LEDGE
Chapter Three: Medical Assist
Kirk's cries of agony could be heard increasing in volume as his body began materializing inches above the glass flooring.
His distorted leg was angled up above the rest of his body, but as soon as his full form materialized, the leg, and his body, came crashing down against the glass. He landed roughly in a side lying heap with a pile of rocks and thin branches raining around him.
Scotty shot to a stand from his station and stared, horrified, at his captain on the deck.
As soon as he hit the floor, Jim cried out, clutching at his thigh as the crew watched a concerning amount of blood began spraying through his fingers. His ankle and knee were clearly dislocated, warped several degrees in the wrong directions, and his face was bleeding from two major abrasions. Coupled with the puddle of blood rapidly pooling on the pad and his torn up hand, it wasn't a sight for the weary.
"Oh my God." Uhura covered her mouth and took a hesitant step towards Kirk, as did Spock.
"Don't touch him!" McCoy shouted before they could move in, pushing between them headed straight for Jim.
Kirk cried out again, squeezing his eyes tight against the pain coursing through his leg and hip. He held the pressure as strong as he could but he knew it wasn't going to be enough.
"I need medical assist down here, now!" McCoy shouted beside Jim, crashing down on his knees and instantly reaching for Kirk's thigh. "Jim."
"Copy, Doctor." Matthews batted at the line and immediately established the connection.
"Letgo, letgo, letgo, let me do it." The CMO shoved Jim's hands away and placed his own down against the rapidly bleeding out limb.
Jim's head lolled on the floor miserably before the broken man refocused back on his leg. His eyes widened in fear when he saw how much blood was still flowing from his body despite McCoy's help. He numbly reached out towards him, clamping onto the man's cuff sleeve.
"Bones…"
Leonard snapped his gaze down to meet Jim's anxious, half lidded eyes.
"I know, you're okay. Just stay still." The doctor tried to soothe him, but he could not hide the fear in his own voice.
Bones spun to look behind him without moving his hands.
"I need that med kit!" He barked in the direction of the discarded kit before turning back and pressing harder against Jim's leg.
Kirk couldn't help but shift away from the doctor's pressure as he growled in pain, turning his face down into the deck floor.
"I'm sorry kid, I know it hurts. Just stay still… don't move."
The CMO did a brief sweep of Jim's body and his eyes scrunched in empathy.
Jim's face was cut up, with various patches of blood splattered about it. There were signs of deep bruising along his left cheek bone beneath his pale and clammy skin as well. He moved his gaze down to the man's right hand and saw it was completely peeled open, the top layers of skin torn away leaving it raw and exposed. Damn it, Jim.
Spock ran up the steps and grasped the kit, gliding over towards the duo at once. He shifted the open pack next to McCoy's knees, then locked his stern gaze on Jim.
The CMO knew Jim's blood pressure was tanking rapidly and he needed to start fluid resuscitation attempts now if he didn't want his vitals to crash all together.
"Spock."
The first officer locked his eyes on the doctor.
"Load one of those blue vials labeled 'Hyp Sal.' Open the dial all the way and inject it into his neck. Do it now."
The Vulcan wasted no time and expertly pulled out the correct tube and snapped it into the cartridge. He leaned over his captain and pressed the medication into his exposed neck.
Jim didn't even flinch as the aerosol hissed.
McCoy cursed to himself as his spiking adrenaline hammered his heart into his chest. Jim's blood was rapidly pooling between his fingers now. This method was not going to work much longer, he needed help.
"I need my med team here now before he bleeds out on this deck!"
"They're on their way, Doctor." Matthews relayed helplessly.
McCoy tried to reposition his hands to better control the bleeding, but that prompted a cry from Jim. The man reached and clasped onto McCoy's wrist while recoiling his hip away from the doctor.
"No Jim, stop moving! I know it hurts but I can't let go. I'm sorry, you have to stay still, just stay still…"
This isn't working, he's in agony. Jim continued to shift under his hands.
"Spock! Hold him down. He's gonna bleed out in a second if he keeps moving like this!"
The Vulcan instantly closed the small distance, kneeling down and pinning Kirk's hip and rib cage to the floor with impossible strength. Spock's fingers were spread out to cover more surface area and he could feel the spaces between each of Jim's ribs as his chest cavity expanded and depressed at a rapid rate. The first officer then looked down at the growing pool of red blood spreading out across the pad.
"He has an arterial bleed." Spock stated as he stared at the widening crimson puddle in shock.
Hazel eyes flicked up at the Vulcan's.
A silent plea ghosted in the air between the two commanding officers over the sheer seriousness of the situation before McCoy finally spoke. "Just don't let go."
"I will not." Was the curt response before they both looked down at the struggling man beneath them.
Leonard's brow furrowed as Jim continued to groan in agony underneath their restraining hands. The doctor snapped his head back to the transport station.
"Matthews, comm my team and tell them he's got an active arterial bleed. He's also got multiple leg fractures, some compound. Tell them to run." He reported, spinning to look into the med kit beside him.
