Chapter One: Forward
Buffalo, Wyoming
September 18, 1976, 2:00 a.m.
Patrick
If there’s one thing he’d learned working the emergency room at the Parkland Memorial Hospital in Dallas as a med student, it’s that nothing good happens after midnight. Maybe in the sleepy town of Buffalo, Wyoming, he didn’t get the prostitutes with fractured jaws, overdosed teenagers, gangbangers with lead between the eyes, or sex adventurers reluctant to explain the gerbils stuffed in their posteriors, but still, when the phone rang at two in the morning, Patrick knew it would be bad.
He rolled over and jostled his wife, who was unseasonably buried under layers of blankets that he’d kicked off himself in the night. “Susanne, I’ve gotta go in.”
“Be careful.” Her mumble was on autopilot—the same words she always said—and he was certain she didn’t break out of REM sleep.
“Susanne. Susanne.”
“What is it?” She jerked to a sitting position, looking wide-eyed, wild-haired, and suspicious in the meager moonlight streaming in the window. But still so damn beautiful. His heart did a somersault. The same woman he’d been in love with since he was a fifteen-year-old honor student at A&M Consolidated High School in College Station, Texas.
He touched her cheek. “Everything’s okay. I have to go in to the hospital. Can you make sure everyone finishes packing in case I’m late getting back?”
She slumped back onto her pillow. “Sure.”
“Thanks.”
He dressed in the near-dark in the clothes he’d left out the night before—he was the doc on call, after all. Before he left, he pressed his lips to Susanne’s temple. A contented “hmm” sound interrupted her soft snores. Then he walked quickly from the upper-level main living area to the lower level—which was built into the side of a hill, and mostly a basement—and out the front door to his car parked on the circle drive. With no garage, it was the same trek he made year-round.
He moved stealthily, using the Indian fox-walking techniques he’d learned as a child in Boy Scouts: crouch low with the hands on the knees, raise the foot high, set the outside of the foot down, roll to the inside, and put the heel down, toe down, and weight down. Repeat. If someone were to see him, he’d feel silly doing it, but he was alone, and it was good practice for his upcoming hunting trip. He was just passing his daughter Trish’s room, and he sure didn’t want to wake her. Lord, save me from moody teenagers. Perry wasn’t as bad at only twelve, but his day would come. It would be bad enough when Patrick rousted his family at the crack of nine to herd them into the truck and up the mountain.
He shut the door of his white Porsche 914 as quietly as he could. Last night he’d parked in preparation for a quiet getaway, facing the car downhill and setting the emergency brake. Now, he released the brake and let the sports car gather speed until he was nearly to the bottom of the driveway. As he made the roller-coaster descent, he cranked the windows down. The only sound was wheels on dirt road. Then he popped the clutch, and the Porsche roared to life.
The drive to the hospital usually only took five minutes, but they were always five minutes of white-knuckled terror. Suicidal deer and low-slung roadsters were a deadly combination, and the deer came out in full force at dusk, terrorizing the roads until nearly dawn. Susanne had chewed him out and good for buying the Porsche. There were only two drivers in their family, she reminded him, and they already had two cars: her bronze station wagon and his old truck. It probably wasn’t time yet to tell her he had his eye on a Piper Super Cub airplane now that he had his pilot’s license. But he loved the Porsche. And dammit, when a man married at nineteen the only girl he’d ever dated, had a child at twenty, and worked multiple jobs while studying medicine just to keep the wolves at bay, well, that man deserved a Porsche as soon as he could afford it. It wasn’t that extravagant—he’d bought the cheapest version they made. But it still said PORSCHE on it like the fancier models, and the black hardtop could be removed to make it a convertible. He’d been proud of his frugality until he’d promptly spent the savings on special-order parts and mechanics who only knew American cars and big trucks. As if it were reading his mind, the engine sputtered when he stopped at a traffic light.
“That’s it. This turd is going on the market.” He mouthed the words to himself.
