Dr. Werner Rolfinck strode through the botanical gardens early the morning of the first meeting with the representatives from Grantville and his faculty. He bent down and pulled a weed shoot from the row of Matricaria recutita. Chamomile was a useful herb for calming the nerves, as an aide to wound healing, decreasing inflammation and an antispasmotic. The people from Grantville had expressed particular interest in the use of herbs and other botanical agents in healing. He didn't want the garden to look anything less than its best. Since it was July, the foliage was particularly lush.
Werner's feelings about the proposed "joint venture" with Grantville's medical personnel were mixed. So were those of the three Jena faculty members who would be sitting around the conference table with him in a few hours. Werner was thirty-four years old and had been the dean at the medical college for several years. He considered himself a forward-thinking man and made an effort to keep up with the latest information in the healing arts. He had been proud of his accomplishments and his career. He still was. Given what he had learned so far from the Grantville texts he had intently studied, he and the faculty here were on the right track in any number of areas. He was proud of the faculty, too. There may not be many of them left, but those that remained were excellent men, all dedicated healers who were devoted to their work.
None of which changed what he had read in those books and the implications of what he had read. Those things had left him frustrated, disheartened and desperately wanting more. There was so much more to be learned, so much more that could be done for their patients. The possibilities were very exciting. He felt as though a new world was opening up and Jena was going to be a part of incredible things. So am I so unsettled because the changes are happening at all or because they aren't happening fast enough?
It would probably be rude to tell their guests, in the American phrase, about damn time. Rationally, he understood that the Americans had needed to secure their borders and that other pressing needs had kept them from addressing anything but immediate medical needs. Still, they could have shared more of their texts sooner and made medical care more of a priority. Werner began to pace through the feverfew section of the garden. Medical care could save lives just as surely as winning on a battlefield. Healing was its own kind of war. They could have been so much farther ahead of where they were now with more books and communication with Grantville's medical personnel.
Compounding his frustration was the sense of pressure he felt. So much would have to happen very quickly to be ready by January. The bits and pieces he had learned had been tantalizing but bitter. He had read the books and then seen patients in his practice that could have benefited from Grantville's level of care. But Grantville was too far away and even if they had its facilities here, he and the others didn't have the knowledge. That had been eating at all of them for at least a year when they began realizing what the Americans could do.
Instead, the Americans had decided to work with his school at their convenience, when they had time. He knew that wasn't really a fair way of putting it, and it certainly wasn't the frame of mind he needed for this upcoming meeting. Still, fair of not, it didn't change how he felt. He made a deliberate effort to unclench his muscles and slow his pacing. The Americans had chosen the medical college as their first real joint venture with the Jena university. It was both an honor and a burden. A lot of people would be watching how he and his faculty handled the merging. He was hardly naive enough to think the Americans didn't have their own priorities and needs but this could be a mutually beneficial partnership, a partnership among equals. He would see to it.
Werner tried to be subtle as he observed his new colleagues from Grantville. He had spoken with each of them at least once by radio and exchanged letters setting up the meeting today in Jena, but he also wanted to actually see them.
The leader of the delegation was an elderly woman who moved rather stiffly. He could see the arthritic changes in her hands, which the trip here and the cobblestones had probably aggravated. The sight didn't inspire much confidence. This old woman was supposed to lead the new college during a time of dramatic changes? Her evident age and ill health didn't bode well at all, even with the much younger Mary Pat Flanagan woman working as her aide. Werner was impressed with what he knew about Fraulein Flanagan and well disposed to her, given how she had gone out of her way to get texts and other materials copied and delivered to Jena. That they were in English made it rather difficult, but he had had them translated and copies made for the faculty.
Beulah MacDonald, as the elderly woman was named, eased stiffly into the hard wooden chair at the long table and smiled reassuringly up at Fraulein Flanagan. Werner could hardly miss the concern or the affection between them. Then Frau MacDonald turned to look at Werner and the others on the opposite side of the table. The smile changed but it was her eyes that Werner studied. Those navy blue eyes held humor, understanding and shrewdness. There was an air of experience and competence about her. He wasn't quite sure how to describe it. He would watch and see how this played out.
