Title: A Blow to the Gut
Disclaimer:We all know by know that they do not belong to me...Whatever! And YES this will go medical.
As they walked out of MTAC, leaving Ducky and Dr Magnus behind, Tony couldn't help but to feel the rumble, the increasing pain in his gut that he had started to feel earlier in the day.
Actually the pain was the same pain that he had felt since the tattooed man had struck him in the gut with the plank, board, log, whatever the hell it was ,it was big and it hurt like hell.
He lagged behind the others, falling into the back of the line down the stairs,, not wanting the others to see his pain, not wanting their attention, it was probably nothing.
His thoughts were actually replaced by Ziva's earlier statement, that she had moved on and now had a new boyfriend. That fact shouldn't bother him, he shouldn't give a damn, but it did ,no matter how he attempted to push it down deep inside, he hated it when he felt jealous. He shouldn't have feelings for his partner, hell, she was his partner and nothing else.
He was glad that she was happy though, regardless. He was actually glad that she had found a new love in her life and like before he wouldn't insert himself or his investigative skills into her relationship. Instead he would just allow her the happiness she seemed to be having at the moment. She deserved it.
He moved slowly to his desk, the pain edging up a notch since earlier in the day, his stomach had even developed a tenderness to it, a pain that was growing by the minute, maybe he should talk to Ducky. He decided to talk after Ducky was finished with Dr Magnus, in the mean time, he would finish his paperwork at his desk, in his comfortable chair.
As he started to sit he was again surprised by a stabbing pain, a pain that wrapped around into his back. After several seconds of panting and trying to push past the pain he finally managed to take a seat but he quickly glanced upwards towards the others to see if they had noticed the perspiration on his face, or the grimace that was etched on his face now as he took his seat.
Even he hadn't expected such a sharp intake of air due to the increased pain when he bent downward. Damn, 'maybe I should call Ducky now', he thought to himself as he pulled out his cellphone and placed it to his ear, but then heard the voice of his boss coming around the corner.
"Taking the rest of the day off, DiNozzo, you're in charge." he grabbed his coat and headed for the elevator, not looking back to see the surprised looks on the team's faces.
"Sure Boss. We'll just stay here and finish those reports boss.", he acknowledged. A realization hit him like a brick, he knew that the rest of the day would be busy and that he wouldn't have time to see Ducky for a while. He slid his cell back into his pocket and got busy with the paperwork from the case, Gibbs would expect their reports on his desk when he returned the following morning, so he got to work, and so did the others.
The one thing that gave him some type of relief as he started typing on the computer was that nobody had noticed his pain, and he was glad.
The brown folders were now finished and piled neatly on Gibbs' desk. Ziva and McGee had disappeared earlier after typing their reports, they hadn't even given him the courtesy of telling him that they were leaving, they just left, ignoring his senior status as always.
Ziva had made a call to her new friend, boyfriend, Ray. They talked about dinner plans and how they had enjoyed their cozy Vermont vacation. It made his stomach hurt that much more, but he did not show his pain, he refused to allow anyone to see his pain.
His report too had been finished for some time, but he had decided that since he was in charge that he would finish some other tasks that had been put off due to the busy case.
"Damn, I'm becoming responsible, hell, I'm becoming Gibbs." he visibly shuddered, that was definitely a scary thought for a man who hated work, well, extra work.
As he stood to deliver the rest of the paperwork to Gibbs' desk he was caught by a pain that ripped through his gut, actually it ripped through his whole being, a pain that was so intense it made him drop the folders from his hand onto the carpeted floor, scattering them from their folders.
He was panting, gasping, attempting to get his breath. The empty office was a relief though as he attempted to bring himself to standing position. After several minutes of ragged breathing and clutching his gut he was able to do just that, but he didn't know for how long, he was hurting. He was in absolute agony.
He reached into his pocket for his cellphone, he needed to call Ducky, he needed to get himself help, he was definitely in trouble.
"Tony, when did you start feeling badly?" Ducky asked as his warm hands started palpating Tony's abdomen. Ducky noticed right away that Tony's abdomen was rigid, tender to touch. A large bruise had formed where the piece of wood had made contact with flesh. As he continue to assess Tony's abdomen he noted how the bruise inched even further towards his back, a deep, dark, purple bruising.
Ducky noted that Tony flinched several times as his hands touched more sensitive areas, he even watched as Tony guarded his abdomen, a sure sign that he was in trouble. The pain plastered on the agent's face told him all that he need to know. Tony would be making at trip to the Emergency Room tonight.
