Time line overlaps between some sections in this chapter.
The night sky is pitch black, so when Henry looks out the hospital window all he can see is his own blurred form and the room he is standing in reflected back at him. His phone is in his hand and his thumb hovers over Will's number. He knows he needs to call him, but his brain is struggling to find the words he should use. He encouraged him to go home and now look where they are. He pinches the bridge of his nose, it might not have made a difference even if Will had stayed, but then that was part of the problem, he just couldn't be sure.
The room is almost oppressively silent other than the ticking of the wall clock, and the sound of it reverberates around Henry's head. He can't stop thinking about Elizabeth; his heart feels like it's sitting in his throat, and with every tick of that damn clock he wonders if this is the moment he's lost her.
Another tick and he lets out a large huff of breath, hitting the call button and bringing his phone to his ear. It rings four times and with each ring, Henry feels worse. When Will answers his voice is heavy with sleep, but even so it has a sharp, worried tone to it, "Henry, what is it?"
"You need to come back in, it's Elizabeth…something's happened"
There's a rustle of covers. "What's happened?"
"I don't know exactly." Henry runs his hand through his hair. "They were running some tests, then all these alarms sounded. They said it was a peri-arrest."
He can hear Will's sharp inhale. "I'm on my way."
Henry taps his foot against the floor. "Will, should I phone the kids?"
There is a brief moment of hesitation and then a heavy sigh. "Yeah, yeah you probably should. I won't be long."
The call cuts at that and Henry's face sinks into his hands at the thought of calling their kids to haul them back in here. He feels like he should be crying, should be inconsolable, but he feels like he is suspended motion. None of this feels real to him.
Still, he can't help but notice that his hands are trembling now as he brings up Stevie's number, wondering how they hell he got to here.
Jason snores softly, whilst Alison is face down in her pillow, with a proprietary hand laid across the sweet packet. The TV drones lowly in the background and Stevie is half-watching it, rolled onto her side, her eyelids beginning to droop as her phone starts to buzz softly.
Her head jerks up, her neck twinging in protest at the sudden move. Despite the phone being next to her, she fumbles for a moment in the dull room, the phone slipping from her grasp. She pushes her hair back off her face as she answers, "Dad, what is it, what's wrong?"
She feels Alison begin to stir next to her, but Jason is still snoring, his head tilted back on his pillow, his mouth agape. Her Dad's voice is quiet, subdued as he asks her to come to the hospital. Stevie blinks, possibilities flooding her brain, none of them positive. "We'll be right in, but Dad is Mom ok?"
Alison is instantly wide awake and sitting upright now at her sister's words, and Stevie can see her staring at her out of the corner of her eye. She turns to meet her sisters gaze and Alison whispers softly, "What is it?"
Stevie gives a shrug because she honestly doesn't know; it doesn't escape her notice how non-committal her Dad is being on the phone, repeating his request that they come to the hospital. She sees Alison give Jason a shake and he swats her away with his hand, grumbling, "Tired, go 'way."
She takes a deep breath and tries again, afraid of next question but needing to know the answer. "Dad, is Mom alive?"
Alison pauses in her attempts to wake up her brother, head swivelling and her mouth opening in horrified shock. The words also seem to pull Jason out of his half-sleep, his eyes opening and staring wide eyed at them both. Stevie doesn't doubt that events of the last day have just come flooding back to her little brother.
The seconds her Dad takes to answer her question must be the longest, most torturous seconds of Stevie's life and his answer brings little relief, "I don't know." The words sound like they've been torn from him and she hears his breath stutter and catch at his admission.
She calculates the lack of traffic in DC and tries to work out how long it will take to get for them to get back to the hospital. "We can be there in about ten…fifteen minutes. Dad…I love you."
His voice is low as he returns the sentiment and Stevie ends the call, lifting her face to meet the panicked gaze of her siblings. "We need to go back to the hospital," she tells them, getting clumsily to her feet.
Jason is shoving the covers off himself. "Yeah I picked up on that."
"Good, so let's just get our shoes and coats on and go."
"Stevie, wait!" Alison calls after her.
Stevie turns on her heel. "We need to go!" She tells them, her voice rising an octave.
Alison blinks, her eyes watering. "Stevie…what did Dad say? You asked him…" she swallows heavily, her voice cracking as she breaks off, her eyes wide and pleading. "What was his answer?"
Jason is staring at her as well and he's lost all of his normal posturing, his shoulders are sloped, his mouth set in a downward turn and his fingers are gripping the duvet cover he's just pushed to one side. She looks between them, her mind racing for a moment before she decides she just needs to be honest. "He doesn't know." She gestures towards the door. "But we need to go."
