"Caucasian male, late twenties early thirties, single stab wound to the abdomen, upper left quadrant."
Tom Meadowcroft's voice rang clear through the ambulance bay to the waiting trauma team.
"BP is 70 over 50, pulse 120, GCS 5 on arrival."
The moment the wheels of the gurney hit the floor, they were moving.
"Airway is clear, patient is on one hundred percent O2 by mask. Two venous lines started in transit – he's had 2 litres normal saline."
Extricating the gurney from the huddle of people amassed in the bay, Jesse's attendants forged through the doors and into the hospital, leaving the second trauma team to deal with the ambulance's remaining occupant.
"Evidence of massive bleeding and hypovolemic shock, multiple abrasions across the abdomen and chest, signs of obvious hypothermia."
The veneer of quiet that belied the never-ending hub of activity seething beneath the surface of the ER was instantly shattered as Jesse was wheeled passed cubicles housing an assortment of storm-associated accidents and injuries.
"First aid applied by attending doctor on scene."
The paramedic was cut off as the gurney pitched to a stop, the most senior doctor barking commands to her awaiting colleagues.
"Everyone ready? On my count, one, two, three!"
No one needed ask to what she was referring, well accustomed as they were to the drill carried out for every patient brought in to the trauma room.
Jesse was lifted fluidly from one gurney to the other, a small trail of blood marking the transfer.
Their job all but complete Tom Meadowcroft and Greg Robson stepped back, observing the proceedings with some consternation, well aware as they were of the severity of their patient's condition.
"Christ!... Is that Travis?" The shorter of the two doctors peered questioningly around his colleagues' faces as if seeking confirmation of his finding.
For the briefest of moments silence fell in the room.
Each member of the team paused to survey the face of the patient who had been brought in in such a dire condition, recognising him as one of their own before reverting almost instantaneously back to their professional manner.
"Get those wet clothes off of him, we need to bring his temperature up. Abdomen is distended and rigid, looks like the blade penetrated the peritoneal cavity. Severe bruising to the anterior abdominal wall, possible rib fractures… swelling around the thyroid cartilage, potential tracheal injury. Book an OR, lets roll him. Everyone got a bit? One, two, three."
Jesse was rolled carefully to one side, every inch of his body supported as the doctor examined his back.
"Some minor bruising and abrasions to the left flank, looks like he took one hell of a beating. Back on three, two, one,"
The doctor counted again the seamless motion of the team's action, and Steve watched on as Jesse's head lolled uncontrolled against the white-sheeted gurney.
"Core temperature is 92.40F."
"Get me two units of 0-neg and type and cross-match for six. I need a trauma panel, ABG, haematocrit, Chem 7 and a coag panel. Prep the rapid infuser and hang a bag of warm saline, we need to reverse the hypothermia if we're going to save him."
"What the hell is this?" One of the attending doctors lifted the tube that protruded from Jesse chest, his face open in bewilderment.
"A chest drain." Robson stepped forwards as he offered this explanation for the strange sight, catching the eye of the obviously taken aback doctor. "Dr. Sloan must have…"
"Mark Sloan?"
"Yeah…"
"Get that thing out of there; god knows what infection it's put in."
The doctor, his eye level dropped to that of Jesse's bloodied body began extricating the makeshift chest tube slowly, fearful of any damage the mock-up apparatus may have caused. He examined the device closely as he removed it, tracing its path as it snaked into the patient's lung and could not help but marvel at the ingenuity of it. Dispensing with any concerns over its shoddy appearance, the doctor noted to himself that the device, and the person who had inserted it, had no doubt played a significant role in saving Jesse Travis's life thus far.
"Airway looks clear, good breath sounds on the right but poor air entry on the left, start a central line and get me a number 9 ET tube."
The shorter doctor bent low over Jesse's face, extending his neck as he gently opened his jaw.
"Insert a Foley, what's his rhythm?"
"Normal sinus rhythm, pulse is 130 BP down to 62 over 40."
