Almost 100 reviews! Thank you to everyone for coming along for the ride! The story's not over yet...hope you will stick with me.
And thanks for those amazing reviews!
Special thank you to Indianagreaser for her help with the detailed medical terminology. I couldn't have done it without ya.
~ Simona
XX
Pony's eyes rolled back in his head and he flopped backwards, crumpling like a discarded puppet. The blood rushed to his head and a curtain of blackness lowered over him as he collapsed into a heap. If Soda hadn't been behind to catch him, he might have dangled precariously over the edge of the bed.
"Two-Bit...Darry, help me!" Soda cried out, struggling to hold Pony up. His head hung to the side. The color had drained from his face. He was completely lifeless. "Pony...hey Pony!" Soda shook him hard, cupped his face, tapped his cheek. Nothing would bring him back to life and he was getting paler by the second.
It had all happened within a matter of minutes but the chaos in the room was at an all time high. Soda was hysterical. "What happened? What happened?" he cried. "His lips are blue!" Darry came over and tried to gently hold Pony's head up, careful of the wound. He slapped Pony's cheek, harder than he had meant to, and Soda winced.
"He's out cold," Darry said, losing that control he had tried to reign in so tightly. "Shit! Where is the nurse?"
XX
Steve hurried back into the room with the nurse in tow just as Soda and Darry attempted to ease Pony's lifeless body into a position that had him laying down on his back on the bed. Two-Bit stood at the foot, hand on Pony's leg. He looked distraught.
"What happened?" the nurse asked, looking at Darry.
"He passed out," Darry said, his voice frantic, "He sat up in the bed and complained he was dizzy and then he just fainted."
"His lips are blue!" Soda cried. There was a whole lot more going on with him, but that was the first thing Soda immediately noticed in his panic. He got up off the bed and stepped back to give the nurse some room.
The nurse looked down at Ponyboy and then put her arms on him and started shaking him hard. Pony didn't respond. "Ponyboy," she called out, and picked up his limp arm, letting it fall back to the bed on its own. She pulled at his eyelids. Then she did something strange where she dug her knuckles of her closed fist into his chest and rubbed vigorously. It looked painful.
No response.
"What are you doing?" Soda asked protectively.
The nurse looked up in surprise. "I'm trying to gauge a response to pain," she said, "There is none," she said, aloud and it sounded like she wanted to say more but stopped herself. Her face looked concerned. "I'm going to page the doctor."
Darry was afraid that she would be gone awhile, but less than a minute later, the nurse scurried in with another nurse, who held a blood pressure cuff.
"We paged the doctor. He's coming now," she said, as the second nurse began putting the cuff on Pony's arms. She checked his blood pressure.
"BP is 94 over 58," the nurse said. She gave the first nurse a look and the guys couldn't understand why.
In the next moment, a new face appeared in the room in a white lab coat. It wasn't Dr. Wexler, who the gang had come to know a bit. It was someone they had never met before and he didn't introduce himself either, rushing past them so fast, that Darry had to practically jump back.
Apparantly, there was no time for pleasantries.
"Dr. Williams," the first nurse spoke up as the doctor came to Pony's bedside, "The PT's blood pressure is 94 over 58."
The doctor looked at Darry, noticing he was the oldest and appeared to be in charge.
"I need you to tell me what happened as I start checking him over," he said seriously, pulling off his stethoscope.
"Ok," Darry said, coming closer as the doctor began to listen to his heart beat. "He woke up, we think from a nightmare. He was warm. But he's been waking up all night because of his fever -"
"Sorry to interrupt," the doctor said, holding his hand out to stop Darry from talking, "Heart rate is 136," he said to the nurse. "Ok, continue," he said.
The doctor pulled out a thin flashlight and lifted Pony's unresponsive eyelids, shining the light into his eyes.
"He's been mixed up all night, saying strange things," Darry said, "It seemed like he couldn't see us real well when he woke up. He said he was dizzy."
"His fever has been high all night long," Soda piped in.
"Patient is diaphoretic," the doctor said, and the nurses seemed to know what he meant, though no one else did. "Skin is cool," he paused.
A nurse called out, "Heart rate is 134 and weak, I barely have a radial pulse, doctor!"
"Take his blood pressure again," the doctor said to the nurse in a low voice. She took Pony's limp hand and started the procedure again, wrapping his arm in a cuff, squeezing and waiting.
"90/54, doctor," she said and a look came over his face.
"It's dropping," he said, his voice more anxious. "We need to call a rapid response."
One of the nurses ran out of the room as the doctor told the other that she should start something called a fluid bolus.
"What? What's happening?" Darry asked frantically.
"It looks like he's going into shock," the doctor responded, "It's septic shock."
