Six Days After Christmas
Part 5
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"Sweetheart."
The policeman smiled at Lindsay like she was a ticking time bomb ready to explode. He spoke to her in a slow, deliberate manner, exaggerating each word as if she had been the one hit on the head instead of Ryan. "We can't get a hold of any one at Ryan's house, honey. Do you know where his parents are? Did they go out this evening? It's important that we contact a parent."
Lindsay sat in the backseat of the police car, clutching a blanket.
It wasn't that cold out.
Why couldn't she get warm?
"Um. They aren't home. I'm not sure where they are, somewhere in Rancho Palos Verde I think. Ryan didn't tell me who they are staying with. Do you know if he's ok? Can I go with him to the hospital?"
She had tried to stay near him, and the policeman had let her, for a few minutes. But once the ambulance arrived, she was quickly shoved to the sidelines, and then to the inside of the police car. The last thing she had been able to see was one of the paramedics cutting off Ryan's shirt. He wasn't breathing properly. They had barely checked him before slipping an oxygen mask over his face.
Another policeman stuck his head in the squad window. "They're ready to roll. Did you get parental consent?"
"Nope," Lindsay's cop answered. "No one's home at the boy's house. She says his folks are out of town. I haven't tried to call her parents yet. I'm gonna' take her statement at HOAG. I want someone to take a look at her, make sure she isn't hurt."
"I'm fine," Lindsay snapped.
They were talking about her like she was five years old. She half expected one of them to shove an ice cream cone into her hand, followed by a trite pat on the head.
"They didn't touch me."
The policeman turned around to face her. "Ok, I understand. You're fine. But you were just mugged and by your own admission repeatedly grabbed, not to mention the fact that you haven't stopped shaking since I arrived at the scene. You're shivering, you're worried about your friend and, sweetie, I'm a little concerned that you haven't even begun to process what happened to you tonight. So we're going to go to the hospital and let a nice doctor give you something to help settle your nerves and then you and I are going to write down everything that happened while we wait to find out how your friend is doing."
Lindsay stared defiantly at him. She couldn't tell if the man was being a condescending asshole or a caring father figure.
The policeman gave her a quick smile and then resumed his conversation with the other cop.
"Dispatch already put out an APB on the Rover. It's registered to the boy's parents. Hopefully we'll apprehend these sons of bitches tonight."
"Foster parents," Lindsay mumbled.
"What?" the cop hanging inside the window asked her, leaned in a little more.
"Ryan doesn't live with his parents. The Cohens are his legal guardians." She looked questioningly at the policemen. "Does that matter?"
"No, not at all," the first cop answered. "In fact, if anything, it simplifies things, makes treatment easier. If he's a ward of the state, the hospital can assume full parental rights."
"Ok," the second cop nodded, stood up straight. "I'll run a background check on the kid, let HOAG know what I find. I'll catch up with you at the hospital."
Lindsay felt the police car's engine turn over. Ahead, the ambulance exited the parking lot, lights flashing, siren blaring.
She pulled the blanket tighter.
The cop may be a bit of a male chauvinist pig, but at least he was talking to her, trying to make her feel better.
Ryan was all by himself in that ambulance.
He shouldn't be alone.
She remembered his phone. Maybe Ryan had the Cohens' cell numbers in it.
Calm down.
She needed to stop freaking out and get control of herself, start thinking straight. It was the least she could do for Ryan. She'd spent the last few months getting to know him and Seth. They behaved more like biological brothers than just two teenagers who happened to share the same address.
Seth would want to be here for Ryan.
She needed to get a hold of the Cohens.
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"I've got decreased breath sounds on the right side," Jeff Alden called up to his partner. "I don't like his color, he looks shocky, working too hard to get air in. No sign of tracheal deviation or NVD, but his pressure's dropping, BP is 100 over 60 palpable, pulse 125 apical and respirations 32."
Jeff estimated that his patient had been unconscious for approximately fifteen minutes, maybe as long as twenty-five. He wasn't sure how much time had passed since the initial injury and the 911 call.
Respirations were shallow despite the supplemental oxygen.
