I'm really sorry I couldn't respond to all of you by pm. If you didn't get a 'thank-you-note' please believe me it was not intentionally. I thank all of you who have reviewed or put this story on alert. Thank you very much.
I have a request though. Please log in when you leave a review, or at least leave a name. This chapter got a ton of reviews from a guest, and I have the slight suspicion one person wrote a few of them. Even though I'm very happy about every single person reviewing, or simply reading for that matter, please don't abuse the fact that you can leave an anonymous review.
A special thank you to Cokie and Sherry for a superb job on this one. Thanks guys.
Open Water – Chapter 10
Nine minutes between life and death
U.S. Coast Guard Rescue 103 – Saturday 1405 hours
"Base this is Rescue 103, we have McGarrett on board."
"Rescue 103, understood."
"Advise Tripler our ETA will be nine minutes. We will give a status as soon as possible."
"Roger that, Rescue 103."
While Lieutenant Drake ended the conversation and looked at his partner; they both knew it didn't look good for the rescued man.
Within seconds the two crew members in the back of the helicopter had their patient out of the soaking wet board shorts and positioned Steve's naked body on the stretcher that was secured to the floor.
While one of them dried Steve off as best he could, the other inserted a thin tube into the still man's esophagus to take his core temperature. Seconds later they looked at the alarming numbers.
"Tim, start him on warmed oxygen," the 'winch-man' Petty Officer first class George Fusserelly told his diver as he finished wrapping Steve in warm blankets. He stopped for a moment and watched his partner intubate their unresponsive patient.
"Good boy," Petty Officer second class Timothy Gale mumbled after he checked the correct placement of the tube and the breathing sounds. "Very good sounds from both lungs. Guess his training kept him from inhaling too much water."
They both knew that was a huge factor in drowning victims. If they could prevent their bodies from inhaling water their chances of survival increased immensely. Unfortunately for most, it's an involuntary reaction from the body and they gulp in water into their lungs. Only highly trained divers or swimmers manage to avoid it.
"Starting CPR?"
"Not yet," Fuzzy, as all his friends called him, answered.
They first had to establish that the lieutenant commander was indeed without a pulse. It could be deadly for a hypothermic person to receive CPR when the heartbeat was just lowered to an almost undetectable rate due to the coldness of the body.
The two trained medics attached the EKG sticky pads on the chest and waited for a bleep. It took a few seconds, but then they heard what they were hoping for, a very slow but strong heartbeat.
"Yes! That's it. Inform Tripler," Fuzzy told his partner.
To increase the body temperature he got an IV started with warmed saline from their thermo box. Thankfully every rescue chopper was stocked with everything needed for victims of hypothermia.
"Do you want to irrigate as well?" Tim asked after he had relayed the information to the waiting doctors at TAMC.
"No, they can start that in the ER if they find it necessary."
PO Fusserelly wouldn't want to insert a Foley catheter to fill the bladder with warm fluids to warm the body from the inside. Not on a bumpy flight like they were having due to the storm. It had been challenging enough to insert the IV.
Any other invasive measure he would leave for when the patient was back on solid ground.
It was also a possibility that the doctors at Tripler wouldn't even go that far, as McGarrett was only on the border of severe hypothermia.
The medics' job on the flight back was to stabilize their patient and make sure he would make it to the ER as fast as possible in one piece and to prevent any further damage.
And they still had five minutes to go.
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US Coast Guard – 400 Sand Island Pkwy. – Saturday 1405 hours
Danny listened to the communication between the command center and the rescue chopper. He was anxious to hear about his friend's condition, but so far they hadn't said anything.
"What did they say?" He asked Lieutenant Myers who was assigned to assist the Five-0 detective as long as he was a visitor at the Coast Guard Center.
"Nothing yet, only that they have him out of the water. Why don't you go and get to Tripler? They will fly him there. It should only take them about ten minutes."
Danny was already calculating how fast he could make the almost seven miles to the Medical Center. Under normal circumstances he would need at least thirty minutes.
"Thanks, I'll do that."
Danny didn't even wait for the lieutenant to say anything but made his way out the door as fast as he could. Danny stumbled and almost fell down the stairs and only then did he realize that there was no reason to race to the hospital like a madman.
No matter how fast he would be, he would not be there before Steve was already in the trauma room. A place Danny wouldn't be allowed to go. So, he would again be fated to wait for any word on his friend.
In light of that realization it didn't make any sense to break his neck in his haste, or to put any other people or himself in danger while he was rushing to Tripler. Steve wouldn't go anywhere and whatever condition he was in, he would get the best care possible no matter if Danny was there or not.
Danny took a deep breath and tried to calm down. He was tempted to call Catherine, but what could he tell her? That Steve had been found, but Danny had no idea in what condition? He decided it was better to wait until he could give her more than the basic information.
A moment later he had left the building and made his way over to his car. Getting on his way and off the island on to the North Nimitz Highway took him only a couple of minutes. But he knew he wouldn't be lucky enough not to have heavy traffic on his way to Tripler Army Medical Center.
A look at the dashboard clock told him that it was only ten minutes past two and that Steve was about five minutes from reaching the emergency room.
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En route to Hilo International Airport – Saturday 1405 hours
Catherine Rollins couldn't believe her luck. If everything went according to plan she would make the flight out of Hilo at 1433 hours. Right now she was sitting in a private helicopter owned by some rich guy who heard her talking about not being able to get to the airport in time to get a flight to Honolulu.
