It was April 14th 1865 on the other side of this mirror. On this side, it was July 15th 2014. How was this possible?
Word of advice: when you become blood brothers with a half-breed Apache, find out if his mother is the Essence of the World before mingling your blood with his.
I walked from the waiting room mirror behind me to the group of startled neurosurgeons kept in continuous alert at this Washington, D.C. trauma center for such emergencies.
The surgeon to my right dropped the cup of coffee as she spotted the man in my arms. “Oh, my god! That’s Abraham Lincoln!”
“That’s right,” I snapped. “Now, you get the chance to re-write history.”
Whether or not they believed their eyes, the team of surgeons leapt into action. The woman surgeon, Charlene Leale, looked at Lincoln and said to the others:
“He has been shot in the left occiput at close range seemingly with a relatively low-velocity bullet.”
A young man, Dr. Charles Taft, sprang beside her and murmured,
“His initial symptoms and his dilated left pupil could be caused by cerebral herniation—displacement and compression of vital areas of the brain by blood and edema fluid accumulating within his skull.”
He looked to me. “You understand what I’m saying?”
“I’m a surgeon, doctor. I understand just fine.” (I failed to add that all my surgeries had been digging bullets out of arms not brains.)
The doctors ripped off Lincoln’s clothes, probably worth a small fortune here in the future. A hurried phone call later had a nurse with an embarrassment of cloth to cover him.
As we carried Lincoln to a gurney and wheeled him into the hastily prepped surgery, Dr. Leale said to the gathering nurses and doctors. “Lincoln’s intracerebral hemorrhaging is causing his ICP to soar.”
At the name “Lincoln,” the surgical staff studied their patient’s face and all went pale and stiff.
Dr. Leale snapped, “It doesn’t matter who he is. We have to save him!”
They inserted an intravenous line, through which fluids and O- blood was administered. They assisted his breathing, using an endotracheal tube inserted promptly into his upper airway by the trained anesthesiologist.
Leale snapped, “No telling the additional trauma you’ve caused by moving him.”
I snapped back. “’Stay-and-Play’ killed him if you recall. ‘Scoop-And-Run’ seemed the only move.”
Taft sighed, “Studies do seem to suggest that patients intubated upon arrival at the trauma center have a substantially better outcome than those intubated in the field.”
My nose wrinkling at the smell of antiseptic, I stood back and let the experts at it.
Lincoln’s dilated left pupil reflected impending herniation and was treated initially with an intravenous concentrated salt solution to support his blood pressure and also to lower his ICP by drawing edema fluid from his damaged brain back into the bloodstream.
Because Lincoln’s ICP was extremely high, he was treated with modest hyperventilation.
A chest x-ray was performed, along with an array of routine blood tests.
After a third physical examination searching for previously unrecognized injuries, he was rushed to the computed tomography (CT) scanner for a definitive examination of his head injury.
Since acute subdural hematomas must be evacuated promptly, Lincoln was wheeled into the operating room for an emergency craniotomy.
The neurosurgeons evacuated the President’s hematomas, débrided the bullet’s entrance wound, and repaired the damaged dura.
They placed catheters inside his skull to monitor his ICP, cerebral blood flow, and brain oxygen levels, as well as to remove cerebrospinal fluid as needed to lower the ICP.
The president was moved to an intensive care unit.
An exhausted Dr. Leale found me in the doctors’ lounge drinking what passed for coffee in the future and hoping my teeth wouldn’t melt:
“The case of U.S. Representative Gabrielle Giffords should give you hope, Dr. McCord.
On January 27, 2011, she was shot in the head with a Glock semiautomatic pistol. A 9mm bullet entered the back of her head just to the left of the midline at almost exactly the same spot at which Booth’s bullet entered Lincoln’s head, and traveled the same path as Booth’s bullet.
Giffords was treated according to a protocol similar to the one we’ve followed, after which she participated in an intensive rehabilitation program.
A little over a year later, she could walk, speak in a halting manner, and she is hopeful of one day returning to politics.”
I raised an eyebrow. “You going to tell anyone you saved Lincoln?”
She laughed, “And be committed? No, thank you. So long as you pay the bills, Lincoln stays a John Doe.”
The police were awkward, especially seeing Lincoln’s face. But hefty contributions to the Commissioner’s re-election fund helped. And the interest accrued on my 1865 bank account gave me more than enough to cover bills and bribes.
A little under a year later, Lincoln, resting in his bed, closed his laptop in our hotel suite. “Thank … you, Mc … Cord. I am … lost here. So much … went wrong after … I was shot.”
I nodded to the mirror to our right. “Just on the other side of that mirror, it is still April 14th 1865.”
“Really?”
I smiled wide. “And tomorrow, we walk through it, and you get to set some things right.”
“How … can … I … thank you?”
I sighed, “Next time, duck.”
