24 June 2011

As soon as Liz had disappeared into the timber, Einar began unwrapping the tight bindings of cloth that were serving both to hold the usnea pads in place on his back and compress his ribs, knowing he needed to take advantage of the temporary stillness to focus on getting some good full breaths and figuring out just what was going on with his ribs. Needed to be working on the bear, too, but Liz had got so much done in his absence that she already had the next several loads portioned out and ready to go, so that seemed the less pressing task.

Ribs all unwrapped and his breathing a bit freer if rather more painful, Einar tried to lie down but felt as though he couldn’t breathe until he propped head and shoulders back up against the tree, reclined there for a while just breathing, counting the breaths--sets of four, that was the pattern into which he settled for no particular reason other than that five somehow seemed far, far too many--to help himself keep at it, knowing he had to keep his lungs clear, despite the way it hurt… After a time he let it go, exhausted, allowed himself to slip back into the pattern of shallow, rapid breathing that seemed best to minimize the pain while still affording him enough oxygen to remain conscious. He needed a rest. Closed his eyes for a minute, but soon opened them again, remembering that he was supposed to have been trying to figure things out, deciding what had happened to him, and what its implications might be. Didn’t even need to look to know that, not really, as he could feel what was going on, now that more time had passed and the muscles around the damaged area were no longer locked up tight and holding everything in place; he possessed little doubt as to the nature of his injury.

One look confirmed his suspicions. A portion of the left side of his chest, in addition to being heavily bruised, appeared to be moving independently of the rest of him with each breath. Sinking as the other side rose. The movement wasn’t dramatic, but was definitely noticeable. Einar closed his eyes again, felt a momentary surge of panic but let it pass. Unnecessary, and certainly wouldn’t do him any good. Focus on the situation. Flail chest, that’s what they called it. Two or three ribs broken in more than one place, preventing the lung on the injured side from inflating and deflating normally and making breathing incredibly painful and a lot of work. Well. That explained why he’d had such a rough time hauling the bear quarter… His was not a particularly severe example of the injury from what he could tell. He’d seen it worse, had seen…well, never mind what he’d seen, had seen a lot of things but most of them weren’t especially relevant at the moment; most of those guys he’d observed with similar injuries had got them by being too near an explosion or impact of one sort or another, sustaining blast injuries or crush injuries to the chest area that often as not significantly bruised a lung and caused other internal injuries as well as breaking the section of ribs, and a lot of them had died in the end, despite everyone’s best efforts.

But he hadn’t been blown up, or even thrown against a tree. He was just a half-starved old mountain critter whose hunger-weakened bones had apparently cracked when he’d been mashed down against the rocks by a bear, and it seemed unlikely to him that his lung would have sustained any significant injury. The slight flail chest, distressing as it was, wouldn’t kill him. Would reduce his lung capacity for a while on that side, for sure, which might give him some real difficulties up there in the oxygen-starved environment of the basin, but it wouldn’t kill him. Didn’t kill people. It was the underlying lung trauma often associated with such injuries that did people in, and he’d already decided he probably didn’t have that. Sure wasn’t getting enough air, but that was almost certainly due to the simple fact that it hurt like the dickens to breathe very deeply at all, leaving his body to automatically keep his respirations shallow in an attempt to minimize the hurt of it. He’d have to get past that. If he could take charge of the situation and make a very conscious effort to breathe in a more normal way, give himself enough oxygen and prevent further problems from developing, he’d get through it.

Glancing up at the sky for the first time in a good while, he saw that the sun was close to going down. Liz would be returning soon, and he figured he’d better get himself put back together so he could be of some use. Would have to wrap the ribs. Current treatment for injuries such as his, he knew, no longer involved the tight wrapping that had been standard in the past, as it had been rightly judged to cause too much interference with normal expansion of the lungs, leading to restricted breathing and sometimes lung infections that could have been otherwise prevented, but then, current treatment also relied on having some way to locally reduce the pain to the extent that the patient would be willing and able to take deeper breaths, in the first place. He could do it, could make himself do it, but the effort, as he had learned earlier, required all the concentration he could muster and left him exhausted and sweating after a dozen breaths, and he couldn’t realistically see himself breathing that way while trying to accomplish other tasks at the same time. Like walking. Or carrying bear meat. “Current treatment,” even if he’d had a way to carry it out, did not make allowances for any such things, he was pretty sure. It seemed to assume one could keep still quite indefinitely, which simply was not possible in his situation. In order to allow himself a bit of mobility and reduce the hurt some, he’d have to keep the ribs wrapped, at least part of the time. Wasn’t easy for him to move in the ways required to get himself wrapped back up but he did it, counting his efforts as a temporary solution and supposing he could see if Liz might be willing to do a more thorough job, when she got back.

