Ethan looked at his brother, he was proud of him, proud of the way he took control of a scary situation without even thinking about it, despite it being too close for comfort, he just took the lead and he lead it well. This why why he was convinced Cal was an amazing doctor. However, now he looked into his brothers eyes he could see the fear, he had got through the initial part and now it had hit him, they were treating a friend, and that was scary enough without it being this serious. His heart plummeted even further, because this really was serious. But he had to get through it, and help Cal through this, for Sam's sake, and for the teams sake.
He stood beside his brother and put his hand on his shoulder, while Rita, who had taken over from Robyn as she was getting too upset, prepped for the RSI. They needed this time to gather their thoughts, that's all it was, just a moment.
"Good job Caleb." He said simply, giving his brothers shoulder a squeeze. Cal looked at him and smiled weakly. He was about to say sorry for shouting, but Rita indicated that they were ready to intubate and time was critical. Cal looked up scanning the area for Zoe, but she wasn't there. Ethan could see the panic in his eyes, and he surprised himself and took control.
"Ok Rita, lets get the Ketamine and sux in and I'll intubate." He nodded at Cal, who looked relieved and smiled. The procedure went without a hitch, and Sam was now hooked up to the ventilator to maintain her breathing. Ethan phoned up to ITU to secure a bed for her. While Cal continued to watch the cardiac monitor. Suddenly Zoe burst through the doors making Cal jump.
"What's happening Cal? I'm sorry, I've only just heard, I was stuck in a meeting of all places!" She sighed. Cal filled her in on the current situation, Rita was just taking another temperature reading.
"We're on the up," Rita smiled slightly, though still knowing they were not out of the woods, things were going in the right direction. "Temp is now 30.5°C, Up 1.5°C since admission."
"Good stuff guys, well done." Zoe said. "Lets keep it slow and steady now." Ethan hung up the phone and moved towards them.
"They will have an ITU bed for her in about 45 minutes." He said simply, looking from Cal to Zoe.
"I still don't like the look of the cardiac monitor though." Cal said worriedly. Zoe looked over it.
"No, its not great. But she's maintaining at the moment, all we can do is wait, and hope she hangs on in there." Zoe sighed. "Have we got initial bloods back yet? We should check her potassium levels, make sure she's not hyperkalaemic."
"No not yet, I'll go chase them up." Ethan said picking up the notes and heading off.
Ethan was on the phone to the lab while they gave him the results they had, it felt like an eternity chasing round and waiting on hold, when he finally headed back towards resus his heart sank further. He saw something he really didn't want to see.
Whilst Zoe and Cal were discussing the treatment plan, and Rita was tidying up after catheterising Sam so they could monitor her output, Lofty was watching the monitor.
"Guys, changes on the ECG!" He said firmly but not shouting. Almost as soon as he did the all too familiar sound of the cardiac monitor went off.
"She's in VF!" Cal shouted.
Rita jumped up and started compressions and Lofty kept control of the oxygen. Cal charged the defibrillator and stood by to shock Sam, checking everyone was clear he sent the shock through Sam's lifeless body and held his breath hoping.
"Pulse check?" He looked at Zoe, she shook her head. Rita continued with compressions and Lofty reconnected the oxygen. After another cycle, with Sam still in VF Cal prepared to shock again.
"Everyone clear?" They all nodded. "Shocking."
Again Sam's lifeless body reacted to the shock, Cal looked at Zoe with hope, but still she shook her head solemnly. "Damnit!" He cursed to himself. He took a deep breath and watched helplessly as Rita continued the compressions again. At this point Ethan came flying back in through the doors. Zoe held him back, but as he was about to demand to know what was going on, he found he couldn't even speak. Besides, it was clear what was going on. He looked at Zoe, then looked at Cal before stepping forward to Sam's side.
"Come on Sam," he said quietly to her, "come on, fight it, you can do it. Come back to us, we need you, we all need you...I need you." He whispered quietly at the end, none of the others heard this bit they were too swept up in their resus attempt of a friend and colleague.
"Right, ready to shock again?" Cal called. Lofty disconnected the oxygen, Rita watched and stopped compressions and stepped back as Cal shocked Sam for the third time. Zoe checked her pulse, taking a little longer this time.
"Yes, I've got one, its faint but its there." She said sighing. Lofty reconnected the oxygen and the team looked at each other in shock.
"Well done guys." Zoe said smiling at her team. "You did well. Now let's get her stable and up to ITU as quickly as we can. Zoe picked up the phone to find out if they were ready for her yet and to update them. Ethan turned around and headed to Cal while Rita and Lofty organised the equipment ready to transport Sam.
" They can take her now." Zoe said to Rita and Lofty. "Let's get her upstairs." The three moved Sam carefully up to ITU leaving just Cal and Ethan stood together in resus.
"You did well." Ethan smiled. Cal looked exhausted from emotion and his eyes filled with tears which he tried hard to blink away. Ethan moved closer and put his hand on Cal's arm, "I'm so proud of you Caleb." He said simply, looking right into his brothers eyes. Cal couldn't control it and the tears fell. He tried to wipe them away but fresh ones fell before he could even get rid of the old ones. Ethan did the only thing he could think of, he knew what his brother needed and he was the only one who could do it. He pulled him in for a hug, which Cal accepted gratefully, he threw his arms around his little brother and the emotions flowed. They stood in the simple embrace with the bustling ED carrying on around them. Neither spoke a word, but at this moment, they didn't need to, their physical contact spoke more than words ever could.
