Chapter 8
Cassie’s small body lay motionless beside me. If it were not for the low, shallow breaths dragging into her chest every now and then I would have thought she was dead. She was unconscious.
A single trickle of blood seeped from a wound buried in her hairline and ran across her temple onto her cheek. Her arms were worse: the normally pale skin now looked a sickly green-white beneath the large smears of blood. Amongst the red were darker, black patches where she had been torn by deep scratches and cuts.
I felt numb and sick and helpless. A random part of me also felt grateful, for the physical enhancements I made a few weeks ago. Without them I wouldn’t have caught Cassie, or been able to pull her to safety. Without the benefit of pain suppression, I might have dropped her… Perhaps, I also reacted faster than I would have done before…? There were many questions, but no clear answers. They would have to wait.
A short while later – seconds or a minute at most although it felt much longer – the shock faded. Another burst of adrenaline kicked through my system and spurred me into action. I was not hurt, although the muscles in my shoulders and arms burned from their recent exertion, and so I moved quickly, beginning an examination of Cassie’s injuries.
Check the head wound first, then look for any bleeding.
I tried to remain calm and remember the emergency training I’d taken at The Clinic.
Without moving her, I gingerly probed the gash beneath Cassie’s hair, lifting the blood-red matted strands away so I could see properly. I tried not to inhale the coppery smell that overpowered the citrus fragrance I’d noticed earlier. Seeing the blood of someone I cared about, seeping out of their damaged body was so much worse than practising on strangers. My hands were bathed in red and the sight of it made me sick.
Shaking my head, I attempted to focus. The abrasion was still bleeding, but did not look deep. I wondered vaguely whether Cassie had banged into the underside of the rock shelf as she fell… I moved on without really trying to answer my own question. Around the edges of the cut, the thin layer of flesh that stretched across Cassie’s skull was already swelling and I knew she would have a painful lump. Thankfully, it did not look too serious and I was sure it was not the reason she had blacked out.
I glanced towards Cassie’s right arm. It was angled oddly away from her body, the forearm pointing upwards. I was positive it was dislocated.
De ja vu.
A similar image of another girl, in this same park flashed before my eyes. There was no blood on that girl, but the unnatural position of the limbs was almost identical.
“Cassie?” I asked softly, hoping for, but not anticipating, a response. I got what I expected and continued my examination. “Please Cassie – if you can hear my voice…Cassie, please show me if you can hear me…”
I’m so sorry I brought you here…this is all my fault…
“…not your fault.”
It was just a whisper: words uttered on a breath of air, but I was sure I’d heard them. My gaze snapped to Cassie’s face, but her eyes were still closed, her lips frozen. Had she spoken to me? Had she answered? It sounded like she said “not your fault.”
“Cassie?”
There was no response. Her breathing was becoming more regular, though. At least I thought it was, perhaps it was hope colouring my assessment more positively, as there was still no obvious movement from her.
Ripping away a clean piece of fabric from the back of my ruined clinic-suit I pressed it against some of the darkest patches on Cassie’s arms, soaking away the blood to try and see how bad the damage was. The cuts were messy and still bleeding, but none of them looked deep enough for stitches. A couple of them were long gashes and I tore away more fabric to wrap around them to slow the blood flow.
It was not good that she was still unconscious – how long had it been now…three minutes…five? I couldn’t tell and felt panic welling up as my mind started running through the possible extent of her injuries: paralysis, coma, brain damage…
I shouldn’t have brought you here…I’m sorry…I’m so sorry…
Pressing my fingers lightly to the side of her neck into the hollow below her jaw-line I searched for a pulse. It was light and irregular.
Please be OK…it’s all my fault…I’m sorry…
“Cassie? Can you hear me – Cassie?” I implored, my voice louder than before.
“…I’m trying…stop being sorry”
This time I saw her lips moving. Cassie was muttering. Her words might be slurring together, barely discernable, but she was definitely talking. Telling me to stop being sorry. Had I actually said that aloud?
“Cassie…Cassie?” I was becoming desperate – I wanted to take hold of her shoulders and shake her to wakefulness, to prove that she was alive, but I couldn’t do that. She looked so fragile and broken already; she would probably fall apart.
Can you even hear me? I pleaded, moving my lips closer to her ears. “Cassie?” I’m sorry…I need you to come back…
A sigh passed through her lips. At first I thought it was just her shallow breathing still, but then it was followed by a light groan. “I’m coming…I’m coming…”
What was she saying? It sounded as if she was dreaming, rather than responding to my voice. Her words didn’t really make sense. I was sure she’d said I’m coming. But, I hadn’t asked her to come back…I’d only wished it, only thought it.
