Title: The Tragedy and His Partner
Author: april leigh
Rating: PG
Summary: "What becomes of hope? I'll bet she's a nervous wreck."
-- 'Houdini's Angels,' Seven Mary Three
Spoilers: Through beginning of season 8
Distribution: Ask first
Feedback: Welcomed at aprilleigh50@hotmail.com
Disclaimer: Not mine; don't sue.
Author's notes: For those of a gentle nature: please take note of the first two paragraphs. This will be your only warning.
* * * * *
Day One of Six
I knew by the way the nurse avoided my eyes when she gave me report that I'd been assigned a Tragedy. One of those patients who would never get better, never wake up from their coma, never be weaned off the ventilator. Never go home. Even though I'd only been a nurse for a short time, I was already too familiar with these cases. I knew that no matter what we, the medical warriors, did for them, they would remain a tragedy.
Fox Mulder was the ICU Tragedy of the Month. One by one, each nurse had had a chance to take care of him, and one by one, each had come to the same conclusion: his case was hopeless.
Report on my other patients was quick and painless. Nancy, the day shift nurse, searched through the card file until she came to the information card on my last patient. She cleared her throat. After that came the series of familiar nuances- the slight pause, the slow shake of the head, and the inability to look the oncoming nurse in the eye.
"Bed ten's case is really sad," she said. It was the standard opening line for report on Tragedies. "Fox Mulder, a FBI agent. Mulder- he goes by his last name only- was found in the woods by a couple of hikers Christmas Eve- who knows how long he'd been out there. Anyway, he was unconscious, but relatively sable when the EMTs first arrived. But on the approach to ER he began seizing. They did a head CT in the ER, and they discovered that he had serious brain trauma- source unknown."
Nancy shrugged and answered the question I had not asked. "Who knows? No one has really offered an explanation as to what exactly happened to him. I did overhear something about a case gone bad. Something about him getting kidnapped and being missing for months. You know how the FBI gets involved in some crazy stuff; it was probably some psycho who wanted to play 'lobotomy.'"
I nodded, not wanting to think too much about it.
"Anyway, his ICPs were sky high so Westcott came in to evacuate some of the fluid and place a shunt."
I felt a brief flicker of hope. Jack Westcott was the best neurosurgeon in three counties. I'd seen him turn more than one Tragedy into a Triumph.
"Unfortunately..." the nurse emphasized the word, drawing out each syllable. "During the surgery he went into respiratory arrest. They were able to bring him out of it, but he's been vented since then." She flipped through her notes, searching for something she had written down. "Initially, Westcott thought there was a chance he'd come out of it after the swelling went down, but he remains in a vegetative state- totally unresponsive. His EEGs are all grossly abnormal, and yesterday he started seizing again, and hasn't stopped." Nancy tapped her head. "Nothing but mush up there, is my guess. Westcott said that it was like someone was mucking around in his head, searching for something, but not caring about the damage being done in the process."
Unfolding the critical care flow chart, Nancy ran through the rest of the clinical details- vital signs, meds, results of neurological checks, lab procedures, and treatments. "He's not going to last long," she said, finally meeting my eyes. "So it isn't like you have to go all out. I mean, on paper he looks like a heavy patient, but we really aren't doing a whole lot. It's mostly comfort measure for appearances sake. Suctioning, turning, clean sheets- you know the routine."
I caught her gaze. "What do you think?" Early in nursing school, I learned that a nurse's intuition was more reliable than any test or expert physician's opinion. "Do you think there's any chance he'll..."
"No way," she said emphatically, then shrugged. "I mean, sure, I suppose he could come out of it, but there'd have to be divine intervention. In my experience, these patients rarely wake up. They either end up at the rehab center for a few months until they die of respiratory problems, or they vegetate for months- until a family member comes to the conclusion that maybe Kevorkian has the right idea. But who knows, right? I've been an ICU nurse for too long to be absolute about anything."
"And what about the family situation?" Everyone knew the Tragedy patient was only half of the story. Completing the cast were the walking wounded, otherwise known as the surviving family members.
"Well there's been the occasional FBI guy or two checking in, and we have his partner or girlfriend or wife or what ever in there with him. I don't think that she's left his side even though it's obvious she needs to rest. Anyway, she has power of attorney, and she is very active in directing his care." She glances at me significantly. "She's a doctor."
"Lovely." I murmur. There's only one thing worse than having a patient who is a doctor: having a patient's family member or friend be a doctor.
Nancy continued. "Well, lucky for you she's just about exhausted every test and procedure that could be done on him within the first 24 hours. She's settled down a bit once there was nothing left to do, but she's still in serious denial. Says that she knows him, that he's been through worse, etc... I've tried to get her to understand the situation and his prospects, but she doesn't want to hear. It's ridiculous."
"No," I corrected. "It's desperate, blinding hope."
"Whatever." She waved away the subject and leaned back in her chair with the relief that only comes when the shift is finally done and report has been given and the baton has been officially handed over. "And how was your Christmas?" she asked, knowing that I'd had the past week off.
"Oh it was fine, the standard stressful holiday fare. Jason's parents came to visit... Drove me nuts," I added.
Nancy laughed, and then stretched her arm out to pat my hand. I knew without meeting her eyes that she was looking at me with warm amusement. "Welcome to the wonderful world of in-laws. You did realize that when you married him, you also married his family."
"Yeah, I realized. But they were never like this before."
"Wait until you have kids." Then she leaned forward to whisper conspiracy in my ear. "The thing that I want to know is how you managed to get both Christmas Eve and Christmas off."
I sighed. "I just traded my soul."
"How many extra shifts?" She asked, accurately interpreting my expression
"This is the first of six."
"Six twelves? Lord... I'm glad that it's you, not me." She stood then, gathering her things. "I'm just glad I've got the next few days off. Taking care of him for three days in a row is enough to depress God." Swinging her coat around her shoulders to protect her from the chill outside, she said, "You have a good night Nadine. "
"Right." I regarded the Tragedy's info card and sighed. Considering the state of the world, it had always been my belief that if there really was a God, She was already pretty damned depressed.
* * * * *
It was not a conscious decision on my part to put him off. Actually, it wasn't until the moment I entered his room that I realized my level of reluctance was higher than if I'd been entering the room of a patient requiring an extensive bowel disimpaction.
The Tragedy-
Mulder
- was alone in his room. The large overhead light was off, but the small light near the head of his bed was on, casting deep shadows under his eyes, highlighting his sunken cheeks.
Death was hovering in the shadows of his face, waiting for its opportunity.
I quickly turned on the bright overhead light, and watched as most of the shadows fled his body. But some were too great, and they hung on tenaciously, unwilling to let go.
His thin body was propped on its side facing the door, a single pillow tucked behind his back. The eyelids, fluttering erratically, were opened just enough to reveal eyes aimlessly rolled from side to side, top to bottom.
Jesus, he's pale. Too pale. Poor guy. And that beautiful angular jaw- what a waste of...
Catching myself, I looked away, not wanting his face to become too real. If I allowed myself to see him as a real person, I might get involved and begin to hope.
'These patients rarely wake up.'
The wall clock behind me ticked, reminding me that I had other things I had to attend to. There were miles to go before I could sit down and rest. I didn't have the time to invest in hope.
I inched toward the bed with the reluctance of an acrophobic approaching the rim of the Grand Canyon. An instant later the body contracted in a seizure. The eyes opened wide...
Hazel. The same shade. The same shape.
...and rolled back. The corners of his upper lip twitched, forming what would look to the untrained observer like a grin.
The cardiac monitor, interpreting the frenzied muscle activity as a deadly rhythm, alarmed in harmony with the high-pitched blasts of the respirator alarm. I checked to make sure that the bite block was in place between his teeth. The last thing that he needed was a crushed endotracheal tube- the piece of plastic tubing through which the ventilator fed him oxygen.
Pulling the suction out from under his pillow, I suctioned the spittle which had ran down his chin and onto his hospital gown. The skin of his neck and face turned a bright red as he bucked the respirator with his gagging. I was gratified to see he at least had a gag reflex. It wasn't much, but it was something.
But to what end? So he can linger as a zucchini that can cough?
I waited for the seizure to end, feeling his radial pulse- a thready, weak blip under the thin skin- and examined his three intravenous lines for signs of infiltration or infection. I had to squint to read the labels on each of the seven IV bags that hung from metal poles placed like sentinels around his bed.
According to the wall clock, his seizure had lasted a full minute. How long can he last at this rate? Twenty-four hours? Less?
And then, as suddenly as it had begun, the seizure ended.
His hospital gown had slipped away from his legs and hip. Something about the sight of that long white skinny leg made me stop. My throat tightened, and I quickly adverted my eyes.
Don't look Nadine. Gotta hurry. Turn, suction, and give him some diazepam... But that leg- the way the hair grows to the ankle and stops. I know that leg...
Searching for complications which may have arisen since his last assessment, I performed a physical exam, feeling for pulses with fingers trained to see, and listening to heart, lung and abdomen for sounds my ears could translate into any of fifty different diagnoses. I separated his nasogastric tube from the bag of thick formula...
Loaded with vitamins and minerals- like pumping fuel into a powerful car that has no steering wheel or tires.
