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Chapter 7
Queens Medical Center Neuroscience Wing
Saturday, 1645 hours
~~~H50~~~
"Would you please hold still?"
An extremely agitated voice replied, "Not movin'. Jus' get da damn ting."
Danny stopped in the doorway of Steve's hospital room, listening to the strange conversation. All he could see was Dr. Makani leaning over the bed and Steve's fist tightly gripped around the bed rail. His legs were jerking in response to whatever the doctor was doing.
"I told you not to sniff it up there or I would have to go fishing and neither one of us would like it."
"I din'nit sniff. You should'na hab answered da phone. Ow! Dat hurts."
"Sorry, but I have a wife who is 8.75 months pregnant and I have to answer the phone. Wait. There. I got it."
Makani stood up, holding up a pair of tweezers and Danny decided it was safe to enter the room. "Is this a private party? Want me to leave?"
Makani turned around and Danny got a glimpse of Steve, both hands on his face holding his nose. He couldn't contain his laughter any longer. "I'm sorry, but just what were you two doing?"
Steve continued to protect his face. "He lost a big wad of gauze up my nose."
The doctor dropped his 'prize' into a small container and held it up for Danny to see. "It's not big and he sniffed it up there. Had to dig to find it."
Danny held up his hand. "Thank you, but I believe you. I don't need to see the evidence."
Steve continued to complain. "If you hadn't left the room to answer your phone, maybe someone would have remembered it was in there before it traveled all the way to my brain."
"I told you the only way it traveled was by you sniffing. And it wasn't in your brain."
"Could've fooled me."
"Well, if you two can stop bickering for two minutes, I actually have some news to share." Danny moved to the opposite side of the bed and set Steve's backpack on the bed near his feet. "How you feeling, Partner?" he asked, while unzipping the pack and pulling out the tin.
Steve rubbed at his nose once again. "Headache's better, but now my nose hurts. What's in the box?"
Danny gave the tin a small shake. "Cookies, which are very good, I might add." He handed the tin to Steve. "Compliments of Mrs. Hu and Caroline."
"You ate my cookies?"
"I had one cookie, Steven, really, does it hurt you to share?"
Steve took a cookie and offered one to the doctor. "So, what's your news?"
"I know how you hurt your head. And for another cookie, I'll tell you." He reached in the container and helped himself.
"But I didn't hurt—"
Danny wagged his finger at his partner. "Ah, but apparently you did. Caroline brought over the cookies as an apology. She said you were showing her some surfing techniques on Sunday night. Remember that?"
"Yeah, sure, but…" his face showed his confusion.
"She said a wave took you both off guard and she tumbled. The board flipped and it smacked you in the back of the head and knocked you under. The cookies, ergo, are her apology," he finished, grabbing another cookie from the tin.
"That could do it," Makani agreed, glancing at Steve. "You don't remember that?"
Steve looked confused, trying to think back to that evening. "Not really. I remember I was finishing a run on the beach and stopped at the Hu's house. Her grandparents were sitting on the sand watching her trying to stay on the board, so I offered to give her some pointers." He shook his head. "Don't remember getting knocked around in the water."
"Well, I'm glad to know that this hasn't been a ticking bomb inside your head for several months. If this developed a week ago, I feel confident it will close quickly on its own." The doctor gathered his things along with the roving piece of gauze and moved toward the door. "You'll have a dinner tray soon. The nurse can raise the head of the bed for a few minutes so you can eat, but then you need to lay back down and sleep some more."
"It seems that's all I can manage to do," Steve replied, emphasizing the fact with a yawn.
"Don't fight it. That's what your body really needs to recharge. We'll do another scan in the morning. Until then, rest." He waved as he headed out the door. "And thanks for the cookie."
~~~H50~~~
Queens Medical Center Neuroscience Wing
Sunday, 0045 hours
Nurse's Notes – Room 520
0045 hours
Patient McGarrett sleeping peacefully. Received oral pain meds at 2300; will evaluate pain level upon waking. Temp is 99.8; well within normal range with low CSF.
