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 turns a pasty white and then it happens...CODE BLUE.
The ambulance jerks to the right and suddenly both men are working on their patient. Abby's car also makes the stop, and immediately she exists. Something is wrong with Tony, something bad, she can feel it and is assured that is the case as Ducky exits the back of the vehicle.
Dave immediately exists the emergency vehicle and jumps inside to assist Steve, their patient in in V-Tach, a lethal rhythm, and he has also gone into respiratory arrest, a common problem with GI bleeders. the pressure builds up in their gut, causing strain on the other systems, the heart and the lungs. The distention can also lead to lethal arrythmias and respiratory arrest, their patient was doing both. Tony's gut was definitely distended now, he was in dire need of surgery.
"Dave, did you call for back up?" Steve shouts as his hands start compressions on Tony's bare chest, the cardiac leads screaming that the rhythm on the monitor is not conducive to life.
Ducky now stands beside Abby, both observers to Tony's plight, a life and death struggle. They stand in stilled shock as they watch the men attempt to save their friend's life.
"They're on the way with assist." Dave replies as he slaps the defibrillator pads on Tony's chest ,the monitors scream for them to do something, to shock their patient.
"Clear!" Steve shouts as Dave removes his hands and reaches over for an intubation tube, wanting to get his patient breathing again, time wasted was brain cells dead.
Dave places the paddles over the pads and hits the button to shock. both men watch as their patient's body lifts off the stretcher, the monitors still screaming, his heart still in a lethal rhythm.
"Again!" Steve yella, keeping his partner's hands clear of Tony's chest for one more shock.
Again their eyes were plastered to the monitor, and finally they have it under control, "Sinus Rhythm!" Dave breathes a heavy breath, thanking God above that his patient now has a viable reading.
"Ducky!" Abby screams into the medical attendant's shoulder, tears streaming down her face, smearing the once prestine make that she wore.
"Now, now dear Abby, we must be his strength right now. Don't give up on our Tony, he is tougher than this, you will see." Ducky comforts, wanting Abby to hang on to hope, hope that was quickly fading for their friend.
"He's still not breathing though, let's intubate!" Steve orders and looks over at the frightened people who had just witnessed their best friend's life and death moment.
His hands stayed busy though and his attention only focused on getting his patient to restart his breathing, and they were do it with little success.
"Any significant medical history?" Dave shouts to the medical examiner as he positions himself over Tony's head and tilts it backwards, taking the larygyscope and with the attached light guids the tube into Tony's trachea. Dave then administers a couple of good breaths with the ambu bag, Tony's color pinks up rather significantly as Steve attaches the tube to a portable ventilator.
Ducky gently pushes Abby back and approaches the vehicle again and with a most serious voice he answers the paramedic's question. "He had pneumonic plague four years ago. He almost died." Ducky delivers to them the unbelievable information, hoping they would not think him senile.
Both men stop their actions, the news stuns them, well, it actually scares them. Their patient has probably very damaged lungs from the disease.
"The black death? This man had the plague and survived?" Steve questions suspiciously, his eyebrows raised in disbelief, the other man also wondering if the older medical examiner has misspoke.
Ducky nodded, as did Abby. "Dr Brad Pitt is his Pulmonologist, he should be notified right away of Tony's condition."
"This could be rather significant, especially given his respiratory status. How bad were his lungs scarred?" Steve asks, now worried that they had to place the man on a ventilator, wondering inwardly if he would be able to be weaned off successfully.
"Badly, I'm afraid. Tony has had multiple bouts with pneumonia, laryngitis and sinus infections since his occurrence with the black death, but never anything life threatening." Ducky gave them the disturbing news, his own concerns evident in his no longer monotone voice, it was now filled with emotion, Tony's near brush with death had greatly effected him.
Abby still stood beside Ducky, holding onto his arm, a tight grip that she couldn't break, she had witnessed Tony's second round with death, she wondered if the third time would be the final blow. She closed her eyes and prayed that he would be okay.
"This episode of arrythmia and respiratory arrest is due more to the internal bleeding than anything else. I do need to notify the hospital, they need to know about his lungs, they will need to pull his medical records. Dr Pitt will also need to get involved after surgery." If the man lying on the stretcher actually made it to surgery, he thought to himself, knowing that the bleed was bad, the monitor readings proof of his suspicions.
He continued to monitor his patient's readings, worried about the lowering blood pressure, his inability to breathe on his own." he picked up the radio and started calling the main Emergency Room at Bethesda, he needed further instructions.
When the second ambulance arrived a third man jumped out and ran to the vehicle, taking the driver's seat, he knew his purpose. " Ready to go Steve?" the man at the wheel asked, wanting to make sure the patient was secure and the doors closed.
"Let's go! We have a critical here!" Steve replies as he closes the doors to the back of the cab.
Ducky and Abby quickly get into her vehicle, they would follow, both afraid that Tony might not make it this time, both knew it be a difficult struggle for Tony to survive.
"Have you called Jethro?" Ducky asks, already knowing the answer to the question.
"He's on his way." Abby spoke softly, her voice a mixture of tears and fear for her friend.
Bethesda Hospital
The ambulance pulla into the Emergency bay area and as they start to unload their patient, Tony, the paramedics know the condition of their patient is critical, and the staff at Bethesda also know and are ready to react.
The team of emergency medical workers are already outside waiting for their patient to arrive, ready to care for the very ill federal agent, chart pulled, typed blood ready to hang and the surgical staff os ready to operate, all they need is their patient.
As the doors to the back of the emergency vehicle open the emergency staff is already at work, grabbing the stretcher and guiding it past the doors, past the ER area and into the surgical area. The surgical medical staff is also ready, placing an identification band on his wrist, hanging a bag of blood with a pressure cuff around it, pushing in the blood as fast as they cab get inside his veins. A rapid infuser being set up for the surgery that would take place in just minutes,
The surgical team wasted no time taking their patient into the radiology area first though, the certified team ready to do a cat scan of Tony's abdomen, then as they finished they rushed his body into the surgical bay area to place him on a ventilator, gather new vital signs and to assess him one last time before taking inside the surgical area, time was of the essence, Tony was bleeding inside his abdomen , time was definitely a factor.
The CT scan results were immediately read and the surgeon was now making the first cut, the staff all in place to do the best job for their patient, Agent Anthony DiNozzo Junior.
Thought this chapter would do you for a while today...more later if you ask...I am willing to please.