Trauma Center: Event Horizon

"We'll have to operate here, Dr. Stiles." Angie said, blood decorating her skirt like polka dots on any contrasting color. "If we wait any longer… Leslie will bleed out as well as Dr. Chase."

"I understand. I still have my roadside surgery kit in my trunk! We're in luck!" Derek announced as he stood up from his knees and dashed to the back of his car.

A few meters away from his vehicle was the other vehicle which had been involved in the collision with the ambulance. Only one of the people involved inside the car were going to need surgery so a small load was taken off of Derek's shoulders. Although, he still had his best friends life sitting in his hands. There have been situations in the past where he doubted his capabilities due to attachments to said patient and he was starting to feel it now. Deep down he knew that he was more than capable, but the idea of something going wrong was chewing at his self consciousness like a piranha.

With all three patients laid out across sterilized fabric from the ambulance which was quickly losing its sterilization in the wet ground, Derek returned with his large kit in arm. Five scalpels, thirty feet of sutures, two pounds of bandages and a limited supply of stabilizer were all that decorated the inside of the box and he along with Angie were going to have to make sure of all of it. If they used too much, someone would likely die while if they didn't use enough, likely ALL would die.

"Alright. Let's brief like a normal procedure, Angie." Derek said calmly, taking this time to pour alcohol all over his hands before putting on surgical gloves.

"Understood. Our first patient is nineteen year old Ashley Burnett who is suffering from several glass puncture wounds, some look deep enough to puncture vital organs." Angie said with her professional voice showing small irregularities and cracks.

"I see. Ashley will be our first priority then… I only hope that I'm making the right judgement call here." Derek said. Angie gave him a slight nod. That was all she could give right now with all of the shock creating a twisted knot feeling in her gut.

"The main objectives for these procedures will be removing the foreign objects from our patients and possibly resetting any broken bones. This will require the upmost concentration… we cannot fail." Angie offered, giving the most amount of inspiration she could before eventually feeling a twitch of fear in her heart. "Please… Dr. Stiles, do your best."

A small hint of self doubt rocked his bones once again, but instead he shook his head and took a deep breath. Remember what you need to do to save their lives, Derek.

"Understood, I won't let them die!" Derek blurted out as he created a jolt of energy in his brain, using that as a running effort.

Ashley was in poor condition for sure. Glass pierced into her skin like craters on an asteroid with blood trickling out of individual holes that were larger. The first thing he would need to do is remove the visible glass before moving into the interior organs.

"I'll need the forceps, Angie." Derek said, not receiving any time before the forceps were placed in his hands. Without shaking at all, he placed the metallic ends around a large shard of glass and pulled back perpendicular with the entry. A small pool of blood formed outside of the wound.

"Here, Doctor." Angie gave Derek a hand sized piece of fabric. "We don't have a drain so you'll need to dab away the hemorrhages when they come."

"Understood." Derek simply said, wiping accurately at the pool to soak up as much blood into a small part of the fabric. If he was going to make it last the entire operation he would need to be careful where he put it and how often he used it to avoid crossing blood into different bodies. Once a large portion of the glass was removed, it was evident that they were ready to move inside.

"Disinfect a small entry line just above the lungs, we'll need access to the both of them." Angie said softly. Derek didn't say a word and instead took a small glob of disinfectant gel and rubbed it along a straight line along the middle of her chest. Once clean, he drug his scalpel slowly down and opened a wide enough slit to use the four small retractors to open a wider view. Once inside, about six shards of glass were seen sticking out of the lungs. Blood was seeping into the lungs at a slow rate but if left alone, they could fill with fluid which is highly dangerous and lethal.

"I see six glass shards. Attempting removal." Derek said, grabbing the basin of each shard over time and pulling them all out. The small slits were just big enough to be sutured and so he zigged his way through each laceration and closed the wounds. Once finished, he began suturing the entry wound he caused to be able to perform said surgery.

This one went rather smoothly. Thank god.

Next up was Leslie, who had a broken rib cage fragment sticking out from the inside of her abdomen. The only reason she wasn't top priority was because most of the blood had been reduced due to Angie tying her blouse around the wound. Had Leslie been conscious, the pain would be enough to make her vomit.

