Silent Misery R&R - Chapter 7
by HidingInSight
Previously...
Gibbs turned, his forearms pressed against Fornell's chest. He stood for a second before he dropped his head onto Fornell's shoulder and bumped his fist against the broad chest in front of him. Gibbs hit him with the other fist, a low, wordless cry bubbling up. Fornell held him as Gibbs continued to strike out, the impacts growing stronger as Gibbs' cries grew louder. The FBI agent stood there, street shoes solid against the wet tile, and let him get it out. He whispered words of calm and comfort, rubbing the fingers of one hand lightly across Gibbs' back. His heart was breaking. This wasn't supposed to happen. Jethro felt things deeply, but he rarely expressed his deep emotions aloud. To see him lose it so badly... Fornell renewed his private oath: He was going to find that bastard, and he was going to kill him.
When the storm passed, Gibbs raised his head and looked at him. There was an expression of abject misery on his face.
"We'll get through this. I promise," Fornell said. Gibbs nodded.
"Let me get the other towel," Fornell said. Gibbs nodded again and let him go. Fornell brought it over and Gibbs dried his body and hair, moving carefully around his injuries.
With Fornell hovering and helping where he could, Gibbs dressed as quickly as he could. The underwear fit fine. The scrubs were a little big, but not bad. He sat on the toilet lid to pull on the socks while Fornell dried the floor with the dropped towel. Gibbs used a toothbrush and paste from a mini tube in the toiletry kit to clean out his mouth, and a comb to straighten his hair the best he could without a mirror. When he was done, he dried the toothbrush with a paper towel and stuck it into his pocket along with the paste. He turned to Fornell.
"You're wet," he said, and Fornell gave him a look. His shirt and the front of his pants were dark with water where Gibbs had leaned against him.
"I'll dry," Fornell said. "You ready?"
"Let's go home," Gibbs said.
Jessica was waiting in the room as she'd promised, sitting on her stool working through some paperwork. There were three cardboard file boxes side by side on the counter. The feds noticed the bed had been stripped, the sheet and blankets gone. A stack of papers, prescription bottles and medical equipment sat on the end of the bed. A paper grocery bag sat upright at Jessica's feet. Two straight chairs were facing her stool, ready for them it seemed.
"You feel any better?" she asked Gibbs. He chose to believe she was asking about the shower, and not the explosion of emotion she must have heard through the door.
"Some," Gibbs said.
"Good. Have a seat while we talk through what comes next." They each took a chair. Gibbs found that sitting hurt, but not too badly.
First, Jessica bandaged his wrists. The abrasions were deep, the right one oozing pinkish fluid again after his shower. She applied antibiotic ointment and wrapped both in white gauze. They would have to be kept covered as long as the wounds were open, she told them, with the bandages changed and ointment reapplied at least daily. The scratches on his torso were ugly but not serious, and wouldn't need treatment. She picked a tube of ointment, several rolls of gauze, and a roll of medical tape off the pile on the bed and placed them in the empty bag at her feet.
That done, Jessica went over signs and symptoms of concussion. Though both men had heard it before, Fornell paid attention. He wasn't sure whether Gibbs was paying attention or not, as Gibbs mostly just sat and stared at his hands. Jessica read off an information sheet, slipping it into the bag when she was through.
The next set of instructions was the treatment regimen for the damage to his backside that would be required at home. Medicated cream applied to the tears on his anus twice daily for ten days, anal douche with the medicated wash twice daily for five days. From the stack on the bed she picked up and showed them a tube of cream and a box of powder that would be mixed with water to form the wash, along with a reusable douche and a box of disposable nozzles. Jessica offered a home health service to come by and apply the medications. At that, Gibbs looked up immediately and said no. He did not want a stranger in his house, for any reason. Jessica nodded and put the items into the bag before continuing.
He would be on a liquid-only diet for three days, she told them next, soft food diet for one week after that, stool softeners for ten days, all to prevent stretching of the anus and reopening of the wounds. No anal penetration other than with the douche for two weeks minimum, with a recommendation but not requirement to be cleared by a doctor before resuming that activity.
"Do you have a doctor you'd be comfortable with for that exam?" Jessica asked. "We can recommend someone if you don't."
Gibbs thought about it. The only doctor who'd treated him for years was Ducky. He wasn't sure he wanted to ask the older man for clearance to resume anal sex, but there sure as hell wasn't anyone else he'd want to ask.
"Yes," he said finally.
"Good," Jessica said. She dropped a recommended diet sheet and a box of stool softeners into the bag.
"You're going to need to clean yourself out tonight, to ease passage of the fecal matter from your lunch. Do you have supplies for that at home?"
"Yes," Gibbs said, with a hint of... something like embarrassment.
"Good," she said again.
