Anything that is wrong in this chapter is down to me, I've tried to be as accurate as possible but feel free to correct me.

And the prompt Grave refers to the situation.

Some terms to help with the chapter, although you might not need them.

Malignant Hyperthermia: A rare reaction to anaesthesia that can result in muscle spasms, mottled skin, increased heart rate and alterations in rhythm, increased breathing rate, a rapid increase in temperature, high levels of potassium in the blood and can cause cardiac arrest and kidney failure. Treated by keeping the person well ventilated and sedated while trying to bring all these factors under control. It effects roughly 1 in 50,000 and can be genetic. Those who suffer from it can still be anaesthetised but there are certain drugs that can trigger it and these should and would be avoided if MH was either confirmed or suspected.

Tachycardia: increased heart rate

Bradycardia: the opposite, a low heart rate

Succinylcholine: A paralytic agent given during surgery. Less common now as it's a known trigger of MH but it works quickly and so is still sometimes favoured in emergency surgery.

Dantrolene: A drug that helps to reduce the impact of MH, sometimes has to be given in high doses to work.

Propofol: Commonly given as a sedative during surgery, although it is mostly famous for the death of Micheal Jackson. Depresses the respiratory system so should only be used in a medical setting.

Any other questions just ask :)

Grave

"How bad is the bleed then?" Harry asked.

Maggie looked over at the anaesthetist. "It's not too bad, a small tear to the liver but apart from that's she's been pretty lucky. This shouldn't take too long to fix, how's she holding up?"

"She's a bit tachy," he admitted, frowning.

Maggie frowned in concern at that statement. "She was bradycardic before we got her in here, it was the fluids that were keeping her stable."

Harry nodded his acknowledgment her words and glanced over at the ventilator's readings. "Resp rate's up at 26, and C02 volume's up as well. I don't like this." He turned to look over at one of the junior doctors. "Lynne, double check her files for any drug allergies."

The young woman flicked quickly through the folder. "Nothing, no real previous medical history."

"She's never had a general before?"

"Nope."

"Shit!" He swore as the monitors began to beep as her heart and respiratory rate continued to climb. "I think she's having an allergic reaction."

Maggie's head snapped up. "You think it's malignant hyperthermia?"

"Well I did give her succinylcholine." He lifted the drape so that he could see one of Jackie's arms. "Muscles are rigid, we need to stop, now! And call down another anaesthetist and surgical team."

"Who do you want?" Lynne asked him, rushing towards the phone.

"Whoever's fucking available!" he snapped getting to his feet. "Get me dantrolene, we're going to need to put in a central line, I need blood gases done and check her temp."

"I can't stop!" Maggie protested. "We won't be able to put her back under until she's stable again, she'd run the risk of bleeding out and that's before you consider the fact that if this is MH then she's at an increased risk of internal bleeding anyway."

"Fine, but try and be as quick as you can, I'll need to give her propofol to deepen her sedation anyway, although I still don't want her on the table for too long." Harry replied. "What's her temp?"

"38."

"And it was normal before."

The nurse nodded. "It was sitting at just above 36."

"Right, we need to change the vent's tubing. Switch her to 100% oxygen and we'll start to hyperventilate her, Lynne I need you to administer that Dantrolene IV now, start with 1mg/kg. I'll change the vent settings." He turned to one of the nurses. "I need 500ml normal saline, if this is MH then she runs the risk of renal failure if we don't bump up her fluids. And someone check her temp again."

"39.6," someone yelled across to him.

"Get ice packs as well, try and cool her down."

Maggie looked up and swore. "Heart rate's up at 120."

"I only have so many hands!" he snapped back at her. "Where's that other team! And Lynne, propofol!"

"Sorry," the woman looked at him wide eyed as she ran to grab the white vial of liquid, just as a group pf people burst through the door.

"What do we have?" One of them asked.

Looks like Malignant Hyperthermia, I'm sorting the vent so I need someone to run an ECG, someone to put a central line in, a blood gas done, we need to get her temp down."

"Heart rates still climbing!" Maggie shouted across the chaos, "you need to giver her something for it now!"

"I think we should try Amiodarone first."

Harry nodded. "Just give the damn thing Lynne."

"Temps up at 41," one of the nurses called across.

"And blood gases showing elevated potassium levels and acidosis," someone else told him.