Coming into the room behind MacDonald and Flanagan were a man and woman. Werner had gotten better about judging ages of Americans. They both looked around ten years older than Mary Pat Flanagan, give or take a few years. The man was of an intimidating size. What Werner suspected were permanent dark circles lay under his eyes. This would be Hayes Daniels, the only man in the group. The last woman to enter the room sat in her chair and carefully arranged pen and paper in front of her. Process of elimination meant this was Ann Turski. Werner still wasn't exactly clear what a health educator was and how that was different from a faculty member. Still, they each gave the impression of confidence and I-know-what-I'm-about he was coming to associate with some of the Americans he had met.
That attitude wasn't always justified, in his opinion. But... At least they all speak decent German. That will make things a little easier, Werner thought as the Americans introduced themselves. Now it was his turn to make introductions.
"At my far right is Conrad Herbers. He teaches iatrochemistry and theories of medicine." Conrad, whom they all called Kunz, gave a small seated bow, his expression polite but a bit cautious.
"Next to him is Wilhelm Hofacker who teaches iatrochemistry and assists me in the botanical gardens."
"I am Willi, please. I shall be happy to give you a tour of the gardens later if you would like." Willi's English was accented but very understandable. He'd spent some time talking to other Americans before the meeting. The two iatrochemists were remarkably similar in more than appearance. Both were blond, forty-ish family men who were interested in what Grantville had to offer but wary of what it might mean for them both personally and professionally.
"On my left is Phillip Ackermann. Doktor Ackermann teaches anatomy and runs the operating theater." Ackermann had just turned fifty. His thinning blond hair was going gray. Werner noticed that although he was over twenty years her junior, Beulah had fewer lines on her face than Phillip. More than about any of the others, Werner was concerned about how Phillip would handle the coming changes. Werner was considered somewhat radical himself and he was younger than the more conservative Phillip. Phillip hadn't said much about his thoughts or feelings on the merger. He was facing the coming changes toward the end of his career, not the beginning. Phillip was terse at the best of times. Now he just gave a stiff inclination of his head in their guests' general direction.
"It is a pleasure to meet others from Grantville at last. We have had so little contact with other healers from Grantville in the last two years." A hint of hostility was present in the polite tenor voice and it was that hostility Beulah responded to.
"It is a pleasure for us as well. If there had been any way we could have made things happen on our end more quickly so we could meet you sooner, we would have. As it is, we finally feel that we have enough to offer to entice your faculty into a long-term partnership."
That comment wasn't what any of them expected. Willi blinked several times and Kunz raised his eyebrows.
"What you have to offer us?" Kunz asked. "Surely, with all you know, the concern should be whether we have enough to offer you?"
No stranger to negotiations himself, a well-briefed Hayes stepped in. Hayes always did his homework. "On the contrary. You have a great deal to offer us. Books with useful knowledge, buildings to hold classes in, the operating theater and, of course, your faculty."
"I've seen your facilities, especially the gardens," added Mary Pat. "They're impressive. We brought a few people from Grantville who are gardeners to help us figure out names of plants since we probably won't call them all the same things you do. You know far more about herbal remedies than we do. You know the local artisans who can make medical equipment and have your own practices here in town. Now, we can offer you our knowledge and the hospital in Grantville as a training site."
"We've been pretty disorganized while we were trying to get everything up and running. There wasn't time to plan anything properly before the Ring of Fire," Ann added with a wry grin.
No, Werner thought, definitely not the way I thought they'd approach us.
"You're already set up and fully functional here," Beulah said. "We've spent two years trying to get ourselves organized and dealing with various crises to get to the point where we could approach you. We do have things to offer. I think you'll agree that those things are important. But this merger won't be easy. This is important to us. We don't want to mess up this venture or any future ones."
Even though he had spoken with them over the radio, Werner wouldn't have predicted this. It was better than he had hoped for and the room's atmosphere was warmed by more than the summer sunlight.
Beulah smiled gently. "There is another bonus to working together. You have students who are much further along in their training than those we have in Grantville."
All four of the Jena representatives became very intent. They had been prepared to fight for their students and defend their students' caliber but it looked like that might not be necessary.
"We will be counting on them almost as heavily as on you. I know that the students will need to learn what we have to teach in addition to what you have already taught them," Beulah continued delicately, "but they are still much better trained in any number of areas than the students we would bring from Grantville. Few of our potential students have studied anatomy or performed surgery, for example. The most many of them have ever dissected is a frog in high school biology. One of the things we'd like to ask is whether or not you think your students would be willing to be teaching assistants for the incoming students. We're trying to put together funding for the positions now. We hope to be able to offer room and board, clinical at the hospital in Grantville and access to our textbooks and equipment sooner. In exchange, in addition to acting as teachers' assistants, we'd want a commitment from anyone we offered the positions to stay in the area, one year for each year of study under the joint system. Naturally, we wouldn't restrict them just to Grantville. We don't think we can come up with enough funding for a stipend but we'll try."