" Well, if you are talking about the terrible, gut wrenching pain, it started a few hours ago, but if you are talking about pain in general, well, I would say that started after the tattoo man slammed the four by four into my gut yesterday." Tony's voice had taken on a new tone, it had a tired, weak, gravely sound to it, he was definitely suffering. Ducky knew that too, because this man, like Gibbs, would never ask for help unless he was desperate.
Ducky nodded in understanding of what Tony had said and then he took out his stethoscope, warming the bell before he placed it onto Tony' s exposed abdomen. He listened for several minutes before he spoke again.
"Your bowel sounds are very hyper, which is a sign of internal bleeding Anthony. I want you to put your shirt back on and I will call an ambulance. You are a very sick young man." Ducky removed the stethoscope and set it down on the metal table before walking over to the phone, quickly he dialed 911 to get assistance.
Tony just laid there, not moving, not talking, not attempting to get ready for the ambulance ride to the hospital.
Ducky makes the call but as he finishes giving the address, the directions to NCIS, he makes the observation that Tony isn't moving, and it dawns on him that the stubborn Tony of old isn't refusing to be taken to the hospital or even refusing the ride in an ambulance. Something is wrong.
" Tony, are you okay?" he asks and quickly approaches the table where Tony still resides, his legs drawn up toward his abdomen.
"Yeah, fine." he lies, his brow now wet with perspiration, his skin clammy. Ducky knows the man is probably bleeding into his gut, he is in dire need of a hospital and probably surgery.
"You want me to call Gibbs? Your dad?" he asks, not wanting to upset Tony, the man was hurting and he didn't want to start a fight, Tony was as stubborn as his mentor.
"No Ducky." he answers, wondering if the others would even give a damn if he was sick or not, they seemed to have their own lives now, they were moving on in their worlds. Everybody was moving forward, except him, he seemed stagnant in his life. Hell, even his own father was moving forward in his life, with a new wife. Step-mother number eleven or twelve, maybe it was even a higher number, there was so much he didn't know about his father.
Ducky just shook his head, he knew he could at least get some things started, it would be a quick ride to the hospital and then to surgery, it was a given.
He went to a cabinet and pulled out an intravenous start kit and an angiocath, an eighteen gauge. He then approached Tony with a new approach, that of a physician, he knew he had to be firm to get done what needed to be done.
"I need to start an intravenous line Anthony, it will expedite you in getting the pain medication you need when the paramedics arrive." Ducky removes the necessary equipment and gloves, he notices Tony's sudden fascination with the rather large needle.
"It will sting for a few minutes Anthony but as you know the pain does not last very long." he assures as he places the tourniquet on Tony's left arm, then swabs the area with an alcohol pad.
Tony gets hit with a wave of unrelenting pain as Ducky slides the needle into a vein, Ducky wishing that he had some pain medication to give his friend.
"Ducky!" Tony cries out, bringing his body into a fetal position as Ducky attempts to keep his focus on securing the adapted line.
"It hurts. My gosh Ducky, it hurts!" Tony cries out in agonizing pain, his long fingers gripping Ducky's white coat, his knuckles turn white.
Ducky attempts to comfort but he also know that he will need to call security and notify them that they need to expect an ambulance.
"Anthony, hold on son, I have to let security know that we are expecting the paramedics, I'll be right back." Ducky hurries across the room again and dials the number for security, and quickly gives the information needed and within minutes he is again by his agent's, his friend's side.
Tony is gasping in pain, writhing on the metal table. Ducky is worried.
"Tony?" a voice from across the room gets both men's attention, even Tony's who is now almost oblivious to anything but the pain in his belly recognizes the voice, attempting to still his body, not wanting to worry his friend.
"Ducky. What is wrong with Tony?" Abby asks as she rushes over to the table, grabs Tony's hand and starts stroking his back.
"He got hit with a slab of wood yesterday on the job. I do fear he is bleeding internally." Ducky states as Abby's face grows pale with concern.
"Did you call Gibbs. We have to call Gibbs! Gibbs would want to know." Abby states loudly but is muted when Tony looks at her with begging eyes, he does not want him called.
"Okay. I will not call him now but when we get to the hospital I am calling and you," she points her finger at Tony's bare chest, "are not going to stop me, because I guess you will be in surgery and you will be doing other things and not be able to stop me. But young man I will be calling your boss!" her voice gets less angry, it becomes more comforting. "Tony, you had better not die on me. You had better be fighting with all your might." she whispers into his face.
"Don't want to die either Abs, but it really hurts." he is in tears now, a sight never seen by either Ducky or Abby and they too are drawn into the emotion of his suffering. Tony is scared, a trait that they have never witnessed.
