Chapter Six: G'Night

Alyson was lying at the edge of the water, holding her left foot and screaming. Her breakfast lay splashed on the sand beside her. Her deck shoes sat a few feet inland. While Doug examined Alyson's foot, Mary washed the vomit from the girl's lips, cheek, and chin.

"Small puncture wound," he said. "Inflammation setting in. Something protruding. Honey! Alyson! Where did it happen?"

He had to repeat the question. She managed get out that it happened a few feet seaward from where she lay. He left her with Mary and waded out. It was easy to spot, but the waves were erasing the disturbance in the sandy bottom. He poked with the toe of his shoe for a moment but found nothing. He returned and knelt beside Alyson.

"I'll carry her," he said, scooping her into his arms. "I need hot water-as hot as she can stand. Maybe a pint for now but also put on the larger pot to heat for later."

Color drained from Mary's tanned face. She started running back to the cabin. "Fish or shell?" she called over her shoulder.

"Fish, I think." He moved as quickly as he could without dropping the screaming girl while Mary raced on ahead. He wasn't a religious man, but he thanked every deity he could name that he'd married a woman who was able to control her motherly emotions and who could both think and act in an emergency. Even when she guessed what had probably happened, she kept her head. She'd seen her share of life-threatening emergencies while on research expeditions, but this was her daughter, and still she kept a cool head even though her guts had to be in the same icy knots as his own.

He'd certainly seen his share of children in pain, but this was Alyson, his Pixie, and her cries for him to stop the pain were shredding his soul. You'd think years of medical school and pediatric practice would inure him somewhat and that he'd operate on autopilot, but putting one foot in front of the other now required conscious effort.

Alyson's stomach heaved again as he reached the door, but she had already emptied it. He turned sideways and eased her through the door.

"Couch," Mary said, emerging from the bedroom with his medical kit. She placed it on a crate used as an end table and opened it. "There's only four," she said, her voice quavering, as she removed a morphine injector.

"It will have to do, Mare," he said as he lowered Alyson. "I didn't plan on being shipwrecked."

Mary comforted her screaming daughter as best she could while he injected her and then removed tweezers and a small magnifying glass from the kit. He tried to immobilize her foot long enough to check the wound and was about to ask Mary for help when Alyson suddenly heaved again and then went still.

"DOUG!"

He gave the girl a quick check. "She fainted. Maybe she'll stay out until the morphine kicks in. Are you okay?"

"No." She wiped her eyes with the back of a hand. "But I'll manage. I'll see to the water. I haven't put the large one on yet."

Doug gave her a grim smile. He wanted to hold her, to comfort her, to tell her that their daughter would be fine. But Mary had been in these waters before and already knew better. And he had a patient to treat. Mary bent to kiss him before crossing to the kitchen and returning with a folding chair. She kissed him again and left a hand on his shoulder for a moment, a plea in her brimming eyes, before returning to the stove.

The porch roof now blocked the rising sun from entering the room. He fished a small flashlight from the kit, turned it on, and sat in the chair, placing her foot on his knees. He held the flashlight in his mouth, lifted the foot, and examined the wound through the magnifying glass. He switched the magnifying glass for the tweezers and removed a dorsal fin spine from the wound, then switched back to the lens. A second puncture wound had gone unnoticed four millimeters from the one with the protruding spine. She had received a double shot of venom. The second wound appeared to have no broken spine in it, but the area around the wounds was red and swelling rapidly.

He moved the lens over the extracted spine. Intact. He had removed all of it. He put away the equipment and checked Alyson's pulse. His diving watch was in the bedroom, but there was no question that her pulse was rapid and felt strange. He reached for the stethoscope, snapped the earpieces in his ears, and placed the pickup between the small, tanned, upright cones. He listened for a moment. Minor arrhythmia had already begun. The only good news he could think of was that she'd had a tetanus shot two years earlier. Small comfort, that. He removed the stethoscope from his ears and let it hang by the earpieces around his neck.

Mary's quiet sobs stole into his thoughts, making it harder for him to maintain his professional attitude as he cleaned the wound with alcohol and a swab. His vision blurred, and hot tears rolled down his cheeks. He should have warned her to wear her shoes while wading, but none of the three wore them. He didn't think the risk was great enough. He didn't know those fish inhabited these waters, or that they would be in the sand away from the rocks. Unless it was a dying one that had washed up near shore. He thought about that to get his mind away from the real issue for the moment.

Mary approached unnoticed. She put the hot water and a clean cloth on the floor at Doug's feet. "Do you think this will help if she's already unconscious?" she asked as she sat on the edge by Alyson's head.

He shrugged. "Can't hurt. Well, I didn't mean the pun. God damn it! I wish I had some antivenin."

"Maybe the heat will..." She shot to her feet. "Papain!"

Doug frowned at her.

"Papain. Meat tenderizer can relieve mosquito bites and bee stings by breaking down the injected proteins. It's papain. You use it for psoriasis and removing dead tissue and..."

"I know what it does." He regretted the harsh tone but said nothing more, letting her speak.

"There are green fruit on some of the papaya trees. What if we use the papain from the latex on her foot? Would it help break down the proteins in the venom?"

Doug looked at the small foot resting on his knees. "Well, I-what the hell? The worst it can do is remove the tissue around the wound when it starts necrotizing."

Mary grabbed the shopping bag with her tree climbing gear. "It's about a quarter-mile to the papaya trees. I won't be gone long."

"Mare, watch out. I can't care for her alone if you injure yourself." That wasn't exactly true, but he didn't need two patients, and the idea of increased risk to her daughter might cause Mary to be a little more cautious.

