Rex's emergency surgery in Quincy

Rex’s emergency surgery at the Quincy Veterinary Clinic is both a painstaking repair of a badly wounded dog and a sharp reversal in Ben Givens’s immediate course: after a car wreck and a journey on which he had intended to die, Ben finds himself scrubbing in to help save a life. Ilse Peterson’s veterinary work gives his medical skill a new, urgent use, while Rex’s treatment ends not with certainty but with a guarded prospect of hunting again.

Arrival and Decision to Help

When Ilse Peterson sees Ben, he explains that he was in a car wreck the previous day. Rather than press him for the full story, she tells him she needs help: Rex will require substantial resuturing, anesthesia, intravenous support, and a signed consent form. She estimates two or three hours of work and a cost of $150 to $300. Ben says he will stay because he wants to, and offers to do whatever he can.

The decision carries particular weight because Ben had not expected to be caring for anyone. He removes his field jacket, rolls up his sleeves, and washes his hands. His last operation had been nineteen months earlier, when he repaired a failing human heart; this time he is assisting a veterinarian with a dog. He feels a flicker of excitement at returning to surgical work. The contrast is stark: at a moment when he had meant to be dead in the sage country, exposed to flies, he is instead preparing to help another living body endure.

Anesthesia and Assessment

Ilse asks Ben to hold Rex while she administers ketamine and Valium. She leaves a needle in the dog’s cephalic vein, secures the catheter to his foreleg, and establishes an IV. Ben gently holds Rex’s mouth open while she inserts and secures an endotracheal tube, then connects it to oxygen and isoflurane. She watches the meters and adjusts the valves until Rex sinks into anesthesia. She asks Ben to administer 500 milligrams of Keflin slowly through the IV access port; he takes responsibility for the injection while she gives a subcutaneous painkiller.

Ilse then examines the wounds under a strong light and cuts away the field stitches Ben had placed. She finds that those stitches, thrown one-handed, have kept most of the dirt out. The praise registers as more than courtesy: Ben’s rough emergency work has protected Rex well enough for the veterinary operation to proceed. Ilse irrigates the wounds with saline and uses a wet sterile-gauze dressing, then checks the other injuries. She considers those wounds skin-deep and the remaining work a matter of sewing.

Repairing the Wounds

In the operating room, Ilse and Ben connect Rex to a heart monitor and prepare the sterile instruments, gowns, caps, and gloves. Ilse applies a final Betadine preparation and drapes the dog to expose the hamstring wound. With Metzenbaum scissors, she removes damaged skin. Ben holds retractors as she methodically picks out sand and strands of hair, first with her fingers and then with tweezers.

The cleaning is an exacting collaboration. Ilse calls for saline irrigation in measured portions and a 14-gauge needle; Ben assembles the equipment and she checks his work. After flushing the wound again, she judges it clean, remarking that they have washed out road dust from all the way back to Vantage. They discuss two possible stitching methods and choose a mattress pattern. Ben watches her place the stitches, admiring the small turns of her wrist and the smooth control of the tension. She adjusts each stitch so the skin lies without dimples or wrinkles, and Ben assists with a Penrose drain and the subcutaneous sutures.

Ilse closes the deeper tissue and skin, then turns to the wounds at Rex’s shoulder blades and throat. She scrubs, debrides, and irrigates each area before closing it. Ben watches the orderly work while rubbing his own side, an embodied reminder that he, too, has been injured. His participation is practical rather than merely observational: he helps prepare the wound, manages equipment, and supports the repair, while Ilse directs the procedure and remains responsible for its critical judgments.

Recovery and Aftercare

Once the wounds are closed, Ilse gives Rex additional butorphanol and acepromazine, disconnects the heart monitor, and reduces the anesthesia. When Rex begins to blink and swallow, she removes the breathing tube and checks his pupil. The dog is expected to come around soon. Ben and Ilse discard their caps and gowns, wash, and go to her office, where she writes detailed notes and sets out a recovery plan.

Rex stays overnight with Ilse. His leg needs thorough rest; the staples can be removed by his veterinarian in Seattle after he gets home, and exercise should remain limited for ten days. The drain is due to come out in forty-eight hours, either at home by Ben or with help from his veterinarian. Ilse gives him ten days of antibiotics and five days of pain relief, emphasizing that the antibiotic course must be completed. She advises normal food and water, rest, and no hunting for a while. With luck, she says, Rex may hunt birds again by Thanksgiving. Ben’s answer—that hunting is all Rex wants—makes the prognosis matter as more than a successful closure of wounds. The operation preserves the possibility of the life Rex knows, even as it forces a temporary pause in it.

Narrative Significance

The surgery places Ben’s medical identity between two forms of vulnerability. He has recently survived a car wreck and entered the country intending not to return; now he uses the habits of a surgeon to assist a veterinarian, not on a human heart but on the injured dog beside him. His skills remain useful, though the scene does not make him the lead clinician: he follows Ilse’s instructions, undertakes specific tasks, and recognizes the steadiness of her work.

That redistribution of care gives the episode its emotional turn. Ben’s willingness to remain and help is expressed through concrete acts—holding Rex, administering medication, preparing irrigation, and assisting with the drain—not through a declaration about his own future. Ilse’s cautious Thanksgiving hope supplies a modest forward point: Rex may recover enough to hunt again, and Ben leaves the operating room with a living responsibility still before him.