Author's note. Sorry for the wait on this one. I wanted to be sure the medical stuff was right, and I had a bit of real life this week. The next chapter (which was originally going to be part of this one) will be sooner. Promise.

Also, a bit of medical background for those who don't know much about it. I don't want to have the characters telling each other things they already know just to exposit it to the readers! PE is pulmonary embolism. It's a blood clot in the arteries of the lung. It's a fairly common complication after major surgery, though most aren't as bad as this one. The clot prevents the blood from getting adequate oxygen from the lungs. It's usually treated supportively, since the clot breaks down on its own, and herapin is given to prevent further clots. But if the clot is extensive and the patient is unstable/deteriorating, sometimes drugs called thrombolytics are given to hasten the breaking down of the initial clot. (Risky, since the drugs also keep the blood from clotting where you want it to, so it can result in uncontrolled bleeding.)

Ok... on with our story.

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The ambulance bay doors flew open. The paramedics were getting lax about calling ahead. Susan had been heading out for lunch. Carter was in Trauma 1 working on an MI. The patient looked pretty stable, so she was going to take advantage of the momentary lull to grab something to eat. But ... no such luck. She'd have to take this one. Maybe it would be quick and easy. Not everyone who arrived by ambulance was at death's door.

Then she saw them. Abby was walking beside the gurney; her face pale, her eyes red and bright with unshed tears. Her gaze was fixed on the figure on the gurney.

The rest of the scene was too familiar. A tall, still form, deathly white, eyes closed. The paramedic squeezed an ambu-bag. But there was no blood this time, and Abby clung to his hand.

Before the paramedic could say anything, Abby glanced away from Luka for a moment, saw her, and began to speak rapidly. The calmness of her voice contrasted with the grief on her face. "I think it's a PE. He was having chest pain, difficulty breathing. He was in shock."

"When did it start?" asked Susan, as they headed into Trauma 2.

"I'm not sure." A little tremor in her voice now. "I was out. I got home, he was unconscious. He woke up for a minute or two ... then he crashed ... stopped breathing."

"How long has he been out?" She might have been talking to a stranger, asking about a stranger. It was the only way she was going to be able to do this again.

"About 10 minutes."

While they transferred Luka from the gurney to the exam table, Susan looked at Abby for a moment. She could see the barely surpressed hysteria there. And she knew that if Abby lost it, she would probably break herself.

"Abby, we'll take care of him now. Why don't you get a cup of coffee and wait in chairs."

"No!" Desperate. "I'm not leaving. He ... he wants me here."

"Ok. Yosh, grab her a chair, would you?" The pain in Abby's face was not that of a nurse worrying about the patient she had been caring for. Nor was it the look of a friend fearing for a friend. This was something new.

Susan turned her attention to her patient, forced herself to focus on the job at hand. The paramedics had squeezed in almost a liter of saline in the ambulance, but he was still in shock, his pressure still too low. When they stopped bagging him for a moment, he made an attempt to breathe, but his resps were much too shallow, too weak, too rapid. She knew that they were not sufficient to provide him with adequate oxygen, and he would only exhaust himself in a few minutes and arrest again. Even with the bagging, his sats were dangerously low; the clot wasn't allowing enough oxygen into his blood.

"Luka!" she called to him. "Luka, open your eyes." A slight trembling of his lashes, then he was still again. She took his hand ... it was ice cold, limp, the nails were blue. "Luka, try to squeeze my hand." Nothing. Abby was still holding his other hand, and a few tears wet her face now.

Susan looked quickly away from Abby and again managed to shut off her own feelings. She was a doctor. Doctors weren't allowed to have feelings. She briskly did all the necessary things; ordering oxygen and a vent, more saline and pressors to get his pressure up, ordering labs, and completing the brief but thorough assessment. His heartbeat on the monitor showed the rhythm typical in massive PE, and listening with her stethoscope, she could hear the murmer.

She knew she should order more tests. There were other things that could cause these symptoms, and if she'd guessed wrong the results could be catastrophic. But she also knew that he wouldn't live long enough to wait for a V/Q scan. She had to do something now. Despite everything they'd done for him, all the supportive treatments, he was still deteriorating. An if she guessed wrong ... she hoped he would understand.

"How long since his surgery, Abby?"

"Just over two weeks."

"Good. Let's start him on TPA. 15 mg. bolus, then 50 over the next 30 minutes, and another 50 over an hour."

"Shouldn't you do more tests?" Abby asked.

"There's no time, and the symptoms are pretty clear." Another look at Luka's grey face. Too still, but he looked calm. The thought came to her head that if he died, at least he wouldn't suffer. He didn't seem to be in any pain now. Then, "Why didn't you get him here sooner?"

"I told you ... I was out. I didn't know."

"You must have seen something before you went out, noticed that something wasn't right. You're a nurse, Abby!"

"He didn't ... I didn't ..." Abby shook her head in confusion, and Susan regretted her words. There was no sense in assigning blame now.

"I'm sorry. That was out of line. It wasn't your fault. But if he'd gotten here sooner ..."

"I know."

"I'm going to do everything I can, and he's strong, but I can't promise anything."

"I know." Again, the deceptive calm just above the storm. Abby touched Luka's face.

Susan took a deep breath to calm herself again, and looked at the monitors for a moment. And saw, through the glass, Carter in the adjoining room. He was looking at them. He'd been looking at Abby, then, seeming to sense something, he looked at her.

Had Abby seen him? Susan doubted that she had. Abby had barely taken her eyes from Luka's face since they'd arrived.

"Ok. It's going to take a little time for the TPA to run in and start working. He looks stable for the moment. I'm going to get a cup of coffee, check on some other patients. Yosh, page me if there's any change, and call up to the ICU. He's going to need a bed soon." That's right, Susan. Be optimistic. He will need a bed upstairs, not a space in the morgue. She gave Abby an encouraging smile, but Abby didn't seem to notice. She was still watching Luka.