"I can't thank you enough for taking me with you," she said into her microphone and looked at the older man sitting across from her.
"I'm glad to help. I'm sorry I intruded on your privacy like that back at the Four Seasons, but you seemed in such distress—"
"No, no, I'm grateful that you butted in. Really, thank you. The earliest flight I could take without your help would be in about six hours," Cath told Robert Core, as he had introduced himself earlier.
"I hope they will find your friend. He seems very important to you. If you don't mind me saying so," Robert said.
"That's alright. Yes, Steve is very important to me," Cath answered with a smile thinking about her relationship with her friend. "Unfortunately he has the tendency to get into trouble."
"I'm sure everything will work out in the end, and your friend will be fine." Core told her with a sad undertone.
"Thank you."
They both fell into silence and Cath wondered what the story was behind his sudden mood change. It would be days later that she'd find out that Robert Core's wife went on a swim and her body was found three days later. She obviously had been the victim of a shark attack and had bled to death from a wound to her leg.
Core had come to the Big Island every year for the last thirty years, ever since his wife had died. He would go out to where she most likely perished and would place a small box into the water. The box was filled with pictures of their three kids, telling the story of their lives after their mother had been taken from them.
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Tripler Army Medical Center – Saturday 1415 hours
Dr. Daniel Kulani entered the trauma room and was determined to get a better outcome for this drowning victim than the one he just treated and had to declare DOA. No matter how good the hospital and the staff are, sometimes it's just not enough.
But he would not call another time of death today. That was his intention, and he prayed that his next patient would walk out of here whole and intact. What he had heard so far wasn't really encouraging though. Not breathing on his own; temp below 84°; heartbeat of just 34, and a blood pressure way below the numbers considered safe. The only thing in his favor was the relatively clear lungs.
As far as he knew their next patient had been in the water for over eight hours, so they would also be dealing with dehydration and sunburn. Possible also was the beginning of multiple organ failure.
Kulani shook his head at what most people thought about the warm waters around Hawaii; the fact that it wouldn't matter to spend hours on end in it and walk away unscathed. That was not the case. And surely not on a day like this, with high waves, cold wind and cold driving rain. Those were dangerous conditions and not to be underestimated.
Adding to the environmental factors were also the personal factors like injuries, general health conditions, the victim's age and fitness status. He was sure that the lieutenant commander was in top shape and probably had no underlying health issues. But he had no information about any injuries. So, there could always be surprises.
Kulani was interrupted in his musings when the door to the trauma bay was pushed open and the gurney with their latest patient was brought in.
"Alright, people, let's get him on the table. On three," Kulani called out and with the help of the attending nurses, McGarrett was on the table in no time.
A flurry of activity started then, from checking the vitals to attaching the breathing tube to a ventilator. Up until now Steve had been ventilated manually with an ambu bag.
Five minutes later they had Steve under a heating blanket, inserted a Foley to irrigate the bladder with warm fluids, also a second IV was inserted to help with hydration and warming him up. Blood work was already on the way to the lab. All the scrapes were cleaned and would be dealt with more closely at a later point. They also stabilized his very bruised wrist and give him an x-ray as soon as he would be more stable.
"How does it look?" Kulani asked his young colleague who was just checking the head injury.
"I think we should do a CT scan as soon as possible. He only shows very weak reactions to stimuli," Jeff Manson, their youngest doctor, said. To prove his point he pressed the knuckles of his right hand on Steve's sternum, but as said there was only very little reaction.
They all knew that wasn't a good sign.
"His BP is dropping!" One of the nurses called out, and a second later the attached EKG started blaring in an alarming rate.
"Damn, he's going into rewarming shock," Kulani said and started measures to counteract this life threatening condition.
It was always a possibility that the body warms up too quickly and causes a collapse. Kulani had hoped to avoid it, but it was now a real possibility that he would have to call a T.O.D. a second time today after all.
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Tripler Army Medical Center – Emergency department – Saturday 1430 hours
Danny was pretty sure his drive up to Tripler had set a new record. He had parked in the lot and was now heading to the front desk in the emergency department.
"May I help you?" The young corporal asked Danny as he stood in front of her counter.
"Yes, Lieutenant Commander McGarrett was airlifted here. I need to know how he is."
"When was that? Mister…?"
"I'm sorry. Williams, Detective Williams. Ah, maybe half an hour ago. They fished him out of the water," Danny explained.
Corporal Denise Hart looked at her colleague, something that didn't go unnoticed by Danny.
"What was that? What was that look?" Danny wanted to know, and got a really bad feeling about what was going on.
"I'm sorry, Sir, but we are not allowed to give out any information about patients. But I'm calling a doctor who can tell you more about the commander."
"Can't you just tell me if he's okay?"
"I'm really sorry, but you should wait over there for the doctor," the corporal said and pointed to the waiting area across from her counter.
"Okay," Danny knew that she only followed protocol, but he found it most frustrating.
He was about to turn and walk over to the designated waiting area when another young corporal came to the counter with an armful of files.
"Hey, Denise, did you hear? The drowning victim didn't make it. Just a warning, Kulani is really pissed, you should stay out of his way."
"Terry!" Corporal Hart called out and glared at the careless young corporal and then at Danny who had blanched at the news that his friend had died.
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