Sutures and Silence

How much blood can a man lose before his stubbornness stops keeping him upright?

On an ordinary Tuesday night with Medic 4, I had seen warehouse workers try to walk off compound fractures with a thermos of black coffee and sheer spite. Men loved pretending their bodies were machines right up until hypovolemic shock dropped them face-first into the sawdust.

Radek Krizsek was currently doing the exact same thing, except he was six feet two of bruised muscle, lethal training, and predatory pride.

The Pier Four warehouse smelled like burnt magnesium, wet ash, and fresh iron. Kolar’s body lay motionless on the high catwalk behind us, his severed femoral artery drained dry through the steel mesh. Down on the ground floor, three more of Tibor’s enforcers were sprawled across the broken timbers where Radek had dropped them.

The assault was over. The silence that followed was heavy and dangerous.

Radek stepped down the last flight of iron stairs, his boots landing with a dull, heavy thud. He didn't stumble, but I caught the subtle hitch in his stride. He was favoring his left flank where his cracked tenth rib sat beneath the muscle. Worse, his dark flannel shirt was torn open from the collar to the left shoulder blade, soaked through in thick, dark crimson. A jagged, serrated claw rake ran five inches across his deltoid, gaping open to the glistening red muscle beneath.

"We need to clear the floor," Radek said. His voice was low gravel, flat and steady. "Tibor's scouts will check their radios in twenty minutes."

"You're not clearing anything," I said, walking down the steps behind him.

He turned his head, his slate-gray eyes cool. "Lenka, we don't have time to linger."

"Sit on that crate before your blood pressure does it for you."

He didn't move. Was it a pack law thing, or just a male shifter failing at basic self-preservation?

I didn't wait for him to debate the point. I grabbed the strap of my red jump bag, marched past him, and kicked an overturned wooden shipping crate toward the light of the side door.

"Sit," I repeated, unzipping the main compartment of the jump bag with a sharp rasp. "You took a four-inch claw tear through the deltoid and your left hand is shaking. That's not adrenaline. That's acute caloric collapse."

Radek looked at his own left hand. The fingers gave a faint, involuntary twitch. A muscle ticked in his jaw, but he didn't argue. He crossed the floor and dropped heavily onto the crate. The wood groaned under his weight.

"You notice too much," he muttered.

"I'm a paramedic. Noticing things keeps my patients from coding in the back of my rig."

I knelt in the dirt beside him and pulled out my trauma shears. The heavy stainless steel blades clicked open with familiar precision. With two smooth cuts, I slit his torn flannel sleeve from wrist to shoulder, peeling the blood-stiffened cotton away from the wound.

The laceration was ugly. It wasn't a clean knife cut. The enforcer's claws had hooked deep into the muscle belly, tearing the skin edges into ragged, jagged flaps. Bright red blood welled steadily from the capillary bed, pooling in the hollow of his collarbone before trickling down his broad, scarred chest.

Beneath the fresh blood, Radek's skin was hot. Too hot. A feverish heat radiated from his torso, warming the chill air between us.

"When was the last time you ate?" I asked, pulling a pair of purple nitrile gloves from my kit.

"Yesterday noon," he said.

"You dropped twelve feet in the rail yard, fought four armed men, and burned through a partial shift. A human would be in a coma. Your wolf is cannibalizing your own glycogen stores to keep that wound from bleeding out."

He reached behind the crate with his good right arm, hauled out a grease-stained canvas haversack, and unbuckled the straps. Inside were four vacuum-sealed blocks of dried smoked venison and a canteen of brackish well water. He tore the plastic wrap off the first block with his teeth, chewing the dense, salted meat down in massive, ravenous bites.

"The metabolic price," Radek said around a mouthful of meat. "Tibor’s pups forget it. They shift for fun, then wonder why they starve in an alley."

"Good thing I’m not Tibor’s pup," I said dryly.

I snapped the purple gloves onto my hands. The tight rubber snapped against my wrists, centering my focus. In an emergency room, a surgeon would have flooded this laceration with three ampoules of lidocaine, washed it with sterile saline under pressure, and taken forty minutes with absorbable sutures.

Here, in a drafty river warehouse with four dead bodies on the floor, we had saline, betadine, and my hands.

"I don't have local anesthetic," I warned him, pulling a brown plastic bottle of povidone-iodine and an irrigation syringe from the jump bag. "I used my last vial of lidocaine on a harbor tech who caught his forearm in a winch cable three shifts ago."

Radek swallowed the last chunk of venison and took a long swig of water. His gray eyes locked onto mine, calm and unblinking.

"Sew it, Lenka. I've had worse."

"Don't sound so thrilled about it."

