Lorena,
First of all, please do not be too distressed. Yancy has two injuries, but at this juncture I don’t believe either of them are life threatening. Clear your mind and be calm. It won’t help Yancy if you are troubled.
First, his head wound: He has a scalp laceration, I believe a graze from a bullet. He sustained a simple linear skull fracture (it’s just a thin line about three inches long), and the skull is not splintered or depressed or in any way distorted. This is good news; but all skull fractures are serious injuries, and he will require constant monitoring for the next twenty-four hours. The scalp laceration required eleven stitches, but the wound and the edges were clean.
For care: Wrap ice chips in a clean white towel and apply to his forehead and eye every hour for about fifteen minutes. Head wounds bleed profusely, and even with the stitches he may bleed through the bandage. Rebandage as necessary, gently cleaning any dried blood at the laceration site if necessary.
As for his mental condition, I do not believe he is in a coma. I think he is unconscious, but in a very light state as he goes back and forth into a deep sleep. He drifted into consciousness as I was stitching his arm, and he seemed to be lucid. He knew his name and could see me very well. But he was in pain, so I gave him some morphia and he slept again. Don’t attempt to rouse him, but if he does wake up just ask him some simple questions: his name, if he knows where he is, if his vision is clear, if he is in pain. You may give him twenty drops of laudanum as often as every four hours if needed.
Head injury patients generally have a sensitivity to bright light and noise, so keep the room dimly lit (I suggest with candles only, and keep the drapes drawn) and speak and move as softly as possible. Also, it is best that he be propped up to a half-sitting position; he will be much more comfortable than lying flat.
I must caution you, daughter, that when people receive the shock of head wounds, they usually evidence some distressing symptoms, but in actuality they are the norm. He will likely be confused as to time; he won’t know what day it is, and it will mean nothing to him when you tell him. He will have lost the instinctive sense we have of knowing whether it is day or night, and this usually results in increased anxiety. I’m sure this will be magnified for Yancy, as he does seem to have sharper senses than most men. Perhaps it is the Indian in him. At any rate, if he wakes up and seems to be alert enough to want to talk, first gently let him know where he is, what day it is, and what time it is for he very well may not know where he is.
It is common for victims of skull fractures to have amnesia to one degree or another. They rarely remember the incident that caused the injury, and the amnesia may evidence itself in many ways. He will almost certainly have holes in his memory, both short-term and long-term. Do not be alarmed, for it’s natural that he will have trouble with his memory for a while.
As I said, I don’t believe the head injury is too severe, but there are a few symptoms that would indicate a graver prognosis, and I wish you would send for me immediately should they occur. They are: convulsions, slurred speech, stiff neck, visual disturbances, or clear fluid leaking from his ears or nose.
As for his right arm, he was shot and the bullet lodged just at the edge of the humerus. I removed the bullet without trouble, but the bone is slightly chipped and it sustained a hairline crack, which is not even considered a break. We will need to keep it bandaged tightly and tied securely into the sling to keep it immobilized for a few days, but I think he will regain full use soon. He may suffer pain at the incision site, and you can administer laudanum for that, too.
The hospital is extremely busy. men are pouring in from Gaines’ Mill just east of town, where the battle was today. Dr. McCaw kindly let me take an hour’s break, and I ate and even napped a little, and so I feel refreshed enough to keep working on. I am going to try to stay tonight as there are so very many emergency surgeries to perform. And you may take that as a measure of what I would term only moderate concern for Yancy. Certainly if I was worried to a great degree I would have come home with him, for as you well know in the last year, your mother and I have come to regard him almost as a son.
Keep hope in your mind, Lorena. Trust my judgment and trust yourself. You’re an excellent nurse, and as you know, Missy and Elijah are wonderful with sick or injured people. Yancy could not have better care. And of course, we will all “pray without ceasing” for Yancy.
