Chapter 4: There's a Hole in the Bucket

As Mike had predicted, no one was really ready for Tim's appearance. True, they had experience with impalement, but generally, people in Tim's state were dead, not screaming in agony in spite of heavy doses of analgesics. Each tooth of the metal harrows was about an inch and a half square. The amount of damage that could have been done internally was more worrisome than the continued screaming as they rolled the gurney into the ER. Each small jolt of the heavy metal embedded in Tim's body was another current of pain...and another scream. A couple of the ER doctors actually looked a little green at the sight.

"Set up an X ray. Stat. We need to know where all these...spikes have gone, what they've done to him."

A nurse shown a light into Tim's eyes and noted the slight dilation. "He could also have a concussion," she reported quickly.

"We can't do anything until we know what we have. Let's get him to X ray." In moments, Tim was being rolled down the hall to another room. If he was lucky, the two teeth that had fully penetrated his torso would have missed vital organs. The fact that he was still alive boded well in that respect. If his heart, lungs or any other internal organ had been punctured, he'd likely be dead already. That didn't lessen the pain in any way and it didn't mean that this still wasn't deadly serious, but that meant there was more hope that Tim might just survive his injury.

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The X rays were about as good as anyone could have hoped...and that meant only that Tim might survive. In non-harrow related injuries, his left leg was broken in two places and he had a nasty knock on his head which, however, looked to be relatively non-serious. There was plenty of internal damage from the harrows themselves. The individual teeth were all rusted and certainly likely to cause infection. Besides the six teeth that had gone all the way through, there were another ten that had penetrated to a lesser degree. One had stopped just short of Tim's lungs. Another was lodged in his ribcage. One had been deflected away from his left lung by two ribs that had already been broken by the roll of barbed wire. Four were lodged in his legs and the remaining three were all in his right arm. The odds of there being no internal bleeding were slim to none...and of course, as soon as they started to remove them, they would have to control all the external bleeding that would undoubtably start. Tim would turn into a terminally-leaky bucket if they didn't do this exactly right.

What made this even more difficult was the fact that they couldn't just clip off the spikes. They would have to use a cutter because they were much too thick for any manual tool. Harrows were used to loosen up soil, break up dirt clods, pull through tangles of weeds. They were constructed with strength and endurance in mind. They didn't bend easily. They weren't hollow. They were solid...all the way through. Solid and very heavy. It made them difficult to work with both on a farm and on the rare occasions when a set of harrows suddenly showed up in the ER.

There looked to be some damage to the tendons in his shoulder and there was a possibility that the tooth in his chest might have nicked his lung, but plugged the hole at the same time, preventing its immediate collapse. The teeth in his leg, arm and side all appeared to have gone straight through without causing extra damage...a minor blessing for which the doctors were all grateful.

Even so..."This is going to be messy," Dr. Stevens observed.

"What do you suggest?" Dr. Lee asked in a worried voice. He was only a second-year resident. This was way beyond his experience.

"Surgery...as soon as we can." He looked at the X rays again and sighed. "Someone needs to get us a cutter. We'll need a full team on this one. Let's go. If we're going to save this guy, we can't waste any time."

"Yes, sir."

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One hour later...

"Why hasn't anyone come out yet?" Abby asked. "Why haven't they told us anything?" She had been pacing the waiting room ever since she'd arrived. Gibbs, Tony and Ziva, who had actually seen Tim, were unsurprised by the lack of information. In fact, it was probably a good thing that they didn't know yet. If someone came out this early, it would probably be to tell them that Tim had died.

"How did this happen?" she asked shrilly.

Gibbs realized that he couldn't sit silently anymore. Abby was on the verge of hysterics. He stood and pulled her into a tight hug. She wilted in his arms.

"What happened, Gibbs? What happened to Tim?"

"We're not sure yet. McGee was up in the loft. The rest of us were pinned down on the ground. All we know is that at some point he fell out of the loft and..." Unbidden, the image of Tim impaled on the harrows came into his head. It was awful. "...landed on some old machinery. It's bad, Abby. It's going to take awhile for them to get to us."

