Patrick watched Noah and Bryan through the waiting room window as they walked slowly down the hall. They both ran their hands through their hair and stared at the floor and he couldn't quite tell whether they were upset or just tired. He hoped they were just tired. He quietly watched them walking in the direction of the waiting room door as he stared at them, time seeming to move in slow motion. He saw Noah give Bryan a tired smile as he placed his hand on the door to the room and opened it. Patrick felt his heart give a leap of joy.
"Dad, how is she?" Patrick asked as soon as Noah entered the room followed by Bryan.
Noah looked up in surprise, a bit shocked by how quickly Patrick asked the question, but he smiled, glad to give good news, the first they had had for awhile. "She's alive, Patrick, Robin's alive," he said smiling. A huge relieved sigh was heard from around the room. "She's far from out of the woods, but she got through the surgery," he said with a grin on his face. "I'll let Bryan fill you in on the rest," he said moving aside to let Bryan face the family.
Bryan gave Patrick a reassuring smile, "Well, as Noah said, she made it through the surgery. The bullet went through her chest, hit her lung, and pierced her pericardium, the sac surrounding the heart. She went into cardiogenic shock consisting of cardiac tamponade caused by the excessive fluid buildup in the pericardium in the emergency room. While there, we performed a periocardiocentesis, which was able to relieve some of that fluid, but of course it kept building up since the bullet had gone through the pericardium. She was actually very fortunate that the bullet, even though it went through the pericardium, actually missed the heart by millimeters. We were able to repair her pericardium, which relieved the cardiac tamponade; therefore, relieving the cardiogenic shock and resulting symptoms." He paused to let the good news sink in.
"However, there were complications during the surgery, as I'm sure you have guessed because it took so long…" he said as he trailed off, looking at Patrick. Patrick nodded his head somberly to let him know to continue.
"Her heart stopped twice on the table, but we were able to revive her both times; however, her blood pressure is still pretty unstable. We put a Swan-Ganz catheter in so we could monitor her atrial and ventricular pressures. Hopefully, using this we will be able to keep her stable by providing the assistance needed," he said hopefully. "We were able to take her off of the ventilator, but she has an oxygen mask to assist her breathing and once she wakes up, we should be able to use a nasal cannula instead. We're monitoring her blood gases, ECG, urine output via catheter, and electrolytes. She's still critical, but that's only until her blood pressure stabilizes, which I'm hoping will be soon."
He paused to let the facts sink in with Patrick. "Barring any more complications, especially that of infection, I predict she will make a full recovery. However," he again paused as he heard relieved sighs throughout the room, "as Patrick knows very well, the risk of infection is huge. With a rifle wound, the bullet's trajectory pulls debris from the air and the debris follows the bullet into the wound and can then cause a multitude of infections. With Robin's HIV status and because of her compromised immune system, she is at greater risk than someone without HIV or a compromised immune system. To reduce this risk, I have started her on preventative IV antibiotics for 7 days. I'm optimistically hopeful that this will reduce or if we're lucky, prevent any infections."
The room became quiet as the information Bryan delivered was processed. Patrick broke the stillness, "What about the bullet wound itself? Were you able to get the bullet out?" he asked.
Bryan looked at Patrick, "The bullet ended up going straight through her so she has two bullet wounds, one on the front and the back. Of course, this increases the risk of infection, but as I said, I'm hopefully optimistic. She did lose a lot of blood though which is contributing to her blood pressure problems and we are still transfusing her," he said quietly.
Patrick looked at his friend somberly, "Can I see her now?" he asked.
"Yes, but only for a few minutes," said Bryan, rubbing his head as he realized he had a headache from the tension that had occurred during the last few hours. "I don't expect her to wake up for awhile. When she does, we can extend the visiting hours."
Patrick nodded his head and started for the door as Noah followed to lead him to Robin's room. They entered the hallway and Patrick sagged against the hallway wall. Noah quickly reached around to help support him, "She's going to be all right, son. You've got to believe that," he said, encouragingly.
"I know, Dad, but you heard what Bryan said. Her heart stopped twice already, not counting that she flatlined while on the island. What about brain damange? Bryan knows that's a possibility, but he didn't even mention that," he said forlornly. He couldn't even consider the possibility that the Robin that he knew would never wake up, but instead someone different. The possibility was incomprehensible to him, but he knew it could happen. "And her blood pressure still isn't stable. That alone could cause anything to happen and quickly," he said, seemingly defeated.
Noah leaned against the wall, close enough to Patrick to provide physical support if needed. "Patrick, she came through the operation. The odds of her coming through just the operation were against her, but she did," he said encouragingly. "She's very strong and she needs you to be strong for her. I truly believe she will be fine. She was provided with constant oxygen every time her heart stopped, so I think the likelihood of brain damage is not very high," said Noah reassuringly. He knew, like his son did, that it was no guarantee, but he knew he had to encourage his son and not add to his feelings of helplessness.
Patrick let out a short, harsh laugh, "Yeah, but you don't know, Dad. You and I both know that. We just don't know." Patrick suddenly straightened, "Let's go see Robin. I need to see her now," he said, gathering strength from some unknown well inside of him.
The employee watched both Dr. Drakes as they walked down the hall, while he was standing in a nearby corridor. He pulled out his cell phone and called Scranton. "She's in the hospital and from what I overheard it sounds like she will probably pull through, but it was touch and go for awhile," he reported.
