Beckett

Colonel Sheppard was one of those lads who got to you. Ferocious and cold-hearted one day, vulnerable and a tad shy the next. As both doctor and sometimes offworld team member, Carson had seen the Colonel endure everything from rampaging gene-mutating Iratus viruses to vigils at the bedside of ill friends. He suspected most of the expedition was familiar with the ferocious side of the man – there were times when Carson was downright frightened of Colonel Sheppard's single-minded streaks of violence.

His closest friends many have even caught a glimpse of the man who was sometimes unsure of himself, despite his physical competence in most other respects.

But as his physician, Carson may have been the only person alive (or alive again) who had seen John truly vulnerable, at the mercy of his own human frailties. The Colonel's hardest moments of recovery had always, before, passed in confidential privacy under Carson's tender care – Paranoia and hypertension after surviving four Wraith feedings and a Wraith restoration; Shock and exhaustion after a run-in with a 10,000 year old castaway, not to mention cracked ribs; Days and days of fretful boredom during the slow return to 100% John Sheppard. And yet, even in the Colonel's darkest, most vulnerable moments, there would be a quirk of the lips, a wry joke, a determined glint in the eye that seemed to say, "S'OK. It's bad now, but it will get better, Carson. Just you wait."

Until now. It had taken Carson a full five minutes to work up his courage to run the scans on the Colonel within the stasis pod. He'd seen the man wrung through the wringer, but never before had he seen John Sheppard defeated.

Carson had wanted to throw his medical scanner to the ground and stomp on it. What good was bloody technology if it didn't tell you want you wanted to hear? He'd seen the desperation and horror on Rodney and Teyla's face, the grim fury on Ronon's, and Carson had so badly wanted their efforts to come to good result. Instead, the Colonel stood entombed at the moment of his own death, if you believed death was the moment the heart stopped. Carson didn't.

So it didn't really take much yelling from Rodney to convince Carson he could pull the Colonel off the ledge in the right direction. Especially after Rodney's miracle epiphany. He would never say it to Rodney, but the ability to repair the severed aortal artery – nicked by a bullet fragment that had ricocheted off a rib – before the Colonel was taken from the stasis field was the difference between emergency surgery in the back of an ambulance with a teaspoon and a real chance at resuscitation.

But the technology alone wasn't enough. Carson needed the procedure that would pull it all together.

So he studied – Woolsey started going purple in the face every time Carson appeared in the control room because he'd asked to open a wormhole to Earth to download more research on thoracic surgical techniques so many times. The stasis pod worked shockingly like Deep Hypothermic Circulatory Arrest (DHCA). The more he prepared, the more he realized the incredible benefit the stasis field could offer emergency medicine.

And he planned –There was a large problem of access. In an operating theatre, he'd gain access to the aorta by either cracking the chest or delivering a stent to the damaged artery by snaking it up through the blood vessels from the leg. Rodney's "puddle" only offered him a small window to work through. Here it was Jennifer who demonstrated her expertise and brilliance and together they borrowed ideas from laparoscopic surgical techniques and scanned the poor man so many times to determine the exact angles and points of entry, etc. that Carson feared Sheppard would start to melt simply from their hovering.

Technique wasn't the only obstacle – he needed tools, too. It was then that Carson learned that Jennifer had spent a fair amount of time fixing cars as a child. Carson simply watched in awe as she took instruments apart and put them back together in just the way they needed. Rodney cobbled together a tiny video probe and monitor system.

When he was satisfied with his plan, he practiced – First he put a CPR dummy in the stasis pod chamber on Atlantis in as close to the same position as Colonel Sheppard stood, bullied Rodney into setting up his hair dryer and the scope with monitor and he practiced every step of the surgery over and over. The first thing he learned was that standing and holding his arms up steady enough and long enough was impossible. So Carson added a stool, just the right height, and made Rodney build him a platform to rest his elbows and steady his hands.

Then he brought his trauma team to the stasis pod and they drilled every step of the resuscitation after surgery. The first time Rodney killed the stasis field, the CPR dummy flopped and went head first onto the skull-shattering tile. There was a lot of yelling and blaming, and they did it again. The second time, the IV wires got tangled and the chest tube was yanked out when they laid the dummy onto the gurney that would be waiting for the Colonel. More yelling. Again and again, until they could perform every step of the rescue like dancers on the ballet stage.

And then he was ready. Woolsey insisted upon a night of rest before they made the attempt and Carson found himself late that night, sitting on the stool amidst the pile of equipment that was packed and labeled and ready to be taken to the stasis room on the outpost.