"We're making good time, Dr. Stiles! Keep it up for Leslie, please." Something about Angie's voice seemed demanding without outright asking him of anything. It was almost like she was begging for his expertise and that made him remember the past operations he had performed on her father.

"You can't let down the woman who always believed in you, Derek. Save them both!" Derek told himself in his head as he changed gloves and disinfected the bed sheet they were laying upon. "Let's get started!"

There were dozens of small lacerations surrounding the exit wound of the bone fragment which Derek made quick work of, suturing quickly but equally careful, mindful of the heart rate he was having Angie feel.

"Her vitals are low, Doctor." Angie spoke gently as to not alarm the surgeon operating on her best friend. "I have the syringe ready for you."

Derek filled the syringe with the oddly green fluid and stuck it into the closest artery which Angie nodded in approval, noticing an increase in vitals. With that, he opened a large entry laceration to be able to view the damage Leslie had faced on the inside. Immediately, he noticed shattered rib cage fragments all piercing into the spleen. Derek would need to keep up the pace before Leslie slipped away. If her vitals dropped all the way and her heart stopped there would likely be no way to combat blood lose while keeping CPR compressions.

"Alright, let's retrieve the bone fragments one at a time. I'll let you keep track of them." Derek spoke as he lowered his forceps into Leslie. One by one he retrieved each and every bone fragment while suturing the wounds that were caused by sudden pressure change in the spleen. The fabric was starting to grow a dim red and squeezing it out produced thick red blood.

"All fragments retrieved and accounted for. Please reset them, Dr. Stiles." Angie said, sliding the tray over to him along with the antibiotic gel which was half empty. Hopefully there is enough to fixate all bone fragments so a secondary procedure isn't required. Regardless, Derek pressed on and commenced reconstruction of the rib cage. After all were placed successfully, he injected another syringe of stabilizer and checked the vitals again. They were near stable.

So, Derek proceeded to apply gel to the bone fragments. Once set in place, he sutured his entry wound and disinfected the sutures before bandaging. The procedure was over for her… And so was the antibiotic gel.

"Oh, DAMNIT!" Derek shouted as Angie flinched.

"What is it Doc—Oh no, we're out of antibiotic gel!"

Derek felt his world come crashing down. With one more procedure remaining – the one needed to remove the foreign object from Tyler's abdomen, he realized that there was no way to disinfect the wounds which meant he could operate but not without a guaranteed chance to give Tyler a very lethal illness.

"What do I do… what do I do!? Think, Derek!"

"Dr. Stiles…?"

Derek closed his eyes and sighed, stepping away from Angie and Tyler. He couldn't take all of them with him to the hospital as there was no room in his vehicle. However, they were all exposed in wet clothing in the lower temperatures. Waiting for too long could cause hypothermia which is highly dangerous in a recovering state. Faced with a situation he never would wish on anyone else, he grabbed his phone from his pocket.

"Doctor! Dr. Chase needs your attention right away!"

"Angie, we don't have any antibiotic gel! I used the last of the alcohol on the tools so I didn't give him an Infection… We have to call for backup no matter what!" Derek shouted as he listened to the buzzing sound of the phone before hearing a voice on the other end.

"Derek? Have you found Tyler and Leslie?" Chief Kasal spoke back on the other end of the phone call.

"Yes, sir. They're in critical condition and we need another ambulance!" Derek blurted out without thinking. "They're in the same location as their GPS last blipped. I performed surgery on Leslie and one of the accident victims but Tyler can't make it much longer with our resources!"

Angie understood regardless of how much she hated their situation. Derek performed the best that he could for where he was and now faith was in the abilities of whoever was going to drive the ten to fifteen minutes it would likely take to reach them. If only they had picked a more popular road…

"Understood. The team and I will be there in fifteen. Hold on, Derek." Sidney gave back, ending the call right away leaving Derek with Angie and his own dark thoughts. They would need to hurry if Tyler had any chance at waking up.

