Chapter 181
Kate quickly inspected the damage to Jeremy's heart and lungs. "Suction… more suction" said Kate. "His lung's in shreds" said Owen working as fast as he could. "More suction… I can't see a damn thing" said Kate. "Going as fast as we can doc" said a nurse. "Get another machine then" barked Kate. "Dammit, he's losing blood faster than we can pump it in" said Owen. "BP dropping, 50 over 30. Sats only 66%" said a nurse. "There it is, there's a hole in the left ventricle" said Kate. "Looks like the bullet went through the lung before hitting the heart" said Owen. "Nurse, I need your finger. Are you sterile?" said Kate. "Yup" said the nurse. Kate grabbed the nurse's hand and pushed her finger into the hole in Jeremy's heart. "Keep it there while I stitch. You're going to move it out slowly as and when I tell you to" said Kate. "Okay" said the nurse looking pale. "You okay?" Owen asked the nurse. "Um…. yeah, just feels weird to feel his heart beating around my finger" said the nurse.
"Tee, just try and calm down and breathe now… stay still" said Sara softly while stroking her sister's hair. "I'm scared Sara… I'm so scared" cried Tegan. "I know… I'm scared too" said Sara. "Okay Tegan, we're going to numb you up and stitch up this gash now" said Teddy. "Don't knock me out please, please don't put me under" said Tegan seemingly a bit calmer. "We'll try our best not to, just some local anaesthetic for now. Keep breathing that oxygen for me and just try and stay really still okay" said Abby. "Obs please" said Teddy. "Pulse still a bit high at 107. Sats 92%. BP's climbing nicely after the fluids, 100 over 70" said Abby. "Good… we're going to have you sorted out in no time Tegan" said Teddy. "Keep the mask on" said Abby.
"Pressure's falling off a cliff" said a nurse back in the trauma room. "Just lost his sats trace" said another nurse. "Hang another bag of blood" said Kate and kept working. "Stay with me Jer… stay with me" mumbled Kate. The nurse kept her eyes fixed on the cardiac monitor. "He's throwing PVCs again… and we're back in V-fib" she said. "Dammit… Give me a few seconds" said Kate still stitching. "Charge the internal paddles to 10" said Owen. Kate kept working, she tried her best to put the fact that this was her friend's heart in her hands out of her mind. "We're charged" said the nurse. "Just a sec" said Kate. "Come on Kate we need to defib" said Owen. Kate didn't reply but swiftly finished what she was doing. "That should do it… clear" said Kate calmly. Owen held the two internal paddles onto Jeremy's quivering heart.
"Could you please call Tegan? Where is she?" asked Lindsey. With that Sonia was wheeled into the room in a chair. "Sonia! Are you okay?" asked Lindsey distressed. "Yeah I'm okay… I'm so sorry about this Lindsey… I didn't suspect anything… I'm so sorry" said Sonia through tears. "It's okay Sonia, it's not your fault. It's okay" said Lindsey and hugged her mother in law. "Are the kids okay?" asked Sonia. "Yeah looks like they're okay. They want to keep them for observation though. They're a bit fussy and groggy" said Lindsey. "Where's Tegan?" asked Sonia. "I don't know… she must be with Jeremy. Could somebody go find Tegan for us" said Lindsey.
"Shocking" said Owen and pressed the buttons. This time Jeremy just twitched slightly with the smaller current directly into his heart. "No change, go again with 15" said Kate and started pumping Jeremy's heart with her one hand. "Charged, clear" said Owen. "Clear" said Kate with her hand in the air. "Nope… charge to 20" said Kate looking less and less calm. "Charged, clear" said Owen and placed the paddles back onto Jeremy's heart. "Shocking" he said. Jeremy twitched again. "We have something… weak sinus" said the nurse. Kate heard the monitor beep weakly and watched Jeremy's heart muscles contract. "There we go… hang in there Jer" said Kate softly. The monitors started wailing again 5 seconds later. "Lost his BP" said a nurse. Blood was suddenly squirting everywhere. "Aorta ruptured" said Kate trying to get control of the situation. "We're back in V-fib" said the nurse. "More suction dammit" screamed Kate with her hand on the squirting artery. "I can't see there's so much blood" mumbled Kate. Kate started repairing the tear as fast as she could. "Come on Jer… I'm not losing you… not today" whispered Kate. "More suction, sponge stick" said Owen. Kate looked flustered. "You've got this Kate… deep breath" said Owen softly. "Prepare to defib with 20" said Kate. "Okay clear" said Kate. Owen put the paddles back onto Jeremy's heart and pressed the shock buttons. Jeremy twitched. The monitor continued its squiggly line "Nothing" said a nurse. "Hang on we need to restore blood flow to the heart before we can shock again otherwise we're just wasting our time" said Kate. "Compressions?" asked the nurse. "No not yet, it's just going to ooze out. Circulation's too compromised" said Kate as she tried to close the tear in Jeremy's aorta.