...and aspirated the contents of his stomach for any residual lagging behind. Unpinning the grenade shaped Jackson/Pratt drain from his turban, I measured and emptied its bloody contents. I calibrated the monitors, hung new IV bags, discarded the expired ones, and pushed myriad medications into his veins and down his feeding tube.
Exam done, I searched for a place to spread out the flow sheet and chart. In moving a sizable stack of folders and assorted papers from his side table, a bag slid off and landed at my feet. A number of photographs spilled onto the floor. I picked one up and I recognized the face. The angular, handsome face...
Don't look! Don't make him real. It's too close to home.
...smiled at me from the photo on top.
A beautiful smile, with a glint of mischief. That's the same expression Jason wears when he manages to sneak a pint of mint chip ice cream in with the groceries. I scold him, but I never say no when he offers me a bowl...
I smiled back and reached for another picture and then another, feeling like a snoop playing with fire.
He'd been...
Slender and handsome...like Jason.
...a FBI agent. In one photo he's crouched near the ground, studying an object, the letters FBI on his back.
Another is of him and a red headed woman. It was taken at an amusement park. On the bottom right was printed "Santa Monica Pier" and in the background I can see a hint of a roller coaster. In the foreground was Mulder with an arm casually thrown over the woman's shoulders. The woman was smiling politely to the camera, but he was staring intently at her face, like he's examining her face for something only meant for him to see, the same smile as before written on his lips.
I flipped through the rest quickly. Some were of people- family or friends I guessed- the rest of the photographs are of locations that I assume would have been familiar to him.
Suddenly feeling guilty, like I'd pried where I didn't belong, I put all of the photos away, save one, and began the neuro exam.
"Mulder, squeeze my fingers."
No response.
I wiggled my fingers inside his, prompting him again to squeeze.
No response.
Holding open the wildly fluttering lids, I flashed my penlight into his eyes.
Right pupil was sluggish to respond. Left pupil remained fixed.
I ran the blunt end of my pen down the length of his soles. Predictably, the great toe pulled upward. The abnormal movement, known as a positive Babinski's sign, was another indication of neurological damage.
The photo I'd put aside was of the couple, and as I charted the red headed woman seemed to stare at me. An idea suddenly presented itself, and while it couldn't exactly be considered part of a standard neuro exam, I figured a case like this gave license to use any means available to ascertain whether or not he was home. Not really expecting a reaction, I held the photo directly in front of his eyes.
At once they stopped their chaotic dance as he focused on the image before him. A beautiful smile- the same one he wore in the pictures- spread across his face. Unmistakingly, recognition and joy registered in his eyes.
My heart was going like a jackhammer as I moved the picture to the left. His eyes tracked the photo to the left. The smile did not falter.
The thought that I should contact Dr. Westcott was just beginning to form in my head when he disappeared inside another seizure.
I tended to the necessities- suctioning, giving oxygen, and pushing more Valium, protecting his limbs from sharp corners- while a variety of nagging, though completely logical, thoughts-
'Nothing but mush up there'... 'These patients rarely wake up'...
- systematically attacked my newly born enthusiasm, eventually murdering it altogether. The notion that he was even slightly aware of what was happening to him, living-
trapped?
- forever in that distant twilight world and never knowing who or where or even what he was, horrified me to the point of feeling ill. Closing my eyes, I took five deep breaths, clearing my mind with pleasant thoughts.
Once he was still, I again held up the photo.
There was no sign of recognition this time. No response whatsoever. Whoever had briefly peered out from the attic window was no longer evident.
The wall clock clicked, reminding me that Mr. Ross' antibiotic was almost an hour late. Rapidly gathering my charting sheets together, I had turned to leave when the sight of the his bare leg and ankle made me stop again.
Exactly like Jason's leg...skinny and white with the fine dark hairs. Same
eyes, same spidery fingers.
Softly, I laid my hand against his cheek, studying the handsome face.
Even the feel of his skin is right. It could so easily be Jason...
Taken by a sudden madness, I rearranged fate by pretending- believing- it was Jason who lay in bed ten. An indescribable anguish hit me with an impact as powerful as having been shot at close range with a .357 Magnum. The reality of losing Jason from my life exploded inside my head and made my temples burn.
I began to weep, forcing the madness away. Jason is alive. Jason is alive. Jason is alive...
* * * * *
It was while I was wiping away the tears that someone touched my shoulder. I immediately recognized the red haired woman, but was surprised to see the swelling of her stomach. Pregnant? On top of this? How on earth is she surviving?
"Has something bad happened to Mulder?" she asked in alarm.
Speechless, I stared into the tortured face. It was as if I was looking into a mirror.
She gripped my upper arm with such urgency I got the impression she was holding on for dear life. Understanding her concern, I shook my head in answer, unable to get my throat to work.
No, not bad- tragic.
Puzzled, she eased her grip, but did not move her hand. "Are you ok?"
Nodding, I sucked in a huge breath. When I spoke, my throat was so tight it hurt. "I'm sorry. I'm Nadine, Mulder's nurse."
Assured that he had not suffered any setback...
He's already set as far back as he can go.
... she nodded, though still confused about my behavior. Her face was gaunt; it was the wasted look that came with grief and worry.
"I'm Mulder's partner." She extended her hand.
No name. She identifies herself only as his partner, afraid to make even that small separation.
She turned away from me and leaned over him and laid her hand on his face exactly as I had just done. "Mulder, it's me." She bent close to him, a smile coming to her lips. "Don't even think about ditching me now. I know that you didn't mean to last time, but now that I've found you again, you need to stay. I don't think that I could go though all of this without you."
Nothing.
Her eyes remained weary but determined. "Can you hear me Mulder? Please, squeeze my hand if you know it's me."
I stared at his hand lying still and felt her despair.
And then the bed suddenly came alive. His back stiffened and the bed came alive with his convulsions. His partner scrutinized his face, intently watching the grimacing and the wildly rolling eyes.
How can she do that and not lose her mind? Isn't every tremor like a knife going into her heart?
I took care of the small tasks, but my eyes continually drifted back to his legs and ankles. When I finally looked up, she was gripping the side rail with both hands, her head thrown back, her eyes shut tight. From deep within her throat came a sort of growl that turned into a strained moan of agony. She shook her head from side to side, in rhythm with her groaning litany. "No. No. No. No. No."
I froze at the sound. It was the same one I made in my recurring nightmare of standing on the beach and watching Jason drown offshore.
She's helpless...unable to stop the horror going on in front of her eyes.
"He's my partner," she whispered. "My best friend. I can't..." She looked up at me in a desperate plea for understanding. "I can't give up. He's stubborn. I know that he's fighting like hell to get back. I can't give up
on him. When it was me..." she faltered for a moment. "...he never gave up on me, and I owe him the same." There was a fierce determination in her voice, but looking at her strained face and the way her knuckles whitened around the rail as she spoke about him, I thought that the hope had gotten very frail.
She fixed me with a probing stare. "You know, don't you? You're the only one so far who doesn't look at him like he's a... a corpse and run out of the room as soon as possible."
"My husband..." I stopped because my voice strangled in my throat and my eyes welled up. I, the caregiver, the one supposedly in control, was breaking down on the job. "My husband looks just like him. When I saw
Mulder, I thought of Jason. I tried to imagine what it must be like, but I couldn't. I couldn't take the pain. It felt like I was going to die."
I pulled my eyes away from his body to look at her, although I was afraid of seeing resentment in her eyes because it wasn't *my* husband who lay dying instead of hers. The lucky and the unlucky, the haves and have-nots.
I was gratified to see nothing other than gentle compassion.
"How... how can you stand it?"
She wiped her tears with a Kleenex and then handed me the box. I watched as she consciously collected herself, her spine becoming steel. I saw the light of hope in her eyes, the same hope that fueled all of the visitors that came through our doors. "I stand it because I have to. I have to fight for Mulder."
* * * * *
When I arrived home in the morning the house was cold and dark. As I walked in, I heard the alarm sounding, the shrill beeps in sharp contrast to the stillness in the rest of the house.
I glanced at the clock. 9:00 am. I had not gotten off of work until late; the extra time I had spent with my patient had delayed my whole night.
The alarm still sounding, I made my way to our bedroom, intending on waking Jason up. He was going to be late; not that this would have been the first time. He had gotten so used to me waking him, that the days I was late getting home, he was late getting to work.
"Jason-" I began as I entered our room, prepared to do my best drill sergeant impression to get him up and off to work in as short amount of time as possible. But the sight of the made bed halted my words.
I guess he was able to leave without my help.
I sat on the bed and switched the alarm off. I began to remove my shoes to get ready for bed, but a nagging feeling began to rise up in me. I suddenly- desperately- needed to hear his voice.
I called his office, but instead of him answering, his voice mail picked up. I hung up without leaving a message.
I held the phone in my hand, staring at it. Don't be silly Nadine. He's on his way to work, that was why he didn't answer. He was able to get up on his own without my assistance and he was on his way. He's ok. You don't need to call him. You don't need to hear his voice to be reassured.
I dialed anyway. I called his cell phone and I waited anxiously until he picked it up, feeling ridiculous but knowing that I would never get to sleep until I did so.
"Jason here."
