AN Thank you for seeing yourself to the next chapter and thank you for taking your time to reading my work.
Neal was on the 5th floor an IV attached to his arm lasiks and beta blockers pumping through his system. El sat next to the bed finally getting into the room after Neal had come back from a chest X-Ray only an hour ago. Neal was still being given oxygen it was good because he was weirdly winded still it seemed.
El had her tablet with her and according to the Mayo clinic a complication of VSD was Eisenmengers syndrome. Eisenmengers syndrome it seemed wrong that because Neal was diagnosed when he was older that he would get this irreversible complication. The doctors had suspected it but the wanted to make sure with a stress test and the X-Ray would give them a clearer picture. They had already done an echocardiogram and MRI but it was still being looked over by Dr. Faux.
El was saddened by this possibility she really hoped that Neal didn't have this syndrome that couldn't be reversed. It wouldn't help that Neal was within help but that the damage had been done. Eisenmengers syndrome was deoxygenated blood sent throughout the body and was supposedly seen throughout childhood not through adulthood so if it was she would have seen it for years.
Peter was sleeping on the small couch in the back of the hospital room a case file on his chest so as not to get bored. The small snoring coming from him made her smile a little. She was still reading up on VSD with everyone around her sleeping.
There was a slight knock on the sliding glass door before Dr. Faux came in with her smile and walked over to the computer terminal. She pulled up an X-ray she also tore off a print-out from the EKG attached to Neal. She smiled as if she knew something that had just made her immensely happy.
"I know it seems scary but I think Neal is doing better than we thought. His color is returning and the lasiks is bringing the swollen features down already. And I see that his X-ray is showing me something that I already suspected he doesn't have Eisenmengers syndrome." Dr. Faux noticed that El released a sigh or relief after telling her the news. "I think Neal is just under oxygenated because the hole is in the atrium where the blood mixes oxygen rich blood for oxygen poor blood. Then the blood goes through the body thinking that the only blood there is oxygen rich." Dr. Faux informed El.
"So either my blood is lost or its want to be a pauper," Neal croaked his voiced laced with sleep.
"You could say that," Dr. Faux smiled at her patient being awake.
"Hi honey," El kissed Neal on the lips feeling the plastic of the nasal canula as she ended the chaste kiss and returned to her seat.
"Hey you look as tired as I feel," Neal rasped to his lover she smiled at him.
"Well that's probably because your heart is doing extra work. Make a fist for me and let me show you something," Dr. Faux told Neal and El she pulled up the X-ray of Neal and pointed to Neal's heart. "See how big your fist is well normally that is the size of a persons heart in your case your heart is bigger than it should be." Dr. faux pointed from Neal's heart to the fist he had made just for this point.
"Well that makes sense," El answered for both of them.
"You see this," Dr. Faux asked the couple who apparently made up the other half of Neal's relationship. "This is not supposed to be there it looks normal until we look at your EKG and the echocardiogram it shows a hole in the atrium the upper part of the heart." Dr. Faux switched to a moving image of Neal's heart with all its lub and dub sound. She then pulled up a MRI shot of Neal's heart where you could actually see a small tear in the middle of Neal's heart.
"Pulmonary," Neal spoke to himself before he looked to the room at large, "When I was younger they thought it was in the pulmonary artery you think atrium?"
"I'm thinking that the septum has a whole and that I want to fix it but yes I'm pretty sure the upper part of the atrium. I'm going to schedule you for a stress test and then I'm going to talk to a few of my colleagues. I'm pretty sure I'm on the right track but I want to be sure. I'm going to send someone to talk to you about options for fixing this hole. I know it's scary but we found the problem and now we're going to fix it. You would be surprised but this condition is not fully diagnosed until people are adults a lot of the time." Dr. Faux added as an after thought to her patient.
"Mhmm," Neal responded as he thought over everything she told them.
"Good I will be back in the morning for the test why don't you get some sleep and we can talk more in the morning," Dr. Faux said as she signed off and went to close the glass door heading for the nurses station.
"You need to get some sleep why don't you take him home. I know he won't sleep well but why don't you let Satch out get out of here come back tomorrow," Neal pleaded to El.
"It's not that easy to get rid of us, Neal I left Satch with Diana and I have a bag for me and Peter. We will leave but when you leave too honey," El assured Neal as they spent the night with Peter snoring in the corner as hospital staff came in and out of his room.