They both nod, their movements are slow and jerky and Stevie wants to scream at them to hurry up, but she knows that she's being unfair to them and that what feels like minutes is really just a few extra seconds. Her hands and arms shake as she pulls on her own shoes. She can feel them behind her, sees Jason stumble with his laces and she bites back her irrational anger. Alison is hugging her jacket around herself and sniffing.
Jason swears under his breath, as the lace falls out from between his fingers again and he simply shoves the loose laces down the sides of his trainers, tucking them out the way. He jumps up. "Right, ready."
Stevie knows that her Mom would never let that slide, would tell him to take the time to tie his laces, that it's dangerous to leave them like that, but she doesn't say any of that to him. She just wants to get to the hospital as quickly as she possibly can and so she shepherds them out into the cold night, where the car is waiting for them.
The anaesthetist rubs his gloved thumb against his cheek as he looks over the most recent blood gases. In the background he can hear the thud and creak of the bed as the chest compressions continue. The gases thankfully aren't terrible, there's some time to play with, but it won't be much. He trails his gaze back up and over Elizabeth. They've corrected the cause of the arrest, but he knows that isn't always enough. He has always wondered why there are times they get some people back but not others, he suspects it might be luck, or lack thereof. He hears the puff of the ambu-bag as another two breathes are squeezed out, into her lungs. "Can we have another rhythm check?" He asks.
Ventricular Fibrillation, shock advised, charge to two-twenty, press charge, press charge the machine drones at them.
He gives a nod of his head, stating, "Everyone stand clear." He sees the team take a step back and nods at the team member in charge of the machine. They press the orange button again. The thud reverberates, her body twitches, her head rolling slightly on the bed.
There's a gap of two seconds before the machine sounds again.
Ventricular Fibrillation, shock advised, charge to two-twenty, press charge, press charge
He nods again. The defibrillator delivers its fourth shock, its bland, automatic tone announcing it to the room. Shock delivered, check output.
A rhythm begins to beat out on monitor, but he holds his breath, she's had PEA before, so until they confirm an output, that means nothing. Maggie leans forward, pressing her index and middle finger against the pulse point at Elizabeth's neck. "We have a pulse," she announces.
Everyone in the room visibly relaxes at the words. The anaesthetist gives a nod. "Good work everyone, now lets get her stabilised." He nods at Lewis. "We need to place a tube into that thoracostomy, then I want a chest x-ray to confirm positioning and check that we haven't missed any further damage." He nods at Ellie. "You happy to bag until we get the tube secure?"
Ellie gave a nod. "Of course."
"Thank you." He watches as the team gets ready, following his instructions. He considers his earlier thoughts. If it does sometimes just come down to luck, then Secretary Elizabeth McCord has had it in spades the last twenty-four hours.
Will can't help but stop at the doors to the ICU, making an attempt to peer through the glass of the long, thin rectangular window set into the door. He can only make out that the lights are on at the top of the ward, nothing else and his stomach sinks.
He considers pressing the buzzer, because he suspects that if anyone had updated Henry then his brother-in-law would have phoned him, which he hasn't, and if he's honest, he's not sure he can sit in that relative's room, waiting. His finger hovers at the buzzer and then his arm drops, he doesn't want to pull anyone away from her when she needs them most. He feels powerless, transported back to when he was thirteen, leaning in through the passenger window of the car and pleading with his Mom to tell him what to do.
His feet are heavy as he turns and walks to the room to wait with Henry. The kids are already in there, their jackets over their pyjamas, hair sticking up at odd angles and that same expression on their face that Lizzie had when they brought her to see him at the hospital that night thirty four years ago. They're pale, eyes red rimmed, holding onto control by a thread, trying to be brave.
Henry looks like a lost soul, his eyes are hollow, and Stevie is grasping onto his hand, Will can see that he isn't even returning the comfort, his fingers slack, hanging loosely in hers. He looks up when the door clicks shut behind Will. "Someone brought some tea in for me, but other than that they haven't been back yet," he tells him.
Will nods, pulling his bottom lip in between his teeth, biting down for a second before letting it go with a hiss. It's what he thought, no news yet, but that doesn't make it easier. "What happened?" He asks. "You said they were running tests before it."
"Um yeah." Henry's eyes are dazed, he looks like a man who has no idea where he is or how he got there. "When I got back from seeing you off, they were giving her a medication. Said it was to stop her system being overloaded by the blood transfusion, that she was working harder than before; they wanted to be cautious." He visibly gulps and swallows. "She seemed to be doing ok for a while after it, so…I fell asleep for a bit…"
Will can see the admission pains him, can see the guilt that's turning him inside and out, but he can't help but push him. He needs to know what happened if he's going to figure out just what Lizzie's chances are. "Then what happened?"