A bottle of pills was next. Antibiotics, Jessica explained, to prevent infection of his injury sites and protect against potential bacterial contagions that might have been transmitted to him. He would have to take them twice a day for ten days.
Next, Jessica addressed the course of ARVs that would be required to combat potential HIV infection.
"HIV takes around three days to reach the lymph nodes, and another two days after that to start infecting cells. Which means there's a window during which the infection can be blocked even if your attacker had the disease. However, the course of treatment is 28 days, to insure complete protection and eradication of any of the virus that might make into the lymph system.
"Your blood was tested as soon as you arrived, and you're clean across the board. Your liver function is also very good, almost abnormally so for someone of your age." She smiled. "Good genes go a long way. It's a great place to start from, because these meds can sometimes be hard on the liver. We'll keep an eye on that over the next month, to be sure nothing goes wrong, though I doubt that'll be an issue."
She took a breath. "We also ran a titer test for hepatitis B vaccine. You're up to date, which almost guarantees you won't get that infection. You'll need to repeat testing for other forms of hepatitis and sexually transmitted infections every two weeks for the next twelve weeks to stay on top of any developing infections."
"What about HIV? How long before we know he's in the clear?" Fornell asked when he saw Gibbs wasn't going to. Her answer was directed at Gibbs.
"If you agree to the course of ARVs, we'll test for HIV monthly for three months, then do a final test at six months. If you're still negative at three months, your risk of converting to positive status drops to less than one in 1,000. A negative test at six months means you're in the clear. If you decide against the treatment, we'll test you every two weeks along with the other testing. Either way, you shouldn't have unprotected sex of any kind for twelve weeks to prevent potential transmission. After that, the risk of transmission is negligible."
Gibbs nodded, glanced at Fornell, looked away. Fornell was next to speak. "You said there were side effects?"
"Yes. The side effects can be severe, and many people quit the regimen before the full course is completed for that reason. Almost everyone gets some amount of diarrhea, nausea and vomiting, headaches and fatigue. Symptoms come on within the first 24 to 48 hours and will subside as your body gets used to the medication. However, if the symptoms are severe to start, even the lesser symptoms over time can be debilitating for some."
"What's the guarantee?" Gibbs asked.
"If you complete the course, and aren't exposed to anything else in the meantime, chances of contracting non-drug-resistant HIV is as close to zero as science can get."
Gibbs nodded again. "I'll do it."
"The side effects and concussion symptoms sound awfully similar," Fornell said. "How are we going to know the difference?"
"That's a good question," Jessica said. "Concussion symptoms will show up in the first 24 hours. After that, it's probably side effects. That being said, if you get a severe headache over the next few days that's centered over the fracture site, or on the opposite side, call your doctor. Headaches from the ARVs will most likely be frontal or slightly temporal."
Fornell nodded his understanding. She went through the medication course. Three drugs, twice a day, for four weeks. She picked each bottle off the bed, showed it to them, and dropped it in the bag.
"The timing is very important. You'll need to think about when tonight you want to take the first dose, because after that, you'll have to take each dose as close as possible to 12 hours after the dose before for best result. Most people set a watch or cell phone alarm so they can stay on track. If you go back to work before the course is finished, it's best to carry the meds with you so you'll have them if you get stuck away from home."
"Can he go back to work?" Fornell asked.
"He can, but he probably won't want to," Jessica said, and returned her attention to Gibbs. "The deal you made with Marc says you're off until day after tomorrow. After that, you can do whatever you're comfortable with. We highly recommend planning to stay home through the first seven days of the ARV course. You're not going to want to be working if the side effects are bad."
Gibbs nodded. Fornell barely kept from rolling his eyes. They both knew if Gibbs could stand, he'd be at work. He was just glad Gibbs had agreed to the 24-hour hold.
"What about alcohol?" Fornell asked, thinking of the bourbon in Gibbs' basement.
"Light social drinking is okay. Avoid drinking to intoxication, and try not to drink every day. This stuff isn't as hard on your liver as some other medications, but if you start to see signs of jaundice, call your doctor right away. We'll run a liver panel along with the HIV test at the end of the course to be sure there hasn't been any negative effect."
She picked up two more bottles. Reglan for nausea and an over-the-counter anti-diarrheal, both to be taken as needed for side effects. "Don't take the stool softeners if you're having diarrhea, and be sure to drink plenty of fluids. Juices or Gatorade work best, or anything else non-caffeinated, non-alcoholic, and non-carbonated. If you have vomiting and/or diarrhea more than two consecutive days without a break and the medications aren't fixing it, or if you start throwing up and can't keep the medications down, call your doctor. Dehydration is a real risk, and it can be serious."
She put them in the bag and picked up another bottle.
