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The Amputation By Yates Walker "Hold this," said a handsome and serious man I'd never seen before. Must be a doctor, I thought. I hated them all, or at least tried to. Every army doctor I met was the kind of guy you'd want your sister to marry: pleasant, thoughtful, smart, gregarious, industrious, wealthy, and almost uniformly handsome. With pricks like that around, the rest of us didn't stand a chance. Anyway, this one handed me something, then immediately became too busy for my questions. He, like everyone in the operating room, was wearing surgical attire and engaged in some unfamiliar doings with alien and forbidding instruments. Witnessing the O.R. being prepped for surgery is bizarre under any circumstances, but it's unnerving if you've never seen it before. The room is filled with busy and shrouded figures. Their eyes are visible behind clear visors. Everything else from head to toe is wrapped, caped, draped, or otherwise concealed by institutional vestments cut from some enriched fabric that repels blood and secretions and infection and possibly evil spirits. Then, these cloaked figures move in small circles, ritualistically touching certain machines and utensils, occasionally muttering in an arcane dialect of medical-speak. If it were four hundred years earlier, I would have accused them all of witchcraft and been done with it. As it was, I just stood still and hoped to remain invisible. I was invisible because I had no specific function. Those with functions were busy preparing to perform an amputation. Officially I was standing in for a surgical technician named Sergeant Zins, but the phrase "standing in" was a shade optimistic. I had zero 2 relevant experience. I may as well have been standing in for a ninja. Surgical techs are the guys who hand instruments to the doctor during surgery. In the movies the job looks easy because the only thing movie doctors ever ask for is a scalpel. In reality, surgical techs go to school for a year to master surgery's many tools and fundamentals, and at a glance can distinguish between forty-seven pair of virtually identical . . . things that look like tweezers. Needless to say, I wasn't qualified for the duty. I hadn't planned to be there. Near midnight on the previous night, a gleefully inebriated Sergeant Zins woke me up. He had decided that I needed to take his slot in the morning surgery so that I could get some experience and so that he could get shit-faced. Sergeant Veysey was pulling double duty in his absence. And Sergeant Veysey didn't like me. "Keep your stupid, goddamn hands folded and on your chest at all times. Anything you touch you're gonna fuck up. You might think you know something about surgery or the sterile field, but you don't know shit, and if I have to start over because of your dumb ass, you're never going to stop paying for it. Roger?" "Roger," I gratefully replied to Sergeant Veysey's sage counsel. He was bug-eyed and angry, short and freckled, loud and dumb. I never saw the man drool, but he often looked like he might. His eyes were set too close together, affecting a strange countenance that was simultaneously confused and furious. His parents were almost certainly siblings. But at the moment, I completely agreed with his assessment of my abilities and was happy to be removed from responsibility. *** 3 I wasn't lazy. I was utterly incompetent. Growing up in the east suburbs of Cleveland, Ohio hadn’t prepared me for this. Neither had the army. Of my sixteen weeks of Army medical education, I'd spent just two days with actual patients. It was back at Fort Sam Houston in San Antonio, toward the end of the last phase of training, that my startlingly ignorant class was sent to Brooke Army Medical Center. In theory, we were there to shadow nurses and doctors as they made their rounds, getting as much hands-on experience with real patients as possible. In the hospital lobby, we were broken up into groups of five and told to shut our mouths while the sergeant-in- charge read an ominous list of the variously specialized wards to which we were consigned. A smiling black woman in hospital attire slapped a "Group Three" sticker on my chest. "Group one: cancer. Group two: trauma. Group three: burn unit." And before I could say, "Fuck you, I quit," I was ushered into an elevator, then into a gown and mask, then into a super-heated, negatively pressurized burn unit chamber. I was four feet away from a seventy-two year-old man with second and third degree burns from his head to his knees. Flesh that wasn't charred was scabbed. What wasn't scabbed was blistered. What wasn't charred, scabbed, or blistered was oozing. Worst of all, the man was conscious. His limbs were rigid and still, but his pleading, terrified eyes darted around desperately. Any movement made his skin rip and bleed. He clearly did not wish to participate in our hands-on training. 