"Should we call his family?"

"Not yet. I'd like to be able to tell them something more than that their son has been injured and might die."

Abby whimpered and burrowed her head into his shoulder.

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"Okay, ready?" Dr. Stevens asked. There was a team of four doctors and three nurses surrounding the surgery table on which Tim lay, unconscious finally. The old rusty harrow pieces were a blight on the otherwise sterile room.

"Ready as we'll ever be, I think, Jack," Alice said. She was the most experienced nurse there and had assisted on a number of surgeries with Dr. Stevens. They worked well together.

Dr. Stevens nodded and turned on the cutter. The first step was to cut away everything but the individual spikes. It would take up valuable time, but it was necessary in order to be able to deal with the more serious problems. Just before he bent over to cut the first spike away, he looked up at the nervous resident standing across from him and at the other doctors, all experienced in surgery, but a bit overwhelmed by the extremity of the injured man lying before them.

"My dad always wanted me to be farmer, you know. I think I'm glad I didn't listen to him."

The reluctant chuckles were drowned out as he began to cut the metal frame.

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Three hours later...

A nurse walked into the waiting room and saw the group waiting for news on Tim and she tried to smile, but it was probably one of the hardest expressions to put on her face at this moment.

The group all stood and turned as she walked over.

"We've just finished cutting away all the harrow pieces," she said.

"What? You haven't even taken any out yet?" the younger man demanded.

"This is going to take all night," she said calmly. "We couldn't start removing the individual...spikes until we had managed to disconnect them from the metal frame. That way we can deal with them one and at a time and prevent any massive internal or external bleeding." What she didn't say was that Tim had nearly died once during the cutting. They weren't sure what they'd be able to do if he went into V-fib. Defibrillation was risky with all the metal in his body. He had rallied, thankfully, but it had caused Dr. Stevens to work much more slowly.

"All night?" the older man asked. He seemed to be the one in charge.

"Yes, definitely."

"Can you tell us anything?" a woman dressed in Goth apparel asked plaintively.

"Nothing positive at the moment, except that he is still alive."

"What's the extent of the damage?" the older man asked.

"Are you sure you want to know?"

"Yes."

"Very well. Your agent..."

"Timothy McGee," the other woman corrected. "His name is Timothy McGee."

"...Timothy is in dire straits. All together, we have to remove sixteen of the spikes from his body. Only six penetrated completely, but the others have done quite enough damage on their own. The five in his torso, of course, have the most potential for damage. Four of them are near his lungs. The other is less serious. There is more than likely tendon and/or nerve damage in his shoulder. The remaining ten appear to be less serious as well. However, all of them could cause dangerous infection because of how dirty they are and the wounds will require immediate debridement upon removal. In addition, we have to watch for internal bleeding in each case. I cannot stress how dangerous this surgery is going to be. Your agent...Timothy could die. We will do our best to prevent that from happening, but it is possible and you should be ready for that."

"He won't," the older man said firmly. "McGee won't die."

The nurse had seen this kind of reaction often enough that she didn't bother trying to correct him. She just gave her smile again. "We'll try to keep you updated if you're going to stay." The looks on everyone's faces told her what the answer to that was. "It won't be regularly, but when we have news, we'll let you know."

"Thank you," the younger man said. His face was very serious, but it looked as though it wasn't his usual state. Only something as terrible as this could change his normal expression.

"There's nothing we can do?" the Goth woman asked.

"Pray...that's all you can do. Wait, hope...and pray."

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"All right. Let's see what we're dealing with," Dr. Stevens said. "How's he doing?"

The anesthesiologist nodded. "Still out...doing as well as can be expected."

"Which is not good at all." He had decided to remove the spikes around the lungs first. They were the worst, and it could be dangerous to do so, putting too much stress on a body already stretched to the breaking point, but it would also mean that the rest of the spikes would be less worrisome...and if they were going to succeed, they should know it right away.

"Here we go," he said and leaned over to carefully remove the first spike.

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Four hours later...

