Hello :) It has been a very long time since I ventured forth into the world of fanfiction writing. Some of you might recognise me from the ridiculously rambly reviews I am fond of leaving on particularly good fanfictions but I have written a fair bit for Casualty in the past. I mostly wrote about Sam/Tom/Fletch etc. who are of course all long gone and although I absolutely adore the current cast I have found their characters quite difficult to get right in fanfiction. Anyway, it has been a very long time since I've written anything remotely creatively, my A Level subjects don't allow for that and so please bear with me as this is probably not very good. However, expect more from me over the coming months as I finish my exams – I have a few ideas for one shots that I can plough through now I have a bit more time on my hands! Anyway, this is a two parter and the second part will be up in due course, probably after my maths exam on Thursday. Let me know what you think if you can :)
Dr Lily Chao was stressed. It was safe to say the past few weeks hadn't been easy, and the mess that was the current ED management team - with Mrs Beauchamp facing a life sentence behind bars, Zoe still showing her ineptitude for the clinical lead role and Dr Keogh being his usual absent and awkward self – was driving her to insanity. She thought she'd turned a corner after her recent moped crash but she could tell her concentration and vigilance was starting to slip again.
She sighed deeply as she was brought out of her revere by a nurse handing her at least five more case files – she wasn't even halfway through her shift and she was bone tired, and it definitely wasn't proving to be a quiet night. A drunken end of term for the university students paired with the current staffing crisis meant it was particularly chaotic. The waiting room was starting to get very rowdy, she noted as she made her way to call her next patient. Scanning the room briefly to try and work out who could resemble a 19 year old called Edward Nelson (nearly anybody) before she called his name, she became aware of one man with a bleeding head shouting especially loudly. He was towering over a young woman clutching a toddler and very loudly claiming she'd stolen his chair in the waiting area. The woman looked terrified of the man and her young child very unwell indeed yet the man was bellowing straight into her face. Not even stopping to think- there was no time to think whilst working in an emergency department – Lily marched over to the man purposefully.
"Sir, I suggest you sit down before we call security and have you escorted outside," she barked sternly as the man turned to face her. She didn't realise just how tall and well-built he was until she was by his side. She could smell the alcohol on him and it was clear that he was very drunk.
"Who the hell are you to tell me what to do?!" the man replied, obviously threatened by Lily's intervention. "I pay my taxes for you to treat me, so don't lecture me!"
"Yes, I doubt you do," Lily muttered dangerously. Noting the anger building in the man's eyes, she moved towards the reception desk to call security. She managed only two steps before she felt a sharp pain in her head and the world went black.
Cal's pulse threatened to jump through the roof as he rushed to Lily's side. He'd seen the girl go down, though helpless to prevent the assault, he heard the sickening crunch her head made as it slammed onto the desk and then the ground. The protests and yells of the man who'd delivered the blow to the junior doctor echoed in Cal's ears as he was dragged away. He had good reason to turn and repay the favour to the man but he stopped dead as he reached the young doctor sprawled lifelessly on the ground.
"Rita, Charlie!" he managed to call out shakily as he spotted the two senior nurses walking past. He didn't have time to gauge their reactions as he fell to his knees, pressing two fingers to Lily's neck and almost collapsing with relief as he felt a weak pulse fluttering under her skin. Scarlett coloured liquid stained her splayed out hair and her skin was shockingly white. "Lily, can you hear me?" he ground out desperately, taking the girl's hand briefly hoping she'd respond. Feeling nothing, he shone his pen torch into her eyes and swore loudly at the lack of response in her pupils.
"Talk to me Cal," Rita's voice made its way into his thoughts and he glanced up to see her equally stricken expression kneeling at Lily's side. He looked up to see Charlie standing over them, ever the professional, but he could see the shock in the older man's eyes.
"She was punched by a patient," he managed, his thoughts struggling to make sense in his head, "hit her head twice on the way down – it was so hard Rita, I'm sure I could hear her skull fracture." Tears threatened to overwhelm the male doctor as he glanced to the ceiling and blinked furiously, knowing he needed to stay professional.
"Okay, Cal – listen to me" Rita's calm voice took the lead, knowing Cal was most likely in shock. "You need to free a resus bed for us and book her an urgent head CT," she glanced at the young doctor lying on the ground noticing her breathing was starting to become shallow. "But find Zoe for us first," she ordered, meeting the registrars gaze. "Now, Dr Knight!"