4 The nurse we were shadowing followed us into the room and nonchalantly lifted the old man's arm. He immediately recoiled from her touch, but the nurse didn't seem to notice. She flexed and extended his arm, working the elbow and shoulder joints. Everything started to crackle and bleed. The old man’s face was screaming, but no sound came out because his airway had been singed as well. Behind my protective mask I blinked back tears. The nurse began flexing and extending his fingers, dispassionately explaining that such movement was necessary because it increases blood flow and that without regular exercise he would lose the limbs. She dropped his freshly bleeding hand and moved to his other arm. I have no doubt that the nurse was absolutely correct, but her tone and lack of sympathy incensed me. The old man was in unimaginable agony. The nurse was bored and fat and talking about the patient’s vital signs like he was a fucking HAM radio. I hated her and tried to kill her telepathically, but the old man's eyes convinced me that my efforts were in vain. He hated her more than I ever could. His anguish and helplessness had morphed into a cartoonish, seething rage under her hands. He wanted his nurse to burst into flames, and she knew it. Her detachment was a necessary coping mechanism. And though I made sense of their relationship, it still horrified me. I didn't think I could ever do what my role as a medic required me to do. Even if I could, I didn't want to. I assiduously and successfully avoided patients for the rest of the first day. On the second, I was assigned to pediatrics where I spent the hours losing board games to a sick kid. And that was the breadth and depth of my practical experience with patients: utter fucking horror. 5 The only other medical contact I'd had with humans was sticking needles into fellow trainees. When I was handed a certificate on graduation day, I thought I was in the wrong line. I didn't know much, but I damn sure knew that I didn't know enough. While my fellow newly-anointed medics smiled and hugged proud parents, I looked around for ways to turn myself in as a quack. And for the six months between graduation and this moment in the operating room, I'd been mowing lawns at Fort Bragg. *** The cloaked figures moved purposefully in their hypnotic circles, their routines both baffling and comforting. These men knew how to do things. I watched in wonder as a dozen facile hands performed intricate and mysterious functions with delicate, expensive equipment that together, I was certain, would instantaneously cure or heal whatever patient was lucky enough to deserve their attention. These men in the OR comprised half of the Forward Surgical Team (the F.S.T.) from the 82nd Airborne Division. Among the remarkable things about the group was their effortless cool. Aerosmith's "Dude looks like a lady" played from some hidden speakers, and reflected the atmosphere of the room. They were about to perform surgery in a trauma hospital, yet they were telling stories and playing pranks. Their effortless cool had developed over months of practicing emergency medicine in Iraq. They had performed surgery in tents across desert locales, with temperatures well over 100 degrees. When an American or an Iraqi was seriously wounded in their sector, the casualty was delivered to them by helicopter or Humvee. Regardless of the hour or fatigue or hunger or any need that normal people expect to supersede their jobs, they went to work saving lives and limbs. 6 Day after day, they were presented with unimaginable gore which they transformed into treatable injuries. Eating, sleeping, and working together, they had proven their mettle and skill to each other and themselves under such arduous, claustrophobic conditions that a jocular operating room became a necessity. They trusted each other implicitly and had earned the right to joke around. And I was the “fuckin’ new guy”— the FNG from day one. Straight out of initial combat medical training, I'd been placed on the 82nd Airborne's Forward Surgical Team a month after they'd returned from their second deployment to Iraq. I was an outsider and a daisy-fresh medic. Nearly the whole of my practical training was with computerized manikins. Yet there I was, a medical professional in an operating room with a half dozen