A New Beginning
An exploration rather than a story per se, of SSA Hotchner's physical, emotional & psychological recovery from serious injury sustained during a bust gone bad ("The Fallen")
To B, for her inspiration via "The Fallen", her encouragement, suggestions & contributions
To TG & AW for bringing a fictional character to life in such as way as to inspire creation of more stories for him
I do not own any of the CM characters; wish I did.
Previously, in "The Fallen":
"Forty year old FBI agent, suffering GSWs to the left calf and left thorax. Respiration is shallow, laboured, and has gotten worse during transport. Heart rate 170 and weak, pressure 95 over 60 and falling. He's in and out of consciousness and has lost a good deal of blood."
"Sir, can you hear me?" the doctor asked, as they rushed the gurney into an ER exam room.
Yes he could hear them. He was fighting to stay awake, but everything seemed muffled and distant. He was barely aware of hands gently removing his clothing and attaching electrodes to his chest. Why did breathing hurt so much? He heard the doctor continue...
"Sir, I have to turn you over for a moment to see if the bullet came out, okay?" without waiting for an answer, the doctor and two nurses turned the man onto his left side. "No exit wound. I'm going to need a CBC and some x-rays, stat! Page Dr. Travis and prepare an OR!" Applying his stethoscope to the patient's abdomen he listened; definitely internal bleeding. Damn. He glanced up at the screen showing his patient's vital signs. Heart rate was still high and pressure still dropping; it was now getting dangerously low. Breathing was also much worse; urgent action was required if the man was going to live long enough to make it to surgery.
He felt a small prick on the inside of his elbow; somebody was drawing blood from a vein in his arm. He was having trouble concentrating. His mind was fuzzy. The fatigue he had felt in the house was now overwhelming. He struggled against the temptation to sleep, although he knew it would be less painful. Something in his subconscious told him that he had to try to stay alert, to keep fighting, that his life depended on it. But he felt so weak and he couldn't seem to get in enough air...He thought he heard the doctor's voice addressing him again...
The doctor had been handed an intubation kit by an ER nurse. "Agent, I'm going to put a small tube down your throat. It will help you to breathe more easily. Try to relax and remain still."
He closed his eyes. The oxygen mask was removed; he could just make out the doctor leaning over him and feel the tube enter his lung. He became aware of an oxygen surge to his lungs as a nurse attached a bag to the tube. That was a bit better, but the pain in his abdomen was unbearable. He gritted his teeth as a wave of nausea passed over him. Just let it be over soon, I'm not sure that I can take this agony anymore! He suddenly wondered if some of the murdered victims he had encountered over the course of his career had felt this way as they neared death. It occurred to him that most had not had a chance, that their lives were simply snatched away. He, on the other hand, did have a chance and a choice. He could choose the tougher, more painful path; he could chose to battle for his life. The thought gave him renewed determination and in his head he replanted the image of himself playing with Jack. I'm not going to let a scumbag take my life. I'm not ready to die, Jack needs me! I'll fight with everything I have left. He was aware of his gurney starting to move before blackness enveloped him once again...
A New Beginning
"'Tis very certain the desire of life prolongs it."
The influence of the anaesthetic slowly began to wear off. Through his still-foggy mind, the patient became vaguely aware of his existence. He tried to muster the strength to open his eyes, but could not. "Where am I?" He was confused but managed one coherent thought: "At least I'm alive" before returning to his drug-induced slumber.
With a soft moan, the injured man awoke for a second time. He felt oxygen streaming into his nose through a small tube which ran under his nose and hooked over his ears. He was aware of a slight tightness on one arm; a blood pressure cuff. His left lower leg was elevated by a pillow. He heard a steady beeping noise and realized it was his own heart beat being sent to a monitor located over his head, via an assortment of wires stretching from his chest. Various tubes entered and exited his body. "What's happened? I can't remember... So much equipment, what's wrong with me?... I need to focus but I can't think... maybe if I just change position..." He tried moving slightly. Pain shot through him and he returned to the darkness.