There was never a sweeter sound. "Good morning." I said as my voice cracked.
"Hey babe." He said off handedly, his usual greeting. "You need something?"
"You weren't in bed, and you weren't at your office. I wasn't sure where you were."
"Checking up on me?" he teased.
"No, I..." I faltered. Now that I had heard his voice, and knew that he was living and breathing, I felt silly for calling. "I just wanted to hear your voice, I guess...
"I was just kidding. I left you a note on the bed, you didn't see it?"
I saw it then, folded neatly and placed on my pillow. I pick it up, and without really reading it, I rub my fingertips over his words. "I must have missed it."
"Michael called last night. It seems that we've run in to a bit of an emergency at work. The Morrison project had to be scraped at the last minute. So I'm off to Portland for the next few days."
"For how long?"
"As long as it takes. I'm guessing at least a few days. We have to start completely over."
"Well, let me know when you know. I love you."
"I love you too. Everything ok?"
The lie came far too easily. "Yeah, everything's ok..."
Just don't ever leave me.
"...you have a good day at work."
* * * * *
Day Two of Six
The man's back screamed of tension, and I knew that they were in the midst of an argument the second that I entered the room.
Their voices immediately stilled as I walked in, but the air remained heavy and oppressive, as though a storm was mere seconds from breaking.
She seemed almost relived by my interruption, and she quickly moved in my direction, standing opposite me, with Mulder lying between us. "Hi Nadine," she greeted me with a forced smile after several stilted moments.
"Hello."
I ventured a glance at the bald, bulky man, and found him looking upward, apparently fascinated by the water-stained tiles of the ceiling.
My first impulse was to back out of the room to give time for the tension to dissipate, but I was already late with his meds, and a glance at the monitor that displayed his vitals, showed that he was very much in need of his blood pressure medication.
The man's hands clenched and unclenched as he seemed to search for something to say. She had turned toward me with her greeting, and her back was to the man. She did not see what I saw. She did not see him approach her tentatively, like she was a wild animal that would bolt if he moved too quickly. She did not see his hand shake as he reached for her. She did not see it still shake as he held it, poised above her shoulder, seemingly afraid to actually touch her.
But I saw it. I saw the pain in his face. I saw the struggle that was taking place within him.
He never brought his hand to her shoulder.
I don't think that he could summon the strength to take her from Mulder's side.
Pulling his hand away from her, he took his glasses off rubbed his eyes with the thumb and index finger of
one hand. "Scully," he breathed this word her name? out slowly, and the anger washed away, replaced by nothing but a deep sadness. "Dana, do you think that this is what he really wants?"
Her mask cracked, and anger seeped through the tiny fissures, and she whirled around to face him. "And how do you know what he wants? I know that he wouldn't give up so quickly, like everyone else, including you, seem so eager to do," she said, replying vehemently. "I know that he wouldn't want me to give up on him; just as I know that he would not give up on me."
"It's not about giving up. It's not," he said, trying to say it soft but the emotion was too raw for soft and his voice cracked. "It's about accepting what has happened and what it means for all of us. I'm not-- I don't want to give up-- I understand the feeling. But I also know that this existence is not supposed to be Mulder's fate. He deserves better than this." He leaned forward toward her so that he could see more of her facial expression.
"He didn't deserve any of this." Each word was clipped, pure in its meaning and articulation.
"You don't deserve this either."
She closed her eyes tightly at his words, and for a moment it seemed that she would agree with him. But then she opened her eyes and she was all steel, her eyes and her voice issuing a challenge. "No. I'm sorry, but I'm not going to give up on him. The Gunmen are looking at the device we found, the one we think did this to him. If we learn-- *once* we learn," she quickly corrected, "how they did what they did, we can try to fix it. It's just a matter of time. We have to give him that."
After a moment of studying her face carefully, he cleared his throat "And what if we can't reverse it? What then? When will it be enough?"
"When I say it is." Though her chin tilted with determination, the arms that folded across her chest were trembling and protective.
* * * * *
Day Three of Six
There's no easy way to say this, but I guess if you're the patient and you're mangled, or sick, and barely hanging onto life, and are being kept alive with all of this technology we have these days, then you likely see me as the angle of mercy.
The family members probably see me more as the angle of death.
There's a fine point with a neuro patient where you've got to make a decision. You have a patient who's just sustained a major injury. The likelihood that this person is going to come out of a comatose state and not
remain vegetative is very slim. On the other hand, it's also very likely that the body - the physical self- will survive this injury given time. If we put a patient on life support and keep him going long enough for the body to recover, many parts of the brain will remain intact and this person will stay in the vegetative state indefinitely.
I spread a thin coat of Vaseline over Mulder's lips. The bottom lip was cracked and bleeding from the constant pressure of the ET tube. I was tired and it was way past the time I should have been finishing up my charting, but somehow I'd kept finding things to do for him.
Things I would do for Jason...small tasks beyond 'comfort measures only.'
She put down his left foot, picked up his right, and continued the passive range of motion exercises. ("He'd be furious," she told me, "if he woke up and found himself unable to run at least a few miles right away.")
I watched her work his feet for a minute, debating whether or not to ask her the question I had been thinking about since I had first heard about him.
I heard the words escape my mouth, even as I wondered what possessed me. "Neither you nor anyone else have said a word about the people who mur-" I snapped my mouth shut, almost biting off my tongue. "Assaulted Mulder." the deep red blush of embarrassment spread upward from my neck. I examined her face to see if she had picked up on my miswording. If she had, she didn't show it.
She paused in her actions for a moment and something flickered across her eyes. I saw them close off, as if she were protecting me from something, and at first I thought she would not answer.
She waited a moment longer before finally answering. "They weren't people, they were monsters." Her low voice was a blade unsheathed, sharp with anger and bitterness. "One day Mulder and I will make sure they will pay for what they've done to him. But not now. Now I only have time for him. Time to help him heal."
"But-"
She held up a hand. "Save your breath- I've heard all the reasons why he isn't going to wake up." Shifting in her chair, she shook her head. "You guys don't know him. You don't know what he's been through. You don't fully understand the situation." She spoke softly. "He's special. He can't die." The cardiac monitor beeped once and went silent, as if to punctuate her statement with an audible exclamation point.
Mulder blinked, eyelids flickering innocently. A yellowish exudate was collecting in the corners of his eyes. I wrote a note on the palm of my hand to ask Dr. Westcott for an ophthalmic antibiotic order. I'd post a warning on his info card reminding- demanding- his nurses pay close attention to his susceptibility to infection. The human petri dish- warm and moist, the perfect medium for any bacteria needing a place to hang out and grow.
"Believe me when I tell you that I know exactly what kind of person Mulder..."
Past tense Nadine.
"... was."
And as if to highlight my comment, another seizure began, and she quickly stood, and gathered both his hands in hers. Leaning over, she murmured softly in his ear. I watched as his face calmed at her voice. Her closeness seemed to bathe him with relief. His seizures had almost completely stopped.
But there were no other signs of improvement.
I resumed speaking, as if what I had just witnessed had not happened. "I honestly believe that Mulder is aware on some level of what's going on here. But..." I felt like Judas Iscariot. "...it's not enough. Even if he was having moments of lucidity, what you have to remember is that he will never again be the same person that you knew before. If he lives..."
Pray to whatever God you believe in, that he does not.
"... he will be only a little better than he is now, and that's the best-case scenario." My disclosure was met with silence. Her expression was unreadable, and with each passing second, my doubts over whether I could continue grew as the silence stretched, thin and tenuous as a cobweb.
I knelt down before her so that my eyes were level with hers. "We aren't the enemy. It's just that you're only seeing a small side of the picture. If I were in your shoes..." I swallowed the lump forming in my throat.
Don't breakdown Nadine. Be true and strong...like an executioner doing a good job.
"... I'd look at the quality of his life. Even if he eventually starts breathing on his own, do you think Mulder would want to live if he knew he'd never be able to have another conscious thought... or talk... or feed himself... or go to the bathroom by himself or-"
"Please... don't." Her chin quivered. "He isn't going to be like that. Mulder's going to come out of this."
"No, no he's not. That's why the other nurses respond to him the way that they do. They've seen this before- lots of times. They know what's in store for him... and for you."
A continuing nightmare from hell. Pain every time you see his wasting arms and legs. Pain each time you wipe away the drool and spoon in the baby food.
"If Jason..." I faltered, catching my slip. "I mean, if Mulder had a choice, would he really want that?"
I could see my voice impale her like a butterfly on a pin. She stared down at her lover's long narrow feet and did not answer. The ensuing silence pressed on her.
It's too much emotion in too short a time.
I could hear the tolling of the bell in my mind. It was the death knell and I was ringing it. Her world was falling into ruins and death, and everything she'd hoped for was crumbling.
I straightened out my knees and studied him. I'm so sorry Mulder. God rest your soul... wherever it may be. My eyes found fresh tears, and my vision blurred. I suddenly felt a deep sadness that was beyond words.
From the expression she was wearing when I left his room...
Facing the demons?
...I thought she may have finally faced the shadows and had a glimpse of what horror was lurking there.
* * * * *
Jason was still gone when I returned home. I saw the light blinking on the answering machine and knew it was from him.
