Dr. Jules Keating finished writing her chart notation and glanced up to see Dr. Rae Brennan approaching. It didn't surprise her to see the oncologist downstairs in Emergency. She simply assumed Rae was looking for Nick.
"Oh, hi, Rae," she greeted, with a tight smile, unintentionally taking out her irritation with the new surgeon on her co-worker. "What's up? You lookin' for Nick?"
"He down here?" Rae raised a puzzled eyebrow, wondering who'd gotten under the pediatrician's skin.
"No, apparently lover boy's decided to stop answering his beeper," Jules snorted, peevishly, and rolled her eyes. Needing a surgical consult - and preferring Nick's bedside manner - she'd paged him continually for nearly a half-hour, before finally resigning herself to a different surgical attending.
Rae's brow furrowed with concern. Nick didn't do things like ignore his beeper.
Jules's face softened as she noticed her colleague's concern. "I overheard him mention something about grabbing some lunch; that was a while ago, but maybe he left his beeper at the restaurant…or something. I'm sure he's here somewhere."
Rae nodded, smiling appreciatively. "Yeah, he'll turn up."
"Walk up with you? I mean…unless you're gonna hang here for a while."
"I'm not that love sick, Jules," Rae laughed, chagrined that it would appear that way to her young colleague. Falling in step with the pediatrician, she softly sighed, hoping – just a little – that they'd bump into Nick on the way back to their offices.
Rae and Jules scrambled out of the way as an entourage of nurses and doctors rushed a gurney into their waiting elevator. Turning nonchalantly, the two waited for the neighboring elevator, which they could see was already on its way down.
"He's probably waiting for you in your office, you know," Jules commented, innocently, snagging Rae's attention just as the elevator binged its arrival.
"What makes you think that?" she chuckled, in response.
Jules shrugged her shoulders. "Well, he didn't come right out and say he had…um…specific plans for lunch, but he did mention something about Egyptian food…"
Answering the pediatrician's amused grin with a sheepish one, Rae shook her head, slightly embarrassed by the insinuation. She still didn't know how her colleagues had found out Egyptian food was her romantic weak spot, but they certainly seemed to have no intention of letting her live it down anytime soon. Blushing slightly, Rae heard the elevator doors open and turned to face them, seeking an escape from Jules's knowing look. The sight that greeted her nearly stopped her heart.
"WE NEED SOME HELP HERE!" Gabriel shouted, even before the doors had finished opening. "See, Doc, I told you we were gonna get you some help. You just hang in there a little longer!"
Less emotionally entangled with the pale, lifeless form lying on the floor of the elevator, Jules brushed past her frozen co-worker. She spared a quick glance at Migs and Gabriel, noting the splinted leg and limply dangling arm, then focused on Nick. His pasty complexion and labor breathing signaled that he was in bad shape.
"WE NEED A GURNEY OVER HERE, STAT!"
Somehow, her shout broke Rae loose from the shock and clicked her into a clinical mindset. Rushing into elevator to help Jules evaluate the situation, she knelt on the other side of Nick. She spared a quick glance at her colleague as Jules checked Nick's pulse.
"Pulse thready, rapid; breathing rapid, shallow," Jules informed. Rae nodded.
"What happened?" she shouted, without looking up. Rae wanted some idea of what they were dealing with.
"We fell through the roof."
She registered the absurdity of the statement, but didn't have time to waste wondering why Nick would be on the roof.
"He banged his chest…er…stomach up real good…mumbled something about hemorrhaging and shock."
As Gabriel spoke, Rae flung open Nick's already unbuttoned shirt. A large bruise running across his mid-section screamed for attention, but she focused, instead, on Nick's slightly distended abdomen. Behind her, Rae heard Gabriel whistle.
"Geez! I'd swear he wasn't swollen like that last time I looked."
Rae nodded, distractedly, and turned to repeat the shout for a gurney. Before she had the chance, two gurneys rolled up. As the new arrivals loaded Migs onto the first gurney, Rae turned her attention back to Nick, struggling to bite back an angry shout. She knew they had to get Migs out of their way to get to Nick, but recognizing that didn't make her feel any better about the delay.