Ducky continues to nervously administer to Tony, providing comfort. Abby provides Bert for him to lie his head on, Ducky a sheet to cover his now shivering body.
Then suddenly the room is filled with the paramedics, several police officers and even some on lookers.
"My name is Steve Drake and this is Dave Barnett, we're paramedics." they announce themselves as they quickly get to work, it is evident their patient is in trouble.
Ducky starts to explain what has been done for their patient, Abby is still holding onto Tony's hand.
"We need to get you to Bethesda as quickly as possible. Are you allergic to anything?" Steve asks as he pulls open his medication box, already preparing a bag of lactated Ringers to hang.
"Ducky." Tony gives the medical okay to Ducky to share his medical information, to be his advocate.
"He is allergic to penicillin and Dilaudid. He is also sensitive to Cephlosporins. He develops the worst of rashes." Ducky starts filling them in as they load Tony onto a stretcher.
Abby does not leave his side, doesn't flinch when the elder of the two paramedics instructs her to let go of Tony's hand.
"Can't do that Dave. Tony needs me, I am his life line right now." she gives the man a smile and continues to hang on to the tight grip they both share, her and Tony.
Dave shrugs, the goth dressed woman is rather intimidating, so he does not argue, the man on the stretcher seems to need her right now.
"Awww!" Tony screams out at the movement, the shift from the cold metal table to the stretcher.
"Give him some Morphine Dave!" Steve is assessing his patient, noting that he is guarding his stomach, a true sign that his patient is in trouble.
"Done!" Dave replies after emptying the syringe into the IV port that Ducky had secured earlier.
They continue to move Tony towards the elevator and then to the ambulance, Abby still clinging to her friend's hand, not wanting to let it go, not wanting to leave him alone.
As they start to load the stretcher into the ambulance they look at Abby who's strong will persists, she does not want to let the bond go, afraid that Tony might not be able to hold on without her support.
Tony looks up in his new drugged haze and nods, afraid to speak, afraid that he might sound goofy instead of sincere.
"You better not do anything stupid DiNozzo or I will hurt you." giving him fair warning, showing her concern in the only way she can right now. The two paramedics just stare at each other, wondering what she might do to the man.
"She really is a sweet goth." he whispers, allowing them know she is a good person, not wanting them to think anything less of his friend.
Steve smiles and speaks, "Wish I had a friend like her, she seems to really care."
"She does." He smiles and gives Abby a weak wave.
Abby agrees to follow in her vehicle, Ducky gets inside and takes his seat beside Steve.
Immediately the men go to work, wanting to give their patient as much of a chance possible if he is having internal bleeding.
Steve gets off his radio and looks over to Ducky, "They want us to see if the bleeding is coming from his stomach, I'll need to first place a tube into his stomach, if we see no bleeding there I will need to perform a peritoneal fluid analysis. That is where we stick a needed into the peritoneal space and pull out fluid, to see if there is blood present."
Ducky is familiar with the tests and worries that Tony will not cooperate, but he is under the influence of drugs, he just might cooperate, he thinks to himself, but is very disappointed as Tony fights the placement of the tube.
"Can't do it." he moans, the confession that he's not able to allow the tests breaks Ducky's heart, Tony is strong , he must be in a lot of pain.
"Anthony, you must allow the paramedic to assist you, we don't want to tie your hands down but they will if you do not allow the tests." Ducky warns, wanting his friend to know that they are serious, that he is in serious trouble with his gut, that he is bleeding inside.
Steve shakes his head, he knows his patient is fighting very hard to stay in control, he decides to go another direction, picking up a package with a long needle instead of the tube again, he will do the peritoneal analysis first. The test will either rule out bleeding into the peritoneal cavity. The paramedic is worried about his patient's abdomen, it is getting more distended, more rigid and more painful to touch.
As soon as the needle hits sensitive skin, Tony attempts to pull away, but the test is positive and the paramedic know immediately this is more than a small vessel bleed or a tear in the stomach, he probably has either a liver laceration or a spleen that is oozing, time just became more valuable.
"Dave, we need to move it!" a signal for his partner to hit the gas, as Tony's pressures starts to drop and his heart rate increases. He places oxygen on his patient, and starts another intravenous line, giving volume expanders to assist in volume loss, it is protocol.
Ducky looks on as his friend struggles for life, knowing that every minute counts now. Tony's eyes suddenly goes dim, his body becomes as still as the day he saw Tony lying on the roadside when the car explosion occurred, the car that Ari had rigged to explode.
Ducky watches as Tony's color go a pasty white and then it happens...CODE BLUE.
The rest tomorrow! And another chapter of Who Am I!