Page 32 of Break For Me
"I need to debride the torn edges and re-close," I say. "The tissue is inflamed, which means the local anesthetic won't penetrate effectively even if I had it. I used the last of the lidocaine on your forearm two days ago."
He looks at me then. His dark eyes are flat, exhausted. They are ringed with the bruise-purple of sustained blood loss and insufficient sleep.
"So?" he asks.
"So this is going to hurt."
"Everything hurts," he says. "Get on with it."
I pour betadine over the wound. It’s cold. He doesn't flinch. The temperature differential is negligible compared to what’s coming.
I pick up the surgical scissors. I debride the necrotic margins, trimming the dead tissue to reach viable edges that will accept suture. The steel bites through the damaged skin. He still doesn't flinch. His jaw is locked, the muscle jumping rhythmically. His breathing is controlled through his nose in long, even pulls.
I pick up the needle driver. I thread the suture through the curved needle. I position the tip against the wound margin.
"Ready?"
"I’ve been ready since the day I was born. Stick me."
I push the needle through his skin.
No anesthesia. No numbing. The needle penetrates the thick dermis and enters the subcutaneous tissue. The resistance is palpable.
He makes a sound. Not a groan. Not a gasp. A sharp exhalation.Hssst.It’s the sound of a man routing intense pain through a pre-built channel, a pipeline that runs from his nerve endings to some internal furnace where it’s converted into fuel.
I pull the suture through. I tie the knot. I move to the next bite.
He watches me work. His eyes track my hands with an intensity that makes the hair on my arms stand up. It is a predator watching a procedure performed on its own body, assessing the competence of the hands inside its wound with the same criteria it would use to assess a threat.
"Why didn't you run?"
The question arrives between the third and fourth suture. His voice is level, almost conversational.
"I had a gun," he continues. "You could have walked out of that truck at any stop. You could have flagged someone on the highway."
"You also had a patient in your lap," I say, focusing on the needle.
"Garrett could have managed. He’s competent."
I tie the fourth knot. I position the needle for the fifth. The tissue is swollen, resistant. Each bite requires more force than the last. His hand twitches in my grip, a reflex he can't control, but he doesn't pull away.
"Then why?" he asks again.
I don't answer immediately. I place the fifth suture. The sixth. His hand is a landscape of pain and I’m navigating it with a needle and thread. The focus required to do this well is the same focus I used in the operating room at Hopkins—total,consuming. A state where the only reality is the tissue under my instrument and the problem it presents.
"My sister," I say.
The words leave my mouth before the decision to speak them reaches my conscious brain. A failure of compartmentalization. The exhaustion, the proximity, the sustained intimacy of having my hands inside this man’s wound—something has eroded the wall that separates the things I say from the things I keep locked away.
His eyes sharpen. The flatness recedes, replaced by something narrow and focused. He’s processing. Unexpected intelligence, recalculating..
"The Russians own her safety," I say. I tie the seventh knot. My voice stays level because my voice always stays level—it’s the last system to fail. "Her name is Elena. She’s twenty-two. She studies composition at Berklee College of Music in Boston. She lives in an apartment in Brookline that she believes is covered by my salary from a private medical practice."
Eighth suture. Ninth. The wound is closing, the edges coming together under my thread. The seam is forming.
"Kazimir Volkov pays her tuition," I continue. "He pays her rent. He pays for the security detail she doesn't know exists—two men who rotate shifts outside her building. They aren't there to protect her. They are there to remind me that they know where she sleeps."
I pause. I look at him.