"What we got?" Someone asked. Entering the elevator and taking Jules place at Nick's side, he checked his pupils. Glancing up, Rae registered that the young, raven-haired newcomer was the ER attending, Dr. Chaim.
"A fall resulting in blunt trauma to the lower chest/upper abdomen with acute, unidentified hemorrhaging," she informed him, shakily, her professionally objectivity beginning to waver as the ER doctor palpitated Nick's abdomen.
"What else?" Dr. Chaim asked, gently placing a cervical collar around Nick's neck and carefully rolling him over as an intern nudged Rae out of the way to slide a backboard under him. Rae gaped, lacking any more information to give him.
"He was unconscious when I found him – out cold for maybe twenty minutes," Gabriel offered, figuring it might be important.
Dr. Chaim nodded, as he took Nick's pulse and listened to his breathing. As he finished, he signaled for the intern and nearby orderly to lift Nick onto the gurney. Following it out the elevator, Dr. Chaim barked instruction as he ran with it toward the nearest trauma room.
"Need O neg, lactated Ringer's in the infuser, get X-ray set up, type and cross…"
Racing after them, Rae listened, numbly, to every order. Two feet inside the doorway, a hand caught her arm and pulled her off to the side.
"Rae, stop!" Jules insisted. Not only was the ER staff better suited to deal with the situation, but Rae was much too personally involved to be effective in any capacity.
Fighting to free herself from her colleague's grip, Rae turned her head and looked, pleadingly, into Jules's compassion-filled eyes. She knew the pediatrician was right, but she HAD to be with Nick.
"Dr. Chaim's one of the best. Let him do his job!"
Rae stopped fighting as the message finally sunk in – she would just get in the way, make it harder to save Nick's life. Resigned to her helplessness, she watched one of the nurses take Nick's blood pressure, as another finish stripping his clothes off, and the intern and yet another nurse finished placing IVs in each of his arms. Rae inwardly cringed as, in the periphery, she caught the swift movement of Dr. Chaim carefully inserting an airway down Nick's throat.
Emotionally unable to deal with the necessity of the ventilator, Rae shifted her gaze downward. She realized her mistake too late, as her eyes fixed on the large, deeply colored bruise extending horizontally across Nick's mid-section, just above his swollen abdomen. The glaring, undeniable proof of the severity of situation slammed into Rae's unprepared brain, sending a tremble racing down her spine.
A sudden fresh flurry of activity distracted her enough to stop it almost as soon it had started. Abstractly, she heard the shouts of the trauma team - the competing voices ordering up more blood… rattling lab results… detailing the X-rays… updating stats…shouting that an OR was ready for him…ordering the trauma team to roll. A sickening wave of dizziness washed over Rae as she registered the last one, and the trembling renewed itself. Nick was headed for surgery…emergency sugery… hemorrhaging massively …!
Jules reached for Rae as her knees wobbled. Wrapping her arms around her distraught colleague, she whispered reassuringly, "Nick's gonna be fine. You of all people know how strong he is, and how stubborn. He'll pull through fine!"
Rae nodded, numbly.
"Come on," Jules prodded, gently guiding her out of the trauma room and toward the elevators. Rae shied away as one binged its arrival. A second later, Jules realized the reason for the reaction and cursed under her breath. It just had to be the same elevator, didn't it?! Still cursing, Jules hit the 'up' button to call down the neighboring car.
Frozen in place, Rae stared at the empty car, envisioning Nick's limp, lifeless form sprawled on its floor. HE FELL THROUGH THE ROOF?! SURGEONS DON'T FALL THROUGH ROOFS! WHAT THE HELL WAS HE DOING UP THERE, ANYWAY?! IT'S MY FAULT! THE IDIOT'S GONNA DIE BECAUSE HE FOLLOWED ME TO SAN FRANSCISCO! HE'S CAN'T DIE! HE…
Rae!" The shout jolted Rae back to awareness. Spinning around, she unexpectedly found herself engulfed in a maternal bear hug.
