A/N: Just to specify the time setting for this fic – it's set during Season 2, post-Conversion but pre-Michael/Allies (hence one or two reference in this chapter to events up to Conversion).
Disclaimer: I know nothing about medicine other than very basic stuff and whatever research I can feasibly do on the internet. In other words – if the details of Shep's injuries and/or the treatment etc make no sense whatsoever then I apologise profusely!
All feedback gratefully received, as ever - review and let me know your thoughts:D
Dr Carson Beckett was a veteran of many a grisly trauma, with ER stints under his belt and medical experience gained in many different countries with wildly different standards of care. He'd dealt with triage situations in places from Scotland to the Sudan – not to mention the last year and more dealing with everything from gunshot wounds to wraith stunner blasts to alien retroviruses here in the Pegasus galaxy.
That said, the scene revealed by the sweeping beam of his flashlight as he stumbled hastily through the debris-filled corridor outside Rodney's lab seemed to burn itself into his very retinas – a frozen moment of horror such as he had rarely witnessed, and would surely be hard pressed to ever forget.
For a stunned second, before his professional instincts kicked into gear and propelled him into action, Carson's overriding impression was of the stark contrast of colours. In the harsh white light of the flashlight everything was cast into relief of light and shade, black and white… and red. So much red.
Colonel John Sheppard lay slumped on the floor of the corridor, crumpled up against the wall as though he'd slid down it before landing on the floor. Dr Rodney McKay knelt over the body of his friend, his hands and forearms smeared with blood where he held them pressed tight against John's abdomen, his hands placed awkwardly around a large, jagged piece of metal that was clearly embedded in the Colonel's belly. Carson took in all this in a fraction of a second, his mind already processing, assessing, considering treatment protocols as he dropped to his knees beside McKay, heedless of the gruesome slick of blood around his patient.
Rodney turned a haggard face to Carson, panic and despair writ large in his expression and his voice a high-pitched babble of fear. "I think his heart's stopped! Do something, Carson!"
Beckett's voice betrayed no hint of fear or worry, his calm professional demeanour slipping naturally into place as he immediately took control of the situation, calling over his shoulder to where the rest of his team came running down the corridor, his orders concise and urgent, demanding IV and type-specific lines and the portable defibrillator to be charged.
He was firm but gentle as he carefully lifted Rodney's hands away from the wound, noting clinically the absolute pallor of the man's face and the trembling in his limbs, making a rapid diagnosis of shock. For the time being, however, Rodney's condition was the least of his concerns and the man would have to wait his turn.
He was rapidly assessing his patient even as his team quickly set up their equipment around him, moving efficiently to carry out his orders, the cluttered corridor a sudden hive of carefully ordered activity centred around the limp form of the Colonel.
Sheppard's skin was cool and clammy beneath his fingers as he checked for a carotid pulse. Focused solely on the task at hand, he was only vaguely aware of Rodney hovering agitatedly in the background, peering over the shoulders of his staff as they worked, his voice high and panicked as he questioned their every move, demanding that they do something, fix this! John was unnaturally still and silent; no respiration, no circulation. "Let us work, Rodney" Carson chided gently as he held out his hands for the charged defibrillator paddles. "We're doing everything we can.."
He rubbed the paddles together in preparation as a member of his trained triage team finished cutting through John's blood-soaked t-shirt, exposing the too-pale skin of his chest as she carefully freed the damp, sticky remnants of fabric from around the ragged edges of the wound. The heart monitor began to emit a shrill, constant tone as she quickly attached the monitoring pads to Sheppard's chest. Even amidst all the chaos and the high-pitched whine of the flatline, Carson was aware of Rodney's despairing, "Oh god..." as his assistant quickly pulled the ever-present dog tags aside and Carson knelt over his patient.
"Clear!"
There was a frozen moment of silence as though everyone in that dark, cramped space were holding their breath as Sheppard's body jerked under the surge of electricity. The heart monitor stuttered for a moment, beeping unevenly as it registered fleeting muscle contractions from the passing current, and then a collective sigh seemed to whisper in the air as the familiar, steady wail resumed.