"Lindsey, Sonia… Tegan's okay but she was hurt" said the kind older doctor. "No…. Tegan" said Lindsey looking pale. "I need to find her" said Lindsey. "Hang on… just calm down for a second and let us update you. She's got a stab wound in her side, it's not very deep and there's no internal bleeding so she's okay" said the doctor. "Oh my God! She's been stabbed? Is she okay?" exclaimed Lindsey. "Yes! She did however have a panic attack which resulted in a serious asthma attack" said the doctor. "She's got a history of lung problems" said Lindsey getting up again. "She's fine… everything's under control. We know all about her history. Dr Altman's with her" said the doctor. "What was she panicking about? What aren't you telling me?" said Sonia. "Tegan and Jeremy were held hostage and… I'm sorry but Jeremy was critically injured" said the doctor. "What do you mean critically injured?" asked Sonia. "He was shot in the chest Sonia" said the doctor. "Oh my god… Jeremy" whispered Lindsey looking shocked. "I need to go to her… Sonia please stay with the babies, please" said Lindsey. "It's okay Lindsey, we've got plenty of nurses and doctors that will take good care of them. Go" said the doctor.
"Okay got it… let's see if that holds. One amp of Epi, one of atropine" said Kate and started squeezing Jeremy's heart in both her hands. "Still oozing" said Owen. "Dammit… where's this bleed" muttered Kate and started exploring again. "Epi's in, atropine's in" said a nurse. "Hang more type specific on the rapid infuser" said Kate. "Kate this is bag number 7 done, we've pretty much replaced his entire blood volume" said Owen. "Then we'll do it again" said Kate and barked some more drug orders.
"Tegan" exclaimed Lindsey jogging into Tegan's cubicle. "Linds" said Tegan and started crying. "Hey baby… are you okay?" asked Lindsey and kissed Tegan's cheek while holding her hand. "I'm okay… how are the kids?" asked Tegan taking the mask off her face looking pale. "They're fine babe… the docs are taking good care of them" said Lindsey. "Go to them" said Tegan. "It's okay, your mom's with them" said Lindsey. "They must be scared" said Tegan. "They're okay, they're settling down now" said Lindsey. Abby put the mask back on Tegan's face. "Deep breaths" she repeated yet again. "Obs please" said Teddy while stitching up Tegan's side. "BP still 100 over 68, she's slightly febrile at 99.5. O2 stats at 93%. Heart rate still up, 112" said Abby. "If you had the day I had your heart would be racing too" said Tegan and put the mask back on her face with a shaky hand. "I know... It's okay Tee" said Abby. "How bad's this cut" asked Lindsey. "It's nothing babe" said Tegan. "I'm asking the Doctor Boo" said Lindsey. "It's not too bad. There's some muscle damage but there's no internal bleeding that we can pick up. We'll try our best to avoid surgery" said Teddy. "Oh my poor baby" said Lindsey and kissed Tegan's cheek again. "I'm fine" said Tegan under the oxygen mask. "And her breathing?" asked Lindsey. "Under control, there's still a bit of wheezing but her sats are coming up" said Teddy. "Can somebody please go check on Jeremy" said Tegan again taking the mask off. "I'll go, mask on!" said Abby.
"Okay that should do it, I've repaired the tear. Push through some more fluids via the central line and charge defib to 20" said Kate and started squeezing Jeremy's heart again with both her hands. "It seems to be holding" said Kate. "Charged, stay clear" said Owen. "Clear" said Kate with her hands in the air. "Shocking" said Owen. Jeremy twitched again. "No change still V-fib" said the nurse. "Dammit Jer, work with me" said Kate and started squeezing again. "Another amp of Epi" said Owen. Abby entered the room. "How's he doing?" she asked. Kate just kept squeezing and shook her head not taking her eyes off the heart in her hands. "We're still trying to stabilise him. He's in cardiac arrest" said Owen.