combat veterans about to perform surgery. A door swung open from the hallway, and Doc Bloch entered. The good doctor was a lieutenant colonel and had been the commander of the FST for the past six years, but, outside of formal meetings and ceremony, he was "Doc." Doc was 45 years-old, an orthopedic surgeon, and an imposing figure. Olive skinned, densely muscled, 240 pounds of man stacked to six foot four with black hair and black eyes – one could assume that Doc wasn't particular about military courtesy simply because he looked like a commander. "Shit. Where's Zins?" he growled when he saw me. "Zins is dishonoring a toilet somewhere. He's hung over," answered Veysey. "Walker's not going to touch anything." "That's not the best way for him to learn," Doc casually observed, then turned to inspect the room. 7 I never even saw it coming. That's not the best way for him to learn. His words echoed in my ears and mocked the silence that followed. My hopes to remain invisible were shattered. Doc just put a neon target on my back. And my veins flooded with ice water. Bizarre moments like this only exist in the military. It's profound and surreal— impossible to fully relate to someone who has never served—how an offhand comment from a ranking officer can so swiftly alter a soldier's life. It's voodoo. In the ten seconds after Doc's comment, I could have grown a beard or learned to play the fiddle. Even the taste of the room's air had changed. It was almost like there’d been a clap of thunder, and the mighty hand of God had descended, seized and shaken my world like one of those glass-encased snow globes, then returned to the heavens to watch His mischief unfold. I was now helplessly in the midst of an insane military game of politics. That's not the best way for him to learn. The comment had morphed into a command of sorts, but, because the command had been given to the whole room, the credit for following it was up for grabs. I was up for grabs, and the grabbing was now inevitable. The only questions were, who would grab me and when. The trick was in the timing. If someone jumped the gun, he'd look like he was kissing Doc's ass. The idea was to appear independent while following an order. Whatever the rules, the game was on, and I was screwed. The door opened again. For a second, I thought I was saved. "Walker, get your ass over there, and make yourself useful," ordered Sergeant Veysey. 8 I turned and saw two orderlies maneuvering a wheeled bed through the doorway. On top of the bed was an unconscious Latin man in his late forties or early fifties. An enormous bandage was wrapped about eight inches above where a second foot should have been. As I approached, the orderly at the head of the bed wordlessly handed me a rubber bag that was connected to a tube stuffed deep in the patient's throat. Involuntarily I squeezed the bag, watching the patient's chest rise as his lungs filled with air. Five seconds later, I did it again. I couldn't believe it. I was breathing for this patient, sustaining his life, doing something that I had been trained to do. One one thousand. Two one thousand. Three one thousand. Four one thousand. Squeeze. Transfixed, I squeezed the bag three or four more times while the orderlies jostled the bed until it was locked and in position, adjacent to the operating table. Standing next to the imposing machines at the head of the table, Captain McCaffrey, a nurse anesthetist, reached over and disconnected the bag I was squeezing from the patient's breathing tube. My brain hiccupped then abruptly ceased function. I stared blankly at Captain McCaffrey. Somehow I couldn't believe that he had done what I had just seen him do. In the middle of the operating room, he was going to snuff the patient. No one else seemed to notice or care. I looked at the unconscious, fifty year-old Latin man with one foot for support, but he offered none. I held the rubber bag and listlessly stared at the murderous Captain McCaffrey. Without an upward glance, he instructed me to grab the bed sheet underneath the patient. At the count of three, the orderlies and I moved the suffocating, fifty year-old, unconscious Latin man with one foot from his bed to the operating table. 