’t exactly the best choice of wear for something like this. Restricted movement, extra weight, and something that would make him sweat more than he was going to? No thanks. Orion piled it in the corner of the tent to keep the heavy equipment out of the way so they could all work without any sort of distraction. He also took advantage of that time to make sure all the instruments and tools he’d set out were in proper condition. Everything was free of debris and everything which was supposed to have a sharp edge indeed had one. Orion also took the time to ensure that his needles were ready with the thread tied and ready to go.
Now that he’s drunk and feverish…gods, how many times have I been there..?
”Let’s get this started. You all ready.”
No one responded, but that was to be expected. No one was ever ready to do this.
Orion took a piece of charcoal and marked his cutting lines. When all was said and done, he’d take about a half inch of healthy flesh above where the gangrenous tissue seemed to be. This was done as a precaution to make sure that he got all of the dead and minimized the chance of the infection spreading. ”Go ahead and get the hot iron over here. I’ll need it as soon as I get done cutting.” It was a fairly interesting procedure, though he wasn’t going to talk to them about that. He would actually have to cut the tissue under the skin in order to ensure there was enough left hanging over to close up the job. Perhaps it was a bit of a morbid fascination, but Orion was stunned by how the human body worked.
”Great, now I’ll need you to be ready with that bucket of water right there. There’s going to be a fair bit of blood coming here, so I hope that doesn’t make you queasy. What I’ll need you to do is constantly rinse for me. I need to be able to see where I’m cutting, and if there’s blood in the way, well, I’m sure you get the picture.” Orion took the cutting tool in his hand, and braced himself for the operation.
The cold steel scalpel kissed the man’s skin, and from the groan he gave, Orion felt like he could continue on. He hadn’t jerked or twitched when he’d made contact, and that was a good sign. He was out enough that perhaps the only issue they would face would be the actual bone itself. Crimson liquid escaped from the first incision, and Orion nodded to the farmhand, whose name he really should have asked, to begin rinsing. She poured a small amount water at his instruction, washing the blood away quickly. Orion continued to make precise cuts, the steel blade slicing its way through the sinewy muscle fibers of the man’s bicep. He could tell the man had been no slouch when it came to upper body strength. Years of training had been put into honing these muscles, and that was all gone. A quick burst of regret hit Orion, but he had no choice in the matter. He had to work through these feelings quickly.
I’m saving your life. You’ll thank me someday..
He continued working and she continued rinsing. With every movement he made, there was more blood to deal with, but he had to complete this. The squire’s hand maneuvered the scalpel around the man’s arm, cutting clean through as he moved. Orion took care to avoid the artery or the deep veins as he worked. The last thing he needed was to have out of control bleeding during an already pressure filled surgery.
Continuing on, Orion remained diligent in his work. It had been so long since he’d held a scalpel in his hand. With every inch the blade slid, he was reminded of how much he missed his old job. It was a strange feeling, but one he welcome openly. Orion finally got to a point where he could move onto the next step. ”Keep rinsing. This is going well. Keep up the good work. A let me steal a sip of that water,” he said, the corners of his mouth barely turned up in a smirk. Orion took his left hand and wiped the sweat from his brow, took a quick drink, and then set about working on the amputation further. ”Now that we’ve got this initial cut done, we get going on the real fun part. You might want to look away here.” The gangrene had destroyed the man’s forearm, but his elbow and above was still healthy. Orion’s cuts had been just above the elbow. In order to potentially save the man’s life, he would have to sacrifice that elbow, thus the reason for the incision being where it was. Not only did it ensure they got all the bad tissue, but it gave him excess skin to work with, which he would need later.
”Might want to close your eyes for this, ma’am.” Orion set his scalpel down on a small trey separate from the rest of his surgical equipment. Now that the cuts were done, he had to peel back the skin. It was as horrifying as it sounded, at least to someone who wasn’t interested in exploring such things. Perhaps some would call it barbaric, but the squire was pretty straightforward with how he went about it. He had fingers, so he was going to use them. Orion grasped the flaps of skin and pulled back, slowly and evenly. The woman kept rinsing, but she was a little more erratic from the splashing. There was no way she was looking directly at that.
Orion paused a moment to examine the exposed muscle, checking it for any sign of spread. The muscle was, thankfully, still healthy. That made things a lot easier. The man would get to keep a fair amount of his arm, all things considered. If it had spread up passed the elbow, it would have complicated the situation vastly. ”See, that wasn’t that bad, was it?” She looked like she was about ready to throw up. Her son remained stone-faced, however. His hands hadn’t moved from the knight’s shoulder in the entire time they’d been there.