When Dr. Faux administered the stress test Neal lasted 10 minutes before he had to stop and be given extra oxygen for the rest of the day. By the end of that day a cardiothoracic surgeon was brought in on his case and shown to Neal's room.
WC
"Mr. Caffrey?" a young surgeon asked before entering the room fully.
"Present," Neal answered looking up from a case file that Peter had left while he returned to work today.
Peter would be back later so would El. She didn't want to leave but she had an important client she would be back as soon the client meeting was over and the rest of her schedule could be rearranged with Yvonne.
"Good just making sure, I'm Dr. Pan I wanted to talk you about surgery options for correcting your heart." Dr. Pan greeted. He sat in the chair near Neal and showed him a picture of a heart and another picture of an abnormal heart it looked weird to Neal.
"So you know how to fix it or will I have to be on medication for the rest of my life," Neal asked he knew that he could be on medication which might mean he could be going back if he couldn't go undercover.
"I think that with my skills you could be back to work within the month at the latest. On desk duty within 3 weeks none of this undercover operation stuff in the FBI I watch on TV. I would like to do open heart procedure to fix this defect on the right atrium you're too old to do a catheter procedure." Dr. Pan pointed out as he circled a small tear between the heart valves in the right side and left side of the heart picture. "When this is all said and done your heart will be back to normal like this one," Dr. Pan tapped the other picture.
"Okay so what does that entail," Neal asked and Dr. Pan explained.
WC
"So he cuts you open and stitches the hole closed," Peter asked when he got back that day Neal told him all about what the surgeon had planned.
"Well yeah but it's the one the surgeon wants to do because the hole is higher and he says I'm too old for the other procedures," Neal told Peter who seemed to blanch at the idea of surgery on his partner.
Peter started to pace but a hand on his shoulder stopped him he turned to see El. El smiled at him and gave him a quick kiss she knew he wouldn't truly calm down until Neal was safe.
"I know this isn't easy but we just have to get through this because Neal needs us," El calmed Peter so they could sit beside Neal.
"I'm going to be fine but we have to just wait and see and I know how much you hate that," Neal told Peter. He hated waiting too probably about as much as Peter if not more it was why he hated the van.
"Okay we wait and see after the surgery, when is it scheduled tomorrow?"
"Yes at 8 p.m. then I should be home by Saturday and we can all sleep a little better," Neal soothed his lovers kissing them softly.
WC
"Ready for me," Dr. Pan asked in all his surgery garb as he saw Neal wheeled into the operating room.
"Well if not this is going to be really awkward," Neal told the surgeon feeling not as confident as his words.
Neal had been shaven, his chest was now hairless and there had never been any hair on his chest to begin with but now there really wasn't. He was not fine with the idea of surgery much like Mozz he hated hospitals but for different reasons.
"So I'm going to start with introducing the room and then we're going to start the surgery okay," Dr. Pan seemed to ask but then people started talking about names and titles
"Dr. Pure anesthesiologist," Dr. Pure said as he began setting up an IV with general anesthesia readying the general.
"Pam surgical nurse with assistance of Vanessa and Lacy," Pam smiles at the young man named Neal as she pulled a surgical tray closer to the operating table and pointed to Vanessa and Lacy as she named them.
"And these are two surgical residents who will be assisting me Neal their names are Dr. Green and Dr. Mote," Dr Pan pointed to the two surgical residents who entered the room and where having their scrubs wrapped in surgical garb by Vanessa and Lacy.
"This is the part where you tell us your name and why you are here today," Dr. Pan requested of what he was pretty sure was his patient.
His mentor had instilled the surgery checklist though so he went over it anyway mainly because it normally saved a few lives with the last two questions. The other thing that he used this checklist for was to remind everyone in the room that Neal or any patient on his table was a human being with a life.
"Neal Caffrey, ventricular septal defect to be fixed by open heart surgery," Neal tentatively told the room at large because he was scared right now he felt just so vulnerable.
He was not shy he was just scared and he was about to undergo surgery for something that he figured was he knew stupid to think but a part of him. That was his last awake thought as the anesthesia did its job.
"Are there any concerns by the staff at this time," Dr. Pan asked the room at large he looked at the residents, the surgical nurse, and the anesthesiologist didn't look like they had any concerns.