With my great love,
Father
Lorena read it all again, slowly. But she felt a tremendous burden and fear both for Yancy and herself. She was frightened that Yancy might actually be much more severely injured than even her father, who had practiced medicine for almost thirty years, could know. And she was frightened that she might make some horrible mistake with his care; with misjudging his state, either physical or mental; some stupid mistake with his medication… An ugly picture of Yancy in bone-jarring convulsions grew large in her mind. Tears welled up in her eyes, and she buried her face in her hands. She was on the verge of panic.
But Lorena knew she was a strong woman who knew where her true strength came from, and with a supreme effort, she suppressed the paralyzing dread and banished the desolate visions in her mind. She bowed her head and quoted softly, “ ‘Come unto me, all ye that labour and are heavy laden, and I will give you rest. Take my yoke upon you, and learn of me; for I am meek and lowly in heart: and ye shall find rest unto your souls. For my yoke is easy, and my burden is light.’” She felt a great calm and clarity of mind and strength of will flow over her and through her, and she thanked the Lord for it.
Gathering her father’s notes, she went upstairs to reassure her mother that Yancy was going to be just fine. She had every confidence that she could take care of him.
Lorena stayed by Yancy’s side all night, except when Elijah came to attend to him. He stirred lightly when she applied the ice chips to his forehead and eye, but he didn’t seem to be in distress. Once he opened his eye—his left eye, for his right was swollen shut—and looked at her. Even with one eye, she could see that his gaze was direct and clear. But his lids were heavy, and after just a few seconds he slept again.
Her father came home at dawn, his shoulders heavily stooped, his eyes shadowed. “Hello, my dear. How is our patient?” he asked, laying his hands on Lorena’s shoulders.
“He just seems to be resting quietly,” she answered. “He opened his eyes once, but he slipped right back to sleep.”
“You know, dear, Elijah and Missy are perfectly capable of watching him. They would let us know if there was any change at all.”
“I know,” Lorena agreed. “But I don’t want to leave him. I want to be here if—when he wakes up.”
“I understand,” he said, moving to Yancy’s bedside. He bent over, gently lifted his left eyelid, and nodded with satisfaction. “But you should have Elijah bring up your favorite chair from the parlor. You could rest easier in it.”
She had been sitting in a side chair with a padded seat. It wasn’t uncomfortable, but neither could one lounge in it. “Wonderful idea, Father,” Lorena said appreciatively. “As always, your prescriptives are just perfect.”
He smiled. “Also, as your physician, I’m going to insist that you rest later today. I’m going to sleep for a while. Later this afternoon, before I go back to the hospital, I’ll stay with Yancy. I need to do an overall assessment of him and cleanse the arm incision and scalp laceration anyway. While I’m doing that, you can have something to eat and sleep for an hour or two. Oh no, young lady, don’t you make that face at me. I insist. If Yancy wakes up, I promise I will come and get you.”
“Very well,” she said reluctantly. “I suppose I will need it, for I intend to sit up with him tonight.”
“Good,” he said and yawned. “I’m off to bed. I’ll see you later, daughter.” He bent and kissed her cheek and left.
Elijah brought up her chair and she sank gratefully into it. It enveloped her with comfort and a thousand happy memories of her family all to
gether in the parlor.
She missed Leslie. He had returned to Washington in November of last year, shortly after Yancy’s last visit. He had written, with vast relief, to tell them that he had joined the 8th Maryland, which was assigned to North Carolina.
It’s extremely unlikely I’ll ever see Yancy on a battlefield again. Tell him for me, and thank him again. And tell him that I hope we may meet as friends again soon, in a time of blessed peace.
She read the Bible for a while by the single candle in the room, but candlelight was too dim for reading at very long stretches. She settled back in her chair and laid her head back, closing her eyes to rest them. Without really realizing it, she fell into a light sleep.
She didn’t exactly dream, but she did have a vague feeling of deep comfort and knew she was in her favorite chair. Airy images floated through her subconscious—her mother, smiling; a warm fire in the parlor; Yancy sleeping.
This faraway picture roused her a little. She stirred and slowly opened her eyes.