The kid's right lung was in big trouble.
Jeff dreaded the combination of head and lung injuries. If he went ahead and intubated, he ran the risk of the patient regaining consciousness and becoming combative, resisting the assistance, not to mention it hurt like a bitch to have an endotracheal tube rammed down your throat.
But he couldn't administer sedation due to the head injury and paralyzing the patient without fully knocking him out was just plain cruel.
Double-edged sword that he hated.
At least they were close to the hospital and although the kid's breathing was labored, he was holding his own for the time being.
"Ryan, wake up."
He rubbed at Ryan's sternum, trying to elicit a response.
Nothing.
Jeff opened one eyelid and then another.
Pupils looked even.
Why wasn't this kid waking up?
The paramedic performed a second blood pressure check and grimaced when he noted no improvement. He started a second IV line in hopes the additional fluids he was now pumping into the teenager would help prevent any major organ damage due to shock.
That task completed, Jeff resumed a cursory evaluation of Ryan.
Skin was pale, cool to the touch and clammy. He lifted one of Ryan's hands, examined a few fingers. The nail beds were pale too, but had a decent refill, indicating that, for the moment, enough oxygen was managing to circulate through the kid's system.
Jeff sat back on his heels a second, studied his patient.
The cops on the scene told him it was a carjacking, and although they were still trying to get the full story, it appeared as though the kid on the gurney was the victim, beaten when he tried to defend the girl with him.
Merry fucking Christmas huh kid?
The boy's face was a mess but despite the many nasty looking lacerations, Jeff hadn't found any sign of major damage to Ryan's eyes, nose or neck. Airway was clear.
He leaned in close to his patient.
"Hey Ryan. Ryan Atwood. You need to wake up Ryan."
Jeff glanced at the ECG monitor. Ryan's pulse was fairly strong but tachycardic. It wasn't unexpected but he'd need to keep a close watch on it. The rapid heart beating could be an indicator of a dozen things, including internal bleeding.
Ryan's abdomen was already bruising. Jeff carefully probed and prodded around. It was flat and soft, with faint bowel sounds present in all four quadrants. He finished up the exam of Ryan's belly, measuring and documenting the circumference in order to provide the hospital a baseline for evaluating possible internal bleeding.
Jeff ran his fingers up and down Ryan extremities, assessing for possible breaks or soft tissue damage but found none.
It was time for this kid to wake up.
He flicked on his penlight and flashed its narrow beam of light in each of Ryan's eyes.
Pupils were still even. He might get off lucky with a mild or moderate concussion.
But the LOC was a problem and the longer the teenager stayed down, the more complicated things were gonna' get.
Jeff pinched the fleshy part of the boy's arm, tried yet again to get some level of awareness from him.
"Ryan, open your eyes for me. Open your eyes Ryan."
A-ha.
Head twitch.
The boy couldn't exactly move with his entire body strapped down, but there was a definite reaction to his name being called. Jeff pried one his Ryan's eyes open again and shined his penlight directly into it, left it there a second longer than before. The pupil constricted, tried to flee the assault of sudden light.
Hello!
Houston we have contact.
'Bout time.
Jeff leaned over the kid, shouted, "Ryan Atwood. Open yours eyes. I need you to open your eyes Ryan."
Slits.
Just a little, but the kid was rallying.
Good for him.
The sooner they ruled out a significant brain injury, the sooner the pain meds and oblivion could begin.
By the sound of his breathing, the kid was facing a chest tube for sure. No one should have to be awake and aware for that shit.
"That's good Ryan, you're doing great. Tell you what, if you open your eyes for me, I'll promise not to flash this light in your eyes anymore. Ok Ryan? Come on buddy, open them up, all the way."
The kid's eyelids slid open a little more, exposing glazed blue eyes trying to hone in on Jeff.
Probably wants me to shut the hell up and let him go back to sleep. Not gonna' happen.
"Ryan, listen to me. Look at me Ryan. My name is Jeff. I'm a paramedic. You were in an accident and hit your head. You're in an ambulance, on your way to HOAG. You're strapped down on a backboard Ryan. You're not going to be able to move. Don't worry about it. The doctors will take all this stuff off once they check you out."