"I think we should get some more blood I don't like only having one bag of A+ for back up," Vanessa piped up, Dr. Pan smiled at her. He expected that one from someone he was going to have called more up from the blood bank if no one had said something he would have.
"Go call for three more pints and then we can get started," Dr. Pan assuaged Vanessa worries as well as his own and then saw Neal start fading as Dr. Pure pushed the general into his veins.
"Today is a good day to save a life," Dr. Pan remarked with his motto as Pam and Vanessa began to scrub iodine onto Neal's right side of his chest and then draped Neal in paper sheets.
Neal didn't stir when his mouth was opened and Dr. Pure intubated him, he didn't stir when Dr. Pan made a cut down the midline of Neal's chest. Neal didn't feel the muscle and skin being ripped open by the scalpel cutting through flesh.
"Bone saw," Dr. Pan asked of Pam who then placed it right at the start of the breast plate.
"It's looks good no excessive bleeding from the bone," Dr. Green told the surgeon as he placed retractors so he could spread the ribs.
"Ah the pericardium is here, it looks good, let's cut away the sack," Dr. Pan asked for the scalpel as he saw the first glimpse of Neal's heart.
"Oh well hello gorgeous," Dr. Pan talked to the heart like it was a living being and in a way it was, "okay let's connect him."
Dr. Pan switched the heart and lung machine on and the blood supply disappeared out a tube then the heart seemed to shrink. The heart still beat through the small amount of blood from the capillaries it was significantly slower though. He clamped the aorta isolating the circulation from the heart it was sad but he had to stop Neal's heart to fix it.
"Ready with the potassium," Dr. Green held out what Pan had just handed him to Dr. Pan
"Okay we have the flush done now bring me the cold water," Dr. Pan comanded to the room at large as the machine was connected to Neal and the machine took over working for Neal's circulation.
"We have a response," Dr. Pure said as he looked at Neal saw the rise of goose bumps on Neal's spread arms.
"Shivering," Dr. Pan asked finishing with the water to protect Neal's heart.
"No just goose bumps please note it Lacy," Dr. Pure asked of Lacy the nurse recording for the doctor's reports.
"Yes Doctor Pure," Lacy chirped she was such a secretary sometimes and less of a nurse.
"When opening the atrium let's make sure that he doesn't bleed to bad okay." Dr. Green joked because they new it was an impossibility to not have Neal bleed when cut.
"We're ready to proceed with the closing of the defect," Dr. Pan said to the room at large as he started to stitch together the hole in Neal's heart.
Dr. Pan stitched the atrium back together and hoped that the polypropylene was going to hold. With time Neal would heal and the stitches would disappear and hopefully his patient would just think of this as another experience.
"Release the clamp and let's see if our stitches hold, take note of the time Lacy," Dr. Pan ordered the nurse. He looked down to the chest cavity he rubbed the heart muscles with his fingers hoping he didn't have to restart Neal's heart it had been going so well so far. He watched as Neal's heart beat for the first time not mixing oxygen rich blood with deoxygenated blood.
"Okay tell me about the levels Pure," Dr. Pan asked his colleague.
"He is holding steady at 97 on oxygen and rising now, we have a good pressure I see no reason to keep him on the machine," Dr. Pure gave his recommendation to switch Neal off the heart machine as he saw improvement from where he had been 30 minutes ago.
"Okay then Dr. Mote will you close," Dr. Pan asked his resident who he knew had a good record with closing.
"Yes," Dr. Mote eagerly answered smiling behind his mask for the opportunity.
Dr. Pan closed the tubes and let all the blood flow back into Neal letting the heart take over. Neal's heart took over without a hitch. He closed the pericardium sack and then let Dr. Mote take over.
Dr. Mote was not a heart surgeon he was in fact a double study in surgery of the bones he thought he would be the next Denton A. Cooly, the inventor of sternal talons. The sternal talon replaced sternal wiring that would often move or break and be more harm than good once the sternum was broken in surgeries like this.
He measured the bones separation when he released the spreader between Neal's ribs. He was pleased to see that Neal was a good candidate for the sternal talons instead of wiring or screwing his chest shut.
"First set of talons please Pam," Dr. Mote held out his hand as he left his finger over his visual markers. "Give me the next set, please," Dr. Mote asked of the matronly surgical nurse.
