Burden of Guilt 




PREVIOUSLY:
But he wasn't quick enough. The vehicle struck him as he attempted to dive out of the way. He collided with a tire and rolled over onto the windshield, then bounced off the hood and onto the hard asphalt. Carter felt the impact on his right side as he landed in a heap on the edge of the road. He only had a few seconds to register what just transpired before seismic waves of pain rippled through him. Before he could cry out, the world went black before his eyes. 

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It all happened so fast. One minute he was yelling and waving down an approaching car; the next, he was in the middle of the road with the oncoming vehicle bearing down on him. Despite his best efforts to get out of the way, he knew it would be too late. Before anything could register in his frantic mind, he was shoved from behind, and was now struggling to get up from the fall. Benton heard the impact of metal on flesh and turned his head to see Carter land on the other side of the road. The sedan that hit him slowed down enough for Peter to see the horrified expression of the man driving. 

"Hey, stop, I need help over here!" Peter yelled as he rushed to Carter's side. As he knelt down beside his friend, tires screeched, and the car took off. Peter didn't have time to curse the driver before their only hope disappeared from sight. 

Carter was sprawled on his back, in a position that suggested a child's making a snow angel. Peter checked for a pulse and was relieved to find one: steady, but a bit slow. It was very difficult to examine Carter in the dark without the aid of any instruments, but Peter attempted to, anyway. He peeled back Carter's left eyelid and put his face as close as possible to check for a reaction, but there wasn't enough light to see the response. After looking into Carter's right eye, Peter was fairly certain that his pupils were equal. No sign of head trauma. Yet. 

Peter pulled away Carter's tie and quickly unbuttoned his shirt. He gently placed his ear over his chest in an attempt to listen for breath sounds. Without the aid of a stethoscope, he determined that his respirations were shallow, and ragged on the right side. Broken ribs, he thought. It didn't sound as if his lungs were punctured, but only an x-ray could determine that for certain. Next, Peter ran his hands over Carter's head, searching for any swelling or lacerations. There was no blood, but his fingers swept over a very large bump on the back of the younger man's skull. 

"Probably from the impact of the road," he said aloud to the empty night. He gently ran his hands along Carter's neck and shoulders. There weren't any indications of broken bones or dislocations, so he continued to probe his ribs, noting at least two broken on the right side. Peter moved his examination down to Carter's legs. He didn't feel any more wounds, but medical experience told him there could be many hidden, and serious, injuries. 

"What the hell am I going to do?" he said under his breath. "Carter?... Carter, can you hear me, man? Carter, wake up." His former student remained motionless. The rain was slowly picking up, and Peter hovered above the younger doctor in a futile effort to keep the rain off. Moving him was contraindicated with his head and possible neck wounds, but leaving him in a puddle of water was sure to cause hypothermia. Peter needed to do something quickly, but what? He could go back to the van and get Mark; maybe there was something inside the vehicle he could use. No, that wouldn't work, there was no way they were going to be able to move Carter without a backboard. What they needed was an ambulance, and a hospital, immediately. Peter was sure Mark had a first aid kit of some sort in his van, but he wasn't going to leave Carter alone and unprotected on the cold, wet asphalt. 

Peter's thoughts were interrupted when he heard footsteps moving up the road. He stood quickly, using his hand as a shield against the rain. There was a shadowy figure moving up the road. Did the driver realize his grievous error? Peter took off his jacket and draped it over Carter's body to protect it from the rain. Giving his fallen colleague one last glance, Peter ran to met the person walking towards him. The urgency of the situation gave Peter an adrenaline rush and he closed the distance in no time at all. 

"Peter, I was getting bored, and I thought..." 

"Mark, I need some help, come on." Peter cut the other doctor off and turned around, starting back toward his injured friend, without so much as letting the other man know what had transpired. 

"Peter?" Mark called after him. "Peter, what's going on?" he yelled breathlessly as he desperately tried to keep up with the surgeon. 

"Carter was hit by a car; I don't have time to explain." Peter returned to where he had left the younger doctor. "He's got a couple broken ribs, diminished breath sounds on the right side. Pulse is 65, a probable concussion." 

Mark knelt on the other side, his jeans soaking through from the puddle. He felt for Carter's carotid artery, reassuring himself that his pulse was still strong. "I've got a flashlight with me!" Mark yelled, as a loud clap of thunder echoed through the mountains. Mark fished in his pocket for the small travel flashlight and went about checking Carter's pupils. 

"Pupils are equal and sluggish, but they are responding to light. We need to get him out of this rain," he added, as Peter snatched the flashlight out of his hands. 

"We can't move him, he may have internal and spinal cord injuries," Peter shouted at the other doctor. 

"Peter, we can't exactly leave him in the middle of the road. It's raining, he's soaked, probably hypothermic," Mark reasoned. 

