Damaged

CHAPTER 55

Benjamin Platt held the young man by the shoulders as he vomited green liquid into a stainless-steel basin. The patient was too weak to hold himself up. That was obvious from the stains already on his bedsheets.

"We're going to give you an injection," he told the soldier as he eased him back down. The man's eyes were glazed. He no longer tried to respond. Platt knew he probably couldn't hear him, but he talked to him anyway.

He nodded for the nurse beside him to go ahead with the injection while he explained. "We'll probably be poking you a couple more times." Platt grabbed a towel from the side stand and wiped vomit from the corner of the young man's mouth.

"Thanks."

The one word seemed an effort so Platt was surprised when he continued.

"This is almost worse"--he slurred his syllables--"than losing my foot."

"It's going to get better," Platt told him. "I promise you." The nurse looked skeptical. He could see her out of the corner of his eye but Platt didn't break eye contact with the young man. He would not let him see that even his doctor wasn't sure what would work.

Platt stopped at the prep room to change gloves before he went on to the next patient.

"Controlled chaos," Ganz said coming up behind him.

"Controlled being the key word."

"I have someone bringing in more beta-lactam antibiotics. You think this will work?"

"Think of Clostridium sordellii as tiny egg-like spores. They have to chew away enzymes for their bacterial cell wall to synthesize. This group of antibiotics binds to those enzymes and makes them inactivate, or at least not available to the bacteria."

"So it won't be able to grow."

"Or spread."

"What about those patients where it's already spread?"

Platt took in a deep breath. "I don't know. I honestly don't know. There is no established treatment. We're shooting from the hip here." He turned to look Ganz in the eyes. "Are you having second thoughts?"

"No, absolutely not." He shook his head. "At this point we don't have anything to lose."

"This will slow the bacteria down even in those advanced cases. It'll really depend on what damage has already been done." Platt's mind looped back to what the young man had said about this being worse than losing his foot. "What do you do with the amputated limbs?"

"Excuse me?"

"The young man I just took care of--what happened to his foot once it was amputated?"

"Some families request the limbs. Others go to the tissue bank."

"In Jacksonville?"

"Right."

"What if the limb has shrapnel in it?"

"That's not my area of expertise."

"But would you send it on to the tissue bank?" Platt insisted.

"Sure. That's where the assessment would be made. But shrapnel still embedded in the tissue? I think the foot would probably be considered damaged and discarded."

Platt wondered about Maggie's case. Was it possible the severed foot that had been discovered in the fishing cooler was actually one that had been amputated from a soldier?