I uncapped the saline bottle and loaded the syringe. "Hold still. This is going to sting."

I flushed the wound with high-pressure saline, washing away the dirt, dried blood, and fragments of flannel fiber. Radek didn't flinch. He didn't even draw a sharp breath. His chest rose and fell in a slow, rhythmic cadence, his jaw set like carved granite. Only the rigid cords of muscle in his neck gave away the strain.

Next came the betadine. I poured the amber liquid over sterile gauze and swabbed the torn edges clean. The chemical smell of iodine mixed sharply with the heavy copper of his blood and the rich, dark warmth of his skin.

Then it hit me.

My fingers paused against his shoulder. A strange, prickling heat bloomed low in my stomach, rushing up through my ribs like a sudden fever. My vision narrowed. The cavernous warehouse faded into muted gray shadows, and the only thing sharp in the world was the curve of his throat, the steady thump of his jugular vein, and the scent rising from his bare skin.

It was pine resin, damp river stones, and the dark, toasted sweetness of cracked barley.

Mine.

The word echoed in my skull, not as a thought, but as a deep, feral purr that vibrated through every bone in my body. My wolf leaned forward behind my ribs, claws digging into my chest, demanding to press my face into the hollow of his neck and breathe him in until the room disappeared.

Why did my body want to claim an armed mutineer in the middle of a slaughterhouse?

I clamped down on my vagal reflex. I exhaled through my teeth, forcing my pulse down, and tore my eyes away from his throat.

"You're breathing fast," Radek said quietly.

His voice had dropped half an octave. It vibrated with a rough, low resonance that scraped across my bare nerves.

I looked up. His slate-gray eyes had darkened, thin rings of molten amber glowing around his pupils. He wasn't looking at the warehouse door. He was looking at my mouth.

"I'm working in a freezing warehouse with no light," I lied, keeping my tone crisp and professional. "Keep your shoulder square."

"Lenka."

"Focus on your breathing, Krizsek. Unless you want crooked stitches."

I reached into the sterile surgical pouch and drew out a curved cutting needle threaded with 2-0 black braided nylon suture. I clamped the needle in the jaws of my stainless steel needle driver, feeling the familiar weight and balance of the tool.

"Ready?" I asked.

"Do it."

I set the point of the curved needle two millimeters from the wound margin, right at the superior angle of the laceration. With a firm, decisive twist of my wrist, I drove the steel needle through the tough epidermis, through the subcutaneous fascia, and out the opposing skin flap.

Radek's right hand gripped the corner of the wooden crate. The pine plank cracked under the sheer pressure of his fingers, but he didn't make a sound.

I used the tissue forceps to pull the black nylon thread through, leaving a three-inch tail. With two quick wraps around the needle driver, I threw a surgeon's knot, pulling the ragged skin edges together until the margins approximated perfectly. I locked it with a square knot, snipping the excess nylon with my trauma shears.

Click. One stitch.

"Good alignment," I murmured, working on autopilot. "The muscle fascia is intact beneath the dermal layer. You'll heal with minimal scarring if you don't tear it open swinging an axe."

"I don't use an axe," he said, his voice tight with controlled pain.

"A crowbar, then. Whatever you pack enforcers use to wreck apartments."

"That was Otakar's style," Radek grunted as I drove the second stitch through his flesh. "I prefer a clean door kick."

"Comforting to know you have standards."

I worked methodically, placing interrupted mattress sutures every five millimeters along the tear. My hands didn't shake. In the back of an ambulance speeding down potholed river avenues at forty miles an hour, you learned to stitch by muscle memory. Here, with Radek sitting motionless before me, every movement was precise.

Yet every time my gloved fingers brushed his skin, that electric current snapped between us.

His scent seemed to grow thicker, wrapping around us in the cool river draft. He wasn't pulling away. His breathing had fallen into sync with mine, deep and measured. He watched every twist of my wrists, every knot I tied, his gaze heavy with an intensity that made the skin on the back of my neck prickle.

"Where did you learn to fight like that?" he asked softly as I tied the sixth knot.

"Like what?"

"You didn't hesitate with Kolar. Most pups freeze the first time a two-hundred-pound wolf tries to tear their throat out. You waited until he committed his weight, then gutted his femoral line."

"I didn't gut him," I corrected, cutting the nylon. "I performed an anatomical division of a major vascular conduit."

"You killed him in forty seconds, Lenka."

I paused, the needle driver poised above his skin. The cold reality of what I had done on that catwalk settled into my stomach. Kolar’s blood was still drying on my jacket, stiff and dark. I hadn't panicked. I hadn't cried. I had simply calculated the distance between his artery and my blade, and struck.

Was that my father's blood waking up? Or was that just who I had always been under the paramedic uniform?