Glancing sideways, he saw a bleary-eyed fellow driver staring at him from the next lane over. It was a teenage boy in a truck with the windows up.
“What’s the matter, buddy, haven’t you ever seen anyone talk to himself before?” He nodded. “At least I always know I’ll get an intelligent response.”
The light turned green. Patrick gunned the engine. The Porsche roared forward, but the truck shot away ahead of it. The little sports car was more bark than bite. Loud, but with about the same acceleration he’d had in his old VW Bug.
Driving along the quaint Western main street with its dim streetlights, Patrick passed under bunting celebrating the bicentennial—Buffalo had taken the event to heart and had been observing it the entire year—and a few minutes later pulled into a spot reserved for the on-call doc outside the ER. Inside, a fluorescent light buzzed and blinked, giving the austere space a Twilight Zone feel.
He hustled up to the X-ray tech, the one whose call had woken him. In most places, a duty nurse would have made the call. Most places didn’t have Wes. “What’ve we got, Wes?”
The tech stood a head taller than Patrick and weighed fifty pounds less. His blue scrubs didn’t quite make it to his ankles. “Well, Doc, we’ve got a possible fractured leg.”
Wes said it matter-of-factly, but Patrick caught a twinkle in his eyes. What could possibly be funny about a broken leg at two in the morning? “Where’s the patient?”
“Out in the parking lot, of course.”
Patrick had been walking toward the interior of the ER, but he stopped and turned to face Wes head-on. “Aren’t we going to bring him in?”
“Her. And no, I don’t think that would be a good idea.”
“What’s the problem?”
“No problem.”
“What am I missing here?” He didn’t usually have to drag answers out of Wes. Maybe the X-ray tech was sleepy. Sluggish. Like Patrick.
“I’m not sure, Doc. Want me to come with you to see her?”
Suddenly Patrick was certain Wes was almost laughing. “Damn right I do.”
The two men walked out together and came upon a young man in dusty blue jeans, a threadbare Western shirt, and scuffed boots. He was standing at the edge of the parking lot, and he whipped off his hat when he saw them.
“Thank you so much for coming in.” The hand that reached for Patrick’s was calloused and rough like sandpaper, its squeeze bone-crushing. “I’m Tater Nelson.”
“Doctor Flint. I hear we’ve got a possible leg fracture.”
“Yes, sir.”
“What’s the patient’s name?”
“Mildred.”
“Mildred. Okay.” He followed Tater into the parking lot, where they stopped at a two-horse trailer. Tater swung the rear door open.
“You’ve got her in here?”
“I didn’t want her to spook in the parking lot and hurt herself worse.”
Patrick peered into the trailer. A hoof lashed out, short of him by six inches. He jumped back two feet, taking no chances. “Mildred is a horse.” He was going to kill the X-ray tech. Wes should have warned him.
Tater nodded enthusiastically. “Yes. She’s a helluva saddle bronc. Can you help her?”
Patrick turned to Wes, who held a hand over his mouth like he was covering bad teeth. But it was a smile he was hiding. “I don’t know. Wes, can we help her?”
“I sure hope so, Doc, since you’re covering for the vet tonight.”
Patrick’s eyebrows rose, but his voice was flat. “Covering for the vet.” Joe Crumpton, the vet, hadn’t arranged for him to cover.
“Yes, sir. Doctor John always covers for him.”
“And vice versa?”
“Now, that wouldn’t be right. A vet taking care of people? Folks wouldn’t stand for it.”
“But it’s okay for a doctor to take care of animals.”
Both men nod. Patrick wasn’t so sure. About the closest he’d come to veterinary medicine was reading All Creatures Great and Small.
“Tater, give Wes and me a minute. We’ll be back to care for Mildred soon.”
“All righty.”
When they were out of earshot, Patrick said, “Okay, wiseacre, what do I do with a broken-legged bronc?”