"They're on their way…" Derek said before dropping down next to Tyler and feeling along his forehead. His temperature had dropped a bit since the beginning of the procedures and so he ran back to his vehicle with Angie and retrieved an emergency blanket and spread it as much over the three of them as he could. Angie even went as far as to slide them all to within millimeters of one another to give as much blanket coverage as possible. It was up to Caduceus now, and Derek was feeling the fear from it in full force.

"Please, make it in time…"

(X)

Once the ambulance left the bay, Sidney floored the gas and even turned on the sirens to divert people out of the way. One by one, the cars turned away from the ambulance to give space.

"I can't believe Tyler and Leslie were in an accident…" Victor groaned. "I knew that idiot couldn't drive but I didn't want him to crash."

"We can only hope we make it in time… Our prayers go out to Derek and Angie." Robert Hoffman said, closing his eyes and praying. For not being religious people, it was definitely out of the norm but Victor even closed his eyes without saying a word and likely prayed as well.

(X)

"I'm scared, Doctor…" Angie said softly, her hands trembling slightly as she felt along the temperature of Tyler. The fear of losing her friend was real now unlike in the beginning of this procedure. Had they not run out of certain supplies this while operation could be over and done with.

"Don't worry, Angie. They'll be here in time." Derek said, beginning to pace back and forth as he waited. Even the sound of sirens was not present yet and he listened sharply for any sort of vehicle sound or ambulance siren. The second he was going to hear one he was going to ready all three patients for transportation.

"I know you gave it your all, you always do… I just don't want to lose any friends. That scares the life out of me…" Angie said as she looked down at her skirt while she sits on her knees. It was like the sudden realization that the blood wasn't her own and instead was her best friends blood came over her like a flash flood and she began to breathe harder and harder. Hyperventilation was starting to set in and Derek picked up on it right away and walked over to her and dropped down to her level.

"Hey, hey! Angie!" Derek said loudly, placing both hands on her soft cheeks and shaking her gently. "Come on, we need to be strong for them right now. I need you to be strong for me. Can you do that for me?"

Angie began calming down as her eyes settled on his, Derek's voice soothing her nerves slowly. Eventually she slowly blinked and nodded.

"Y-Yes… Doctor…" Angie spoke, her voice barely audible. There, the two hung close to each other with their faces only centimeters apart.

"Ever since the first operation we performed together I have been relying on you. I thought it was more obvious than it is but I need you to be OK. Whenever you're not, I'm not because we're a team. If you can't treat them like any other patient and watch over them until help arrives, then neither can I… And Tyler Chase and Leslie Sears need us right now. Take deep breathes… Think things through, Angie." Derek said, removing his hands from her face and taking a couple slides backwards as the sound of an ambulance siren became apparent in the distance.

Angie hung frozen with her eyes fixated on his and a small tear building in her left eye. It was almost like she realized something right then and there. Soon after, she gripped herself and stood up with Derek, beginning to remove all of their surgical items from the area to prepare the patients for transportation.

Soon the ambulance appeared in the road and parked next to Derek's vehicle with Victor, Sidney, and Robert jumping out and dashing over to them.

"How is he!?" Sidney yelled as he approached.

"Leslie is stable for the moment as well as one of the other patients. Tyler wasn't able to receive treatment, he needs to get to the hospital NOW!" Derek yelled as he helped Victor with the stretcher and transport bed. "On three! One! Two! Three!" Together they lifted Tyler up onto the bed and wheeled him back to the ambulance while Sidney and Angie did the same for Leslie.

"Thank god you came when you did, Derek." Robert said. "With Leslie's injuries she wouldn't have lasted another fifteen minutes."

"I'm not relaxing until Tyler is in recovery. Angie and I will ride back to the hospital and meet you all there!" Derek yelled, his professionalism and leadership abilities showcasing just how capable he was of keeping his cool during emergency situations.

'Sounds good. Drive safe, Derek." Chief Kasal said as all three of them loaded into the ambulance after making room for all emergency patients. Once again their sirens came back on and they skidded out of their parked location and down the road.

