“Help me,” Walt said, to no one and everyone. “We need to get him flat on his back.”
Agnieszka crouched beside him, hesitantly moving Jakob’s legs as Walt shifted his upper body and arm before rolling him onto his back. Walt wasn’t gentle. He was fast. Most people associated medicine with being careful and precise. Gentle, attentive contact. In battlefields, and emergency medicine, that wasn’t the case. The priority was to assess for critical injuries, and that meant grabbing and yanking when needed.
Jakob grimaced as he was being moved. He wasn’t fully unconscious, though his eyes were closed.
Walt checked Jakob’s pulse and breathing—fast and slow, respectively—and as he touched him, Jakob groaned, face contorted.
“Jakob.” Walt pinched his trapezius muscle, right where his shoulder met his neck. It was a safe spot to pinch that hurt enough to either wake people up or shock them into focusing enough to answer questions.
“Hurts,” Jakob said, barely moving his lips.
“You fell when you passed out. You might have hit something—”
“Didn’t pass out. Pain. Shoulder. Chest.”
Walt had seen men bigger and tougher than Jakob cry like babies while getting stitches, and tiny little women who could shrug off the pain of broken bones. Still, Walt didn’t think Jakob would say something hurt unless it really hurt.
“Shot,” Jakob said.
He’d been shot? Walt didn’t panic. He simply processed that information and adjusted his next steps.
Walt glanced at the staff member, then at the circle of people. “Does anyone have scissors or a knife?”
A second later, a pocketknife hit his hand. He sliced up the center of Jakob’s shirt. The fact that there was no blood on, and no visible hole in, the fabric didn’t matter. Clothes could hide injuries, and one of the most important elements of triage was to assess for yourself. Even when patients were awake and talking, there could be injuries they didn’t feel and therefore didn’t mention, especially if they were in shock.
A moment later, Walt had Jakob’s upper body exposed.
The only visible issue was a small area on his shoulder that was slightly swollen and flushed darker than the rest of his skin. There was no blood. No visible wound.
He hadn’t been shot. A bad feeling curdled in Walt’s stomach.
Walt bent closer, examining the swollen flesh. There was a small puncture mark. That plus the swelling…it looked like an insect sting.
Jakob’s forehead was damp with sweat, and as Walt watched, the muscles of Jakob’s arm and shoulder contracted. Jakob made a faint noise of pain so low, it was almost inaudible.
This kind of pain, the relatively small mark…
In medicine, when you heard hoofbeats you assumed horse, not zebra. In Krakow, Poland, an insect sting meant a bee or maybe a wasp. Saying that Jakob had been stung by a bullet ant, an insect that injected poneratoxin into the body, was like predicting a zebra was coming when you heard hoofbeats.
And yet…
The paramedics who’d been called for the woman with the broken ankle rushed over, pushing him out of the way. Walt had just a moment to decide. To decide if he should trust what his instincts were telling him. Instincts that insisted this was a bullet ant sting, despite their location in Europe and not an equatorial jungle.
“Tell them he’s been stung,” he said to Agnieszka. “He needs to be treated for neurotoxin poisoning, and, given the location, they need to check his heart. His blood pressure. It might cause cardiac arrhythmia.”
One of the paramedics glanced over. “What stung him?”
Walt was pathetically grateful to hear the man speaking English because that meant he’d understood what Walt had just said. “Bullet ant.”
The paramedic frowned. Either he didn’t know what that was, or he knew and now thought Walt was losing it, because how the hell would Jakob have gotten stung by a bullet ant?
Jakob let out a short scream when they got him to his feet. Sweat poured down his face. The sting of the bullet ant was the most painful sting of any insect. People who’d experienced it said it felt like being shot. Jakob started retching, and the paramedic whipped out a bag, holding it to his chin in case he vomited.
Right now, Jakob’s nerves were all firing, unable to stop sending his brain the pain signals, while his skeletal muscles contracted and tensed beyond his control. Walt winced and followed as the paramedics guided him over to sit on the back bumper of the ambulance. While they strapped on a blood pressure cuff, Walt crouched in front of Jakob.
“I think you were stung by a bullet ant. I know it doesn’t make sense, but I’ve seen a sting before, when I was in Nicaragua. It hurts, and it’s going to keep hurting, but it isn’t deadly.”
“Ant?” Jakob wheezed.
“Yeah.”
“Shot.” Jakob looked at his shoulder, or at least tried but gave up with a grimace. The muscles of his shoulder and neck were visibly twitching.
“Nope. Ant sting.”
“Hurts.”
Walt could tell that admission cost Jakob something. Could tell it wasn’t something he would have said if it wasn’t someone he trusted.
Someone he trusted…
Walt sucked in air and shoved himself to his feet, frantically scanning the thinning crowd on the sidewalk. It looked like the hotel was letting people back in.
Jakob reached out, catching Walt’s hand. Walt looked over, his stomach sinking even as his heart was in his throat. Jakob’s eyes were wide, and a little glassy with pain, but he was functional enough to have figured out what—who—Walt was looking for.
“Annalise,” Jakob wheezed.
Walt ran through the crowd, back into the hotel lobby, thinking maybe she’d gone inside.
But he knew. Deep down, he knew that there was no way she would have left Jakob, the man she just confessed to loving, all alone when he was vulnerable and in pain.
Walt checked the alleyway near the corner where Jakob had collapsed and their rooms. He asked the staff if anyone had seen her and enlisted their help in searching.
An hour later, Walt, and a shivering, pain-wracked Jakob, who had refused to go to the hospital, sat side by side on a bench in the lobby. Walt had felt helpless before, though as a doctor, he could usually do something to make him feel like he was being useful.
Chest compressions even when he knew the likelihood of success was small.
Clamping arteries and ordering someone to hang blood even when the person had hit the point of fatal exsanguination.
This helplessness was different.
Because Annalise was gone, and he knew she hadn’t gone willingly.
Chapter Eleven
Jakob lay face up on the hotel bed, but only because Walt made him. He was twitching, his muscles spasming like crazy, and Walt was concerned he’d fall down. Every fucking part of his body hurt.
Walt had told him he could expect these waves of agony to continue anywhere from twelve- to twenty-four hours.
Jakob was certain that was information he could have lived without.
“Phone.” Jakob tried to point toward the nightstand, but even that slight movement sent shock waves of pain through his body.
Walt crossed the room and picked up the cell.
“Need to call vice admiral.” Jakob tried to lift his hand and take the phone, but Walt shook his head.