Soft noises pulled him out of mentally chanting the steps he'd memorized for the surgery and he looked up to see Rodney and Teyla and Ronon surrounding a very nervous looking David Sheppard. Carson rubbed his eyes, curious. David had hovered at the edges of Carson's world for the past three days, always present, always in the background. Upon a closer look, though, Carson was suddenly concerned for the man. David looked pale, pinched. He was impeccably groomed, however, even the casual style of his clothing revealing a sophistication that indicated quality and expense. But his eyes were hollow and he lifted his chin with a nervous jerk when Carson addressed the group.

"What can I do for you good people?" he asked softly, hearing the weary tone in his own voice. Woolsey was right – he needed rest.

"Dr. Beckett," David began, his voice gravelly, "I would like - " David stopped, bit his lip, "I need to ask you... As John's brother and only living blood relative, I feel... I would like to be the one to turn off the stasis pod when you attempt to revive John tomorrow. I just...think it should be...me."

Carson flicked a look at Rodney, then at the rest and saw only support for the idea.

"I can have no objections, lad," Carson agreed with a nod. "Lord knows you've watched how it's to be done often enough."

"Thank you. For...everything. However it turns out, I...thank you."

David lifted his chin, then spun to shove past Teyla and walk briskly out of the room, his head high and his shoulders back, but every step shrieking with stress. The others drew closer. Carson recognized the signs, knew immediately what they needed, so he let them speak first.

"Are you ready?" was Rodney's question.

"Aye," Carson answered as firmly as he could muster. He left it at that.

"Will John be in great pain?" was Teyla's soft query.

"I won't lie to you, lass. He'll be in a fair amount of discomfort from surgery and the injuries themselves if he survives the procedure. The chest tube that will be present for several days is damn uncomfortable, as is intubation – we'll keep him sedated for as long as that's required..." he trailed off, giving these friends the space they needed.

"Is Sheppard going to make it?" came from Ronon, the words more challenge than question.

Carson looked the large man sternly in the eye and refused to flinch when Ronon's glare cried with accusation.

"Colonel Sheppard is a strong, healthy lad. But the injury he has suffered is very serious. Back on Earth, most don't survive damage to the aorta. Most die before they reach a hospital. But John has something none of those people did – you. Your tireless work and quick minds have given him every advantage available. And some advantages that weren't until yesterday!"

Carson stood, reached for Ronon's shoulder. "I can't predict the future, but I can promise you I will do my best. If John slips into the comfort of the long sleep, it will mean it's his time and I will rejoice in his life well lived."

They stood together for many quiet moments, then one by one the team murmured farewells and drifted to their rooms, to rest if not sleep. Carson watched them go, his hands in his pockets. He was to bed, as well. But like them, he wasn't sure sleep would find him either.

At 10:00, they were ready. Ronon and Teyla had had the Marines wipe down every surface in the room and hang sterile sheets on every wall for good measure. All of Carson's equipment was moved, checked off his list, installed, tested, and lay ready at his fingertips.

Carson pulled the surgical mask over his nose and took a deep breath, with his hands in his lap. He closed his eyes and chanted the steps one last time. Behind him, the room was very, very still. The trauma team stood or rested on stools beside the gurney, knowing their part would come hours later – unless something went wrong and the Colonel was taken out of the pod early.

Teyla, Ronon, Rodney, David, and – to Carson's surprise – Woolsey stood along the far back wall, their postures tense and lethargic at the same time. Jennifer stood beside Carson, ready to assist and he could tell she was smiling at him from the crinkles around her eyes above her mask.

"Let's begin," he said.

It was by far the most difficult and strangest and most rewarding surgery Carson had ever performed. The challenges and peculiarity of working on someone who was standing up offered enough for a whole paper by itself, not that he'd be allowed to publish it. Step by step, though, he worked through his plan so painstakingly prepared, and so infuriatingly thwarted by the wholly uncooperative Colonel.

First was the bleeding. Then was the bullet fragment that slipped out of position when the area was thawed. Then was the unexpected problem of repairing the artery itself – there was not enough of it thawed to "pull" the edges of the tear together and it took Rodney's intervention and a terrifying moment of messing with the hair dryer's field to expand it far enough to tug them into place. And then there was the damage done by the bullet's path through the lung that hadn't shown up on scans.

At long, long last, Carson completed the last step, placed the last instrument on his tray, turned off the hair dryer so that the Colonel was once again fully embraced in the Stasis field (along with several important additions of Carson's doing), and sat back. There was rustling and soft murmuring behind him, but he had to concentrate on the moment to relax his trembling arms, flex his cramped fingers.

"That's that," he announced at last.