Derek and Angie were left behind with blood all over the street and their clothing. The entire back seat of Derek's car was a dim red from Tyler bleeding out over everything. Now it was up to the rest of Caduceus to reach the hospital in time to be able to operate on him. Regardless, it was time to get out of there.

"Angie…" Derek started as he walked up to her. She was frozen but seemed to be aware of her surroundings. "Are you OK?"

"Yes, Doctor… Let's get moving." Dodging his concerns, she walked around his vehicle and hopped into his passenger seat. It took him a few seconds but eventually he followed suit and grabbed his spot in the driver seat and floored it away from the crashed vehicles and blood pools, not looking back at all.

(X)

"Angie, we're ready." Derek said from inside the O.R. After prepping Tyler for emergency surgery, Derek sat in the operating room looking over his best friend. The scissors still hung from his abdomen but pre-op procedures were done to control the blood that was leaking out amongst his body. Still, Derek didn't feel right operating on his own best friend. Normally if there was a procedure that pushed him like this, Derek would hand it off to Tyler. But like Hoffman always said, "No doctor can operate on themselves."

"I have Dr. Hoffman in the gallery watching just incase something goes wrong…" Angie said softly. "But, I'm more than sure we'll be fine."

This tone of hers was different than what it was thirty minutes before hand. Much different.

(Thirty minutes earlier)

Derek and Angie arrived at Caduceus and launched out of their vehicle and throwing their doors closed. They were in such a rush to get inside that Derek barely remembered to lock his car when he bolted away into the hospital. Soon after getting in, they found Tyler on a patients bed in an exam room with Victor and Sidney. They were likely checking his brain activity since his heart was still beating.

Angie and himself were standing outside the closed door side by side. Out of the blue, Angie turned to look at Derek and sighed.

"Do you think Dr. Chase and Leslie will be OK, Doctor?" Angie muttered. Derek pressed his left palm onto her hair and pat away gently.

"I don't see the good in assuming the worst, Angie." Derek said with a half smile. "I'll do my best."

The answers just weren't enough for Angie, as she focused her eyes on the floor but her gears kept turning. In her mind, anxiety was taking over and the answer she received from Derek did nothing but push her fears over the edge.

"That's it? You promise nothing but the best for all of your patients! You tell me about how much you want to save their life and how you won't let them die! You're telling me that you're just going to do your best?" Angie bickered, which caused Derek to step back from her, blown away by her random outburst.

"Angie… I told you I would do my best." Derek fired back, looking down at the floor as well out of shame. Something deep down was telling him that he wasn't taking in the full gravity of the situation. Angie began tearing up and eventually silently sobbing into her hands. When Derek reached out to pat her shoulder for moral support, she pulled away and fast walked down the hallway. Out of instincts alone, Derek cupped his hands around his mouth like an megaphone. "You can't just run away from this, Angie! We both took this hit!"

Once he was alone again, Derek slammed his shoe into the hallway walls and sighed. Now there was real pressure behind his eyes.

(Present)

"Right." Derek muttered as he placed his gloves onto his hands. "I'm ready for the briefing."

Angie nodded. "Our patient is Dr. Chase who was involved in a car vs ambulance accident earlier today. Currently, his vitals are balanced in the 40's but it won't be long before they take another dive, and we can't use defibrillators until the scissors have left his body." Angie said as Derek listened intently. "Our main objective for this operation will be: Remove the scissors from our patients abdomen and repair any damage done internally."

"I understand… I won't let you die, Tyler!"

(X)

Sidney stopped by the daycare in Caduceus where the children and young teens would be held for the shift of their parent or guardian. Here, Amy Chase, Tyler's sister, was spending her day helping out Ms. Harrison with taking care of the children. Being fourteen years old, Amy spent her time working on school work or volunteering at the Caduceus Day-Care.

Unfortunately, the little sister of Tyler wasn't informed of his accident and Sidney was here to break the news.

"Ms. Chase." Sidney said from the entrance as he caught Amy showing a younger child how to use a digital drawing pad that was in the room. Once she saw Sidney, she stood up from her spot and walked over to the gate.

