[Update: 11/2017 - As I'm working to edit through these beginning chapters, this is the one that will likely show the most change in storyline. Reason: I have actual healthcare experience now so what I wrote before isn't exactly feasible. I hope if you're reading this through again you enjoy the much better writing]
Whoa - am I missing something? This editing page is really different.. hmm.
So sue me. I FINALLY got around to updating, what with all the hullabaloo going on in "First Comes Love..." I thought for awhile about scrapping this but something kept me from doing it and I'm not sure what.. (cough.. ITB.. cough)
Just to warn, this chapter features a bit of strong language. It is rated M, after all...
Jack and Katherine Corrigan (c) Me.
Everyone else (c) Atlus
DID YOU GUYS SEE THE NB WEBSITE?! OMG, YOU KNOW ALL THOSE BLANK CHARACTER SPACES ARE FOR DEREK AND CO.!
Or crack patients, one of the two :)
(Extra disclaimer - i tried to keep everything as real as i could in here, but didn't feel like doing a lot of research because i would've never have written the chapter.. so, don't be like, "that couldn't happen!" because i will unleash my posse on you. And yes, i just used the word posse..)
Derek, Angie, and their staff surveyed the damage. A medium sized dagger had been buried in the woman's flesh, the black handle sporting a very unique design.
"I don't think I've ever seen something this intricate in my life." Derek started, lowering his top half to inspect the design more closely.
"It looks to me like a dagger for some sort of martial arts, Doctor." Angie replied, catching Derek's attention while she continued. "The studio where I go for Aikido has other classes where people use things such as this, and the handle to this one looks like it could be for that."
"We're ready for incision " Cybil interjected, organizing her supplies at the head of the bed. "Work your magic Stiles."
Cybil lowered herself into a chair behind the patient's head, fingers twirling and fiddling with knobs on the anesthesia machine. She looked at the monitors and began charting on the computer in front of her, paying no attention to Derek any longer. He had been concerned that something disastrous would happen during her transfer to the OR table, but now that she was anesthetizes, he allowed himself to breathe a momentary sigh of relief.
After a deep breath, Derek raised his head to look at Angie, who was still extending her hand toward him with the scalpel and raised eyebrows, waiting for him to accept it. Her stare was more loving than he was used to and lingered once again on him, allowing his mind to briefly skip back to the moment they shared in their office - even in the presence of a woman who was millimeters away from death. He broke their stare to reach forward and pull the scalpel into his possession, attention shifting to the wound in front of him.
"Okay, from what I can see here…" Derek started, speaking out loud while he moved around to get a panoramic view of the entry wound. "It looks from the curve in the handle that the edge is facing inward, but because we don't know the curvature, it's hard to say what it's in contact with…"
Derek placed the blade of the scalpel on the edge of the wound and pulled it downward just slightly, he and Angie peering down into the wound to attempt to see the width of the blade.
"Because of the position of the dagger and the size of its entrance wound, I would say that the knife most likely has a slight curve to it, though it looks like the width of the blade stays uniform." Angie said gently, still examining the sight in front of her. "You should probably lengthen the cut laterally so we can pull the blade away from her vasculature and try to get a better look."
Derek nodded, changing his grip on the scalpel to get ready. Angie drained the excess blood around the area and he placed the blade at the far corner of the incision. His pointer finger pressed down and slowly pulled toward himself, layers of skin and subcutaneous tissue separating underneath him as he calmly lengthened the incision. However, calm quickly turned to panic as he heard commotion from the head of the bed in his periphery, followed by a uncharacteristic shriek from the woman working up there.
"Derek!" Cybil shouted, causing him to whip his head in her direction, startled. "She's having a reaction to the anesthesia, you need to do something, FAST! You!-" she yelled, pointing at the circulating nurse, "page overhead for anesthesia, STAT!"
Derek shot his gaze over to Cybil, who was moving a mile a minute and unable to pay attention to him.
"What do you mean she's—"
"End-tidal is through the roof, tachycardia, nothing is working – I think it might be early MH!"
