Chapter 12

At the park

They all drove to the park It was nice and sunny, none of them well except for Brian and Bridget have ever been down to this park before it was huge. So Annie, Eric Sam and David were in one car. Brian and Bridget had his convertible. Matt, Sarah and the twins had the rental still. Matt and Brian parked across from one another. Matt and Sarah let the twins out of the car they were so excited to see the beach and get to the park, before Matt and Sarah could stop them they bolted across the parking lot.

The boys didn't see the car that was coming through the parking lot. Brian saw it first and ran to them. He got to them and pulled them out of the way and hit the ground right before the car would have hit them. Brian hit the ground very hard and landed on his shoulder and hit his head hard on the ground. He felt pop in his shoulder. An intense pain washed over him and then he blacked out.

Matt and Sarah ran and grabbed the twins and hugged then thankful that they were ok. They were consoling the boys because what just happened frightened them. Annie and Eric and Bridget saw what happened. They were so concerned about the boys they didn't notice Brian right away. Matt let go of the boys and went to thank his brother Brian for saving his sons' lives. He looked over at Brian something was wrong. Brian hadn't gotten up, he hadn't moved at all he was on his side faced the other way.

Bridget saw him too. "Oh my God Brian!" she yelled.

They both moved quickly over to him. "He is unconscious." Bridget gasps, she goes to move him,

"Don't touch him! You could compound any injury he has. Let me assess him 1st. Mom call 911" A very upset Matt commanded.

Sarah was over to Brian by this time. Deena and Dave were there with the girls by this time too and were very upset that their friend was hurt.

Matt told everyone" I know you want to see if he is ok but back up, Sarah and I need to check him take the kids away he looks like he is really hurt."

They continued to assess him Sarah checked his neck and back. She said "Neck and back doesn't appear broken"

Matt rolled him over slowly to check his airway that seemed clear but that's when he saw the blood he said "Sarah look he has a head injury on the left side of his head and it's bleeding"

Matt took off his button up shirt that he had over his t-shirt and had Sarah hold it over Brian's head wound to stop the bleeding, and then they noticed his shoulder. It didn't look right. While Matt examined the shoulder, moving it caused Brian pain and he regained consciousness.

"Oowwwwwww" Brian moaned in pain. "Matt, what happened?" Brian said as he moaned again in pain.

"Don't move buddy your hurt." Matt said, "and your shoulder is dislocated. We called 911 an ambulance will be here soon"

"No I will be OK I don't do Hospitals. Plus I don't think my insurance is active anymore. You're a doctor just pop my shoulder in, I will be ok" Brian said as tried to get up,

Matt wouldn't let him up "Nothin' doin' you stay put, you need at the very least a CT scan for that head injury and an X-ray on that shoulder."

Brian tried to argue and get up again, but every time he moved he had shooting pain from his shoulder all the way down his arm.

"Do you remember what happened Brian?" Matt Asked him,

Brian couldn't remember, which is not a good sign given he lost consciousness

"I know he has a pretty bad concussion." Matt thought to himself.

They heard sirens in the coming closer the ambulance pulled in the parking lot. The EMTs brought a stretcher and their equipment.

Matt explained to the EMTs, "My wife, Sarah and I are doctors"

He brought the EMTs up to speed on Brian's condition. Matt wouldn't even let Brian move. Matt stabilized the shoulder but didn't pop it back into place, he wanted that done in the hospital after an X-ray to see any other damage that may have occurred plus he wanted the hospital to give Brian pain medicine before they did anything to it. Once Matt and Sarah had him immobilized and his head bandaged, they again told him he was going to the hospital .

Brian protested, "I don't need to go to the hospital"

"Yes you do." Bridget told him," I want to make sure you are ok honey, so just lay still and do as Matt tells you ok" She said in a very quiet voice she wanted to try and keep him calm.

Bridget was very worried, they all were, Brian was very pale and you could see the pain he was in although he tried to hide it he wasn't doing very good at it and it looked like he was going into shock, Matt checked his vitals Pulse was very rapid and blood pressure was low. Matt and one of the EMTs gently lifted Brian on the stretcher it still hurt him and he moaned in pain. They then elevated his legs and feet.

"I really don't want to do this," Brian said weakly, "But I will go on one condition."

"Ok what's the condition" Matt asked.

Brian replied "I don't want everyone going with me, this was supposed to be fun for the kids I don't want it spoiled they all stay here and play or I am not going anywhere."

"Ok Ok did you hear him?" Matt asked everyone. "Please just do as he asks so we can get him to go to the hospital."

