The Fiery Cross - Diana Gabaldon [438]
I didn’t know whether I had a few minutes or an hour, but the process was inevitable, and there was only one thing to do about it. No more than a few molecules of air were seeping through that mass of crushed and mangled tissue; a bit more swelling would seal it off altogether. If no air could reach his lungs by means of nose or mouth, another channel must be provided.
I turned to look for Jamie, but it was Brianna who knelt beside me. A certain amount of racket in the background indicated that Jamie was dealing with the spectators.
A cricothrotomy? Fast, and requiring no great skill, but difficult to keep open—and it might not be sufficient to relieve the obstruction. I had one hand on Roger’s sternum, the soft bump of his heart secure under my fingers. Strong enough . . . maybe.
“Right,” I said to Brianna, hoping I sounded quite calm. “I’ll need a bit of help.”
“Yes,” she said—and thank God, she sounded calm. “What shall I do?”
In essence, nothing all that difficult; simply hold Roger’s head pulled well back, and keep it steady while I slit his throat. Of course, hyperextending the neck could easily sever the spinal cord if there were a fracture, or compress it irreversibly. But Brianna needn’t worry about that—or know about it, either.
She knelt by his head and did as I told her, and the mediastinum of the trachea bulged into view as the skin and fascia over it tightened. There it was, neatly lined up—I hoped—between the great vessels on either side. If it wasn’t, I could easily lacerate the common carotid or the internal jugular, and he’d bleed to death right under my hands.
The only virtue to hideous emergency is that it gives one license to attempt things that could never be done in cold blood.
I fumbled for the small bottle of alcohol that I carried in my pocket. I nearly dropped it, but by the time I had poured the contents over my fingers and wiped both my scalpel and Roger’s neck, the surgeon’s trance had come over me, and my hands were once more steady.
I took a moment, hands on his neck, eyes closed, feeling for the faint throb of the artery, the slightly softer mass of the thyroid. I pressed upward; yes, it moved. I massaged the isthmus of the thyroid, pushing it out of the way, hard toward his head, and with my other hand, pressed the knife blade down into the fourth tracheal cartilage.
The cartilage here was U-shaped, the esophagus behind it soft and vulnerable; I must not stab too deeply. I felt the fibrous parting of skin and fascia, resistance, then the soft pop as the blade went in. There was a sudden loud gurgle, and a wet kind of whistling noise; the sound of air being sucked through blood. Roger’s chest moved. I felt it, and it was only then that I realized my eyes were still shut.
70
ALL IS WELL
THE BLACKNESS CRADLED HIM, comforting in its warm completeness. He felt some faint stirring of something outside it, a painful, intrusive presence, and shrank back into the shelter of the dark. It was melting away around him, though, slowly exposing parts of him to light and harshness.
He opened his eyes. He couldn’t tell what he was looking at, and struggled to understand. His head throbbed and so did a dozen smaller pulses, each one a brilliant, tender burst of pain. He felt the points of pain like pins that nailed him like a butterfly to a board. If he could but pry them free, he might fly away . . .
He closed his eyes again, seeking the comfort of the darkness. He felt a dim recollection of terrible effort, his rib-muscles tearing with the struggle for air. There was water somewhere in his memory, filling his nose, wetness ballooning the hollows of his clothes . . . was he drowning? The idea sent a faint flicker of alarm through his mind. They said it was