by John O'Brien
“Hold it close to the opening,” he commanded.
The pale yellow light lit the interior cavity. Not well, but enough to see.
Well, some light is better than no light.
Some doctors would have given up, closed the surgery, shrugged as they removed their gloves with a snap, and walked away. Dr. Altman would have none of it. He had worked with the family and the little girl for a long time now. It took a long time to find a donor match. The kidney wouldn’t last much longer—nor, for that matter, would little Rachel lying unconscious on the table. It was now or never.
“Okay, good thinking, that will have to do for now. We’re continuing on. Get another set of instruments ready. And for heaven’s sake, don’t touch the flame to tissue, and keep it away from the oxygen.”
“I have to tell you that the lighter is getting warm in my hands. I’m not sure how long I can hold it,” the nurse next to him responded.
“Anyone else have lighters?” Altman asked.
A moment later, a couple more lighters flared in the darkness.
“We’ll have to take turns. This is going to be a bitch, but we can do it. Keep communicating, we can’t afford to lose light for a moment. How are the ventilations?”
“Chest is rising and I can hear good air passage,” the anesthesiologist answered.
Behind him, Altman heard the swinging doors to the operating room open.
“Doctor, the entire hospital is down.”
Turning toward the voice, his face lit by the glow of the lighter, he responded: “Make your way to the lounge on this floor and return with every lighter you can find. And see if you can find any operable flashlights on your way.”
“Back in a flash,” the voice replied.
“Okay, we need to work quickly. Let’s get this done.”
Inspecting the kidney in the poor lighting, he didn’t see any apparent problems with it. Even working quickly, he knew the chances of success were dramatically lowered without the use of modern equipment. But he owed it to the child to try.
He heard the doors opening and closing behind him and soon there were a few people in scrubs standing in line beside the operating table, each waiting for their turn to hold their lighters to provide light. Those waiting felt good to be a part of the fight for a little girl’s life.
Dr. Altman quickly, but with care, sutured the renal artery and vein of the donated kidney to the external iliac artery and vein. Lighters flickered on and off over the surgical site, never once losing light to the area. Lines of concentration flowed across his forehead and he sought to keep his vision clear and focused on the procedure. A monstrous headache was forming, but he pushed that to the back of his mind.
Finished with connecting the blood supply to the kidney, gauze pads dabbed the area around the stitches. Altman leaned forward to inspect the area for bleeding and was relieved to see that the sutures were holding. Stretching upward with a heavy sigh, he leaned backward to ease the cramp forming in the small of his back.
“Almost there, folks. Nice work, but let’s not ease up now.”
With his nimble fingers once again working, he sutured the ureter to the bladder.
“Okay, that was nicely done, everyone. Insert a drain and close her up. Wheel her down to ICU afterward; I want a nurse stationed at her side until she wakes up. Monitor her for infection and make sure to keep ventilating until she’s able to do it on her own. I’m going to try and make my way to her parents. Again, nicely done.”
Dr. Altman’s surgical scrubs were drenched with sweat, but he felt good at what they’d just accomplished. That had to be the fastest surgery of its type that he ever performed, and under the worst conditions. Yes, the team he had assembled was the very best at what they did. Less than half an hour after the lights went out, Dr. Altman walked through the operating room doors and into a darkened hallway.
Throughout other hospitals and clinics, many surgeons faced the same conditions. Some found the same degree of success that Dr. Altman did, but others did not. Patients across the world died on operating tables, some even coming awake after the administered anesthesia wore off. Those on life support died within seconds…minutes at the latest.
Nurses rushed through darkened corridors to patient rooms, many not able to do anything except assure those present that they weren’t alone. The lighter mode of providing illumination became a common theme, the flare of flame providing the light necessary to administer medicines or pain relievers. Candles were brought up from the chapels and used. The practice of medicine was brought to its most basic levels.
