*** You were all so kind to review positively!! I'm excited you like the story and will continue :) ***
*** Marshall is going to have so much more trivia in his head now! ***
And in the fire of war make me as iron to temper. Let me know no fear and should death find me let it be with sword in hand and a curse on my lips.
---A Warrior's Prayer, George Yesthal
HR: 128 NBP: 125/65 MAP: 85 RR: 20 SPO2: 97 Temp: 38.5
Fentanyl drip: 7.5ml/hr Propofol drip: 10ml/hr
Two antibiotics and fluids. Food through the feeding tube. Only one IV in her right arm now and the one remaining in her neck.
It was the fifth night after surgery and Marshall stood in the room looking at the monitor with a frown. Her heart rate seemed too high, and he knew she was running a fever. He also noted her respirations were higher than 16 which he had thought was the setting on the ventilator, so why wasn't the vent alarming? Looking at the machine, he saw the display screen was different but didn't know what that meant. Mary just looked slightly uncomfortable and he placed his hand on her forehead in the old fashioned way of checking for a temperature.
Sure enough, she was warm to the touch and actually shifted her head just slightly as his hand rested on her. As delighted as he was with that small reaction, Marshall really wanted to talk to her nurse to see what was going on. He didn't get any information from Mary's family as they seem to have forgotten he was around. Stan had told him Brandi and Jinx were arguing in Mary's room the day before and had gotten kicked out by the nurse after Mary became agitated. He didn't know if they had been allowed back in and really didn't care much at this point. Looking out her door into the main nursing area, he was relieved to see Kelly back on duty and hoped Mary was one of her patients. She saw him looking for her and held up a finger to indicate she'd be there in a minute.
He slid the lounge chair over to the side of the bed and settled in, taking Mary's hand as he usually did and telling her about the day and the goings on at the office. About twenty minutes into his stories, Mary suddenly jerked and the ventilator honked. Her heart rate increased and she jerked again and Marshall was alarmed. It looked like she was coughing, but he wasn't entirely sure that was supposed to happen. The ventilator certainly thought it was something to draw someone's attention to, and since he could see Mary's brow furrow, he decided he needed to get Kelly into the room.
As if reading his mind, he heard the nurse approaching Mary's room.
"I hear you, Mary…hold your horses, girl, I'm coming."
Kelly came in and put on some gloves while talking, "Hello, Marshall. How're you?"
"I'm okay. What's going on? She doesn't seem comfortable…and is she supposed to be coughing like that?"
Mary's nurse looked at him for a moment and explained, "Her family obviously hasn't updated you, but they said you could have information so I'll fill you in." She was hooking some tubing from the wall to the suction port on the ventilator tubing, "Mary's developed pneumonia because some of the fluids we had to give her initially leaked into her lungs. It's very common and we expected it and she's been on antibiotics plus we're now giving her additional ones to combat the specific infection. She's got a lot of junk in her lungs that she's coughing up, and I'm going to suction her to get some of it out."
The word 'pneumonia' stuck in his brain and all the worry he had been able to release in the past few days suddenly piled upon him again. Eleanor's comment about her husband dying after spending over a week in the ICU echoed through his mind, and he remembered reading something about infection being more dangerous than the initial injury for trauma patients. He felt slightly ill and rubbed his face as he heard Kelly speaking to him again.
"Marshall, I'm going to suction her and it may bother you. It's going to make her cough and all the alarms are going to go off…it's not pretty. You may want to step out for a minute, okay?"
"No, it's all right. I'll be fine."
Kelly proceeded to perform the suctioning and Marshall decided he would definitely step out the next time it had to be done. The coughing that ensued nearly brought his partner off the bed and the sight of her limply falling back against the pillows made his vision swim. Mary's eyes opened briefly and she brought one hand up towards her face that Kelly caught and held until she calmed down again.
To try to take his mind off the event, Marshall asked, "Is she awake?"
"I wouldn't say she's aware, but this definitely wakes her up. We try to keep the sedation as light as we can, and highly stimulating activities like this wake her pretty easily. This is the first time she's reached for the tube though, and that's really encouraging."
"It is?" Marshall saw it as a cry for help and felt especially useless.