"I'll be careful." She raced out the door. Doug wondered just how Mary would define "careful."

He tested the water. It was uncomfortably hot but not enough to burn. He dipped the cloth in it and wrapped it around the injured foot. The heat would help make the pain bearable, and maybe it would help dissipate the venom. He wasn't sure that the papain would help given the depth of the venom injection, but Mary needed some hope. And, if he could get the papaya latex into the wound, maybe it could help destroy some of the venom.

He held the hot cloth in place, looking with blurred vision at the toes peeking out from the wet bandage. He lifted the foot and kissed each one. When was the last time he'd done that? When she was a baby, he supposed. "Pixie, I'm doing all I can for you, but you'll have to help," he whispered. "Hear me? You have to help. I can't do it alone."

She convulsed with another attempt at vomiting. He wiped his eyes and listened to her breathe. No apparent aspiration of what little fluid was in her stomach. He had to turn her on her side in case she wasn't so lucky the next time. When that was done he reached for the stethoscope. Lungs were clear, the heart arrhythmia... Was it worse, or was his imagination working overtime? He moved the pickup and listened. And again. And again, trying to memorize the sound for later comparison. Modern medicine, he decided, made doctors too dependent on graphs and displays and read-outs and too removed from their own senses. His great-grandfather could differentiate diphtheria from whooping cough halfway from the door to the patient's bed based solely on the smell in the air.

He slowly became aware that the edge of his hand was resting against her left breast and yanked his hand back. What if Mary had seen that? She might think I was fondling Aly when she wasn't around, even though I haven't. She'd know for sure that I'd fondled some patients. Especially Tiffany, that sexy little bitch who just had to mention to her mother that she'd had a pelvic exam during her physical. Mare will tell Hodgson, divorce me, take Aly away, and let me lose my license, all out of spite because I never told her about the investigation. And she'll probably marry that old fool as thanks for telling her about the investigation. I should have listened through Alyson's back, and by damn! that's what I'll do from now on.

"I'm sorry I touched your breast," he whispered to her unconscious form. "I didn't mean to." What if Mare had seen that? How could you have been so thoughtless?

He sat back and felt the cloth. It was cooling. He dipped it in the hot water, wrung it lightly, and wrapped the foot again. He used one hand to help trap the heat and stroked her ankle and calf with the other, whispering words of encouragement. He suddenly realized that his attempt at comfort could also be misconstrued as fondling and moved that hand to also help contain the heat of the cloth. How could you have been so thoughtless? Watch what the hell you're doing with your hands! Mare wants to marry Hodgson, and you're going to give her to him gift-wrapped.

He was removing hot water from the large pot when Mary returned. While he told her that the situation was unchanged she removed one green papaya fruit from the bag and put it on the kitchen table. With her belt knife she scored the skin and watched the white latex ooze forth. "Teaspoon," she said, and he handed her one. When she had collected several drops she said, "Another one," and swapped with him. He took the first to Aly.

Swelling had closed the wound. He spread the sap over the swelling while he thought. When he was finished he took the morphine syringe and spoon to the stove. He rinsed the spoon in the hot water and handed it to her. "Get me some clean sap," he said. "Don't scrape the outside of the fruit with the spoon. I'm going to inject it into the wound. Let's try to avoid secondary infection."

"Take another fruit and rinse it first," she said, "but I don't think secondary infection would be a problem."

She let the latex drip in the spoon while Doug cleaned the syringe. It seemed to take forever, and she twice brushed a tear away on her shoulder. Neither said anything. Both knew it was a gamble. Neither wanted to risk not trying, especially Doug. Aly was the only thing that would keep him from losing Mare to that bastard Hodgson. Doug checked on Alyson when she again dry-heaved. Her pulse seemed fainter, the arrhythmia more pronounced. He kissed her forehead and whispered for her to keep fighting.

Alyson opened her eyes, looked at him, smiled weakly, and closed them again.

Doug replaced the plastic over the wound and wrapped the swollen foot with the hot bandage. The plastic kept the water from removing the latex. Mary had washed the few late-lunch dishes and returned to take the water container for a hot refill. He looked up into Mary's anxious eyes. "Some necrosis around the wound, but the papain is dissolving the dead tissue. Her breathing is erratic, heart arrhythmia is slowly increasing, the body tremors are beginning, but she's quit trying to vomit. I wish to hell I knew if that last is a good sign in light of the others."

Mary nodded and turned to take the water container to the stove for a refill. He looked at Alyson and was startled to see her looking back at him, quietly crying. "I'm not going to make it, am I?" she sobbed.

His first instinct was to tell her everything would be okay. She would know he was lying and wouldn't trust him after that. He had to tell her the truth, but how much?

"Sweetheart, I..." The buzzing noise high outside finally penetrated his consciousness. He bolted for the door. A small twin-engine plane was up and to the north. He raced to the signal pyre, tore away the cover, doused it with generator fuel, and grabbed Welch's lighter. He struck it aflame and shoved it into the signal fire, ignoring the small starter torches because there wasn't time. The fuel roared to life, singeing the hair from his arm and igniting the rest of the pyre. Flame and white smoke boiled forth. He had the signal mirror out in an instant.

At first he thought he'd been too late, but the plane banked left and began descending. It stopped turning when it was on line with him. It overflew him, turned over the sea, and began a return path. No pontoons, he noted. Just wheels. It can't land.

Doug stood by the SOS in the sand. When he was certain he could be clearly seen he grabbed his chest, fell over, and rose to his knees, pointing to the cabin, where Mary stood on the porch, watching. The plane banked as it reached him, circled over the lagoon briefly, and then headed toward him again.