The Last Surgery of Doctor Frost
by Jay Wilburn
He did not think he would wake up again and he was surprised when he did. He stared up into blue sky with only the scant wisps of clouds to clue him in that he saw this scene in the real world. Alive. Still.
It could have been a warm day back home. The humidity wasn’t high enough for it to be the riverfront in summer. It would still be the main property with the shutters open and furniture uncovered then. The long drive with the brick edging. No more leaves to worry about, but the grass would need cutting whether the family was there or at the river house. He liked the grass cut in rows in both directions. Little Scott called it Alice’s checkerboard like in his Wonderland picture book.
He felt boiling hot though. He tried to remind himself that this might be a fever. He might be in trouble. Infection.
He shivered. He still shivered. It was cold. Deathly cold. He stared up into clear skies and realized he felt hot because his body temperature dropped. Dropped too much probably.
He still lived because the cold consumed him as he bled out.
Jeff Frost lifted his head and stared down into his open belly. He needed a rib separator and he needed a wider incision. Higher. Probably would do to crack the sternum too.
He reached up with a bloody index finger and checked the oxygen tube in his own nose. His hand felt dead and icy. Jeff stretched to his right and fumbled his way up the canister to the valve. The thing didn’t want to turn. His own weakness betrayed him or the bolt had frozen solid one.
“Try. Just try,” he said not for the first time. He pictured his son reaching for a book he wanted on a shelf
His son’s name was Scott. Scott was five and had eyes the color of the blue sky above the icy plain where Doctor Frost bled. His mother’s eyes. Jeff remembered little Scott’s last hug before bed. Jeff left the next morning before dawn, so Scott was still sleeping. So, was Carol, so Jeff didn’t see their blue eyes again the morning he left.
The grass needed cutting, but he’d have to pay someone for that once he returned.
The hug had been different. It was only by a few seconds really, but it was longer than normal. Jeff didn’t say anything extra after goodnight and a kiss on top of the boy’s clean hair. Scott rested his head on his father’s chest in the chair that extra couple seconds.
He didn’t ask where daddy was going nor when he would be back. He’d probably ask mommy a hundred times. He might be asking her now for all Jeff knew.
It was only a couple extra seconds. A five year old seeking reassurance maybe. Daddy is real. Daddy is here. Maybe it was a glitch in the boy’s internal timer that threw off the routine by a mere couple seconds. A minor operational error. Self correcting. Maybe nothing more.
Jeff was having trouble tracking mental time at the moment that was for sure.
Still. Jeff had the impression it was something else that went unsaid between them. The impression that the boy was afraid to let go.
He fought it and the valve twisted finally. The effort constricted his stomach muscles and he felt his guts shift in the open incision. The raw pain that traveled up his center from his balls to the base of his skull felt like corkscrew inside him. Everything felt wrong. Both tight and loose at the same time.
The airflow weakened. He’d turned the damn thing the wrong way. Dr. Frost twisted the valve wheel three squeaks the other way before it froze up again. Cold oxygen blasted up into his sinuses drying them out for a moment. Wide open. He’d run out sooner, but what the hell? He needed the kick to the brain for a few seconds. Feed the cells.
“We’re all slowly burning to death in a sea of oxygen.”
He needed someone else to perform the damn surgery.
At the very least, he needed two other people to assist. Even that Commie in Antarctica had two scientists assisting before he won the iron cross for taking out his own appendix.
The rest of the crew died in the crash, so Frost had to do this alone. And no man could repair his own spleen. No one. Not possible. Packing himself with snow was going to have him dead of hypothermia even if it did buy him time to sew himself up.
His hand shook as he lowered the cauterizer. He tried to steady himself. No luck. He went into the laceration anyway. Frost screamed and convulsed. His cries echoed across the cracked ice sheet beyond the fuselage and one broken wing jammed into the snow past his boots.
He saw black spots and his eyes teared up once his hand traveled halfway across the field of surgery. He shook his head to clear the moisture and felt the tears freeze to his cheeks. Light flashed in his vision from the synapses blasting inside his skull from the overload of pain. He stared down as he continued to traverse slowly with the tool.
