"150 over 95," she read. "Heart rate 110. You're in pain."
"I'm fine," Ryder gritted out.
"Rule Number One," Elena said, unhooking the cuff. "Don't lie to the doctor. You're at a level eight pain. I can see it in your pupils."
She walked to the dresser. She picked up the amber bottle.
She shook outonepill.
She brought it to him with a glass of water.
"Take it," she said. "You'll need it on board for what we're about to do."
Ryder took the pill. He swallowed it dry, chasing it with the water.
"What are we about to do?" he asked warily.
Elena pulled the sheet off his legs. She looked at the heavy white cast.
"Today," she said, "you stand up."
Ryder laughed. It was a short, sharp bark. "I can't stand. I can't even twitch my toe without seeing stars."
"We're not walking," Elena clarified. "We are transferring. Bed to chair. We need to get you upright to clear your lungs and reset your blood pressure regulation. Gravity is the medicine today."
She moved to the side of the bed. She lowered the safety rail.
"This is going to hurt," she said. She didn't sugarcoat it. She didn't use the "patient voice." She looked him dead in the eye. "It's going to feel like your leg is ripping apart. But it isn't. The hardware is solid. The bone is stable. The pain is just noise. Do you understand?"
Ryder looked at her. He saw the challenge.
The pain is just noise.
That washisline. That was what he told himself in the chute.
"Let's do it," he said.
II. The Iron Maiden
The process of moving a one-hundred-and-eighty-pound man with a shattered femur is a study in leverage and agony.
"Good leg first," Elena commanded. "Scoot your hips to the edge. Use your good arm and your left elbow. Push."
Ryder pushed.
His body felt heavy, like lead. He dragged his hips across the sheet. The movement sent shockwaves up his left leg. He groaned, biting his lip.
"Keep going," Elena said. She was standing right beside him, her hands hovering but not touching. "Edge of the bed. Legs over the side."
Ryder hooked his good foot under his cast. He lifted the heavy white log of his left leg and swung it over the mattress edge.
Gravity took hold.
Blood rushed down into the injured limb.
The pressure was excruciating. It felt like his leg was inflating, like the skin was about to burst.
"Breathe!" Elena shouted. "Don't hold it! Exhale!"