"Here you are," Pam smiled as she handed over the next two clips; she liked Dr. Mote he was always polite and interested in things like her son.
Dr. Mote placed 3 of the talons and pulled them close together. Pam handed him the tool used for tightening the talons. He did this in precise movements hoping to get the right tension that was needed and yet seem more comfortable if that was possible.
"Okay we're good can you hand me the polypropylene so we can stitch the incision closed," Dr. Mote asked.
When stitching it was like stitching was an art to Dr. Mote. As he made a pattern with a half inch spacing after that was done with the repair. Dr. Mote applied the bandage over the stitching asked Lacy to make a note of the time and saw that Dr. Pan and Green leave the room to scrub off the blood. Dr. Mote saw the transfer of Neal to recovery while Dr. Green disappeared to do charts and Dr. Pan informed the family.
WC
"Mr. and Mrs. Burke," Dr. Pan asked the couple holding hands in the corner, "Neal did great he came through the surgery without a hitch and now we're just going to wait for him to wake up."
"That's good news," El sighed with relief her shoulders relaxed with Peter next to her as she sunk further into him.
"I know you're anxious to see him let us get him settled in recovery then we can take you back to see him," Dr. Pan reassured the couple.
"Thank you doctor," Peter confided to the young looking doctor probably only a little older than Neal he realized.
Peter kissed El on the temple and rubbed her shoulder so he could hold her close. He wanted her close because he knew that El wanted the comfort as much as he needed it. It was a reminder that they where both still here for Neal when he would wake up and go home with them.
WC
"Hey honey," El cooed to Neal as she saw movement behind his eyes his breathing had hitched when he flashed those blue eyes.
Neal looked around the room saw the woman next to him and smiled as she came into focus the brown hair and blue eyes, El. He coughed in front of her, he would not recommend to anyone after surgery, El held a pillow over his chest which helped some then she poured a glass of water.
"It's okay, you're okay," El consoled her boyfriend as she said, "take small sips and hold the pillow to your chest it helps."
El remembered her uncle after having open heart surgery from a car accident, his chest had been wired. Neal apparently had clips and it was likely a lot different but the nurse had told her if Neal coughed that he should use a pillow over his chest. She had instructed that this pillow would help when Neal was in the car as well and apparently whenever needed for the first months.
"Hey you look tired," Neal rasped to El, "where's Peter?"
"He just went to get some coffee he'll be back in a second. It's Thursday so Diana and Jones are going to stop by after work," El assured Neal she stroked a piece of fly away of hair.
"Don't worry I didn't run off too far," Peter returned through the sliding glass door on the cardiology wing coffee in one hand a crossword puzzle in the other.
"Okay Mario," Neal mocked the fact that Peter hadn't shaved in 4 days and had started growing what was the beginning of the mustache.
"Hey I was worried don't get snippy with me about the Magnum PI impersonation," Peter sassed to Neal who smirked at his lover.
"I never liked the whiskers in the first place," El chimed in to the flirting.
"Oh I don't know you said it felt good on a certain part of your body," Peter reminded El of when he had the moustache in their first few years of marriage.
"I never said that part of my body didn't miss your 'stache," El smiled and let a little blush on her face.
"Okay now I'm lost," Neal informed his lovers.
"It's okay your tired and we'll show you when your ready," Peter winked at Neal.
WC
"Neal you awake," El asked as she looked in the backseat to see Neal fast asleep in the back seat of the Taurus.
Neal had been released today and it was Saturday 8 in the morning, the Burkes where taking him home and he had fallen asleep in the backseat. Neal had a pillow in between his chest and the seatbelt. Neal had a band aid on his chest hidden by a simple white shirt the rest of his outfit believe or not was a pair of old pjs. Neal had slept through the drive from the hospital to Diana's to pick up Satchmo and now he was sleeping just outside the house.
"I guess that answers that question," Peter yawned as he looked at Neal asleep.
"Come on let's get him up stairs and we can finally sleep for the first time in a week," El advised her husband as she left the car. She grabbed Satchmo's leash and Neal's bag from the back leaving Neal for Peter to get.
"Hey Neal wake up," Peter whispered to Neal as he crouched to his partner and saw those blue eyes with bleary redness behind them.
"I'm up," Neal rubbed his face with his hands and unhooked his buckle.