"Marc prescribed you a seven-day course of Vicodin for pain from your injuries. It'll also cover headaches from the ARVs. If you've got injury pain longer than that, go see your doctor. For headaches after that, OTC pain killers should be enough. If not, see your doctor."
The bottle went into the bag and she picked up the last one on the bed.
"You're likely to have trouble sleeping for a while. These will help. They can be habit-forming, so try not to use them unless you need them." Into the bag.
Jessica took a stack of papers off the bed, the last items left. There was a computer-generated list of all the medications she'd mentioned with dosing instructions, potential side effects and cautions and warnings. There was a referral for counseling, information about the D.C. Rape Crisis Center, a card for the hotline, and a list of therapy groups that specialized in male rape survivors.
"You might not think you need counseling now, Jethro, but that's likely to change as time goes on. Hang onto the list. Also, there's support available for partners of survivors as well." Fornell nodded his understanding.
The final items were two booklets. "These will help with what comes next," Jessica said. "There's one for each of you. They explain some of the things you're likely to be feeling and what to expect in the days and months ahead. They include danger signs to watch out for, including signs of post-traumatic stress, what's normal and what's not. Take some time to read through them in the next few days. Our experience shows that those who read the guidebook are more successful at dealing with the aftermath. Okay?" When both men nodded, she put the booklets in the bag.
"The only thing left is what you want to do with the evidence." She swiveled her stool a little and pointed at the cardboard boxes. "If you're ready to make a police report, we can call Metro Police now," Jessica said.
"No," Gibbs said, and Jessica nodded.
"I figured as much. I strongly encourage you to report the assault. Besides potentially helping to get a predator off the streets, it's a big part of the healing process."
"We'll get him off the streets, don't worry about that," Gibbs said. Jessica shook her head.
"I've worked with members of the law enforcement community before, and I understand the desire you're undoubtedly feeling to personally track down the man who did this. It's reasonable and it's expected." Jessica paused.
"I have to warn you, though. If you decide to pursue this on your own, it will likely complicate your recovery. You'll get all caught up hunting this man, and you'll be able to avoid dealing with what happened, maybe for a long while. But the longer you avoid it, the harder it's going to be to get through. You need to let the police handle this. Besides, if you're involved in the case, there will be rumors of impropriety that will make the case harder to prosecute, down the line."
"We know all that," Fornell said. "Jethro's got some good people, and as soon as he's ready, he'll get them on it."
"Good enough. In that case, we can store the evidence here up to the one year statute of limitations for reporting."
"I'll send someone to get it shortly," Fornell said.
"And take it where?" Gibbs asked, turning to look at him.
"I'll have them take it to Quantico," Fornell said, referring to the FBI lab.
"No. Send it to Abby," Gibbs said. Fornell looked at him like he'd completely lost it.
"You really want her involved?" he asked.
"No. But she's the only one I trust."
"You can trust my lab," Fornell objected. "We'll run it blind, no names. I'll have them send the results directly to me."
"The second they get a blind SAE kit from an SSA out of WFO, one of your lab flunkies is going to step next door and check in with CODIS. There's too much potential high profile gossip in this town to let that one go," Gibbs said.
"You don't think Abby's going to check the DNA?" Fornell countered.
"Not if I tell her not to," Gibbs said.
"I don't know, Jethro. You sure you want to take that risk?"
"Better it's someone I trust," Gibbs said with finality, and Fornell nodded. He turned back to Jessica.
"Does any of the evidence have his name associated?"
"No. Only his medical record number. That'll cross-reference with the reports in our system, when you're ready for it. Until then, it's password protected. We can sanitize the relevant notes and send them along."
"Good. Give me the number," Fornell said. She checked one of the forms in her clipboard, then wrote the medical record number on a blank page before handing it to him. Fornell made sure he could read her handwriting before folding the page and sticking it in his shirt pocket.
"I'll send an FBI agent for it," he said. "He'll have identification."
"The wet samples need to be dried within four hours to prevent evidence loss. Would you like our lab to do that?" Jessica asked.
"No. I'll make sure it gets done."
"Alright. That's it then. You're free to go. I'll get a wheelchair."
"Not necessary," Gibbs said.
"Policy," Jessica said.
"I'm not leaving right away," Gibbs said. "I'm going to check on my partner in the ER first."
Jessica considered him, then turned to Tobias. "You promised to take him home and make him rest," she reminded him.
"He needs to see for himself. I'll take him home after that." He stood up and retrieved his jacket, pulling it on.
"Okay. Good luck, Jethro. Stop by and see us sometime, let us know how you're doing." She picked up the bag of supplies and held it out. Fornell took it.
"Thank you," Fornell said. Gibbs said nothing. Jessica smiled and pulled the door open, ushering them out.