* * * * * *
Afghanistan
The hot surface below Corporal Carlos Rodriguez blasted heat through his fatigues. Even though it was nighttime, it still felt like he was lying on a bed of coals. Sand was in his hair and his ears, and he could feel the crunch of it between his teeth. Every time he swished water in his mouth to wash it out, it seemed like more found its way in before he finished spitting. Grit made its way past his vest, fatigue top, and beneath his T-shirt, into and below the waistband of his pants, into his boots. The fine particles seemed to constantly shift beneath his clothing; the heat combined with the sand caused his skin to perpetually itch.
God I hate it here. Only four more months to go, then this place can kiss my ass.
Carlos shifted his position, attempting to find some degree of comfort from the heat rising from the ground. Glancing to his left and right through his NVGs, he noted the others in his squad lying behind a small berm, squirming with the same discomfort he felt.
Arranging his carbine to keep it out of the sand, he looked back to the front over the lip of the small hill. A line of trees partially obscured a small village. The operation they were on was part of a limited mission to clear out the valley in which they found themselves, one of many in the area that were surrounded by towering, rubble-strewn sandstone ridgelines.
Nestled and hidden within the tree line was the small village through which Carlos and the rest of the company were tasked to conduct a nighttime sweep. They had been assailed by small arms fire accompanied by flanking machine guns coming from both the adobe walls and the trees. Almost with a shrug, they had provided covering fire and withdrawn to their current position, where they called in air support to pound the village’s defenders.
The order had come to scale down operations to small, limited sorties from which they could easily disengage. However, to Carlos, they could call it what they wanted. When steel was being exchanged, the operation was no longer a limited one. Limited, large scale, sweep, or whatever they wanted to call it, a bullet could still kill or maim no matter what language was applied. When a firefight started, it became just like the many others he had been involved with during his tours in this hellhole.
Carlos watched bursts of red tracers from their own machine guns stream across the darkness and into the tree line, more to keep the enemy heads down than in an attempt to inflict casualties. More than likely, the assailants had already fled the area, conforming to their usual pattern by not waiting around for the bombs to arrive. Lying on the hot sand, waiting for the promised air support to arrive, listening to the chatter of the heavy machine guns, he wondered again at his decision to go into the Army.
It had seemed like a good thing to do at the time, and his only way to get off the streets of LA. However, he’d spent most of his time lying on the desert sands or trudging through the streets of villages with names he couldn’t ever hope to pronounce…and all of this far from home. He thought time and time again that the streets he’d fled back home were not all that different than “the Stan”.
And without this fucking sand that gets into everything.
The one thing that kept him sane in the Army, for the most part, was the row of his people lined to both sides behind the small rise of sand. It was his brothers that kept him going on a day-to-day basis. Without the camaraderie, there was no fucking way he’d go out into the streets, openly inviting some fucker to sh
oot him. Or jump into a vehicle to be blown away by a roadside IED. No, it was those beside him who kept his feet moving toward the helicopters, their rotors turning in a blur overhead, to be deposited on yet another stretch of sand to conduct another useless sweep.
Carlos noted the cessation of machine gun fire and looked back toward the tree line. A moment of silence descended upon the valley, the last of the gunfire echoing off the surrounding hills. A small, dark object streaked in from one side, more felt than seen, passing just above the trees. The ground shook below him as he watched twin blossoms of flame and smoke punch upward from a point just inside the trees. The cavalry had arrived.
A second aircraft arrived and he watched as two objects tumbled from beneath the stubby wings. They broke apart above the treetops and smaller objects dropped out of his sight. Moments later, hundreds of small eruptions joined with the two larger ones delivered less than a minute before. Airstrikes were one thing Carlos never tired of seeing. One, for the sheer awesomeness of the firepower being delivered. What kid didn’t love fireworks? Two, it meant he and the others most likely wouldn’t have to clear out the buildings one at a time. Well, at least they wouldn’t have to wade through gunfire while doing it.