Well, he takes instruction well , if nothing else. Good on you, big man.
”Give me another rinse here and then I’m going to set about stopping this bleeding.” While the farmwoman was hard at work making sure that he would be able to see what he was doing, Orion was grabbing the hot iron. He gave her a moment to finish up and get out of the way before he dove right in. Strike where the iron is hot, or so they say. The tip of the hot metal caressed the various vessels as Orion worked. A small sizzle escaped each time that the hot iron touched, the heat burning each of the vessels shut. It was tedious work, but Orion worked quickly. Each second spent was a second that the iron cooled.
These hands have been training for twenty years for this sort of thing. Come on, Orion..
Piercing blue eyes jumped around the man’s arm, searching for any further serious bleeding so that it could go about joining metal and flesh together as required. Orion would acquire his target, line up the poker, and strike. Again and again he moved the hot iron around the open flesh until the squire was satisfied with the progress. With the bleeding minimalized, he could move on.
”Clamp,” Orion said, handing off the metal rod. ”I’m going to clamp the artery here, cut it, suture it shut, fold it over, and then give it another suture for good measure. We’re almost done here, folks.” Orion would owe these two more than a drink after this was done. Even the big man was exhausted, but there was still work to be done. Controlling the artery was one thing. That could undo all of this hard work in an instant if it were accidently cut. He’d seen the aftermath of an unintentionally severed artery, and it wasn’t a pretty scene. It was impressive how quickly someone could bleed out.
The farmhand offered him the clamp, which he took and set about stopping the blood flow of the vessel. Orion took the scissor like tool, placed the radial artery in the opening and then closed the clamps on it. ”Alright, one more clamp.” She retrieved a second one and passed it over to the surgeon who took it and placed it a half inch above the other one. The tube stood no chance against the sharp blade Orion wielded, the organic material giving way Orion pressed the sharp instrument against it. The bit of blood between the two clamped areas dribbled out, but Orion wasn’t concerned with it at the time. He needed to stitch up this artery.
Orion turned his attention to the instrument trey, eyes scanning for the proper needle. If he had a legit assistant, he wouldn’t be grabbing these items himself, but thanks to the lack of qualified personnel and the traumatic situation, he was on his own. With a needle, a needle holder, and a thread, Orion could get to work. He took the needle and secured it firmly in the needle holder, allowing the thread to dangle behind it freely.
From there, he placed the needle against the artery, preparing to send the needle in. He would do six mattress sutures, three on each side, and then finish out the job with simple interrupted stitches. He placed the needle at a right angle, letting it slide into the tube. He pulled the needle through, over to the other side, bringing the needle up from inside of the artery and then redirected it back down, retracing its path to the initial side of the vessel where he brought it back. He then set about tying the suture off, precise hands moving expertly to create the small knot. Once that was done, he looked up to the farmhand. ”Go ahead and cut above the knot,” he directed.
The farmhand nodded and complied with the doctor’s orders, picking up a tool and separating the thread from the needle. ”One down.”
It was a tedious process to do each and every one of these stitches on such a small area, but he had to make sure that the job was done right. If he didn’t get it done completely, then it would leak and the man would slowly lose blood until he died. What a waste of time that would be. Orion diligently worked about stitching up the artery. Each movement had to be with purpose as he sinuously navigated the small metal needle with its thread back and forth throughout the man’s artery.
One of Orion’s favorite things about surgery was the fact that he could just push everything else aside when he was doing it. Some people didn’t have the strength, or maybe weakness, depending on point of view, to just push everything aside and work at something like this. For the squire, it was an escape. When he was putting everything out there to save someone, he could forget everything else. Emily had nipped at his thoughts since she’d been thrust into his life. A daughter long forgotten unceremoniously returned to him with a litany of curses. Since he’d begun to work in the tents she hadn’t crossed his mind once, which was a very good thing. The last thing he needed while navigating needles through arteries was the memories of a little girl calling him a ‘petch face.’
With the first set of sutures completed, he went about reinforcing it with a simple, though time consuming stitch. The interrupted stitch got its name from the fact that it stood alone, unconnected or non-continuous with other stitches. The drawback of this sort was the time that it took to use. In cases where the stitch was to fail or get damaged, the entire work wouldn’t be undone. The other sutures would be able to pick up the slack.