Abby walked back into Tegan's cubicle. Tegan yanked the oxygen mask off again. "How is he?" she asked. "Stay still Tegan" said Teddy still fixing up Tegan's stab wound. "The trauma team is still working on him, trying to stabilise him" said Abby looking flustered. "What do you mean stabilise him?" said Tegan. Abby looked up at the heart monitor that was suddenly beeping much faster. "Just calm down Tee" said Lindsey. "Is he not stable yet, is he going to be okay?" said Tegan and started wheezing again. "They're doing everything they can Tegan" said Abby. "No no no…. that's not what I want to hear… is he going to be okay?" wheezed Tegan through her tears. "We don't know yet Tegan. But he's fighting okay. He's got an amazing team working on him" said Abby and put the mask back on Tegan. Tegan started clutching her chest. "Tegan baby what's happening?" said Lindsey. "Chest hurts… can't breathe" wheezed Tegan. "Nebulise with arbuterol please, repeat a full ECG" said Teddy. "Okay Tee… you're having a panic attack. Try and slow down your breathing. Deep breath in through your nose, out through your mouth... easy does it" said Abby. "Baby just calm down, it's okay" said Lindsey stroking Tegan's hair. "Pulse up to 148, BP up to 140 over 80, Sats 86… 84 and falling" said a nurse. "Good thing that BP was low to start off with" said Teddy and gave some drug orders.
"Come on Jer, get beating" whispered Kate. "Epi's in, defib with 20" said Owen. "Let's go Jer, this is the one" said Kate. Owen shocked Jeremy's heart for the umpteenth time that day. Kate's eyes flew up to the monitor. "No change" said a nurse. Kate started desperately pumping again. "Please Jer… Please" said Kate becoming emotional.
Tegan wheezed and grabbed a hand full of sheets, her neck muscles straining as she struggled for air, her eyes wide with fear. Images started to get fuzzy. She squeezed Lindsey's hand as hard as possible. "Okay Tegan breathe now... breathe" said Abby looking scared. Tegan tried her best to breathe normally but she just couldn't. "Baby just breathe" cried Lindsey. Lindsey's words faded in and out and Tegan tried desperately to cling to consciousness. The images started getting more fuzzy. "More albuterol please" exclaimed Teddy. Tegan's eyelids were drooping and eventually closed as she gasped for air. "Tegan stay with me! You stay with me!" said Lindsey panicked. "Tegan open your eyes... come on open your eyes" said Teddy rubbing Tegan's sternum. Tegan didn't respond. "Bag her" said Teddy.
Tegan was suddenly back next to the lake... this time she didn't feel peaceful, she felt panicked. "No no no" she muttered. She looked up and saw Jeremy in the distance. "Jer" she shouted. Jeremy just smiled. "Jer come here" she shouted. "Jeremy are you okay?" she yelled and started running towards him. Jeremy moved further away from her, he seemed to be floating. No matter how fast she ran she couldn't reach him. "Jeremy... Jer don't leave me" she shouted and fell down onto her knees crying. Jeremy put his hand up and waved in the distance. "I love you Tee... your family needs you, go home" his voice said. Tegan didn't understand as he was far away but she heard him clearly. "No" she whispered. Jeremy smiled again. "I don't want to let you go" shouted Tegan. The next second she felt a sucking sensation and everything went black.
Kate was still pumping Jeremy's heart, desperately trying to restore a heartbeat. "Get me one amp of Epi with a cardiac needle" said Kate. A few seconds later the nurse handed Kate the syringe. Kate immediately plunged the needle directly into Jeremy's heart. "Come on Jeremy" she breathed as she pulled the needle out and started compressions again. "Get ready to shock at 20" she said. "We're charged... stay clear" said Owen. Kate took her hands out of Jeremy's chest cavity and took a deep breath. "Clear" said a nurse. The current coursed through Jeremy's heart yet again. Kate looked up at the monitor. The squiggly line was replaced by a flat one. "Asystole" said the nurse. "Dammit Jer I'm not giving up on you" said Kate loudly and started squeezing Jeremy's heart again.
Tegan's eyes flew open and she gasped. "Airways opening up again" said Teddy listening to Tegan's chest. "Welcome back, you gave us a bit of a scare there" said Abby. Tegan just closed her eyes and tried to normalise her breathing. "Pulse coming down a bit, 109. Sats up to 89%" said Abby. "Good, keep nebulising" said Teddy. "Hey Tee... it's okay honey... it's okay" cooed Lindsey. Tegan turned her head towards Lindsey and pulled the mask down with a shaky hand. "He's... he's gone Linds" said Tegan, tears rolling down her face. "No Tee, they're still working on him" said Lindsey. Tegan closed her eyes and her face was flooded with grief. "Stay calm Tee... breathe" said Abby.