"Malignant hyperthermia?!" Angie yelped, her head flipping between Cybil and Derek who both looked panicked. "You can't be serious!"
"Does this look like something I would joke about?!" Cybil fired back, ripping the oxygen tank from the anesthesia machine and beginning to hand-ventilate the patient with an ambu bag, other hand pushing sedatives. Quickly a team of people from the anesthesia department descended on the room to assist her, commotion growing."
"We can't afford to stop, though!" Derek shouted back, now required to yell to be heard over the commotion. "This is literally life or death, here!"
"We'll handle it, just get going! Get that knife out before there's damage and you can slow down then!" Cybil replied, working quickly with her team to administer medications and attempt to cool the patient to the best of their ability. Derek quickly shot his chocolate eyes downward as his hands dropped the scalpel onto Angie's tray, one hand bracing itself on the table and the other on the handle of the dagger as another shout spurred his movements forward.
"You're running out of time, Stiles!" Cybil warned, fumbling furiously with her monitor as it beeped out of control. "She's going to burn through this paralytic in no time – we can't keep up!"
"I'm going to pull toward me and try to slide it out – just keep pressure on the opening, okay?!" Derek nearly shouted at the assistant who was only inches from him, pressure of the situation getting the better of his nerves.
"On it!" she confirmed, reaching to her tray to grab giant handful of gauze. She placed it at site of the incision as Derek wrapped his other hand around the blade, pulling back and towards himself. He watched as Angie's green eyes widened even further behind her surgical goggles as a screaming pitch fired through the room, causing an instant panic.
"We're in V-fib!" Cybil yelled, sending one of the anesthetists in a mad dash toward the crash cart toward the back of the room. She quickly returned with the defibrillator and rolled it next to Angie, who turned the dials to the correct charge, prepared to shock the patient on Derek's call.
Briefly her eyes flickered downward to the woman in front of them, who was still tightly held down by a head brace and bondings down at her feet. The gravity of life or death procedures was never lost on Angie, always bewildered by the fact that patients could lay motionless on the table, completely unaware of the state of peril they were in.
"No, Angie… wait!" Derek yelled just as she dropped the gauze pile and pulled the paddles into her hands. "She convulses from that shock and the knife transects her whole aorta. We've got to get it out, NOW! Put pressure on the wound for me, let's GO!" he barked, the paddles clattering back on the crash cart as Angie nearly threw them to jump straight at his orders. "I can't just rip this thing towards me – I have to be careful, we still have no clue what this thing looks like!"
Feeling the all-too-familiar pressure to move quickly with limited time, Derek activated his Healing Touch, casting a thick hue all about the room as his colleagues still worked through the emergency, but slowed considerably. Both hands on the knife Derek turned immediately to the monitor, the sickening tracing of ventricular fibrillation pushing him to move as fast as possible – she needed defibrillation urgently, but definitely didn't need to exsanguinate in the process.
One hand held the handle of the dagger steady as Derek drove the fingers of his other hand into the woman's abdomen just next to the sharp side of the blade to search for its end. Locating it would allow him to better discern its shape, and hopefully, the leverage from holding it at both ends would assist him in swiftly pulling it back and out of her.
There wasn't much time left before sustained cardiac arrest would result in massive damage to the patient's body, and then it would be all over. As his fingers maneuvered through muscle, tissues, organs, fat, and blood to reach the bottom of the knife, his eyes finally spotted the abdominal aorta, the tip of the curved blade resting against it – intact, but with a slight nick on its wall.
"Man, they weren't kidding…" Derek muttered to himself.
Sweat trickled down his forehead under the hot light and his brain throbbed, a sign that his Healing Touch was quickly giving way. All he had to do was get to the bottom of the knife and pull it away from the artery before something devastating happened, though he wouldn't be so lucky.
"She's vomiting!" he heard Cybil yell from his left, her suction turned on as she attempted to clear it from the patient's mouth.