"I think the students will be happy with that plan, if we can make it work," Werner said. "We had been concerned about our students and how they would fit in. None of us is under any illusions that we or the students could just go to Grantville and practice. That has not been an easy thing for any of us to admit. Do you see a similar role for the faculty?"
Again, it was Beulah who spoke. "Not exactly. We do think that there will be things you will need to learn and learn quickly. Part of the reason we wanted to come here is to get to know you and your backgrounds more personally. You are all experienced faculty. You don't need to learn how to teach anymore than I do." She gave a little shrug. "There may be a few teaching strategies you'll need to adapt because of different material but you know how to deliver a lecture or teach students in a clinical setting already. There will also probably be some differences in styles that we will need to work on but I think that would be the case anyway. And, it wouldn't necessarily be you adapting to our style all the time, either. We're hoping that you will be the ones doing most if not all the teaching of material like chemistry and anatomy, at least at first."
"That's part of what I'm doing here," said Hayes. "I'd like to work with each of you on course materials, what you have here, what we have and how they can be combined to get the material to the students in the best way."
"You'll probably not be too far ahead of the students sometimes in terms of learning some of the new material," Ann said. "It won't all be new to you though and it will get you ready to learn the practice stuff at the same time."
"What about our learning about your kind of practice? We are already physicians. If you expect us to teach more than the basic courses, we must know more about your kind of practice." Phillip's tone was very firm but without hostility.
"I had hoped to arrange time in Grantville for all of us before we began in January." Judging by the looks the Grantville team exchanged, Werner didn't think they had considered that. "We've studied all you have lent us but the material is complex and has not been given to us in any systematic way." Werner held up a hand. "This is not a complaint. It is just a fact. We would be able to learn more material more quickly if we spent some time with all your material, resources and medical people in Grantville. We would also be able to see how you practice."
Mary Pat chuckled. "We'd been thinking the same thing but from the other direction. How much time would you want to spend in Grantville? Maybe we could split our time between the two places. Hayes will have to be going back to use his desktop computer for this anyway. We could spend some time here and then all go to Grantville together."
Werner thought a few moments. "Two months would be good. We would need time to see what was there and then decide what to focus on to bring copies of material back with us."
"We would need some time to make other arrangements as well." Kunz sounded a little hesitant. "Willi and I have wives and children."
"If you would like to bring them along, I would be happy to start making arrangements for housing," Ann volunteered. "It might work out even better if we can make arrangements with medical personnel for places for you to stay."
"What about bringing some of the students?" asked Phillip.
Beulah cleared her throat. "I think we should take a week or so and decide who should be approached about the teaching assistant positions. That way, if we stay here a month, the students still have several weeks to prepare for the trip. And we'll all be back here by November to get ready for the students. Does that sound reasonable?"
Nods all around. "Now, how many children do you each have and how old are they?" asked Ann.
"Guten Morgen, Doktor Rolfinck."
Werner looked up from his contemplation of the rather wilted looking mugwort. He'd have to speak with the gardeners about watering the plants more frequently. Mugwort was a versatile sort of herb in medicine. He used it regularly.
"Guten morgen, Frau Professorin MacDonald."
"I see you like to walk in a garden early in the morning as well. This is so lovely. Very nice layout, too. I try to stop for a bit at Leahy's garden each morning as I start my day. Some days, it is the only calm or quiet I get. Mugwort, isn't it? Stoner, our best herbal expert, has been talking about how useful it is, but I don't know much about it."
"I am pleased you like the garden. Feel free to walk here whenever you wish. I use mugwort primarily for pain, as a diuretic, an emetic or laxative. I've also used it for headaches, insomnia and as an appetite stimulant." Heartened by her admiration of the botanical garden he had created, Werner probed a bit. "From what you and the others said yesterday, I gather you are quite busy in Grantville."
