Rushing to Save Victor
I was 30 miles down river at the Ajoya clinic the night of the tragic flash flood, and in Ajoya it didn’t even rain. However, a lively display of flashing and thundering further back over-the mountains revealed that heavy storms struck not far away. Word of the tragedy in La Tahona had still not reached Ajoya when I set off on mule back for El Zopilote three days later, yet the many oranges, limes and the occasional body of a pig or calf floating by in the swollen river bespoke of misfortune upstream. No sooner had I dismounted at El Zopilote the following morning than Victor’s brother, Bartolo, arrived out of breath and begged me to hurry to La Tahona to care for his brother who, he said., was dying. I tossed some medicines and instruments into a bag and, as my mule was a bit saddle sore from the long ride, I set off on foot with Bartolo down the steep trail toward La Tahona. Now, at the close of the rainy season, the whole mountain was aflame with orange-flowering cosmos that grew in a thicket as high as our heads. The sky was a deep blue, the air cool, the sun welcome. Yet we remembered our mission. We almost ran.
I knew that the only chance of saving Victor's leg, and possibly his life, was immediate surgical debridement.
Victor, fortunately was still far from moribund, although from the gangrenous stench that rose from his left leg, I guessed that he soon might be. I was amazed he had survived at all. Not a patch of his body was not bruised or torn. His whole face was black and blue, nearly all the skin had been scraped from his back, and his arms and legs had multiple open wounds, some of them down to the bone. The only injury which was now life-threatening, however, was the dime-sized hole on his lower left leg, where a sharp stick had carried mud and debris deep into the flesh. Now the whole leg was badly swollen, and by the putrid gray-green fluid it oozed, I knew that the only chance of saving Victor’s leg, and possibly his life, was immediate surgical debridement.
While I gave him pre-medication and had the womenfolk boil the instruments, Victor related once again the events of that tragic night.
Rain had begun to pour down in the late afternoon, a very local storm, with much thunder and lightning. As night came on, it began to rain harder; a deluge! The five children in the house had long since gone to bed, but the grown ups were still up putting pails and urns under new leaks, when they heard a sudden thunderous explosion. It sounded as if the whole perpendicular face of the mountain had given way and crashed into the canyon upstream. (This is precisely what happened.) The echo reverberated for some moments and then, instead of fading away, began to grow louder.
“It’s the arroyo!” cried María Nuñez in alarm. “It’s coming! Quick! Get the children out to higher ground.”
But it happened too fast. The roar grew to a thunder. The children were still climbing out of bed when the seething wall of water, mud, boulders and trees crashed against the stout adobe walls and swept the house downstream. At the instant the water hit, Victor heard his aging mother cry out, “Mis hijitos!” (My children!) followed by a gasped, “Diós!” as the roof beams, tiles and walls crashed down. Victor clutched his seven year old daughter to him and tried to shelter her as best he could as their world fell in on top of them. He felt the crush of adobes and sharp tiles; at the same instant the churning wall of water tumbled and swept them downstream, Victor still clinging to his small daughter. Something in the maelstrom struck him on the forehead. From that moment on he could not remember well . . . except that the nightmare went on and on, and now he was alone. He remembered being hurled against a jagged shore and pulling himself out. He was more that 100 yards downstream from where the house had been. Stripped of his clothing and covered with mud and blood, he managed somehow to drag himself back to the village.
Provisional surgery on Victor’s leg proved that the anaerobic infection. under the skin was more extensive even than I had feared. I made an incision from below his knee nearly to his ankle and laid back the skin, still without exposing the limits of the rank infection. With a catheter on a syringe, I irrigated and oxidized the lesion with hydrogen peroxide; before releasing the tourniquet, I cauterized the severed blood vessels with a red-hot wire which Bartolo brought running from the cooking fire.
Victor's fever had subsided, and he was in good spirits, relatively speaking.
I explained to Bartolo that while Victor would possibly recover where he was, provided he got extensive care, that if the infection could not be brought undercontrol, amputation might be life-saving and I recommended we take him to Mazatlán, where the facilities were available should this prove necessary.
Victor’s fever had subsided, and he was in good spirits, relatively speaking. He lay in an improvised stretcher which, with the sheet we had rigged as a sunshield, looked for all the world like a covered wagon. As the arroyos were still treacherous after the big flood, for the first part of the long trek we took the ridge trail, which involved several steep climbs and drops of more than 2000 feet, on paths so precarious that even mules sometimes lose their footing and. tumble to their deaths. I marveled at the sure-footedness and stamina of these mountain youths that carried the heavy stretcher. (Victor weighed about 170 pounds and the stretcher another 30.) We started with a group of 25 young men, mostly from La Tahona and Verano, but we sent runners ahead to request help from the next villages along the line, so that the number of stretcher bearers grew. We rarely stopped, except just long enough to change bearers. Arriving at the river, we crossed more than 20 fords, some of them chest deep and the current swift. A few men had brought carbide lights, so that when night fell, we kept moving. By the time we reached Ajoya at about 10:00 p.m., more than 70 persons had helped carry the stretcher.
Arriving in Ajoya, Bill Gonda and Phil Mease, who have been doing a superlative job as medics in the Ajoya clinic, helped re-irrigate and dress Victor’s leg, which was still rank, but looked better. The following morning we drove Victor to San Ignacio in my Jeep, transported him across the Rio Piaxtla on a raft, transferred him into Bills VW and drove the last 70 miles to Mazatlán . Having little confidence as to the sort of treatment he might get at the Hospitál Civíl (where more than once I have seen limbs amputated which could have been saved) we took Victor to the Sanatorio Mazatlán, which, although expensive, provides first rate care. There, we requested the services of Dr. Miguel Guzmán, a fine person and an excellent physician, who has helped us several times in the past, often donating his own services.
Dr. Guzman examined the leg, and told us that he would be glad to hospitalize the patient, but that he would, for the present perform no further surgery, and would continue with exactly the same treatment of peroxide irrigation that we had already begun. After talking it over, we decided to take Victor back to our Ajoya clinic and treat him there —this primarily to save on expenses.
Three weeks have passed since I began, in spare moments, to write this account. The reports that come up to El Zopilote from Ajoya have been encouraging; the infection in Victor’s leg is under control and healing has begun. He now moves about on crutches, and is in fine spirits. Amazing!
As for Fermín, I haven’t seen hide nor hair of him since that misty day he ate the apple—and his absence is probably a good sign.