All in his Head

Coma

One week after starting treatment, Matt was put into a medically induced coma to reduce the risk of permanent brain damage. His symptoms had been worsening and he was almost entirely unresponsive, and he was having regular uncontrollable movements, his arms and body jerking almost violently, they'd had to put protective barriers on the bed rails, his arms were already covered in bruises. He'd had six seizures, each lasting longer than the previous one, Kelly had shed more tears than he thought possible. Matts road to recovery would be long, and now he was fearful that some sort of complication could kill him, never mind leave him with lasting brain damage. With no improvement made with first line immunotherapy, the doctor started Matt on two other medications, Rituximab and Cyclophosphamide, they were riskier, but the benefits outweighed the risks. He'd have these new medications alongside continuing steroid and IVIG infusions. Because of the rarity of the illness, there was no set treatment plan, so they would be continually monitoring Matt, regularly checking his blood and spinal fluid to see if the treatment was working.

Knowing Matts recovering was going to require months of supportive care and possibly years of continued medication after having another frank discussion with his doctor, he'd started taking notes, writing down anything and everything to do with Matt's care. Shay had given him the idea when he admitted he was worried he'd forget something.

Kelly walked the rows of pews and stopped when he met the man he'd been looking for.

Chaplain Orlovsky turned and smiled. "Kelly Severide, what do I owe the pleasure?"

"Hi, Chaplain," he greeted.

"How are you and Matt doing?"

Kelly just gave a shrug in response. "I probably should have called ahead, do you have time?"

"Always for you, want to sit?"

"I'd rather not make this official," Kelly responded.

"Official?"

"Don't wanna sit down like I'm talking about my feelings to a shrink or something…"

"Then feel free to follow me around as prepare for tonight's service," the Chaplain suggested.

"Thank you," he said gratefully.

"So, how are you?"

Kelly didn't reply right away, he followed the Chaplain as he walked the length of one pew before he spoke. "I don't know," he said honestly. "We know Matt's sick now, but that doesn't make things any better, I mean, he was always sick. I feel like I failed him, like the doctors failed him… yeah, I hate that they didn't figure it, that they know this horrible thing can happen but they didn't do a simple antibody test. But then I feel guilty because… well, it kinda made sense that… well, that he lost it…"

"He lost it?"

"They thought he was crazy… I thought he was crazy, not right away but, I let them make me think he was… I hate that I didn't stand up for him…"

"Why didn't you stand up for him?"

"Well, I did, or at least I tried to but…"

"See, you stood up for him, from what Boden told me, its something that's hard to diagnose," the Chaplain responded sympathetically. He had Boden had been chatting more than usual recently, and mostly to do with Matt.

"Yeah… I mean, what would have happened if it was never diagnosed, he'd have been stuck like that, everyone, including me, thinking he was crazy… he was crazy, he was delusional, he was standing on the roof, swinging an axe…"

"It must have been really scary," the Chaplain said.

"He was so scared…"

"It must have really scary for you, Kelly," he corrected.

Kelly sat down. "I was worried about Matt, and scared… it was horrible to see him like that, but then I feel bad for thinking it was horribl, when it was happening to him, not me."

"It was happening to you, you were there," Orlovsky stated.

He let out a breath. "They've had to put him in a coma."

The Chaplain sat down next to him and put his hand on Kelly's arm comfortingly.

A few days later, Kelly was sitting with Matt. He would spend all day with Matt, every day, and in the evenings he'd work, doing as much as he could at the boat yard before he grew too tired. Sometimes he would sleep in the chair beside Matts bed, other times he'd read to him, or just watch TV on the tablet attached to the bed, always making sure to choose something Matt would approve of, just in case he could hear.

He was filling in a crossword puzzle, pen in his mouth as he thought, when the door opened.

"Hi, Kelly."

Kelly beamed when he saw Boden entering the room, a large box under one arm. "Chief, it's good to see you."

Boden smiled back. "I wanted to drop off some gifts and cards from everyone, quite a collection has gathered."

"Thank you, Matt'll love them," he said as Boden placed the box down. "They may be reducing the meds tomorrow, he's out of the danger zone apparently, which is good, erm…"

"Sit back down, we don't need to make this awkward," Boden spoke.

