The Aspen were turning a golden brown, the cattle were fattened for market, and Doc Marsden was drunk again. His head lay on the two planks that served as a bar in what could only charitably be called a saloon. There were two places for a man to drink in Timberline, and this was Doc’s preferred watering hole.

Earlier that day Doc had been busy enough. There’d been a big brawl at the Triple H, and Billy Harkness had shot his younger brother, Lukas, after a lucky punch had broken Billy’s overlarge nose. It wasn’t a bad wound; Lukas had ducked, and the bullet had skimmed his back and lodged in his calf.

Doc had dressed the back wound with a poultice and fished the 0.45 slug from the gastrocnemius. He knew that much anatomy, but not much more. His hands had shaken ’till he had swigged a few swallows of what passed for bourbon. It was nervous work whittling on a Harkness. Luckily Lukas and Billy were a sight more intoxicated than Doc, and their big brother Boone Harkness was somewhere up the trail. The eldest Harkness brother had restless snake eyes. Boone never missed a thing, especially a target. He made Doc Marsden sweat. Doc gave Lukas a spoonful of laudanum, and his patient was soon snoring peacefully on the door they had used as an operating table. Doc took a small swig himself.

Doc Marsden thought about the gun in his holster. It would not be hard to put a slug in Billy’s back and make for the high country. He might get away. But then he’d spend the rest of his days looking over his shoulder.

After he was sure that the Harkness boy was settled down and Doc’s helper Marty Johnson was there to watch over Lukas, Doc headed for the saloon and started drinking again. He pondered how he had ended up in Timberline. This hadn’t been his plan when he’d left Philadelphia all those years ago.

Back in Philadelphia his name had been Antonio Lombano. His parents had been immigrants, and he had been lucky to work for a butcher. He’d grown sick of slicing meat, and when the war came he enlisted. Anything to get away from the smell of blood and hanging beefs.

When he enlisted with the 37th infantry he’d expected to learn to shoot a gun and maybe even to die. He might have to kill a couple of Rebs, but at least he would leave Philadelphia. Instead, when they learned he had worked as a butcher, he was relegated to the cook’s tent. He was back to slicing meat. For two months the only flank he outmaneuvered was with his cutting blade.

He had been disemboweling a steer one day when a group of surgeons walked by, looking for an eyeball to dissect. They watched approvingly as he wielded his blade. Three days later he had been reassigned to the medical service as a surgeon’s assistant.

Antonio was assigned to work with Dr. Marsden, a fine surgeon from Boston. He watched with admiration as the surgeon amputated shattered arms and legs, sometimes twenty in a session. Antonio’s job was to help staunch the flow of blood with tourniquet or cautery, to brush the maggots from open wounds, and to count and burn the severed limbs. He was handling meat again.

During the months with Dr. Marsden, Antonio kept his eyes open and watched the doctor’s technique. When things got too busy, he would take up the knife as well. He became expert at sounding bullet wounds and was competent at below-the-knee amputations.

The war dragged on, and Antonio grew tired of endless surgery that seemed to be alleviated only by weeks of boredom. Dr. Marsden had been lying sick in his bunk for a week, febrile, jaundiced, and vomiting blood. Antonio suspected he’d picked up yellow jack in Texas. One day, he walked into the tent and found the surgeon dead. Without further thought, Antonio loaded the surgeon’s books and surgical kit into a bag, mounted a blue roan, and rode away from the war.

Fourteen years later, he sat with his head on a bar, vertiginous from the cheap liquor. He had become Old Doc Marsden, who liked a drink but sure was handy with a blade. He had pulled a thousand arrowheads, had sounded even more bullet wounds, and set countless fractures. He kept to the rough mining towns and frontier spaces where there was no shortage of injuries and no questions were asked. Timberline was just his speed. Recently, a second doctor had come to town. He did not mind the competition; in fact, he was glad to have someone to whom he could send the tougher cases.

Time passes.

It was a cool fall morning. There was a frost on the ground, and Doc Marsden was hung-over, sitting on his porch rolling his first morning cigarette. Boone Harkness had returned to town those many months ago with a wife, and she was pregnant. The new doctor in town had taken her case. Doc was glad; he wanted nothing to do with either Snake-Eye Harkness or his bride. He’d seen her only once, walking in town, and that was enough. She seemed a tiny china doll next to the tough man with the narrow hips and wide shoulders.

A rider approached his house. Some cowboy had probably been shot last night, or had stumbled down drunk and broken his leg. But it was Billy Harkness. He told Doc he was wanted on the Harkness ranch, pronto. The new doctor, Jenkins, was having trouble with Helena Harkness and wanted Doc’s help. That could only mean things were bad, real bad. Doc had foaled a few in his time, but he was no hand at tricky birthing. Doc Marsden said he’d be by shortly. Billy looked at him with pity. Snake-Eye had said now.

Doc ran into his home and took a quick drink from his whisky bottle, then grabbed his bag and his Colt. They rode out in the cool morning air, Billy leading the way. Doc Marsden thought about the gun in his holster. It would not be hard to put a slug in Billy’s back and make for the high country. He might get away. But then he’d spend the rest of his days looking over his shoulder. He might as well face his doom straight up. He was a fake and a drunk, but he was no coward. He had never shot a man, and he wouldn’t start now.

Halfway to the Harkness spread, Billy pulled up. He had another chore to run, he said; he’d be up at the big house later that day. This was Doc’s chance. He might not be willing to shoot Billy and run for it, but he was mounted, and the road was open to the north and west. He thought about the scene in the ranch house: thin-legged Helena trying to squeeze out that big Harkness baby, bleeding, crying, dying. If she died so would Doc, no question about that.

Doc turned north and headed up the road a mile, then stopped. He looked out over the prairie. He thought about the immigrant boy, the butcher shop, the war, the bullets and arrows. Philadelphia was a lifetime away. Antonio Lombano was long dead. He was Doc Marsden. He took a deep breath of mountain air, thought about the bottle in his saddlebag, and left it there. He turned the blue roan with the double snake brand south and headed toward the Harkness ranch. TH

Jamie Newman, MD, FACP, is the physician editor of The Hospitalist, consultant, Hospital Internal Medicine, and assistant professor of internal medicine and medical history, Mayo Clinic College of Medicine at the Mayo Clinic College of Medicine, Rochester, Minn.