Okay, reading back through this chapter it gets pretty gruesome in places so you have been warned! Lotsa medical stuff in this one (if blood makes you squeamish you may wanna read this one through your fingers!) and I've also been doing the old research thing so hopefully all the medical lingo sounds convincing and makes some kinda sense :)
The last chapter may have been kinda short but this one pretty much makes up for that! In previous chapters we've had a different POV for each chapter… I'm changing things up a little in this one and we've getting several POVs of events. We've got Shep whumpage and McKay angst galore so…Enjoy!
Hope you like it.. did I mention that reviews make me write faster? (grin)
P.S. Evil cliffies… Erm, I did it again didn't I? Sorry…
The infirmary was chaos and confusion. McKay sat on an exam bed and watched the crisis unfold before him. He'd tried twice to get off the bed and go get a closer look, go and help, go and… Christ, he had no idea what, just do something! He had about 4 inches height advantage over the nurse but man, she had a grip like a steel vice. After his second attempt to leave her tender ministrations, she'd threatened to sedate him. He ignored her now, not even flinching as she flicked the beam of a penlight into his eye and out again, in and out, in and out. His gaze was fixed over her shoulder. Between the flashes of bright, white light he saw the cluster of medical staff disappear through the doors into the surgery suite. He couldn't see John, couldn't see what was happening through the crush of scrubs-clad bodies. The wailing of an alarm was silenced abruptly as the doors slid closed. The infirmary was suddenly cold and silent and empty. Like a devastated town after the tornado has passed, the sudden absence of chaos and destruction left a vacuum of tense expectation.. a sense of disbelief that the drama was over, had moved on. The debris of battle was scattered around the room; sterile swabs and blood-soaked dressings, discarded packaging from IV tubing, empty IV bags, drained of fluids and blood products. The remains of Sheppard's habitual black t-shirt lay abandoned in a corner, tossed aside in a moment of urgency. A pool of blood stained the infirmary floor, wheel tracks dragging through it and leading outwards towards the firmly closed doors. The doors behind which McKay's friend was fighting for his life.
Rodney sat on the bed and stared at the doors to the surgical suite. He was vaguely aware of rubbing his hands together in a slow, constant, nervous motion, the repetitive susurration of skin on skin loud in the silence of the infirmary. His hands felt gritty, dirty. He didn't notice the flakes of drying blood that peeled from his skin and floated slowly downwards in the stillness of the room, dotting the floor with specks of red and brown. Rodney sat and watched the doors…and waited.
The overhead lights in the surgical suite were glaringly bright. Under their unforgiving glare the Colonel's injuries were thrown into sharp, detailed relief. Dr Beckett took a moment to steady himself before approaching this most delicate task. The last 20 minutes had been a whirlwind of action with precious little time to do anything but react, treating each crisis as it arose, doing everything they could to keep Sheppard hanging on to that thin thread of life a little longer. The lad was a tough one, that was for sure. A fighter. Anything less and they'd have lost him several times over. They'd had to intubate as his breathing function had deteriorated and he'd coded again in the infirmary, the blood they were transfusing into him running out again almost as fast as they could squeeze the bags dry. As they'd rushed him into theatre Carson had had a brief moment of doubt, fearing that this time they wouldn't get him back. He should have known better than to ever give up on John Sheppard. Still, it had taken several charges of the defibrillator to get his heart started yet again and he was still hovering dangerously on the edge of dysrhythmia. There was no time to waste.
Examining and debriding the wound to Sheppard's abdomen was a slow, careful process. The flesh was ragged and torn, blood-soaked and crusted and contaminated with dirt and debris. Carson flushed the area repeatedly with saline and used a magnifying visor to allow him to pick out any visible foreign particles, his hands delicately manoeuvring a pair of long-stemmed tweezers as he pulled fragments of fabric and tiny shards of metal from the wound. Sweat beaded his forehead as he concentrated intensely on the intricate task. Cleaning out the wound was vital to preventing infection – John's body was in shock and dangerously weak from massive blood loss and the slightest fever could be enough to overwhelm his already overtaxed system. The biggest obstacle to John's continued survival however, was going to be removing the twisted piece of metal embedded into his flesh. Carson couldn't even begin to guess how deep the shrapnel had penetrated but it was clear from the amount of blood loss that John had a major bleed and they urgently needed to find it and stop it – and to get to it they would need to remove the piece of metal. There was a limit to how long they could continue to transfuse fresh blood into John and a limit to their supplies of blood – though even now members of Beckett's staff were rounding up donors to replenish their fast-disappearing supplies. There were also complications inherent in massively transfusing in this way; John was at risk for thrombocytopenia, hypocalcaemia, hyperkalemia, a catalogue of blood imbalances that could be disastrous in his weakened state. The jagged chunk of metal needed to come out, and it needed to come out soon. The problem was, as Carson well knew, that the shrapnel itself could very well be acting as a tamponade, helping to obstruct the bleed and slow the blood loss. If that was the case.. if the metal itself was partially sealing off the bleed, then once they removed it they'd have to work fast – incredibly fast - or John could very well bleed out in mere moments.