Regaining consciousness for a third time, the blackness that had surrounded him became a series of grey blurs that began to take shape. Vaguely remembering his failed experiment with movement, he lay still. Even without turning his head, the gunshot victim could discern some of his surroundings as the long-practiced powers of his senses took over automatically. The smell of sterilization, the hum of medical equipment with its blinking lights, the outline of other beds with similar degrees of apparatus and the soft glow emitting from a nearby nurses station told him he was in an ICU and it was night-time. "One step at a time" he told himself. "I just need to make it to morning... I'll remember it all then. I'm going to be okay, Jack, don't worry..." Suddenly, his thoughts were interrupted by an enormous surge of pain in his gut; it literally took his breath away. He felt like he was being suffocated. He struggled to get air back into his lungs, rasping and choking. His effort was met with another jolt in his abdomen and his chest tightened as though trapped in a vice. Nausea and pain overwhelmed him. Through it all, he somehow realized that his body was failing him. "No! No! No! I won't let this happen! Jack...I won't... give up..." Still he fought to breathe. Alarms sounded from the monitor above his head. For a brief moment, he felt dizzy... and then he felt nothing.
The head nurse on the ICU night-shift saw the blinking red light for bed #3 just as she heard the first alarm. "Code Blue!" she shouted at a colleague and rushed over to the patient. He was in respiratory arrest and already turning blue by the time she reached the bed. Looking up at the monitor, she saw that the heart rate was elevated and very erratic. A doctor and more nurses appeared seemingly from nowhere, one wheeling a small cart. The doctor tilted back the man's head and attempted to insert a tube into his throat. "Damn it, I can't see the chords, his airway is swollen!" Concomitantly, a nurse set up the cart's defibrillator and stood holding a paddle in each hand while another attendant drew clear fluid up into a needle. The pattern on the ECG became even more irregular.
"He's going into cardiac arrest!"
"Ok, I'm in, pass me that bag and turn on the oxygen tank."
"Pressure 100 over 50 and falling!"
"Give him 10cc of adrenaline and stand by with those paddles!
"He's in v-tac!"
"Alright, shock him NOW!"
Paddles were applied to the injured man's chest; his back arched upwards momentarily then smacked down on the bed. There was no change to the ECG pattern on the monitor; the erratic beeping noises continued.
"Still in v-tac!"
"Hit him again, 340!"
"Pressure 92 over 40, still dropping"
The nurse put the paddles back onto the man's chest to deliver another shock. Again, there was no change to the cardiac monitor.
"Dammit! Come on, man, fight! FIGHT! Crank it up, 360!"
"Hurry, pressure's 70 over 35"
Another jolt of electricity surged through the man's heart. Once again his back arched and this time his shoulders also briefly left the bed before crashing back down. The beeping from the ECG screen stopped and the line went flat. The medical team held their collective breath, all eyes glued to the monitor.
"Come on, come on... LIVE, dammit!"
Suddenly, the flat line took on the jagged shapes of a heart beat and the accompanying beeps indicated the heart had returned to normal sinus rhythm.
"Pressure rising, now 105 over 60"
"Oh thank God!"
"That was too close. We'll need to keep a watch on him; checks every 5 minutes. Good catch, Beth, and great job everyone." The crash team left the doctor and head nurse at the bedside, taking the defibrillator with them.
"Beth, let's get him on a ventilator; his breathing is far too ragged. I'm also concerned with what caused the arrest. Check his chest tube for blood or blockage. And please get an ultrasound of his abdomen and another CBC, quick as you can. I need to know if he's bleeding internally again, or if there is any evidence of infection. Let me know the minute you have the results... I'll page Dr. Travis and tell him that we may need to operate on his patient again...and I'll book an OR just in case."
The nurse nodded. She was already drawing blood from a small line which protruded from the back of one of the man's hands. The hand felt cold. She asked, "But do you think he could survive another surgery so soon? His vitals are still extremely weak... we were incredibly lucky he even made it through the first operation, not to mention this crash."
"Yes, I know... he has endured a lot and I'm not sure how much strength he has left. But if he's developed another bleed we won't have a choice but to cut him open again. Let's hope his desire to live remains strong..." the doctor replied grimly.