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Ventilators are machines that can breathe for the patient when the patient can't manage. With a flail chest,
we'd need to do that so the bones could knit together while the machine breathed for him. We can't splint
the ribs when they're broken that badly because we could drive a piece of bone into his lung. Plus, unlike
limbs, which can be immobilized by casts or splints to heal, the ribs will move multiple times each minute
with every breath. It would take too much strength for him to do that himself for a few weeks. With a
small flail, we'd give it a try but this is just too large. The other injuries he has might kill him as well but if
we can't keep him breathing, it's a moot point."
She finished drawing the morphine into a syringe and headed back to the patient. "All we can do ismake
him comfortable. We don't have a vent to breathe for him for weeks after the surgery. We also don't
have any of the substance that could help glue the bones together. Even though we know he won't make
it, we could try to keep him alive until his family gets here so they could say goodbye." She handed the
syringe to Mara. "There's ten mg in the syringe. I thought you could space it out as needed."
She turned back to Philip and motioned him back from the bed. "We can't use the supplies to buy him
an extra hour and give them a chance to say goodbye. We only have so many chest tubes. That blood
was scheduled to be used this afternoon in surgery. We don't have all the resources we once did. Even
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then, we never had endless resources anywhere I worked.Which means making tough choices
sometimes. "
Everyone who remained was oddly hushed, their movements and aspect subdued, Philip thought. They
continued to do small tasks for their patient and to clear away material, used or not. There was an air of
sadness and frustration in his Grantville colleagues. He was familiar with the feeling of losing a patient.
How much more difficult must it be to lose one that you might have saved, that you had the knowledge to
save.
3
"For God's sake, Mary Pat, did you have to come armed?" Beulah hissed the aside as she looked out
into the lecture room on the third floor of Leahy. They were using the future medical library for a lecture
on the history of public health and infection control for theJena students. A lecture Beulah was giving.
Damned if she was going to let anyone else face them after her experience last time inJena .
Mary Pat tenderly patted the Berretta 9mm pistol her oldest brother had given her and tried very hard to
look innocent. Beulah didn't think she looked at all repentant and the sparkle in those green eyes was far
from innocent. "I'm on duty. So of course I'm in my Basic Dress Uniform and carrying a side arm. Do
you really think I'd shoot one of these med students for getting out of line?"
"Idon't think you'd do it but they might. This is serious overkill here. Not that I don't appreciate the
sentiment but even I'm more subtle than that." She looked at Mary Pat out of the corner of her eye. "That
smile would reassure me and our audience a little more if it had fewer teeth in it."
"I'm on duty. I wouldn't go around shooting unarmed civilians for no good reason." She pursed her lips
thoughtfully. "Like say, oh, disorderly conduct."
"We have cops to handle that. I don't buy the just happened to turn up here of all places while on duty
line Lieutenant."
"Didn't think you would but it got your mind off the lecture didn't it? I'll be on my way, Officer Flanagan,
always at your service."
Beulah laughed and shook her head at her. She was so relieved to see Mary Pat teasingagain, she'd
forgive her just about anything."Brat. Okay, okay, it worked. Besides, I think they've already got your
point. The lecture's about to start, now scoot. You're scaring my students."
Besides, she thought, I've got to be in the right mood to pull this off.These were not stupid people.
In fact, some of those in that room, like Werner, had first rate minds. They also wouldn't be strangers to
some of the political maneuvering she was about to try. Ah, well. Misdirection and cooptation were tried
and true strategies. She just had to make sure she approached it properly so that she gave them an
"invisible war" that they would be fascinated enough by not to look too closely to see what other invisible
war they might be fighting.And to think I've given James such a hard time of late. Maybe I should
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