To place economic security in the hands of the government is quite literally a return to our medieval ancestry where feudal lords took responsibility for the economic survival of the serfs working their estates.

—LANCASTER R. HILL, Climbing the Mountain, SAWYER RIVER BOOKS, 1941, P. 18

Lou estimated they were five miles from the lodge, assuming they had averaged ten minutes per mile over the uneven terrain. The concierge had warned him that cell phone signal strength in the mountains was spotty at best. After failing to get a dial tone, Lou checked the time. He had a new concern. It could take two hours to get back to the lodge and return with help—probably not much less even with an ATV. By that time there could be severe tissue damage caused by the tourniquet. The other potential danger was one he could not shake from his mind—severe shock and cardiac arrest.

Despite what Cap had said right before he stumbled and fell, he was never hot about making this run. Lou had talked him into it. Now there was no way he could allow him to die. The tourniquet had to be loosened as soon as hemorrhaging had clearly been stopped. Somehow, someway, Lou would get the man out of these woods without leaving his side.

“Listen, buddy,” he said, his voice managing to stay even. “This is going to be the tough part.”

“Do … what has … to be … done,” Cap answered, stopping between words to breathe.

With a few decent sips of water, and the bleeding slowed to an ooze, the physical evidence of shock had begun to ebb. As Lou had done with the tourniquet, most of the tools he needed to complete the next phase of the process would have to be improvised. Most medical schools and hospitals, Eisenhower Memorial included, offered a variety of continuing education classes on a regular basis. Six months back, Lou had taken a two-day wilderness emergency medicine course. Ironically, his decision to do so was inspired by his newfound passion for trail running. The class, taught almost exclusively by incredibly competent paramedics and specially trained EMTs, with a few ER docs sprinkled in, was well organized and terrifically informative. With two jobs and a kid, courses and lectures were often triggers for him to catch up on sleep. But fortunately, not that one.

Lou performed a quick, repeat physical. Cap was going to need all of his will and his strength just to survive the pain of what was about to be done to him. The exam offered Lou a whisper of confidence that his friend could endure what lay in store for him without slipping back into shock. Looking over the leg, the ugly bent angle, twisted like a wrung-out dish towel, the bone splintered and frayed at the edges, Lou questioned his own ability to inflict the required amount of pain. But the leg had to be straightened or the chances of saving it were negligible.