Jeff moved quick, not knowing how long the kid would stay conscious. He placed his hand in Ryan's open left palm.
"Ryan, squeeze my hand."
The boy closed his eyes.
"Nah-uh. No go Ryan. I need you to open your eyes and squeeze my hand. Get your eyes back open Ryan."
The teenager blinked several times before opening his eyes again. He glimpsed in Jeff's general direction but the paramedic guessed that the kid was having difficulty focusing in on him.
"That's awesome Ryan. You're doing great. Squeeze my hand now. Squeeze my hand Ryan." Jeff wiggled his fingers, tickling the inside of Ryan's hand before placing three fingers flat in Ryan's palm. The paramedic waited for a few seconds, his patience rewarded by a strong grip.
He let out a silent sigh of relief, gave Ryan's bicep a pat to acknowledge the boy's cooperation. "That's great man, good job."
Better.
The kid was following simple commands.
Jeff maneuvered to Ryan's right side; placed three fingers in the teenager's right hand. "Now this hand, Ryan. Give me all you got. Squeeze my hand as hard as you can Ryan." Jeff repeated his attempts at stimulating a reaction. Ryan responded with much less pressure this time.
The right side was weak, confirming Jeff's suspicions that the lung on that side wasn't doing its' job properly, wasn't delivering enough oxygen. Either that or the head injury was resulting in partial paralysis.
Set back.
But at least the kid's brain didn't appear to be completely scrambled.
Considering the cops mentioned a vicious little pistol-whipping and five minutes ago the teenager was more or less bottoming out on the Glasgow, things were looking up.
Or not.
Ryan's chest heaved.
Now that he was awake, his body was fighting all the more to compensate for its lack of oxygen.
Jeff leaned close to Ryan's ear, "Ryan, I know you're having a little trouble breathing and I'm sure this entire situation is scary as hell but it's ok, I'm gonna get you through this and the doctors will have you fixed up in no time. I need you to just relax and concentrate on deep breaths until we get to the hospital. Slow, deep breaths Ryan," Jeff reminded the teen as he checked the boy's blood pressure.
It was still dropping.
Could be shock, could be the pneumothorax that Jeff was almost certain of.
Could be both.
He lifted the oxygen mask off Ryan's face and wasn't surprised to see the telltale bluish tint around the boy's lips.
Don't do this kid, we're almost there.
Ryan's eyes flitted around the ambulance; his chest struggled to achieve a full breath.
Jeff felt the ambulance turn the curve leading to HOAG's emergency entrance.
The vehicle slowed down.
"Ryan, stay awake, hear me? It's very important that you stay awake Ryan. I'll go in with you. There's gonna' be people all over the place but don't worry about it. Let them do their jobs. Just relax and keep taking deep breaths."
The ambulance stopped and the back doors flung open.
"Here we go Ryan, remember, deep breaths."
Jeff relinquished control of his patient to a flurry of hospital personnel. The paramedic climbed out of the ambulance, lifting the multiple IV bags high above Ryan's gurney before his hands were liberated of the medical paraphernalia. He kept pace with the racing gurney as it entered the ER, reporting to the hospital staff, "Seventeen year old white male, assault victim with blunt head, chest and abdominal trauma. Hypoxic. Diaphoretic. BP 90 palp, pulse 135 with no arrhythmias, respirations 32 and shallow, diminished on the right side. Dyspneic. Abdomen soft. Pupils equal and reactive bilaterally. Down for approximately 25 minutes. Came to in route, nonverbal but responding to command. O2 at 100 non-rebreather mask, one liter of Lactated Ringer's in and 2 lines open."
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Sandy hid in the Emersons' guest room, reading a book. Ryan should be checking in any time now and then he could go to bed.
The lawyer smiled to himself.
Ryan was on a date.
Of course the kid hadn't called it that, but Sandy was pretty sure that "hanging out with Lindsay" was the equivalent of a hot date in the world of Ryan Atwood.