"Damn, we need to get his pressure up. Where's that type specific!?" The tall doctor barked, shooting a ferocious glare at a nearby nurse who responded by scurrying to chase-up the lab.
"I need some crichoid pressure!"
There was tense moment as the doctor tried to insert to insert the intubation tube, his face fixed in concentration, the brief respite of activity broken only by the re-emergence of the nurse, a stainless-steel tray of blood bags clutched in her hands.
"I'm in, bag him."
The scene of perfectly organised chaos recommenced at once, the mass of hands working in unison as Jesse's failing body was attended to.
Stethoscope pressed purposefully to Jesse's chest, the shorter of the two doctors listened intently,
"Good air entry bilaterally."
"BP is still falling doctor."
"God damn it! Can't you squeeze that blood in any faster?"
"He's losing it faster than we can push it in, doctor." The nurse responded with a scowl, only the fleeting crack in her voice betraying her concern for her colleague.
In the corner of the room, a phone rang. A nurse, her pastel scrubs stained with blood, answered. She listened silently for a moment before replacing the handset, her expression grim.
"Labs are back, blood pH is 8 and haematocrit is 30"The taller doctor paused momentarily, apparently considering his next move.
"Hang another unit of warm saline and get the heating pads, we need to warm him now."
Steve lingered in the background, hovering uncertainly, a silent observer to the flurry of activity that was unfurling in front of him.
Whilst he was somewhat accustomed to the complexities of medical jargon, seeing as it was, his father and two closest friends were doctors, Steve could barely begin to understand the stream of technicalities that fired back and forth between Jesse's physicians.
Watching wordlessly Steve could feel his heart pounding uncomfortably in his throat, his eyes trained as if mesmerized by the scene; the rapidity of which made him dizzy.
Within a moment much of Jesse's body was enveloped in what resembled to Steve a large sheet of aluminium foil, an unwarranted memory of his childhood games of make-believe astronauts sparking curiously in his mind.
The sound of the heart monitor, the one thing singularly more tangible than any of the words vying for comprehension in Steve's mind, pitched suddenly into a chaotic rhythm, rapid and unnatural the machine literally seemed to squeal in protest.
"He's in v-fib!"
The tension seemed to mount yet further, palpable like a wave of electricity pulsing through the room.
"Starting compressions" the tall, nameless doctor, his arms locked rigidly, began to rhythmically depress Jesse's chest, his face set in determination as he silently counted off the beats.
"Push an amp of epi, stopping compressions."
The doctor raised his arms as if to demonstrate his compliance with his companion's request.
The frenetic rhythm continued unabated.
Without waiting, the tall doctor stooped again and resumed compressions.
"Push another amp of epi" His words came haltingly, stuttered in time to the rhythm he was beating onto Jesse's lifeless chest.
"He's in asystole"
The sound of the monitor had changed. No longer a tempo of haphazard beats, it now discharged a monotonous, pitched squeal that spawned a flat green line across the screen of the monitor.
"Let's shock him. Charge to 260"
Steve stood rooted to the spot, a sickening fist clamping in his chest that made it hard to draw breath. The sheer weight of his helplessness came pressing down on him and he could feel the blood draining from his face, an icy dread creeping through his fingers.
He could not breath, his lungs whispering pitifully in protest as he watched the awful scene unfolding in front of his eyes, powerless to stop it. Steve's vision began to blur, a strange darkness that clouded his vision as the hazy images began to swim.
Steve could feel himself falling, mildly aware of the cold, hard floor's unforgiving surface as his body hit it, and the fresh wave of pain that washed through his injured wrist.
The disorder of voices muddled to his ears, and as the cool blanket of obscurity claimed his senses, the sound of an electrical charge whining as it pulsed through Jesse's body faded away, and he knew no more.
oooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo
An untold amount of time had elapsed before Steve awoke to find himself in what, even to his foggy head, was unmistakably a hospital room. The astringent scent of disinfectant permeated even his unconscious, stirring his senses and dragging him back into the realms of consciousness.
He lay still for a moment, contented in the warmth of the bed, at ease all but for the vague ache that lay behind his eyes.