I wanted to listen to the message. I wanted to hear his voice to know that he is ok.
But I didn't.
I didn't deserve that reassurance.
It took me hours of restless turning before I could sleep.
I had the dream again. But this time, instead of not being able to reach Jason in the ocean, I'd pulled the safety line out of his reach.
* * * * *
Day Four of Six
She could only sleep to the sound of his heartbeats. The electric, artificial sounding heartbeats that came from the cardiac monitor.
The sound filled the room with its artifice, and it pained me to hear it continue.
But I did not turn the sound down. She needed her sleep.
She refused to leave him for more than the few minutes it took to run to the bathroom. She ignored the rules of the unit that dictated that visitors were only permitted for ten minutes each hour, and so I ignored the rules about not having food in patient care areas, and not having visitors after eight p.m.
She was a FBI agent after all.
I stopped trying to convince her to leave, to sleep, and to eat. Instead I began to order her food from the cafeteria, and the day before I had managed to swipe a rocking chair from the pediatrics department. It's red, blue, and yellow, the primary colors in sharp contrast to the muted grays of the rest of the room. She had smiled and whispered a thank you as I brought it in and set it next to him.
She slept in this chair, with the warm blanket that I placed over her tucked around her small frame. Only her arm remained uncovered. Instead, it lay in the bed with Mulder, her hand firmly gripping his wrist even in her sleep. Her fingers over his radial pulse, feeling the steady measure of his heart, in perfect time to the cadence that filled the room.
* * * * * *
Day Five of Six
Nights is not the easiest shift to work. Not only does it disrupt your sleep; it also disrupts your life. This is even truer for twelve-hour shifts. The days that you are scheduled to work all you have time for in your life is work and sleep, and pretty soon your life becomes centered around the hospital.
The first thing that I missed was the sunlight. When I got off work in the mornings, the sun was just beginning to make its appearance, and by the time I woke in the late afternoon, it was already making its retreat.
But it had never really been a problem, because until then, I'd only worked two, maybe three days in a row, and I didn't ever develop the need to see sunlight. Then came that week. Six days without sun; six days of living at the hospital.
Six days worth of taking care of the Tragedy and his partner.
By my fifth night I was desperate for sunlight. I so needed to see with my own eyes some light in the world.
I stood in Mulder's room at his window, my forehead pressed against the cold glass, searching for any starlight in the night sky. I couldn't find any. A storm was coming; the sky bruised and sagging with moisture obliterated any chance of me finding a star to wish upon.
My patients were asleep behind me; one in a fitful place, another in one that he would never surface from.
My forehead was quickly becoming frozen, but it felt refreshing, a luxury almost. I felt, before I heard, the helicopter land above me, the vibrations from the rotors cutting through the air shook the glass uncomfortably, and only then do I pull away.
Another Tragedy on it's way?
I saw her reflection in the glass as she stood, so when she spoke it did not startle me.
"Storm coming?"
"That's what I heard. Looks pretty ominous out there."
"Think it will snow?"
I felt my shoulders shrug as I turn to face her. "It's cold enough, but I don't know if it will stick around. It snowed a few days before Christmas, but it didn't stick around for it to be white."
She nodded slightly without responding and we were both silent. Mulder's heartbeats filled the room, separating us from the other.
"I spoke with my friends in D.C. earlier. They said that it's been snowing ever since I left. I missed my white Christmas this year, but I didn't care. When I got the call Christmas Eve, and when I saw him that morning I thought it was my own personal miracle. I thought that I couldn't ask for more. He was back. That was all that mattered. Everything else I could deal with later." Her voice was dull, even emotionless, but I could see the shuddering horror behind her facade.
"But it's later now, and I realize I was wrong in believing that that would be enough. How can you stand it? How can you take care of these patients each day and not go mad? How can your hope survive?" she whispered, her voice laden with emotion.
"I don't know. Sometimes... sometimes it becomes too much and I wonder how I could possibly come back the next day."
"My friends told me that they can't help him. We thought-- we thought that there might be another treatment, but we were wrong. There was a time... there was a time when I wouldn't have called them my friends. They were Mulder's first and foremost, and I'm not sure that they trusted me." Her smile faded
as she glanced past me and into some distant place I could not see. "But now- they were the only ones who agreed with me. Who thought that Mulder deserved a chance. But not any more. Am I fool for not letting him go?"
"No, not a fool." Tentatively, I touched her shoulder. Through the wreckage, a fragile quality had surfaced in her and a fleeting, irrational fear that she might shatter into a thousand pieces made me pull my hand back.
She raised her head to meet my expression, and read what I could not speak. I knew that she knew. She is a doctor, and hope can only take you so far.
"I should let him go, shouldn't I?" I could tell the words had to come unstuck in her throat before she spoke them. It was an admittance of defeat.
Where did acceptance end and defeatism begin?
Something twisted and broke inside me. I took a step closer, my hand closing over empty space between us, but I was somehow unable to close the distance.
There wasn't anything else that I could say that wouldn't be a lie or make things worse, so my only response is to nod at her. My silence was almost tangible - a living thing.
She looked at him a moment longer, then closed her eyes. She was weary, hurt, and so deep in grief. She began to cry, the hot tears making their slow progression down her cheeks. "Mulder, I'm so sorry..." She was pleading, desperate.
Hope had fled.
* * * * *
Day Six of Six
The automatic doors to the acute ICU swung open. I did not see this as a welcome like most people did- knowing what lay in wait on the other side, I instead saw those mechanical doors as a set of menacing jaws.
Heading for the refrigerator to deposit my lunch, I glanced into room ten as a new habit. I saw her sitting at the bedside; her head resting on the patient's chest, the red hair brilliant against the white of the sheets. Although she lay as still as stone, she radiated such a deep sadness it could almost be seen.
I paused, and made myself hyperaware of my surroundings. The tension which permeated the unit and filled the faces of each person at the nurses' station was familiar. It was the particular silence- that type of strain- that spoke of failure, relief, and death. It all translated into the fact that somewhere on the unit, we'd lost one. I didn't need to think twice to know who.
Dropping my lunch and jacket on the nearest chair, I briefly explained to the charge nurse where I would be. Not waiting to hear her protests, I walked briskly into Mulder's room and pulled the curtain across the glass door.
Close up, Mulder's partner looked terrible- like she'd fallen off a high-speed roller coaster. For a time I watched her watch her partner fight for his final breaths. It was clear she had accepted that inconsiderate
tenacious fate- ignoring his relative youth and the immeasurable value of his spirit- had chosen him for death after all her valiant protests.
The war over, she wept, her arms entangled with his.
All the IVs were gone save one. His breaths were shallow and irregular. The ventilator had been shoved in a corner, a white sheet had been thrown haphazardly over the top- perhaps in an attempt to hide the evidence of failure.
"He's going now," she said suddenly, never taking her eyes from his face. I don't think she was talking to me. It seemed more likely that she needed to hear the sound of her voice saying the words. It was an effort to ground herself and stay in touch with reality.
I looked over at the cardiac monitor, thankful that the alarms had been silenced. She was correct in her estimation- the complexes were now slow and wide, as usually happens when death is imminent.
"I'll miss you Mulder," she said in a battle weary voice. "I always will."
Numbly, I backed toward the door, wanting to give them privacy, yet powerless to turn my eyes away- wanting to run away, yet anchored to that room.
She kissed him lightly on a mouth still swollen from the presence of endotracheal tube, caressing his cheek with the palm of her hand. "Don't worry about us Mulder. I know that you don't want to leave, but we know
that's not your choice. It's not a ditch, I know. You're leaving us behind, but I'll catch up with you before you know it."
The rhythm on the monitor went from eight complexes per screen to four.
"You are the heart of my life." She stroked his head, letting her fingers idle in the new growth of fine dark hair that was less than a half inch long. "You will be with me every..."
I turned and stumbled out of the room, unable to stand the pressure inside my chest. Head pressed against the coolness of the corridor wall, I waited for the soft explosion of unrestrained weeping.
* * * * *
Jason was home, asleep, when I arrived the next morning. It was the first time that I'd seen him in nearly a week. I watched him as he lay there for some time before reaching over to shake his shoulder. "Jason, you're going to be late for work..."
His eyes blinked open and focused on my face. "Have the day off," he murmured, his voice hoarse and scratchy from sleep. He struggled with the sheets until he had one end free. Holding it up, he entreated to me, "Come in, I made it toasty for you."
I climbed in, uniform and all, pausing only to remove my shoes.
Jason sighed. A deep, shuddery sigh, and pulled me tight against him. "So how was work?" he mumbled, eyes closed. He had only surfaced briefly, and I could feel him sliding away again.
"Oh, same old same old," but my voice broke on the last word.
"That's good..." He kissed my cheek, the feel of his lips was warm and sure and reassuring. Drawing in one more deep breath, his breathing became steady as he fell asleep once again.
I watched him as I waited for sleep to take me, and I wondered what dreams would come. I brought my hand to his face, cupping my palm against his cheek.
How thin the lines between life and death, joy and sorrow. Chance... fate...the invisible forces which in split seconds can change our lives forever.
"How can I stand it? How can I face death everyday, yet have the courage to live?"