"Charge to 200 – clear!"
"Come on, come on, come on!" Rodney's voice was shrill and desperate in the background as Sheppard convulsed again, electricity spasming his muscles.
Beeeeeeeeeeeeeeeeeeeeeeeeeeeep
Flatline.
The rhythmic hiss of the oxygen reservoir bag forcing air into John's lungs was a steady counterpoint to the controlled chaos of noise and movement, every member of the team grim with concentration as they worked to stabilize their patient. "Come on son, don't give up just yet.." Carson murmured softly as the rising pitch of the defibrillator's hum warned of the charge building up.
"Clear!"
The sharp snap of the defibrillator discharging echoed from the cool metal of the walls. The heart monitor beeped, stuttered, whined for a long, long moment, and then suddenly beeped again, and again.. and again. Feeling as though he hardly dared breathe himself, Carson pressed his fingers carefully to John's neck. It took him a moment to find it and it was dangerously faint and thready but it was there, the flutter of a pulse in the carotid artery.
There was no time for the luxury of relief – John was a long way from out of the woods and Carson's voice was tight and authoritative as he issued brisk commands to his team. "Alright everyone, we've got him back, now we've to get him stabilized. We've got massive blood loss, I want as much type-specific as we can get into him until we can isolate the haemorrhaging. Jannsen, shine that flashlight over this way son.." He spared a quick glance for McKay where he hovered anxiously in the background. The scientist's face was as white as a sheet, sweat beading his pale forehead where a swollen bruise was already beginning to discolour the skin. "Karen," he called out as he turned back to his work. "Take care of Dr McKay please – and make sure you check for concussion."
Dr Beckett sat back on his heels as he took a moment to get a proper look at the wound for the first time. It was hard to get a clear picture of the damage; the area around the wound was thick with oozing and clotting blood, with yet more viscous fluid pumping out now that circulation had been restored. He probed gently at the wound with gloved fingers; the metal fragment was jagged and bent and appeared to be deeply embedded in the abdomen, the flesh around it ripped and torn. In the bright glare of the flashlight he did his best to examine the wound for debris and contaminants, fragments of fabric from John's clothing, particle debris from the explosion; this whole area was filthy and still acrid with smoke, clearly infection was going to be a concern.
Carson sat back with a sigh.
"Right then." He stripped off his gloves with an audible snap, his decision made. "We can't deal with this here – we need to get him into surgery in a sterile environment."
"Whoa, whoa, whoa, wait!" McKay interrupted angrily, pushing away the nurse who was trying to check his pupil reactions. "You're gonna move him? Like that?"
Carson spared Rodney a sympathetic glance as he moved back to give room for a litter to be moved in next to Sheppard.
"We've no choice Rodney.." he began.
"Look at him!" McKay's voice was shaking, fear and tension flooding his system with adrenaline as he gesticulated wildly, his jittery hands encompassing the whole chaotic scene as he ranted. "He's got a piece of metal a foot long sticking out of him – he's bleeding all over the floor..!"
"Aye, and he'll continue to do so until we can get him into surgery and isolate the bleed!"
Carson regretted the bite in his tone almost before he finished speaking. Rodney was pale and shocky, his eyes huge in the semi-darkness and his concern for his friend evident in his anguished face.
"I've no time to discuss this now, Rodney," Beckett stated calmly, keeping his voice soft and reassuring. "We can't possibly treat him here, we need to get him to theatre as soon as possible."
He turned back to his team and lost no time in supervising John's careful transfer to the litter. Sheppard's limbs were limp and toneless as they lifted him between them oh so gently, raising him from the floor only just enough to swiftly move him across and lay him carefully in the litter, one of the team supporting his head as a nurse continued to push oxygen into him. The wound packed as best they could for transport, the litter was swiftly raised from the ground and they prepared to return to the infirmary, the team clustering around the litter even as they set off, working to keep John breathing, holding bags of blood and IV fluid, trying to keep the bleeding under control. Time was now of the essence.
Carson could only hope that their time wasn't about to run out.
TBC...