Yancy’s eyes were open. The swelling in his right eye had gone down considerably with Lorena’s faithful applications of the ice packs. In his half-sitting position he leaned back against the mound of pillows propping him up. He looked relaxed and comfortable, but his eyes were bright and sharp. His expression was not apprehensive and certainly not fearful, but as her father had predicted, he appeared to be slightly confused. “Hello,” he said.
“He–hello,” Lorena stuttered. She was startled, and the faraway feeling of her dreamy slumber had not yet faded.
He continued to look at her with his fathomless dark eyes.
She sat up straight, smoothed her hair back, and looked at the pendant watch pinned to her shoulder. It was 3:30 in the afternoon, and mindful of what her father had told her about Yancy’s probable lack of time perception, sharply she made herself recall that it was Saturday, June 28, 1862.
Calm now, she looked back at him and asked, “Do you know your name?”
He frowned. “Yes, of course. I’m Yancy Tremayne.”
“Can you see me clearly?”
“Yes, my vision is clear, but my right eye….” He moved his right arm, but it was immobile in the sling. He looked down at it with some surprise. “What happened to me?” he asked.
“You were hurt. Injured. Do you remember anything at all?”
Long seconds elapsed as he stared into space blankly. “I… I remember a big black horse, riding a big black horse….” His vision focused sharply on her face. “I’m a soldier. In Stonewall Jackson’s outfit. My horse’s name is Midnight, and I’m—I’m a courier for Major Jackson.”
“General Jackson,” Lorena corrected him gently.
He looked bemused. “That’s all I can remember. Riding Midnight. Carrying dispatches for Maj—General Jackson.”
“It’s all right,” she said soothingly. “You’ve had a head injury, and that’s why your right eye is swollen, and that’s why you’re a little confused right now. It’s very common with this type of injury, but it will pass.”
He nodded, seemingly satisfied at the moment. His gaze wandered around the room. “What time is it?”
“It’s 3:30 in the afternoon. Today is Saturday. It’s June—June 28.”
“Oh,” he said blankly. Then he looked down and touched his bound right arm with his left. “What happened to me?” he asked again.
Lorena hesitated. She was uncertain whether she should give him the bald, frightening facts that he had been shot in battle. But he seemed steady enough and she knew that Yancy was a strong man. She replied, “You’re right, Yancy, you are a soldier. You fought in a battle. A bullet grazed your head, and you have a slight fracture, and the wound required stitches. You were also shot in the arm, but the bullet was removed without any problems. The only reason that your right arm is immobilized is because the bullet lodged against your humerus—that’s the big bone in your upper arm—and chipped it just a bit. Your arm isn’t broken, but it’ll be best to keep it still for a few days.”
He listened carefully, and still he was expressionless. Lorena really couldn’t tell how much he comprehended, but he was not at all distressed. His respiration, she noted, was full and steady, and his eyes stayed clear and focused. “Ma’am, could I please have a drink of water?” he asked at last.
“Of course,” she said. She rose and went to the washstand, a solid chest with a marble top and a cabinet and drawers underneath. There was a large bowl and pitcher for wash water, and now Lorena had kept a pitcher of water on ice. She poured him a glass and noted with satisfaction that it was cool but not too cold, as her father had instructed. She brought it to him and hesitated, notreally knowing if he was so weak that she needed to hold it for him.
But with no apparent problem he reached up with his left hand and took the glass and drank thirstily.
“More?” she asked as he emptied the glass.
“Please, ma’am.”
Lorena was a little troubled by his formality, but she dismissed it as Yancy’s natural courtesy. She filled the glass again.
He drank about half of it and then set it on the bedside table. She was glad to see that he apparently moved with relative ease, for the table was on the right side of the bed, by her chair, and he had made the awkward crossover of his body to set the glass down securely. He settled back into the pillows, but they had come disarrayed.
She bent over and pulled up on one slightly. “Can you lean forward a bit, Yancy? If you are able to, I think I can arrange your pillows a little better.” It was a test, to see if he could sit up straighter without her help. He did. He’s very strong, she reflected with a sort of furtive feminine admiration. He should heal quickly.