They all promised. Matt went in the ambulance. They were going to take him to the closest hospital which was Cedar Sinai and Bridget got Brian's keys and followed behind the ambulance. Everyone else stayed behind. Annie was so upset that her son was hurt she desperately wanted to go to the Hospital but she did what Brian asked and stayed behind. They took the kids to the park and put on a happy face for the kids but none of the adults wanted to be there.

In the Ambulance

Matt continued to monitor Brian's vitals he his B/P had come up a bit but pulse was still really rapid in response to the pain he was in.

"it's ok buddy we will be there soon and then we will get you something for the pain." Matt tried to reassure him

"My head feels like it is going to split in two it hurts so bad….I feel like I am going to pass out Matt" Brian said in a weak voice.

Matt knew he needed to keep him awake he had a head injury and he couldn't tell how bad it was yet based on his initial assessment.

"No don't pass out stay with me Brian" then Matt tried to just carry on a conversation. "Do you know you saved my sons' lives today, it would be them in this ambulance instead of you? God if you hadn't basically dived at them and grabbed them to get them out of the way of that car, they are so little if they were hit …..I don't even want to think about what could have happened."

"Is that how I got hurt?" Brian questioned.

"You honestly don't remember do you, well don't worry about it you have a pretty nasty bump on the head its normal to be a little fuzzy" Matt didn't let on but the short term memory loss wasn't a good sign.

All of a sudden Matt watched as any color that had come back to Brian's face, completely drained out he was paler than he was before.

"I am going to be sick" Brian said

Matt didn't want to hurt him but he knew he had to quickly sit him up if he was going to vomit or he would aspirate on it. Matt grabbed a basin and sat him up. And the EMT put the stretcher in a more upright position Matt actually had to hold his Brian up or he would flop over because he was so weak from the pain, then Brian proceeded to really get sick. When he was done Matt washed his face with a wet cloth. He sat real close to him Brian's head actually rested against Matt's chest. Matt had all he could do to keep Brian conscious,

At the Hospital

They finally got to the ER and he was brought in Bridget parked and was and while he was taken back She registered him and gave them his insurance card she hoped it was still active Matt came back to make sure she was allowed in. The ER Orthopedic wanted to get that shoulder taken care of first to alleviate the pain so they could then concentrate on the head injury A neurologist came in and did a basic assessment and felt the Ct scan could wait for a little bit so a portable X-ray was brought in and the shoulder was X-rayed it was determined that nothing was fractured so they could manually pop it into place without surgery.

Brian was given pain medication to take the edge off and a mild muscle relaxant. The nurse came in for some paper work for him to sign it gave the hospital permission for Matt and Bridget the ability to make decisions for him in case he couldn't and it gave permission for them to be informed about his medical status.

After all that was signed Matt pulled Bridget aside he told her "normally patients are sedated to do a shoulder reduction but given Brian's head injury that wasn't a good idea." Then he told her, "You need to step out of the room while we pop his shoulder into place Oh and as far as anyone is concerned you are Brian's fiancée they will allow you more access to him if we tell staff that"

She said ok and then She reluctantly agreed to step out of the room and go down the hall.

She realized and said out loud "Oh god someone has to call Nicole" She tried Nicole and it went to Voice mail She then called Deena's cell,

Deena answered, " "Oh thank God any news? How is he?"

"He's not doing too good. I am worried. They are trying to fix his shoulder now they asked me to step out but Matt is with him helping. Listen I tried to call Nicole to tell her what was going on and got her voice mail"

Deena then told Bridget. "We will keep trying to reach her, now you go back to Brian and keep us informed."

She hung up and waited to be able to go back into the room. The Orthopedist decided to Traction-counter traction reduction they laid Brian flat and looped a sheet around his armpit. The Orthopedic doctor pulled down on Brian's arm Matt was at, the head of the bed, pulled on the sheet that is looped around Brian's armpit to apply counter traction. Brian gritted his teeth and then cried out in pain but after a few tries his muscles did finally relax, they were able to pop his shoulder back in. They immobilized his shoulder again to keep it from popping out again until the muscles around the area were healed He now was taken to radiology for a CAT scan.

Matt went to talk to Bridget "How is he?' she asked.

"His shoulder is back in place he said, "but I am more concerned about his head injury they took him to get a CAT SCAN that will tell us the extent of his injury"

He told Bridget of how Brian was in the ambulance." I am concerned that based on his symptoms that he has brain swelling /increased intracranial pressure, In Laymen's terms a brain bleed."

"Oh my God what do they do for that" Bridget said in a horrified voice. "I depends on how bad it is If it is just a bruised brain They keep him sitting up and keep him quiet and medication is given to reduce swelling and he is closely monitored, In more severe cases it may require surgery But we don't know anything yet"

Just then Matt's cell phone started to vibrate it was his mom's phone Number, "Hi Mom" Matt said as he answered the phone.