With the wound cleaned out as best he could, Carson stood back as a nurse swabbed the area thoroughly with iodine and carefully laid a sterile drape over John's abdomen. The drape left the area of the wound exposed, a stark square of pale white flesh, stained orange with disinfectant, and the ugly, jagged piece of metal rising up out of the ragged hole it had made for itself. Blood continued to ooze sluggishly from the wound. The operating theatre was quiet now, a hushed sense of anticipation seeming to settle on the medical team. The repeated sigh of the ventilator seemed unnaturally loud in the silence. Carson looked round at his team and nodded. Everyone was ready.
The waiting room was beginning to feel claustrophobic. Elizabeth felt like she'd been waiting there for hours. Far too regular glances at her watch told her it had been much less than that and yet time seemed to have stretched and slowed and she would be sure that 20 minutes had passed only to check her watch – again – and find that only a minute or two had crawled by. She stood up in a sudden motion, restless energy burning through her veins, and began to pace. How many times had she been here, in this situation? Waiting outside the infirmary for news that someone under her command, someone whom she had sent out on a mission, someone who was only in this galaxy in the first place because she had chosen them was going to live… or to die. How many times? They'd been through so much in the last year and more – and lost so many. And come close more times than she cared to think about. How many times had she been here waiting for news of John? She'd come to depend on him so much; not just in the performance of his duties, as ranking military officer, as her 2IC, but on his friendship, on his easygoing charm, the way he could bring a smile to her face even in the direst of situations, the darkest of moments. He had put himself on the line for her and for Atlantis time and time again, had killed 60 men to save the city – save her - and now death had come stalking him again, here in Atlantis itself.
When she heard the infirmary doors hush open behind her, for a moment she was almost afraid to turn, to accept the responsibility of knowing for sure which way fate had turned, her heart pounding suddenly loud in her ears. She almost laughed with bitter relief when she saw it was not Beckett who stood in the doorway but the nurse who had accompanied McKay to the infirmary. It was no kind of reprieve to be left once again to the agonizing wait and yet a part of her relished not having to let go of the luxury of hope just yet. The nurse could nonetheless see the question in her eyes and she shook her head with a regretful smile.
"I'm sorry, Dr Weir. No news as yet."
She looked round at the empty waiting room. "I thought you might prefer some company though…?" she asked gently.
Rodney McKay was watching the doors to the surgical suite. He had not looked round when the infirmary doors slid open with their distinctive hush, he had ignored the muted conversation in the background, he hadn't reacted when the doors slid closed again. Rodney was waiting. Waiting for news.
He didn't look away when a shadow fell over the bed, was hardly aware of a voice speaking his name, it was only when a hand rested gently on his, stilling their constant motion, that he came to himself enough to take note of his surroundings.
"Elizabeth!"
Surprise made his voice high and ragged. Surprise and the smoke and god knows what other crap he'd inhaled in the aftermath of the explosion, that was all. It had nothing to do with the solid lump in his chest, the one he couldn't seem to breathe around.
Dr Weir's face was tight with the same fear and dread that made his throat feel strained and sore. She smiled reassurance at him and for a moment he envied her her self-control, her ability to be strong for others. Rodney wasn't strong. He.. he panicked and he blustered but he wasn't strong. In that dark, cluttered corridor Rodney had tried to be strong for John but it wasn't enough, he was so terribly afraid that it wasn't enough. He was trying to hold on to hope but in his mind's eye all he could see was the blood oozing and pulsing through his clenched fingers, draining away John's life no matter how hard he tried to stop it. Even as he sat here in fresh, clean scrubs, propped up on pillows in a medical bed, he shivered with goose bumps as the skin on his legs still tried to cringe away from the remembered sensation of warm, sticky, blood-soaked fabric clinging to them. Somewhere deep inside, pushed down into the farthest recesses of his consciousness, he suspected that John wasn't going to make it this time. Rodney was deathly afraid that a part of him had given up hope. And that fear felt like betrayal - felt like he'd failed Sheppard.