"Still asystole" said Owen looking up at Kate. "How are you doing with that lung" said Kate still pumping. "It's as good as I'm going to get it outside of an OR" said Owen. "Come on Jer... we've fixed it... come on just beat... beat" said Kate. A nurse rattled off some blood test results. Kate shook her head but kept pumping. "Keep going" she said.
"Tegan he's going to be okay... just stay positive" said Sara. Tegan took a few deep breaths. "Vitals stabilising" reported Abby. "He saved my life" said Tegan pulling the mask away again. "What do you mean?" said Sara. "He... he jumped in front of me... that bullet was meant for me. He... saved my life" said Tegan softly. "Just close your eyes and relax now Tegan, you can talk about this later. Just take it easy" said Abby. Sara put both her hands over her mouth and nose and stared at Tegan looking pale.
Kate was still pumping, she looked at Jeremy's pale, bruised face with a breathing tube down his throat. "Give us something to shock Jer... you can do this" said Kate. The monitor's screaming sound pierced Kate's ears. "Someone turn that damn alarm off" barked Kate. "Let me take over" said Owen. "I've got it" said Kate looking up at Owen. "Let's try some atropine and a sodium bicarb infusion" said Kate. The nursing team immediately pushed the drugs into Jeremy. Jeremy's heart felt like a stiff balloon in Kate's hands. With every squeeze she felt her hope drown in fear.
Tegan's cubicle was quiet. Lindsey and Sara held her hands tight and Tegan stared into the distance in silence. "Hang tight guys, we'll know more soon" said Abby patting Tegan's thigh. "Your breathing's improved quite a bit. Sats are up to 95%. Good job. Abby, can you get Tegan cleaned up please?" said Teddy. "Sure" said Abby and left to go get some warm water. Nobody said a word until Abby returned with the water. "I'm going to give you some privacy" said Sara and moved to get up. "Don't go" said Tegan still holding Sara's hand. "Okay... I'll stay as long as you want me to" said Sara. "Alex and Erin arrived. They're with Sonia and the babies. We told them you're not ready for visitors yet" said Abby. "Thanks... are they okay? The babies?" asked Tegan. "Yeah, doc said it's okay if they go to sleep now. When I checked they were pretty close to nodding off. They're doing well. They're in good hands Tegan. They're going to be just fine" said Abby. Tegan nodded and Lindsey replaced her oxygen mask. Abby started cleaning the dry blood on Tegan's body. Tegan stared at the clock on the wall. Every second felt like an eternity.
"Dr Morgan, he's been down for 48 minutes... 25 of those in asystole. He's gone" said Owen. "Keep going" said Kate, never losing focus. Owen shook his head and watched Kate intensify her compressions. "Kate" he said softly, touching her shoulder. "I said keep going... let's have another dose of Epi and Atropine into the central line" said Kate loudly. Owen stared at her. "We were maxed out on drugs 3 doses ago Kate" said Owen. "Owen please... one last round" said Kate. "Okay... Let's have a last dose of Epi and Atropine" he said. Kate was sweating profusely. "Epi's in... Atropine's in" said the nurse. Kate kept pumping. "No change on the monitor... all vitals flat" said the nurse. Owen took a neuro torch and pried open Jeremy's eyelids. He swung the light in and out of Jeremy's pupils. He swallowed hard. "Pupils are fixed and dialated" he said softly. Kate kept pumping as if in some kind of trance. "Kate... You did everything you could. Let him go... You need to let him go" said Owen. Kate gave a few last squeezes before stopping. She held Jeremy's still heart in her hands and breathed fast. "I'll call it" said Owen. "No" said Kate looking up at the clock on the wall. "Time of death... 7.24pm" she said softly and removed her hands from Jeremy's chest. "Get him cleaned up. His friends may want to see him" said Owen. A nurse disconnected the ventilator from the tube in Jeremy's throat and another looked at the monitor's flat line before switching it off. Kate stared at Jeremy's open chest and slowly pulled off her gloves and her mask. She looked up at Jeremy's face, his mouth had a blue ring around it, his face pale. She softly touched Jeremy's stubble. "I'm so sorry Jeremy... I'm sorry I couldn't save you... You were a great man... rest in peace" she whispered, tears rolling down her cheeks.
A/N: I know you're all hating me right now. I'm sorry guys but that's life. Let's hope Tegan and Sara deal with this okay. Send me some feedback if you get a chance.