"How is your Brother?" Well on the upside his shoulder is back in place and they have it immobilized….."

"And? What aren't you saying Matt?" Matt told her about the ambulance ride and his concerns but neglected to mention possible surgery no sense in worrying any one yet.

Matt told her, "He is having a Cat Scan right now mom we don't know anything yet. I will let you know as soon as I know…..

He was interrupted by a doctor he hasn't seen before. "I am Dr. Fitzpatrick Neurologist/ Neurosurgeon "Are you Dr. Matt Camden, Your brother is Brian Davis?"

"Yes I am and this is his fiancée Bridget Keller,"

"You both need to come with me we are admitting him the Neuro floor"

Matt went back to the phone "Mom I have to go something is up I will call you when I find out what."

"No Matt I heard the Doctor in the background. Something is wrong Matt we are coming to the hospital"

She hung up and proceeded to tell everyone the little information she had. Deena had managed to get in touch with Nicole and she was headed to the hospital. Everyone headed over to the Hospital and Eric and Annie called the other members of the family and they were headed there as well. Matt and Bridget went with the Neurologist. Bridget started to cry as they got in the elevator Matt hugged her,

She asked Dr. Fitzpatrick. "What's wrong with Brian?"

"Let's wait until we can go into a private conference room on the floor." He advised

Matt didn't say anything but he knew what this meant and it wasn't good they walked into the room and Matt closed the door behind him

Matt asked "What are the results of the CT Scan,"

"It isn't good" Dr. Fitzpatrick responded, "but before we go over the results I have to let you know he had a seizure after the Scan due to the pressure in his brain. We have administered anti-seizure medication but that is only a temporary fix and he is being closely monitored The scan showed severe swelling on the left side of the brain he has increased intracranial pressure causing significant pressure in the ventricles in his brain"

"So what do you do about it "Bridget asked.

Matt said "Surgery Bridget"

Her heart sank the man she loved more than anyone in the world was facing brain surgery the Doctor advised that there are 4 types of surgery used with brain swelling: "

Ventriculostomy - ventricular catheter, is a catheter placed into the ventricles, fluid-filled spaces within the brain, and drains cerebrospinal fluid (CSF) externally. It is typically connected by tubing to a cerebrospinal fluid collection device which can be elevated or lowered at the bedside to vary the amount of CSF that is drained.

Craniotomy – the skull is opened to relieve the causes of any increased pressure inside the skull.

Burr holes – Small opening is made into the skull in order to remove any blood clots

Bone flap removal – A piece of bone is removed from the skull in order to relieve any pressure caused by swelling of the brain tissue.

"That sounds barbaric" Bridget says after he explains the options

"Bridget they don't have a choice" Matt tells her "If they don't relieve this High pressures it can cause damage to his brain and well, I may be a doctor but I am an OB/GYN not a Neuro surgeon so I need to defer to Dr. Fitzpatrick. What do you feel is the best option Dr. Fitzpatrick"

He responded. "For now the best option is Ventriculostomy. But if we get in there and the swelling is worse we may need to do a craniotomy. So we need you both to sign the consent form. In the meantime we are going to start prepping him for surgery. "I need to call my family first they need to know what is going on Ok Dr. Fitzpatrick " Matt said

"I will give you two sometime do you want a chaplain," the Doctor replied

"Well our dad is actually a minister I need to call him first He dialed his Dad's cell

His dad answered "Hi Matt how is he doing?"

"Dad where are you guys because if you are not on your way here you need to get here ASAP." Matt could barely get the words out because he was so choked up"

"We just arrived and are in the Hospital, where do we go?"

" Oh good I am glad you are here, get up to the Neuro floor in the Advanced Health Sciences Pavilion, 6th floor tell mom to let everyone else know where to go too" he filled his dad in on what was going on, and what staff were prepping Brian for.

"Oh dear God" Eric said "Matt I am going in the elevator I will lose you we are almost there" but stayed on the phone

Dr. Fitzpatrick came in I will take you to his room have you made a decision? Even though we explained the situation to your brother, I am not sure how much he comprehended."

"My family is in the building we will make the decision together." Matt said Then he went back to told his dad "We are going to his room. He is in 615 HSP."

He hung up and Matt and Bridget followed the Doctor. They entered his room Brian was really out of it from all the medication he was connected to multiple IVs Brian looked worse than before Bridget walked over to his bed side kissed him

"Hi Bri how are you feeling?" In a very sluggish almost slurred voice he responded

"Not so good" Matt walked over to the other side of the bed. He didn't want to lose the Brother he just found

"It will be ok Brian" he hugged his brother, and waited for the rest of the family to arrive.