"How are you, Rodney?"
Elizabeth's voice startled him out of his absorption and he dragged his eyes away from the doors, putting on a brave face as he met her concerned gaze.
"I'm fine," he assured her shortly. "I'm not the one we need to be worrying about."
The nurse was fussing around nearby, hovering rather less than inconspicuously, and Rodney threw her an irritated glare as she chose to add her opinion on matters.
"He has a nasty bump to the head," she informed Dr Weir mildly, "though thankfully no concussion. It'll be sore for a while but there are no neurological complications. He was very lucky…"
"Oh yes," Rodney muttered, surprising himself with the bitterness evident in his tone. "Lucky Dr McKay. Yes, it's been a great day all in all…."
He clamped his mouth shut as he became aware of Elizabeth's quizzical look.
"He's got some minor smoke inhalation and he's somewhat dehydrated and exhausted." The nurse continued prattling on in the background and Rodney turned his attention back to the doors beyond which a life was being saved… or slipping away. "More than anything he needs a good rest and he'll be just fine…"
There was a moment of uncomfortable silence and Rodney tensed.
The nurse's voice was quiet, subdued. "He won't let me clean up his hands."
Tattle-tale.
Rodney looked down at his hands. They were stained a dull rusted colour now as the smeared blood had dried and flaked. Elizabeth's hand still rested atop his, her skin white and flawless against the evidence of his struggle to be strong, to save John.
"Rodney?"
He set his mouth and turned his gaze back to the doors. All he could do now was wait.
Elizabeth's voice was as gentle as her hands as she lifted his from the blankets. "Come on Rodney, let's get this cleaned up."
He didn't look at her for a long time as the nurse brought her a damp cloth and she carefully wiped away the traces of his struggle. She perched on the bed beside him as she cleaned one hand at a time, her touch gentle as she carefully smoothed the warm cloth over the skin between his fingers where the blood – so much blood – and dirt had caked and crusted. Rodney watched the doors and waited.
As she placed his hand back on the blanket Rodney turned his head suddenly and caught her solemn gaze.
"I really tried, you know" His voice was calm, quiet. His heart was thundering in his chest.
"I know," she smiled. "You did good, Rodney. Real good."
He nodded abruptly, suddenly unable to meet her eyes.
She stayed perched on the bed beside him as he turned his attention back to the doors that held the answers to how his life would be from today onwards.
All they could do was wait.
Carson wrapped a hand – double-gloved to help cushion against the sharp metal edges - carefully around the jagged piece of shrapnel and gave a cautious, preparatory tug. It didn't move. "Okay," he sighed. "It looks like this isnae gonna come out easy, ladies and gentleman." His team were tensed, ready to move quickly, as he gently gripped the shrapnel in both hands.
"Ready?"
He didn't try to jerk the metal free from the wound, rather he steadily increased an upward pressure, slowly lifting the metal towards him, away from the torn flesh. Blood trickled from the wound, soaking the edges of the surgical drapes, turning the blue fabric a dark, ugly purple stain. Carson's arms began to shake. The mangled flesh clung to the metal, sucking it down even as he pulled gently, firmly upwards. He felt the pressure give slightly and an inch or so of bloodied metal rose out of the wound. Blood welled around it. His staff were moving concisely around him, suctioning the blood to keep his view clear, hanging a further bag of type-specific – dear god, he'd lost count of how many pints they'd poured into the poor lad now – monitoring vital signs.
He gritted his teeth as he increased the pull, slowly and steadily. A silence descended on the room as everyone tensed in anticipation.. sooner or later something had to give. Finally, shockingly, suddenly, something did. With a wet, sucking sound the jagged piece of metal suddenly pulled free from the wound, the release of pressure so sudden that Carson staggered backwards, the large chunk of shrapnel gripped awkwardly in his hands.
Before he had time even to think a spray of blood spattered across the front of his scrubs and alarms began to blare loudly. His team were rushing to action even as he dropped the metal hastily to the floor. It was as he had feared; blood was fountaining from the open wound and suddenly there were out of time.
"Arterial bleed!"
"Pressure's dropping!"
The room descended into chaos.
"Suction and clamps please!" Carson ordered tightly, regretting the mere seconds it took for him to be handed his tools. Right now, fractions of a second could mean the difference between life and death for John Sheppard.
TBC….