Jules smiled, relieved to see Dr. Harriet Lanning arrive. As the matriarch of the clinic, Jules knew Harriet could provide wiser words of comfort than she. Giving them space, the pediatrician shook her head, amazed that the senior physician already knew about Nick. How she always seemed to know about everything going on in their lives never ceased to amaze Jules. Still shaking her head, she unobtrusively stepped into the waiting elevator, feeling increasingly like a fifth wheel.
Rae leaned heavily against the doorframe watching Nick's chest rise and fall with the artificial rhythm of the ventilator – as she'd been, on and off, for the past several hours. So far, her feet had refused to carry her any farther into the room, although she knew no one would stop her. Even without her ID, which she had a knack for forgetting, enough of her patients had spent time on the floor that none of the ICU staff questioned her presence. Still, she lingered in the doorway. Closing her eyes, Rae sighed.
"Excuse me, ma'am." A male hand on her shoulder startled her. Opening her eyes open, Rae spun around, defensively.
"Oh, geez, I'm really sorry, ma'am. I didn't mean to scare you."
Rae smiled, shakily, and waved away the stranger's apology. As he returned a tentative grin, her brow furrowed. There was something familiar about him, but she couldn't quite…he'd been with Nick in the elevator!
"You're Rae, right?" She frowned, wondering how he knew that – she wasn't wearing a nametag. Gabriel chuckled at her questioning eyebrow. "It's written all over your face, ma'am."
Rae continued to stare at him, bewildered by how her name could be written all over her face. Gabriel frowned, before realizing the problem and chuckling again.
"Nick mentioned you, ma'am," he explained. When she continued to look puzzled, he decided to elaborate. "I was trying to keep him awake…didn't know what else to do. Anyway…he mentioned your name. You know, the guy's pretty taken with you."
Rae blushed, slightly.
"So, how is he?" Gabriel asked, abruptly changing the subject in an attempt to hide his embarrassment. "He still doesn't look too good, does he?"
Hearing him sigh as he stared at Nick, Rae placed a gentle hand on the man's arm. "He's doing all right."
The sideways glance Gabriel tossed her actually managed to make her smile.
"Really!" She assured him. "His vitals are holding steady, which means the hemorrhaging is under control. He's gonna be fine."
Gabriel shook his head, slightly, and gestured toward the vent. "He's still on a ventilator, though. He shouldn't be, should he? He's been out of surgery a long time…"
Rae raised an eyebrow.
"I don't really know much about it, ma'am. It just doesn't seem like a good thing," Gabriel explained, noticing her look.
Rae didn't immediately respond. Experience told her that it was sub-optimal – to say the least - that Nick continued to need ventilator support, but she didn't want to worry the man, nor did she want to give voice to her own fears. However, as the silence between them grew increasingly awkward, Rae knew she would have to say something.
"You're right. We expected to have him off the vent by now…but we haven't been able to convince him to breathe on his own, yet, so…." Hearing Gabriel sigh, deeply, Rae paused.
"Oh, sorry, ma'am," he offered, noticing she'd stopped talking. "I didn't mean to interrupt."
Sensing he had more to say, Rae waited patiently.
"I know it's stupid, but I guess I just sort of figured he'd be all right once the docs got to him, you know…"
"He is gonna be all right," Rae insisted, again. "His body's been through a lot; we just need to give it a little time to recover. That's all."
Smiling, reassuringly, she gave Gabriel's arm a gently squeeze. He responded with a paternal pat on her hand.
"Sure. He's worn out, just needs a little more rest."
Rae smiled, compassionately. Sensing that Gabriel remained unconvinced, but unsure of what else to say, she decided to change the subject.
"How are you doing?"
Gabriel patted his injured arm, lightly, and politely smiled.
"Oh, I'm fine, ma'am – just dislocated my shoulder."
"And the other man…?"
"Migs, ma'am." Gabriel informed her. Rae nodded.