"You're sleeping alone tonight, right Ryan?" Sandy had razzed him when the teen phoned earlier that evening. "No girls, no drugs, no parties and if I neglected to mention it before, no sex in my house…or my pool house, or Kirsten's car. But if you do have sex, use a condom. I'm not saying you should, God knows there are a million reason not to. But if you do decide to have sex and you need one, they're in my top dresser drawer."
Ryan had balked at the suggestion, assured Sandy he wouldn't be having any sex and was pretty sure Lindsay would kill him if he tried.
No way, she was Kirsten's newly discovered sister. Could they please stop talking about it now? Please.
Besides, she was just a friend.
'So was Theresa,' Sandy had suppressed reminding the kid. Instead he had interjected, "Just be careful Ryan. We can't ever have a repeat of last summer."
That was hours ago. Ryan had promised to call when he was safely home.
The phone rang.
Sandy glanced at the display, Ryan's cell number.
Excellent.
He was tired; it was time to go to bed.
"Hey kid," Sandy answered casually. "Did you have a good time tonight?"
"Mr. Cohen?"
A girl's voice, not Marissa, not Summer, must be Lindsay.
"Mr. Cohen?"
Was she crying?
Sandy sat straight up.
Where the hell was Ryan?
"What's wrong?"
Something had to be wrong. Why was Kirsten's newly discovered half-sister calling him on Ryan's cell at one A.M.?
"Is this Lindsay?"
"Mr. Cohen, you need to come back to Newport, Ryan's been in an accident."
Sandy scrambled off the bed, almost tripping in the exchange.
"Lindsay, what happened? Where's Ryan?"
The girl didn't give a reply to his question so Sandy repeated it.
A man's voice answered him.
"Is this Mr. Sanford Cohen?"
"Yes," Sandy willed himself to remain clam. "Whom am I speaking to?"
"Mr. Cohen, my name is Officer James Mitchell. I'm very sorry to inform you of this over the phone sir, but your foster son, Ryan Atwood, was the victim of a suspected assault this evening."
Sandy flung open the bedroom door.
"Sir, are you there?" the policeman questioned.
"Yes. Please, where's Ryan? Is he all right?"
"He's on his way to HOAG sir. I really don't have any further information, but I did respond to the scene and I can confirm that he was transported via ambulance. I'm really not at liberty to divulge any additional information. But he was unconscious at the scene and to the best of my knowledge, remained so at the time of transport."
"I understand," Sandy raced down the Emersons' stairs. "We're leaving right now. We'll be at the hospital within the hour."
"Drive safely sir," the policeman cautioned.
Sandy hung up on him.
"Kirsten," Sandy shouted, jumped the last three stairs, raced into the living room.
His wife was sitting on the couch with Trish Emerson. Both women looked up in surprise at his frenzied entrance.
"Sandy," Kirsten chastised, "what is wrong with you, honey? You're going to wake the whole house up."
"Kirsten, Ryan's been in an accident. I just got off the phone with a policeman. He wouldn't give me any details. All I know is that Ryan's being transported to HOAG. We need to go. Now."
Kirsten sat up straight, asked a confused, "What?"
"I'll get Seth," Trish offered quickly. "Do you want Keith or myself to drive you Sandy?"
Sandy ran his fingers through his hair, "No, thank you. I'm fine. We just need to get out of here. I'm going to go start the car Kirsten."
"Oh God," he heard his wife mutter as he grabbed the car keys and quickly exited the Emersons' home.
Minutes later the three Cohens were in the BMW, speeding back to Newport, Seth in the backseat, trying to make heads or tails of the situation.
Trying to ramble his way to comprehension.
"Well, did the cop say what was wrong? Why they were taking Ryan to the hospital? Do you know what happened? Was there a car accident?"
"I'm not sure Seth, the policeman mentioned something about Ryan being the victim of an assault."
Kirsten flinched at his words. "Ryan was beaten up badly enough to be taken to the hospital?"
"Maybe," Sandy projected. "I don't know honey. Assault can take more than one form."
"Well how did they know where to call us?" Seth questioned. "I mean Ryan has to be ok, he had to give them the Emersons' number, right? So he's fine. They probably just make you go to the hospital because of police procedure or something."