At that the man seemed to regain composure and with a quick squeeze of the lifeless woman's hand, he practically sprinted into the midst of the ED chaos. "Just hold on for us darling," Rita whispered, feeling the girl's pulse become thready, and then nothing. "She's lost output Charlie." She swore under her breath as she began chest compressions, silently praying they weren't about to lose another colleague so soon.
As the panic of the night began to settle down, Zoe took the opportunity to slip into resus and check on the young doctor recovering inside. If she was honest, having seen her as she first came into resus Zoe was stunned that the woman had made it. Her heart had stopped for almost 10 minutes and the team were about to give up as a tiny hint of life flickered on the monitor. The concern now was if there was any lasting damage – the CT scan had showed some mild cerebral contusions which were unlikely to cause any long term issues but Zoe knew how unpredictable head injuries could be. It would break all of their hearts to see Lily, who was well known for being fiercely independent, struggle.
She was roused from her thoughts by a small hiss of pain coming from the junior doctor on the bed as she frowned and attempted to open her eyes. Taking her hand gently, Zoe glanced over at the monitors as the woman seemed to remain fairly stable as she regained consciousness, a very good sign.
"Alright Lily," Zoe spoke soothingly to the young doctor as she noticed the panic in her eyes as she tried to gauge her surroundings. "You're okay, just keep nice and still for me."
Lily could have cried out as she awoke, the pain in her head intense and her chest on fire. The lights above her were painfully bright but she could just about make out who she thought was Zoe speaking quietly to her and she could feel a reassuring hand in hers. She tried to turn her head to work out where she was but was hit by a wave of nausea. Panicking, she tried to sit up as she coughed and spluttered but only succeeded in making herself incredibly dizzy. "Alright Lily, just stay calm," Zoe's voice broke into her thoughts again and she could feel the bed moving slightly and a bowl being held under her chin as she vomited violently. A hand moved calmly across her back and she closed her eyes drowsily as the nausea subsided.
"No no Lily, keep your eyes open darling." She tried to obey the voice but her eyelids were heavy. Prising them open, everything seemed just as blurry as before and made her feel claustrophobic.
"I can't see." she whispered tearfully, the confusion becoming suddenly frightening. Why was nobody telling her what was going on? Why was she here?
"Okay, don't panic. You've had a nasty bump to the head Lily, it's quite normal." Zoe smiled reassuringly at the junior doctor and realising just how vulnerable she was right now.
"Am I in resus?" she responded, suddenly realising the severity of the situation as she tried to focus on the consultant stood by her side. She couldn't remember hitting her head, but she knew a whole lot about head injuries.
"Yes, but just for now. You're going to be okay but you have some mild cerebral contusions and a severe concussion, we just need to keep an eye on you for a bit, alright?"
Lily tried to nod in response but then winced as pain shot through her head again. Instead, she just let her eyes flutter shut tiredly, hoping Zoe would know she understood.
"Just try not to move your head too much," Zoe responded lightly, reaching out to squeeze the younger woman's arm. "Rest for now. Can I get you anything Lily?"
"No, I don't think so-" she responded, though Zoe could hear the anxiety in her tone as she made her way to leaving the junior doctor alone.
"I'm going to get Ethan to sit with you for a little bit, alright? I think he might go mad if I make him pace outside the door for much longer."
Lily opened her eyes again long enough to see Zoe, with a knowing smile, wink at her reassuringly, and with another brief squeeze of her arm she removed herself from the edge of the young doctor's bed and left resus, allowing Ethan to make his way into the room.
"I think you've given poor Caleb a heart attack Lily," Ethan said lightly as he entered resus and made his way to the washed-out looking doctor lying on the bed. "Robyn said she hadn't seen him look so worried since I almost died on him. Between us we are certainly keeping him on his toes." Ethan chatted nervously to the girl, trying to hide the residual anxiousness he felt at seeing his friend looking so unwell. He sighed in relief as a hint of a tired smile crept across Lily's face as she managed to open her eyes.
"Cal was worried?" she whispered, and then her forehead pinched slightly as her headache worsened. "Do you know what happened Ethan?" Hearing of Cal's worry for her was naturally concerning as the two were not always the best of friends, not to mention the sympathetic and somewhat traumatised look Ethan seemed to have etched onto his face whenever he looked at her.