There was no response from Jason.
end
Author: april leigh
Rating: PG
Summary: "What becomes of hope? I'll bet she's a nervous wreck."
-- 'Houdini's Angels,' Seven Mary Three
Spoilers: Through beginning of season 8
Distribution: Ask first
Feedback: Welcomed at aprilleigh50@hotmail.com
Disclaimer: Not mine; don't sue.
Author's notes: For those of a gentle nature: please take note of the first two paragraphs. This will be your only warning.
* * * * *
Day One of Six
I knew by the way the nurse avoided my eyes when she gave me report that I'd been assigned a Tragedy. One of those patients who would never get better, never wake up from their coma, never be weaned off the ventilator. Never go home. Even though I'd only been a nurse for a short time, I was already too familiar with these cases. I knew that no matter what we, the medical warriors, did for them, they would remain a tragedy.
Fox Mulder was the ICU Tragedy of the Month. One by one, each nurse had had a chance to take care of him, and one by one, each had come to the same conclusion: his case was hopeless.
Report on my other patients was quick and painless. Nancy, the day shift nurse, searched through the card file until she came to the information card on my last patient. She cleared her throat. After that came the series of familiar nuances- the slight pause, the slow shake of the head, and the inability to look the oncoming nurse in the eye.
"Bed ten's case is really sad," she said. It was the standard opening line for report on Tragedies. "Fox Mulder, a FBI agent. Mulder- he goes by his last name only- was found in the woods by a couple of hikers Christmas Eve- who knows how long he'd been out there. Anyway, he was unconscious, but relatively sable when the EMTs first arrived. But on the approach to ER he began seizing. They did a head CT in the ER, and they discovered that he had serious brain trauma- source unknown."
Nancy shrugged and answered the question I had not asked. "Who knows? No one has really offered an explanation as to what exactly happened to him. I did overhear something about a case gone bad. Something about him getting kidnapped and being missing for months. You know how the FBI gets involved in some crazy stuff; it was probably some psycho who wanted to play 'lobotomy.'"
I nodded, not wanting to think too much about it.
"Anyway, his ICPs were sky high so Westcott came in to evacuate some of the fluid and place a shunt."
I felt a brief flicker of hope. Jack Westcott was the best neurosurgeon in three counties. I'd seen him turn more than one Tragedy into a Triumph.
"Unfortunately..." the nurse emphasized the word, drawing out each syllable. "During the surgery he went into respiratory arrest. They were able to bring him out of it, but he's been vented since then." She flipped through her notes, searching for something she had written down. "Initially, Westcott thought there was a chance he'd come out of it after the swelling went down, but he remains in a vegetative state- totally unresponsive. His EEGs are all grossly abnormal, and yesterday he started seizing again, and hasn't stopped." Nancy tapped her head. "Nothing but mush up there, is my guess. Westcott said that it was like someone was mucking around in his head, searching for something, but not caring about the damage being done in the process."
Unfolding the critical care flow chart, Nancy ran through the rest of the clinical details- vital signs, meds, results of neurological checks, lab procedures, and treatments. "He's not going to last long," she said, finally meeting my eyes. "So it isn't like you have to go all out. I mean, on paper he looks like a heavy patient, but we really aren't doing a whole lot. It's mostly comfort measure for appearances sake. Suctioning, turning, clean sheets- you know the routine."
I caught her gaze. "What do you think?" Early in nursing school, I learned that a nurse's intuition was more reliable than any test or expert physician's opinion. "Do you think there's any chance he'll..."
"No way," she said emphatically, then shrugged. "I mean, sure, I suppose he could come out of it, but there'd have to be divine intervention. In my experience, these patients rarely wake up. They either end up at the rehab center for a few months until they die of respiratory problems, or they vegetate for months- until a family member comes to the conclusion that maybe Kevorkian has the right idea. But who knows, right? I've been an ICU nurse for too long to be absolute about anything."
"And what about the family situation?" Everyone knew the Tragedy patient was only half of the story. Completing the cast were the walking wounded, otherwise known as the surviving family members.
"Well there's been the occasional FBI guy or two checking in, and we have his partner or girlfriend or wife or what ever in there with him. I don't think that she's left his side even though it's obvious she needs to rest. Anyway, she has power of attorney, and she is very active in directing his care." She glances at me significantly. "She's a doctor."
"Lovely." I murmur. There's only one thing worse than having a patient who is a doctor: having a patient's family member or friend be a doctor.
Nancy continued. "Well, lucky for you she's just about exhausted every test and procedure that could be done on him within the first 24 hours. She's settled down a bit once there was nothing left to do, but she's still in serious denial. Says that she knows him, that he's been through worse, etc... I've tried to get her to understand the situation and his prospects, but she doesn't want to hear. It's ridiculous."
"No," I corrected. "It's desperate, blinding hope."
"Whatever." She waved away the subject and leaned back in her chair with the relief that only comes when the shift is finally done and report has been given and the baton has been officially handed over. "And how was your Christmas?" she asked, knowing that I'd had the past week off.
"Oh it was fine, the standard stressful holiday fare. Jason's parents came to visit... Drove me nuts," I added.
Nancy laughed, and then stretched her arm out to pat my hand. I knew without meeting her eyes that she was looking at me with warm amusement. "Welcome to the wonderful world of in-laws. You did realize that when you married him, you also married his family."
"Yeah, I realized. But they were never like this before."
"Wait until you have kids." Then she leaned forward to whisper conspiracy in my ear. "The thing that I want to know is how you managed to get both Christmas Eve and Christmas off."
I sighed. "I just traded my soul."
"How many extra shifts?" She asked, accurately interpreting my expression
"This is the first of six."
"Six twelves? Lord... I'm glad that it's you, not me." She stood then, gathering her things. "I'm just glad I've got the next few days off. Taking care of him for three days in a row is enough to depress God." Swinging her coat around her shoulders to protect her from the chill outside, she said, "You have a good night Nadine. "
"Right." I regarded the Tragedy's info card and sighed. Considering the state of the world, it had always been my belief that if there really was a God, She was already pretty damned depressed.
* * * * *
It was not a conscious decision on my part to put him off. Actually, it wasn't until the moment I entered his room that I realized my level of reluctance was higher than if I'd been entering the room of a patient requiring an extensive bowel disimpaction.
The Tragedy-
Mulder
- was alone in his room. The large overhead light was off, but the small light near the head of his bed was on, casting deep shadows under his eyes, highlighting his sunken cheeks.
Death was hovering in the shadows of his face, waiting for its opportunity.
I quickly turned on the bright overhead light, and watched as most of the shadows fled his body. But some were too great, and they hung on tenaciously, unwilling to let go.
His thin body was propped on its side facing the door, a single pillow tucked behind his back. The eyelids, fluttering erratically, were opened just enough to reveal eyes aimlessly rolled from side to side, top to bottom.
Jesus, he's pale. Too pale. Poor guy. And that beautiful angular jaw- what a waste of...
Catching myself, I looked away, not wanting his face to become too real. If I allowed myself to see him as a real person, I might get involved and begin to hope.
'These patients rarely wake up.'
The wall clock behind me ticked, reminding me that I had other things I had to attend to. There were miles to go before I could sit down and rest. I didn't have the time to invest in hope.
I inched toward the bed with the reluctance of an acrophobic approaching the rim of the Grand Canyon. An instant later the body contracted in a seizure. The eyes opened wide...
Hazel. The same shade. The same shape.
...and rolled back. The corners of his upper lip twitched, forming what would look to the untrained observer like a grin.
The cardiac monitor, interpreting the frenzied muscle activity as a deadly rhythm, alarmed in harmony with the high-pitched blasts of the respirator alarm. I checked to make sure that the bite block was in place between his teeth. The last thing that he needed was a crushed endotracheal tube- the piece of plastic tubing through which the ventilator fed him oxygen.
Pulling the suction out from under his pillow, I suctioned the spittle which had ran down his chin and onto his hospital gown. The skin of his neck and face turned a bright red as he bucked the respirator with his gagging. I was gratified to see he at least had a gag reflex. It wasn't much, but it was something.
But to what end? So he can linger as a zucchini that can cough?
I waited for the seizure to end, feeling his radial pulse- a thready, weak blip under the thin skin- and examined his three intravenous lines for signs of infiltration or infection. I had to squint to read the labels on each of the seven IV bags that hung from metal poles placed like sentinels around his bed.
According to the wall clock, his seizure had lasted a full minute. How long can he last at this rate? Twenty-four hours? Less?
And then, as suddenly as it had begun, the seizure ended.
His hospital gown had slipped away from his legs and hip. Something about the sight of that long white skinny leg made me stop. My throat tightened, and I quickly adverted my eyes.
Don't look Nadine. Gotta hurry. Turn, suction, and give him some diazepam... But that leg- the way the hair grows to the ankle and stops. I know that leg...
Searching for complications which may have arisen since his last assessment, I performed a physical exam, feeling for pulses with fingers trained to see, and listening to heart, lung and abdomen for sounds my ears could translate into any of fifty different diagnoses. I separated his nasogastric tube from the bag of thick formula...
Loaded with vitamins and minerals- like pumping fuel into a powerful car that has no steering wheel or tires.
