A Breath of Snow and Ashes - Diana Gabaldon [304]
“Give me a retractor—yes, that thing.” Yes, it was Bree; a long-fingered hand, wet with disinfectant, picked up the claw-shaped thing and put it in my waiting left hand. I missed the services of a good surgical nurse, but we’d manage.
“Hold that, just there.” I nosed the blade between the muscle fibers, splitting them easily, and then pinched up the thick soft gleam of the peritoneum, lifted it and sliced it.
His innards were very warm, sucking wet around two probing fingers. Soft squish of intestine, small half-firm lumps of matter felt through their walls, the brush of bone against my knuckle—he was so small, there wasn’t much room to feel around. I had my eyes closed, concentrating on touch alone. The cecum had to be right under my fingers, that was the curve of the large intestine I could feel, inert but live, like a sleeping snake. Behind? Below? I probed carefully, opened my eyes, and peered closely into the wound. He wasn’t bleeding badly, but the wound was still awash. Ought I take the time to cauterize the small bleeders? I glanced at Malva; she was frowning in concentration, her lips moving silently, counting—and she had one hand on the pulse in his neck, keeping track.
“Cautery iron—a small one.” A moment’s pause; with the flammability of ether in mind, I had doused the hearth and put the brazier across the hall, in Jamie’s study. Bree was quick, though; I had it in my hand in seconds. A wisp of smoke rose from his belly and the sizzle of seared flesh struck into the thick warm smell of blood. I glanced up to hand the iron back to Bree, and saw Mrs. McCallum’s face, all eyes, staring.
I blotted away the blood with a handful of lint, looked again—my fingers were still holding what I thought . . . all right.
“All right,” I said out loud, triumphant. “Got you!” Very carefully, I hooked a finger under the curve of the cecum and pulled a section of it up through the wound, the inflamed appendix sticking out from it like an angry fat worm, purple with inflammation.
“Ligature.”
I had it now. I could see the membrane down the side of the appendix and the blood vessels feeding it. Those had to be tied off first; then I could tie off the appendix itself and cut it away. Difficult only because of the small size, but no real problem . . .
The room was so still, I could hear the tiny hisses and pops from the charcoal in the brazier across the hall. Sweat was running down behind my ears, between my breasts, and I became dimly aware that my teeth were sunk in my lower lip.
“Forceps.” I pulled the purse-string stitch tight, and taking the forceps, poked the tied-off stump of the appendix neatly up into the cecum. I pressed this firmly back into his belly and took a breath.
“How long, Malva?”
“A bit more than ten minutes, ma’am. He’s all right.” She took her eyes off the ether mask long enough to dart a quick smile at me, then took up the dropping bottle, lips resuming her silent count.
Closing up was quick. I painted the sutured wound with a thick layer of honey, wrapped a bandage tightly round his body, tucked warm blankets over him and breathed.
“Take off the mask,” I said to Malva, straightening up. She made no reply, and I looked at her. She had raised the mask, was holding it in both hands before her, like a shield. But she wasn’t watching Aidan anymore; her eyes were fixed on her father, standing rigid in the doorway.
TOM CHRISTIE looked back and forth from the small naked body on the table to his daughter. She took an uncertain step back, still clutching the ether mask. His head twisted, piercing me with a fierce gray look.
“What’s to do here?” he demanded. “What are ye doing to that child?”
“Saving his life,” I replied tartly. I was still vibrating from the intensity of the surgery, and in no mood for rannygazoo. “Did you want something?”
Christie’s thin lips pressed tight, but before