Chapter 1 - Five Days Without A Hospital
The emergency-room resident saw the movement beneath my bandage and forgot how to hide his face.
“Why are there larvae there?”
Nobody answered.
For a few seconds, the only sound in the treatment bay was the monitor beside my gurney and rain striking the hospital windows somewhere beyond the corridor.
I was thirty-six years old.
Twenty-nine weeks pregnant.
Covered in dried Louisiana mud.
Exhausted enough that the fluorescent lights looked like white sheets hanging above me.
And there were larvae beneath the makeshift bandage wrapped around my left thigh.
Dr. Malcolm Harris stood on my left.
He was in his fifties, silver at the temples, with the calm expression of someone who had seen almost every ugly way the human body could arrive through an emergency-room door.
Almost.
He bent closer.
The resident, Dr. Patel, moved behind him.
A nurse named Yvonne stood near the instrument tray.
Dr. Harris took only the loose corner of my dressing and lifted it a few inches.
No dramatic tearing.
No exposed wound.
Just enough.
Small pale larvae moved near the edge.
Yvonne turned her face away and covered her mouth.
The resident whispered:
“Oh my God.”
I watched Dr. Harris.
He did not recoil.
That mattered.
His eyebrows moved slightly.
Then he leaned closer without touching anything.
“How long has this dressing been on?”
“Since yesterday.”
The words came out dry.
Yvonne immediately lifted a cup toward me.
Dr. Harris said:
“Small sip.”
I drank.
The water tasted better than anything I remembered.
“Yesterday where?”
“St. Martin Parish.”
“The evacuation site?”
I nodded.
“Bayou St. Claire veterinary annex.”
The resident looked confused.
“That facility flooded.”
“Yes.”
“You were there?”
“Yes.”
“For five days?”
I closed my eyes.
“Yes.”
Dr. Harris straightened.
He looked toward my belly.
Then the fetal monitor that obstetrics had placed as soon as I arrived.
He did not tell me what the numbers meant.
That frightened me.
“How much pain?”
“In my leg?”
“Anywhere.”
“My leg. Lower back. Head.”
“Contractions?”
“I don’t know.”
That answer terrified me more than anything else.
I was seven months pregnant.
I should have known what my own body was doing.
But after five days of sleeping in twenty-minute pieces, rationing clean water, moving between flooded buildings and trying not to look at the wound beneath my bandage, pain had become background noise.
Everything hurt enough that nothing felt reliable.
Yvonne adjusted the monitor.
“Baby’s moving?”
“Yes.”
“When did you last feel movement?”
“Ambulance.”
“Strong?”
I put one hand over my belly.
My daughter shifted beneath my palm.
“There.”
Yvonne’s shoulders relaxed a fraction.
Mine did not.
Dr. Harris reached toward the instrument tray.
He selected a pair of forceps.
I watched his hand.
He turned back toward my thigh.
“No.”
The word came out sharper than I intended.
His hand stopped.
I reached out and grabbed his wrist.
Yvonne looked at me.
The resident stared.
Dr. Harris did not pull away.
“Cassandra.”
He knew my name from the chart.
“I need to examine this.”
“Don’t remove them.”
His eyes narrowed.
Not suspicious.
Processing.
He lowered the forceps.
“You put them there?”
I nodded once.
Dr. Patel took a step closer.
“What?”
Dr. Harris looked at me.
“You deliberately placed larvae in the wound?”
“Yes.”
“Why?”
My hand moved automatically to my belly.
Because every time someone asked why, I remembered the same night.
Dark water.
A generator dying.
A radio with one blinking bar.
Mrs. Boudreaux struggling to breathe in the next room.
A helicopter leaving with one patient when six of us needed evacuation.
My own leg beginning to smell wrong beneath the dressing.
I looked at the resident.
“I had five days.”
He waited.
“And no hospital.”
Nobody spoke.
Dr. Harris looked back toward my thigh.
Then toward the larvae.
He leaned closer again.
Still did not touch.
His expression changed.
Not disgust.
Confusion.
“What?”
Dr. Patel asked.
Harris held up one hand.
He studied the small exposed section of the bandage.
Then the surrounding skin.
Then he slowly straightened.
“Wait.”
My stomach tightened.
“What?”
He looked at me.
“Something’s different.”
Yvonne moved closer.
“Different how?”
Dr. Harris did not answer immediately.
He looked at the resident.
“Get wound care down here.”
Then:
“And call surgery.”
My heart began pounding.
“Why surgery?”
“Not because of the larvae.”
That did not reassure me.
“Then why?”
He looked at the dressing again.
“The wound should look worse.”
I stared.
“What?”
“After five days in contaminated flood conditions, with the history EMS gave us, I expected a lot more surface breakdown.”
The resident looked at the larvae.
“You think they—”
“Maybe.”
Dr. Harris stopped him.
“Don’t finish that sentence yet.”
Then he turned to me.