"Fortunately, I've been too busy to tell myself I'm too old for all this very often." Her eyes were distant and grave. "We had casualties within the first hour and not even a clinic in town, much less a hospital. There were several pharmacies so we had a small supply of our usual medicines, but most of those were set aside for those who already needed them. They didn't last long. The pharmacies up-time also had some other supplies, bandages and such. We nationalized those supplies right away but most of them didn't last long either. At first, we turned the high school into a makeshift hospital. There were only about ten doctors in town, some of them retired. All told, we had fewer than two hundred people with any medical training at all. Some, like me, were retired. Some have died. We did have the aide and LPN vocational technology program at the high school, thank God. We've been able to train some new people but not many and not at the higher levels. It's been a real scramble to get organized and get the hospital built. Everyone was just trying to get themselves and their families through each day at first. We had some things to work with but we didn't even know what materials, personnel, equipment or problems we had initially. Fortunately, we had an architect and Mayor Dreeson put together a sanitation committee within the first week to oversee the public health needs. We've done the best we could but..." Beulah broke off with a grimace, eyes still distant.
Werner remained quiet and after a bit she continued. "Add to that the rapidly expanding population as refugees flooded in, most of whom didn't have a lot more than the clothes on their backs and maybe a few items of furniture or tools and a little food. The resources we had, in terms of supplies and building materials were very limited when you think of the need. Then there were the deaths. There have been so many people we had the knowledge to treat but couldn't. Instead, we had to watch them suffer, sometimes die. Too often, there was little or nothing we could do about it, however hard we worked. I'll warn you now, that has left a mark on us all to some degree. Even with the most advanced materials, the best trained staff, there were still plenty we couldn't have saved anyway. We know that. None of us are miracle workers. I hope you and the others aren't expecting us to be."
"It still hurts to lose a patient, whatever the circumstances. I knew things had been difficult, but I hadn't realized how difficult. I am sorry." Werner could certainly understand what it was to be spread so thin. The university had gotten much smaller with the war. Everyone was taking on a variety of roles. His feelings about the lack of materials from Grantville diminished. In its place was the realization that none of them had gone to Grantville's aide. When Grantville had first appeared, no one had known what was happening or what to think or do about them. Later, he had thought the Grantvillers could handle things themselves and that they were so advanced, he and his colleagues wouldn't have been of any use. Now, he wondered if that had been true. How can they be so cheerful then, so optimistic? The situation there may be worse than I thought. What does that mean for us?
"We don't expect you to be miracle workers. From our view though, the things you can accomplish do seem miraculous. Thank you for explaining. We did not understand why you didn't approach us sooner. Truthfully, we resented it. I understand a bit more now about why you are here and why now. To be frank, the meeting yesterday went far better than I had hoped."
"I'm also pleased by how the meeting went yesterday. We still have a great many details to take care of but I think we can do it. At least as we started getting down to some of the details in the afternoon, we weren't having major disagreements."
"It is, as you Americans say, early days yet. I hope we can work out any problems. Tell me, Frau MacDonald, do you think all your people in Grantville will be as open to working with us and our students?"
Beulah paused a moment before answering. "Most of them will, just as I hope is the case here." Hearing the questioning tone in her voice, he nodded but kept silent. She provided him with what she called "thumbnail sketches" of some of those he would be meeting soon. He would have to remember the phrase. He looked forward to meeting Ray and Stoner to talk about plants, and Balthazar who was from his own time but was being treated as a valued member of the team by the Grantvillers. Werner had a great many questions for Balthazar Abrabanel. The respect in her voice when she spoke of him was obvious. Less obvious were her reservations about Mara. It wasn't anything she said, so much as what she didn't say that piqued his interest. The contrast with the way she spoke of Starr and Garnet was what made her reservations so evident. Werner could appreciate both the gesture of trust she showed by providing the information about her staff and the discretion. When she spoke of Fritz and her hopes that he would be in the first class, Werner fit that in with the rest of what he had seen and heard the last few months. They really do want to make this a partnership.
"I have no doubt you'll want to share some of what we have talked about this morning with your faculty. That's fine. I would also like to arrange time to talk with you privately about some things as my counterpart. There are undoubtedly things that we wouldn't even consider because we aren't originally from this time or issues we should discuss between us before talking with the others. I hope you will share any concerns or problems you see."
"An excellent idea. Since we both enjoy the garden, perhaps we could meet here early each morning to talk."
"I'll look forward to it. And please, call me Beulah."