The actual suture itself was quite simple. Orion took the needle, placing it perpendicular to the target, pressed the needle through, brought it through the other side, up and through again. He then tied it off and hat her cut it once more. It wasn’t a quick process though. He’d watched seamstresses work in the past, working without breaking stride. There were similarities, but the material was clearly different. There was a lot more room for error when working with cotton rather than with human skin , flesh, and bone. Each meticulous movement was done with care, slowly and deliberately. Orion tied the small threads together and offered it up for her to cut. He was careful to not have the knot itself directly over the former opening as it could cause complications down the line.
With the initial set complete, Orion reached down to release the clamp. ”Let’s take a look . . .” The metal device was opened and set aside, and set aside, and Orion was relieved that no blood was coming forth. He reached down and grabbed the artery gently between his index and them to test and make sure everything was good. The added pressure forced the blood to push against the suture, and there was no hiding the displeasure on Orion’s face when a trace amount of the red liquid found its way out. It was a simple enough fix. After the woman gave him another quick rinse, Orion grabbed his needle and thread once more, tying another interrupted suture into the tube. It was a good thing that his father had forced him to practice needlework a lot in his youth, so it was second nature to him. Orion’s skill as a doctor was in dealing with traumas. Truth be told, he had a lot to learn about diagnosing actual illness, but if someone came to him in the state of this man, Orion was confident that only a marked healer could outdo him.
With the additional stitch in place he tested the artery again and was pleased to see that it was holding now. ”Now I’m going to fold this thing over itself and give it a second set to make sure everything is secure.” Orion set about doing just that. The tube folded in over the top of the closed off area and he began to feed the needle through again.
It was at that point, as Orion was focused on his work that the man came in carrying the severely injured child. Nothing ever worked out as they needed. The timing could have been any worse. ”Shyke,” he muttered while he finished up the stitch. The artery was fine, but he still needed to amputate the bone, file it down a bit, and fold the skin over the opening. ”I’ve got it from here! Get a cot pulled over for him and tell me what you see on him!” He quickly grabbed a knife from his tools and looked down to the exposed bone. He’d been under control throughout this entire process, and all of a sudden everything was going to fall apart. Even on the busiest of days at the Soothing Waters, Orion hadn’t had to deal with these kinds serious injuries back to back to back. He was almost done with the amputation, but if this boy was bad, then that knight would have to wait.
”S-ser, I don’t know what this is! I’ve never seen anything like this before. I don’t know what to do.” That was the last thing Orion had wanted to hear. He hoped she’d be able to take care of it and let him go about his work, but it didn’t appear it would be an option. He sighed and looked down at the exposed bone. The hard parts were done. He could set this up and switch over to the new patient. Orion reached down the with the blade at the point where he wanted to separate and carved a rough ‘x’ shape into that point.
”Alright. Switch places with me here. I need you to finish the amputation!”
”S-ser! You have to be kidding me. I can’t do it!” Orion came over to the woman after setting his knife down. She had to, they couldn’t waste time.
”You’ve survived the attack of these beasts and helped me get to this point. It’s easy to do it at this point. I’ve already marked it. All you have to do is bend the bone backwards over the edge there, lined up with the mark I gave you. The bone will go on its own.” Orion knelt down by the boy, turning his focus to him, tossing one last comment at her. ”You’re the strongest woman I’ve ever met,” he lied. ”These people need us; They need you. We can do this. You can do this.”
With his attention fully on the child, he was confused by the scene before him. He’d never seen anything like what was lying before him. There was so much blood and he wasn’t sure what the cause was. He’d never witnessed an injury of this sort in all his years. He would have to work fast to diagnose it or the child would die. Blue eyes scanned every inch of the boy searching for a source, but all he could think about now was how he was as young as Emily. So much for keeping his mind focused on the task at hand.
"Did you see what happened," he inquired, turning his gaze briefly from the pained child. He couldn't believe the condition that the poor boy was in, and he wasn't sure if he could do anything to save him. The information which the man had or didn't have would go a long way towards determining the child's fate.
"First things first, get me a hot iron going so I can set about closing the vessels when it's that time. I need a fine point so I can be precise, okay?" He actually missed doing this, even though that was kind of sick. People had to be so terribly wounded for the former doctor to have to really push himself. He improved through others misery, as was the life of a doctor.
