Chapter 1 - The Saw's Edge
My patient arrived with a 103.8-degree fever, purple fingers, and a month-old cast hiding a nightmare beneath it, but her husband looked me in the eyes and calmly said, “It’s just the flu.” The moment I told him I was cutting that cast open, his confidence shattered into panic, and I realized I was about to uncover something he desperately wanted hidden.
The smell reached me before the stretcher did.
Sweet. Metallic. Rotten.
After eight years in emergency medicine, I knew that smell had no business being anywhere near a healing fracture.
“Thirty-two-year-old female,” Marcus said as he hurried beside me. “Heart rate 138. Pressure’s falling. She’s barely responsive.”
Then he lowered his voice.
“You need to see her arm.”
Emily Harris looked frighteningly small beneath the hospital blankets. Her lips were dry and cracked, her cheeks hollow. Each breath seemed to require more strength than the last.
Then I saw her right arm.
A fiberglass cast ran from her hand to above her elbow. It should have been white. Instead, it was gray and brown with old stains, and the swollen flesh around its edges bulged against it.
Her fingers were purple.
The fingertips were turning blue.
I pressed one of her nails until it whitened.
The color barely returned.
“How long has she been in this cast?” I asked.
“About a month.”
The voice came from the corner.
Her husband, Daniel, stood there holding a coffee. His jacket looked expensive. His shoes were spotless. He seemed almost bizarrely composed for a man whose wife was crashing ten feet away.
“She fell down the stairs,” he said. “Emily’s always been clumsy.”
He took another sip.
“She woke up feverish. It’s probably the flu.”
I looked at Emily’s arm again. Something beneath that cast was producing the odor filling the room.
“Mr. Harris, your wife is critically ill. Her circulation is compromised, and I’m concerned about a severe infection. This cast needs to come off now.”
For the first time, Daniel stopped drinking.
“No.”
I turned toward him.
“Excuse me?”
“Her orthopedic doctor said six weeks,” he replied sharply. “She has two weeks left. Give her antibiotics.”
“Antibiotics aren’t enough if infected or dying tissue is trapped underneath this cast.”
His jaw tightened.
“We’re not removing it.”
That was when everything changed.
A worried husband might have been frightened. Confused. Desperate.
Daniel was none of those things.
He was trying to stop me.
I reached for the cast saw.
“We’re removing it.”
His coffee hit the floor.
The cup burst open, splashing across his polished shoes, but Daniel didn’t even look down. He rushed toward the bed, suddenly pale.
“No! You can’t!”
Marcus stepped between us.
And as the saw began screaming against the fiberglass, Emily stirred for the first time.
Her eyes opened just enough to find mine.
Then, in a voice so faint I nearly missed it, she whispered:
“Please don’t let him take me home.”
I froze.
Daniel did too.
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And suddenly, I wasn’t afraid of what I was going to find beneath Emily’s cast.
I was afraid of how it had gotten there.
