Chapter 10
An Imperfect Life – Bear Hugs
Friday, January 26th
"Is it strange that we steal away to an on-call room to talk about the kids?" Amelia questioned as Owen, fully clothed in scrubs, spooned her from behind. The two were snuggled tightly on the miniscule bottom bunk, resting and thankful for the break from the busy afternoon in the ER.
Chuckling, Owen admitted, "Strange? Yeah, probably." He nuzzled his five o'clock shadow against her cheek and hummed with contentment. "But if I get to lie here with you in uninterrupted peace and quiet, I'll talk about anything."
"Anything?" she teased. "Hmm… what do I need to bring up that I've been saving for just the right moment?"
Owen sputtered, "What? Please tell me you're joking." He ran his hand through his hair and yawned, "I need a shower. There's no way I'll make it through this shift awake."
"You know what we need? We need a co-ed shower in this hospital – in a private bathroom with a locking door, of course," she flirted.
"Amelia Shepherd, if we had that, there would be a long line for it and nobody treating patients," Owen responded in jest.
She turned onto her other side and stroked Owen's jawline as she gazed into his light blue eyes, "You'd have special privileges… you know, as Chief."
Leaning down, Owen kissed her repeatedly. His hand slid under her scrub top and caressed her breasts tenderly. Within moments, she had slid onto her back. He remained halfway on his side and had maneuvered halfway on top of her. Her hands grasped his muscular arms as the two long themselves in one another.
As if on cue, just as Owen pulled his scrub top off and threw it on the ground, his pager went off. "Dammit," he sighed. "Let me look. Maybe it can wait." Amelia smiled knowingly certain the situation was crucial – Owen's pages were always urgent.
He rolled over her and stretched to reach his pager. The readout made his next move clear: Incoming chopper. MVA, poss TBI. Mult internal.
Owen hopped up and glanced at Amelia with a frown, "You're about to be paged. Let's go."
She stretched, pretending for one last second that she had all the time in the world. Her pager sounded and communicated, Chopper. Poss TBI. Alt consciousness.
His long legs strode quickly down the hall as Amelia nearly ran to keep up with him. After pushing the elevator button multiple times, he looked over and attempted to smile at his wife. He mouthed, I'm sorry.
Amelia, in the midst of throwing her hair into a ponytail, mumbled with a smirk, "Not your doing. Maybe we'll get to operate together."
When the elevator doors opened, a trauma nurse and a 3rd year resident were already aboard. "Roof?" Owen confirmed as both nodded. "Ok, let's brace ourselves. This sounds grizzly." Although everyone heard him, nobody responded. Impatiently, Owen focused on the elevator's floor display and tapped his foot. He reached for Amelia's hand and grasped it, nearly pulling her out of the elevator when he ran to the chopper.
The Seattle rain poured down, instantly drenching the medical team. The EMTs began shouting vitals and concerns over the rotor blade noise. Oh, God, no, Amelia thought when she saw the patient and his bloodied body. He couldn't be more than 18. Owen commanded the EMTs, "Follow us down. There's no time to wait."
The medical team propelled the stretcher toward the elevator and immediately began assessing the patient as they descended to the ER floor. "Owen, respiratory insufficiency," Amelia called out as she listened to the patient's lungs.
"Hypovolemic shock," Owen added before inquiring, "Consciousness en route?"
"In and out, Doc. Mostly unconscious. Some moaning, unable to speak," the EMT answered.
"Michael," Owen instructed the nurse, "We're heading directly to the OR. Find out which ones are open."
"I need a head CT before we do anything," Amelia protested.
Quietly, Owen whispered, "He's bleeding out, Shepherd."
"That won't matter if an aneurysm ruptures," Amelia pointed out with raised eyebrows.
"Make sure there's a portable CT in the OR, Michael," Owen added.
"Yes, Sir," Michael nodded as he spoke to the OR.
The elevator stopped short of the ER level and opened a floor higher. Owen and Amelia both threw their white coats off and tossed them toward a nurses' station counter as they ran by.
"Get the ER team up here – we'll need hands. No time to scrub. Let's gown and go," Owen led.