Sandy cleared his throat, tried to concentrate on the driving. "Lindsay had Ryan's phone. She called me on my cell."
"Lindsay was with Ryan? Is she all right?" Kirsten asked.
"She sounded shaken up, but the policeman didn't mention any injuries."
"Wait, Dad, if she has Ryan's phone, let's just call her back."
Sandy gripped the wheel.
Stupid.
He was positively stupid.
Seth was absolutely right.
Sandy tossed his phone into the back seat.
Seth promptly scooped it up.
"Do it," he instructed his son.
Kirsten sat motionless in the passenger seat, her arms wrapped around her midsection.
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Ryan waged a losing battle to catch his breath.
He was trying, but it was so hard. With each inhale, the pain felt like someone was jabbing at him with a pitchfork. He tried taking quick little breaths but it didn't help.
His heart was pounding; trying to claw it's way out of his chest.
Nothing made sense.
He didn't understand what was happening, barely knew where he was, and had no idea how he had gotten there.
Where were the Cohens?
Had he and Seth been in a car accident?
Ryan's head felt like it was going to split wide open, break in half.
He squeezed his eyes shut as the bed he was laying on started to move.
God, the light was so intense. Everything was blurry, like Christmas lights if you looked at them through a fishbowl.
Ryan felt himself coming to a stop and then lifted sideways, the movement causing his stomach to flip-flop. He started to reach for the oxygen mask covering his mouth, but his hands wouldn't work and his stomach was tired of waiting. He gagged on vomit as it rushed up his throat.
He was turned to his side, the continued movement only exacerbating the nausea and chest pain.
The oxygen mask disappeared, replaced by something loud and raspy, shoved into his mouth. A little vacuum, trying to suck out of him what little breath he had left.
Ryan choked.
He couldn't breathe.
He was dying and he didn't even know why.
Eventually the loud thing went away and the mask was back over his mouth.
Close to his ear he heard a familiar voice but he couldn't remember how he knew the person.
"Ryan, it's Jeff. You're doing fine buddy. We had to suction your mouth to get rid of the gross stuff. But it's over now, you did great. Concentrate on those breaths we talked about, nice and slow and deep, Ryan. Expand your chest as much as you can."
Ryan puffed rapidly, in and out.
It was no use.
He couldn't get enough air in to satisfy his burning lungs.
His chest was on fire.
Ryan recognized letters being called out, but they were scrambled, randomly arranged, as if a deranged Muppet was now in charge of a dysfunctional Sesame Street.
"KUB, ABG's, EKG, CBC."
His left eye was abruptly pried open again and a bright light flicked directly at him, then the right eye.
He felt cold hands pressing on his chest and stomach. He tried not to move, but couldn't resist when the hands touched his right side. He felt himself jerk and that made the pain even more unbearable, something stabbing him over and over again.
Voices were shouting at him, repeating his name, instructing him to open his eyes, squeeze a hand, wiggle his toes. Ryan tried his best to do everything the voices asked, hoping that they would leave him alone, stop hurting him.
He was freezing. They had taken his clothes. Why was this happening? Where were the Cohens? For the first time in a year and a half he wanted his mom. No matter what, she had always been good at comforting his physical pain, even when she could have prevented it.
Suddenly, he was turned to his side and something cold and hard was placed under his back. The voice told him to hold his breath. Jesus Christ, couldn't they make up their minds. First with the slow, deep breaths, now with the don't breathe. Like he could control anything to do with his breathing at this point. Then, just as quickly, he was turned again and the unwelcomed object was removed.
Ryan attempted to watch what was happening to him, but everything was out of focus.
It was painful to open his eyes, so he gave up and just kept them shut.
He lay exhausted; gulping in breaths so minute that he didn't think a person could survive with that little amount of air.
His body shuddered with each small movement. The voices were very distant now, almost nonexistent.
He whimpered softly as the bed was repositioned, his body raised up and his head leaned back.
Tears of pain escaped from his eyes and he didn't give a damn. If he could just catch his breath, he's be screaming like a fucking schoolgirl.