Above the roiling fire and smoke, Carlos noted green streaks appear in the nighttime sky. At first, there were just a couple of them, so faint that he wasn’t even sure that what he was seeing was real. He knew, and had experienced firsthand, that the desert could create all kinds of illusions. Raising his goggles, he rubbed at his eyes, taking care not to get any sand in them. Looking back at the sky, he saw that the streaks had multiplied. The sight was mesmerizing, and for a moment, Carlos found himself in his own little world as he watched the lights dance across the heavens.
A dark shadow passed over him, interrupting his momentary reverie and drawing his attention back to the present.
Fuck, this heat and stress is getting to me. I need to pay attention to what’s going on or I’m going to end up just another name on a list.
The shadow was accompanied by the heavy thrumming of attack helicopters passing overhead. This was joined by the whoosh of rockets leaving mounted pods as they streaked toward the trees and village trailing fire, enveloping both in heavy blasts. The two helicopters veered off after delivering their payloads.
Looking at the destruction being delivered, it always amazed Carlos that anyone or anything could live through such devastation. But, inevitably, something always did. Thirty seconds later, another ground-shaking explosion tore into the village as the first of the jets returned. Amid the roar of destruction in the near distance, he heard his squad sergeant tell them to get ready to move. Carlos knew the drill. Fall back, let the air strikes do their job, then move in on the heels of its deliverance while the enemy was still hunkered down, if they were still there.
The second jet appeared. Knowing that the order to advance would come once it delivered its ordinance, Carlos checked his mag and shifted his knees to get ready to rise and race toward the tree line. He followed the flight path of the dark object streaking against a background of towering, darkened ridges. Expecting to see smaller objects tumble from the aircraft, he was confused by the lack of their appearance.
Perhaps they already dropped all they had and are just making a pass to keep the insurgents’ heads down.
Tracking the F-16, he was further confused by it not pulling up like its predecessor. Instead, it continued its downward path. Carlos cringed as the jet exploded into the side of the ridge. He looked for the telltale smoke trail of a rocket from the village, but saw only the plumes from the bombs.
The poor fucker didn’t even have a chance to bail out, Carlos thought, knowing he had just watched someone plummet to their death. He wondered if they had a family.
A hushed quiet descended upon the landscape. The silence, except for the shuffling of bodies on the berm, was broken by two faint thumps behind. Turning, he saw two thin, dark smoke plumes in the distance rising into the sky. Looking back toward the village, a fourth dark column of smoke appeared in the far distance, rising above the tops of the ridges. In the immediate vicinity, the ground shook as all of the supporting helicopters autorotated into the ground.
What the fuck? he thought, worried that they’d been led into a trap.
Their new company commander must have had the same thought, as the order was sent to form a defensive perimeter, with a focus toward the village from where they expected an attack at any moment. Carlos found himself next to his squad sergeant, who was in the process of changing the batteries in his radio.
Moments later, Carlos heard him utter, “Nothing ever works in this fucking place.”
A few minutes later, the company commander, accompanied by the platoon commanders, arrived at their position.
“Sergeant, do you have any comms?” their platoon commander asked.
“None, sir,” his sergeant replied.
“Fucking great! That’s just fucking great! Now how are we supposed to get out of here?”
A chill went through Carlos, wondering whether the statement was regarding their current predicament and seeming entrapment, or whether the captain meant that they had no way back to base. Carlos anxiously settled into position, waiting for an attack to develop, his eyes occasionally wandering upward to watch the glowing streaks of light.
* * * * * *
Western Atlantic Ocean: off the coast of Virginia
Commander Lawrence stood on the bridge, presenting an outward calm that he didn’t truly feel. A warm breeze brushed his face and he closed his eyes, allowing himself to enjoy the sensation for a brief moment. Two lookouts stood silently topside to either side, scanning the horizons. Below him was 2.6 billion dollars of machinery that plowed through the gently rolling swells of the Atlantic. Within the black hull were eighty other experienced crew members serving as the skeleton crew to conduct the first deep sea dive test of the USS Washington, the Navy’s newest Virginia-class fast attack submarine.
