A Measure of Mercy

Bethany House Publishers

Chapter One

"Go or stay." Astrid stared at the daisy in her hand and pulled off two petals. Sitting on the back porch, she was supposed to be hulling strawberries. But somehow that didn't work as well when one had life-altering decisions to make. She pulled another petal. "Go." And watched it drift down to the second of the three steps.

"You done with the berries?" her mother, Ingeborg, asked from the other side of the closed screen door.

Astrid shook her head. "Almost." She laid the daisy down and stood herself up, stretching her clasped hands above her head and twisting first to the left then to the right. The pull made her long for a good run across the fields. And that made her think of the old swing down by the river, where she and the others used to pump up to the sky until the day one of the ropes broke and one of the boys landed in

the water. From then on they used it to swing out over the river and jump in. At least the boys did. The girls weren't allowed.

But she and cousin Sophie had leaped from the rope and never told anyone.

Maybe she should ask Sophie for advice. Maybe not.

"Here, I need a breeze for a while." Ingeborg handed her a tray with a plate of cookies and glasses of lemonade, ice chunks floating in it. Ever since they'd purchased the icebox from Penny's store-the Blessing Mercantile, the new name she'd given it-ice in the drinks was a common event.

Astrid set it on the table and sat in the chair to begin hulling. She could smell the fine perfume of strawberry jam cooking.

"I'm making biscuits for strawberry shortcake for dinner. That will make your far supremely happy." Ingeborg sat down, waving her apron to create a breeze. "Mighty still out here." She looked toward the west. "Could be rain coming. We sure need it."

They picked up their glasses at the same time, and Ingeborg drank a good part of hers. "All right, what is wrong?" She glanced over at the limp flower, now lying on the porch with several of its petals missing. "He loves me, he loves me not?"

Astrid made a face. "Now, who would I be thinking that about?"

"What, then?" Ingeborg, her braids fading from golden to silvered gilt and wrapped around her head crownlike, leaned toward her daughter, her voice full of love and concern.

"Same old thing. Do I stay here or go to Chicago for the surgical training?"

Ingeborg sighed. "I thought God would have made it clear by now, but one thing I've learned through the years, though He seems mighty slow at times, He is never late."

Astrid sipped her drink and nibbled on a ginger cookie. "These berries are for the shortcake?"

"Yes, so you might as well slice them too."

"Just us?" Since Jonathan Gould was living with them for the summer again as he learned to farm Dakota style, "us" included him.

"I think so. But what is left over we'll make into syrup for swizzles."

"And pancakes and ice cream and ..." She smiled at her mother. Strawberries fixed any way were a favorite at the Bjorklunds'. "Feel that?" She tipped her head back to let the breeze whisper her neck. "But how do you know, Mor? God doesn't speak out of the bush anymore or in a thundering cloud. I need to know absolutely."

"Astrid, all I can tell you is that at the right time, God's time, you will know." She spoke each word precisely, softly, and yet with the conviction of steel holding them together and yet apart.

Astrid stared down at the daisy, all life drained out of it. When the time was right, she would know. How many times had she heard her mother speak those words through the years? Her answer was similar when Astrid used to ask why the sky is blue or how do the cows know when it is going to rain, or any number of other questions: "God made it so, and so it is." She'd known better than to ask again. At least for a while.

"Tomorrow I have my big exam with Elizabeth."

"I'll be praying for you."

"I know. To think she is putting me in charge of everything at the surgery for the day. I sure hope everyone is healthy around here."

"Then it wouldn't be much of a test, would it?"

"True." She set her glass back down with a click. "I'd better get the berries finished, and then I'm going to weed the garden."

"Put your sunbonnet on."

Astrid kept the groan to herself. She'd let it fall down to her back like always. Sunbonnets were so hot, no honest breeze could even make it around those wide brims.

* * *

"Another one?" Astrid looked up from cleaning the boy's wound. The easy day in the surgery was not turning out at all like she had hoped.

"An emergency." Dr. Elizabeth left the room in a swirl of skirt and apron. "Hurry!" She spoke firmly.

Astrid smiled at her young patient. "I'll be right back." She handed a gauze pad to the boy's mother. "Hold this on his arm, and I'll come back as soon as I can."

"of course."

Astrid stepped into the hallway and across to the larger of the two examining rooms. She could hear several voices talking at once. Then a cry saturated with pain caught at her throat. Something bad had happened. As part of her physician exam, this was the day she was responsible for treating all of the patients who came to the clinic. No one had considered a serious accident occurring. She paused in the doorway. A man thrashed on the table while two others fought to hold him down. His teeth were clamped on the piece of wood someone had given him, yet he still sent one of the men crashing toward the wall.

Dr. Elizabeth glanced over her shoulder and nodded toward the other side of the table.