"They were taking bloods, bringing the doctor up to review her, they asked for a chest x-ray." He blinked a couple of times. "I knew it wasn't good, but I didn't think…the monitors just started going." The muscle in his jaw twitches as he returns to that moment in time.
"Why did they want the x-ray? What were they looking for?"
"Infection, or air…blood in her lungs."
Will sees Alison wince at the words but he ignores it, just as he ignores the way Jason's head drops down to his chest, as he stares at the floor, his fists curling in on themselves. "What alarmed?" He asks urgently.
Henry shook his head. "I don't know."
"What did they say?"
"Ellie…she pulled an alarm. Said it was a peri-arrest. They wouldn't tell me what that meant, just said she was very unwell." He looks up. "What does it mean?"
Will bits the inside of his cheek. "It means that if they don't do something fast then her heart will stop." Henry's shoulders shake, whilst Stevie studies the floor and he can see a singular tear roll down and drip off the edge of her nose. "Henry, did they say anything else while you were in there?"
He shakes his head. "I don't know," he admits on a sigh.
"I need to know!" Will can hear the sharp edge to his own voice, he knows it's unfair, knows his brother-in-law is suffering and a small part whispers he should stop pushing, but the bigger part is screaming at him for answers.
It's Alison who jumps to her Dad's defence. "If he knew he'd tell you," she snaps back at him.
Will runs a hand through his hair, gripping momentarily at the strands, feeling the tug at his scalp. "Henry, she was fine. I saw the numbers. I don't understand how this happened. If you can just tell me…tell me…" He throws his hands outwards. "Tell me what they said about there being blood or air in her lungs."
"Just that they were looking for it."
There's a growl from Will's throat. He's not annoyed with Henry, he's annoyed at himself. He's annoyed that he left, can't help but wonder what might have been. "She was fine," he repeats again, now thinking aloud. "She must have been compensating, but even then…it shouldn't have been so quick." He rubs agitatedly at his jaw. "She was stable," he insists again.
"Uncle Will, stop," Stevie tells him, looking up and wiping at her eyes with the edge of her pyjama top. "This isn't helping."
But he can't stop, it's like someone's released a valve and he can't hold it back, everything spews out of him, he's muttering it, "She was meant to be stable. Peri-arrest…it came on quickly…if they thought it was her lungs..."
It's Henry who explodes first. "What does it matter!" He's on his feet, his cheeks flushing. He can't listen to more of this, the questions, the guilt and the what ifs are already sounding in his own head, he doesn't need anyone else's. "What difference could it possibly make now?"
Will looks at him, he feels oddly calm, his next words trickle out as if they should be plainly obvious already. "Because, she shouldn't have survived the gunshot, but she did. I need to know what happened because I need to know her chances. I don't know if she can be that lucky twice."
Henry blinks at him, giving a slow shake of his head as he turns and walks away. He goes to stand at the window, his hand across his mouth, his whole body so tense it looks as though it might snap. The kids sit in silence.
Will glances down at the tea set laid out on the coffee table, fine china teacups sitting on delicate saucers. He chokes back a panicked laugh. They've given them the good tea set; they're screwed.
Studying the x-ray on the screen, the anaesthetist taps at the image of the left lung. "That is a fairly significant pneumothorax. Chest tube positioning is good though." He claps Lewis's shoulder. "Good job."
"Thank you, Sir, but I feel I should have caught it sooner."
"Looking at her numbers she did one hell of a job compensating for it, especially considering the pre-existing trauma. For what it's worth, no-one, not even me would have seen that deterioration coming."
"Any idea what caused it?" Ellie asked, from the top end of the bed. She's fixed the ventilator back onto Elizabeth's ET tube and with Maggie's help is sliding the pillow back under her head.
"There's a small nick to one of the left ribs, potentially from the bullet, so it could have been a bone fleck. Or it could have quite easily just have been a complication from the ventilator, or the central line." His finger traces the screen again. "Fracture to the 6th anterior rib on the right side. She's going to feel like hell when she wakes up."
Maggie winces at his words, she knows it's a common occurrence during CPR, but she still feels a bit guilty about it. Ellie gives her a sympathetic smile and then has another thought. "Did you ask someone to speak to her husband?"
The anaesthetist looks up. "Ah…no. She's fairly stable now so we can go and do that." He taps the chart. "I've left the parameters for the ventilator settings written here. If you can get blood gases in an hour, I've also written up a plan to bring the ventilators support levels down depending on how she responds and what the gases show." He scribbles a signature on the chart. "You ok for me to send the husband back in?"