"It's not awkward," he responded with a smile.

"Truth is, I've been worried about seeing him," Boden said, looking at Matt lying on the bed, surrounded by a lot of equipment. He had never seen him look so small, and he wasn't a small man, he was strong and dependent. He knew Matt was sick, and it had been more two months since Matt had seized in the common room, the last time Boden had seen him was dropping him and Kelly off at their house, and Matt looked nothing like the man he'd watched Kelly help into the house that day. He'd lost weight, and even with the bed sheets, he could tell that his muscles had atrophied. He looked back at Kelly, clearing his throat, realising he'd been staring at Matt.

"All the tubes and wires make it look worse, you see past them eventually," Kelly told him.

"So, they're waking him up tomorrow?"

"He may not wake up, but they're not gonna be inducing a coma anymore, may take him a while to wake, but he will," Kelly said with certainty.

"And how are you doing?"

Kelly nodded. "I saw the Chaplain."

"Did that help?"

He shrugged. "It did, but it didn't… I mean, talking's great but I wish I could just do something to make him better, physically do something, because I've been sat around on my ass for weeks," he said, exasperated.

"Don't be so hard on yourself. I did a bit of reading… what Matt has, it seems like it can be really difficult to diagnose. You did the best you could for him, and you still are. You make a difference to his life every day, Kelly. Before all of this happened too. You made him happy."

"I thought he was happy, then I found out how much he's been hurting… God… if… no, when he gets better, we've got all that to deal with too…"

"The psychosis?"

Kelly nodded.

"Matt was happy. I do think most of the psychiatric side of this really was his brain… playing up, for want of a better word."

"But he hasn't dealt with anything, his past, I feel like I never knew anything about him… and I don't mind that he didn't tell me, I don't think I mind… I don't," he said adamantly. "I just… it's a fucking mess, isn't it? All of this. It's not fair."

Boden agreed. "It's not."

"Shit, what if he can hear me moaning…" Kelly said, looking at Matt. "I'm sorry, Matt. I think I need to get some more sleep, that's what you'd tell me… and make a joke or something. You're funny, not clown funny, but you have this dark humour… I love it and I miss it, you'll be awake soon though, and you're gonna be fine. I just know it."

Boden smiled softly as he watched the one-sided interaction.

During second watch's next shift at the firehouse, Boden entered the common room with a sombre look on his face. He looked around at everyone. Despite the upheaval of their truck lieutenant going on indefinite leave, and their squad lieutenant soon following, everyone had coped well with the change and had got on with their jobs. Boden had of course heard rumours travelling around the house, and beyond, but nothing sinister.

He cleared his throat and spoke. "Can everyone come to the briefing room, I know it's dinner, but I have something that needs to be said."

He waited as everyone filed out and then followed them.

It took a short while for everyone to grab a seat, and then Boden stood in front of them all. "You've all been left in the dark for a while, about Lieutenant Casey…"

"We wanted to respect his privacy," Herrmann spoke up, everyone nodded in agreement.

"I know, and I'm really grateful for that, and so is Kelly, who as you know ended up taking some time off as well, but you've been left in the dark and well, so were Matt and Kelly for a while too…"

"Chief?"

"Matt is very sick, which I'm sure you all gathered. He has something called autoimmune encephalitis, from my limited understanding, his own body thought his brain was under attack, so it fought back… erm… causing chaos in his brain because… because there wasn't anything there to fight against…" Boden paused and let out a breath. "He's currently in hospital receiving treatment, everyone's positive he'll recover."

"He'll be back at work in no time at all then," Herrmann responded.

"That's the hope," Boden said, nodding. "And Kelly says thank you for all the cards and gifts, he's displayed them in Matts room."

"Casey liked it all then?" Otis asked.

"He's still really sick at the moment, but I know he'll be very happy when he sees everything," he replied.

"And Severide? When will he be back?" Capp asked, speaking up.

"Could be weeks," Boden said. Or it could be months, he thought. "He just wants to be with Matt right now, which is understandable."

"Is there anything we can do?"

"Nothing at the moment, just good thoughts," Boden finished.

TBC