Mia realised she was prevaricating. As a doctor, the dictum first, do no harm was weighing heavily on her mind, but without the possibility of getting Douglas to a hospital, was it any kinder doing nothing?

‘OK, Rob. Hold him firmly in case he wakes up again.’

At the head of the table, Nash placed his hands on Douglas’s shoulders. After dousing the utility knife and the wound site with a bottle of Kaboro’s rum, Mia made two incisions above and below the shaft. As blood oozed out, she carefully pulled the incisions apart, the muscle fibres separating like strings of vermicelli. Just under the surface of the skin, she could see a thicker bulbous section which connected the shaft to the unseen arrowhead. Under her gloved finger, it had a scaly texture which felt like animal hide.

With the tip of the blade, she nipped away more of the clinging muscle. Then, she used the pliers again to check resistance. The arrow was embedded in the bone. She was going to have to cut deeper. Pushing her finger into the incision, she felt her way along the junction and cut through the next layer of muscle until she encountered the arrowhead itself. It was smooth, a little over a centimetre in diameter, possibly some kind of bone, but black in colour. She grasped hold of it with the pliers and began twisting.

Suddenly it came free, and Douglas came to with an ear-splitting scream.

Nash bore down as instructed.

‘Hang in there, Frank,’ he grunted, struggling to keep him still.

A hole was visible in the white of Douglas’s rib, and before the wound refilled with blood, Mia caught sight of bright red lung tissue beneath. With her free hand, she placed a pad in the wound and applied pressure.

‘Oh shit,’ groaned Douglas.

‘There is no frothing, Frank,’ she encouraged him loudly. ‘The lung is OK.’

Douglas mercifully passed out again, and Mia was able to examine the peculiar black arrowhead in the jaws of the pliers. Projecting from a scaly ball, it was as long as a man’s finger, tapering to a sharp point with a distinct curve.

‘What is that?’ Rob was looking pale.

‘It’s a cassowary claw. The inner toe is used like a dagger for defence.’

The very idea of it – not to mention the bacterial load – was revolting. Mia proceeded to thoroughly clean the wound of detritus and bone fragments. Then she doused everything with generous glugs of rum, and stitched the lower pectoralis muscle closed with the light monofilament fishing line Nash had found on the bridge. For a drain, she used a small length of plastic tubing from the water filter. Finally, she stitched up the upper layers of the pectoral muscle and the epidermis and dressed it. By the time this was done, she was drenched in sweat.