Smoke rose out of his belly. Actual smoke with the steam of what was left of his body heat.
A quick glance into the blue sky. We’re all slowly burning to death in a sea of oxygen.
He had to finish.
Even if he could lock down the spleen, which he doubted, he still had to deal with injuries to his intestines.
He dropped his head back into the snow to stare up into the sky again.
He needed to stay conscious. If nothing else, he had to close himself up. He probably was about to die anyway. Maybe repairing the intestine wouldn’t matter ultimately. Either he’d be rescued or he wouldn’t. That’s what this really came down to.
They were downed in a remote area though. Through a storm and off course. Radio and transponder out, he thought. He had considered getting a Breitling watch like the aviators and astronauts always wore. It had a mini transponder inside that reached out a few nautical miles over clear view like the ice sheet. Maybe ninety miles even? Probably not all the way to the water, but still.
It felt like an extravagance for as seldom as he flew on missions. He remembered holding one in his hand in that little shop in Boston when they went on the fourth. It had a twenty-four hour dial just like the ones the astronauts wore in the sixties.
He had bobbed his hand deciding whether to buy it, but ultimately set it down. He had been so proud of himself for not spending the money. Like it had been a great, personal victory. The aviator’s watch with the transponder inside stayed in Boston then. He saved his money to pay for his yard to be mowed in rows for Alice and the Queen to play checkers.
“Clear fucking skies now though,” he said and watched his breath break apart above his face.
No one was going to find him in time. He felt as dead as the rest of the crew. Broken apart like his own breath.
Probably would be found by accident. It would be years later. Maybe decades. Climate change would break up the already thinner ice miles east. Cutter ships would muscle through. Someone would spot the bits of wreckage and send a crew. It probably wouldn’t even be Americans. They stood decades behind in the ice race. Maybe Canadians. Probably the Chinese or Russians though who already had nuclear powered ice breakers. The pictures of emaciated bodies would hit whatever version of the Internet existed a half century in the future. The real puzzle would be why the flight surgeon went crazy and started cutting himself up in the snow. It would make all the listacles of strange and disturbing discoveries.
Maybe he’d get lucky and melting ice would send the whole thing to the bottom of the drink. Entombed forever. Buried by rising temperatures they were sent to map from the sky.
God, he was hot. He wanted to strip off some layers.
How many people ended up naked and dead in the snow from hypothermia? Or while accidentally locked in some meat locker? Mistaking freezing to death for burning. He glanced up at one of the wisps of cloud again.
Jeff growled and forced his head off the snow again.
He spread his incision and gritted his teeth. He reached in to try and find the nick he had spotted on the intestine. He pulled at the purple, bumpy rope of bowel and felt it in his ass. His stomach lurched. He’d eaten nothing, but he forced the surge back down.
Blood welled and spilt over the side of his belly to absorb in the snow. It spilled again. Too much. Too dark.
He blinked and sucked in a breath of cold oxygen through his dry nose.
Jeff released the intestine and gingerly examined his spleen again. It looked like a swollen berry. The thing would have to come out even if his work held long enough to be rescued. No bleeds though.
Where was it? Why so dark?
His eyes went wide and he felt over the dark surface. His hand came back soaked.
“My liver. Oh, God, my liver.”
Jeff shook his head and prodded the thing to find the bleed. If it was too far back, there was no point. He couldn’t hold it up and repair it at the same time. There shouldn’t have been any way for a man to operate on his own liver anyway, but here he lay.
Liver damage sort of needed to repair itself sometimes. It just needed to be monitored or there had to be a transplant of one lobe or the entire liver, if the damage was too extensive. That couldn’t be an option here.
He found the bleed and reached for his tools again.
“Why am I not dead yet?”
Try. Just try, buddy.
“Liver damage is one of the most common internal abdominal trauma injuries,” he said.
He watched his breath.