There was a lot of work to be done, and not nearly enough time, so he'd have to get to work. The poor knight wouldn't even know what happened. The fevers had already began to take him, and if the dead flesh wasn't removed, death would take him soon enough. "Go and get someone to help us hold him down while you're at it. The last thing we need is this guy thrashing about. If there's something to tie him down, we'll want that, too."
Orion sighed as he looked down at the soon to be former knight. It would be a horrid thing to wake up to, but when it came to life or limb, Orion chose life. It was a hard call to make, but at least he had a chance at picking up the pieces of his existence rather than ending it. ”How’s everything going?” Orion turned and glanced back at the farmhand. While she didn’t have it near as bad as the knight, he still felt quite bad for the woman. She never could have expected that this is what would be meeting her when she got up the previous day. The knights kept the outpost safe so that they could go about their business and work. She was just a simple farmwoman, raising crops and taking care of her family. These horrible beasts were supposed to be kept at bay.
”It’s coming along, Ser. The iron is heating, and I’ll go see about getting someone to help us.” She was exhausted, that much was clear enough, but Orion needed her help more than anything. There were so many tents with so many wounded and there weren’t nearly enough healers at the outpost yet. He and Septimus had been some of the early responders.
”Thank you,” Orion said, forcing himself to flash a smile at her. ”You’re doing great.” Another thing he’d learned in the past was that berating your people hardly got anything done. It didn’t inspire confidence and didn’t lead to good work. He was lucky that his attitude hadn’t cost someone their life.
The squire checked his surgical tools again and again, making sure that everything was there and in proper condition. They’d all been wrapped up neatly in cloths for so long, he’d almost forgotten what they looked like. The steel tools all felt so fragile in his hands when compared to the steely swords and shields he’d spent bell upon bell learning to wield. He felt, however, that the surgical tools were just weapons of a different kind. It was the only power he had in a battle against death, after all.
Orion fought off his nerves as the woman returned with a rather muscular civilian. He’d hoped for a knight, and should have specified it, but there was no time to fret about it. He’d make do with what was available. ”Hello, I’m Orion Michaels. Thanks for coming to help.”
The woman smiled and patted the man on the back. ”He’s my son. Strong as an ox, but he took a fall when he was younger. Doesn’t talk much, but he works the fields like no one else.” The farmwoman looked up at her son, smiling. ”Alright, boy. Hold down that man like I asked, alright.” The hulking man strode over behind the cot the knight lay on and held down his shoulders.
”Got these leather straps, too. Normally used for tying down hay bales, but should work just as good on a man.” She handed the straps over to Orion, who grasped them in his hands.
”Thanks again. I’d not be able to do this without you.” Orion knelt down by the cot and fed a strap under it to the woman who was residing on the other side. She took it and ran it across the man’s thighs and then returned it to Orion, who took it and cinched it down to keep his legs in place. They then did the same for the chest, securing him tightly to the cot. After he was satisfied that the man wasn’t going to be able to move, Orion set about dragging a table over to set the man’s arm on. It was rudimentary equipment. He’d never missed the Soothing Waters as much as he did at that moment. If he were there they would have actual tables to operate on, rather than a mishmash of whatever they could scrap together.
I wonder if this is what all of my medic experience will be as a knight.. He knew that this was the reason he was here. Orion could learn the sword all he wanted, he could learn to shoot arrows out of the sky with his bow, but it wasn’t his purpose. He was recruited for his medical knowledge, plain and simple. Everything else was a rather drawn out formality.
”I brought some booze along, just in case, Ser.” She gave the doctor a toothy grin, handing him the glass bottle of a clear liquid. ”It’s good stuff. I use it when my boy hurts himself. Shuts him up and cleans out the filth if it’s a wound. Figure it could be of some use here.” She managed to get a full grin from Orion with that one. ”Ahaha, thanks. I’ll have to take a sip of it once this is done, too. Let’s get some of it down the guy’s gullet. Hold him up and we’ll get this guy so drunk he won’t realize that his arm is gone.”
It was a surprisingly difficult task. The bulky farmer held him up, Orion forced his mouth open and the little farmwoman poured. The man was in and out of consciousness, so a good bit of the alcohol didn’t make the mark. Once they’d gotten a fair amount down his throat, however, they could actual move about proceeding with the amputation.
After they gave him time to get drunk, that was.
