Leonard slid his hand down Jim's foot to his ankle, and encountered another strap. Looking up at Tavarkian, he narrowed his eyes angrily.

Tavarkian shook his head slightly and tucked the chart that Smith had started under his arm. "He was totally out of control when they brought him in, Dr. McCoy. The EMTs didn't know what was wrong with him…if he was on drugs, if he was seriously hurt, nothing. We had no idea, and we didn't want to risk him making his injuries worse, or hurting anyone who was just trying to help him."

Leonard took a breath and swallowed down his anger at the way Jim had been treated. He hadn't been there. He hadn't seen. But he could imagine how Jim must've fought. How feeling like he was suffocating in a c-spine collar would send him into completely into a fight or flight response. And if he was acting irrationally, he could understand why the medical personnel would've felt like they needed to protect themselves…and him…from his frantic fighting.

Looking at Jim now – arms pulled to his chest, breath short and labored, pale and somehow managing to look so much smaller than he really was – he wanted to kill someone for everything he'd been through. But he was maybe a little irrational too, when it came to the man he loved. So instead, he simply unbuckled the strap, and then moved to do the same to the other ankle.

"Just…please check his chart carefully before giving him anything," Leonard said. He paused when he realized that Jim was missing a shoe, and that shook him more than anything else so far.

Jim was in a car accident.

Tavarkian said something that Leonard didn't really register, but he nodded vaguely, and then rejoined Jim at the head of the bed, taking his hands again and sitting on the stool left there by someone else. His head was spinning with the crushing, overwhelming knowledge Jim could just be…gone.

"Bones…what're they doing?" Jim asked. He licked his dry lips and turned his head to follow the movement in the room.

Jim's question snapped Leonard out of the haze that had settled around him momentarily, and he focused on his husband, really looking at him with a clinical eye…needing to reassure himself that there weren't any quietly deadly injuries that they didn't know about yet.

"They're just going to take some blood, Darlin'," Leonard answered. "No big deal, right?"

"Yeah," Jim said hoarsely.

"Will you use an oxygen mask?" Leonard asked, concerned at how breathless he sounded. When Jim hesitated, Nadjia spoke quietly from the other side of the bed.

"Nasal cannula?"

"That's the one that goes in your nose, Jim. Would that be okay? Please?"

"Okay," Jim said, smiling faintly. "Since you asked so nicely."

With his okay, Nadjia quickly set that up, and the effect was almost immediate, his sats going up by a couple of points. She continued to work quickly, setting up for a blood draw that made Jim wince slightly. With that done, Leonard then very carefully helped Jim out of his clothes and into a patient's gown. That left him gasping and with tears of pain in his eyes, and Leonard spoke to him quietly as they waited for him to get control of himself.

"You don't have to be in pain, Jim," Leonard said, his heart aching for him.

"I don't want to be drugged. Please Bones. This isn't your hospital. I don't…"

"Jim, I'm not going anywhere. I promise."

"Not yet. It's not that bad."

Not wanting to force anything on him, Leonard let it go, but he wasn't buying what Jim was selling for a second. If it looked like his pain was getting too bad, he'd be a little more insistent about it.

"Jim, may we exam you for any other injuries now?" Nadjia asked.

"Bones stays," Jim said, squeezing his hand.

"Yes of course. After all the calls I made to get him here?" she said winking at him, her voice gently teasing. "He's not going anywhere."

She and the other doctor who'd been in the room did a quick exam, listening to Jim's chest, checking for tenderness or guarding in his abdomen, and checking pupillary reflex. They had him move and flex his arms and legs, and checked again for strength in his hands and his feet.

And everything – Thank you, God, Leonard thought – seemed ok. Jim was sore and banged up and cut and bruised from the seatbelt and from getting slammed around in the car, but he seemed okay, except for his chest.

"Okay, Jim," Tavarkian said, coming back into the room, a tech with an ultrasound right behind him. "Since we were delayed in treating you, I don't want to wait for a CT or an MRI to see what's going on with your chest. We're going to use the ultrasound to confirm what's going on in there, and then we'll send you for some other imaging."

Jim's hand tightened on Leonard's and he gently brushed his hair back off his forehead.

"That ok with you, Darlin'?"

In pain, and not wanting to be touched because of how much he hurt, Jim was nervous about what they wanted to do. But he knew he could hold on to Bones and know that he would be okay.

"Yeah," Jim said quietly.

The tech set up on the other side of the bed, Jim's injured side, and got his equipment ready. Jim hissed though his teeth when the tech spread conductive gel over his chest.

"Sorry," he said. "I'll be as careful and quick as I can."

Jim just nodded and took a careful, deep breath. He grimaced when the tech placed the transducer on the area, and it was all he could do to stay still as he moved it over his skin, zeroing in on the area over the break that resulted in the tear.

"There," Tavarkian said quietly, indicating a spot on the screen. The tech moved the transducer again and Jim jerked in pain, a moan escaping despite his clenched teeth. The images on the screen didn't mean a whole lot to Leonard, but the negative space where his lung should be filling the area was easy enough to identify. "Okay…that's enough."

The tech removed the transducer at Tavarkian's word, and in the next second almost wiped the gel off the patient's chest.

"No," Leonard said firmly, moving quickly to grab his wrist. "You'll hurt him."

"Oh – I'm sorry. Should I…?"

Leonard rolled his eyes at the incompetency. "Just give it to me," he said, releasing his wrist and holding his hand out for the paper cloth.

The tech glanced at Tavarkian, who nodded slightly before turning to Smith and Petit. "We need to set up for a chest tube. Now."

Leonard registered this, but he was carefully cleaning the gel off Jim, keeping his touch as light and gentle as he possibly could. Jim was breathing through clenched teeth, his brow furrowed with discomfort, and Leonard was at the point of pushing pain meds again, but Tavarkian beat him to it.

"Jim, as we suspected you have a pneumothorax – a partially collapsed lung – because it was damaged by a broken rib. The tear in your lung is pretty small, but because you…because it's been without treatment for so long, the pressure in your chest is making it harder and harder for you to breathe, and your lung is being compressed by that pressure. We need to insert a chest tube to relieve that pressure so your lung can expand again. Will you let us do that?"

Jim's heart raced in his chest at the thought of another invasive procedure. He'd only undergone a handful of medical procedures in his life, but each one sucked, left him completely at the mercy of the doctors and nurses and always seemed to come with nasty side effects. He really didn't want to go through anything like that.

Laying there, even knowing his breathing wasn't what it was supposed to be, he couldn't just agree to something like that. I don't want it! His stress level rocketed up, and Leonard leaned over to hold him as well as he could, letting Jim press his face to his shoulder as he shuddered at the thought of what they wanted to do…tear a hole through his chest wall in between his ribs and stick a tube in there…it was enough to make him sick.