~~~H50~~~
0245 hours
Patient continues to sleep without incident. Temp remains at 99.8.
Steve tossed restlessly on the bed, his headache beginning to make itself known once again, even in his sleep.
I hired you… you're safe
Won't have to go through life as a meter maid
He frowned, tossing his head on the pillow as the words wove through his dreams.
~~~H50~~~
0445 hours
Patient appears restless. Temp up slightly to 100.2. Awoke, startled and disoriented at my touch. Refused pain meds. Will check in half hour to ensure he is back to sleep.
Steve jumped when he felt something touch his forehead. "Huh?" He jerked his head up to see where he was, then winced when the movement caused an immediate spike of pain in his skull. He dropped back to the pillow, not quite controlling the groan that slipped out.
"Hey, I'm sorry," the nurse assured him, placing her hand on his forehead to keep him from jumping up. "I'm just taking your temperature."
"Hmmm." His eyes opened once again and he anxiously looked around. "Where? … oh, hospital." When he realized where he was, he visibly relaxed although she could see the pain and stress outlined on his face.
"My name is Betty," the older nurse said, smiling down at him. "You've been asleep every time I've come in here tonight, so that's good. How's your headache now that you're awake?"
"I think it was fine until I moved."
"Sorry, that was my fault. I didn't mean to startle you," she told him. "Earlier, you seemed to be sleeping so well, I didn't want to wake you. I'm sure you are ready for your pain meds now."
"It's not too bad," Steve told her, hating the thought of another dose of pills. He rubbed his hand over his eyes and then blearily looked up at her. "But I'm kind of thirsty."
"Of course," Betty replied, pouring a cup of water from the pitcher on the nightstand and inserting a straw into the cup. "Here, not too much at once," she told him. "Are you sure you don't need anything for pain?"
He handed the cup back to her and shook his head. "Not right now. Don't like the way they make me feel."
"Are you nauseous?"
"Kinda, but it's OK. Don't need anything."
"All right," she told him. "I'll leave you alone if you think you can get back to sleep.
"Yeah." To prove his point, his eyes were already closing.
~~~H50~~~
0515 hours
Patient sleeping restlessly. Temp remains at 100.2. Did not attempt to awake for meds, but is scheduled for follow up cisternogram at 0700 and will receive pain meds prior to that time.
The words continued to be repeated over and over as his dreams changed throughout the night. Mostly he heard his own voice, taunting and grating, harsh and hateful while speaking to people he couldn't see.
Minority quota Won't let you be a real cop… grunt job … meter maid
You can thank me later … thank me later … thank me…
… doesn't like the truth
She's related to you…
…. Related to you …
I hired her. She's safe. … don't worry, so are you…
She came whining to you?
… tired of you people
… your kid at my house … would like the night off
Suddenly in the middle of his dream, he could hear Danny's voice shouting at him, "She loves you, you know…"
… she loves you …
Loves you…
Danny's words continued to play over and over in his head and they made him very sad. Where is Grace? Need to find Grace. Something's wrong, Grace is gone. She's not coming back.
"Grace?"
… tired of you people…
The only one with a problem is you … problem … is you …
job is yours
Because I'm done …
I'm done …
done …
"I'M DONE!"
Steve bolted upright in bed, repeatedly screaming the two words. When he jerked upward, pain lanced through his skull, taking his breath away. He grabbed his head with both hands, his fingers gripping tightly, squeezing on the outside to counter the beating pain on the inside.
The upward movement caused his stomach to flip and he felt the nausea increase shortly before the hot, churning liquid spewed forth. Thankful for the railing on the bed, he fell sideways against it when he began throwing up.
"Commander!"