"I'm well aware of that, but where the hell do you want to move him to? The van? How will we do that?" Peter snapped angrily, daring Mark to challenge him. 

Mark took a deep, calming breath. "Peter, I know you're worried, and I know this is an extremely difficult situation, but we simply can not leave him here. We don't know where or when we can get help." Peter didn't say anything, so Mark continued on. "He doesn't seem critical, and under normal circumstances he would be on a gurney, stabilized, on his way to a hospital. We don't have that luxury right now." 

Peter gritted his teeth and spoke forcefully to make his point crystal clear. "We can not just haul him to the van and risk having one of his ribs puncture his lungs or rupture his spleen. We are out here because we didn't supervise his care properly before. I will not compromise it out here now, no matter what the circumstances." 

"God, will you please stop arguing... my head is killing me." Both doctors looked around, startled, hoping help had arrived. It took them a few seconds to realize that the whisper had come from their patient on the ground. 

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Both men returned their attention to him. "Carter, look at me. Look at me, Carter," Peter said before Mark had a chance to speak. He waited until Carter's eyes were focused on him. "Can you tell us how you feel?" 

Carter closed his eyes as if trying to mentally analyze his condition. He opened them again, slowly, and both doctors recognized the worry reflected in them. His whole body shook as he spoke, making it harder for him to breathe. 

"Right now...ahhh...I think I'm slipping into shock." Carter gingerly wrapped his arms around his trembling body. He tried to regulate his breathing, which was made impossible by the sharp pains that shot through him with every lungful of air. His chest felt as if there was a giant weight on it, crushing him. It was also distressing that both men looking down on him were surrounded by several blurry twins. 

When he spoke he had a certain detached clinical tone. "I...I know a few of my ribs are broken." He closed his eyes again, trying to ride out wave after wave of pain. The sensation was something he hadn't experienced the first time he was hurt. There were firey hot streaks of pain, which lanced through his chest, burning each injury like hot coals. It was accompanied by a very deep cold that chilled him down to his bones. 

"I'm experiencing double vision, from the concussion, I guess...a horrible headache. I...I don't know what else...my chest hurts. It's...It's like more then broken ribs." His mind automatically ran through everything, making diagnoses as it was trained to do. Carter turned his head, planting the side of his face in the cold water beneath him. The water felt good; it had a nice numbing effect. But after a few seconds, it caused the inside of his head to explode; fire seemingly to coursing though his skull. He gasped. 

"Carter, don't move around," Mark admonished. He gazed up at Benton and they shared a look of concern. 

"Okay, Carter, I'm going to press down on a few areas," Peter informed him. "You know what I'm looking for. I know everything hurts, but please try to distinguish between the different levels of pain." Carter opened his eyes, and an agreement was shared between them without a word being said. 

Peter applied pressure to different areas, while Mark held the flashlight over them. He pressed down on Carter's abdomen. He started with his right side, since it had taken the brunt of the impact. From the younger man's reactions, he discerned that it was tender, but the pain was tolerable. He moved to the left side. His fingers gently felt along Carter's ribs, and around the incision from his previous surgery. The scar was still very pronounced and angry looking. Benton sighed, thinking of how everything had changed in just a few short months. 

Carter knew what was going through Benton's mind. Even though it was far-fetched, there was a small inkling of fear that body parts which had gone through hell at the hands of Paul Sobriki could be reinjured. Carter knew the chances of that were small, but it was the only explanation for Peter's being more thorough on that side. When the surgeon carefully felt each rib, there was not doubt which ones were broken. But when his fingers reached the sternum, Carter cried out in pain. 

"Are you alright, Carter?" Mark asked rhetorically. 

"God! That hurts," he gasped through clenched teeth. 

"It could be broken or bruised," Peter said, touching it again. Carter concentrated on not screaming. "Probably broken, but I can't tell without x-rays. Arms and legs look fine," he added, concluding his examination. 

"I...kind of what to get ...out of this puddle." Carter said, his teeth chattering. He looked at the other two men. "I think its...worth the risk to the van." He could barely spit the words out. He knew he had to get warm, and out of his wet clothes. He didn't know the extent of his injuries, but the possibility of surrendering to hypothermic shock did not sound enticing. 

"No." Peter was adamant. He shook his head and fixed Carter with a stare that reminded him of the days when he would screw up and piss Benton off. "Its too risky." 

"I think he's right," Mark said firmly. "We could help you back to the van, maybe find some dry clothes." He fixed Benton with his own menacing stare to quiet his objections. "I still have my bag in there, and we'll be able to help you better. It's a no win situation, Carter, but the better option is to get you to the van and get you warmed up." Mark gestured for Benton to follow him, indicating that they needed to speak privately. 

Peter looked down. "Carter, don't do anything stupid, like trying to get up." 

They began to speak, both thinking their patient couldn't hear them. They couldn't have been more wrong.