The only sounds were waves lapping against the hull, the occasional splash as the rounded bow hit a trough and began rising on the next wave, and the wind rushing by. It reminded him of his early years when he took his dad’s small sailboat out on summer weekends to sail in the nearby bay. It had been just him and the boat, accompanied only by the sounds of the hull knifing through the waters and the fluttering of the wind through the sails.
As it always had in the past, the seemingly endless ocean surrounding him and his boat made him feel small. The only other things in sight were the four destroyers accompanying him and his crew. Their dark gray hulls slid through the swells, occasionally throwing a spray of water from their bows as they guided the Washington into deeper waters.
There had been talk of delaying the test, but it was decided in the end to proceed, even if there were a chance that communications might become disrupted. The weather was perfect and it would take some time to gather the currently assigned resources again. Besides, the Navy was anxious to see how their new toy behaved, and the remote possibility of a temporary communication outage wasn’t going to stop them. Each day the boat spent in its sea trials cost dollars that were becoming scarcer with each passing year. If they waited too long, there was the off-chance that funding could be cut, which was a worry with each budget session. That, however, was way beyond Lawrence’s pay grade. He went when ordered and did what he was ordered, leaving the whole political nature of it in someone else’s lap.
Although enjoying being out at sea again, the anxiety that Commander Lawrence felt stemmed from the fact that the next four and a half hours could make or break his career. Well, technically, it could only break it if something went wrong. His career was already on the upswing, as he’d been selected to command the latest and greatest underwater technical marvel. If something did go wrong, whether or not it was his fault, then that would become a permanent stain on his record, and he would be lucky to ever see another command. However, he couldn’t allow that anxiety to sur
face.
He watched as the two escorts ahead of him turned, their bows knifing away from his heading. From their actions, and the reports reaching him from the control room below, they had reached the waters in which they would start their tests.
“Let’s get this started, shall we?” Lawrence said to the lookouts.
“Aye, aye, sir,” they responded in unison.
Stepping to the ladder, Lawrence left the open air and made his way down to the control room. With everyone at their stations and with all hatches sealed, he nodded at the report that the boat was ready to dive. There wasn’t any of the quick activity that would normally accompany a dive. They took their time to ensure that every control, every switch, every hatch was in the correct position. There wasn’t any rush to do anything—the focus was on doing it right. If they took an hour to make sure, it might raise an eyebrow or two, or bring about a query to ensure that everything was going well, but it wouldn’t cause problems. Their task was to take the boat down in increments, make sure that everything functioned as designed, run through maneuvers, and bring the multi-billion-dollar piece of equipment back safely. The drills would come at a later date. It was basically deeply submerge and see if it continued to be a boat or if it became an anchor, write up anything that broke, and hope that whatever did wasn’t too essential.
“Okay, chief, let’s take her to three hundred feet and see if this sardine tin leaks,” Lawrence ordered.
“Aye, sir, three hundred feet.”
With the balance between floating and sinking altered, the deck tilted forward as the Washington sought the depths. The sub and those crewing it would come to know those depths as safety once the trials were over and it entered service, but until then, there was an uneasy relationship. With the boat being an unknown at the depths they were going to, safety lay with the open air above, which was a funny feeling for Lawrence.
The conning tower was reported under water, and he envisioned the view from the destroyers circling their position above, the sub disappearing from sight, leaving a wake behind, then nothing. They had entered their own world, a world of stealth, one where a deadly game of cat and mouse was played with the opposing forces. However, all of that was in the future for the sub. Now was the time to test its mettle. For those inside, it would take hours of careful maneuvering and note-taking, all without communicating with the outside world. For those topside, it would be hours of waiting in silence for the Washington to surface.
