Ice Cold: A Rizzoli & Isles Novel

pulseless.
    “He’s going to lose the leg,” said Doug, echoing her thoughts. “We’ve got to loosen the tourniquet.”
    “Won’t he start bleeding again?” asked Elaine. She remained at the other end of the room, her gaze averted.
    “He’d want us to save his leg, Elaine.”
    “If you take off the tourniquet, how are you going to stop him from bleeding?”
    “We’ll have to ligate the artery.”
    “What does that mean?”
    “Isolate the torn vessel and tie it off. It will interrupt some of the blood flow to the lower leg, but he still might have enough alternative circulation to keep the tissues alive.” He stared down at the leg, thinking. “We’ll need instruments. Suture. There’s got to be a sewing box in this house. Tweezers, a sharp knife. Elaine, get some water boiling.”
    “Doug,” Maura said. “He’s probably ruptured multiple vessels. Even if we ligate one, he could bleed out through the others. We can’t expose and ligate them all. Not without anesthesia.”
    “Then we might as well amputate it right now. Is that what you’d have us do? Just give up on it?”
    “At least he’ll still be alive.”
    “And missing his leg. That’s not what I’d want if I were him.”
    “You’re not him. You can’t make this decision for him.”
    “Neither can you, Maura.”
    She looked down at Arlo and considered the prospect of slicing into the leg. Of digging through flesh that was still alive and sensate.She was not a surgeon. The subjects who ended up on her table did not spurt blood when she cut into them. They did not scream.
    This could turn into one big, bloody mess
.
    “Look, we have two choices,” said Doug. “Either we try to save the leg, or we leave it the way it is and let it necrose and turn gangrenous. Which could kill him anyway. I don’t see that we have a lot of options here. We have to do
something.”
    “First do no harm
. Don’t you think that applies here?”
    “I think we’ll regret
not
acting. It’s our responsibility to at least make an attempt to save that leg.”
    They both looked down as Arlo sucked in a ragged breath and moaned.
    Please don’t wake up, she thought. Don’t make us cut you while you’re screaming.
    But Arlo’s eyes slowly opened, and although his gaze was cloudy with confusion, he was clearly conscious and trying to focus on her face. “Rather … rather be dead,” he whispered. “Oh God, I can’t stand it.”
    “Arlo,” said Doug. “Hey, buddy, we’re going to get you something for the pain, okay? We’ll see what we can find.”
    “Please,” Arlo whispered. “Please kill me.” He was blubbering now, tears leaking from his eyes, his whole body quaking so hard that Maura thought he was convulsing. But his gaze remained fixed on them, pleading.
    She draped a blanket over his exposed body. The fire in the hearth was burning brightly now, revived by a fresh load of wood, and with the rising warmth the smell of urine grew stronger.
    “There’s Advil in my purse,” she said to Doug. “I left it back in the Jeep.”
    “Advil? That’s not going to
touch
this.”
    “I have Valium,” groaned Arlo. “In my backpack …”
    “That’s up in the Jeep, too.” Doug stood. “I’ll go get our stuff and bring it all back.”
    “And I’ll search the houses,” said Maura. “There’s got to be something in this valley we can use.”
    “I’ll go with you, Doug,” said Elaine.
    “No. You need to stay here with him,” Doug said.
    Reluctantly Elaine’s gaze dropped to Arlo. Clearly this was the last place she wanted to be, trapped with a sobbing man.
    “And boil some water,” Doug said as he crossed the door. “We’re going to need it.”
    Outside, the wind lashed Maura’s face with stinging clouds of snow, but she was glad to be out of the house and breathing fresh air that did not stink of blood and urine. As she headed toward the next house, she heard footsteps crunching behind her, and she turned to see that Grace had followed her.
    “I can help you look,” said Grace.
    Maura eyed her for a moment, thinking that Grace would probably be more of a hindrance. But at that moment, the girl looked lost, just a frightened kid whom they had ignored for far too long.
    Maura nodded. “You could be a big help, Grace. Come with me.”
    They climbed the porch steps and pushed into the house.
    “What kind of medicines are we looking for?” asked Grace as they headed up the stairs to the second floor.
    “Anything.