The murmuring became scraping as stools were pushed out of the way and the trauma team stood and stretched, preparing for their part. As they readied the defibrillator and tore open sterile tools, Carson walked the room a bit, spoke hopeful words to each of the Colonel's friends, took a leak and re-scrubbed.

This time, when he stood beside the stasis pod, the trauma team on their marks beside him (literal marks – he'd put x's of tape on the floor to indicate each person's position so that they could precisely reproduce the motions they'd practiced on Atlantis), a flutter of adrenaline chased his heart up to speeds that another doctor would find worrisome. This was the hard part. He took a deep breath, blew it out, lifted the hand to give the cue – and froze.

For a terrifying moment, he could see nothing but his hands shaking in wide terrified tremors in front of him. All he could think about was the mountain-sized pile of "whatifs" that he'd had no hope of preparing for. A gentle hand on his arm pulled him out of the shocked moment and he jumped, turned to see the encouraging face of David Sheppard looking solemnly into his eyes.

"It's time, doctor," David said with quiet conviction. Carson jerked his head in a nod, feeling suddenly free – as if David's permission had somehow released the fear. Carson's fear could now be for John alone. David returned the nod, then resumed his place beside the control panel.

"Ready ladies and gentlemen?" he asked, leaning into position. "Now!"

The first step went perfectly. David slapped the stasis release and John fell into their waiting arms as if he, too, had practiced. The next stage also went off without a hitch – Carson had scheduled 30 seconds for his team to strip the Colonel and prepare him for the resuscitation. The quarter master had been very amused when Carson had asked for 10 worn out uniforms that they could put on their dummy to practice cutting the clothes off.

Carson looked at his watch and counted, loud and slow. When he got to 30, not only was the Colonel stripped and covered at the waist with a sterile sheet, but all his external wounds had been slathered with disinfectant, the IV lines Carson had inserted in the stasis pod had been connected to bags of saline and whole blood, EKG leads were attached, and the modified pacemaker had been connected to the modified defibrillator.

But nothing that any of them had yet done would matter if they couldn't get the Colonel's heart started. And the trauma team members who had been performing CPR from the moment the Colonel's back hit the gurney didn't count.

"Intubate," Carson cried and it took only seconds for the breathing apparatus to be inserted. The Colonel's chest began to rise and fall, though all motion was artificial.

"Here we go, lad," Carson murmured to John alone. "Administer first electrical correction. Clear."

The trauma team took a beautifully coordinated step back from John and the pacemaker/defibrillator hummed very softly. John's torso twitched, though not as dramatically as with a paddle defibrillator. There was a collective breath in the room.

"Nothing," Carson called. "Again. Level 2. And turn the pacemaker on. Let's see if we can fool that tough heart of the Colonel's into believing it's been beating all along."

The group cleared the table again, and again John twitched. Carson kept his eyes glued to the EKG monitor. It blipped and flashed with the artificial pulses of the artificial pacemaker. When it started to flutter with the symptoms of fibrillation, Carson's own heart leaped in hope.

"We're getting VFIB! Hit him with level 3!"

Another twitch. Another collective gasp. Carson waited.

"We've got normal sinus rhythm," he breathed, not yet allowing the words to turn into a cheer. "Let's watch for a few minutes, see if it sticks."

One minute of painful waiting passed. Two. The Colonel's heart puttered along, but something held Carson's relief in check. John was steady, but not growing stronger.

"Blood oxygen is dropping!" One of the trauma team called, only a little more anxiously than his professionalism should have allowed.

"Blood pressure dropping."

"Heart rate's dropping," Carson called out as the steady patterns on the EKG monitor grew lethargic. "Put him on 100% oxygen. Resume pacemaker and increase voltage."

Carson threw himself into crisis management mode. There was no longer any plan, no longer any preparation except his years of experience and a healthy dose of instinct. Jennifer worked at his side, equally focused, equally concerned. The friends and loved ones around the table were statues of terror, but Carson spared no attention on any of them.

John's heart faded, returned, faded again.

"Put him back in the stasis pod," a distraught, strangled voice begged when John shuddered again. Rodney.

"NO," came the firm, grief stricken answer from David's side of the room.

With each falter and revival, the likelihood that they simply would not be able to get him back the next time increased exponentially. Exploratory surgery was out of the question. A dozen other options also unavailable, even on Atlantis - they were either too far away or John was too weak to try.

"Come on, lad. You've come this far," he whispered as he worked. Carson had tried, he'd really tried to save the Colonel. He'd done everything within his power, used the resources of two galaxies. But in the end – from the beginning, maybe – it was really up to John to save himself.

"Fight."