He'd never been in this much pain before.
Someone lifted his right arm above his head and something cold and slimy was smeared on his side.
And then a single voice, hovering somewhere above him, female.
He wished that it were Kirsten and that she would come and save him from this insanity.
"Ryan, we're going to give you something to put you asleep. I promise when you wake up you'll be able to breathe much better. Everything's all right Ryan, just go to sleep."
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Dr. Caulard watched his staff in action.
An extraordinary ballet, trauma.
Everyone knew their place, performed their jobs to a preprogrammed perfection.
There was an added tension in the room that was always present when the patient was young.
Nobody wanted to see children in the ER.
Quick responses from all present when the kid vomited.
Caulard ordered suction, waiting for the current frenzy to subside before a proper exam could begin.
"What's his name?"
"Ryan," someone answered the doctor. Caulard tracked the speaker, realized that Jeff Alden was still in the room, leaning over the teenager, offering words of encouragement.
The paramedics always hung around when a kid was involved.
"How are we doing with contacting Ryan's parents?" He asked his head nurse, Yvonne.
"Newport PD called in, he's in foster care," she answered. "Guardians are out of town but heading in, should be here within the hour."
"Ok," Caulard acknowledged the information. "What are we looking at guys?"
All at once the information flowed in, but somehow didn't overlap. Each individual contributed without interrupting one another.
"He's semi-conscious and responding, pupils are still even. Bleeding has slowed down. He's definitely going to need this gash stitched up."
"Belly is tender, there's some guarding on the right flank. At least two ribs are giving way. Definite bruising."
The ER doctor quickly began giving out instructions for a portable chest x-ray, KUB, ABG's, EKG, CBC, lytes, and urinalysis.
"Dr. Caulard, I'm not getting anything from the right lung."
Noting Ryan's continuing fight for breath, the ER doctor promptly called for a thoracostomy tray.
"This kid needs some relief. What are we thinking concerning the head trauma?"
Jeff Alden jumped in. "Other than the initial LOC doc, he's been as alert as possible, all things considered."
Someone else spoke up, quoted vitals.
Caulard made the decision to risk a sedative. At this point, the head injury was looking like the least of their problems.
"Let's go ahead with light sedation, enough to keep him from fighting us. We'll increase it as I gain confidence with the head injury."
His staff carried out the orders swiftly and within seconds the teenager was no longer conscious. Standing over the head of the gurney, Yvonne confirmed, "He's out."
Dr. Caulard first inserted the chest tube, demonstrating to an intern the proper placement and steps involved in the procedure. The med student looked almost as young as the kid on the bed.
With the chest tube in, Caulard quickly positioned Ryan's head for endotracheal tube insertion. He performed the intubation procedure himself, although he probably should have allowed the intern a stab at it.
To hell with it.
At this moment, the patient required oxygen more than the intern needed experience. The last thing the kid on the table needed was someone fumbling around for an airway . Caulard told the intern to listen to the chest sounds, assess proper placement of the breathing tube. The student nodded and stepped to the gurney.
The doctor ordered a repeat of the chest x-ray to confirm the ET and chest tube placement.
Ryan's stats swiftly showed signs of improvement, his skin pinking up with the introduction of the chest and endo tube.
With the teenager's struggle for breath over, Caulard concentrated on assessing his other injuries.
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Lindsay sat numb in the small, private waiting area that was adjacent to the HOAG Emergency Room.
Her personal policeman, AKA Officer Mitchell, came in followed by a man in blue scrubs. Lindsay supposed he was a doctor. He took her temperature, pulse, asked her questions, put his hands all over her neck, head, pressing here and there. She answered him and when the exam was over, asked softly, "Is Ryan ok? Did you see him? Can you check for me?"
The doctor glanced at Mitchell who shrugged.
"Please?" Lindsay asked quietly, "Can you just go check, make sure he's ok? His name is Ryan Atwood."
The doctor excused himself. He returned with a little white pill and a piss poor amount of information on Ryan, "Your friend is still being evaluated. I'd like you to take this. It'll help you calm down and relax. I just spoke to your mother, she's on her way right now."