“What’d you do with a broken-legged bronc rider?”
“You mean that kid from Kaycee?”
“That kid from Kaycee—Doc, you’re killing me. That kid is the champion bareback bronc rider of the world. Chris Ledoux.”
“He didn’t say anything about that when he came in. Just told me he’d be back the next week for another cast, because he’d be taking off the one I put on him for”—Patrick made air quotes—“work.”
“That’s Chris. But before you put the cast on him, what did you do?”
Patrick looked at him blankly. “Is that a trick question?”
“X-rayed it, Doc. So you’re going to x-ray Mildred’s leg, of course.”
Patrick sighed and rubbed the thinning spot in his hair, which he couldn’t help doing no matter how many times Susanne told him to stop. “I thought we’d established that Mildred wasn’t coming inside.”
“The portable X-ray machine. Of course.”
“And if it’s broken?”
“We’ll cast it.” Wes left off the “of course” that time, but Patrick heard it anyway.
“We will, huh?”
“Yes, we will.”
“I’ve never cast a horse’s leg before.” And he doubted medical malpractice covered it.
“Piece of cake for an old Sawbones like you.”
Whenever Wes switched from calling Patrick “Doc” to “Sawbones,” it meant he was easing up. He’d given Patrick a six-inch pocketknife for his birthday earlier that summer with SAWBONES etched in the handle, plus a card that instructed him to “throw away that Minnie Mouse starter knife and carry something useful.” Now Patrick never went anywhere without it. At night, it went on his bed stand by his wallet and watch. Putting the big knife in his pocket was just part of getting dressed in Wyoming.
Patrick patted his pocket and the knife, then snorted. Piece of cake. Right. He was feeling dumber and less capable by the second. He’d never been a horseman until moving to Wyoming two years ago. But he’d learned enough to respect a cornered animal with hard hooves, big teeth, and a strong jaw.
Remembering the kick Mildred had levied at him, Patrick asked, “Do we have a twitch?” He always twitched the muzzle of his horse Reno so he couldn’t bite the horseshoer. It worked fairly well.
“Nope.” Wes broke into a wide grin. “The trick will be to move fast and stay out of the line of fire.”
“Great.” But now Patrick smiled, too. Having grown up in Texas, he thought he knew the West, but Wyoming out-Wested Texas and then some. A man had to be able to laugh at himself, or life got pretty unfunny real fast.
“Or some folks lift the opposite foot at the same time. Most horses stay pretty still with two feet off the ground.”
“You can have the back end, then. I pick the front.”
Wes laughed.
Back in the ER, the two men continued their good-natured gibes as they gathered supplies and equipment. Then Patrick heard a commotion in the reception area. Loud voices, a clattering, and a sound like flesh hitting flesh.
A woman shouted “Stop” in an agitated voice.
Patrick was out the door of the crowded supply room—knocking only one row of pill bottles off a shelf in the process—one step ahead of Wes, who was dragging a wheeled portable X-ray machine. In reception, they rushed up on a man in a Game and Fish uniform with the short, muscular build of a wrestler. He was holding a woman facedown, one arm behind her, his knee against her back. Her hair covered the side of her face but didn’t muffle her voice. The woman was cussing like she meant it, expertly and with great variety. The fluorescent light crackled and blinked, strobing over the grayish-white walls and floors and silver-armed chairs. A thin man in overalls and a round woman in a lavender flowered housedress and slippers huddled in the corner. On the opposite side of the lobby, Kim, the duty nurse, was standing between Patrick and a wiry young guy in hiking boots who was clutching his red, pimply face.
Kim was a solid woman who wore her hair in a no-nonsense gray bun. She had her hands up and was speaking to the hiker in a firm voice. “Come with me, sir. I’ll get you set up in an exam room.”
He wailed to her. “She hit me. The bitch hit me.”