"Shit!" He swore. "Right is that central line in yet? We need to stabilise her and we need to do it now!"

Robbie lowered himself into the seat across from Ryan Phelps, glowering at him. "Anyone would think you were nervous."

He ran a torn sleeve across his face. "Look, I didn't touch that copper!" He told them, his hands shaking.

"Oh give over," Burke replied. "We found the knife on you, and I'll bet that it's covered in your prints and that the blood on the blade belongs to DS Reid."

Letting out a pained moan, he pressed his forehead against his hands, his feet drumming off the floor. "I need a hit, please you need to get me something."

"I don't think we do." Robbie told him, his lips curling in distaste.

"Look if I admit it will you give me something?"

"Why did you do it?" Robbie asked persistently as he leaned forward, his face flushed with barely repressed anger.

"I wanted to get away, I carry the knife for protection, I didn't think I just did it!" he insisted. "Now please!"

Robbie drew in a hiss of breath. "I think you'll find you'll be waiting for a while before we're able to find a doctor to administer it."

With that he stormed out of the room, Burke following after him. "DI Ross!" he snapped.

Robbie stopped and swung round. "What is it!"

Lowering his voice, Burke told him, "You need to calm down, we've got him, he's not going anywhere."

"Still can't believe this happened, Boss," he confided quietly. His face darkened with anger "He's not even bothered that he could have killed her."

"He didn't though, that's the important thing."

"Just…" Robbie shook his head. "I don't know," he growled in frustration.

Burke patted his shoulder. "Come on, I've got a bottle of scotch in my drawer, one wee nip won't do us any harm, we'll get Stuart to do any driving."

"Finished," Maggie informed them.

"Good."

"How's she holding up?"

Harry shook his head. "I've increased the tidal volumes on the ventilator and resp rate's fallen slightly but it's still sitting in the mid twenties, she's also still tachy and her temps sitting at 40 despite cooling her."

"We could up the Dantrolene again."

"Done it already," he told her grimly. Turning to the scrub nurse he asked, "Did you get an ICU bed arranged?"

"Yes, they're expecting her immediately post op."

"Good, we'll just need to keep her sedated and continue to treat. When she gets up there I want a repeat ECG to check that arrhythmia and run priority one bloods to check kidney function. I'll do the handover but make sure everything's in the notes." He got to his feet and asked. "We ready to go?"

"Nothing left to do on my side," Maggie told him. "I've got another procedure but I'll come up after that, check on her. Page me if there are any changes though."

"Will do."

"I have the feeling that Ryan Phelps will be taking a tumble down the station stairs at some point tonight," Burke commented lightly.

Stretching in the chair across from Burke's, Robbie murmured, "Won't that be unfortunate." He glanced down at his mobile as it began to ring, leaning forward his expression changed, becoming more serious "DI Ross," he answered calmly even though in reality he felt anything but. Every time his phone had went this afternoon, he'd been convinced that it was the hospital, he just wanted to hear she'd been given the all clear.

Leaning back in his chair he listened to the nervous sounding feminine voice on the other end. "DI Ross, I'm Lynne Graham, I was one of the doctor's treating Ms Reid-"

"How is she?"

"There were a few complication during surgery."

His voice took on a more urgent tone, "What kind of complications?" He saw Burke's head snap up, his eyes narrowing.

"If you'd like to come in then we can discuss the matter further."

"Is she ok?"

There was a long pause, before she finally answered, "We're managing the complications, but I really can't discuss the matter any further over the phone."

"I'll be right there," Robbie assured her. Hanging up he looked over at Burke, "Something's happened, they won't say what but they've asked me to go in."

"Stuart and I will come with you," he informed him shortly, only to find that Robbie was already racing out of the room.

They were shown into a waiting room, in which Robbie paced around in like a caged animal, while Stuart sat silently in the corner, twisting his hands and Burke's gaze switched between the two men, wondering who would break first.

It was Robbie. His hand slammed against the windowsill, he snapped loudly, "Where is everyone? They asked us to come in and now they've just left us here!"

"You need to calm down"

"Don't!" Robbie snapped, rounding on him. "What I need is to know what the hell is going on here!"

"Aye and you need to be calm enough to listen to what they're going to tell us."

Robbie scrubbed a hand across his jaw, his voice broke very slightly as he muttered, "How can she be in intensive care? They said she was going to be ok, said there wasn't any substantial damage, you heard them!"