"Everyone ready to go?" Ann looked around the common room of the Black Bear Inn in northern Jena to make sure the others had everything they needed for the Jena tour. Werner and Phillip arrived to be their tour guides as she finished speaking. Willi and Kunz had classes this morning and couldn't come. Since there would be six of them and the streets were rather narrow, that was probably just as well.
"All set here." Mary Pat was carrying what Beulah would have called a visit bag in her public health days. Instead of the brown leather bag Beulah had carried, Mary Pat had turned her WVU book backpack into a mobile emergency kit. The kits had been standardized and accompanied all the teams that left Grantville with a medical type. Other kits had been made up for those without trained medical personnel along given the skills needed to use some of the equipment.
As they stepped into the street, Ann couldn't help but appreciate the lack of odor. Jena's town fathers planned on developing indoor plumbing but right now, emptying chamber pots wherever was still the order of the day. Jena did have one crucial advantage however. At night, the city flushed the streets from a water reservoir so the city was actually much cleaner than most. What having raw sewage flushed downstream did to others was another issue. They were all concerned about what the level of sanitation meant for public health. Now wasn't the time to say anything about that, though, and the Grantville team followed Werner and Phillip through the streets with their colorful red-roofed buildings to the local clinic. They were only a short distance from the clinic when they were hailed.
"Herr Doktor! Ah, und Herr Doktor Ackermann." The rather breathless student looked relieved to see Werner and Phillip but barely glanced at the others. From what Beulah gathered between pants, a young printer had been working, suddenly became short of breath and collapsed. His fellow workers had brought him to the clinic. Werner and Phillip headed for the clinic at a rapid walk. Mary Pat and Beulah exchanged a glance. Someone this short of breath and they weren't running?
The clinic was on the first floor of a building indistinguishable to Mary Pat from its neighbors. Inside, the clinic was an open area divided into several sections. One section looked like storage, another a procedure area and the third had cots set up. About half the cots had patients in them, including one near the door with the breathless young man. Tall, thin, Caucasian, young male, severe shortness of breath, supraclavicular retractions, touch cyanotic. Don't see any Jugular venous distention or tracheal deviation. Mary Pat could see Beulah making her own assessment as automatically while Werner and Phillip bent over to examine him.
"What happened to him before this started?" Mary Pat asked a nearby man in a printer's apron similar to the young man's.
"Veit just coughed and suddenly there was terrible pain in his chest and he couldn't breathe."
"He hadn't been injured or feeling ill before this?" she asked.
"No." The man turned away to watch the doctors, clearly thinking that Mary Pat was asking questions that were none of her business. It wasn't the first time she had seen that attitude and wouldn't be the last, no doubt. She had seen it during her deployments in Somalia and Yugoslavia but not to the degree she had seen it traveling around 1630s Germany. Right now, she didn't have time to pander to their delicate sensibilities about women and health care.
"Spontaneous pneumothorax?" Beulah's pronouncement caught the attention of Werner and Phillip. Mary Pat was already swinging her backpack around and unzipping it. She nodded and handed Beulah the stethoscope, then reached back into the bag. "I need to listen to see if air is still moving properly in his lungs. Sit him up, please."
No one moved despite the clear command in Beulah's voice. "We will treat him, Frau MacDonald." Phillip's voice held enough dismissive know your place to make Mary Pat flush angrily. She hadn't had too much exposure to that attitude in her previous life. Beulah glanced quickly at her then back to Philip.
"In just a minute, I can tell you if this is what I think it is. I need to use this to listen to his chest. If I'm right, we only have a few minutes to act before he is in very serious trouble."
"You do not consider this serious?" Werner's tone was disbelieving.
"Serious headed for critical and possibly life threatening. If there is nothing you're going to do for him in the next couple of minutes, what have you got to lose by letting us try to help him?" To someone who knew her as well as Mary Pat did, it was obvious it took everything Beulah had not to physically push them out of the way and to keep her voice level. The patient would soon be losing consciousness. There was no time for this. Beulah obviously thought so too.
"Hayes? About a thirty-degree angle. Please take care not to compress his chest."
