Edward was alone.
Alphonse had left with Hawkeye to talk with the doctors about something. He had promised to be back soon, and Ed didn't doubt him, but solitude is solitude, no matter its duration. He decided to take the opportunity to sleep while he waited for his brother-or anyone at all-to come stare at him with eyes round with pity.
His rest was deep and dreamless. When he awoke, it was as if his consciousness was snagged by a sharp, unwelcome hook and pulled from the depths of oblivion he had been so warmly cocooned within. Instinctively, he searched for the source of that hook. He found it in the nurse sifting through the contents of a folder. She was sitting in the chair Al had occupied when he'd been in the unit. The folder lay open on her lap. She seemed to sense his eyes on him because she raised her head and met her gaze with his. She smiled pleasantly.
"Oh, dear. It looks like I've woken you."
It did, indeed.
Normally, Edward would have answered as stupid a statement as that one with a sarcastic agreement. Instead he simply stared silently.
The nurse stared back. Ed pictured the two of them, he on the hospital bed and she in the chair, staring at each other while the walls around them crumbled to dust. The image was ruptured a sudden twinge in his jaw. To his horror, Ed felt the corners of his mouth pulling back of their own accord. He quickly rolled onto his side, body screaming in protest, so that the nurse couldn't see his face.
"I bet that's uncomfortable," she said, and though it was unnecessary, he covered his face with his right hand. Edward felt his eyebrows being yanked up his forehead. Vainly, he tried to force his countenance into a somewhat normal position with his metal fingers. The muscles in his face were stubborn and refused to be manipulated. Frustrated, he slapped his hand onto his forehead and pushed the flesh down towards his eyes. Nothing came of it but the contraction of his right triceps. Pain burst from his port and sizzled along his neck to his brain, and Ed couldn't stop the hissy yelp from escaping him.
The nurse stood up, the chair legs scraping the floor, and pried his automail hand from his head. Out of habit, he snatched it out of her grasp, and the movement made him dizzy agony. His left arm wriggled free from beneath his side and cradled its fellow, gripping the upper joint as if to keep the limb still.
"The distortion of the face is normal for your condition," said the nurse. She sounded like she was reading a paragraph from a textbook out loud. "If you want, I can give you a relaxant that would-"
"No!"
Edward swallowed thickly. He hadn't meant the word to come out so intensely. There was an awkward pause.
"Your shoulder seems to be troubling you." She seemed determined to keep his mind focused on all the hurting he was trying to ignore.
"No. Just… just go away. Please."
He added the mannerism for his brother's sake; Alphonse was always scolding him for his tendency to be impolite.
Another awkward pause.
"Well, then… would it be okay if I checked your heart rate? Typically, we would have the patient connected to an EKG, but the doctor thought it might give you a shock when the sedatives wore off."
Edward considered. Stethoscopes were cold, but that was practically the only negativity they had. They were never placed near his automail, and contacted his skin for only a few seconds at a time.
"…Okay."
Rather than unroll him from his curled position, the nurse simply worked around it. It was odd to have a complete stranger-a woman, no less-slip her hands under his shirt and touch his chest, but he did not react beyond thought. Her fingers were starkly warm compared to the icy listening piece of the stethoscope. She held it over his heart, mentally counting his breaths and palpations, then withdrew it, to replace on the opposite side of his body. Edward had always wondered why that was done. Presumably, if the practitioner was listening to one's heart through one's back, then he or she had already listened to one's heart through one's chest. Ed doubted that anything had changed in the seconds between the transitions of the listening piece from his sternum to his spine, but he kept silent. He suspected that if he questioned the procedure, he would receive a long, disinteresting lecture about the dynamics of the human infrastructure and the general history of doctoring. This was a caution that had been instilled in him by the antics of Major Armstrong.
The nurse removed the listening piece from his person and detached the instrument from her temples with a muted "hmmm" of concern. Edward didn't have to ask her the reason behind the noise, he could feel the speed with which his blood was flowing through his veins, and the overeager pounding beneath his ribs sent vibrations through his teeth. He watched the nurse warily, half convinced she would insist upon injecting him with a chemical designed to calm his rampaging heart. Instead she referred to the folder full of papers, pulled a pen from the lapel pocket of her uniform, and scribbled some notes on a choice page. She reviewed the sheet's portents for a moment, then turned her attention to Ed, pasting a smile on her face as their gazes met.
"I bet you'd like to get some sleep, wouldn't you?" Edward's relieved nod made her laugh softly in sympathy. "I'll leave you to it then. If you need anything, just speak up. There are nurses standing by at all times, and I'd bet they'd love the chance to assist such a handsome young man." She was gone, folder in hand, before she could notice the boy's reddening face. She had deigned to honor his request for withholding medication and had judged him to be a young man. Ed's surprise was so great, he could taste it in his mouth. Strangely, the flavoring was reminiscent of a freshly-baked apple turnover. Al was right, he thought, the doctors here were unusually considerate. He was asleep before any other thought could form in his mind.