Ellie's mouth quirks as she glances around the room. Packaging is strewn around it, the trolley with the blood-stained instruments from the thoracostomy is still lying out, whilst the defibrillator is pushed against one wall and Elizabeth's sheets are splattered in blood and iodine. She doesn't think it will do Henry McCord any good to see any of this. "Not yet, we'll get her comfortable and then he can come back in and sit with her. I'll send someone out to get him when we're done."
"Alright, Dr Monaghan, you should come with me. We don't often get to give them good news after something like this, so it's nice to see for a change."
The two men leave the room and Ellie gives a sigh, surveying the damage. "Can you give me a hand?" she asks Maggie.
"Of course. It's almost 4am, you want to just get her washed? Since we need to change the sheets anyway?"
"Think that's the best idea." She gives a snort. "Will we just send him in," she echoes, shaking her head in disbelief.
Henry hasn't been able to find the words to comfort his children, he feels like the worst father in the world, but everything he thinks about saying sticks in his throat. How does he make any of this better?
Will at least has calmed, he's sitting against the corner of one of the sofas, his elbow propped on the arm of it and his chin resting on the upturned palm of his hand. He hasn't said a word since his outburst, but Henry recognises the look on his face, it's the same one that Elizabeth gets when she's trying to figure out the impossible. The difference is that Will taps his fingers against the sofa cushion as he thinks, drawing irritated looks from Jason.
As the clock continues to tick, Henry can't help but wonder that if they're still waiting it means that there is still hope.
Another five minutes pass and the door finally opens, two men in scrubs stepping into the room. Henry recognises the younger one from earlier, but the second one he hasn't seen before. He steps forward. "How's Elizabeth?"
The older man looks around the room. "Are you all together?"
"Yes." Henry takes another step forward. "How's my wife?"
"I'm Dr Tim Miller, I'm the lead on call anaesthetist tonight." He is gestured towards the chair. "Do you want to sit down Dr McCord?"
"No. I…we just want to know what's happened."
"I'm glad to tell you that we have managed to stabilise Elizabeth's condition."
Henry feels like a weight has been lifted from him, he can hear his kids sounds of joy buzzing in the background of the room. "Thank God," he breathes out. "Thank God." His hands shake as he presses them against his mouth. He feels like he could throw up from the relief coursing through him.
"I won't lie, it was very touch and go for a while. Elizabeth suffered a complication from her left lung collapsing, where the air escapes out of the lung but then becomes trapped within the chest wall. It meant that with each breath Elizabeth took in, the pressure in her chest increased, pushing her lungs and hearts to one side. We had to insert another chest tube into the left side of her chest to relieve this pressure."
"She had a tension pneumothorax," Will clarified.
"She did," he gives Will a quizzical look.
"My brother in law is a trauma surgeon," Henry clarifies.
"Ah." He gave a small frown. "I do have to advise you that Elizabeth's heart did stop before we were able to treat this-"
Henry's heart stutters at that. "Does that mean there's a risk of further brain damage?" He interrupts.
"Elizabeth received prompt treatment, there was oxygen given throughout and we ran oxygen levels in her blood both during and following her arrest. Given what those levels showed, I am hopeful that this won't worsen any impact her earlier arrest may have had."
"But you can't rule it out," Will states.
There is a slow shake of his head. "No, until she regains consciousness, we can't give any guarantees." His cheek gives a twitch. "I also need to inform you that that during the compressions to restart Elizabeth's heart, one of her ribs were fractured. It's a common but unfortunate side effect of CPR."
"Will that affect her long-term recovery?" Henry asks. He feels like even when he gets good news it's followed by another blow. His brain is already reeling and he's not sure how much more he can really take in.
"No, it will cause a few weeks of discomfort, but shouldn't cause any long-term side effects."
"Well that's one thing," Henry sighs.
"What caused the original pneumothorax?" Will asks, he's standing now, his fingers tapping against his thigh.
"It may have been a slow tear caused by damage from the bullet, it could have been a complication from the ventilator. We simply can't say for definite."
Henry sits back in his chair, he feels drained, exhausted. He just wants to see Elizabeth, to reassure himself that she really is still with him. "What does it matter, Will?"
He gives a muttered inaudible reply.
"I'd like to see Elizabeth." Henry informs them.
"Of course. The nursing staff are just making her comfortable. They'll come in and get you when they're ready."
Henry nods, standing as the two men stand. He offers them his hand, shaking both of theirs in turn. "Thank you," he tells them. He thought she was gone, that he had lost her, thought he had seen his wife alive for the last time as he was hustled from that room.
As the doctors leave the relative's room, Henry feels his children rush him, hugging him tightly. He returns the hug, wrapping his arms as tightly around the three of them as he can, thanking his lucky stars that, for now, their family is still intact. He knows there is a long road ahead of them, knows that nothing is certain, but for now she's still on that road with him.