He tried to recall what might have occurred to mandate his presence once again in a hospital bed. Steve found however, that even the comparatively simple process of thought seemed to provoke the ache in his head, inciting it into a vicious, rhythmic pounding. He raised his hand to his face, seeking to soothe the pain that reverberated through his temples, but found – to his cost – his arm firmly encased in a plaster cast, pure and white in its newness. His right arm, Steve found, offered no greater hope of use, restrained as it was by the length of tubing that snaked from the back of his hand and up into a half-empty IV bag.
What? Steve thought dazedly, what on earth happened?
He remembered being at the beach house… in the kitchen. He was making dinner, he knew that much.
Steve nestled his head back into the pillow, entreating solace from its softness and warmth, but finding it did nothing to ease the pain that was building in his head.
My head! The memory came to him, and for a brief moment offered explanation.
Head in the fridge, rifling through packets and jars… "Dad, do you know where I put the dip for the chips?" A sharp pain across the top of his head.
But surely that wasn't significant enough to land him in here? And it certainly did nothing to explain his arm…
What happened after that?
Steve fought hard against the fatigue that clawed at his senses, dredging another memory to the surface.
Rain… cold, dark... muddy footprints…
Steve knew he was on the edge of a precipice, the memories he sought hanging tantalisingly close, just beyond his reach.
It was the vague sense of unease that returned to him first, caressing a cool touch across his skin and chilling him to the core.
Something terrible had happened, and as this realisation dawned on him the fatigue was replaced by the desperate urgency to find out what it was that had transpired.
With renewed clarity and determination, Steve lifted himself onto his elbows, a deep ache flaring in his back, making it known that however he had sustained his injuries, his wrist and head had not been alone in their suffering.
The room was sparsely furnished and gleaming in sterility. The blinds were drawn leaving Steve uncertain as to whether it was night or day, and the door shut, cutting him off from the rest of the hospital. Totally isolated.
The absence of his father in the plastic chair that sat unoccupied besides the bed spoke volumes to Steve, accustomed as he was to Mark's usual protective attentiveness, and regardless of the force with which he decried its necessity, he could not deny his despair at the lack of his father's comforting presence now, when he needed it most.
Breathing slowly, Steve raised himself further, struggling against the pain blazing throughout his body and the rising nausea that bit at his throat.
With some difficulty Steve managed to balance himself into a sitting position, teetering tenuously as the room swam in and out of focus.
It was raining, cold… someone in the darkness…
Steve's heart began to pound sickeningly in his chest, the weight of an unseen threat pressing in on him.
Where was his father? Had something happened to him? Was that why the chair remained mockingly empty? And where were Jesse and Amanda? Surely they would fill him in on what was going on. Why was he in here, alone?
Questions filled Steve's head, fighting for prominence as his blood pounded in his ears.
Where were they? Where were his dad, Amanda and Jesse?
Jesse…
The memory his Steve with a force he never thought possible, as physically painful as a fist colliding with his stomach.
Oh god, Jesse…
The memory filtered freely through his mind, every grim detail played out with him as its private audience, flooding through his head, each scene in all its horrible glory.
The sound of the defibrillator paddles as they had whimpered into life, whining its uniquely electric timbre.
Steve wrenched the white sheets from his body and swung his legs over the edge of the bed.
All trace of dizziness gone, the adrenaline coursing through his veins compelled him forwards.
His fingers clumsy, Steve ripped the IV from his hand, the sting of pain and trickle of blood going unnoticed as he stood.
The room wavered unsteadily as Steve stood besides the bed, blinking furiously against the haze of darkness that crept into his vision.
Determination however drove him onwards, and Steve staggered the few steps to the door, reaching out for it and clinging urgently for support.
He turned and leant against it for a moment, eyeing the hazy sight of his bed; the subtle hollow in the mattress and the dishevelled sheets marking out the pattern of his sleeping body from only moments earlier. For one enticing moment Steve considered crawling back into the bed and wrapping himself tightly in the sheets, but the yearning passed and drawing a steadying breath Steve turned and opened the door.