"These things aren't always black and white," Stuart pointed out.

Rounding on him, Robbie snapped, "How the fuck is that helpful!"

Burke grabbed him by the back of his shirt and hauled him back, forcing him into a chair. "Don't take this out on Stuart," he warned him. "None of us wanted this to happen and we all want them to tell us that she's going to be ok. You having a temper tantrum is not going to help anyone, least of all Jackie."

Robbie nodded, having the decency to look slightly shamefaced as he did so. "You're right, I'm sorry Stuart."

"It's fine," the younger man mumbled in reply, returning his attention to looking out of the window.

After what felt like an age to all three men, the door opened and a tall balding man stepped into the room. He offered his hand to Robbie, shaking it as he introduced himself, "I'm Mr McDonald, I was the consultant anaesthetist on Ms Reid's operation-"

"How is she?" Robbie asked urgently. "We've not been told anything-"

"Did something go wrong?" Stuart asked.

Harry let out a deep breath. "The procedure itself to repair the damage caused by the knife was as straight forward as we had expected, the complications arose due an allergy to one of the drugs that were given as part of the anaesthetic. It's a rare reaction known as malignant hyperthermia, it can often be genetic but as we had no family history to go on we were caught off guard by it."

"Surely you can treat an allergy," Robbie pointed out hopefully.

"Yes, but this is a very severe reaction, it causes an increase in heart rate along with altering the rhythm of the heart, an increased breathing rate and a rapid climb in temperature. It also causes muscle spasms and can lead to kidney failure, internal bleeding or cardiac arrest. Now in Ms Reid's case we were able to catch it relatively quickly, but reversing the symptoms can prove difficult while the drug remains in her system. To treat this we've had to keep her sedated and ventilated as we need to keep her oxygen levels as high as possible to prevent any possible brain damage due to high CO2 levels in her blood. We're also still trying to bring down her heart rate and temperature, she's being closely monitored but it is possible that she could still suffer another relapse within the next 36 hours."

Robbie felt his face drain of all blood. "But will she be ok?" he asked.

"She's seriously ill, and as I said this is a rare reaction that we very rarely see so it's difficult to predict what is going to happen next and the effects have been known to last as long as twenty four hours, so we're in a very critical time period right now. I know that it's little comfort but we're doing absolutely everything that we can," he replied gravely.

"Can we see her?" Robbie asked.

"Of course, if you follow me through."

The three men trailed after him, Robbie in the front. He wasn't sure what he expected to see when he entered the room, but it wasn't what awaited him. He'd never thought he'd see the day when Jackie looked so weak, even a few hours ago when she'd been bleeding in his arms she'd still been joking and answering him back. Now though she was still, the only noise in the room coming from the constant whir of machines that surrounded her, wires everywhere, trailing out of almost every gap of the hospital gown she wore, a thin white sheet covering her up to the waist. Her face was flushed pink and the rest of her normally perfectly pale skin was a mottled hue and covered with a thin sheen of perspiration.

He went to step forward and paused, seeing his hesitation, Harry told him, "You can still talk to her, no-one really knows how much sedated patients can hear, so it could be helpful. The nurses can monitor her from the desk but they will need to move in and out of the room quite frequently."

"Can we sit with her for a while?" Stuart asked.

"Of course, you can stay as long as you want, we don't really follow normal visiting hours here, and she's in a single room so you won't be disturbing anyone."

Both Robbie and Stuart sat down, while Burke stood in the corner and dug his hands into his pockets. Robbie reached out his hand touching Jackie's arm lightly, feeling his chest constrict when he felt the intense heat that was radiating from her skin.

The ensuing silence was awkward, until finally Burke stepped forward, standing on the opposite side to the other two. "And I thought Robbie went to extreme lengths to avoid work," he finally remarked to her prone form.

The comment actually drew a smile from the two other men, although neither still knew what to say. A little while later, Burke pushed his hands into the small of his back and stretched. "I'm going to go, get some rest."

"I'll drive you," Stuart replied. "Robbie, you coming?"

"Um, no," Robbie finally replied. "Think I'm going to stay here for a bit."

"Ok, well call if you need anything or if anything changes," Burke told him.

"Will do, Boss," Robbie replied. He watched them go and leaned back in his seat, waiting, for what he didn't know but he didn't know what else he could possibly do."