Lindsay complied with the request. Within minutes, all her shaking had stopped. A new sensation slowly ebbing its way through her body, warming her, making her feel more like herself, less like a basket case.
Officer Mitchell handed her a steaming cup of something. "My daughter loves hot chocolate," he told Lindsay. "I figured you could use some."
She nodded, took a tentative sip. It was delicious. Her throat felt scratchy, the warm liquid soothed it.
Ryan's cell phone vibrated in her pocket. She flipped it open as quickly as possible.
Seth didn't even say hello before he began to drill her.
Where was Ryan?
What the hell had happened?
Was Ryan ok?
What were the doctors telling her?
Lindsay told him what she knew, that Ryan was unconscious, having trouble breathing.
Bleeding.
Kirsten Cohen came on the phone.
How had it happened?
What were the police saying?
Was she all right?
Where was her mother? Did she have anyone with her?
Not to worry.
Ryan would be fine.
They would be there shortly.
A family friend named Jimmy Cooper was coming to the hospital. Marissa's father. He would help her get some information on Ryan. Please be sure and call immediately if she found out anything.
Lindsay passed the time by answering Officer Mitchell's questions. Standing up, she methodically reenacted what had happened. Walking around the small room, pretending it was the parking lot. This is where the gunman had stood, and this is where Ryan was, when the man hit him and the brothers' descriptions, and their clothes, and their faces, and one was named Chris.
Mr. Cooper arrived, rumpled, a nervous wreck, excused himself, promising to come back with answers about Ryan and then sitting down dejected when he returned with none.
Sandy Cohen called.
They were minutes away.
Had she heard anything about Ryan yet?
Next thing she knew her mom was there and suddenly she was crying and couldn't stop.
Officer Mitchell shook her mother's hand, told Lindsay he'd be in touch, promised her that he was sure everything would work out.
And then Seth Cohen stormed in, followed by his parents.
Lindsay got control of herself.
Ryan's family was here. Her new family.
She owed them information, what little she could give.
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"Dan?" Caulard looked up at Yvonne from his cup of coffee.
"ICU called, he made it up fine. Vitals are holding steady."
"Good," the doctored responded. "Who's on tomorrow?"
"Um," Yvonne studied a manila folder in her hand, "Jackson and Elders."
"Let's assign him to Elders, I'm more comfortable with someone with pediatric trauma experience and Elders came to us with a hell of a lot."
Yvonne nodded and made a note on her paper.
"The foster parents just arrived. They're looking pretty frantic. Do you want me to stall them or are you ready to speak with them."
"I'll go now," Calaurd answered, thinking of his own son. Holding out information for parents was something he strived to avoid.
He swung open the waiting room door, glancing around at the small group gathered there.
It was hard to determine the foster parents. Everybody in the room fit the description of frantic looking.
"Mr. and Mrs. Cohen?"
A black haired man immediately stepped forward, held out his hand, "I'm Sandy Cohen. How's Ryan?"
Wanting a little more privacy and a smaller audience, the doctor suggested, "Why don't we step outside?"
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"Ryan sustained multiple injuries. He has a grade 3 concussion, the result of a blunt force trauma to his head. He had an initial loss of consciousness for approximately 25 minutes and arrived at the ER, semi-conscious, complying with simple commands, but disoriented and nonverbal. The good news is that the CT Scan is showing no signs of intracranial bleeding. His skull isn't fractured. Make no mistake, Ryan received one hell of a blow and a concussion of this grade can be tricky. But no bleeding is the first step to recovery, so we'll keep a close eye on him, repeat the CT Scan within the next ten hours and watch for any sign of hidden bleeding. With most grade 3 concussions there is some short term and possibly long term memory loss as well as other side-affects. We'll treat the symptoms as they appear."
Sandy took a deep breath. "It could have been worse, right? I mean basically this is fairly good news you're telling us."
"Yes," the doctor nodded. "Provided a bleed doesn't develop."
Sandy stared at him.
The doctor cleared his throat and continued.