...and aspirated the contents of his stomach for any residual lagging behind. Unpinning the grenade shaped Jackson/Pratt drain from his turban, I measured and emptied its bloody contents. I calibrated the monitors, hung new IV bags, discarded the expired ones, and pushed myriad medications into his veins and down his feeding tube.
Exam done, I searched for a place to spread out the flow sheet and chart. In moving a sizable stack of folders and assorted papers from his side table, a bag slid off and landed at my feet. A number of photographs spilled onto the floor. I picked one up and I recognized the face. The angular, handsome face...
Don't look! Don't make him real. It's too close to home.
...smiled at me from the photo on top.
A beautiful smile, with a glint of mischief. That's the same expression Jason wears when he manages to sneak a pint of mint chip ice cream in with the groceries. I scold him, but I never say no when he offers me a bowl...
I smiled back and reached for another picture and then another, feeling like a snoop playing with fire.
He'd been...
Slender and handsome...like Jason.
...a FBI agent. In one photo he's crouched near the ground, studying an object, the letters FBI on his back.
Another is of him and a red headed woman. It was taken at an amusement park. On the bottom right was printed "Santa Monica Pier" and in the background I can see a hint of a roller coaster. In the foreground was Mulder with an arm casually thrown over the woman's shoulders. The woman was smiling politely to the camera, but he was staring intently at her face, like he's examining her face for something only meant for him to see, the same smile as before written on his lips.
I flipped through the rest quickly. Some were of people- family or friends I guessed- the rest of the photographs are of locations that I assume would have been familiar to him.
Suddenly feeling guilty, like I'd pried where I didn't belong, I put all of the photos away, save one, and began the neuro exam.
"Mulder, squeeze my fingers."
No response.
I wiggled my fingers inside his, prompting him again to squeeze.
No response.
Holding open the wildly fluttering lids, I flashed my penlight into his eyes.
Right pupil was sluggish to respond. Left pupil remained fixed.
I ran the blunt end of my pen down the length of his soles. Predictably, the great toe pulled upward. The abnormal movement, known as a positive Babinski's sign, was another indication of neurological damage.
The photo I'd put aside was of the couple, and as I charted the red headed woman seemed to stare at me. An idea suddenly presented itself, and while it couldn't exactly be considered part of a standard neuro exam, I figured a case like this gave license to use any means available to ascertain whether or not he was home. Not really expecting a reaction, I held the photo directly in front of his eyes.
At once they stopped their chaotic dance as he focused on the image before him. A beautiful smile- the same one he wore in the pictures- spread across his face. Unmistakingly, recognition and joy registered in his eyes.
My heart was going like a jackhammer as I moved the picture to the left. His eyes tracked the photo to the left. The smile did not falter.
The thought that I should contact Dr. Westcott was just beginning to form in my head when he disappeared inside another seizure.
I tended to the necessities- suctioning, giving oxygen, and pushing more Valium, protecting his limbs from sharp corners- while a variety of nagging, though completely logical, thoughts-
'Nothing but mush up there'... 'These patients rarely wake up'...
- systematically attacked my newly born enthusiasm, eventually murdering it altogether. The notion that he was even slightly aware of what was happening to him, living-
trapped?
- forever in that distant twilight world and never knowing who or where or even what he was, horrified me to the point of feeling ill. Closing my eyes, I took five deep breaths, clearing my mind with pleasant thoughts.
Once he was still, I again held up the photo.
There was no sign of recognition this time. No response whatsoever. Whoever had briefly peered out from the attic window was no longer evident.
The wall clock clicked, reminding me that Mr. Ross' antibiotic was almost an hour late. Rapidly gathering my charting sheets together, I had turned to leave when the sight of the his bare leg and ankle made me stop again.
Exactly like Jason's leg...skinny and white with the fine dark hairs. Same
eyes, same spidery fingers.
Softly, I laid my hand against his cheek, studying the handsome face.
Even the feel of his skin is right. It could so easily be Jason...
Taken by a sudden madness, I rearranged fate by pretending- believing- it was Jason who lay in bed ten. An indescribable anguish hit me with an impact as powerful as having been shot at close range with a .357 Magnum. The reality of losing Jason from my life exploded inside my head and made my temples burn.
I began to weep, forcing the madness away. Jason is alive. Jason is alive. Jason is alive...
* * * * *
It was while I was wiping away the tears that someone touched my shoulder. I immediately recognized the red haired woman, but was surprised to see the swelling of her stomach. Pregnant? On top of this? How on earth is she surviving?
"Has something bad happened to Mulder?" she asked in alarm.
Speechless, I stared into the tortured face. It was as if I was looking into a mirror.
She gripped my upper arm with such urgency I got the impression she was holding on for dear life. Understanding her concern, I shook my head in answer, unable to get my throat to work.
No, not bad- tragic.
Puzzled, she eased her grip, but did not move her hand. "Are you ok?"
Nodding, I sucked in a huge breath. When I spoke, my throat was so tight it hurt. "I'm sorry. I'm Nadine, Mulder's nurse."
Assured that he had not suffered any setback...
He's already set as far back as he can go.
... she nodded, though still confused about my behavior. Her face was gaunt; it was the wasted look that came with grief and worry.
"I'm Mulder's partner." She extended her hand.
No name. She identifies herself only as his partner, afraid to make even that small separation.
She turned away from me and leaned over him and laid her hand on his face exactly as I had just done. "Mulder, it's me." She bent close to him, a smile coming to her lips. "Don't even think about ditching me now. I know that you didn't mean to last time, but now that I've found you again, you need to stay. I don't think that I could go though all of this without you."
Nothing.
Her eyes remained weary but determined. "Can you hear me Mulder? Please, squeeze my hand if you know it's me."
I stared at his hand lying still and felt her despair.
And then the bed suddenly came alive. His back stiffened and the bed came alive with his convulsions. His partner scrutinized his face, intently watching the grimacing and the wildly rolling eyes.
How can she do that and not lose her mind? Isn't every tremor like a knife going into her heart?
I took care of the small tasks, but my eyes continually drifted back to his legs and ankles. When I finally looked up, she was gripping the side rail with both hands, her head thrown back, her eyes shut tight. From deep within her throat came a sort of growl that turned into a strained moan of agony. She shook her head from side to side, in rhythm with her groaning litany. "No. No. No. No. No."
I froze at the sound. It was the same one I made in my recurring nightmare of standing on the beach and watching Jason drown offshore.
She's helpless...unable to stop the horror going on in front of her eyes.
"He's my partner," she whispered. "My best friend. I can't..." She looked up at me in a desperate plea for understanding. "I can't give up. He's stubborn. I know that he's fighting like hell to get back. I can't give up
on him. When it was me..." she faltered for a moment. "...he never gave up on me, and I owe him the same." There was a fierce determination in her voice, but looking at her strained face and the way her knuckles whitened around the rail as she spoke about him, I thought that the hope had gotten very frail.
She fixed me with a probing stare. "You know, don't you? You're the only one so far who doesn't look at him like he's a... a corpse and run out of the room as soon as possible."
"My husband..." I stopped because my voice strangled in my throat and my eyes welled up. I, the caregiver, the one supposedly in control, was breaking down on the job. "My husband looks just like him. When I saw
Mulder, I thought of Jason. I tried to imagine what it must be like, but I couldn't. I couldn't take the pain. It felt like I was going to die."
I pulled my eyes away from his body to look at her, although I was afraid of seeing resentment in her eyes because it wasn't *my* husband who lay dying instead of hers. The lucky and the unlucky, the haves and have-nots.
I was gratified to see nothing other than gentle compassion.
"How... how can you stand it?"
She wiped her tears with a Kleenex and then handed me the box. I watched as she consciously collected herself, her spine becoming steel. I saw the light of hope in her eyes, the same hope that fueled all of the visitors that came through our doors. "I stand it because I have to. I have to fight for Mulder."
* * * * *
When I arrived home in the morning the house was cold and dark. As I walked in, I heard the alarm sounding, the shrill beeps in sharp contrast to the stillness in the rest of the house.
I glanced at the clock. 9:00 am. I had not gotten off of work until late; the extra time I had spent with my patient had delayed my whole night.
The alarm still sounding, I made my way to our bedroom, intending on waking Jason up. He was going to be late; not that this would have been the first time. He had gotten so used to me waking him, that the days I was late getting home, he was late getting to work.
"Jason-" I began as I entered our room, prepared to do my best drill sergeant impression to get him up and off to work in as short amount of time as possible. But the sight of the made bed halted my words.
I guess he was able to leave without my help.
I sat on the bed and switched the alarm off. I began to remove my shoes to get ready for bed, but a nagging feeling began to rise up in me. I suddenly- desperately- needed to hear his voice.
I called his office, but instead of him answering, his voice mail picked up. I hung up without leaving a message.
I held the phone in my hand, staring at it. Don't be silly Nadine. He's on his way to work, that was why he didn't answer. He was able to get up on his own without my assistance and he was on his way. He's ok. You don't need to call him. You don't need to hear his voice to be reassured.
I dialed anyway. I called his cell phone and I waited anxiously until he picked it up, feeling ridiculous but knowing that I would never get to sleep until I did so.
"Jason here."