The world around him suspended in slow motion, Derek just watched as the abdominal muscles around his hands slowly tensed, the patient's body beginning to move. And just at that moment, the Healing Touch expired: half because of his exhaustion, and half due to the shock of it breaking what little concentration he had left. With his fingers just grazing their destination, Derek watched in real time as the woman's abdomen suddenly spiked upward. To his horror, he had watched as the convulsion pressed the aorta up against the blade of the knife, slicing into it before he could even think to react.
"DAMN IT! DRAIN, NOW!" he screamed at Angie, who practically threw the drain at him with eyes wide and panicked, blood now pouring from the patient's abdomen faster than the suction could collect it. It gushed out and over the sides of the bed, covering Derek and Angie with it as they frantically attempted to take control of the situation.
"What happened?!" Cybil yelled, noting Derek's normal stoic control had given way to panicked movements as he attempted to keep up.
"It transected the fucking aorta!" he yelled as he pulled the dagger back and out, pitching it over his shoulder and to the floor. "Hemostats!" he called out, Angie slapping them into his palm as she reached over and held the drain for him.
"We need a shock or she's done, Derek!" Cybil said, her words falling on deaf ears as Derek tried to concentrate.
"Dammit, don't do this… Don't DO THIS! You hear me?! You're NOT going to die – NOT LIKE THIS!" he snarled at his patient, attempting to find the aorta through an insane amount of blood in order to clamp off the flow and try to repair the damage. His actions remained quick and urgent but he began to feel an energy change in the room as his coworkers slowed their motions and conceded that no more could be done. Somewhere deep inside Derek knew it was all over – that she had likely already lost her entire blood volume – but he continued to work until he heard Angie's voice, soft and shaky.
"Derek. She's in asystole."
Derek's heart sank like a weight as he shot his gaze to the monitor, wishing that it was still screeching instead of boating that monotonous tone that chilled him from the inside out.
"No, there's got to be something I can do – the knife's out! I'm not done!"
"Derek." Angie repeated quietly, tears in her eyes as she stared at him, his attention slowly lifting toward her. Everyone in the OR remained motionless, watching Derek as his and Angie's eyes did silent battle with one another, until he finally dropped his shoulders in defeat. Gently, he removed his hands from the patient, dropping his tools onto the tray that Angie had waiting with a loud clatter that rang through the otherwise silent room. He took a step back and removed his scrub cap, shaking his messy brown hair loose before casting a quick glance up to the observation deck, where Sidney watched solemnly, a look of sympathy evident. The staff all recognized that they were powerless against the preceding chain of events, though losing a patient still cut through every one of them like the bloody knife that now laid on the ground.
Derek pulled down his mask until it hung loosely around his neck, all occupants of the room still watching him. He looked at Angie who was crying out of sympathy for the woman and for those who had worked so hard to save her, especially Derek – she knew from the few times it had happened to them that nobody took this harder or more personally than him. She could already see it in his eyes as they remained on her, before he cast his glance over to the clock at his left.
One by one he ripped off his bloody gloves and threw them forcefully on the ground, dropping his hands to his sides as he clenched them into fists.
"Time of death… 20:51" he muttered.
Silence filled the room for only a brief second before it was broken again.
"Son of a FUCKING BITCH!"
In an uncommon display of rage for the normally reserved surgeon, he screamed the above statement before one of his balled up hands cut underneath the cool steel of the surgical tray and pitched it off of the stand and onto the floor, tools scattering everywhere with an earsplitting crash. The staff in the room immediately jumped back except Angie, who only started to cry harder, heart full of anguish for her doctor in a moment she knew ripped him apart inside. Without looking at anyone, Derek paced briskly towards the door with his hands still balled into fists and punched the light wood in front of him, sending the swinging door flying into the wall behind it with a loud bang.
Standing in silence for a few moments, the remaining staff of the OR began to clean up the mess, all of them out of words to say. Angie turned her head up to Sidney who motioned silently towards the door, suggesting she go after Derek. She nodded in understanding and after cleaning up a few things, Angie walked slowly out of the doors of the OR and cut the corner into the prep room, where Derek had already peeled off his coverings and was scrubbing viciously at his hands and arms with his back to her.
He shut off the water and rested his hands on either side of the sink, hanging his head.