“Cassandra, I need to know exactly what happened to your leg.”
I closed my eyes.
“Sheet metal.”
“When?”
“First night.”
“Deep cut?”
“I couldn’t tell.”
“Did anything break off inside?”
“I don’t know.”
“Any loss of sensation?”
“Some.”
“When did the skin start changing?”
“Day three.”
“Fever?”
“I already had one.”
“How high?”
“I didn’t have a thermometer.”
Dr. Harris glanced at Yvonne.
“Temperature now?”
“101.9.”
His face stayed calm.
Mine did not.
“That’s bad.”
“It means we investigate.”
“Is my baby—”
“The obstetric team is monitoring your baby.”
“That’s not what I asked.”
Dr. Harris looked directly at me.
Good.
No false reassurance.
“I don’t have enough information yet to answer you safely.”
I hated the sentence.
I trusted him because of it.
The curtain opened.
An obstetrician entered with another nurse.
Behind her came a wound-care specialist.
Suddenly the treatment bay felt crowded.
Everyone had a question.
Blood cultures.
Ultrasound.
Antibiotics.
Imaging.
Hydration.
Fetal monitoring.
Tetanus status.
When had I eaten?
Had I lost consciousness?
Was the floodwater fresh, brackish, sewage-contaminated?
I answered until my words started blending together.
Then the wound-care specialist asked the question Dr. Harris had not.
“What kind of larvae?”
I looked at her.
Dr. Harris looked too.
She repeated:
“Cassandra, you said you placed them deliberately. What exactly were they?”
“Medical-grade.”
The resident blinked.
“Human?”
“Veterinary.”
Silence.
I swallowed.
“I’m an equine veterinarian.”
Dr. Harris’s eyes moved toward me.
That changed the room.
Not because suddenly everything I had done became safe.
It didn’t.
Because now they understood I had not wandered into a swamp and decided insects were medicine.
I continued.
“We had a sealed larval debridement shipment at the annex for a horse with a chronic wound.”
The wound specialist said:
“You used veterinary product on yourself?”
“I used what I had.”
“That was extremely risky.”
“I know.”
“You could have introduced organisms.”
“I know.”
“The product storage conditions after the storm—”
“I know.”
My voice broke.
That stopped her.
I put my hand over my face.
“I know.”
For five days, I had been the person who knew.
Which generator could support oxygen.
Which animals could wait.
Which elderly evacuee needed fluids.
Which wound dressing might stretch another twelve hours.
What bottled water remained.
How far floodwater had risen.
Which radio channel worked if you stood beside the west window.
What I did not know was whether my daughter was still safe inside me.
That was the knowledge I could no longer manufacture.
I whispered:
“I did not think it was a good idea.”
Dr. Harris waited.
“I thought it was the least bad idea left.”
The room became quiet.
He pulled a stool beside me.
“Tell me from the beginning.”
So I did.
Not everything.
Not yet.
I told him about Hurricane Lucille changing course.
About the parish evacuation center being cut off.
About the metal slicing my thigh when a service door blew inward.
About believing the cut was manageable.
About giving away my first evacuation seat.
About the radio note that later marked me as someone who had “declined transport.”
About the second day.
Third.
Fourth.
About the smell beneath the dressing.
The supplies left in the veterinary refrigerator after backup power failed.
The sealed package.
The decision.
The shame.
The fear.
Dr. Harris listened.
Then said:
“I need you to hear something before we move.”
I looked at him.
“If those larvae are doing what you think they are doing, that does not mean the wound is treated.”
“I know.”
“They may have removed some devitalized surface tissue.”
“Yes.”
“They cannot tell us what is happening deeper.”
“I know.”
“And nobody hearing this story should conclude that putting larvae into a wound outside controlled medical care is safe.”
I almost smiled.
“Doctor, if anyone hearing this story has access to a hospital, I recommend the hospital.”
He smiled slightly.
Then stopped.
Because the surgery consultant had entered.
She held an ultrasound report.
Her expression was not dramatic.
That frightened me anyway.
Dr. Harris stood.
“What?”
She pointed toward my thigh without showing me the screen.
“There’s something deeper.”
My hand closed around the blanket.
“What?”
“Foreign material.”
The room went silent.
“Metal?”
“Maybe not.”
“How deep?”
“We need better imaging.”
Dr. Harris looked toward obstetrics.
“Can we?”
The obstetrician nodded.
“If it changes management, yes.”
I heard the medical conversation around me.
Risk.
Benefit.
Shielding.
Contrast questions.
Vascular proximity.
Surgical timing.
I understood enough medicine to understand the danger of understanding halfway.
Then my daughter kicked.
Hard.
I put both hands over my belly.
For the first time since the storm, I cried.
Not because I thought I was dying.
Because I was finally somewhere I did not have to be the person deciding what happened next.
May you like
And I had never realized how tired I was of being useful until professionals surrounded me and said:
We have this part.