XXX
"Linda," said the doctor, turning to his desk and his assistant behind it. "It has occurred to me that Mr. Elric is unattended at the moment, seeing as how his brother is here in the office. Could you go keep an eye on his condition?"
"Of course, Doctor," said the nurse, who efficiently closed the folder and weaved her way from behind the desk and passed the colonel and out of the room. Impressive, Mustang thought, watching her go. Her movements were immediate and satisfactory, her concentration complete. He needed more subordinates like her. Especially with those legs-
Riza flattened his already bruised foot into the floor. He winced and shot her a questioning glare. Her answering scowl instantly wiped the incredulity from his mind. Whatever he had done, according to Hawkeye's expression he'd deserved her stomp, and he did not feel the right to argue with her.
"Tetanus isn't a common disease, not since the introduction of the vaccination, at least. In fact, it used to be one of the greatest causes of death, as well as the most painful."
"It still is."
Roy hadn't been able to stop the words from leaving his mind. All eyes, flesh and soul, turned to him.
"You've seen it before?"
"I've seen people die from it. In the war."
Riza shifted closer to him, so that their shoulders were brushing. He didn't allow himself to show it, but he found solace in the contact.
Alphonse emitted a ringing, whooshing sound, the best imitation of a gasp he could manage. The noise caught the doctor's attention, ending his consideration of the colonel before him.
"I implore you, young Elric, don't worry. In the war they had little to no access to the materials needed for the proper treatment of this disease. But we have it here, and I will personally make sure your brother receives it."
Al studied the doctor's face and, finding sincerity in the depths of the eyes, he believed him.
"Yes. Thank you, Doctor."
"So what is the treatment?" asked Roy.
The doctor nodded in approval to Mustang's inquiry. Roy subconsciously thought that he ought to be annoyed by this man's tendency to assert himself as mankind's disciplinarian. In hindsight, he would realize that, in all bluntness that was what any doctor had ever been.
"Tetanus is a peculiar condition. Rather than being caused by an infection of bacteria, the symptoms are the work of a byproduct created by the bacteria as they digest-"
"Digest? Digest what?" The doctor answered Alphonse's question truthfully, but not without sympathy.
"Their host. In this case, that would be your brother's tissue."
Mustang could have sworn Al's helmet turned green around the mouth.
"Unfortunately for the host, this byproduct is incredibly toxic-in fact, it is the most toxic known substance that is engineered by an organism. Only a few hundred bacteria can create enough toxin to kill a full-grown man-however, the body has ways of expelling the toxins to keep that amount from accumulating in the bloodstream." He amended the ending of his sentence in response to Al's horrified start.
"What does it… what does the toxin do exactly?" said Alphonse, raking together any remnants of composure he had left.
The doctor took a minute to think upon the answer before giving it.
"Well, as far as reactions in the body go, relatively little. You see…" The doctor paused to think again.
"You see, muscles are made of fibers that are intertwined with each other, forming the stringy constitution of meat. Every one of these fibers is, to be honest, a tiny spring, and these springs are connected to nerve receptors.
"When a muscle is stimulated, nerves send certain signals to these receptors, and in response to those signals, the springs shorten. Millions of springs, all connected and all pulling into themselves, is essentially what a contraction of a muscle is.
"Now, the receptors accept two chemicals: one telling the springs to tighten, the second telling the springs to loosen. These chemicals, of course, put a check on how long and how tightly the springs are coiled. What the tetanus toxin does is block the receptors from receiving the chemical ordering the relaxing of the muscle. The only message the fibers can be given is that to contract. And without any indication to loosen at any point or time, they will continue to contract, harder and harder, until they are physically incapable of remaining coiled any longer.
"Think of it like a traffic light. The toxin breaks the yellow and red lights, so only the green light can give any direction. Cars will go speeding through the intersection nonstop because it is the only instruction they're given."
"You said 'until they are physically incapable of remaining coiled any longer'", Alphonse quoted the doctor perfectly. "What… what does that mean?"
Roy winced, lost in his memories of the war. Hawkeye cast him a concerned look but said nothing.
"I'm afraid it means exactly what it sounds like," said the doctor. "The fibers could coil so tightly that the connections between them snap, tearing the muscle and rendering it useless. Or energy could be consumed keeping the muscle contracted than can be produced through respiration, and fermentation can only do so much. So the muscle would simply go limp from lack of fuel."
"Or the muscles harden around the bone that supports them and crush it," Mustang added. The doctor and Al both stared at him, Al in disbelief and the doctor in resignation. "Or the victim suffocates. Or the victim goes into cardiac arrest."