She finished and Yancy settled back. “Thank you, ma’am,” he said.
“You’re welcome.” She studied him for a few moments and he met her gaze with no apparent discomfort. Lorena took a deep breath and her eyes dropped to her hands, folded in her lap. She had become nervous, twisting the fabric of her skirt into little knots. With a conscious effort she stilled her hands then looked up. “Yancy,” she said, and her voice had deepened with tension, “do you know me?”
His gaze didn’t waver. “I know that you’re a beautiful lady and very kind. Like this room, you seem familiar, but it’s a very faraway feeling, like you’re not really connected to me. It’s like—it’s sort of like I’ve seen pictures of you, and this room, a long time ago, in some book.”
Numbly she nodded and ducked her head again to hide her distress. It shocked her to realize just how desolate his matter-of-fact answer made her feel.
“Do I—have I offended you, ma’am?” he asked with the first sign of anxiety. “Am I supposed to—are you—have I—”
Quickly she arranged her features to hide the turmoil of emotion she felt and looked back up. “No, Yancy, of course you haven’t offended me in any way. As I said, you may have some trouble with your memory for a day or two; you were injured only yesterday, you know. You are in Richmond, in the Hayden home. My father, Jesse Hayden, is your physician, but not only that, you are a close friend of our family’s.”
He relaxed. “That’s good then,” he said vaguely. He reached up with his left hand and barely touched the bandage on his head, wincing slightly.
“Are you in pain?” Lorena asked quickly.
“Well, yes, I’m getting the beginnings of a headache. And my arm is starting to hurt some.”
Lorena took a brown bottle from the bedside table and carefully measured the light brown liquid into a spoon. “Here. This will ease your pain and help you to sleep.”
Obediently he opened his mouth and took the dose. He made a face and Lorena handed him the glass of water. He washed down the bitter medicine with a long drink.
“Do you think you could drink some broth, Yancy?” Lorena asked him.
“I don’t really want anything else right now, ma’am,” he answered. His eyes were already dulling somewhat, his eyelids dropping. Laudanum was a mixtur
e of the tincture of opium and brandy. Dr. Hayden added sugar to his prescriptive, but it did little to mask the unpleasant taste. Yancy was already feeling the effects of the powerful drug. He blinked slowly, twice.
“When you wake up again perhaps you’ll feel more like eating a small meal,” Lorena managed to say lightly. “For now, just go back to sleep.”
He closed his eyes and breathed deeply.
Lorena now let the anguish show on her face; she pressed shaky fingers to her forehead. Feeling helpless tears rising, she got up and tiptoed to the door. She certainly wasn’t going to sit by Yancy’s bed and sob like a hurt child.
She had only gone a few steps, when behind her Yancy murmured, “Ma’am? What is your name, please?”
“Lorena,” she said, her voice raw. She couldn’t help it. “Lorena Hayden.”
He blinked, then his eyes closed again.
Lorena fled, running into her bedroom across the hall. It was long minutes before she could stop crying.
“ ‘… and so after seven bloody days of battle, once again our heroic Army of Northern Virginia has triumphed over the Yankee invader. The cowardly McClellan with his rabble cowers on the far bank of the James River, his plan to overtake Richmond thwarted by our brave commander, General Robert E. Lee. With a force of barely eighty-eight thousand, General Lee and his fighting commanders General James Longstreet and General Stonewall Jackson pushed the one hundred thousand Federals a full twenty miles from our beloved capital. Even though our army was so vastly outnumbered, they were so overpowering in battle that the well-bloodied Yanks could not run fast enough. In tremendous triumph, General Lee and the Army of Northern Virginia have taken close to ten thousand prisoners and have inflicted nearly sixteen thousand casualties (killed, wounded, and missing) on the enemy. In addition, General Lee has seized fifty cannons and ten thousand muskets for the blessed Confederacy.
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