Chapter 11- ER & Surgery
Upon arriving at the Bethesda ER, Tony was quickly wheeled into a treatment room- Jimmy had called ahead. Jimmy gave an update to the ER doc on his suspicions and soon orders where being given out.
"I need a CBC drawn now and let's get another set of vitals." The doctor called out to his staff. Soon the orders were being followed and Tony felt a needle stick for the blood draw and then the insertion of an I.V. "
"When did you last eat?" The doctor asked.
"Umm… around 7 last night though I didn't eat a whole lot. Maybe half a portion of ravioli. I wasn't as hungry as normal. Didn't think anything of it at the time." Tony responded.
"Alright that's been over 12 hours ago so that's pretty good."
"Why does it matter?" Tony inquired.
"We prefer patients who have to go under anesthesia not to have eaten- it helps avoid complications in surgery."
"Surgery?" Tony asked again. He knew Jimmy had mentioned that but he was really hoping he was wrong.
"If it is your appendix, which seems likely given your presenting symptoms, then surgery is inevitable. I'm afraid I need to redo some of the tests your friend did earlier."
"Can't you just take his word for it? I'm in enough pain as it is." Tony tried negotiating.
"Sorry. Have to see for myself in order to sign off on things. Your friends may want to wait in the hall I am likely going to need a slightly more thorough exam." The doctor added hinting at the need for a rectal to confirm his final diagnosis.
Tony blushed at the doctor's words and then looked to Jimmy and nodded and also signed briefly to Jana.
"Doctor says you need wait outside for a minute."
She nodded and followed Jimmy out. Once in the hallway Jimmy pulled out his cell and dialed a familiar number. It rang once before being picked up.
"Mallard residence" came the distinguished sounding voice of his mentor.
"Ducky, its Jimmy."
"Well hello Mr. Palmer what can I do for you this fine Saturday morning. I was just getting ready to walk the corgies. Did you know that walking corgies was first done…."
"Ducky." Jimmy interrupted before he could continue on one of his discourses.
"What's wrong?" Ducky replied changing gears quickly at hearing the tone of urgency underlining his protégé's voice.
"It's Tony. We're at Bethesda probable appendicitis."
"Oh my! That boy certainly does have the worst kind of luck doesn't he. Have you alerted Gibbs?"
"Not yet", Jimmy replied a hint of shame coloring his voice, "I was hoping maybe you would."
"Well of course I can, but you know he wouldn't kill you for delivering bad news. His bark is worse than his bite."
"So you'll keep saying but I don't really care to test that theory- caution is after all the better side of valor."
"Tis true my boy. Tis true. We'll be there shortly tell young Anthony to hang in there."
"I will. Bye Ducky."
"Bye Mr. Palmer."
With that said Palmer hung up the phone and went to lean against the wall by Tony's other friend. She looked very anxious her foot tapping frantically and her hands wringing together in worry. Jimmy gently grabbed one of her hands and gave it a gentle squeeze grabbing her attention. He followed up the action with a gentle smile hoping to ease her fear a little. It seemed to work some as she stilled slightly and smiled back leaning back into the wall to wait and see.
Around ten minutes passed before the doctor stepped into the hall and signaled they could come back in. Jana immediately walked to Tony's side and started brushing his bangs away from his eyes. Tony smiled briefly at the caring gesture before allowing his face to go back to the painful grimace it had adopted for the ordeal.
"Well your diagnosis appears correct. We'll get a CAT scan shortly to confirm, but I am tentatively booking an O.R. in anticipation of the results. Someone should be in to take him to the scan in the next thirty minutes. Until then try to rest as much as you can and hit the call button if you need anything."
Tony and Jimmy nodded in response and watched the doctor step out. Jana then signed "what happening?"
"One more test. Then surgery. A-p-p-e-n-d-i-c-i-t-i-s. " Tony signed.
"Okay you rest now. We sit and wait with you." She replied. Tony grateful for the permission to close his eyes did so in hopes of escaping the pain some by resting.
The doctor was pretty accurate with his timing and soon Tony was off to get his scan. It was while he was gone that Gibbs and Ducky arrived.
"Where is he?" Came the gruff voice of Tony's Boss. He had signed his question also in noticing Jana's presence. He also walked over to her and gave her shoulders a gentle squeeze.
"Getting a CAT scan to make the final confirmation. An O.R. has been booked and he'll probably be in surgery soon after."
"You two okay?" Gibbs asked after nodding at Jimmy's explanation.
Jimmy shrugged and Jana started signing. "Worried. All happened so fast. Seemed fine earlier and now this. Not sure I have my mind around it all yet."
"I understand. That's Tony though. He is a bit of a disaster magnet." Gibbs signed and spoke.
"So true." Ducky affirmed. Having nothing else to really say the four individuals settled back to wait for Tony's return. It didn't take long. When Tony was wheeled back into the room Gibbs walked up and leaned over to him whispering in his ear. "You don't have permission especially not for something as routine as a troublesome appendix."
Tony's eyes opened briefly at the familiar voice of his boss and mentor. "Yes sir." He whispered back adding a mock salute to the words.
Twenty minutes passed and a different Doctor from the ER one they'd dealt with so far came into the room. Behind him was another man as well.
"I'm Doctor Salazar with surgery and this is Dr. Parker with anesthesiology. We got all your tests back and they confirm the diagnosis of appendicitis. We are going to be taking you up to get prepped now. Have you had surgery before?"
Tony rolled his eyes at the question and replied "unfortunately."
The Doctor stayed quiet waiting for more details so Ducky spoke up. "He's had his tonsils out, surgery on his knee twice due to a football injury and had surgery for a gunshot wound to the chest and shoulder. He doesn't respond well to morphine and he has damage to his lungs due to a bout with pneumonic plague- Dr. Brad Pitt is his pulmonologist and you should probably consult him about correct levels for the anesthesiology."
The two doctor's eyes had grown large during the listing of Tony's medical history especially at the comment about the plague.
"Alright we'll do that now while the nurse wheels Tony upstairs to surgery. All of you can wait up there – its floor four. We'll update you as things go."
The group nodded and then prepared to say their goodbyes. Gibbs went first.
"I already said my part you just remember it." He said and gave Tony a light head tap. Tony gave a shaky thumbs up in response.
"No funny business. We still have to have that bowling rematch sometime. I want my fifty dollars back." Jimmy added next causing Tony to laugh a bit and then groan in discomfort.
"My prayers are with you my boy- you'll do fine." Ducky said contributing his wisdom.
Finally Jana stepped up and started signing. "You still owe me a full date so get better fast. I see you on the other side."
Tony signed back. "I look forward to it- you are definitely a reason to get better quick." He signed and then the nurse started wheeling him away.
As he got wheeled towards surgery he got one last look at his friends and he sent up a prayer of thanks for the support he had.