Steve's final medical procedures were scheduled for early the next morning. We had spent one last night together, tender and sweet, knowing that we wouldn't have another stretch of time alone together until the wedding. In the morning, I gave myself permission to feel clingy. It was appropriate anyway, since Anna and I were supposed to stay close during the process, in case, for some unexpected reason, the radiation made a return. Tony wouldn't be immune to it anymore, but she and I hadn't been through the elimination regimen yet. Plus, since the process we had worked out in hopes of a cure would be administered over several hours, it gave me an excuse to keep Steve company for the duration. Not that I needed one.
We made our way to the lab. The quarantine room inside the lab had been set up as a medical bay, complete with hospital bed, dialysis and vital-monitoring machines, and all the other accoutrements of a modern hospital.
I held Steve's hand as the nurse prepped him for the modified hemodialysis that we planned to remove the contaminant that was flowing through his veins, mingled with his blood. First she administered the chelation agent that I had designed to bind up the contaminant, to make sure we got every last trace of it from his system. She gave it fifteen minutes for it to work through his system, mingling fully with his blood, before she started hooking up the cannulae to connect him to the dialysis machine.
I knew this was coming. Yet, though I was a biologist, I was not in medicine. I knew how dialysis worked. I thought I was prepared. But, seeing those huge needles go digging into the arm of someone who I had come to love was very different than knowing the theory of it. I quavered a bit, and looked away. Steve gave my hand a long squeeze, and I looked at his face instead.
"I'll be fine. I'm an old pro at getting poked and prodded."
Although he showed no outward sign, I felt his nervousness. This isn't about me. I rallied and put on a brave face. I squeezed his hand back.
"I thought you said you didn't get sick anymore."
"There's always research. Dr. Kabalevsky's always telling me why she needs more blood. The reasons change, but the needles stay the same."
The nurse started up the machine, and we settled in for the four hours it would take for the hemodialysis to run its course.
We talked about everything. Our childhoods, our lives, our hopes for the future. We made some sketchy plans for what we'd get up to before the wedding. I'd head off to Wakanda a few weeks earlier than him, to make some arrangements. He'd stay behind, and take care of things from this end. I still hadn't told my family about us. That was waiting for the secrecy rating to drop a level. Not that I didn't trust my family, but if details got out before things were finally settled, it would put both of us in danger.
A few hours in, an assistant dropped off a DVD with a note scrawled in Tony's handwriting. "Do you understand this reference?"
Steve explained, "It's an old inside joke."
I smiled as I recognised this small signal from Tony to let his friend know he was thinking of him.
I put the movie on, and we started watching together.
Part way through the second act, Dr. Kabalevsky came in to supervise the nurse unhooking the dialysis machine. She sent a blood sample out to Dr. Cho in the lab next door, and started the IV drip of bioengineered stem cells.
"We've run some cultures, and these should replace the bone marrow modified by your exposure to the contaminant. You may feel some weakness and dizziness. That's normal. And, we're going to continue to monitor your vitals very closely. We're going to let it infuse over the next couple hours. It'll be easier on your body that way."
Steve gave her a tight lipped nod in confirmation.
He didn't feel much like talking, so we turned the movie back on, and watched quietly for a while.
As the final credits played, Steve started talking quietly.
"I first saw this in theatre during its original run. It cost me twenty-five cents. I knew should have saved that money for a new winter jacket, but I just wanted to have a bit of fun. I went with Bucky. We were so young then. We thought we carried the weight of the world on our shoulders, but we had no idea really. We'd known struggle. I understood struggle. But I hadn't seen war. I didn't understand betrayal. Not then. Not yet."
I was a bit alarmed at his small monologue. I'd never heard him so melancholic. I passed my eyes over his monitors. His heart rate was elevated and his blood pressure was dropping. Before I could do anything, alarms started to go off and the medical team rushed into the room.
There was a scramble to figure out what's going on, as Dr. Cho and Dr. Kabalevsky checked readouts and issued orders to nurses to hook up extra monitoring.