It wouldn’t do them any good to have wasted all that perfectly delicious alcohol if they went at it right away. This led to several awkward chimes of standing around waiting. With more patients to see, it was almost criminal to waste this kind of time. He thought about running to another tent and trying to start work there, but attention divided in such a manner would likely end up in more dead than people saved. Orion did take advantage of the time to get better dressed for such a surgery. Or rather, he decided that full plate wasn’t exactly the best choice of wear for something like this. Restricted movement, extra weight, and something that would make him sweat more than he was going to? No thanks. Orion piled it in the corner of the tent to keep the heavy equipment out of the way so they could all work without any sort of distraction. He also took advantage of that time to make sure all the instruments and tools he’d set out were in proper condition. Everything was free of debris and everything which was supposed to have a sharp edge indeed had one. Orion also took the time to ensure that his needles were ready with the thread tied and ready to go.
Now that he’s drunk and feverish…gods, how many times have I been there..?
”Let’s get this started. You all ready.”
No one responded, but that was to be expected. No one was ever ready to do this.
Orion took a piece of charcoal and marked his cutting lines. When all was said and done, he’d take about a half inch of healthy flesh above where the gangrenous tissue seemed to be. This was done as a precaution to make sure that he got all of the dead and minimized the chance of the infection spreading. ”Go ahead and get the hot iron over here. I’ll need it as soon as I get done cutting.” It was a fairly interesting procedure, though he wasn’t going to talk to them about that. He would actually have to cut the tissue under the skin in order to ensure there was enough left hanging over to close up the job. Perhaps it was a bit of a morbid fascination, but Orion was stunned by how the human body worked.
”Great, now I’ll need you to be ready with that bucket of water right there. There’s going to be a fair bit of blood coming here, so I hope that doesn’t make you queasy. What I’ll need you to do is constantly rinse for me. I need to be able to see where I’m cutting, and if there’s blood in the way, well, I’m sure you get the picture.” Orion took the cutting tool in his hand, and braced himself for the operation.
The cold steel scalpel kissed the man’s skin, and from the groan he gave, Orion felt like he could continue on. He hadn’t jerked or twitched when he’d made contact, and that was a good sign. He was out enough that perhaps the only issue they would face would be the actual bone itself. Crimson liquid escaped from the first incision, and Orion nodded to the farmhand, whose name he really should have asked, to begin rinsing. She poured a small amount water at his instruction, washing the blood away quickly. Orion continued to make precise cuts, the steel blade slicing its way through the sinewy muscle fibers of the man’s bicep. He could tell the man had been no slouch when it came to upper body strength. Years of training had been put into honing these muscles, and that was all gone. A quick burst of regret hit Orion, but he had no choice in the matter. He had to work through these feelings quickly.
I’m saving your life. You’ll thank me someday..
He continued working and she continued rinsing. With every movement he made, there was more blood to deal with, but he had to complete this. The squire’s hand maneuvered the scalpel around the man’s arm, cutting clean through as he moved. Orion took care to avoid the artery or the deep veins as he worked. The last thing he needed was to have out of control bleeding during an already pressure filled surgery.
Continuing on, Orion remained diligent in his work. It had been so long since he’d held a scalpel in his hand. With every inch the blade slid, he was reminded of how much he missed his old job. It was a strange feeling, but one he welcome openly. Orion finally got to a point where he could move onto the next step. ”Keep rinsing. This is going well. Keep up the good work. A let me steal a sip of that water,” he said, the corners of his mouth barely turned up in a smirk. Orion took his left hand and wiped the sweat from his brow, took a quick drink, and then set about working on the amputation further. ”Now that we’ve got this initial cut done, we get going on the real fun part. You might want to look away here.” The gangrene had destroyed the man’s forearm, but his elbow and above was still healthy. Orion’s cuts had been just above the elbow. In order to potentially save the man’s life, he would have to sacrifice that elbow, thus the reason for the incision being where it was. Not only did it ensure they got all the bad tissue, but it gave him excess skin to work with, which he would need later.
”Might want to close your eyes for this, ma’am.” Orion set his scalpel down on a small trey separate from the rest of his surgical equipment. Now that the cuts were done, he had to peel back the skin. It was as horrifying as it sounded, at least to someone who wasn’t interested in exploring such things. Perhaps some would call it barbaric, but the squire was pretty straightforward with how he went about it. He had fingers, so he was going to use them. Orion grasped the flaps of skin and pulled back, slowly and evenly. The woman kept rinsing, but she was a little more erratic from the splashing. There was no way she was looking directly at that.