"Good we're going to go upstairs and sleep the weekend away how do you think that sounds," Peter asked as he helped Neal stand and start walking up the front stairs.
"I would make a kinky joke about spending all day in bed but I'm too tired, yes that sounds good," Neal kissed Peter chastely as they slowly made their way up the stairs where El already was pulling back covers and placing pajamas on the bed for her and Peter.
WC
"Hey honey," El smiled as Neal walked down the stairs on Monday unaided.
"Hey my love," Neal smiled carefree at the most beautiful woman known as El.
"You want some breakfast, oh don't bother looking for Peter he already left I'm staying home with you today he gets tomorrow and Thursday I get Wednesday and Friday then we all get the weekend again." El informed Neal as she brought a bowl down and handed it to Neal.
Neal pretty much didn't really feel like eating too much it was morning and he was not allowed coffee, it was sacrilegious. He smiled as he heard he wouldn't be left alone he didn't need a babysitter but he knew that his partners cared and worried over him.
"I liked the weekend we slept and watched a good movie or at least you two did sorry I fell asleep during." Neal apologized though he knew El would wave it off like she did that second and kissed him deeply leaving him wanting more.
Neal blinked and found that he loved El deeply but doing anything would be a terrible idea. He wasn't that impulsive he had tried sex once with broken ribs not something he would recommend. He ate his bowl of fruit for breakfast as she ate her cream of wheat with a little cinnamon.
"So I was thinking Mediterranean for dinner if you feel up to it could you help me cook Mr. Sous chef," El pleaded her loving boyfriend.
"Trying to keep my heart healthy I see, how could I say no love," Neal sealed the promise with a kiss.
El and Neal finished their breakfast then watched a movie it was an old murder mystery classic called "Dial M for Murder." Neal fell asleep once the movie was over and "Witness for the Prosecution," started which El watched and then woke Neal to take his antibiotics.
By the time it was 5:30 Neal was helping cut up some tomatoes and spinach for the added flavor to the chicken. El was sautéing some chicken in olive oil and when she was done with the initial cooking she added the tomatoes and spinach. El gave a quick kiss as he moved onto the salad.
Neal was setting the table when Peter walked in the door with a box of case files and a smile on his face at seeing Neal up. Peter still saw that Neal was pale and exhausted but he saw that the weekend of sleep had done vast improvements on his appearance.
"Hey hon," Peter laughed at that he meant both his lovers when he said that sentiment.
"What," El asked when she set the salad down.
"Nothing it's just a goodnight to be home," Peter told his lovers before he set the case files down and went to sit down for dinner.
WC
"Neal it's time for your meds," Peter shook Neal awake.
"I'm up," Neal answered the summons to wake up.
Peter handed over the pill bottle which Neal opened and took them with the glass of water offered to him. Neal looked up and saw concern in Peter's eyes he wondered what was wrong. Peter answered his question of what was wrong before he asked though.
"You where talking in your sleep just wondering if you forgot the bad dream," Peter inquired because Neal had screamed before he started to stir.
"No I think maybe it was the plane but other than that I can't remember anything else," Neal admitted to Peter.
Peter turned down the TV volume with the game on, "Want to talk about it."
"Not really mainly because I don't remember it," Neal explained as he sat up on the couch and pulled what he assumed was the afghan from the back of the couch closer.
"Cold," Peter asked innocently enough but he got a disapproving look from Neal for his question.
"Don't be a hoverer I'm not that cold and no I don't have a fever," Neal scolded Peter before giving in a little with a smile.
"Okay," Peter gave in and raised his hands in the air before sitting behind Neal and turning up the game again.
"Who's winning," Neal dutifully asked Peter about the game it was boring but it was lulling him to sleep.
"Well we're up 4 and the other guys are scratching their heads you know today was almost a wash out game," Peter told Neal after giving a look of his own one that said 'you care are you sure you're not running a fever.'
"Mhmm," Neal lazily responded Peter before yawning and leaning his head against Peter's shoulder.
"Love you, you know that."
"Love you to and don't you forget that," Neal finished the sentiment before lazily watching the game with Peter.
THE END!
AN I hope you have enjoyed this attempt at filling a lovely prompt from a lovely author.I love you for reading and thank you if you comment but mainly thank you for time. One last thing I like hurt comfort Neal especially fever Neal so I'm going to be going over old prompts see you all soon
-Solce.