There was never a sweeter sound. "Good morning." I said as my voice cracked.
"Hey babe." He said off handedly, his usual greeting. "You need something?"
"You weren't in bed, and you weren't at your office. I wasn't sure where you were."
"Checking up on me?" he teased.
"No, I..." I faltered. Now that I had heard his voice, and knew that he was living and breathing, I felt silly for calling. "I just wanted to hear your voice, I guess...
"I was just kidding. I left you a note on the bed, you didn't see it?"
I saw it then, folded neatly and placed on my pillow. I pick it up, and without really reading it, I rub my fingertips over his words. "I must have missed it."
"Michael called last night. It seems that we've run in to a bit of an emergency at work. The Morrison project had to be scraped at the last minute. So I'm off to Portland for the next few days."
"For how long?"
"As long as it takes. I'm guessing at least a few days. We have to start completely over."
"Well, let me know when you know. I love you."
"I love you too. Everything ok?"
The lie came far too easily. "Yeah, everything's ok..."
Just don't ever leave me.
"...you have a good day at work."
* * * * *
Day Two of Six
The man's back screamed of tension, and I knew that they were in the midst of an argument the second that I entered the room.
Their voices immediately stilled as I walked in, but the air remained heavy and oppressive, as though a storm was mere seconds from breaking.
She seemed almost relived by my interruption, and she quickly moved in my direction, standing opposite me, with Mulder lying between us. "Hi Nadine," she greeted me with a forced smile after several stilted moments.
"Hello."
I ventured a glance at the bald, bulky man, and found him looking upward, apparently fascinated by the water-stained tiles of the ceiling.
My first impulse was to back out of the room to give time for the tension to dissipate, but I was already late with his meds, and a glance at the monitor that displayed his vitals, showed that he was very much in need of his blood pressure medication.
The man's hands clenched and unclenched as he seemed to search for something to say. She had turned toward me with her greeting, and her back was to the man. She did not see what I saw. She did not see him approach her tentatively, like she was a wild animal that would bolt if he moved too quickly. She did not see his hand shake as he reached for her. She did not see it still shake as he held it, poised above her shoulder, seemingly afraid to actually touch her.
But I saw it. I saw the pain in his face. I saw the struggle that was taking place within him.
He never brought his hand to her shoulder.
I don't think that he could summon the strength to take her from Mulder's side.
Pulling his hand away from her, he took his glasses off rubbed his eyes with the thumb and index finger of
one hand. "Scully," he breathed this word her name? out slowly, and the anger washed away, replaced by nothing but a deep sadness. "Dana, do you think that this is what he really wants?"
Her mask cracked, and anger seeped through the tiny fissures, and she whirled around to face him. "And how do you know what he wants? I know that he wouldn't give up so quickly, like everyone else, including you, seem so eager to do," she said, replying vehemently. "I know that he wouldn't want me to give up on him; just as I know that he would not give up on me."
"It's not about giving up. It's not," he said, trying to say it soft but the emotion was too raw for soft and his voice cracked. "It's about accepting what has happened and what it means for all of us. I'm not-- I don't want to give up-- I understand the feeling. But I also know that this existence is not supposed to be Mulder's fate. He deserves better than this." He leaned forward toward her so that he could see more of her facial expression.
"He didn't deserve any of this." Each word was clipped, pure in its meaning and articulation.
"You don't deserve this either."
She closed her eyes tightly at his words, and for a moment it seemed that she would agree with him. But then she opened her eyes and she was all steel, her eyes and her voice issuing a challenge. "No. I'm sorry, but I'm not going to give up on him. The Gunmen are looking at the device we found, the one we think did this to him. If we learn-- *once* we learn," she quickly corrected, "how they did what they did, we can try to fix it. It's just a matter of time. We have to give him that."
After a moment of studying her face carefully, he cleared his throat "And what if we can't reverse it? What then? When will it be enough?"
"When I say it is." Though her chin tilted with determination, the arms that folded across her chest were trembling and protective.
* * * * *
Day Three of Six
There's no easy way to say this, but I guess if you're the patient and you're mangled, or sick, and barely hanging onto life, and are being kept alive with all of this technology we have these days, then you likely see me as the angle of mercy.
The family members probably see me more as the angle of death.
There's a fine point with a neuro patient where you've got to make a decision. You have a patient who's just sustained a major injury. The likelihood that this person is going to come out of a comatose state and not
remain vegetative is very slim. On the other hand, it's also very likely that the body - the physical self- will survive this injury given time. If we put a patient on life support and keep him going long enough for the body to recover, many parts of the brain will remain intact and this person will stay in the vegetative state indefinitely.
I spread a thin coat of Vaseline over Mulder's lips. The bottom lip was cracked and bleeding from the constant pressure of the ET tube. I was tired and it was way past the time I should have been finishing up my charting, but somehow I'd kept finding things to do for him.
Things I would do for Jason...small tasks beyond 'comfort measures only.'
She put down his left foot, picked up his right, and continued the passive range of motion exercises. ("He'd be furious," she told me, "if he woke up and found himself unable to run at least a few miles right away.")
I watched her work his feet for a minute, debating whether or not to ask her the question I had been thinking about since I had first heard about him.
I heard the words escape my mouth, even as I wondered what possessed me. "Neither you nor anyone else have said a word about the people who mur-" I snapped my mouth shut, almost biting off my tongue. "Assaulted Mulder." the deep red blush of embarrassment spread upward from my neck. I examined her face to see if she had picked up on my miswording. If she had, she didn't show it.
She paused in her actions for a moment and something flickered across her eyes. I saw them close off, as if she were protecting me from something, and at first I thought she would not answer.
She waited a moment longer before finally answering. "They weren't people, they were monsters." Her low voice was a blade unsheathed, sharp with anger and bitterness. "One day Mulder and I will make sure they will pay for what they've done to him. But not now. Now I only have time for him. Time to help him heal."
"But-"
She held up a hand. "Save your breath- I've heard all the reasons why he isn't going to wake up." Shifting in her chair, she shook her head. "You guys don't know him. You don't know what he's been through. You don't fully understand the situation." She spoke softly. "He's special. He can't die." The cardiac monitor beeped once and went silent, as if to punctuate her statement with an audible exclamation point.
Mulder blinked, eyelids flickering innocently. A yellowish exudate was collecting in the corners of his eyes. I wrote a note on the palm of my hand to ask Dr. Westcott for an ophthalmic antibiotic order. I'd post a warning on his info card reminding- demanding- his nurses pay close attention to his susceptibility to infection. The human petri dish- warm and moist, the perfect medium for any bacteria needing a place to hang out and grow.
"Believe me when I tell you that I know exactly what kind of person Mulder..."
Past tense Nadine.
"... was."
And as if to highlight my comment, another seizure began, and she quickly stood, and gathered both his hands in hers. Leaning over, she murmured softly in his ear. I watched as his face calmed at her voice. Her closeness seemed to bathe him with relief. His seizures had almost completely stopped.
But there were no other signs of improvement.
I resumed speaking, as if what I had just witnessed had not happened. "I honestly believe that Mulder is aware on some level of what's going on here. But..." I felt like Judas Iscariot. "...it's not enough. Even if he was having moments of lucidity, what you have to remember is that he will never again be the same person that you knew before. If he lives..."
Pray to whatever God you believe in, that he does not.
"... he will be only a little better than he is now, and that's the best-case scenario." My disclosure was met with silence. Her expression was unreadable, and with each passing second, my doubts over whether I could continue grew as the silence stretched, thin and tenuous as a cobweb.
I knelt down before her so that my eyes were level with hers. "We aren't the enemy. It's just that you're only seeing a small side of the picture. If I were in your shoes..." I swallowed the lump forming in my throat.
Don't breakdown Nadine. Be true and strong...like an executioner doing a good job.
"... I'd look at the quality of his life. Even if he eventually starts breathing on his own, do you think Mulder would want to live if he knew he'd never be able to have another conscious thought... or talk... or feed himself... or go to the bathroom by himself or-"
"Please... don't." Her chin quivered. "He isn't going to be like that. Mulder's going to come out of this."
"No, no he's not. That's why the other nurses respond to him the way that they do. They've seen this before- lots of times. They know what's in store for him... and for you."
A continuing nightmare from hell. Pain every time you see his wasting arms and legs. Pain each time you wipe away the drool and spoon in the baby food.
"If Jason..." I faltered, catching my slip. "I mean, if Mulder had a choice, would he really want that?"
I could see my voice impale her like a butterfly on a pin. She stared down at her lover's long narrow feet and did not answer. The ensuing silence pressed on her.
It's too much emotion in too short a time.
I could hear the tolling of the bell in my mind. It was the death knell and I was ringing it. Her world was falling into ruins and death, and everything she'd hoped for was crumbling.
I straightened out my knees and studied him. I'm so sorry Mulder. God rest your soul... wherever it may be. My eyes found fresh tears, and my vision blurred. I suddenly felt a deep sadness that was beyond words.
From the expression she was wearing when I left his room...
Facing the demons?
...I thought she may have finally faced the shadows and had a glimpse of what horror was lurking there.
* * * * *
Jason was still gone when I returned home. I saw the light blinking on the answering machine and knew it was from him.