Kelly was watching Mary's vitals and answered him as she kept a hand on her patient's arm, "Oh yeah. With all the blood she lost and the cardiac arrest, the fact that she's trying to get at a source of discomfort shows us her brain is working."
Turning to look at Mary's worried partner, the nurse waved him over, "Come here and hold her hand. She's still aggravated and I can feel her trying to move this arm. I'm going to get her some anti-anxiety meds to help her calm down but I don't want her getting a hold of this tube."
Marshall was more than happy to hold Mary's hand, and he stroked her forehead while Kelly retrieved the meds from another area.
"Hey Mare, take it easy. You have to rest…get better. Let them take care of you. You're doing great…I'm really proud of you." his voice caught as he murmured to her. He was trying to calm himself down as much he was trying to comfort her.
Kelly soon returned and gave Mary a dose of versed to relieve her agitation. It worked quickly, and Marshall also relaxed as his partner looked much more comfortable and her vital signs returned to their previous values.
"Sometimes it'll seem like she'll take two steps back for every step forward, Marshall." Kelly knew he was worried and slightly discouraged, "That's typical for her condition and it's why we tell you to take it day by day in here. It may not seem this way, but she's doing very well…considering how little of a chance we gave her when she rolled in. No one thought she was really going to make it…she's proved us very wrong and there's not a single person here who isn't relieved."
Marshall swallowed, "She's a fighter…wouldn't go out without kicking and screaming the whole way. Probably be disappointed if she didn't take someone down with her."
Kelly placed her hand on his shoulder, "She's also got you to anchor her to this side. I think she draws a lot strength from you when you're with her…it's just a gut feeling, but that's what we go on around here most of the time."
He understood gut feelings and smiled at Mary's nurse, "Thanks. That helps."
Kelly left and dimmed the lights as she exited.
Marshall took a washcloth from the linen cabinet and wet it with cold water. He gently wiped Mary's face and then placed the cloth on her forehead, hoping it was soothing against her feverish skin.
"You're giving me more gray hairs here, Mare. You need to quit screwing around and get better, woman."
Settling back into the chair, Marshall leaned his forearms against the railing as he studied her.
"I miss you. Do you know we've never been out of contact for this long before? I keep waiting for my phone to ring and see that it's you. That you've woken up and healed and are ready to boss me around again." He brushed away tears with irritation, tired of crying, tired of having emotions so close to the surface but helpless to stop either while looking at her sleeping form. He took her hand and held it in both of his, bringing it up to rest his cheek against her fingers.
"This is all wrong, and I don't know what to do to make it right. They don't show this part in the movies and on the TV shows. This waiting and hoping, watching helplessly as you hurt and struggle to live…no one tells you about this. Everyday that I walk in here I close my eyes before I come through that door, willing you to be awake…to be better…and you're not. It makes me so angry. Not angry at you, but angry at everyone who put you here." Marshall kissed her fingers and laid her hand back on the bed as he leaned back in the chair trying to restore his composure and failing.
"I can't lose you, Mare. I think I might honestly waste away without you. I've learned to look at the world differently since I've known you and it would be a dull and colorless place without you with me. We've grown together in some weird fashion and now I don't think we could be separated without leaving pieces of ourselves behind, in fact, I may be so bold as to say we need each other. No one has ever understood me as you do, accepted me as you do, and I've never let anyone know me as well I've let you."
He chuckled slightly as a memory surfaced clearly, "I remember the smile on your face the first time some idiot pushed me too far. It was like you had just opened the best Christmas present ever and I was thrilled. A part of me I've always struggled with didn't have to be hidden from you and it was…I don't know…it just seemed right. We seem right."
Marshall sat and thought about that for a while, his brain turning over ideas and images as he relived their partnership. He was reminded of those desk toys with the clear and blue fluids in them. Separate due to molecular properties but existing in the same space. The liquids would swirl around each other, each moving seamlessly to fill any void left by the other. If you mixed them up, they would slowly become separate again, but there were little bits of each left embedded within the pair that would stay forever. He and Mary had been mixed up too many times…too many bits of him dwelt within her and bits of her infused him with something he did not want to give up. He came to a conclusion and stood to lean over her so he could whisper into her ear.
"You have to fight, Mary, because I'm going to fight for you. I don't know how that's going to look, but I'm going to be the one standing at your side when this is all done. I love you…and I'm not going to let you go." Kissing her temple, he sat back down in the chair, grabbed their book and began to read.