I pulled myself together. Inside, I was a roil of emotional distress, but I shoved it down and tried to act rationally, to stay out of the way and assist where I could.
"What is it? What have we missed?" Dr. Cho mused out loud. "We couldn't take Rogers' whole-system response into account during our in vitro trials. Check for anti-bodies and white blood cell count." A nurse stepped in to take a blood sample, then rushed it out to the lab outside.
Suddenly, a new sound filled the atmosphere. It was the radiation sensors. Steve's old cells must be emitting it as a swan song as the new ones took over. This would make things more difficult. The medical team, wearing lead aprons in anticipation of this potentiality, quickly finished their tasks and exited the room, leaving only me and Dr. Kabalevsky.
"Are you prepared to assist?" she asked.
I took a deep steadying breath. "Yes. Just tell me what to do."
But before I could do anything, the steady blip of Steve's heart monitor changed to a flat whine. He'd gone asystolic.
"We need the code cart in here!" Dr. Kabalevsky called out, knowing that there was a whole team listening just outside the room. "Start chest compressions. Now," she commanded, as she moved to attach an oxygen mask to Steve's pallid face.
I started CPR, standing on the chair next to the bed to get better leverage as I pushed down into his barrel of a chest.
"No! No. Stay with me Steve!" I'd only just found him. It was too soon. He couldn't go. I wouldn't let him. "Fight." He was so good at fighting.
A lead-clad technician entered the room, bringing in the crash cart, and then swiftly leaving again. Anna left her place at Steve's airway to pull out parcels and equipment from the cart. With Steve flat-lining, defibrillation would be no help, but she pulled out a syringe of epinephrine, and administered a dose into his IV, calling it out for the transcriber listening in on the other side of the glass.
As she returned to Steve's airway, I glanced at the clock. Two minutes in. I knew that chances of recovery dropped to nil at fifteen minutes of CPR. Brain death. We had to fix him by then. We had to. Anna and I had our hands full, doing a full team's worth of work with only two people. It was up to the people outside this room now. It was up to Tony and Dr. Cho. I prayed they were up to it.
I schooled myself into some semblance of calmness. I needed to steady my compressions. With the radiation in the room, there was no one else to spell me out. But I swore I was going to keep pumping as long as there was still hope. I tried to quiet all the alarmed thoughts in my head, and just focused on keeping my rhythm steady, and my compressions the right depth.
A second lead-clad nurse entered the room, handing Dr. Kabalevsky a vial and exiting again. She read it briefly, "Tacrolimus. An immuno-suppressant," out loud, presumably for my benefit.
Dr. Cho's voice came in from the other room "His immune system is fighting back. We think it may be interfering. 4 cc's of Tacrolimus should be enough to calm things down."
Dr. Kabalevsky gave a brief nod and moved to administer the drug. Is that going to be enough? I thought to myself, as I continued CPR.
My hopes perked up as a voice called in on the PA, but it was only the scribe letting Dr. Kabalevsky know it was time for the next dose of epinephrine. That's eight minutes down. Come on Helen.
As the initial rush of adrenaline started to clear out of my system, an oppressive sense of despair started to sink in. For the first time I started to admit to myself that this might be when I lost him. We've killed him, I thought. We've killed Captain America. We should have done better. I should have been better. This is my fault.
I blinked back the tears that were clouding my vision and focused on my compressions again. I had one job in this: keep steady, keep pumping. Another three minutes passed. Another dose of epinephrine.
Another lead-clad tech brought in an IV bag and handed it to Dr. Kabalevsky. As she hung it, and connected it to Steve's IV, my eye was caught by my own name printed on the bag, along with "PLASMA" in capital letters. I racked my brain for a mechanism that might explain their choice, but came up empty. They're grasping at straws. I felt another bit of hope die within my breast.
My skin began to prickle all over, and then I heard Tony come in over the PA, "We're trying alpha radiation."