"Good, good, exactly as planned. That was excellent shooting, I have to say," chuckled Scranton.
"I aim to please," said his employee. "Do we proceed with the next part of the plan now?" he asked.
"Yes, but give it a couple of days so it appears that she's on the road to recovery." He paused as he contemplated his next words, "You've talked to the doctor in charge of the floor she'll be moved to, I assume?"
"The employee chuckled, "Yes, it's all set up. Exactly as you requested. They will never know what hit her," he smiled evily.
"Excellent work. Maybe I'll have a bonus in this for you when we are done," he praised his employee.
The employee just smiled knowing that a big bonus would be his when this job was finished. He secretly enjoyed doing these kind of jobs for his employer. He always had loved watching people suffer and this couple was in for a boatload of suffering, he thought happily. "I'll call you when I have more information," he said as flipped the phone shut, smiling.
Noah nodded and led the way down the hall to Robin's ICU room. After what seemed like the longest walk he'd ever had, Patrick was finally able to enter Robin's ICU room, which was an oxymoron in itself. ICU doesn't actually have rooms, they were more like cubicles with curtains that pulled around in a wide arc around each individual patient. The beds were lined up in a half circle down one side while the nursing station was smack in the middle of the room. The massive amount of machinery and supplies needed for this room, which was a constant hotbed of activity, consumed the rest of the space that was left. Each cubicle held a bed, most of them with patients, who needed the specialized care that was only available here. This was where the most critically ill patients, who could still survive, were brought. They were brought here to have these delicate machines keep them alive until their own bodies could do it for them.
Patrick slowly walked over to cubicle #4 where Robin was. He took in the site of her delicate, petite body hooked up to all of the machines that Bryan described. She had two IV lines in, one on each arm, one that delivered fluids and one that delivered blood. She was hooked up to a heart monitor with the wires snaking out the top of her gown and attached to the machine that was beating a reassuringly constant rhythm. In addition, she had a blood pressure cuff, an oxygen mask, a chest tube coming out the side of her chest, and a catheter line snaking out to the bag hanging on the side of the bed at the bottom. Even though he was a doctor and had seen people like this a thousand times or more, he realized that when you see your loved one struck down like this, it was a totally new experience.
He couldn't keep his eyes off of her pale and drawn face. Something was striking him as very odd about this whole situation and something just seemed to be so off, he realized, watching her breathe in and out. She just looked so vulnerable, he pinpointed, with a start, that was what was bothering him so much. He smiled thinking about how full of life and energy Robin was, even though she was so small. She was just a little bundle of energy and vitality, it was just one of the many things that had attracted him to her so much. And, of course, now that was gone, at least for the moment, he thought.
Patrick slowly sat down and leaned over, gently picked up her hand, holding it next to his face and rubbing her hand over his cheek. "Hi, Robin," he said softly, knowing that she probably couldn't hear him, but knowing it was always worth a try. "This is our wedding day, darling," he said with a sad sigh. "This was not exactly the way I had imagined spending it," he said sadly. "Right now, I don't care how we spend it as long as you are with me. I know you've had a really hard time of it the last few hours, but you have to stay strong and stay here with me," he said as a sob threatened to overcome him. "I love you so much and I cannot imagine my life for a minute without you," he said brokenly as a tear escaped.
Patrick felt a hand touch his shoulder and he turned around abruptly, startled. The nurse said, "I'm… I'm sorry, I just wanted to give you her personal effects that were brought in with her. These are her personal items she had with her when she was brought in," she said handing Patrick a plastic bag.
He smiled at the nurse, "Thank you. I appreciate you giving these to me." The nurse turned to go and Patrick turned back to Robin.
"Sorry about that, darling," he said as he started rummaging through Robin's personal items. He found her wedding band that he had just put on her before the horror of the afternoon had started. He picked it up and examined it closely. There didn't seem to be a trace of her blood on it, he thought. She didn't even have time to grab her chest before she passed out, he mused. He gently took her left hand and slipped the ring back into place. "There, Robin, he said, "this is the symbol of our beautiful wedding that was interrupted so suddenly. "We are husband and wife now and we will love each other forever. I will love you forever, I hope you will always remember that," he said sadly, looking up at her sleeping face. "I choose to believe you will wake up and be fine, though, sweetheart," he said taking her hand again and planting kisses along her palm. Patrick stayed there, holding Robin's hand, for what seemed like hours, but in reality were only mere minutes.
Noah came up behind him and gently put his hand on his shoulder as he watched his son with the woman that he loved. He loved her too, this small child-like woman who had come into his life and transformed it. She had brought him face to face with his son, encouraged his son to fight for Noah's life when Noah himself hadn't wanted to, and then given Patrick what he most wanted in life, even if he hadn't acknowledged it at the time, love. Noah was beyond grateful for Robin's influence in his and his son's lives and he knew he would do anything to help her get through this frightening time. The most important thing to her, he knew, would be for him to take care of Patrick. If he was able to do that for Robin, he knew her recovery would be quicker because she wouldn't have to worry about him. He knew he could do that for her, his new daughter-in-law.
"Come on, Patrick," he said gently, "she's resting. We need to leave so the nurses can continue monitoring her."
Patrick nodded as he made a move to get up. Robin's eyes started to flutter open and he felt her squeeze his hand as he was starting to remove it…