The pneumonia was tenacious and Mary fought the infection for the next three days before showing signs of improvement. Luckily, with all the antibiotics on board, she didn't develop an infection in her gut and her wounds were healing as expected. They kept her pain and sedation drips adjusted to account for her increased wakefulness, and sometimes she would just randomly open her eyes to stare at the ceiling. Marshall could tell she wasn't really seeing anything, but being able to look at her eyes was somehow comforting and encouraging. Not surprisingly, she had a habit of trying to grab her breathing tube when she was awakened and the staff was worried she'd yank it out if she could. He had learned that she was initiating all her breathing on her own, thus the change in the ventilator setting, but still needed the machine to help her get enough air with each breath. She was too weak to do that yet, and it would be dangerous for her to pull that tube out.
Kelly said her lungs were finally sounding a bit clearer and she wasn't coughing up as much…her nurse seemed optimistic, and Marshall gauged his own level of optimism with hers. He and Eleanor had taken it upon themselves to learn as much as they could about the new words and terms they heard everyday; sedation vacation, extubation, pressure support, anoxic brain injury…
The last term is the one that worried Marshall the most. No one really knew how long Mary's brain had been without sufficient oxygen when her heart stopped, and no one could tell them if she'd ever fully wake up again. The thought of her lost forever in there actually caused him physical pain. He knew she wouldn't want to live like that and prayed fervently for either full recovery or release. Every day that went by without the nurses and doctors being able to get Mary to follow commands weighed on everyone. They knew she could move everything as she was often restless and shifted her arms and legs around randomly. She would reach for the tube with her right arm, but that was the only purposeful movement she had made so far.
One of her doctors had stayed to talk to Marshall one evening and tried to give him more hope about his partner's condition. The doc said Mary was young and healthy with a strong will to live, based on her ability to already survive what would've killed most people, and he truly thought she would wake up on her own time. Her body had some pretty severe damage, and conscious thought was usually the last priority of your brain when it was trying to just heal. It didn't make Marshall feel any better, but he appreciated the information and the doctor's time.
He was relieved to finally see that she was more comfortable as the infection resolved, not coughing as much and able to tolerate a little less sedation without becoming agitated. He sometimes worried that she was in pain, but Kelly told him they watched for that by monitoring her heart rate and blood pressure, and Marshall trusted her enough to keep Mary from suffering. He stroked his partner's forehead as she frowned and realized the swelling of her face and hands had gone down significantly. Marshall decided that must be a good sign…he'd take anything at this point.
"Keep fighting, Mary," he'd say every night, "You're almost there. Come back to us."
He ran into Raph one night as he was arriving, surprised to see Mary's fiancé there so late. Marshall certainly hoped Raph was leaving as he wasn't planning to share his time with Mary.
"How are you holding up, Raph?"
"It's hard. I want her to wake up…but I guess that's what everyone wants. Have you been here every night?" eyeing Marshall with a look that wasn't quite clear as he gathered his things.
"Yes. I thought it would let you and her family rest better if you knew someone was with her during the nights."
Raph nodded and muttered, "Thanks" as he walked by Marshall to exit Mary's room. Stopping, he turned to the tall man and asked, "Do you think she'll want to go back to this job once she's recovered?"
The question was loaded with doubt, hope and just a frisson of fear. Marshall stared at him for a moment before replying.
"I have no doubt in my mind she will be back doing just that as soon as she can. It's who she is."
Raph gazed at Mary with a look of longing and sadness. "I've just been sitting here and thinking. I don't know if I could go through this again…knowing it might happen again. To watch her walk out the door everyday not knowing if she'll come home…"
There were a few minutes of silence from the two men, punctuated by the sounds of the machinery surrounding them. Marshall finally spoke.
"That's something you should spend a lot time thinking about Raphael. You can't live in fear…it'll destroy you both."
After a few more minutes of contemplation, Raphael just turned quietly and left, Marshall watching after him and noting Mary's fiancé hadn't even told her goodbye.
He took up his usual spot next to her bed and held her hand in his, "I'm not afraid, Mare."
*** Waiting, waiting, waiting...it's exhausting. Every baby step forward is small celebration. Please keep reviewing...it keeps me encouraged!! ***