“Cassie,” I leaned closer still, searching for more signs. Her eyelids flickered but remained closed as though she was struggling to fight off unconsciousness, but trying hard. Her eyelashes fluttered – more forcefully this time.
“Cassie – can you hear me?”
More movement: she was coming round. A loud groan creaked out of her throat, as she became aware of the pain. “Shhhhh,” I stroked the hair gently away from her face trying to soothe her. In the next moment Cassie’s eyes blinked rapidly, suddenly opening wide and then closing quickly against the shock of the daylight.
“It hurts,” she whispered, her voice cracking over the words
The sound of her voice! My chest flooded with relief.
“Cassie! Thank goodness!!” I shouted the words realising, too late, how close I was to her ear and half-deafening her.
“Too loud,” she complained weakly, her eyes still closed. When she opened them – squinting into the light – I felt her gaze searching for me and leaned close once more, trying to shield her from the brightness. Cassie examined me thoroughly as though I was the injured person, before shutting her eyes again, grimacing as if it hurt her just to move that small part of her body.
“You look awful,” she muttered.
I laughed – half-bitter, half-relieved. Apart from the relief, which filled me like oxygen, I felt empty – completely drained – now the adrenaline was leaving my body.
“You know, you don’t look so great yourself right now.” I tried to put her at ease, but the joke fell flat. My eyes were burning with tears of shock and happiness, but I was determined not let them fall. What would she think of me if I cried?
Then – to my disbelief and horror – Cassie started trying to roll over.
“Can you help me up?” she asked, her voice sounding more normal every time she spoke.
“Hold on a minute, don’t move,” I reached forward, pulling her gently back. “We need to make sure you don’t do any more damage. Your shoulder is a real mess.” There was only one sensible option and I knew it. “We’ll have to get you to The Clinic to get everything checked over. The one in the Red Zone is closest, so we could go there…” That was going to be a difficult conversation: how to explain where we’d been without a lot of unwanted questions. But that didn’t matter – I’d have to deal with the consequences later – Cassie needed treatment.
I was surprised when she shook her head. “That’s not a good idea. There’ll be lots of questions and they’ll contact our parents. It’s not worth it.”
; “What do you suggest?” I argued back immediately, ignoring the fact I’d just been thinking exactly the same thing.
I knew I shouldn’t be angry with Cassie – I wasn’t really – I just felt useless. It wasn’t like I had any ideas of my own, but the events of the last few minutes had left me an absolute wreck. I tried again.
“You can’t walk around with a dislocated shoulder – I think people will notice.” It wasn’t my best attempt: I came off sounding more sarcastic than concerned.
“You can do it,” Cassie said.
For a moment or two I had no idea what her words actually meant. Did she want me to go for help and bring them back here?
Then I realised what she was saying. She wanted me to realign her shoulder. The shock of that idea had barely registered with me, but she was already talking again.
“You’ve done your first couple of modules in the Emergency Medicine rotation.”
I was incredulous. Cassie spoke as if she was asking me to take a look at a splinter in her finger. “Are you kidding?!” There were just no other words for how stupid an idea it was. “Your shoulder could be broken, not dislocated, or even both! I can’t do that – I could hurt you even more!”
“You just pulled me over the edge of cliff!” she retorted with a scoff, “I’m sure you can do this. Joel and I did the basic training for Field Medicine on the second day of our rotation.”
Yeah, well – I’m sure Joel would be the perfect person for this situation…
I shook my head to silence the jealous voice because it wasn’t helping. There was being brave and there was just plain stupid. I might be feeling shell-shocked from everything that had happened in the last few minutes, but I was pretty sure that what Cassie was suggesting was the latter of those two things.
“Two days of Field Medicine training does not quite match up with a clinic full of equipment and trained Medics.” I didn’t bother disguising my feelings. Perhaps I spoke more harshly because – despite my words – a small part of me agreed with Cassie’s motives for trying to keep this a secret.
Of course, Cassie was right: we would get into a lot of trouble for coming here, no matter how good an excuse we found for how she got injured. The scanner at the park entrance would have logged us coming inside and so even if we lied about where Cassie had gotten hurt, they would still probably investigate here. I had too much history in this place; literally too many secrets buried in the park, to risk losing it. But those secrets were my reasons – not hers.
Why was she so concerned with being examined properly?
“You can do it,” Cassie insisted, interrupting my thoughts and searching my face until she found my eyes and fixed me in an unwavering, emerald spotlight. If nothing else, her determination was persuasive. “You can do this,” she repeated, as though sensing I might waiver if she was convincing enough.
Pushing aside my own selfish concerns – as well as the questions I had about what had happened when Cassie was unconscious – I paused to consider her request. Could I do this?