Hayes didn't waste time with questions. He just moved behind the gasping young man and propped him up. Given his size and the element of surprise, the others moved out of his way quickly. Ann started clearing out the ward to give them more room, moving people out of the way. She knew what a spontaneous pneumothorax was, even if she wasn't a clinician and couldn't treat it. There were still people hovering in the doorway but now there was a good sized circle of empty space around the cot. From the looks on Werner and Phillip's faces, however this turned out with the patient, it wouldn't be good. She took note of the confusion, anger, curiosity and resentment there. She hoped things went well for the patient but the timing probably couldn't have been worse. Hi, we've been here less than twenty-four hours to set up a partnership with you and we shove you aside to treat the first of your patients we see. There didn't seem to be a good resolution from a political standpoint. If they couldn't save the patient after this, it would be even worse. If they did, it was rubbing salt in a very tender wound but at least the patient would be alive.
Beulah looked up at Mary Pat. "Pneumo, big one. Left lung is almost entirely down. Got a flutter valve in there? Lay him back down please Hayes and prop up his feet."
Mary Pat handed her an alcohol-based cleaning agent in a squirt bottle, and gauze. "Yeah, there are only a few left. I'll insert it." Mary Pat went after his shirt with a pair of industrial sized scissors. They were great for cutting through clothes. The young man was losing consciousness now and they were out of time. She wished she had even a few liters of oxygen by cannula to make this a little better.
"Hurry, trachea beginning to shift." While Mary Pat cut the shirt away, Beulah was already wiping the skin under the shirt with the alcohol. Ideally they'd let it dry but this would have to do. Mary Pat had the small package containing the flutter valve and a few other pieces of equipment in hand.
"Wait, what are you doing?" demanded Werner.
"I'll explain later. For now, get out of the light," snapped Beulah.
Mary Pat hooked up the syringe to the end of the one-way valve and pulled the 16 gauge needle cap off the other end. She'd splashed alcohol over her hands. She didn't take time to put on gloves, just hoped she didn't hit a vessel. Second intercostal space, midclavicular line. She'd done this before and her movements were rapid and crisp. No fumbling. The needle slid right in and Mary Pat pushed a little further, feeling for it—ah, got it—and ignoring the gasps and chatter of the onlookers. The one-way flutter valve allowed air and fluid to escape but not to go back into the patient. As the air began to rush out of the pleural space through the valve, it made a honking sound, further startling the onlookers. Werner and Phillip were demanding to know what was going on. There was more to do so she and Beulah ignored them for the time being. Beulah had the suture ready to go and stitched the valve in place while Mary Pat reached for dressings, scissors and tape. They needed to get this secure. The valves were almost gone, since they needed plastic materials to make them. Plastic Grantville couldn't produce anymore. The flutter valves were just a stopgap with a big pneumo anyway. There were a few minutes of onlooker chaos but Ann had them in hand.
"His breathing is easing. Hayes, put this pillow under his feet. His pressure is probably somewhere in the basement." Beulah reached for the stethoscope again, listened. "Breath sounds are improving, respiratory rate a little better, too. Nice work you, guys."
Werner was tightlipped. "Does this mean you will finally explain what you have done to our patient?" Phillip looked too angry to even talk without yelling.
"Given the signs and symptoms we saw and the brief history Mary Pat got, we realized we were probably dealing with a medical emergency called a spontaneous pneumothorax. Young, thin white males are at particular risk for this. What happens is that a part of the lung is weak and bursts. Instead of air going in and out when he breathes, it gets trapped in the pleural lining between the lung and the chest wall. Each breath, more air goes in than comes out. The air builds up in the pleural space and begins pressing on the lung. The lung cannot properly expand anymore. If enough air gets into the space, the lung will start to press on the heart. A sign of that was the tracheal shift I mentioned. The air has to be removed right away so that the lung can reexpand and heal. We used a small piece of equipment called a flutter valve that will help with that." Beulah kept the explanation simple but Mary Pat could tell that some of it still went over their heads.
Beulah glanced back at their patient. His breathing was more regular and he was beginning to pink up nicely. Mary Pat took a turn explaining the procedure and how the valve worked. When she got into chest tubes and X-Rays, Beulah stopped her. It wouldn't do any good to make the local doctors look more ignorant in front of their townfolk. Besides, she though uneasily, I don't think they're getting this. Is it that they are too angry to think or something else?
Mary Pat frowned and turned to Beulah. "He needs a chest tube. You can't just drop a lung like that and expect a flutter valve to fix it. An X-Ray will tell us how bad it is."
"Agreed. We may not be able to hook him up to wall suction but at least in Grantville, they can put in a chest tube and hook him up to a waterseal system."