I didn't hear any triumph in his tone of voice, only the brusque tone that told me he was still in problem-solving mode, but my heart lurched with hope anyway. Was that it? Have they done enough? But time ticked on, and there was no change.
At one point Dr. Kabalevsky asked, "Stop compressions for a second. Let's check his rhythm."
I did so, but it was the same desolate flat line. I picked up where I left off.
A melancholy quiet fell over the room, filled only with the soft whirr of machinery, the swish of Anna's clothing as she moved about the room, re-seating the oxygen line or adjusting the flow on the IV, and my own heavy breathing as I continued compressions, my muscles protesting, my shoulders knotting up with tension at the awkward position. We were running out of things to try. We were running out of time.
Suddenly, Steve gave a huge gasping intake of air, throwing off my hands as his chest arched upward. For just an instant, time froze. And then the cardiac monitor started beeping steadily.
I paused, unsure of what to do next, but then the medical team flowed back into the room, the flurry of activity around Steve blocking him from my view. The radiation must have cleared, and I watched the doctors make a series of minor adjustments to the lines going into Steve, checking the readouts of the various pieces of monitoring equipment. I picked up enough from the medical chatter to gather that the crisis had passed; that he was stable, although still unconscious.
They had things in hand; my role here was over. I was just an extra body in a room full of more qualified professionals. Now that I was no longer needed, my brain started to throw up all the emotions I had shoved down during the crisis. Feeling a freak out coming on, I slipped out of the room, side-stepped the lab commotion just outside, and snuck down a short, quiet hallway.
With that little bit of privacy, all of the panic that I had suppressed came rushing back at me. First the tears started, and then deep, wracking sobs. I knew things were fine, I knew he would be okay now. But, irrationally, my body was going to panic now anyway. I had been so afraid. Afraid he would die. Afraid I would lose him. Afraid it would be my fault. My legs gave way, and I slid my back down the wall and rested my forehead on my knees, and just stopped thinking.
I heard Natasha approaching my spot in the hallway. "Rachael?"
I rose and wiped tears off my cheeks, embarrassed to have lost my composure in front of the stoic Black Widow. But as I turned to her, I saw her own eyes were glistening. He means so much to so many people. Who am I to monopolise his attention.
"He's awake. He's asking for you," Natasha said gently.
I squared my shoulders. It wouldn't do to fall apart now. Natasha reached out and gave my shoulder a squeeze of reassurance. I smiled back gratefully to her, then headed towards the medical bay.
I re-entered Steve's room. When I left, it had still been a flurry of activity in the aftermath of a medical emergency. Now, it was a quiet space of recovery. I sat down gently in the chair next to the bed.
"Hey," Steve said weakly, turning his head to look at me.
"Hey," I choked out, catching back a sob.
I reached out to clasp his hand in mine, holding it tightly against my cheek. It was warm and dry.
"I thought you said no touching. Not that I'm complaining."
I laughed, which didn't manage to diminish my tears at all, only adding hiccoughs to the mix.
I climbed up in the bed beside him, conforming my body to his side, gingerly resting my elbow across his chest, holding his hand, tucking it tightly under my chin as I rested my head on his shoulder, his other arm wrapped around my back, snugging me in to him.
"I'm so sorry. We let you down. We almost killed you."
"Nonsense, I'm just on the mend. I'm feeling more like myself already."
"You were dead!"
"Nevermind that. I've been dead before and I'll be dead again, but my time's not up yet."
"When I thought I'd lost you… when I thought you were gone…"
"Shhh," he soothed me, reaching up to gently caress my hair, "I'm not going anywhere."
I clung to him. Reassured by his quiet solid presence. I let myself believe in us, in our future together. I heard him let out a happy sigh, as he breathed in the scent of my hair. I was more determined than ever to stick by him forever. To claim him as mine, legally and to the universe, in defiance of anything that it might throw at us. We were stronger together, and I wasn't going to let anything tear us apart. I love him.