"He broke his leg…um…a simple fracture of his tibia and fibula – just like Nick said. Still can't believe he got it dead on in the state he was in." Shaking his head, Gabriel grinned disbelieving.
Smiling at the look on the man's face, Rae stole a quick glance at Nick. It didn't really surprise her; Nick didn't miss much – not professionally, anyway. The smile faded as she abruptly realized Gabriel might be able to answer a question still taunting her.
"Rueben, ma'am. Gabriel Rueben. Please, call me Gabriel," he introduced himself, sheepishly realizing he should have done so sooner. Rae smiled, politely.
"Gabriel, I'd really like to know what he was doing on the roof. Can you tell me?"
"I'm sorry, ma'am. I truly would tell you if I knew, but he didn't say," he answered, shrugging his uninjured shoulder apologetically. Rae sighed.
"He must have said something…," she insisted. It was Gabriel's turn to sigh.
"He really didn't, ma'am. When we saw him, he was admiring the view. We told him he'd have to leave, but he talked us in to sharing his lunch with him and next thing we knew, all hell broke loose."
"Lunch?" Rae inquired, curiously, as Gabriel stole another glance at Nick.
"Yes, ma'am. Egyptian food. He said he had enough for all three of us, but he was fibbing a bit, cause he really had enough for an army. I'd never heard of any of it, except the baklava…which, come to think of it, was the only thing I didn't get a chance to sample," he chuckled, distractedly absorbing the many sounds and smell surrounding him.
Out of the corner of his eyes, he caught Rae frown. Worried that he'd said something to upset her, Gabriel silently reviewed the conversation and cringed. He'd meant to avoid telling Rae about the food – certain that she'd been Nick's intended lunch mate. For whatever reason, it hadn't work out, and Gabriel didn't figure Rae needed to be thinking about it with Nick still in such bad shape.
"Well, I guess I better get going, ma'am," he sighed, deciding he should excuse himself before he did any more damage – assuming that was possible. "I had to do quite the bit of fast talking just to set foot on this floor; I don't want to find out what that pretty little thing'll do to me if I hang around too long."
Gabriel glanced, discreetly, at the nurse sitting at a nearby desk. Following his gaze, Rae chuckled.
"No. I wouldn't want to find out, either," she quipped, earning a smile from him. Giving her hand one more paternal pat, he excused himself.
Watching him stroll over to the elevator, Rae smiled, realizing how beneficial their chat had been for her. In trying to assure Gabriel, she had actually managed to convince herself that Nick was doing all right. Taking a truly deep breath for the first time in nearly nine hours, she finally stepped into the room.
Rae's training immediately kick in and pulled her attention to the array of medical equipment. Striding towards Nick, she watched his heartbeat on the monitor. The strong, steady rhythm brought a slight smile to her lips, which remained as she studied his pulse-ox numbers. Peeling her eyes away from the monitor, Rae examined the EKG leads to confirm they'd been properly placed. They were, so she shifted her attention to his IV lines. She checked to see what was hanging and inspected the delivery rate of each. Satisfied with what she saw, Rae double-checked the placement of the pulse-ox monitor on Nick's finger, before carefully pulling down the sheets and lifting his gown to have a look at the incision.
Peeling back the bandage and getting her first look at it, Rae's stomach clenched and her pulse quickened. She frowned, annoyed at the reaction, and silently chided herself - she'd seen incisions more dire than this one. Swallowing hard, Rae focused more intensely on it, scrutinizing every detail. Spotting nothing untoward, she checked the drainage from the incision. It was bloody, but not excessively, and she saw no indication of a problem.
As satisfied as she could be, under the circumstances, Rae re-covered the incision…and Nick. Her hands trembled ever so slightly as she straightened the sheets, but she didn't reproach herself this time. Her inspection finished, it no longer seemed necessary to keep as tight of rein on her emotions. Rae pulled a chair over, as the quivering moved into her knees. Sitting, she rested an elbow on the edge of the bed, as her other arm reached for Nick's hand. Mindful of the IV, Rae gingerly held it and studied its every line and curve. She loved his hands. Closing her eyes, she gently pressed his fingers against her cheek and took a several deep breaths, hoping for a whiff of the smell that what so distinctly Nick. She loved his smell. Rae frowned, disappointedly, at the scent of Betadine and antiseptic that assaulted her nose, instead.