"What?! But why would-"
"The heart is a muscle too, young Elric," the doctor explained as gently as he could. "And a person's breathing is orchestrated by a muscle called the diaphragm. When the diaphragm relaxes, air is forced out of the lungs in an exhale as the diaphragm pushes against them. When it contracts, air fills the lungs in an inhale as the lungs expand with the extra room. But if the diaphragm doesn't contract, then air can't enter the lungs at all, and a person can asphyxiate. In the matter of the heart, which is a stubborn organ and only takes orders from the pacemaker, it will be unwilling to remain contracted for more than a few seconds at a time. Still, though, the toxin can manipulate it, and it will be forced to contract more often than normal, resulting in a high heart rate-just like with your brother. This can exhaust the heart and deplete it of energy, and unlike other muscles, the heart cannot make due without energy made from respiration. The heart will begin to die, and when that happens, it is referred to as 'cardiac arrest'."
"So Brother… could have a heart attack?"
"Yes, he could."
"At the age of thirteen?!"
"Yes."
There was a terrible crashing sound. Alphonse had fallen into a state of shock, and his body had descended with him. He sat there, silent and bemused. The doctor let him be, allowing him to collect himself in his own time.
"How… how do we stop this? How do we get rid of the toxin? How do we keep him from dying?"
"Keep him in a calm, quiet environment. The lights should be low and there should be no sudden or loud noises. Speak to him gently. Make sure he eats and drinks, it doesn't matter what as long as he swallows it. Let him rest. Convince him to take his medicine. And above all, keep him feeling safe."
"But what if-"
"We'll have an oxygen ventilator close at all times; if he ever has trouble breathing, we'll hook him up to that. We have medicine to lower his heart rate and keep his muscles relaxed."
Silence. Horrible, awful silence.
"What about the toxin?"
It was Roy who spoke. The doctor turned his attention to the colonel slowly, reluctant to jeopardize the flimsy semblance of trust he'd formed with Alphonse by looking away.
"What about it?"
"Like the boy said. How do we get rid of it? How are you going to get it out of his nerves?"
The doctor sighed tiredly.
"We don't. It can't be done."
XXX
A familiar crashing woke him.
It was the sound of his brother's armor falling to the ground. In that instant, brain dulled by sleep, the only thing Edward knew was that his baby brother had fallen. So he ran to him. His entire being shrieked, but he ignored it, and continued to push himself to Al, to his little brother, who needed him. For how long he did not know, he lay there, fighting himself for Al's sake. And then he realized he was not running. He hadn't even left the bed. And all the air in the world had vanished.
XXX
"WHAT?!"
"Now, wait a minute-"
"No! You say you can help Fullmetal, that you will help him, and now you're saying it's not possible?! What are you playing at?!"
"I meant it's not possible for me to annihilate the toxin-"
"Then who?! Who can?! Tell me!"
"Mr. Elric."
"Brother?"
The rage faded from Roy as he realized what the doctor was trying to say.
"Fullmetal… has to sweat it out?"
"I would prefer the term 'perspire', but essentially, yes."
"How long will that take?"
"In all honesty, he's doing it now. In order to keep the toxins from damaging any more nerve endings, his will perspire almost constantly to expel it."
"What about the toxin that's already in the nerves."
"I'm sorry. There's nothing I can do about that."
Roy roared with fury and lunged for the man. Riza caught him by the shoulders and pulled him forcefully towards her.
"Colonel! Listen to what he has to say!"
"When the toxin blocks the nerve endings, it destroys them," the doctor said calmly, despite Mustang's crimson face and clawing hands a mere foot away from him. "Mr. Elric's body has to break down the damaged nerves and rebuild them. Of course, such endeavor are pointless if the toxin isn't removed completely from his system."
"Brother has to get rid of the toxin and build new nerves?!" Al's voice was weak, as if he didn't believe that there was anything anyone could say or do to make the situation worse. "That could take weeks!"
"Months," the doctor corrected him. "The process is a slow one. He will probably harbor symptoms for a while."
Al moaned.
"How did this happen? Why did this happen? Why can't Brother just be left alone?!"
"The bacteria that causes tetanus survives anywhere exposed to the elements. Did or does he have any dirty wounds? Did he step on a rusty nail or was he scratched by a feral animal?"
"No. No, no he didn't-wait. We were on a mission in the countryside. And Brother… Brother got stuck in a barbed wire fence. He fell in a patch of poison ivy and wouldn't stop scratching. But I cleaned the scratches, I cleaned him up, he shouldn't... oh my God, his automail…"
The doctor closed his eyes and nodded once.
"He could very well have been punctured beneath the edge of the port. That would explain the tenderness in his shoulder. It's probably where the bacteria that are producing the toxin have gone to ground. We have to-"
He stopped talking abruptly, his eyes riveted in the direction of the entrance to the office. Instinctively, all gazes followed his.
Maes Hughes stood in the threshold, bent double and resting his hands on his knees.
"Maes… I thought you were on the phone with your wife?"
Hughes ignored him.
"Do you… where is… ventilator! We need an air ventilator! Now!"