I wanted to listen to the message. I wanted to hear his voice to know that he is ok.
But I didn't.
I didn't deserve that reassurance.
It took me hours of restless turning before I could sleep.
I had the dream again. But this time, instead of not being able to reach Jason in the ocean, I'd pulled the safety line out of his reach.
* * * * *
Day Four of Six
She could only sleep to the sound of his heartbeats. The electric, artificial sounding heartbeats that came from the cardiac monitor.
The sound filled the room with its artifice, and it pained me to hear it continue.
But I did not turn the sound down. She needed her sleep.
She refused to leave him for more than the few minutes it took to run to the bathroom. She ignored the rules of the unit that dictated that visitors were only permitted for ten minutes each hour, and so I ignored the rules about not having food in patient care areas, and not having visitors after eight p.m.
She was a FBI agent after all.
I stopped trying to convince her to leave, to sleep, and to eat. Instead I began to order her food from the cafeteria, and the day before I had managed to swipe a rocking chair from the pediatrics department. It's red, blue, and yellow, the primary colors in sharp contrast to the muted grays of the rest of the room. She had smiled and whispered a thank you as I brought it in and set it next to him.
She slept in this chair, with the warm blanket that I placed over her tucked around her small frame. Only her arm remained uncovered. Instead, it lay in the bed with Mulder, her hand firmly gripping his wrist even in her sleep. Her fingers over his radial pulse, feeling the steady measure of his heart, in perfect time to the cadence that filled the room.
* * * * * *
Day Five of Six
Nights is not the easiest shift to work. Not only does it disrupt your sleep; it also disrupts your life. This is even truer for twelve-hour shifts. The days that you are scheduled to work all you have time for in your life is work and sleep, and pretty soon your life becomes centered around the hospital.
The first thing that I missed was the sunlight. When I got off work in the mornings, the sun was just beginning to make its appearance, and by the time I woke in the late afternoon, it was already making its retreat.
But it had never really been a problem, because until then, I'd only worked two, maybe three days in a row, and I didn't ever develop the need to see sunlight. Then came that week. Six days without sun; six days of living at the hospital.
Six days worth of taking care of the Tragedy and his partner.
By my fifth night I was desperate for sunlight. I so needed to see with my own eyes some light in the world.
I stood in Mulder's room at his window, my forehead pressed against the cold glass, searching for any starlight in the night sky. I couldn't find any. A storm was coming; the sky bruised and sagging with moisture obliterated any chance of me finding a star to wish upon.
My patients were asleep behind me; one in a fitful place, another in one that he would never surface from.
My forehead was quickly becoming frozen, but it felt refreshing, a luxury almost. I felt, before I heard, the helicopter land above me, the vibrations from the rotors cutting through the air shook the glass uncomfortably, and only then do I pull away.
Another Tragedy on it's way?
I saw her reflection in the glass as she stood, so when she spoke it did not startle me.
"Storm coming?"
"That's what I heard. Looks pretty ominous out there."
"Think it will snow?"
I felt my shoulders shrug as I turn to face her. "It's cold enough, but I don't know if it will stick around. It snowed a few days before Christmas, but it didn't stick around for it to be white."
She nodded slightly without responding and we were both silent. Mulder's heartbeats filled the room, separating us from the other.
"I spoke with my friends in D.C. earlier. They said that it's been snowing ever since I left. I missed my white Christmas this year, but I didn't care. When I got the call Christmas Eve, and when I saw him that morning I thought it was my own personal miracle. I thought that I couldn't ask for more. He was back. That was all that mattered. Everything else I could deal with later." Her voice was dull, even emotionless, but I could see the shuddering horror behind her facade.
"But it's later now, and I realize I was wrong in believing that that would be enough. How can you stand it? How can you take care of these patients each day and not go mad? How can your hope survive?" she whispered, her voice laden with emotion.
"I don't know. Sometimes... sometimes it becomes too much and I wonder how I could possibly come back the next day."
"My friends told me that they can't help him. We thought-- we thought that there might be another treatment, but we were wrong. There was a time... there was a time when I wouldn't have called them my friends. They were Mulder's first and foremost, and I'm not sure that they trusted me." Her smile faded
as she glanced past me and into some distant place I could not see. "But now- they were the only ones who agreed with me. Who thought that Mulder deserved a chance. But not any more. Am I fool for not letting him go?"
"No, not a fool." Tentatively, I touched her shoulder. Through the wreckage, a fragile quality had surfaced in her and a fleeting, irrational fear that she might shatter into a thousand pieces made me pull my hand back.
She raised her head to meet my expression, and read what I could not speak. I knew that she knew. She is a doctor, and hope can only take you so far.
"I should let him go, shouldn't I?" I could tell the words had to come unstuck in her throat before she spoke them. It was an admittance of defeat.
Where did acceptance end and defeatism begin?
Something twisted and broke inside me. I took a step closer, my hand closing over empty space between us, but I was somehow unable to close the distance.
There wasn't anything else that I could say that wouldn't be a lie or make things worse, so my only response is to nod at her. My silence was almost tangible - a living thing.
She looked at him a moment longer, then closed her eyes. She was weary, hurt, and so deep in grief. She began to cry, the hot tears making their slow progression down her cheeks. "Mulder, I'm so sorry..." She was pleading, desperate.
Hope had fled.
* * * * *
Day Six of Six
The automatic doors to the acute ICU swung open. I did not see this as a welcome like most people did- knowing what lay in wait on the other side, I instead saw those mechanical doors as a set of menacing jaws.
Heading for the refrigerator to deposit my lunch, I glanced into room ten as a new habit. I saw her sitting at the bedside; her head resting on the patient's chest, the red hair brilliant against the white of the sheets. Although she lay as still as stone, she radiated such a deep sadness it could almost be seen.
I paused, and made myself hyperaware of my surroundings. The tension which permeated the unit and filled the faces of each person at the nurses' station was familiar. It was the particular silence- that type of strain- that spoke of failure, relief, and death. It all translated into the fact that somewhere on the unit, we'd lost one. I didn't need to think twice to know who.
Dropping my lunch and jacket on the nearest chair, I briefly explained to the charge nurse where I would be. Not waiting to hear her protests, I walked briskly into Mulder's room and pulled the curtain across the glass door.
Close up, Mulder's partner looked terrible- like she'd fallen off a high-speed roller coaster. For a time I watched her watch her partner fight for his final breaths. It was clear she had accepted that inconsiderate
tenacious fate- ignoring his relative youth and the immeasurable value of his spirit- had chosen him for death after all her valiant protests.
The war over, she wept, her arms entangled with his.
All the IVs were gone save one. His breaths were shallow and irregular. The ventilator had been shoved in a corner, a white sheet had been thrown haphazardly over the top- perhaps in an attempt to hide the evidence of failure.
"He's going now," she said suddenly, never taking her eyes from his face. I don't think she was talking to me. It seemed more likely that she needed to hear the sound of her voice saying the words. It was an effort to ground herself and stay in touch with reality.
I looked over at the cardiac monitor, thankful that the alarms had been silenced. She was correct in her estimation- the complexes were now slow and wide, as usually happens when death is imminent.
"I'll miss you Mulder," she said in a battle weary voice. "I always will."
Numbly, I backed toward the door, wanting to give them privacy, yet powerless to turn my eyes away- wanting to run away, yet anchored to that room.
She kissed him lightly on a mouth still swollen from the presence of endotracheal tube, caressing his cheek with the palm of her hand. "Don't worry about us Mulder. I know that you don't want to leave, but we know
that's not your choice. It's not a ditch, I know. You're leaving us behind, but I'll catch up with you before you know it."
The rhythm on the monitor went from eight complexes per screen to four.
"You are the heart of my life." She stroked his head, letting her fingers idle in the new growth of fine dark hair that was less than a half inch long. "You will be with me every..."
I turned and stumbled out of the room, unable to stand the pressure inside my chest. Head pressed against the coolness of the corridor wall, I waited for the soft explosion of unrestrained weeping.
* * * * *
Jason was home, asleep, when I arrived the next morning. It was the first time that I'd seen him in nearly a week. I watched him as he lay there for some time before reaching over to shake his shoulder. "Jason, you're going to be late for work..."
His eyes blinked open and focused on my face. "Have the day off," he murmured, his voice hoarse and scratchy from sleep. He struggled with the sheets until he had one end free. Holding it up, he entreated to me, "Come in, I made it toasty for you."
I climbed in, uniform and all, pausing only to remove my shoes.
Jason sighed. A deep, shuddery sigh, and pulled me tight against him. "So how was work?" he mumbled, eyes closed. He had only surfaced briefly, and I could feel him sliding away again.
"Oh, same old same old," but my voice broke on the last word.
"That's good..." He kissed my cheek, the feel of his lips was warm and sure and reassuring. Drawing in one more deep breath, his breathing became steady as he fell asleep once again.
I watched him as I waited for sleep to take me, and I wondered what dreams would come. I brought my hand to his face, cupping my palm against his cheek.
How thin the lines between life and death, joy and sorrow. Chance... fate...the invisible forces which in split seconds can change our lives forever.
"How can I stand it? How can I face death everyday, yet have the courage to live?"
There was no response from Jason.
end