Self-doubt was not something I was too familiar with – conceited I know – but I’d always just seemed to know what I was good at, and been able to sense where my limits lay. If we were in The Clinic and it was someone else, I’d probably be jumping at the chance to test my skills. This was different. We didn’t have the luxury of diagnosis equipment, medicines or experienced teachers to help. And it was Cassie. The thought of doing this – doing anything that might hurt her – made me feel physically sick.
Before I made my decision I needed to know that Cassie understood what she was asking me to do. “What if it’s not just dislocated?” My voice lost some of its conviction as Cassie was already brushing off my protest before I’d finished speaking. Maybe I could appeal to her practical side… “You should have a bone scan and some pain relief before anything is done. I don’t even like the idea of moving you from here in the first place – maybe I should just go and call for an emergency team?”
“You know a shoulder dislocation can often be more easily reduced in the period of time immediately following the injury when the muscles are not yet in spasm.”
Cassie managed to sound like a medical training guide as she dismissed my suggestions. I grimaced with irritation. Just the idea that we would attempt to mend something like a shoulder dislocation on our own was crazy! Surely, Cassie knew she was being ridiculous?
Apparently not – she was still talking.
“I’m pretty certain I know what to look for, so if you check me over and we think it’s OK, will you try?” Her final plea was undeniably hopeful. “And if I promise to go to The Clinic if it doesn’t work?”
I couldn’t believe I was actually considering doing this – despite Cassie’s confident sounding words, I was sure that under any other circumstances she would not be considering letting me loose on her body with just a few weeks of medical training.
I said nothing. Partly because I was still considering whether I might actually do this. The other part of me had gotten mildly distracted with the phrase let loose on her body as it ran through my mind. I shook the thought away – this was neither the time nor the place to be a ridiculously stereotypical boy, was it?
“You’ll do it?”
Cassie pounced on my silence, obviously assuming it meant I conceded. Apart from the medical aspects, her plan made sense: we would get into a world of trouble for endangering ourselves by coming here. Was I really selfish enough to put my secret life above Cassie’s well being? I tried to defend my actions by telling myself it was what she wanted, but that felt like a lame excuse even as I thought it. I was not ready to give up everything I’d worked for… not even for her?
“As if you gave me any choice,” I finally muttered, shaking my head in disgust with my own self-interest.
“Great!” Cassie grinned – happy with her victory – until the movement made her frown in pain.
If we were going to do this, we should get started. It was probably too late for ground rules, but it felt necessary. I nodded to confirm I was going to do as she asked, clarifying: “but I’m doing this only if we’re sure it’s a dislocation.”
Cassie nodded obediently.
“I can’t believe I’m actually agreeing to this…” I shook my head – mainly at myself – once again dismayed with what I had consented to try. It was more for my benefit than hers.
“Ready?”
She nodded.
“Let’s see then, shall we…?”
Cassie’s gaze rested heavily on me as her eyes tracked my movements. I tried to ignore that and focused on her injuries instead. It’s just another patient at The Clinic, I told myself as I leaned over her body and let my hands begin the examination.
Even though I was as gentle as possible and didn’t move her arm, Cassie still flinched away as I touched her shoulder. “Are you OK?” I froze immediately. The anger I felt with myself leaked into my voice as I spoke. “I’m not going to do it if you’re in this much pain.”
Cassie shook her head, cringing once more as the movement affected her shoulder. “No it’s OK, I’m fine.” She was not a good actress.
“You’re a liar,” I told her, adding a silent “just like me,” before starting again. I watched her face for a few seconds, searching for any sign that she realised what a selfish monster I was. I found nothing in her eyes but trust and that pained me more than anything. “I can’t hurt you,” I whispered, not really knowing whether I was talking about her arm or the numerous other things about me that I knew could cause her harm.
“I’ll tell you if it’s too much,” Cassie promised.
I could only nod in acceptance. Deep down I wished that I could promise her the same thing, but I knew I was just not that honest. Looking into her face gave me the terrible feeling that if I continued along the path we had begun together, I would only succeed in bringing Cassie more pain… Steeling myself I refocused on the problem before me. This was not the
time or the place to get distracted by my own confusion: it would not be helpful for either of us.
Moving as slowly as before, my hands resumed their examination. After a few seconds Cassie’s eyes closed – perhaps because of the pain – but with some relief I felt her relax a little too. Being wholly professional, I tried not to notice how much I liked the feel of her bare skin beneath my fingers when I touched her. I am a Medic, she is a patient I told myself over and over again as I worked, it distracted me a little.