"In addition to the head injury Ryan was repeatedly kicked in the abdomen. The force of the blows fractured several ribs, one of which punctured a hole in Ryan's right lung, causing a build up of air in his chest cavity. That put pressure on his lung, making it impossible for Ryan to breathe properly. By the time he made it to the hospital, the lung had collapsed. In order to relieve the pressure, we inserted a chest tube. This tube will help re-expand Ryan's lung, allowing it to function normally again."
"Well at least that's good news, right?" Seth asked eagerly. "I mean he can breathe and breathing is better than not being able to breathe so Ryan's ok, right? Can we see him?"
"Seth," Kirsten said quietly, "Let the doctor finish."
Caulard gave her a quick smile before continuing.
"Ryan's body expended a massive amount of energy trying to make that damaged lung work. He's worn out and he needs to rest in order to heal properly. Despite the chest tube, he's not able at this time to breathe efficiently on his own. We're assisting his breathing with a ventilator, but it's not as bad as it sounds. Ryan's body is doing much of the work. The ventilator is just a precaution. It insures that he's taking enough breaths per minute and that the breaths are deep enough to help the lung re-expand. We'll keep him sedated while he's on the ventilator but because of the head injury, we'll periodically allow him to surface for a few minutes to test his levels of response. He'll remain basically unconscious, unaware of everything that is happening to him. We'll also continue to monitor for any signs of internal bleeding. It wouldn't be uncommon, given the nature of Ryan's injuries, for an abdominal injury to be present but not manifesting. There's a significant amount of bruising and that bruising may be masking something a bit more critical. But things are looking promising for Ryan, although I'm sure given the amount of information I just dumped on you, it doesn't seem like it right now. All in all, he's a pretty fortunate young man. Providing he responds positively to the neuro-checks and his lung is able to rebound, he could be out of ICU and in a regular bed by as early as tomorrow night."
"So he's out of the woods?" Sandy asked hopefully.
The doctor bobbed his head back and forth with indecision.
"At this point Ryan's listed as critical but stable. I'm extremely optimistic but the injuries he sustained are very serious. There's always a chance of complications and the lung injury is going to affect his quality of breathing for some time. He vomited several times. We haven't found any indications that he aspirated any of the material, but with the lung injury, pneumonia is always a definite possibility. Once Ryan's out of the ICU, off the ventilator and up and moving around, we'll have a better understanding of what's going to be involved with his recovery. I'm not in a position to tell you that everything is absolutely fine. But keep in mind; my job is to be hypersensitive to what could happen, in order to prevent something from being overlooked. Ryan is stable. He's responding well to treatment. Every indication is pointing to a successful recovery. Go upstairs, sit with him, hold his hand, talk to him. You'll feel better. I'll be checking on him off and on throughout the night until I go off duty tomorrow afternoon."
Kirsten and Sandy thanked the doctor.
Seth remained uncharacteristically quiet, arms folded, head down.
"Seth, things could be worse," Sandy attempted to break the grim mood. "You heard what the doctor said. Ryan's going to be all right. Eventually."
"Are you kidding me?" Seth scoffed. "You guys did this. Ryan should have been with us or we should have been home with him. You guys would have never left me home alone for four days. But you always treat Ryan differently and now he's in the ICU and I hope you're happy with yourselves. I'm gonna' go see him and apologize for not being there when he needed me."
Seth took a detour into the waiting room because Lindsay was in there and no matter what had happened to Ryan tonight, it mostly happened because he had wanted to keep her safe. If she was that important to Ryan, important enough to get his head smashed in with a gun, then she belonged up there, with Seth, in Ryan's room. A part of Seth wanted to scream at Lindsay, blame her for the fact that Ryan evidently needed a tube to breathe. He wanted her in the ICU, to see the damage she had helped cause.
But he knew deep down that he wasn't thinking rationally. Lindsay wasn't to blame and neither were his parents.
Ryan just had bad luck.
So he walked into the waiting room and explained to Lindsay's mother that they would be back in a little while and he took Lindsay by the hand and put his arm around her and together they got into the elevator, and waited in silence for it to take them to see Ryan.
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End of Part 5