Liz. She’d be cresting that hill any moment now, stepping out of the timber, and what was he going to tell her? That he was finished, broken, couldn’t get up and was leaving the rest of the work to her? To her, and the baby? No. On your feet. You hauled the bear out of that crevice, butchered it and carried a quarter down there with this injury, and if you did that, you can help finish the job before quitting. At which he promptly sat back down on the aspen log, holding his ribs and staring at the sectioned pile of bear segments, here a load, there a load, four or five more of them, plus one more trip for the hide, if they were going to keep the loads at or under fifty pounds as he had hoped, not wanting to ask Liz to carry any more than that along with her ever-present burden and knowing that he would himself be doing very well to manage anywhere near that much, a second time. Ha! Way things are looking, you’ll be doing well just to get yourself back down to the cabin before dark tonight, let alone any more of this bear. Not a useful thought, and he shoved it aside, stepped over to the neatly arranged piles of bear parts and knelt beside them, contemplating, trying to choose what he ought to carry but he found himself a bit indecisive, contemplating, generally taking a good while longer than he found acceptable to make his decision. Don’t want to leave her to do all the work tonight, but at the same time you’d better watch out that you don’t puncture a lung or something moving and twisting and carrying things with these busted ribs, or you’re gonna end up leaving her with a lot more than this bear to handle on her own…

Liz found him still crouched there over the bear carcass when she returned several minutes later, hand pressed to his side, breathing too quickly as he had been when she left, but still seeming unable to get enough air. At first she wasn’t even sure whether he was aware of her return, as he went on staring at the bear for a few moments, eyes glassy and distant-looking. He’d heard her though, had been listening to her climb up through the timber for the past several minutes, hand on his knife until he’d recognized her walk, and as soon as he managed to slow his breathing adequately, he spoke.

“Go…Ok down there?”

“Yes, it went just fine, got the meat hung and checked the cabin, but it didn’t look like anything had been trying to…hey, look at me for a second. Are you alright? Can’t you get your breath, still?”

Einar didn’t want to look at her but she insisted, got down beside him and put a hand to his face until he glanced up, checked his pulse again and looked worried. “It’s just the ribs. Broke a couple, looks like. Making it a little hard to breathe. If you could just…wrap them for me…did it myself but…needs to be tighter.”

“I’ll wrap them, but not until you let me have a look. I need to know what’s going on. Can you lie down? I won’t be able to get a look with you all hunched over like this, and won’t be able to do any wrapping, either. Come on, let me help you.”

Einar shook his head, wouldn’t move. Didn’t want her to see how much it hurt him to move, not until she’d helped him into that pack board and loaded it down--and wasn’t entirely confident in his ability to conceal the fact. “I’ll tell you…tell what’s going on. Got a section of…ribs busted loose in the middle. Making my breathing…less efficient but…be Ok. This…isn’t gonna kill me. I can still…”

“Ok, Ok, just slow down and try to get your breath.”

“Yeah. This is…about as good as it gets. May need a little help…getting that pack on.”

Pack? No, you don’t! Didn’t you just get done telling me that a section of your ribs has broken loose? The only place you’re going today is straight down to the cabin and to bed. I’d use the rabbit stick before I’d let you… Wrong. It was all wrong, would only strengthen his determination to carry the next load. Try something different. “I can help you get the pack on if you want me to, but look at it this way. Night is coming pretty fast, and we still have over half a bear to haul down there and get secured for the night. You’re not going to be moving very fast with your ribs injured like that--it’s just a fact. You can’t breathe well enough to move quickly. Since one of us has to be here to guard the meat, anyway, doesn’t it make most sense to let me do the hauling this time, and you be the guard? Just as a simple matter of how best to use the daylight we’ve got left?”

He couldn’t refute her logic. Didn’t like it one bit, but had no answer. She was right. He’d only slow them down if he insisted on making half the remaining trips. Her last one had only taken fifteen minutes or so, in total, while his…well, he hardly even wanted to know how long it had taken him to cover the same distance. Felt like half a day. He looked up at her. “You doing alright with the weight? You and little Snorri?”

“Oh, we’re doing just fine with it! It’s all downhill. No problem at all.”

“Yeah, then. I guess since it’s getting so late…if you can take two more loads, and then on the last one, I’ll come along and take one too since there won’t be anything left to guard, up here. And we’ll be done.”