Rizzoli & Isles 8-Book Set

“There’s nothing left to splint.”
    “We have to keep it rigid. We can’t let it flop all the way down the mountain.”
    He stared down at Arlo’s mutilated limb, but could not seem to move. He doesn’t want to touch it, she thought.
    Neither did she.
    They were both physicians, pathologists accustomed to slicing into torsos and sawing open skulls. But living flesh was different. It was warm and it bled and it transmitted pain. At the mere touch of her hand against his leg, Arlo began to scream again.
    “Stop! Please don’t!
Don’t!
”
    As Doug held down the struggling Arlo, she insulated the leg with folded blankets, cloaking shattered bones and torn ligaments and exposed flesh that was already turning purple in the cold. The limb now cocooned, she taped it to the two ski poles. By the time she’d finished splinting the leg, Arlo was reduced to quiet sobs, his face streaked with glistening trails of drool and mucus. He did not resist as they slid him sideways onto the sled and taped him in place. After the agonies they had put him through, his face had paled to the waxy yellow of impending shock.
    Doug took the towrope, and they all started back into the valley.
    Back toward Kingdom Come.

W HEN THEY BROUGHT A RLO INTO THE HOUSE, HE HAD FALLEN UNCONSCIOUS again. It was a blessing, considering what they had to do next. With pocketknife and scissors, Maura and Doug sliced away what was left of Arlo’s clothing. He had emptied his bladder, and they smelled the ammoniacal stench of urine that had soaked into his pants. Leaving only the tourniquet in place, they peeled off shredded and bloody scraps of fabric until he lay stripped, his genitals pitifully exposed. It was a view unsuitable for a thirteen-year-old girl, and Doug turned to his daughter.
    “Grace, we need a lot more wood for the fire. Go out and get some. Grace, go!”
    His sharp words snapped her back to attention. She gave a dazed nod and left the house, admitting a cold draft of wind as the door shut behind her.
    “Jesus,” murmured Doug, turning his full attention to Arlo’s left leg. “Where do we start?”
    Start?
There was so little left to work with, just twisted cartilage and torn muscles. The ankle had been rotated almost 180 degrees, but the foot itself was bizarrely intact, although it was a lifeless blue. It might have been mistaken for plastic were it not for the thick and all-too-real callus on the heel. It’s dying, she thought. The limb, the tissue itself, was starved of circulation by the tourniquet. She did not have to touch the foot to know that it would be cold and 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