Orion paused a moment to examine the exposed muscle, checking it for any sign of spread. The muscle was, thankfully, still healthy. That made things a lot easier. The man would get to keep a fair amount of his arm, all things considered. If it had spread up passed the elbow, it would have complicated the situation vastly. ”See, that wasn’t that bad, was it?” She looked like she was about ready to throw up. Her son remained stone-faced, however. His hands hadn’t moved from the knight’s shoulder in the entire time they’d been there.
Well, he takes instruction well , if nothing else. Good on you, big man.
”Give me another rinse here and then I’m going to set about stopping this bleeding.” While the farmwoman was hard at work making sure that he would be able to see what he was doing, Orion was grabbing the hot iron. He gave her a moment to finish up and get out of the way before he dove right in. Strike where the iron is hot, or so they say. The tip of the hot metal caressed the various vessels as Orion worked. A small sizzle escaped each time that the hot iron touched, the heat burning each of the vessels shut. It was tedious work, but Orion worked quickly. Each second spent was a second that the iron cooled.
These hands have been training for twenty years for this sort of thing. Come on, Orion..
Piercing blue eyes jumped around the man’s arm, searching for any further serious bleeding so that it could go about joining metal and flesh together as required. Orion would acquire his target, line up the poker, and strike. Again and again he moved the hot iron around the open flesh until the squire was satisfied with the progress. With the bleeding minimalized, he could move on.
”Clamp,” Orion said, handing off the metal rod. ”I’m going to clamp the artery here, cut it, suture it shut, fold it over, and then give it another suture for good measure. We’re almost done here, folks.” Orion would owe these two more than a drink after this was done. Even the big man was exhausted, but there was still work to be done. Controlling the artery was one thing. That could undo all of this hard work in an instant if it were accidently cut. He’d seen the aftermath of an unintentionally severed artery, and it wasn’t a pretty scene. It was impressive how quickly someone could bleed out.
The farmhand offered him the clamp, which he took and set about stopping the blood flow of the vessel. Orion took the scissor like tool, placed the radial artery in the opening and then closed the clamps on it. ”Alright, one more clamp.” She retrieved a second one and passed it over to the surgeon who took it and placed it a half inch above the other one. The tube stood no chance against the sharp blade Orion wielded, the organic material giving way Orion pressed the sharp instrument against it. The bit of blood between the two clamped areas dribbled out, but Orion wasn’t concerned with it at the time. He needed to stitch up this artery.
Orion turned his attention to the instrument trey, eyes scanning for the proper needle. If he had a legit assistant, he wouldn’t be grabbing these items himself, but thanks to the lack of qualified personnel and the traumatic situation, he was on his own. With a needle, a needle holder, and a thread, Orion could get to work. He took the needle and secured it firmly in the needle holder, allowing the thread to dangle behind it freely.
From there, he placed the needle against the artery, preparing to send the needle in. He would do six mattress sutures, three on each side, and then finish out the job with simple interrupted stitches. He placed the needle at a right angle, letting it slide into the tube. He pulled the needle through, over to the other side, bringing the needle up from inside of the artery and then redirected it back down, retracing its path to the initial side of the vessel where he brought it back. He then set about tying the suture off, precise hands moving expertly to create the small knot. Once that was done, he looked up to the farmhand. ”Go ahead and cut above the knot,” he directed.
The farmhand nodded and complied with the doctor’s orders, picking up a tool and separating the thread from the needle. ”One down.”
It was a tedious process to do each and every one of these stitches on such a small area, but he had to make sure that the job was done right. If he didn’t get it done completely, then it would leak and the man would slowly lose blood until he died. What a waste of time that would be. Orion diligently worked about stitching up the artery. Each movement had to be with purpose as he sinuously navigated the small metal needle with its thread back and forth throughout the man’s artery.
One of Orion’s favorite things about surgery was the fact that he could just push everything else aside when he was doing it. Some people didn’t have the strength, or maybe weakness, depending on point of view, to just push everything aside and work at something like this. For the squire, it was an escape. When he was putting everything out there to save someone, he could forget everything else. Emily had nipped at his thoughts since she’d been thrust into his life. A daughter long forgotten unceremoniously returned to him with a litany of curses. Since he’d begun to work in the tents she hadn’t crossed his mind once, which was a very good thing. The last thing he needed while navigating needles through arteries was the memories of a little girl calling him a ‘petch face.’