9 The orderlies unlocked the wheels on the bed and nonchalantly pushed it out of the room. My heartbeat quickened and thumped in my ears. I was vaguely aware that Sergeant Veysey was now reminding me that he outranked me and that I was a dumbass and that after touching the patient's sheet I was no longer sterile and needed new gloves and a new gown. Just as I was about to scream that the patient hadn't breathed in twenty seconds, Captain McCaffrey fastened the patient's tube to an oxygen line, and one of the colossal machines began to breathe for him. "You all right, Walker?" asked a familiar voice. It was Sergeant First Class Olssen, the ranking enlisted man on the Forward Surgical Team. He was one of a handful of people, all more qualified than me, who was there to observe the surgery. I mumbled some unconvincing version of "I'm okay" and walked past him and out of the room. "Don't puke in the scrub sink" and some ensuing chuckles were the last things I heard before the door closed behind me. I didn't need to throw up. What I needed was an escape route or a time machine or six or seven cocktails. Instead, I peeled off my surgical mask, gown, and gloves and found my t-shirt drenched in sweat. I stood still and breathed for a moment in front of a large sink in a corridor adjacent to the O.R. I began feverishly washing my hands and arms. Closing in behind me, I heard Sergeant Olssen forecasting sun-shiny goodness and spouting hap-happy cheer-me-ups sprinkled with encouragement about the wonderful learning experience I was about to have, but I wasn't really listening. I couldn't. I was on autopilot in a parallel dimension. He was enthusiastic and full of pep. No, he was enthusiastic and full of shit. Olssen's forecast may have been true in the Realm of 10 Rainbows and Frolicking Ponies or whatever fucking world he was talking about. In mine, I knew that the nightmare was about to begin. *** A few weeks earlier when the entire team was watching a PowerPoint presentation, I had thoughtlessly let it slip that I was a little apprehensive about seeing blood and guts. The presentation featured pictures of various injuries that army medical personnel had encountered in the combat zone. The pictures weren't pretty. Because of advances in body armor, soldiers are now surviving attacks that would have killed them a few years ago. As a result, the modern army medic has to confront and treat injuries that he used to zip into body bags. Slide after slide showed Iraqi and American boys with remnants of faces and limbs leftover from blast injuries. Next to me during the presentation sat Specialist Margo, a former ranger and soulless redneck from Oklahoma. Margo is the kind of guy who notices the discomfort of others like a lion notices a gazelle's limp. After a few dozen slides of charred flesh and exposed bone, I started to shift in my seat. Theatrically leaning toward me, Margo asked if I was in the mood for Taco Bell. *** "You're ready for this," Sergeant Olssen beamed as I tied a double knot on a new sterile gown. For the second time that hour, I stood by the scrub sink and stared at the door to the O.R. Cloaked, masked, gloved, and petrified, I mustered a thank you to the kind and sympathetic Sergeant Olssen, and as he opened the door I considered faking a seizure. I folded my sterile gloved hands on my sterile gowned chest, and I knew that 11 just a few feet and moments away I was going to watch the unconscious, fifty year-old Latin man's footless leg get even shorter in my first trauma surgery. I breathed a deep breath, and I took four steps into the O.R., and sweet, buttered Christ, that leg had seen better days. In my absence, the leg had been unwrapped and stained orange with iodine. Doc Bloch and the handsome prick were chatting and holding the leg up, making observations from various angles. Captain McCaffrey stood at the head of the surgical table, presumably keeping the patient breathing while monitoring the anesthesia and vital signs. Sergeant Veysey pored over a meticulously organized and frightening medical arsenal, preparing to hand over whatever cutlery might be requested. No one acknowledged my entrance. I stood a few feet behind the doctors, inwardly rejoicing that I had become a spectator again. Except for the subject leg, the fifty-year old Latin man had disappeared completely under thin layers of surgical blue that blanketed the table and cascaded to the floor. Listening to the doctors, I learned that our patient had crashed his motorcycle and had had his foot amputated the week before. The remainder of his leg had gotten infected, so the docs were going to have to trim off a little more. They were discussing exactly how much more when they suddenly agreed and dropped the orange stump onto a nest of sterile towels. "Is Walker back yet?" Doc barked, turning his head to the side. My tongue spasmed in my mouth, and I let out an involuntary gurgle. "Walker, what the hell are you doing? Get your ass up here." There wasn't a hint of playfulness in Doc Bloch's voice, but