"If I would've worked faster… if I would've been paying more attention and I hadn't let the Healing Touch lapse… maybe she'd still be alive."
Angie's eyes widened as she paced slowly into the room, removing her gloves before fiddling with her fingers.
"How did you know it was me? I didn't make any noise and I'm not wearing heels today…"
He spun around to look at her with a look of failure plastered on his face, robbing it of its usual happy-go-lucky style.
"Had a feeling." he said, attempting a smirk. Just as she knew how failure got to him, he was aware that she would come after him every time to console him in a way that only she could.
"Derek, this wasn't your fault." she said. "What happened in there was the most unlikely chain of events I've ever seen… that I think could ever happen."
He looked her in the eyes, nodding slightly to her explanation as she continued to talk, pacing towards him. If there was anyone in his life that would call him out on his fault it was her, and every time she admitted it was out of his reach he found himself able to breathe a sigh of relief.
"I mean, what are the chances you have a knife pushing against an artery, the patient reacts to anesthesia, goes into V-fib, and her convulsions from vomiting cause the knife to sever the artery. We would've had to have been doing six things simultaneously!" she said, chortling out of sheer amazement, which he returned.
"I guess you're right, Angie. It still..."
"Sucks? I know Derek – but don't let it get you down too much. You did everything right, and stopped me from making a huge mistake in the process. It just couldn't be helped."
Now Angie was standing right in front of him, staring up and into his eyes, which returned her gaze through pain still swam behind them.
He forced a smile to her. "Thank you, Angie. Thank you for your hard work and support, and for coming to check on me as always. But, I don't think this will be going away for a while."
"I don't expect it to, Derek." she said, looking at the ground. "Just – you can, uh… talk to me, if you know, you need to…"
Derek watched and couldn't help but smile as Angie stammered and blushed right in front of him, her eyes still on the floor as she nervously shifted under her own weight.
"I appreciate it Angie. The same goes for you – it's never easy when we lose someone."
"I know." she said with a nod. "I obviously wish things were different, but it doesn't change the fact that I'm still proud of you. You're a wonderful doctor, but sometimes things are just out of our hands."
She looked up at him again and smiled, their gaze unusually intense. Angie felt the same shift in their dynamic as earlier in the day, eyes unable to break from his as they stared at one another deeply. The attempt to comfort him had quickly changed into her realizing that she needed him in that moment as bad as he needed her. And so, against the wishes of her mind, Angie felt herself rise onto her tiptoes, putting herself face-level with Derek. She took note of his nervous expression and searched it for a sign to stop, though she could not find one. What she could see, however, was the growing blush on his cheeks and she smiled internally at it.
Derek, soaking this in, simply stood frozen in front of her and watched her like a hawk. He gripped the sink as hard as could and leaned his whole weight against it so that his legs wouldn't give out from under him, mind racing while she moved in.
Angie could feel his warm breath on her face as she grew closer, his hair gently tickling her forehead as the space between them closed. She reached her right arm up first and wound it around his neck, followed shortly by her left, though her eyes never left his. A tingle rocketed through her body under the feel of his strong hands abandoning the sink in favor of slowly grasping onto her hips, using the leverage to pull her up and closer into him in a move that finally cemented that he wanted this too.
The two of them traded a small smile before their eyes gently closed, lips just centimeters away. After years of working together and all the times they had separately thought of this moment, Derek and Angie were finally going to find out what it would be like break the barrier of their professional relationship…
…until…
"Stiles, you in here?"
The hands gripping Angie's hips firmly pressed her down and away from him as she quickly unhooked her arms from his neck and put space between them. Sidney stepped into the room just in time to see the surgical duo standing next to each other with their eyes down on the ground, frustration on their faces and both of them red as tomatoes. Sidney raised an inquisitive eyebrow at the sight, but quickly changed pace.
"Stiles, you need to go talk to her husband." he said solemnly, before chuckling again at the state of the pair in front of him. They both looked up at his inappropriate timing with hesitance, knowing what was coming before it even left his mouth.
