1
HELENA
Liam Stoddard crashes through my clinic door with blood soaking through the flannel shirt wrapped around his forearm.
"Doc." His voice comes tight, controlled in the way that means he has pain he's not admitting. "Had a disagreement with my chainsaw."
Blood drips steadily onto my waiting room floor—cherry red, which means arterial risk if the wound is deep enough. At least twenty minutes since this happened, based on the saturation pattern. I'm already moving, guiding him toward exam room one while my brain catalogs details: amount of bleeding significant but not spurting, skin tone pale but not shocky, breathing elevated but steady.
"Sit." I unwrap the flannel, and the smell hits immediately, chainsaw oil mixed with blood and the distinctive scent of wood splinters embedded in tissue. "When did this happen?"
"Maybe half an hour ago. I was cutting firewood up at the north property line."
"Alone?"
"Yeah."
He was alone. Half hour drive to get here, which means he field-dressed this himself and drove one-handed while bleeding. Stupid and efficient in equal measure, which describes most of my patients.
I peel back the makeshift bandage. A deep laceration runs diagonally across his forearm, several inches long, gaping wide enough to show muscle fascia. Wood debris packed into the wound edges. Close to the radial artery; close enough that a couple inches left and I'd be dealing with arterial spray instead of venous bleeding.
"Hold still." My voice stays level as I apply pressure with fresh gauze. "You're lucky. Another inch or two to the left and you'd have hit the radial artery, and we'd be having a very different conversation."
Liam grunts. "Chainsaw kicked back. Happens."
"It happens when you're running equipment that needs maintenance." I apply lidocaine, allowing the area to become somewhat numb before I irrigate the wound, watching the way tissue responds, checking for nerve damage or tendon involvement. "This needs more than a dozen stitches."
"Figured."
My clinic in Glacier Hollow operates out of a building on Main Street that used to be the general store before I converted it. Two exam rooms, a proper office with filing cabinets and a desk that actually locks, a small waiting area with decent chairs, a storage room for supplies, and a surgical suite that's saved more than a few lives when the weather makes helicopter transport impossible. The town provides electricity, but I've got dual diesel generators with automatic failover as backup—power loss during surgery isn't an option when your nearest hospital is hours away by helicopter.
Most of my supplies come through standard medical distributors. Some of it doesn't. Trauma dressings rated forbattlefield injuries, IV antibiotics most rural clinics wouldn't stock, suture kits in sizes designed for everything from facial lacerations to abdominal closures—I've acquired those through medical surplus auctions and supply chains that don't ask too many questions about remote practitioners treating gunshot wounds at odd hours.
Some of it came from Zeke MacAllister after I patched up one of his people who'd taken a bullet meant for a trafficking witness. Word spreads in certain circles when you're willing to treat people the system's failed, when you understand that paperwork can be a death sentence for someone running from the wrong kind of attention.
I like it that way.
Liam watches me pick up the suture needle. "You ever think about places that are warmer or have better facilities, Doc?"
"No. This town and the people suit me fine and I don’t like the heat." I start the first stitch, working with the precision born from long practice.
Silence settles while I work. Liam knows better than to push. Everyone in Glacier Hollow knows better. Years ago I moved here from Anchorage with exactly two suitcases and a medical license that still carried my married name. Dr. Helena Sage, widow, looking for somewhere quiet to disappear into work. The locals accepted it the way they accept most things: don't ask questions, don't expect answers, and appreciate that someone with actual medical training decided to set up shop in a town hours from the nearest hospital.
I finish the last stitch and bandage the arm. "Keep it clean and dry. I'm prescribing antibiotics—take the full course, don't stop when it feels better. And come back in a week so I can check for infection and remove the stitches."
"What do I owe you?"
"Two cords of firewood. Split and stacked."
"Deal." Liam stands, testing the range of motion in his arm. "You're a hell of a doctor, Helena."
"I know."
He leaves through the waiting room, letting in a blast of November cold that rattles the windows. I watch through the exam room window as Liam's truck disappears down the main road, then turn back to close up.
Mountains are visible beyond town, dark against the gray sky. Beautiful and unforgiving.
David would've loved it here. Open sky, mountains cutting sharp lines against the horizon, wilderness that demands respect and gives nothing for free. We used to hike the backcountry around Anchorage every weekend, mapping trails and testing our endurance against terrain that didn't care if you were prepared.