"Yeah, I do," he nodded, moving closer to the younger doctor and sitting on the stool beside her bed. "It's better that you try and remember yourself though, alright?"
"What if I don't though?" Lily replied, frustrated tears threatening to spill down her cheeks. The rational part of her brain told her this was temporary amnesia, but the emotional side of her was terrified that this was the end – of being her own personality, her career… "I'm scared Ethan." She admitted as she gave in to the tears.
"Hey," he murmured soothingly, rising from his seat to sit in front of the woman. "It's still very early on Lily. It'll come back to you, I promise." He reached out gingerly, wiping at the tears falling down Lily's face with his thumb. He relaxed as Lily barely responded to his touch, unsure how she'd react to physical contact. "Been a bit of a shock, hey?"
Lily could only nod as she relaxed back into the pillows slightly, wincing as the pain in her head began to intensify. "My head really hurts," she whispered tearfully, feeling more comfortable admitting she was struggling with the pain in the company of her friend.
"I know," Ethan simply murmured in response before taking Lily's hand. "Just close your eyes, Lily" rubbing small circles onto her palm to soothe the distressed woman. "Get some sleep. It's all going to be okay."
As he watched Lily sleep, Ethan sighed deeply. Lily's assault today had scared the hell out of him that was for sure. He knew that his brother had been left shaken up himself from being witness to the incident but after a good cup of tea and the news that the junior doctor had been stabilised Cal seemed pretty much back to his normal self. So why was Ethan still feeling so anxious? Watching the young woman shift uncomfortably in her sleep, he reached out to take her hand again and smiled to himself as she visibly relaxed back into slumber. She was beautiful, Ethan knew that but he was certain that any feelings he had towards the woman were not reciprocated. Lily was diligent, focused on her work with little time for any form of relationship. So he'd tried to distract himself with other things, notably his brief relationship with Honey which left him heartbroken and confused when she had to leave again for Manchester, and of course the small matter of being defrauded thousands of pounds by his brother. It had been a horrible past 7 months and what he really wanted to do was tell Lily the truth – that he loved her, wanted to be with her and just kiss her – but he was terrified of the inevitable rejection and certainly not as brave as Cal.
Suddenly the monitors which had been beeping melodically started wailing, and Ethan roused from his thoughts and looked over at Lily in concern. She looked like she was sleeping, but her blood pressure was sky-rocketing and her pulse was all over the place. Grabbing his pen-torch hurriedly, he panicked the moment he opened her eyes to see how dilated and fixed her pupils were.
"Ethan, what's going on?!" Ethan hadn't even noticed Zoe enter the room but guessed she'd been alerted to the crash alarm.
"Uh, no idea-" Ethan stuttered, struggling to collect his thoughts. "Blood pressure through the roof, fixed and dilated pupils, cardiac arrhythmia…do you think this is brain herniation?" he asked Zoe, almost praying for her to say no. It was a rare, but viable complication of cerebral contusions and Ethan knew it would almost certainly end in Lily's death.
"I really hope not, the contusions and swelling on the scan weren't anything significant. Definitely raised intracranial pressure though. Could be petechial haemorrhaging, CT scan can easily miss it." Zoe replied, knowing a bleed on the brain was not much better an option than herniation. "Right Ethan crash call the anaesthetist, I'm gonna do an RSI and then fast bleep the neurosurgeons and tell them they are taking her now." Zoe almost barked at the young man, knowing at this point he needed someone to just firmly tell him what to do. Her heart broke for the man – he'd had an awful year what with his mother's death, the minibus crash and all the recent problems with his brother – and Zoe had a feeling it was about to get even worse.
Hope that was okay. Stay tuned to find out what happens to Lily...
Thought I might do a few explanations for medical terms to save anybody confused- (but trust me I'm not an expert, just an aspiring nurse who reads a lot of medical books haha)
Cerebral contusions – basically bruising on the brain
Cardiac arrhythmia – irregular pulse
Brain herniation – a complication of brain swelling (raised intracranial pressure) in which the brain is squeezed past structures in the skull. Very serious as it puts severe pressure on parts of the brain and can cut off blood supply, as well as cause spinal damage.
Petechial haemorrhaging – multiple tiny bleeds within the brain, associated with contusions, which often are not visible on CT scans but of course are just as serious as other types of bleed. Often requires surgery as prognosis is poor and can cause pressure in the brain to be very high.