I knew he was reveling in this. He was training me while pandering to his audience and amusing the shit out of himself, and it was my responsibility as the FNG to deal with it 12 passively. The two doctors made room for me at the surgical table. As I approached, I felt like I was walking the plank. The stump was bloody and scabby and within arm's reach. A lot of the tissue was dying and dead, yellow and black. In the center of the hideous mess was a protruding tibia. The bone jutted an inch or two beyond the stump. It had been cut off at about mid- calf. I was mesmerized and struck dumb. "Scalpel!" Doc ordered. Upon hearing that word, I was confident that I had seen what I was supposed to see. Surely "Scalpel!" was my cue to leave. I was about to slip away when Doc put the scalpel in my hand. He lifted the stump at a forty-five degree angle and directed me to cut four millimeters deep around the perimeter of the leg where the skin had died, then he held up the leg and looked at me expectantly. I realized that any protest was futile. This was happening. In a few moments, I would be able to add surgery to my list of life experiences. I examined the stump, looking for a definitive line between living and dead tissue. There wasn't one. Settling on a yellowing patch, I made my first incision. The blade went through the skin with little resistance. I cut slowly and carefully, holding the scalpel like a pencil. It was like drawing. For a second I mused about signing my name, leaving a permanent autograph in the Latin man's leg. "That's all dead," said Doc after I had cut less than two inches. "You have to err on the side of living tissue. If it bleeds, it's alive. We can't leave dead tissue on the leg. That's how it got infected in the first place. This guy isn't going to be pissed if he loses a little skin. If it gets infected again and he loses more leg, he's going to have a tough time 13 getting a decent prosthetic." With that, Doc took the scalpel, made an inch-long incision into obviously living tissue and said, "Start there." Blood was already seeping out of Doc's incision when he handed back the scalpel. Following his line, I completed the perimeter in about a minute. When I was finished, I was oddly pleased. I had faced the gore with surprisingly little drama. "You can peel off the dead flaps," Doc offered, interrupting my self- congratulations. "You can," I countered. "No, it's easy." Doc placed his thumb near the incision and peeled off a strip of dead tissue. Then he tossed it into a blue plastic tub marked SPECIMEN. I mimicked Doc and began thumbing off strips of tissue around the incision. At some point in the previous minute I'd unconsciously decided that the more I hesitated, the more Doc would torment me. I still couldn't fucking believe what I was doing. I expected some uniformed authority to barge in, seize me, and put me in a cage for decades. But somehow, amidst my hands and fingers following Doc's orders, while ten medical gods watched without protest or criticism, I'd been instilled with some relative of comfort. No longer was my heartbeat thudding in my ears, and my sweaty, fumbling hands were starting to move deliberately. After I had finished thumbing the stump's perimeter, Doc rested the leg on the table and barked for the next instrument he wanted. I can't remember the instrument's name, but to me it sounded like he said "Bring me the Lightning Disemboweler!" His booming voice, coupled with my ignorance of the instrument's function, quickly rid me of any notion that I knew what I was doing. 14 Sergeant Veysey handed the Lightning Disemboweler to Doc who handed it to me. It was heavy and shaped like a pistol. In place of a muzzle was a wide, horizontal blade with very small teeth. I soon learned that it was a bone saw. Doc instructed me to pull the trigger, so that I could see how it worked. I did, and the machine screamed to life. Its electric whirr sent the wide blade with small teeth into a jostling, menacing frenzy. I silently concluded that this trade of healing that I had joined was just well-disguised sadism. Apparently a single trigger-pull is all the training required for the Lightning Disemboweler because Doc's next instruction indicated the place in which to cut. Just below the patient's knee, I was to saw through about two and a half inches of protruding tibia. I placed the machine's blade on the patient's bone and after confirming that I was in the right place, pulled the trigger. The blade tore into the bone, sending small fragments of tissue to its sides as it jostled. To my amazement, the bone began bleeding. I had always