That's when they all heard it. The voice that came over the intercom.
"Rapid response, Room 302. Rapid response, Room 302."
Soda blanched, as the blood drained from his face. "Why do they need to get so many doctors," he asked aloud, "Is he dying?" He looked over at Two-Bit, who didn't know what to do with himself except stay out of the way. Soda felt someone grip his shoulder from behind him. It was Steve.
"No one's dying yet," Steve said, and his voice was void of emotion but you could see on his face that he was scared.
"What the hell is going on?" Darry asked, somewhere between angry and emotional, as more nurses and 2 ICU doctors entered the room. Then more arrived, and Darry and Soda immediately recognized Nurse Julie, a nurse named Cheryl, and Dr. Roberts from the ER. Another doctor showed up.
The room was beginning to go into chaos. Alarms from the heart monitor were starting to go off loud, faster, and more urgently. The doctors and nurses flew past them to Pony's bedside where Dr. Williams was calling out orders. The gang, including Two-Bit and Steve, had to move quickly to avoid being trampled. People were talking at once. One of the nurses was scrambling for supplies. Another doctor was reading a chart, while Dr. Williams was giving the room an overview of Pony's condition. His voice sounded calm but urgent. The guys heard words like hypoglycemia and cyanosis. Supplies were being wheeled in and there was the sound of metal wheels scraping against tile, pages flipping, and doctors shouting. Someone yelled out something about oxygen being too low.
Then suddenly Ron was there and Darry wondered if he might tell them something, but didn't dare ask just yet.
"Ron? What are you doing here?" Darry asked.
"It's an emergency, Darry," he said, his face drawn and serious. "Every doctor that can come, should."
Ron gave Darry and Soda a quick look of support and then went up to the bed to hear what was going on.
Someone shouted, "His blood pressure is bottoming out!"
Ron had stepped back a bit from the situation so Darry decided he would try to ask him. He rubbed his hands just below the pocket of his jeans. It wasn't the same, but this eerily felt like the night that Dally had been shot, crumpling under the streetlight. Darry had sort of just stood there, rubbing his hands on his jeans and willing himself not to cry, for once not knowing what to say or do. All sense of control had been gone...until Pony had passed out.
It was bad. But now things felt so much worse.
"Ron? C-can you...tell us anything?"
"His blood pressure is dropping and they're trying to stabilize it. He's in septic shock. It's serious."
"Is he going to die?" Soda asked, his eyes brimming with tears, having heard Ron's brief summary. He began to tremble. Steve put his arm around his friend, squeezing hard.
"It's like we're cursed or something," Soda said suddenly, "When are we gonna catch a break, Steve?"
"It's gonna be ok, Soda. He'll be fine," Steve said, though he wasn't sure he believed himself. How many times could Pony actually be saved? But he didn't want Soda to feel his worry."He's tough, Soda. He's a tough kid."
"Alright everyone," one of the doctors said, "Let's try to turn him around, get me bilateral fluid boluses going."
Dr. Williams looked at Ponyboy, whose lips were dusky. "Can someone give me his O2 sats?" One of the nurses answered that the number was 89%, which meant that Pony would need oxygen.
The guys sort of backed up against the wall, letting the doctors and nurses do what they needed to do to save Pony's life, but Darry and Soda craned their necks to get a better look.
Pony still looked bad, and he was so, so still. His hair, of what was left of it, was matted against his forehead in sweat. His skin was pale, while his lips were tinged with the blueish gray color that seemed to trail down to his fingertips. Nurses were constantly hanging strange bottles of clear fluid on poles next to the bed. Someone put an oxygen mask over his nose and mouth and attached the tubing to a port on the wall that looked like an upside down Christmas tree. That nurse turned a dial on the side up until another nurse said oxygen was at 15 liters.
Dr. Williams ordered a glucose check, and one of the nurses replied that glucose was at 98, which was normal. There was no problem with his blood sugar.
Darry was too panicked to really pay attention but Steve and Two-Bit were starting to notice Soda's calm demeanor crumbling little by little. It wasn't completely obvious to people who didn't know him, but they noticed the turned down mouth, the staring, the lip biting, the pacing - he didn't get very far, there wasn't much room - and the way he constantly rubbed his eyes and wrapped his arms around himself.
No one said anything, though, and just watched the scene in front of them. Perhaps they would regret it later.
Some time had passed now as the doctors were giving the fluid coming out of the big glass bottles some time to work. Finally, Dr. Williams told the group that a liter had been infused.
"Let's recheck the blood pressure," he said.
"78/52," a nurse called out.
"Too low," the doctor, "Let's get that blood pressure up, folks," he told the group.