"You know, the prep room isn't a very romantic place – why do you think that you two have a couch in your office? Sure as hell isn't there for feng-shui…" he said with a laugh as he turned on his heel and walked out.
Derek sighed and shook his head at Sidney's comment, silently cursing him for adding another layer to the already awkward moment. Today had been bad luck for unwanted interruptions, and Derek was forced to concede that if it had already been blown twice, he was unlikely to receive another chance.
Angie looked at him bashfully, playing with her hands again.
"Um… I guess, you should… uh…"
"Yeah." he interjected, rubbing the back of his head. Angie smiled at him and began to walk towards the door, stopping in her tracks when his voice called out to her.
"Wait, Angie."
Maybe he wouldn't receive another chance, but he sure as hell could try to create one himself.
Angie had been reluctant to leave in the first place, thankful to hear his voice as she turned around and her eyes fixated on Derek's smile.
"I know it's late – but do you want to get something to eat after this? I could really use some comfort food and someone to, um… talk to, right now."
Angie smiled, nodding. "Of course. I'll meet you back at the office."
With that she turned and walked from the room, leaving Derek behind to finish the job. Delivering bad news was always the part of his job he dreaded the most, perfectionist in him unable to cope well with the feeling of letting anyone down. Though Dr. Kasal had always cautioned against it, Derek couldn't help but get attached to the people he treated, caring about their well-being as much as he would care for those he loved.
Derek had barely made it a step into the waiting room before being rushed by his patient's husband, startled as he immediately asked for an update.
"Dr. Stiles - my Katherine… is she alright?"
Derek sighed, motioning for the man to sit down next to him. He attempted to wipe emotion from his face as best as possible for this talk, though pain was evident in his eyes as he began to explain how they had lost the woman this man loved.
"Sir, the dagger was lodged right next to the abdominal aorta, which is the largest artery in the body. When we were attempting to remove it, she suffered an unexpected reaction to her anesthetic, and it caused her some serious complications."
"She… she was allergic? I had no i-idea… I mean, she's never had surgery in her life!" he exclaimed, beginning to tear up. "Oh, Katherine…"
Derek clenched his teeth, trying to prevent his own emotions from showing through. "I know – there was nothing that any of us could've done to prevent that – she needed to be put under."
The man nodded. "So, she had an allergic reaction, how long will it take her to rebound from that?" he asked, a hopeful gleam in his eyes.
Derek was finding it harder and harder to press on with the conversation without letting onto her fate before he could explain himself.
"Sir, when she began to convulse and vomit, the movement was just enough to jerk the knife in the wrong direction."
Derek watched as the gleam in Jack's eyes disappeared, replaced by a look of terror.
"…Doctor, what do you mean the 'wrong direction'?"
"It severed the artery, and the damage was irreparable. I'm so sorry, but there was nothing we could do. We… we lost her."
Derek watched as Jack's eyes shot around the room, searching it for anything to make the situation better. "No, please… please, Doctor. You can't… y-you can't be serious! No! I won't LET YOU!"
He dropped to the ground onto his knees as sobs overtook him, rocking himself back and forth and whispering his wife's name as he struggled to try to breathe. Derek gently knelt down next to him, surprised when Jack pulled him down by his scrubs and began crying into them. Uncomfortable but sympathetic, Derek simply wrapped an arm around the devastated man's shoulders, trying to calm him as best he could before he was knocked flat on his butt.
Standing above him was Jack, tears streaming down his face but a look of unimaginable fury in his eyes.
"YOU! You SAID you would save her, and you DIDN'T!" he choked out, movements erratic and panicked as he paced around in a circle.
Derek shakily rose to his feet and tried stepping to the man, who shoved a firm hand into Derek's chest to keep him away.
"No! Don't come near me! You call yourself a doctor?! You killed my WIFE, you FUCKING BASTARD!"
The shout had caused everyone in the immediate area to take notice of the situation as Derek became embarrassed. He knew from experience that he needed to let Jack's grief run its course, and that attempting to calm him down would be unsuccessful in a time like this. However, he began to worry as the panic worsened, the man's breathing growing more rapid as his face and neck turned an unhealthy shade of crimson. After the outburst Derek had the brief intention of walking away, but couldn't bring himself to leave the man that needed someone so badly.