“It doesn’t feel like a shoulder separation,” I told her, as I ran through the various diagnostic indicators we’d been taught to look for in the Emergency Medicine sessions. I ran my fingers around her shoulder. Her skin and subcutaneous tissue yielded to the light pressure of my fingers in all the wrong places: I could detect no connection at all between the bone and socket. Despite my inexperience, I was confident it felt like a complete dislocation.
“The humerus has definitely lost contact with the scapula,” I told Cassie as I moved on from her shoulder and began checking the bones in her lower arm. “There don’t seem to be any obvious breaks…from the position of your arm, it looks like a dislocation.”
Finished with my examination I leaned back on my heels. When I touched her arm, I had felt her flinch away from me. It was obvious she was trying to hide how much pain she was in, so that I wouldn’t take her to The Clinic. She was a stubborn girl.
“Definitely feels like the humerus is sitting at the front of the shoulder blade.” I gave my final diagnosis, watching her face carefully for any reaction. Something that might make me do the right thing, perhaps?
“An anterior dislocation?” Cassie clarified my words immediately, drawing the correct terminology from our recent training.
I nodded, smiling. “I told you that you were good at this.”
“So are you.” Cassie offered me a small grin, before prompting me to get to work. “Now we know what it is, we need to get it reduced then…”
“It seems straight-forward enough…” although, my uncertainty as to whether I could actually do this, was beginning to return. “But, if I get it wrong it could lead to worse complications.”
“If that happens you can take me to The Clinic,” Cassie promised. I felt her working to find my eyes with her own; as if she somehow knew what kind of power they held over me. Her gaze locked onto mine and I found her confidence surging into me as she told me: “I won’t need that, you’ll get it right.”
I nodded. Maybe I would get it right.
“We need to get you stood up to try this.” I worked hard to sound professional and capable. “Do you feel OK to do that?”
“Can you give me a hand?” She asked, by way of an answer to my question. Taking her left arm as she offered it to me, I lifted her from the ground. Her body swayed slightly once she was upright and I held on until she stopped moving.
“I can’t believe you’re making me do this,” I muttered to myself – talking to the selfish beast inside me. I felt Cassie twitch and realised she must have thought I was talking to her. Clearing my throat I addressed her now, trying to cover for my misdirected accusation. “I’d at least feel a little better if we had some pain relief for you.”
“Well, look at it this way: if it hurts that much I’ll probably black out again anyway!”
Cassie was trying to joke with me. Trying to make me feel better about what we were about to do. I couldn’t have felt worse about how I was behaving. Even though I thought I was falling in love with this girl, I was still putting everything I wanted first. I was an idiot. I was selfish. I wanted to keep my secrets.
“Let’s just do it,” Cassie prompted, stirring me from my trance.
She was right. “Turn around,” I said, helping her to spin into position in front of me. Our bodies pressed close together, slightly out of line so that I stood behind Cassie’s right shoulder – my chest and right arm able to move comfortably around her injury. I tried to sound less brusque when I spoke again, it wasn’t fair for me to sound angry with Cassie when I was only disappointed with myself. “I’m not going to give you a countdown I’m just going to do it, OK?” She merely nodded in response.
In preparation, I gently circled her right arm in front of her body, so that it sat across her stomach to form a L-shape. Cassie didn’t resist my direction, although I felt her tense as she registered the movement. Once in position, I secured her arm in place, grasping her wrist in my left hand.
At first as we stood there, I could feel Cassie’s heart racing inside her chest. The light, thrumming beat pumped through her back and into my body where I held her close against me. I didn’t want her to be scared when I tried to do this. For a while – long or short I don’t really know – I just held her and waited. Finally, her heart rate slowed and her breathing calmed. In a couple of breaths I synchronised my own breathing with hers and on the fourth breath rotated her arm away from her body, coaxing her shoulder back into the socket.
To Cassie it probably felt like a single movement. Her body sagged forwards as the pain obviously increased and I struggled to hold her fully upright with just my left arm around her waist. But I was able to continue the circular movements we had been shown and on the third rotation, I felt her shoulder slide back into the joint.
On the verge of blacking out, Cassie staggered into me. I pulled her arm back in front of her body to rest, now it was reset, and tightened my grip around her waist. Her knees buckled and we both sank to the ground. I did my best to break her fall with my legs, whilst protecting her right arm as we moved. It wasn’t a bad effort: we ended up in a neat sitting position, with Cassie’s body wound inwards, wrapped inside my arms.
“Shhhhhhhh,” I whispered into her hair. “It’s done now. It’s over.” There was no answer, but I wasn’t expecting one. Cassie’s eyes fluttered closed and I held onto her as her breathing became less ragged, more peaceful. I don’t think she felt it when I kissed her head.