thought of bone as the hardened, lacquered type of biology classroom skeletons. Living bone is wet and spongy, and, like all living things, doesn't appear to enjoy being sawn. Before my whirring blade reached the back of the tibia, the infected, distal bone fell and swung like a hinge at the place of my cut. I relaxed my trigger pull, and the blade fell still and silent. The hanging bone reminded me of the balsawood soapbox derby racecars that I'd cut and shaped with my dad as a boy scout, except this wasn't balsawood, or fun. "Finish cutting, Walker," commanded Doc Bloch in a tone that suggested that I needed to stop sniffing glue at work. I aimed the blade at the remaining hinge of bone and pulled the trigger. Screaming again to life, the Lighting Disemboweler made quick work 15 of the rest. The truncated chunk of tibia fell to the table, and Doc dropped the patient's leg next to it. The handsome prick plucked the bone from the table and tossed it into the specimen tub. Doc Bloch took the Lightning Disemboweler from my hands and passed it to Sergeant Veysey. My panic had diminished, but its place had been filled by a bewildered daze. I felt my movements occur, but they didn't seem voluntary. The professional ease and quiet confidence of the men around me seemed bizarrely inappropriate. Cutting off a man's leg is a grossly impolite thing to do, yet I was surrounded by authorities who witnessed the assault without objection. Doc called for the next instruments and indicated that one of them be given to me. I turned robotically to Sergeant Veysey and, to my surprise and delight, saw that he was fuming. It was a beautiful thing. Until that moment, it hadn't occurred to me that anyone on the planet would be envious of my position, but Sergeant Veysey clearly was. He couldn't imagine handing one of his instruments from his table to me. He handed things to doctors, officers, up the chain of command. I was a private and therefore a shitstain, a creature so unthinkably useless, stupid, and vile that it needed constant correction. Whenever Sergeant Veysey addressed me as "Private Walker," he spat the word private like it tasted bad. Over the previous six months, he had ordered me to do thousands of push-ups, among assorted other demeaning tasks. And now our commanding officer had issued an order that disrupted order itself. I thought Veysey's head might explode. There was heat in his stare as he was deciding how to deal with the situation. It was a rare and bizarre role reversal, and though 16 it wasn't my fault, I knew I'd pay heavily for it later. So I decided to revel in the moment. I winked at him. Veysey didn't react to the wink. He probably thought he was hallucinating. He solved his dilemma by handing my instrument to Doc, who turned and gave it to me. Its steel handle was thick and ten inches long and angry. At the end of the handle was a sharpened, steel hook that vaguely resembled a coat hanger. The thing looked medieval. Apparently Doc could smell my ignorance because he quickly turned and took my hook away, sinking it into the center of the tibia's bleeding bone marrow. Pulling the steel handle backward and upward with two hands, Doc lifted the stump again to forty-five degrees and nodded to me. "Hold it like this, Walker." I ducked under Doc's arm and grasped the steel handle with my right hand. Doc released his grip, and I almost dropped the stumpy leg. With both hands on the hook's steel handle, I lifted the leg to the height Doc had requested. The full weight of the stump was only twenty-five to thirty pounds, but holding it aloft with outstretched arms while the doctors examined it was no mean feat. The effort made me conscious of my hefty, ventless clothing and the rivers of sweat underneath while salty beads trickled down my forehead into my eyes, and from my gloved hands to my flexed arms, shoulders, and back. The doctors became preoccupied with their hunt for dead tissue, and my struggle and I faded into the background. From where I stood, I couldn't see what damage they were inflicting on the stump. Doc would cut with the scalpel, then lay it on a towel and resume the onslaught. The handsome prick had a ghastly probing device in his right hand 17 and seemed to be facilitating Doc's massacre. Intermittently, bloody chunks of red and black tissue fell onto the white towel beneath the elevated stump. The handsome prick dutifully fielded each and tossed them into the specimen tub. "What do you do with the tissue in the specimen tub?" I asked, immediately astonished at my own question. "Shut up, Walker," answered Sergeant Veysey. "Sautee it with paprika