The team surrounded the patient as a neuro nurse rapidly set up the CT. "Abdominal and spinal CT as long as we're scanning," Amelia ordered.
"Get a full trauma panel and get ready to intubate," Owen called out as the CT scanned.
"We've got eyes, people!" Amelia informed the team. She leaned down as the CT was wheeled away, "Hey… I'm Dr. Shepherd. You've been in a serious accident. You're at the hospital. We're taking care of you. What's your name?"
The patient moaned incoherently before coughing.
"No time, Mia," Owen responded, unintentionally using his pet name for his wife even though they had covenanted to refer to one another as 'doctor' at the hospital. In a moment of crisis, sometimes they slipped and neglected the formalities.
"Pat," the patient barely sounded. Amelia repeated the name to confirm and looked Pat in the eye, "We've got you, Pat. We've got you. The anesthesiologist is going to sedate you. Give my hand a squeeze as you go to sleep." Weakly, the patient loosely grasped her hand.
"Let's go," Owen instructed as he handed the resident the intubation tool and tube. With finesse, the student began the process. Adding a specific reminder, Owen stated, "Thrust the jaw, align the spine." The resident nodded as she followed the Chief's instructions.
"Excellent work, Leason, excellent," Owen praised, even amidst the serious trauma.
"Doctors, we have a call from your son on the line," one of the OR nurses announced.
Simultaneously, the couple answered, "Which one?"
"Ryder," the nurse specified.
"We'll call him back," Owen replied.
"He insists it's urgent," the nurse pressed.
Amelia glanced at Owen as she reviewed the CT results and he shook his head. Their patient was far too unsteady to waste even 15 seconds for a brief call. She requested, "Explain we're both in a trauma. Have him wait just a minute."
"Airway's in, patient sedated, starting ex-lap," Owen announced. "Shepherd, what's your status?"
"No apparent bleeds. Neuro exam inconclusive. Strong pupillary responses and corneal reflexes. Possible frontal lobe paralysis. Impaired grasp response. I want to see his spine. Do what you need to do," she shared as she stepped to the side of the OR to speak with Ryder.
"Right," Owen agreed. He turned to the EMTs who had followed them into the OR, "Do we know any further details from the scene?"
One EMT stepped out to call the personnel on site while the other responded, "This kid was the first one treated. We didn't stay to get more of the story. Kid hit his head on the window and window was gone when we got there. From the looks of things, he was thrown around onto the headrest from the airbag. We pulled him out with a board – was hard to tell if he could move because he was in and out of consciousness."
"Was he conscious when you encountered him?" Owen asked the EMT as he changed his mind and told the nurses, "We're doing a laparotomy. There's too much bleeding to go in laparoscopically." Turning to the resident, he ordered, "Leason, you're my second set of hands. Retract and suction unless I give other instructions." The resident was already in place and suctioning as she awaited further direction.
"Semi," the EMT offered.
The second EMT entered, "The scene is anxious, Doc. A bunch of kids. We don't have much information to add at this point except that the kid's name is Patrick Douglas. Seventeen."
Meanwhile, the nurse had handed Amelia the phone. "Ryder…" she greeted. "Two minutes."
"Mom, holy crap. I'm… I'm ok," Ryder panted. His tightened voice spoke rapidly.
"What do you mean? What happened?" Amelia attempted to clarify.
Sounding almost shocky, Ryder responded, "Umm… umm… it all happened so fast, but I'm ok."
Amelia nodded and peered over to Owen, who briefly glimpsed over and lowered his eyebrows with concern. "Ryder… listen. Listen to me," Amelia consoled at a snail's pace. "Ry… take a deep breath. Tell me what happened."
"A bunch of us were leaving indoor soccer. There was a huge accident," he began.
"But you're ok?" Amelia hoped to confirm.
"I think so," Ryder guessed. "The Mustang is banged up. I'm sorry, Mom. To avoid the pile up, I moved to the side and bumped a Jersey barrier."
"I'm not worried about the car, Ry," Amelia clarified. "I want you to come to the hospital to be checked out. Was anyone else in the car with you?"
"No. I was supposed to pick up Olivia. I called her. She's catching a ride with a friend's mom," he explained. "The littles are home with Lynne."
