Chapter 2 - The Scissors and the Gown
The emergency department at St. Jude of the Pines did not smell of eucalyptus or lavender. It smelled of floor stripper, isopropyl alcohol, and the burned fat of an electrical cautery unit working somewhere behind the double doors of Trauma Two.
Dr. Ronald Kincaid was fifty-one years old, had two pins in his left hip from an old tractor rollover, and had spent twenty-two years stitching chain-saw kicks and combine mangles out of the timber holdings along the river. He did not look at my face when the paramedics wheeled the gurney through the sliding glass doors; he looked at the vitals monitor clipped to my right earlobe.
"Heart rate one-forty-eight," the lead paramedic said, keeping her hand flat against my thigh to stabilize the gurney over the rubber threshold. "BP ninety-two over fifty-six. She was found in the drainage swale four hundred yards east of the Vance turn-off by the county road crew. Severe hypothermia, core temp ninety-four point two. She’s approximately twenty-six weeks along, fundal height twenty-seven centimeters."
"Get her into Three," Kincaid said, pulling a pair of heavy surgical shears from his breast pocket with his right hand while his left snapped open a pair of blue nitrile gloves. "Who called it in?"
"The road crew," the paramedic replied, unhooking the saline bag from the portable pole. "Found her face-down in the gravel. She was trying to climb into the ditch under the culvert pipe. When they rolled her, the whole back of her blouse came away like wet tissue paper."
The gurney slammed into the wall bumpers of Trauma Three. The room was small, lit by two massive circular overhead halogen clusters that buzzed at a high, singing pitch that set my remaining teeth on edge.
"Ma'am," Dr. Kincaid said, leaning down so his graying beard was three inches from my cheek. His eyes were small, watery behind gold-rimmed bifocals, but they had the cold, steady focus of a surveyor looking through an optical level. "My name is Ronald Kincaid. You are at the county hospital in Pine Bluff. You are safe, but I need you to stay completely still while we clear the fabric away from your spine. Do you understand me?"
I tried to nod, but the muscles along the left side of my cervical spine had seized into a solid, iron knot. I made a clicking sound in the back of my throat—the wool sock was gone, pulled out by the road crew driver before they lifted me into the ambulance, but my tongue was swollen to twice its normal girth, the margins scalloped and white where my teeth had ground into the muscle.
"Nurse," Kincaid said, his voice dropping an octave into that dangerous, unhurried cadence doctors use when they are trying not to panic the orderly. "Call surgical intake. Tell them I need two units of O-negative on the rapid infuser, and page Dr. Charles from OB. Tell her we have a blunt abdominal trauma with suspected placental insufficiency."
The shears were heavy, forged from surgical steel, and cold against the skin of my lower ribs.
Snip.
The poplin of my work shirt gave way along the left lateral seam. Kincaid did not pull the cloth; he used a warm saline spray from a plastic bottle to float the fibers away from the coagulated crust beneath.
When the two halves of the shirt fell away onto the sterile paper sheet, the nurse at my feet—a woman named Miller whose name tag bore three small silver crosses—let out a short, wet breath that sounded like she had been hit in the solar plexus.
"Oh, sweet Jesus," she whispered, her hand rising instinctively to her mouth. "That's... that's not a road slide."
Kincaid did not speak for ten seconds. The only sound in Trauma Three was the rhythmic, high-frequency ping-ping-ping of the fetal monitor the nurse had strapped across my pelvis.
"Turn on the surgical spot," Kincaid said finally. His voice was no longer flat; it was hard, brittle, like dry birch before it snaps in the frost. "Get the camera from the lockbox. The legal camera, Miller. The thirty-five-millimeter with the scale ruler."
"Dr. Kincaid—"
"Get the camera," he repeated, not turning around. He leaned down, his gloved fingers hovering half an inch above my twelfth vertebra, tracing the pattern of the lacerations without touching the raw flesh. "Thirty-two distinct impacts. Cross-hatched in four quadrants. Parallel contusions with central tissue avulsion, consistent with an unyielding cylindrical implement between twelve and fourteen millimeters in diameter."
He stopped. His fingers moved to the skin just below my left shoulder blade, where the red dust had settled into the deep furrows of the muscle.
He leaned closer, sniffing the wound once, his bifocals sliding down the bridge of his nose.
"Miller," he said.
"Yes, Doctor?"
"What does that smell like to you?"
The nurse stepped up beside the gurney, holding a four-inch plastic forensic scale against my hip. She leaned down, her eyes narrowing as she looked at the orange-crimson crust that filled the lacerations.
"It smells like... like barbecue," she said, her voice trembling. "Like chili pepper."
"Capsicum," Kincaid said, his face darkening until the veins in his temple stood out like blue string. "Pure, agricultural-grade cayenne. They beat her until the fascial planes separated, and then they rubbed capsicum into the raw meat to induce neurogenic shock without leaving secondary subcutaneous hemorrhage."
He straightened up. His shoulders, usually stooped from years of leaning over operating tables, squared back against the white cabinetry of the trauma room.
"Now turn her," he commanded softly. "Gently. Two of you on the left hip. Support the abdomen. Do not let her twist."
The roll was agony. The raw meat of my back touched the cold air of the room, and every nerve ending that had been deadened by the cold began to fire with a screaming, blinding intensity that turned my vision entirely white.
When my chest cleared the mattress, Kincaid caught his breath.
Across the dome of my stomach—stretched thin, veined, carrying the weight of my unborn daughter—was a continuous, four-inch-wide band of deep, blackened friction burns. The skin had been ground away in horizontal layers, embedded with gray splinters of Douglas fir, white traces of industrial agricultural lime, and the yellow residue of pine resin.
"She wasn't on the ground when this happened," Kincaid said, his voice dropping into a register that made the orderly at the door look down at the floor. "She was held down. Her belly was ground into something flat and wooden with every strike. Look at the transverse striations on the rectus abdominis. That's a three-hundred-pound counter-weight holding the thoracic spine down while the lumbar was flexed."
He looked down into my eyes. His face was three inches from mine, and for the first time since they had pulled me out of the ditch, I saw a man who was not afraid of the Vance family name.
"Clara," he said. "Who held you?"
My tongue felt like a piece of salted beef in my cheek, but the name had been burning behind my teeth for three hours, hotter than the pepper in my skin.
"Warren," I whispered. The word came out wet, broken by the blood from my cheek. "Warren sat on my shoulders."
"And the cane?" Kincaid asked, his thumb gently wiping a fleck of dried blood from my temple. "Who had the cane, Clara?"
"Evelyn," I said. "She kept it in the brine."
The doctor looked at the nurse. He did not ask for a consultation. He did not ask if we should wait for the morning shift supervisor to arrive from town.
"Call the State Police," Kincaid said. "Not the township constable. Not Warren’s cousin at the municipal barracks. Call the District Four Bureau of Criminal Investigation in Newburgh. Tell them we have an attempted homicide and an aggravated battery on an unborn child with chemical enhancement. And tell them to bring the forensic kit for the bench."
"Dr. Kincaid," the nurse said, her voice dropping to a whisper as she pointed toward the hallway doors. "Warren is in the waiting room. He just walked through the front entrance with his mother. He says his wife had a seizure in the garden and fell through the cold frames."
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Kincaid took off his blue gloves, dropping them into the red biohazard bin with a dry, rubbery slap.
"Tell the security guard to lock the interior fire doors," Kincaid said, walking toward the stainless-steel scrub sink. "And tell Warren Vance that if he takes one step into this corridor before the troopers arrive, I will take the bone saw from Case Three and introduce him to his own femur."