She wants me to take care of this? But I'm not ready, fired through her mind. Rather than turn and run like her heart screamed, Astrid stepped up to the blood-spattered table. The younger of the three men pressed a towel against the belly wound, his eyes wide as they darted from Dr. Elizabeth to Astrid.

Astrid turned to the pan to scrub her hands. "What happened?"

"He fell off the wagon onto a pitchfork that was stuck in the ground. The handle tore halfway through him."

Her heart hammering as if seeking exit, Astrid let the water run down her raised arms and took her place on the other side of the table.

"What would you do first?" Dr. Elizabeth asked.

How could she be so calm? Astrid sucked in a deep breath of air heavy with the scent of blood and something worse. "We can tell he is breathing all right, so settle him down with chloroform?" The words flowed in spite of her panic. "So we can do a thorough examination. Clear the clothing away from the site of the wound and check for other injuries."

"Right." Elizabeth lifted the towel just enough to look at the wound and laid it back down.

Astrid reached in the cabinet for the chloroform bottle, poured a few drops on a cloth, and moving swiftly, held it above the man's mouth so it didn't burn his skin. He gasped, his face relaxed, and his terrified eyes closed.

"Thank you. Now, if one of you gentlemen would take her place at his head and hold that bottle, I will tell you when to add a few more drops so we can keep him sedated."

"I will." The older man took Astrid's place. "This is my eldest son, Vernon. Doctor, please-I know this is bad-help God work a miracle."

Astrid heard a slight German accent in his plea.

"We'll do our best." Elizabeth felt beneath the patient. "You said the handle went halfway through?"

"Yes. Thank God it didn't go all the way. His legs work, as you saw. Arms too. But his insides are a mess."

Elizabeth looked to the younger man standing at her shoulder. "If you would go find my housekeeper and ask her to come in here, please? Her name is Thelma, and she's most likely in the kitchen." As he left, she turned to Astrid. "Go out and tell those waiting that we will be busy for some time."

Astrid flew out of the room, popped into the other examining room, where she had been before, and told the boy's mother that they had an emergency and she'd get back when she could. Several in the waiting room stood when they heard and said they'd come back another time. Astrid lifted down the earpiece on the telephone and asked the operator to ring the Bjorklund farm.

"What's wrong?" Gerald Valders, the daytime switchboard operator, asked as he put the call through.

"Terrible accident. Please call Pastor Solberg. We're going to need all the help we can get." She heard the phone ringing.

"Hello?"

Astrid calmed a little at the sound of her mother's voice. "Mor, come quickly. We need help. Bring your bag."

"I will."

Astrid hung up and returned to the examination room, now quiet but for the stentorian breathing of the man on the table. Thelma was helping cut away the man's shirt, her face even more wrinkled than normal.

"I called Mor," Astrid said.

"Good. I figured you would. The bleeding has slowed. Thelma, bring us a bucket of hot water and lay the instruments in the carbolic acid." She looked to Astrid. "Put on a surgical apron and scrub again. Sir? What is your name?"

"Baxter. We work on the bonanza farm across the river."

"Mr. Baxter, watch your son closely, and if he starts to blink or flinch, drip a couple more drops on the cloth."

"Yes, ma'am. You need my other boy?"

"We might." She addressed the young man who was once again at her shoulder. "Would you please wait in the hall. And if you are praying folk, please do so. We need the Almighty's help here." She closed her eyes for a moment.

After tying a kerchief over her hair, the color of aged honey, and donning the straight surgery apron that covered her from neck to ankle, Astrid lifted the instruments out of the disinfectant. She sucked in a deep breath, as the odors coming from the wound made her throat start to close, but kept moving. With the blood-soaked towel out of the way, the enormity of the wound made her glance up at Elizabeth, who was focused on the task before them. Astrid swallowed her question and began digging out debris, pieces of cloth, bits of wood, and bone where a rib had broken off. Please, Mor, get here soon.

Thelma kept handing the two women sterile cloths and mopping up blood and body fluids, along with the sweat from their foreheads.

When Astrid saw the tear in the intestine, she wanted to cry. How would they ever fight off the infection that would cause? She set her sorrow aside and slid her hand into the cavity to feel for more debris. "The handle bypassed the major arteries," she reported. Otherwise he would have never made it this long.

"Good girl." Dr. Elizabeth nodded. "Can you detect any more foreign substances?"

"Not big enough that I can find. How it missed his heart and lungs, I'll never know."

"Mostly stomach and intestine damage. We can suture those and then wash as much out as we can."

"Will we leave a drain in?"

"Yes. But take out as much damaged tissue as possible. You start with suturing the stomach wall, and I'll do the intestine. Thelma, we'll need several of the bulb syringes, and ask that young man out there

to make sure there is water boiling. We're going to need more."

"How can I help?" Ingeborg stepped through the door.