Betty had heard his shout from her seat at the nurse's desk and ran down the hall, entering the doorway just as he began to vomit. She managed to contain some of it in the emesis basin, but most hit his tee shirt, the bed covers and floor.
When the meager contents of his stomach was gone, he continued to retch and each time he gagged on the bile, he felt tendrils of fire pierce his brain. His body was weakened from the exertion and he leaned against the railing, trying to catch his breath when the heaves began to subside. Betty held the basin in one hand and rubbed his back with the other while he continued to hold the sides of his head in a vice grip.
"Make it stop," he moaned between heaving. "Please make it stop."
Another nurse entered the room and Betty looked over her shoulder, barking orders. "Get Makani on the phone – I know it's early, but we need him. I need a verbal order for IV pain meds. After that, please bring me Phenergan 25 mg."
Miranda ran out the door, just as a second nurse entered. "Betty, how can I help?"
"Kami, help me get him back down." The nurse carefully maneuvered around the mess on the floor and moved closer to the bed while Betty leaned over her patient.
"OK, Steve, just try to relax. You'll have something for the nausea very soon, so hang in there. We're going to move you."
He tried to slow his breathing but his effort only caused a round of coughing, which in turn brought another bout of dry heaves. One hand was now tightly holding the bedrail and the other was firmly planted on his forehead, his fingers digging into his skull.
"No… Head hurts. And… can't… breathe."
Kami placed her hand on his chest. "Take slow breaths – you're almost hyperventilating." She tried to help regulate his intake of air by keeping the pressure on his chest while Betty lowered him onto the pillow, rolling him to the side and placing pillows behind his back to keep him in that position.
"Here we go," Miranda said as she returned, carrying Steve's chart and two syringes. "Don will be here soon. Want me to inject the Penta into the IV?"
"Yes, please, and give Kami the Phenergan so we can get it in his backside." Betty quickly pulled down the elastic band of Steve's sleep pants and held it so that Kami could swipe an alcohol swab and insert the needle into the muscle.
"Steve, you're doing fine and should start feeling better in a couple of minutes." Betty rubbed her hand over his shoulder, waiting for the tense muscles to relax.
He kept his eyes tightly squeezed shut, one hand still gripping his forehead, his breath coming in small hitches as he breathed through his open mouth.
"I'll call housekeeping," Miranda said as Kami removed the soiled covers from the bed, once again side-stepping what was on the floor. "Do you need anything else?"
"Not at the moment," Betty replied, keeping her hand on Steve's shoulder. "He's doing good."
When the pain meds began easing the throbbing to a more steady level, Steve finally let his hand fall back away from his face and said in a gravelly voice, "My nose is runnin' again."
Betty leaned down to check his nose and then reached for one of the gauze plugs they had placed in the bedside table. "I'm going to put this in until Dr. Makani can get here, so lie still for me. You're breathing better, but with this in, breathe through your mouth and try to relax. The meds will probably make you sleepy, so don't fight it. Sounds like you were having a nightmare," she commented and had to strain to hear his next words.
"Wish it was a nightmare," Steve quietly replied, closing his eyes.
Kami returned with a sheet and blanket and prepared a warm, wet washrag which she handed over to Betty who began to clean up her patient, washing his face and neck. "Steve, want to rinse out your mouth with water?"
"Don't want to move," he admitted.
"We need to get this dirty shirt off, but we'll be as quick as possible. Kami, would you mind getting me a gown, too?"
Betty set the wash cloth aside and rubbed her hand down his arm. "Commander, please bear with us and we'll have you cleaned up in no time." She saw that his eyes were already half-mast from the combination of drugs he had received. "Go ahead and sleep. You'll feel better when you wake up."
Betty stared at her patient, hoping that her statement wasn't a lie. She had been shocked upon seeing the amount of green-tinged fluid that had leaked in such a short time. And she hadn't had a chance to check his temperature, but from touching him, she could tell his fever was up a bit. Housekeeping came in to clean the floor, but she didn't move, keeping watch over him, her hand on his arm until the doctor finally arrived.