Dr. Williams asked for the cap refill and someone responded that it was at 4.
"Ok," he began, ""Let's try some vasopressors. Start me a norepi drip."
"I'll go get it," the nurse named Cheryl offered and she left the room immediately and came back with a bag of fluid that looked like it was wrapped with aluminum foil. The bag was hooked up to Pony's IV and hung over his head.
Darry was distraught. Pony, or what he could see of him that wasn't being blocked by doctors and nurses, was still looking gray, and his lips flesh-colored under the oxygen mask that was clouding his face. The bruised eye that he had barely paid attention to since he had first seen it after the surgery was suddenly more purple and prominent than ever.
He wanted to go over and card his hand through Pony's hair, and tell him not to be scared - that everything was going to be alright. But since he couldn't interrupt what the medical workers were doing, he put his arm around Soda, who was starting to tremble and pulled him close.
Although Pony's condition didn't change as time passed, there was a lull in the room as the medical staff waited for the vasopressor to kick in and treat the low pressure. Meanwhile, nurses and doctors rechecked vital signs, prepared intubation kits and crash carts, and discussed the next steps of the care plan.
Meanwhile, the doctor asked nurses to check Ponyboy's blood pressure constantly.
That was when Ron came over to update the gang. He was joined by Dr. Roberts, who put a supportive hand on Darry's shoulder and squeezed hard.
"How are you, Darrel?" he asked, not actually expecting a response.
"It's been rough," Darry answered honestly, "It seemed like he was on his way to getting better and then this happens..."
Dr. Roberts nodded, "It's not uncommon for meningitis to cause sepsis. It's serious, but - let's be glad the doctor called the rapid response quickly.
"Is he gonna be ok?" Soda asked timidly. Then louder and more panicked, "What's going on with him now? How are you guys treating him?"
"His blood pressure dropped really low, that's why it's an emergency," Ron explained, "Low blood pressure due to sepsis can cause his organs to shut down. We need to avoid that at all costs. So he had to be treated as quickly as possible. We gave him fluid bolus therapy - basically infusing fluids into his body in order to get some kind of response. Well, that didn't work...so now we've got him on new medication that will hopefully raise his blood pressure. And oxygen to help him breathe of course."
Soda gaped at them, not fully comprehending even though they were very clear.
Ron looked at him with concern. "Hang in there, Soda," Ron said, putting a sympathetic hand on Soda's shoulder.
"Blood pressure is 102/60," a nurse called out and the gang literally saw Ron's mouth turn up ina small smile. He didn't want to get anyone's hopes up, but this was a good sign. Pony's blood pressure was going back up. He and Dr. Roberts went back to Pony's bedside.
"Ok, let's back off on the nor-epi," Dr. Williams was saying, "Slow it down and titrate to effect. Let's maintain his pressure here and bring it up slowly."
There was a new feeling in the room as the tension was dissipating and the fog was lifting. Pony's blood pressure had begun to go back up and his heart rate had begun to slow down. Little by little, even his physical appearance was beginning to change. His face was more dry and less sweaty. And the grayness was starting to disappear. Darry craned his neck to look and noticed his cheeks were pink again.
Things were turning around.
"I think he's getting better," Darry whispered, as if he was afraid if he said it louder, it wouldn't be true.
But for some reason, Soda didn't FEEL better. There was a weight on his chest that wouldn't go away. A cold, foreboding feeling. A fear that the blood pressure would drop again. Soda tried to smile, but he couldn't. Instead, he wrapped his arms around himself.
Everyone was focused on Pony. No one paid him any mind.
Pony's condition continued to improve until finally, the crowd of doctors and nurses were no longer necessary and they began to file out, to get back to their own patients. Dr. Roberts shook hands with Darry and Soda. Nurse Julie gave them a kind smile. Ron said he would come back later to check on Pony.
Soon only Dr. Williams and the two nurses remained. They continued to monitor Pony's condition.
The thoughts were beginning to escalate in Soda's head. The doctors were saying that Pony was improving and that they had caught it just in time but...what if they hadn't? What if his blood pressure would drop again? What if the fever would climb again? What if the infection would get worse? What if his organs would begin to shut down?
What if next time they wouldn't be so lucky?
Soda's breaths were coming faster and faster and he couldn't control them. They came out as gasps. His chest was beginning to constrict.
Soda's heart was thudding in his chest. It was like he had swallowed a hammer that was now trying to break free through his ribs. What was happening? He needed to be there for Pony, but...what if he couldn't? The room was starting to spin.
He was lightheaded. The room was closing in. He was having a heart attack!
"I - I - I need to go!" he stuttered, trying to suck in air. The three other guys stared after him as he ran out of the room.