Phillip had had enough of them using words that he couldn't understand. Even if they were speaking German for most of it. There was nothing he or Werner could have done for the man but watch him die. They didn't even know what had happened to him. These women had known at a glance. Phillip didn't even understand what had happened in just a few minutes. The two women had done something in front of their students and townfolk that seemed incredible. The speed and skill with which they had acted was impressive. More confused than he had ever been in his entire life, he turned around and walked out, not waiting to see what those women, who weren't even doctors, would do next.
"I had thought you would be getting some sleep but Leutnant Flanagan said you had come here".
Werner's voice brought Beulah out of her thoughts. The stone bench she had been waiting on was not exactly comfortable but at least it had a nice view of the garden. She noted the change from Fraulein to Leutnant when he referred to Mary Pat with a sinking heart. "We had agreed to meet here in the mornings. Did our patient get off to Grantville all right?"
"Our patient? Interesting choice of words, but yes, Veit and Leutnant Flanagan just left. I would have thought you would be getting some sleep."
"It will take them most of the day to get to Grantville. They'll have to go slowly, even with the new suspension on the coach." She smiled softly. "As for sleep, talking with you is far more important. It's been a while since I've sat up all night with a patient. Not that I could have done much else for him if anything had gone wrong. The supplies and equipment are in Grantville. So are the people who can fix it if the lung doesn't reexpand. As for Veit being our joint patient, yes, he is." The testiness she heard in her own voice was enough to make Beulah wince. Every joint she had hurt and she had to face the fact that what had started so promisingly in Jena was rapidly falling apart. Add that to her fears about their patient's outcome and a sleepless night, and she wasn't at her most tactful. That was still no excuse for taking her feelings out of Werner.
"Look, I'm sorry. I shouldn't have snapped at you, now or yesterday. Not exactly professional behavior on my part. Let's be clear on a few things here. I'm not sorry that a man who would have died is still breathing. I am sorry for the way things happened. There were two choices, treat him or stay silent. I knew you didn't have the resources we did to treat him. If I had stayed silent, he could have very well died. How would you be feeling about this if I had and later, you found out we could have treated him but didn't for the sake of political expediency? What else could I have done?"
Werner was quiet a moment, weighing what she said. His innate fairness was warring with his anger and humiliation. How much of the humiliation he felt was because Veit had been saved by two women who weren't even physicians? What would he have done in her place? Given the stakes, would he have held one life as highly as she clearly did? What else could she have done, indeed? He spent a few minutes trying to get his thoughts together, to say what he had to say without making things worse.
"I can understand why you did what you did and I am very glad Veit did not die. That doesn't change the facts. You brushed us aside to treat one of our people. As though we were nothing, knew nothing. We are not used to being treated in such a fashion, especially by women. Don't you understand? That you were right, that we could do nothing while you could save him just makes it harder for us to bear. Phillip and I have spent our entire lives caring for our patients, studying, teaching and trying to give the best care we could. You gave us a graphic demonstration of how little we know, how limited is our skill. And you did it in front of our students and townfolk. I know things happened quickly, but what happened couldn't have been more poorly timed or more painful to us. How can we have any confidence that we have anything to offer you? That we aren't nothing next to you?"
"Please, Werner, sit down with me."
While he sat stiffly at the opposite end of the bench, it was her turn to struggle to find words. "If any of us thought you were nothing or that you had nothing to offer, we wouldn't be here. What you have to offer hasn't changed since our first meeting. The last thing any of us wanted is to make you feel that way. I've thought about it all night but I don't know what to do to try to make this better."
"Show us what you did and why." Werner demanded promptly. "If we can understand it, then it won't seem so mysterious or out of reach."
Beulah smiled hugely. "That I can do. Can we have both students and faculty present?"
"Yes, I think we should. I'll set it up for tomorrow so you have a chance to sleep and I can take care of some other things today."
"Would Phillip be one of those things? Is he all right?"
"He is struggling with this. I hope he will be calmer by tomorrow. Get some rest now, Beulah. I will send a message to you tonight about the class." He didn't want her to ask about the other things he needed to address today. He was on his way to a meeting with the other deans. News spreads quickly in a small town. He had a feeling there would be more than just medical school faculty and students at the lecture Beulah would give tomorrow. He thought about warning her but dismissed the idea. She and the others needed to understand just how serious what had happened was to his people. Part of him also wanted to know how she would handle such a surprise. It was not very Christian of him, Werner thought, as he watched her leave the garden.