The Game and Fish warden nodded at Kim. “Can we put her as far away from him as possible?” He shook out his cuffs. Patrick hadn’t met him before, but he knew the previous warden, Gill Hendrickson, and assumed this man was Gill’s replacement. In fact, when Gill’s body was brought into the emergency room earlier in the year—shot on the job and DOA—Patrick had been the doctor on call.
Kim pointed. “I’ll put him in number one. You put her in number four.” Number four was farthest from the waiting room.
Patrick glanced at the cowering older couple. Good call, Kim.
The warden said, “Sir, do you want to press charges?”
The man was bouncing back and forth on his feet, shaking his head, hand still to his jaw. “What? No. No. Uh-uh.”
The warden hauled the woman to her feet, not ungently. Her face was red where it had pressed against the linoleum, but she looked otherwise uninjured. Her T-shirt was pitted out and damp around the neck. Her respiration was high, but she didn’t appear to be hyperventilating.
Her eyes flitted from person to person, settling on Patrick in his doctor’s jacket. “I think I’m having a heart attack.” Her hand went to her chest and shoulder.
Unfortunately, Patrick had seen behavior and symptoms like this before, and often, in Dallas. But only once in Buffalo. She didn’t look like she was having a heart attack. He was willing to bet she was high on speed. That they both were, her and the male hiker. The sweating, his hyperactivity, her chest pain—they were often side effects of amphetamine-induced anxiety. But why was Game and Fish here?
“I’m Alan Turner,” the warden said to him and Wes, without releasing the woman.
Wes introduced himself.
“I’m Doctor Flint. Nice to meet you. Where are these two from?”
“They were driving erratically up on Red Grade near their campsite. I decided they needed a lift here, for obvious reasons.” Game and Fish wardens were full law-enforcement officers, with the authority to enforce all the laws of the state of Wyoming when necessary, although the wildlife management laws were their special responsibility.
Kim walked back in from getting her patient situated.
“Kim, can you take vitals while Wes and I tend to a patient outside?” If Patrick was right that speed was all that was wrong with them, it was nothing a couple of Valium wouldn’t fix.
Kim bobbed her head toward the female patient. “Alone?”
“I’ll stay with her,” Alan said.
Kim nodded. “In that case, no problem.”
“Don’t leave me, Doctor,” the woman said. “I’m dying.” She clutched her chest.
“You’re in good hands. I’ll be back.”
Patrick hustled outside with Wes.
“I hate seeing drug cases around here,” Patrick said to Wes.
“A lot more of it lately. Had a few last weekend when Doctor John was on call.”
The contrast between the quiet night and the waiting room drama was stark, save for the clattering wheels of the portable X-ray machine. Patrick stopped just shy of the parking lot.
“I wonder what’s going on? Hopefully it will end with tourist season.” But tourist season ended with Labor Day, which had been several weeks before. Patrick’s mind returned to the horse. “Did you get a look at Mildred’s leg before I got here?”
“I did.”
“How bad is it?”
“It’s not broken through the skin, but Miss Mildred is hurting and unhappy. Pretty near her pastern joint, but I think it’s clear of it. You’re lucky, Doc. The prognosis for horses that break into their joint is bad. A fair number of them die of joint sepsis.”
Not a compound fracture, not in the joint. No open wound, so no infection. Those were good things. Patrick didn’t want another patient to die of blood poisoning on him, even a horse. Especially not after losing a patient to it for the first time the previous week. Bethany Jones. That had been her name. If her family hadn’t waited to bring her to the hospital until she was next to death, Patrick might have had a chance to save her. People in Wyoming were nothing if not self-reliant. A little too self-reliant sometimes.
“Good.” Patrick resumed walking toward the trailer.
Wes put a hand on his arm, stopping him again. “One of those Jones boys came by this afternoon wanting a copy of his mother’s autopsy report.”
“Again, huh?” Patrick hadn’t met them, but he kept hearing reports of their visits.
“They’ve always been pushy.”