He should have checked the liver first. If he hadn’t been on the fool’s errand on trying to repair a spleen, his own spleen, he might have caught it.
“If I had, I would have given up sooner.”
He still could.
Jeff shook his head to clear it, but it didn’t work. It just made him feel more dizzy.
How long had he been open out in the snow? How much had he bled out?
He should have had bags and bags of blood to transfuse. And an operating room. And a surgical team that didn’t include himself.
He went to work. Simple enough in a patient that was hemodynamically stable. Bleeding all the way out was one way to reach stability, he supposed. Unstable patients with liver bleeds were a risky gamble even for skilled surgeons. Most died of it in the early part of the last century. Numbers had improved slightly since then.
“I’m doing this for Scott …for Carol. He’ll ask when I’m coming home.”
Was that true though? Maybe Jeff needed to believe it was true to keep going, but did he need to keep going?
The spleen wasn’t going to hold even if he repaired the liver in time.
“Shit, this hurts.”
He continued to work.
If they found him in time, the spleen would still burst as soon as they put him on the stretcher. He’d bet his left nut on it. On his son’s bright, blue eyes …
“Just pack it and close. Wait. Hope for the fucking best.”
Or maybe just slightly better than the fucking worst would do. Was there something worse than operating on your own insides? Dying? Dying might actually be a relief at this point.
Jeff feared to let go. He continued to suture. The liver was at such a shit angle. His neck hurt. He needed a chair or even a mound of damn snow to hold him up to see. Like repairing every organ wasn’t impossible enough. He needed to crane his neck too? How much could reasonably be asked of a person? How much trying was enough? When was the damn trial over?
“I’ve lost too much blood.”
Jeff’s hands stopped. He waited a beat. Two. Why? He wanted to see if he had the courage to let go. To quit this insanity. If he stopped, it would be over soon. His body was primed for an exposure death. He barely felt the cold anymore …
His hands returned to work. He thought about the feel of Scott’s little head on his chest that final bedtime. The feel of his clean hair under daddy’s lips. That extra couple seconds that probably meant nothing.
Jeff lifted his hands and the tool away from the damaged lobe of the liver. He waited. No blood. Had his pressure dropped too far at this point or had he fixed it?
Jeff’s hands cramped and went numb, but he used the back of each wrist to pry his fingers back apart and to straighten the joints. The liver rested back in place.
He felt along the ropes of his intestines, causing that terrible feeling in his ass again. His balls tightened against his body and his left testicle throbbed.
“Quit. This is as good as you can do. Close up and hope for rescue now. Come on, asshole.”
No one is giving you the iron cross, Comrade.
He found the nick and gritted his teeth. To come this far and not finish the job. He just couldn’t justify that now.
It would be a hell of a thing to be found in fifty years and have them discover he successfully repair three of his own organs. Oh, the listacles he would make then.
Surgeons deserving of the iron cross …
He took a deep breath. The oxygen had stopped. Depleted the tank or frozen over. One or the other.
He clawed the tube away from his nose. His fingers smelled like shit. Caked mucus came away with the nose piece.
His nose ran from his right nostril down into his mouth.
Jeff coughed and then gasped. His guts stung.
He laughed and then groaned.
Jeff blinked several times and then began to close the incision.
He woke up to see more clouds over the blue. Still daytime? Probably this far north in the summer. Sure, it was.
“Please, mow the snow into rows for me.”
The sun hugged the blue sky a little longer than usual. Bad internal clock. Afraid to let go.
We’re on top of the world. Literally.
“I did it, buddy.”
He lifted his head. The incision was closed. He didn’t remember finishing. Had he repaired everything or given up?
Maybe he needed to open back up to be sure.
The skin around the incision was raw. Red. Hot. Could be from the cold. Probably infection. Snow not as clean as he had hoped.
He needed to get out of the cold.
Everything hurt as he tried to shift.
He couldn’t feel his legs though and they refused to respond. He could drag himself. Into the cover of the wreckage at least.