"Dad and I are in surgery and will be for quite a while. Ask one of the responders if you can ride in with another patient," Amelia suggested. "If they give you static, respectfully let them know Dad's position."
"Mom," Ryder stammered, "A chopper came. It's a mess here."
"I know, Ry… I know," Amelia reassured him.
"Clamp it!" Owen hollered from the other side of the room.
"Sweetie, I need to go. I'll try to get down to the ER. You're ok," Amelia comforted.
"Love you, Mom," Ryder confessed.
Tears formed in Amelia's eyes upon hearing the now rare words that used to be so customary. "I love you, too, Ryder. Very much."
She hung up the phone and walked rapidly to the table. "How's it going?"
"He's a mess internally. I need to get a hold of this bleeding. He was cyanotic. Leason spotted and repaired liver and abdominal lacs – probably saved the kid's life. He had a pneumothorax. I performed a thorocenteses. We're pushing blood," Owen reported rapidly as Leason smiled while continuing her efforts. "It's not good, but we're doing what we can."
"Spinal CT is clear. Do you need me?" Amelia queried since her area of specialization had been analyzed and cleared.
As he operated, Owen nodded then questioned, "What's up with Ry?"
"No worries," Amelia purported. "Page me if you need me."
"Will do," Owen promised without shifting his focus from the patient.
Amelia pulled off her trauma gown, scrubbed out, and breathed deeply. She walked to the nurses' station and retrieved her lab coat before heading to the ER.
"How's the chopper kid?" Karev inquired when Amelia exited the elevator.
Frowning, Amelia disclosed, "Pretty serious, but there's hope. My son here yet?"
"No," Alex shook his head. "Which one?"
"Ryder. He was in a small accident," she told him.
"Dude," Alex popped off. "I'll stay down here if you want."
"Sure," Amelia nodded. "He's fine, or at least sounded fine. A little disoriented, but that's understandable - he was in a car accident."
"Hey," Jackson greeted as he approached the duo and regarded Amelia with concern. "Ryder's here. Did you know he was headed in?"
Amelia nodded, "Where is he?"
"Let's sit down first," Jackson insisted as he mouthed the treatment room information to Alex. Putting his arm around Amelia, he led her to an empty room and pursed his lips.
"What? I just talked to him, Jackson. What's wrong?" Amelia stuttered.
"He's going to be fine," Jackson assured her before pausing.
"Going to be? What do you mean?" Amelia shuddered.
"Derek's with him. He has a sizable hematoma on his forehead. His neck hurts and there's a headache. He's pretty banged up and has some cuts and scratches. I just sutured a lac on his forearm," Jackson detailed.
Amelia covered her mouth with her hands and furrowed her brow. With a pleading and inquiring gaze, she sought more information.
"He's going to be fine," Jackson reassured her, realizing he was now interacting with a concerned mother and not a colleague. He patted her knee and pursed his lips, "Shall we go see him?"
Wiping the tears that were welling up in her eyes, Amelia nodded. She reached for a tissue and wiped her eyes. "I don't want him to see me like this."
Jackson led Amelia down the hall to a treatment room where Ryder kicked back in a hospital bed as Derek typed in some chart notes. Alex was performing a basic neuro exam at Derek's request – the plan was to repeat them every 10-15 minutes for the first hour.
After opening the door, Jackson patted Amelia's back and nodded at Derek before stepping away. Alex followed Jackson and patted Amelia's shoulder as he departed.
"Amy, he had a mild concussion. CAT scan is normal," Derek reported as he hugged his sister. She barely returned Derek's grasp as she focused on approaching Ryder.
"Mama Bear!" Ryder greeted with a sleepy smile. "Everyone's all stressed out about me, but I'm all good."
Wrapping her arms around Ryder's neck, Amelia kissed his cheeks and whispered, "Oh, Baby Bear…" She pulled back and surveyed his face before running her thumbs over his cheeks.
"Stop flipping out," Ryder grinned. "Mom, no worries. I'm fine." As he reassured his mom, his eyes glazed with tears and he yawned.
"Did you see that?" Amelia grilled Derek as she turned to him.
