Hypothetically speaking? [One corner of the automaton's mouth twitched with a hint of a wry smile. He extended his hand to Peter, intending to haul him to his feet.] We're stranded on an island with very few supplies, no shelter other than what we can build ourselves, and no access to medical aid.

[The Spine's voice wavered and dropped in volume at the last point. This was something that was weighing on him particularly heavily. He hoped that Peter wouldn't catch his vocal slip; irrational as he knew it was--and he was usually so very rational--he felt as though speaking of Miss B's injuries would remind Death that she hadn't been collected yet.]

I think the colloquial term is "up a creek without a paddle".