He watched as Jack gripped onto his shiny bald head and held it tightly, walking back and forth with gasping, shuttering breaths that grew quicker and shallower by the minute.
Eyes still on Jack, Derek lifted the microphone up to his mouth, pressing the button to activate his radio. "This is Stiles. I need someone to the first floor OR waiting room with an oxygen tank and a gurney, stat."
"Mr. Corrigan, you need to stay with me here. You're breathing too quickly – please try to slow down." Derek said, pacing towards him again bravely though he was shoved back once more, this time with much less force.
"No… Don't come near me, you… you.."
Derek's mouth dropped open as Jack's eyes rolled back into his head, the six-foot two-inch, 185 pound man falling forward into Derek's waiting arms. He barely caught him, quickly lowered him onto the ground, and rolled him to his back, just as Angie came racing around the corner with another floor nurse, the gurney and oxygen tank in hand. Both nurses stood in shock at the situation as Derek knelt down on the floor and checked the man's pulse, before he turned to the two of them.
"I need the tank, now!" he barked, sending the nurse flying over to assist him while Angie radioed for backup. Quickly the other floor doctors came rushing around the corner to help Derek, who gave them the scenario. Together they loaded Jack onto the gurney and the other team wheeled him away, leaving Derek and Angie alone together.
Sinking back into the plush waiting room chair, Derek rested his elbows on his knees and held his head in his hands, breathing in and out slowly to trying to avoid losing it. He calmed slightly when he felt Angie take a seat next to him, a soothing hand coming to rest on his back and tracing over it lovingly. Within minutes his urge to cry had faded into exhaustion, her touch working to put him at ease. Gently, he released his head from his hands and cocked it to the side to look at her, her bright green eyes shining with worry and sympathy. He smiled just barely at her before closing his eyes.
"This day sucks."
She nodded. "I'm so sorry, Derek. I know that must have been hard."
He was silent for a moment, though his eyes opened again. After a moment of eye contact, he smirked back at her.
"Thank you, Angie. This is just what I needed."
"Any time."
There was another short silence between the two.
"If you want, we can do dinner another night. You need to get some rest." Angie spoke, barely audible.
Slowly, Derek sat up and heaved a big sigh, his body instinctively rotating to face her.
"I think after all that's happened today, I need to spend time with someone who makes me happy."
Angie blushed at the rare display of honesty, feeling honored to be the person to help him through life.
"I don't know where we're possibly going to have dinner though – it's pretty late now." he said, bringing up his wrist to check his watch.
They both pondered for a moment before Angie rose to her feet, smiling as she held out her hand. Derek looked back at her hesitantly, eyes darting between her and her hand with a stare that made it clear he wasn't budging until she offered an explanation.
She rolled her eyes and sighed, though the smile never dropped. "How about this: we stop by your house on the way home to pick up a change of clothes, we swing by the store, and head over to my place. I'll whip up some steaks and we'll buy a ton of junk food. We'll relax in comfy clothes together, eat, talk, and watch a movie. I know it's late, but it's not like either of us are going to be able to sleep anyway." she said, stepping forward to push her extended hand further toward him.
Derek smiled and placed his hand into hers, allowing her to help him to his feet.
"Sounds perfect. Thank God for that day off tomorrow, huh?" he chuckled.
Angie nodded and began to walk ahead, though she slowed to a stop when the hand in hers squeezed tightly from behind her. She cast a glance over her shoulder just in time to watch Derek intertwine his fingers with hers as he stepped to her side, smile and blush on his face that was identical to hers.
Hand in hand was how the pair walked to their office, stopping briefly to grab their belongings before leaving for the night.
The day had started to come around, but unfortunately, it would be short lived.
Their troubles were just beginning.
Dear God, I am so behind on this friggin story. Oh well, at least I'm not scrapping it! Sorry for the delay, I'm kind of more preoccupied with updating FCL... so, I will see everyone over there soon! Please review!