They moved through the ER the way they'd come. Gibbs' pace was slower than normal, his lingering pain limiting his movements. The final dose of medication had helped reduce his headache to a constant pressure on the right side of his head. Better than the pounding it had been before. Fornell matched him step for step, shortening his own stride to stay by Gibbs' side. He kept the hand closest to Gibbs free, in case he was needed.
The trauma unit was at the front of the ER, right inside the ambulance entrance. It was secured on the public side by a code access door. A security guard sat behind a podium next to the doors.
"Fornell, FBI," Fornell said and displayed his credentials. "We need to see a patient." Gibbs stood silently beside him.
"Name?" the guard asked, and the men realized they had no idea what name Tony has used.
"Not sure. White male, brown hair, about 6'2, 190. He came in about three hours ago, beat up."
"Trauma four," the guard said. He pushed a button under the podium and the doors swished open.
The trauma suite was very busy. Probably the wreck Jessica had mentioned. No one paid them any attention as they moved down the center of the hall. Glassed-in rooms were to their left and right, each marked with a number hanging from the ceiling. Four was to their left halfway down. The curtains were drawn across the glass. Fornell stepped through first, slipping a hand through a break in the curtain to create an opening large enough to see through. It was the right room. They stepped in.
Tony was lying on his back on a semi-reclined bed. The lights in the room were off, though there was plenty of light coming through and around the curtains. Ducky was sitting in a chair by the bed, reading something.
"How's he doing, Duck?" Gibbs asked quietly. Ducky looked around and his eyes immediately widened.
"My word, Jethro, you look terrible. Are you alright?"
"He's alright," Fornell confirmed. "He hasn't seen it yet."
"Seen what?" Gibbs asked, looking first at Fornell, then back at Ducky.
"Your neck. And your eyes," Fornell said without further explanation. "How's Tony?" he asked Ducky.
"Fine," came Tony's voice from the bed. He opened one eye and looked at them. The side of his face was tight and smooth with swelling and purple bruising. "Which is why I don't understand why I have to spend the night."
"Because you have a concussion," Ducky said.
"It's nothing serious. I used to get them in college all the time," Tony objected. "I feel fine."
"Are you still nauseated?" Ducky asked.
"Just a little," Tony admitted.
"Dizzy?" Ducky asked.
"Some," Tony said reluctantly.
"I rest my case," Ducky said.
"How are you, Boss?" Tony asked, giving it up for the moment.
"Discharged," Gibbs said. "Can you stay the night with him, Duck?" Gibbs asked.
"Where are you going?" Ducky asked.
"Home," Fornell answered. "For 24 hours. Doctor's orders."
"In that case, it will be my pleasure to spend the night with Anthony. They're taking him to a room shortly. I'll have them bring in a cot."
"Thank you," Gibbs said. He turned to DiNozzo. "You, do as you're told. I'll talk to you tomorrow."
"Yes, Boss," DiNozzo said with resignation. "Are you sure you're alright?" he asked.
"I will be," Gibbs said and turned away. He'd seen all he needed to see. Tony was conscious, breathing well, and making sense. Everything else would heal.
"Take care of him, Agent Fornell," Ducky said as the FBI agent turned to follow Gibbs out.
"I will," he said.
They returned to Fornell's car. The FBI man opened the passenger door and hovered while Gibbs carefully got in. The bag of supplies went into the trunk. He got behind the wheel in time to see Gibbs flip down the visor mirror.
The first thing Gibbs noticed was his eyes. The whites were streaked with red marks. Petechial hemorrhages. From being strangled. Most commonly seen in the dead. No wonder Ducky'd been startled; they must have still been developing when he checked in the first time. The bruises around his neck were dark and vivid, four fingers on one side, a thumb on the other. They were so clear, Gibbs thought for one ridiculous moment that Abby might be able to collect fingerprints off them.
"It'll heal, Jethro," Fornell said and Gibbs shoved the visor back into place.
"Not going to be presentable in public for a while," Gibbs said.
"Another good reason to stay home." Fornell started the car. He pulled out his cell and made a call, telling someone to go pick up the evidence and take it to NCIS.
"You want to tell Abby or you want me to?" he asked Gibbs when he hung up.
"I'll do it. Dial her up." Fornell did, and handed the phone across before starting out of the parking lot.
To be continued. Thank you so much to everyone who's reviewed. Hearing from you makes the muse eager.
A note in response to the review from "Kara" who did not sign in: You're absolutely right. In the big picture, rape of a man is no worse than rape of a woman. It's just different, mostly because of the physiological response men believe they should be able to control, and the homophobia that seems to lurk just beneath the surface of so many men. The psychological battle of "my body responded, does that mean I enjoyed it?" is shared by both genders, but men have the complicating question of "does that mean I'm gay?" (Oh My God, I might be gay?!) That's what I was referring to. No disrespect intended to survivors of any gender. I appreciate your comment, and the invaluable work you do.