Carefully laying his hand back down on the bed, she discovered his eyes were open and smiled, reassuringly, feeling a tickle of relief in her stomach. He'd already opened his several times for the ICU staff, but knowing that didn't provide the assurance she felt as she gazed into the endless depths of his brown eyes. She loved those eyes.
"Hey, you," she whispered, lovingly, taking his hand again. She reached up with her other hand and gently caressed his forehead with one finger. Nick simply blinked, sleepily; Rae hadn't expected much more.
"You have a concussion and you did a number on your liver, but the hemorrhaging is pretty much under control, and you're doing fine," she informed him, taking care to keep her tone reassuring. They'd explained everything to him already – each time he opened his eyes, actually. None of them were quite sure how much of it he was getting, or retaining.
Nick repeated his sleepy blink, giving her no clue as to whether or not he understood. Smiling patiently, Rae gave his limp hand a gently squeeze and stroked his forehead a few more times. When he continued to stare at her, Rae let the smile fade and shifted it into a stern, maternal façade.
"I need you to take a breath for me now, okay," she stated firmly, keeping her eyes fixed on him as she listened for the telltale squawk of ventilator. It didn't come. Frowning disapprovingly, her face grew sterner.
"Nick, I really need you to try to take breath for me," she insisted, frustration coloring her tone. There's no reason for you to not be taking breaths on your own, Nicholas Kokoris! You're just being lazy! The thought would have made her smile were the circumstances less serious; lazy wasn't word that easily came to mind when thinking about Nick.
Rae waited, impatiently, but still no squawk sounded. She sighed, disappointedly, and closed her eyes for a moment. When she opened them again, she thought she detected just a hint of anxiety in Nick's eyes.
"Shh. It's all right. We'll try again in a little bit," she soothed, squeezing his hand, again. Nick just closed his eyes. When they didn't open again after a minute, Rae decided he'd fallen back to sleep. Still gingerly holding his hand, she rested her head on her arm and watched him, her finger continuing to caress his forehead. A soft knock froze it in place and brought her upright in the chair. Seeing Harriet in the doorway, smiling compassionately, Rae smiled back.
"How is he?" Harriet whispered, even though she'd already spoken to the nurse on duty.
"He had his eyes open a few minutes ago," Rae replied, with a weary shrug. "Still can't get him to take a breath, though."
"It'll come. He's had a rough day."
Rae nodded and, wistfully, glanced back down at Nick.
"Your husband's looking for you," Harriet announced, gently. She hated to drag Rae away, but her husband wasn't a patient man. He'd throw a fit if she didn't turn up soon. That was never a good thing for anyone.
Rae glanced up, briefly, and nodded. Rising slowly, she pressed his fingers to her cheek, one more time, and laid his hand gently back onto the bed. Still holding it loosely, she turned toward the foot of the bed, but paused when she felt the wisp a single, light caress tickle the back of her hand. Turning back, Rae found Nick's eyes open, again, and smiled.
"I'll be back in the morning," she whispered, placing a tender kiss on his forehead. "You get a good night's sleep; I'm going to expect you to breathe for me tomorrow."
Squeezing his hand one more time, she reluctantly released it and moved away from the bed. Rounding the corner, she froze mid-step as a squawk filled the air. The sound brought a broad grin to her face. Glancing over to Nick's still open eyes, she could have sworn she saw a smile in them, but they closed before she could be certain. She glanced toward Harriet, who smiled, as they waited, eagerly, for another breath. But it didn't come, and, after four minutes of relative silence, Rae sighed and continued toward the door.
"It's a start," Harriet whispered, wrapping a motherly arm around Rae as they turned toward the elevator.
Rae nodded and turned her head for one last glimpse before going home for the night with her husband.