He clawed into the snow beside him, but had no strength in his arms to pull after that. His fingers remained buried in the snow as he went back out of consciousness.
In and out. A few times.
The sky took on a twilight glow with the sun closer toward the horizon. Behind the largest part of the plane.
Why did he come out in the snow to operate? The cold slowed things down. Slower bleeding. Slower dying. Was that a good thing? A few seconds longer to die than usual.
“Afraid to let go.”
Blue sky. Another long day. Cloudless. Nothing to remind a man that he looked into sky instead of a drowning pool. Burning alive in a cold sea of blue oxygen miles deep. A child’s imaginings of a sky.
He forced his elbow to bend and drew his left hand out of the snow. Fingers clawed. Black. The nails folded back away from the necrotic, frostbitten flesh of the gnarled fingers.
He lifted his right hand into view for comparison against the backdrop of impossible blue and cloudless sky.
Lighter. Lines of purple and red. Maybe blood poisoning even. Still stained with blood from his own guts. Almost brown or rust colored now. Grey. Dark grey. Frostbite in both hands for sure.
Probably his feet too and up his legs as well. Maybe the whole underside of his body.
He felt clumsily at his jacket pockets. He needed a pencil and a paper. He should have spent his last moments writing to them.What would he have said though.
Nothing. No pen. No way to leave a note. He could burn it on himself with the cauterizer. No crazier than what he had already done really. Right?
Could he write something in the snow? What?
Something that would hurt them to hear. Even haunt them maybe.
Best to slip out quietly in the dark and let them sleep.
“You said goodnight the night before. That’s good enough … Has to be.”
He dug through the tools beside him with his right hand. The satchel bumped the empty oxygen canister and tipped it over in the snow.
He used his dead left hand to drag furrows into the snow. He turned the angle of his wrist perpendicular and clawed another set across the first to create a small checkerboard. Two of his fingernails tore off in the snow on the second pass.
He pulled out the bloody scalpel from his satchel with his right hand and brought it to his forehead. The flesh parted easily. Blood ran down his nose into his mouth and tasted salty. He actually felt stronger for it. Warm inside. Like he had just eaten a heavy meal.
He turned the blade and sliced down to the bone across his forehead, creating a disproportioned cross. Something for a god with short legs and long arms.
“Nurse. Sponge, please … Alice, bring the checkers …”
Jeff took out scissors. Not exactly bone flap cutters, but good enough for a quick trepanning. Hell, they even did this sort of thing in the Stone Age. People survived it too. Easier than the liver.
The bone crackled and his stomach tightened on the spot of blood he had swallowed. His insides burned.
He almost lost his nerve.
“Try. Just try, buddy.”
Jeff couldn’t see the work, but he felt the skull open as his twisted the grips and folded the bone flaps apart in four compass directions. Easier than twisting the oxygen valve. He had a dizzy, light feeling like he was floating.
He dropped the scissors in the snow without bothering to look. He could use almost anything at that point, but he went for a powered tool. It whirled and he lowered it into the opening in the center of his forehead. He went slow. Jeff knew if he missed completely or ricocheted off the edge, he might not have the nerve to try again. Not being able to feel his hands didn’t help, of course.
Shutter the house and cover the furniture. We’re heading to the river.
He didn’t get far. An inch. Maybe two inches deep.
It sounded like running a blender over cream. His hand fell away and the tool went silent, wedged in the hole and pointing up from his forehead like a unicorn horn.
Thoughts didn’t vanish instantly or completely like he expected. He did not die nearly as fast as he hoped either. He did forget all those concerns fairly quickly though.
His lip twitched twice on the left side. A spasm in the left eye too, but that passed as well.
His lips moved, but no sound came on the breath. His breath did not show as vapor above his mouth this time. “Goodnight, buddy.”
No clouds in the sky for a point of reference. Nothing to make it seem real.
As Jeff faded, he held onto the blue that was the same color as Scott’s eyes just like his mother’s. He didn’t understand the blue anymore, but he never took his eyes off it.