"Run of the mill concussion symptoms, Amy," Derek stated calmly.
"Uncle Derek, when are you going to let me eat?" Ryder whined.
Derek lowered his chin and reminded Ryder, "Remember, we're going to keep an eye on your nausea."
"You're just afraid I'll barf on you," the regular, everyday Ryder quipped with a grin.
"You," Derek began and patted Ryder's arm, "are far too much like your mother. Now, remember, no TV, no texting, just rest. I'm turning off the main light – that should help the headache." Turning to his sister, Derek mumbled med-speak to let her know that Ry had blurry vision and some forgetfulness.
"Did you pass out?" Amelia inquired as she performed her own basic neuro exam now that the doctor's had left her alone with her son.
"I don't think so, but check this nasty gash out," he invited as he held up his forearm. "Dr. Avery used this clear deal so I can watch it heal."
Smiling, Amelia resumed her questions, "Dizzy? Numb anywhere?" She noted he was not slurring at all, which reassured her.
"Nope." Ryder explained, "Just sleepy, my eyes are blurred, my head and neck kill, and I've barfed a few times. Can I have something for the headache?"
"Not yet, but I'll talk to Uncle Derek about it," she assured him.
Ryder held out his arms and begged, "Snuggle me, Mama Bear."
Not hesitating, Amelia climbed into the bed and rested her head on Ryder's shoulder. He adjusted her arm and laughed, "I bet I stink… I was gonna shower at home after soccer."
"I'm just glad you're safe, Baby Bear," she responded as the two dozed off.
By the time Owen finished surgery, hours had passed and Ryder had been admitted to a room. Derek waited to leave the hospital until he could speak to Owen. Doing so meant that he was able to finish Amelia's shift for her while she sat with Ryder. While he would haze her about it later, he was secretly happy to help out his sister.
Owen stepped out of the OR and encountered Derek waiting for him by the sinks. "Shepherd…" he greeted as he pulled off his mask and cap.
"How's your patient?" Derek inquired.
"Good. Great, actually. I wasn't sure the kid was going to make it, but I'm pretty sure he's out of the woods. I'm eager for a post-op neuro check when he wakes up. He had significant internal bleeding, but seems to have escaped anything more serious," Owen explained, wondering why Derek was loitering in the scrub area. "So?"
Smirking, Derek shared, "Everything will be fine, but Ryder has a concussion. I admitted him for observation, and Amy's been at his side the last few hours."
"What happened?" Owen questioned as he dried his hands and turned toward his brother-in-law.
"Car accident. I suspect it was part of the same one your patient was in. A bunch of kids ended up in a pile up this afternoon," Derek mentioned. "Luckily, nobody was killed. From what I've heard, your patient was the most seriously hurt."
Owen nodded and inquired, "Where is he? Ryder, I mean."
Derek shared the room number and volunteered to walk there with Owen. He planned to finally head home after one last check on Ryder.
When the two entered the room, Ryder's eyelids fluttered as he attempted to stay awake. Amelia was asleep next to him.
With a quickened step, Owen walked over to his son with a look of concern. He studied the goose egg on his forehead and swept Ryder's hair to the side. Owen's hand remained on the back of Ryder's head as he leaned down and kissed his cheek. "I'm so glad you weren't hurt more seriously," Owen sighed with relief.
Owen sat down in a side chair while Derek examined his nephew and asked him for updates on his nausea, vision and fatigue. When he completed his brief efforts, Derek whispered his assurance to Owen, "He looks good. You know the drill – nothing but rest. He can eat if he's able to tolerate it."
"Can I steal Mom?" Owen grinned after Derek left. Ryder shrugged and agreed. Leaning close to Amelia's ear, Owen whispered to her and let his presence be known. He'd already called Lynne on his way up to Ryder's room and arranged for her to spend the night at the house.
"Mia?" he offered gently, "I'm here. My patient's doing well."
She opened her eyes and smiled without saying a word. Owen held his hand out and motioned his head toward the empty bed just feet away. Bending over to pick her up, Owen stroked her hair and kissed her forehead before scooping her into his arms. He carried her to the other bed and covered her with a blanket before slipping off his shoes and climbing in next to her.