“Hopefully we’ll get the report soon, so they won’t have any more reason to show up here. I’m pretty anxious to get my hands on it, myself.” It was hard not to feel responsible when someone died on him, whether it made sense to or not.
Wes released Patrick’s arm, and the two men rounded the back of the trailer. Mildred was facing out now, and Tater was whispering in her ear. He nodded when he saw them.
“I’m going to give Mildred a painkiller before I examine her and x-ray her leg,” Patrick explained.
He got into the trailer with Tater and Mildred. Mildred immediately pinned her ears and started battering the inside of the trailer with her back hooves.
“Shh, Mildred.” Patrick stepped closer to her. “It’s okay, girl.”
“Maybe we oughta take her out of here, Doctor Flint,” Tater said.
“Good idea.” Patrick wanted room to run.
Tater pulled at the knot in Mildred’s lead rope. “Well, hell. She’s gone and snugged it up so we can’t never get it untied.”
Patrick pulled his Sawbones pocketknife out and held it up. “Yes?”
“Sure. I’ll hold her, and you move in there quick and slice it off at the knot. We’ll still have enough to work with.”
Patrick did, then dropped the knife back into his pocket.
Wes said, “That Minnie Mouse knife wouldnta done that, now would it?”
Patrick grinned.
Tater walked Mildred out of the trailer without further injury, thanks to the first-rate splint someone had put on her leg. Then he tied her lead to a side slat. Patrick approached her again, aiming to give her a shot in her neck. The horse struck quick as a rattler and sunk her teeth into Patrick’s chest.
“Aah,” he yelled. His shoulder dipped and his knees bent. “Son of a buzzard bait!”
Tater whacked Mildred on her side, but Mildred held on for two excruciating seconds before releasing Patrick. He backed away quickly. She swished her tail.
Wes crossed his arms. “Son of a what?”
Patrick didn’t answer. He rubbed his chest. She hadn’t broken the skin. He’d have a good raspberry tomorrow, though.
Tater stroked his mare’s nose. “Sorry, Doctor Flint. Mildred’s a mite short-tempered.”
Something he wished Tater had told him before he got in range of her teeth.
“And here I thought everybody loved you, Doc,” Wes said.
Patrick shot Wes a look. To Tater, he said, “You ever given a horse a shot?”
“A time or two.”
Patrick handed him the syringe. “Knock yourself out, then.”
Wes coughed into his hand, but it sounded a lot like more laughing.
Pounding feet and a breathless voice startled Patrick. “Doctor Flint. We got a call.” It was Kim. Kim never ran.
“What is it?” He backed away from Mildred to keep both himself and Kim out of range.
“A deputy. Attacked by a prisoner. They’re transporting him here.”
Patrick could move to the ends of the earth and not get away from the worst of what man was capable of. His heart plummeted. He knew the local deputies. One lived next door to him and his family. “Johnson County?”
“Big Horn.”
He didn’t know any of the Big Horn County deputies. That didn’t minimize the tragedy, though. “How far out are they?”
“Forty-five minutes.”
“And the patients inside?”
“Their vitals are consistent with amphetamines. No other indicators. And the older couple? She’s diabetic and forgot to refill her insulin.”
Patrick closed his eyes for a long second. “All right, then. Five milligrams of Valium and observation for our speedy customers. Check the glucose level of our diabetic patient. We’ll get Mildred squared away, and then I’ll be in to check on everyone and sign prescriptions. We should be done before the ambulance arrives. Thanks, Kim, and let me know if anything changes.”
“Got it.” She nodded and retreated to the hospital.
A heavyset man appeared in her place with a Great Pyrenees in his arms. The dog’s head hung on his shoulder, facing away from Patrick. One paw rested on the man’s arms. Patrick did a double take. Make that one paw caught in a bear trap.
The man said, “Are you the doc covering for the vet?”
Patrick wanted to deny it, but he said, “I am,” and thought, It’s going to be a long, long night.
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