With the first set of sutures completed, he went about reinforcing it with a simple, though time consuming stitch. The interrupted stitch got its name from the fact that it stood alone, unconnected or non-continuous with other stitches. The drawback of this sort was the time that it took to use. In cases where the stitch was to fail or get damaged, the entire work wouldn’t be undone. The other sutures would be able to pick up the slack.
The actual suture itself was quite simple. Orion took the needle, placing it perpendicular to the target, pressed the needle through, brought it through the other side, up and through again. He then tied it off and hat her cut it once more. It wasn’t a quick process though. He’d watched seamstresses work in the past, working without breaking stride. There were similarities, but the material was clearly different. There was a lot more room for error when working with cotton rather than with human skin , flesh, and bone. Each meticulous movement was done with care, slowly and deliberately. Orion tied the small threads together and offered it up for her to cut. He was careful to not have the knot itself directly over the former opening as it could cause complications down the line.
With the initial set complete, Orion reached down to release the clamp. ”Let’s take a look . . .” The metal device was opened and set aside, and set aside, and Orion was relieved that no blood was coming forth. He reached down and grabbed the artery gently between his index and them to test and make sure everything was good. The added pressure forced the blood to push against the suture, and there was no hiding the displeasure on Orion’s face when a trace amount of the red liquid found its way out. It was a simple enough fix. After the woman gave him another quick rinse, Orion grabbed his needle and thread once more, tying another interrupted suture into the tube. It was a good thing that his father had forced him to practice needlework a lot in his youth, so it was second nature to him. Orion’s skill as a doctor was in dealing with traumas. Truth be told, he had a lot to learn about diagnosing actual illness, but if someone came to him in the state of this man, Orion was confident that only a marked healer could outdo him.
With the additional stitch in place he tested the artery again and was pleased to see that it was holding now. ”Now I’m going to fold this thing over itself and give it a second set to make sure everything is secure.” Orion set about doing just that. The tube folded in over the top of the closed off area and he began to feed the needle through again.
It was at that point, as Orion was focused on his work that the man came in carrying the severely injured child. Nothing ever worked out as they needed. The timing could have been any worse. ”Shyke,” he muttered while he finished up the stitch. The artery was fine, but he still needed to amputate the bone, file it down a bit, and fold the skin over the opening. ”I’ve got it from here! Get a cot pulled over for him and tell me what you see on him!” He quickly grabbed a knife from his tools and looked down to the exposed bone. He’d been under control throughout this entire process, and all of a sudden everything was going to fall apart. Even on the busiest of days at the Soothing Waters, Orion hadn’t had to deal with these kinds serious injuries back to back to back. He was almost done with the amputation, but if this boy was bad, then that knight would have to wait.
”S-ser, I don’t know what this is! I’ve never seen anything like this before. I don’t know what to do.” That was the last thing Orion had wanted to hear. He hoped she’d be able to take care of it and let him go about his work, but it didn’t appear it would be an option. He sighed and looked down at the exposed bone. The hard parts were done. He could set this up and switch over to the new patient. Orion reached down the with the blade at the point where he wanted to separate and carved a rough ‘x’ shape into that point.
”Alright. Switch places with me here. I need you to finish the amputation!”
”S-ser! You have to be kidding me. I can’t do it!” Orion came over to the woman after setting his knife down. She had to, they couldn’t waste time.
”You’ve survived the attack of these beasts and helped me get to this point. It’s easy to do it at this point. I’ve already marked it. All you have to do is bend the bone backwards over the edge there, lined up with the mark I gave you. The bone will go on its own.” Orion knelt down by the boy, turning his focus to him, tossing one last comment at her. ”You’re the strongest woman I’ve ever met,” he lied. ”These people need us; They need you. We can do this. You can do this.”
With his attention fully on the child, he was confused by the scene before him. He’d never seen anything like what was lying before him. There was so much blood and he wasn’t sure what the cause was. He’d never witnessed an injury of this sort in all his years. He would have to work fast to diagnose it or the child would die. Blue eyes scanned every inch of the boy searching for a source, but all he could think about now was how he was as young as Emily. So much for keeping his mind focused on the task at hand.
"Did you see what happened," he inquired, turning his gaze briefly from the pained child. He couldn't believe the condition that the poor boy was in, and he wasn't sure if he could do anything to save him. The information which the man had or didn't have would go a long way towards determining the child's fate.