~~~H50~~~
Dr. Makani removed the saturated gauze plug from his sleeping patient's nose, disturbed to see how wet it was. He then watched the slow trickle of fluid which began to drip once the gauze was removed. "Betty, did he jerk his head when he woke up?"
She nodded her head. "I assume so. I didn't see him, but I came running when I heard him shout, apparently from a nightmare. He was sitting up and just beginning to vomit. In addition to throwing up, he was in quite a lot of pain. Look at the marks he left on his forehead from gripping it so tightly."
The doctor nodded in thought. "I'm going to go ahead and take him down and we'll probably do a blood patch after the cisternogram. I was hoping this would close on its own, but after this morning, it looks like we'll need to plug it. We can keep the same schedule and get him in at seven. I'm going to wake him up, so have another dose of Phenergan ready."
"Oral or IM?" she asked, heading to the door.
"Better make it IM. I doubt he can handle pills right now."
When Betty left the room, Dr. Makani turned back to the bed. "Hey, Steve, can you hear me?" He had worked with military personnel enough times to know that touching the man to wake him was not the wisest move, so he continued to talk. "Commander!" he spoke sharply, finally earning a grunt from the sleeping man. "Steve, wake up. That's an order."
Not one to willingly disobey orders… military ones, that is, Steve groaned and opened his eyes, then allowed them to close once again. "What?" he croaked out, his throat raw from heaving so forcefully.
Makani reached for the cup of water and offered it to his patient, who was still rolled onto his side. "This might help," he offered.
Steve blinked and saw the cup and took a couple of sips, wincing as the water went down his sore throat. "Thanks."
"How's the head?"
Steve's eyes remained closed. "Can I trade … for a newer model?"
"Sorry, I don't do transplants," the doctor explained, "but I hope to have a solution to help."
"I don't care what it is, do it," Steve pleaded. "Can't take much more of this."
"On the scale, what is it while you are lying down?"
He grimaced. "Don't know… can't even think it hurts so bad."
Dr. Makani knew that it must be bad if his patient even admitted that much. "We're going to do a procedure called a blood patch. We'll take blood from your arm and inject it into your spinal column directly into the leak. It should close it pretty quickly."
"Should'a done that… couple'a days ago."
"Well, there is a risk of infection any time we introduce something into the spinal fluid. And while it should help with your headache, it isn't the most pleasant of procedures."
"Don't care. Just… do it."
"You're on the schedule for seven. I'll call your partner and fill—"
"NO!" His voice sounded near panicked and he began taking short, panting breaths, once again holding his head in his hands. "No, please. Don't call them. I… just don't."
"I told them I would keep them informed—"
Steve opened his eyes and tried to glare at the doctor. "I don't care what you said. I don't want them here. Understand?"
"Clearly," he agreed, nodding his head and making a notation on his pad. "What do I say when they call… or show up, which they surely will."
"You can… tell them I don't feel like company. And…" he squeezed his eyes shut. "And that's the truth. I don't want to see anyone."
"That's your call," Makani agreed as Betty returned with the syringe. "How's the nausea?" the doctor asked, reaching to take the syringe from her.
"Can't think about it… or I'll puke again."
"Then this should help," Makani said while Betty pulled down the cover and moved aside the hospital gown.
Betty swabbed his buttock and Steve squeaked, "What are you do—OUCH!" His eyes shot open in surprise and pain. "What'd you do that for?"
"No need for modesty, son, I've seen it all before," Betty told him while rubbing the injection site.
"Want my pants back," Steve mumbled, closing his eyes once again, feeling the heat in his cheeks that had nothing to do with a fever.
"They'll come get you in a few minutes," she told him. "Just try to go back to sleep and you'll forget about your modesty," she promised while tucking the gown back around him and pulling up the cover.
She doubted he even heard her.
~~~H50~~~