"Mr. Kasal! What can I do for you?" Amy chirped, her optimism shining through much like Tyler. It even registered in Sidney's consciousness that he was talking to a mini-Tyler.

"It's about your brother. Do you mind coming with me?" Sidney asked as he looked past Amy and towards the day-care leader. The woman smiled and nodded to Sidney who then looked back to Amy.

Amy turned around and received the same nod from Kiara Harrison. Turning back to face Sidney, she nodded with a little concern in her face as she followed along. On the way, Amy did her best to keep up with the chief of surgery of Caduceus. His legs were just too tall for her and she found herself stepping twice for every step of his. Regardless, she begged the question.

"Is my big brother alright? Is he OK?" Amy whined as they started up a staircase.

"He will be. Your big brother was involved in a car accident along with Lesl-"

Sidney was cut off by a gasp followed by widened eyes. It looked like Amy was seconds away from bawling her eyes out but she listened as Sidney continued.

"—ie, but Dr. Stiles is with him right now taking care of him. Don't worry, Dr. Stiles is doing his very best with your brother." Sidney finished as they rounded around to the gallery. Once they peaked through the glass, they saw Angie congratulate Derek as he didn't respond and instead ripped his gloves off and threw them into the trash aggressively. Sidney caught a glimpse of Angie staring at Derek as he left, surprised by his outburst.

"Is he done? Is my big brother OK?" Amy whined which Sidney looked back over to Angie who returned a nod. Slowly, a smile crept over Sidney Kasal's face.

"Yes, he is. Dr. Stiles saved your brother!"

"Yay!"

(X)

Once the lab coat came off, Derek sat down on a bench in the hallway and plastered his hands to his thighs to support his upright position. His glasses hung down slightly and he stare at the ground with thoughts and scenarios zooming through his brain.

"I performed the operation just fine… But I don't feel like Angie had complete confidence in my capabilities…" Derek thought to himself as he sighed. After all the time working at her side he felt slighted now that he had spent years proving himself to that woman. If she wasn't faithful to his surgical expertise just because a friend was hurt, God knows what she would think when a random patient is critically hurt.

These thoughts were pulled like strong gravity from his brain when heel clicking became apparent.

Of course. It was Angie.

"Um, Dr. Stiles…?" Angie muttered as he opened his eyes and leaned back against the wall to look at her. There were no tears or bags but Derek still looked tired. "I was wondering if I could talk to you."

"Angie, why do you not trust me?" Derek said quietly to which Angie looked surprised and widened her eyes slightly.

"What are you-"

"I could feel it in there before the operation, and I could feel it during the surgery. Why?" His voice was a little intense, reflecting on the surgery they just had.

Derek was starting to feel a slight sense of overwhelm. The blood was pouring from his liver at incredible speeds, and he felt the warm blood of his best friend burn at his veins and tendons in his arms. The entry wound was easy as cake, but repairing the wound in the liver was time consuming and needed to be done quickly before the beginning sutures were off. Every opportunity he had to suture the wound, a blood clot would snag the sutures and tear it or the blood would loosen the grip. Something needed to happen before they suctioned all of his blood away.

"Angie, I need you to hold the drain just above the wound to drain the blood. While you're doing that I'll make sutures and place synthetic membranes over them to lengthen my time before they wear off again." Derek said.

"But wouldn't that take too much time? He'll lose all of his blood before we even close the wound!" Angie argued which Derek snagged the drain from her hand and held it over the wound while his other hand slowly sutured the wound.

"Come on, Angie. I need you to HOLD the drain!" With that, she gave up her fight and held the drain in place while he sutured and applied membranes over the suture lines.

"W-well…" Angie stuttered before going quiet and looked back up from the floor to Derek as if giving up on what she was going to say.

"As a doctor, I need your support in their never mind us being best friends. If you don't believe in me when we're saving someone's life then please, don't follow me into the next O.R. Because if you made me doubt myself and I killed Tyler because of it, I would NEVER be able to look at you the same ever again." Derek said sharply as he stood up and walked away, leaving her to recoil at his harsh voice which she only heard a handful of times in her life alongside Derek.

"Doctor… I'm sorry…"