“Ask that guy over there in the green plaid shirt to get my medical bag from the trunk of my car,” he ordered the chef nearest to his left. “Then get me a large bowl of ice water and some dishwashing soap. Dove, Palmolive. Anything you have is okay.” The circle of people gathered around them began to close in. “You’ve got to back up!” Lou said firmly, applying gentle pressure. “Give us more room.”

Blood flowed from the wound in thick spurts. Hemostasis? Ice? Cleansing?

He evaluated the pluses and minuses of each maneuver.

Stop bleeding.… Get alignment.… Sterilize.… Protect any microscopic arteries that might still be intact.…

Lou made decisions while talking to the boy almost continuously. A single rolled apron had been placed under Joey’s neck, and stacks of towels were now elevating his legs from the knees down.

Lou rested the damaged hand palm down on a clean towel, gently adjusting the thumb into an anatomically correct position.

“Okay, Joey … listen to me now.… Everything is going to be just fine.… I’m going to help.…”

“Help me,” Joey answered back meekly. “Please help me.”

“Someone give me a scissors, please.”

Lou pulled one of the towels from the pile and cut off a long three-inch strip. Next, he wrapped the strip twice around the middle of Joey’s forearm and tied it off. The bleeding began to slow. To add torque, Lou slipped a wooden cook spoon under the strip and turned it until the bleeding began to slow even more. He made note of the time, 12:50. There may have been as much as two hours of wiggle room to keep the tourniquet on before there was tissue damage, but he had no desire to cut things that close.

“Here you go, Lou,” he heard Dennis say.

Lou’s heavy black leather bag materialized on the floor beside his knee. A number of states had enacted Good Samaritan laws to protect doctors who offered help in an emergency from being sued. But many of those laws were vaguely constructed, and some had even been challenged in court. As a result, there were docs who went out of their way to avoid involvement in trauma or medical emergencies—an aspect of his profession Lou had never been proud of. Instead, he had chosen to make himself better prepared. He carried a well-equipped medical bag in his trunk, and at one point, had actually participated on a committee that helped the airlines to design a sensible and useful emergency first-aid kit that could be placed on planes.

“You still with me, Joey?”

“Yes … I’m with you, sir.”

The physical evidence of shock had already begun to recede, and some strength had returned to the youth’s voice. Bleeding had been reduced to an ooze.

“I need that icy dishwashing soap now,” Lou called out.