When the nurse came out again, the group had increased in size to seven people. Three were sleeping, but the three who had come in first were still awake as was an older man who was speaking with a British accent. He broke off suddenly when he noticed her approach.

"How is he?" he asked.

The smile was slightly easier this time. "We've managed to remove four of the spikes in his torso, and reinflate his lung. There are still twelve to go, but the hardest ones have been removed."

There was a sigh of relief from all four.

"It's gone midnight now, and the surgery will probably continue until six a.m. at least. You could go and get some sleep."

Two of them actually rolled their eyes at her and she smiled.

"All right. It was only a suggestion."

"We're not leaving until we know," the older, not British, man said.

"Very well." She shook his hand and walked back to the OR.

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"We've got a bleeder!"

"Clamp it! Clamp! Now!" Dr. Stevens ordered. "Give me suction." He took over at the spike in Tim's thigh. "Get me a unit of O neg. We'll be needing it."

Quickly, he managed to tie off the artery and suction out the rest of the blood. Still, it had been close.

"What happened?"

"It must have been caught, but it didn't show in any of X-rays," Dr. Lee said. "I checked and double-checked them before I started."

"It's okay. We stopped it in good time." He let out a whoosh of air. That could have been it and they were doing so well. Ten of the loathsome teeth lay on the cart. The internal bleeding had been stopped, and now, the only full penetration was the one in his shoulder. Dr. Stevens was waiting for one of his colleagues to come and take a look. He was worried about nerve damage because that, if too serious, was often permanent. He looked toward the doors and saw her scrubbing in. He waved at her and she stopped her scrubbing for two seconds to wave back.

"What have we got?" Dr. Lipton asked and her eyes widened briefly when she saw the remains of the harrows. "What happened to this poor man?"

"Fell onto the harrows."

"Wow. Where's my nerve damage?"

"Right shoulder. X-rays are there."

Dr. Lipton examined the images of Tim's shoulder, the placement of the spike, its curvature, shape and any other information that might tell her what she was dealing with. "Looks bad."

"All of it's been bad," Dr. Stevens retorted.

"He's been hanging on?"

"Two bleeders and a near V-fib, but so far, yeah."

She whistled through her surgical mask. "I think you might be in danger of another bleeder here. It's awfully close to the brachial artery...and the brachial nerve. This one's going to tricky. I think we'll need to do it together."

"Want to help with the others then?"

"Sure. Where do you want me?"

"We still have the three partial penetrations in his right arm."

"Got it."

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Four hours later...

Gibbs was dozing. Abby was asleep with her head in his lap. Ziva and Tony were both snoring sonorously next to each other on the couch. Michelle and Jimmy, leaning on each other, and Ducky, resting with his head on his hand, completed the sleeping seven. It had been hours since they'd had an update and even the best intentions couldn't keep them all awake.

The same nurse who had been their contact with the surgical team approached once more. Gibbs regretted Abby's choice of sleeping position because he couldn't even stand to talk to her. She smiled in understanding and came closer, keeping her voice low.

"There are two left and they have to set the bones in his leg. The last one will be tricky, but we have a nerve specialist and we're hoping for the best."

"Which one is last?" Gibbs whispered.

"The shoulder. It's in a bad spot. I probably won't get back out here until the surgery is over, but he's been doing well."

"He'll recover?"

"We won't know for certain until we're finished and even then, it will be a long recovery, but it's looking better."

"Thank you...uh...?"

"Lauren."

"Thank you, Lauren."

"No problem." She left as quietly as she'd come and Gibbs allowed a small exhale of relief. Obviously, it wasn't over yet, but that was better than he'd expected.

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"He's bleeding!"

"Clamp!"

"Going into V-fib!"

"Get the crash cart!"

"Come on, Timothy! Don't do this! Not when we're so close!"

"Tara, you got it?"

"Clamped!"

"Charging!"

"Still in V-fib!"

The last spike was out...but it had been too close to the brachial artery and had torn it, in spite of Dr. Stevens' and Dr. Lipton's best efforts. The third bleeder had pushed Tim's already over-taxed body to the edge.

"Clear!"

"Nothing!"

"No!"