"Thank God you are here." Elizabeth quickly raised her eyes toward her mother-in-law. "Pray while you clean and sterilize the instruments. If only we had a real operating room. Scrub up too in case we need another pair of hands."

"I've been praying. Gerald put out the call for prayer."

Astrid glanced at her mother. "Could you please get me a glass of water?"

"Me too," Elizabeth said. "How about you, Mr. Baxter?"

"Please." He nodded. "I just added three more drops."

"Oh, and please go finish bandaging that boy in the other room. His mother must think we have forgotten about him."

"I will." Ingeborg closed the door carefully behind her.

Astrid tied off another stitch and cut the thread. "His stomach is going to be lots smaller. So much of the tissue is damaged." She wiped the sweat from her forehead with the back of her hand. Trickles ran down her spine. They might have been at this for hours; she couldn't tell. She picked up another needle that Thelma had prepared and started again.

"There, last one I can find," Elizabeth said as she tied off a small bleeder some time later. "Let's irrigate."

Having just returned, Ingeborg put the stethoscope in her ears and listened to the man's chest. "His heartbeat is slow but steady. Lungs sound clear."

"That is truly miraculous." Astrid glanced up at Mr. Baxter to see a tear leaking down his cheek.

"Your son is very strong. But he's not out of the woods yet, not at all," Elizabeth warned.

"I know, but thanks to you he has a chance. I know about belly wounds. I've seen men die from them."

"Please, God, let this be one who makes it," Ingeborg said.

Astrid removed the last pad and dropped it into the bucket with the others. "Ready to close?" At Elizabeth's nod, Astrid looked to her mother. "You want to help?"

"of course."

The three of them worked together as if they were quilting. They closed the peritoneum, repaired the damaged muscles, and finally stitched the layers of skin.

"He looks like a patchwork," Ingeborg said as she tied off her final stitch. "Please, heavenly Father, we have done our best. We thank you for giving this man life and strength, and we leave him in your mighty hands. Thank you for the wisdom you have given here and for the love you so freely spread on all of us. In your son's name we pray." The others joined her on the amen, along with another male voice.

"Ah good. You are here, John." The older woman smiled at their pastor, John Solberg.

"I've been out here praying for what seems like hours."

"That's because it has been hours." Elizabeth tipped her head back, stretching muscles too long tense. "Mr. Baxter, you did a fine job as our anesthesiologist. You can let your son come more alert now. The pain is going to be atrocious, so we will keep him sedated as much as possible for the first couple of days." She held a syringe filled with morphine. "This will help with the pain," she said as she inserted the medicine into his buttock.

"You will keep him here?" Mr. Baxter looked around. "Where?"

"We have rooms for such as this." Elizabeth checked the patient's pulse.

"Where do you want us to put him?" Waiting in the doorway, Thorliff Bjorklund looked at his wife.

"Let's use the bigger room. Mr. Baxter, my husband and our pastor are used to moving patients. They will show you how to assist them."

Astrid watched their patient. First his eyelids fluttered, and then he grimaced. "We better move him quickly. He's coming around."

The women stepped out of the room to give the men the space to do their job.

"This certainly shows our need of a surgical room with decent lighting and enough room to move about. Astrid, you passed today's examination with flying colors. Even without formal surgical training, I'd rather have you assisting me than any other doctor I know."

"It seemed as if the two of you could read each other's minds, you worked so smoothly together." Ingeborg leaned against the wall. "Astrid, how did you know what to do?"

"I guess I've memorized the pictures in Gray's Anatomy. But I can sure see the value of working on a real body." Now that it was over Astrid realized that, though physically she was tired, her mind was racing trying to process all the new information the surgery had given her.

"So has this convinced you to go to Chicago?"

Astrid thought for a moment. Elizabeth had been insisting she go for more formal instruction at the Alfred Morganstein Hospital for Women and Children. Since she already had so much practical experience helping at the surgery in Blessing, she would only need to go for the surgical training. If she could pass the tests on all the other required classes first. But Chicago was so far away! Yet working with Dr. Althea Morganstein, Elizabeth's own mentor, would be invaluable. Astrid knew her sister-in-law had taken her on with this plan in mind. She also knew Elizabeth would take it personally if Astrid didn't pass the rigorous examinations Dr. Morganstein required.

Astrid glanced at her mother and nodded. "Yes, I am certain."

Was that a whisper she'd heard or had God really spoken? or just sent this test for her?

Ingeborg blinked at the moisture gathering in her eyes and returned the nod.

The trio followed the men into the larger of the rooms with beds on the first floor, the one they'd designated as the recovery room, and checked to make sure there was no blood leaking. When the young man groaned, his father took his hand.

"You rest easy, Vernon. The doctors are doing their best for you."

(Continues...)

Excerpted from A Measure of Mercyby Lauraine Snelling Copyright © 2009 by Lauraine Snelling. Excerpted by permission.
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