and lemon," answered the handsome prick. "Bring it to a taxidermist," answered Captain Loughlin. "Give it to the patient in a doggy bag," answered Doc Bloch. Vowing silence for the rest of the surgery, I went back to my struggle against gravity. Despite the frequently falling hunks of tissue, the leg seemed to be getting heavier. I was no longer perspiring. I was raining. Every joint was cramping, but I was determined not to draw any more attention. "That's necrotic," observed the handsome prick after prodding something with his probe. "Yep," agreed Doc. "That's gotta go," and another bloody piece of flesh tumbled and found its way to the specimen tub. Necrotic quickly became my least favorite word. Every time one of the doctors said necrotic, it meant that they had found more dead tissue, which meant there was more to cut and more to investigate, which meant I had to keep holding the stump aloft. The weight was getting unbearable. I prayed for the Latin man's tissue to live, to be whole. I needed the Latin man to be healed. Either that or die. I couldn't hold this much longer. 18 "Wow. Look at this," Doc said in surprise. "I think most of his hamstring is necrotic." Without my consent, my throat made a short and very quiet humming sound. It was my body's fervent protest. It was barely audible. I hadn't quit or relaxed. My arms were still flexed and rigid. The stump hadn't fallen an iota, but the sound had been made and I couldn't unmake it. "Walker, could you hold the leg a little higher? My neck's getting tired at this angle," Doc said without looking up. I lifted the leg a few inches higher. "A little higher, please," Doc pleasantly requested. Someone snickered behind me— a fun, new game with the private. I sucked in a loud, strained breath, raised the leg a little higher, and accepted my loss. My personal struggle was again community entertainment. Doc put the scooping rod down, glanced up at me then picked up the scalpel and refocused on the stump. "I'm going to cut a few inches under the thigh to see how far the necroses goes," he announced. Then, without looking up, Doc asked, "Is that getting heavy, Walker? "No sir," I panted audibly. "Do you need a potty break?" "No, sir." "You just let me know when your little muscles are tired." "Thank you, sir." 19 For the next several minutes, Doc and the handsome prick continued their attack on the dead hamstring. Finally Doc said, "I think that's it." He nodded to me and I almost dropped the leg onto the operating table. I placed the steel hook next to the stump and began to regain feeling in my shoulders, arms, and hands. Doc gave a new order for another pistol shaped instrument. This one had a hose attached to its handle and a clear plastic cup-shaped muzzle. "You're going to use that to wash off the leg, Walker. Put the cup against the tissue and try not to make a mess. Use your other hand to shield the splash." Behind me I heard Doc Bloch tearing off his surgical gown. That indicated that his role in the surgery was over. The handsome prick held the leg up. I placed the cup against the tissue and my hand around the cup and pulled the trigger. Blood, water, and small bits of tissue began to rain on the operating table. In less than a minute, it looked like I was done. I relaxed my trigger finger and looked up for approval. "All right, we're good to go." Doc Bloch threw his mask, gown, and gloves into the hazardous waste bin. Captain Loughlin began wrapping the stump in what looked like yellow Saran Wrap. The attending audience began to shuffle out through the swinging door. Doc Bloch waited while the handsome prick tore off his sterile gear, and then they both left the OR. Sergeant Veysey was repacking his gear. I stood, without orders, mystified. "You're done, Walker. Congratufuckinglations, you popped your cherry. Start picking shit up," ordered Sergeant Veysey. "You ever wink at me again, I'll cut your nuts off and feed 'em to you." 20 I tore off my gown and mask, marveling at what I had just done, and marveling still at insouciance of the rest of the F.S.T. They were heroes and so good at what they did, they couldn't share my awe at their skill. I wondered how this be could routine to anyone. As I bent over and began picking up surgical refuse, the door swung open again. It was Doc Bloch. He grinned at me, and said, "Good job, Walker." The door swung closed, and he was gone. A few seconds passed before I realized what the praise meant. "I'm a medic," I stated as a smile crept across my face. "No shit," answered Sergeant Veysey. "Now get back to work."
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