"There's not a vascular regenerator in there, is there?" McCoy's eyes darted over the various items in the small kit. As badly as he wanted to give his friend a hypo filled with an incredibly strong pain killer, every vile in the set was useless due to Kirk and his stupid allergies to everything. Uhura stepped forward and fumbled through the contents. "I'm not seeing one." She stated causing Leonard to curse and shut his eyes in frustration.
He looked back down at his side lying friend.
Kirk's fight had faded substantially in the last few seconds, distressingly so in fact, despite the intense pressure the doctor was applying to his warped thigh. He had lost too much blood already and he was starting to lose consciousness now. No! This can't be happening –
"Hey! Hey now… Come on Jim, stay with me." Bones ordered loudly, trying to rouse his friend back to awareness. Jim batted weakly at McCoy's arm and sleeve as he moaned in pain, his face still pressed into the floor. Not a good sign.
"Your kit's on the way. I'll get you something for the pain in a minute, just hang on." McCoy glanced down at his hands which were stained red and then trailed his eyes to the deformed leg in front of him, still tangled securely in a root. He shook his head in disbelief.
But when he looked up, he let out a breath as his med team came sprinting through the transporter doors towards them.
"He needs pain control, now." The CMO ordered immediately. Christine Chapel was the closest and she was also holding Jim's specific med kit filled with hypos that would not throw him into anaphylactic shock.
Spock instantly released his hold on Jim's side and stepped back to allow the med team to converge on their fading captain. Jim let out a painful gasp when Spock released him.
Christine crashed down next to McCoy and snapped the kit open as she loaded a hypo with a pain reducer first. She wasted no time in stabbing it directly into Kirk's carotid before withdrawing and loading the second.
M'Benga bumped up against McCoy's side holding the lifesaving vascular regenerator in hand.
"I need to know his vitals, he's at least in compensated shock by now. Prep an IV bolus and run two lines. I already pushed a full dose of hypertonic saline."
Leonard watched Chapel load the second hypo before he felt a weak hand wrap around one of his wrists.
"Bones–" Kirk groaned out from below him, finally turning his face away from the floor to peer up at his friend.
"Hold on." McCoy shook his head to stop Chapel's movements as he stared down at Jim. My God, he looked so young in that moment.
"Y-you can fix it, r-right? The leg?" He gasped outas.
Leonard bent in closer to him, he could tell Jim was scared and it made his chest swell with the need to comfort.
"Ya, Jim. It looks worse than it is. You're gonna be okay."
He wanted to say more but they were already short on time as it was. McCoy turned to Chapel and gave her a nod before locking his eyes back on Jim's. "We're gonna put you out now, I'll see you when you wake up."
The hypo was pressed into Kirk's neck and instantly his eyes sagged before drifting closed.
The fight in his body finally let go as his hand thumped to the floor and his torso uncoiled. The root and dry branches crunched as his leg fell down a few inches towards the floor but luckily, the medical team was there reaching for the limb as their captain lost his fight with consciousness.
"He's out."
"Heart rate is 160, BPs 70/40, resps 32."
"Skin is cold and pale, he needs fluids, now." M'Benga stated as he lifted one of Jim's eyelids up and assessed his pupillary response while doing a quick visual exam on the man.
"Copy, bleeder first. Once he's stable we need to check peripheral blood flow before we move him anywhere… we'll reduce here if we have to." The CMO directed. The med team confirmed their agreement and continued to work to stabilize Kirk.
"If you're squeamish, get out." McCoy disclosed courteously as he snapped his eyes over to meet his colleague's. "You ready?"
M'Benga nodded as he readied the vascular regenerator.
"On my count then. One, two, three."
He removed his hands just as a spurt of blood shot through his fingers and M'Benga instantly activated the life saving device. The artery began to close and the skin reconnected around the fracture site, albeit disorganized and disjointed. Once the bleeding was under control, M'Benga proceeded to wrap the limb in a thick, white cloth, covering the wounded area for now until they could properly repair it in the operating room.
"Boss, he's tachycardic. BPs 60/40 and falling."
"Alright, let's get his pressure up. Flush him with fluids, tell me when his BP starts to rise."
McCoy had been handed a fresh pair of gloves which he quickly donned as he slid up to assess Kirk's obvious femur fracture. "Check distal pulses, tell me if you find anything." He was worried about his friend's vascular compromise as he was handed a scanner.
Bones hovered the diagnostic scanner over Jim's leg, starting at his ankle and went up, listing off the abnormalities he could identify as he saw them. The list was extensive.
"He's got a mid-shaft tibfib fracture and dislocation with syndesmosis injury… Obvious tibfemoral dislocation, all four ligaments look ruptured, potential peroneal nerve injury."
Well, so far not so good.
McCoy shook his head as he rose up to Jim's hip. "And I count one, two, three… three pelvic fractures, no obvious hemorrhaging, and a hip dislocation."
Jim's pant leg was being cut open to expose the horrid fracture sites and Scotty had to get up and leave.
"'M sorry laddie, I cannae watch you go thru this." He shook his head and was gone in an instant. Uhura followed him out. They cared immensely for Jim and the outcome of this situation, but they were not medical providers, and they did not have the stomach's for this gruesome of a procedure.
Spock remained with Giotto as the rest of the room emptied, leaving them two and the medical team behind to work.
"Doctor, BPs starting to respond, 68/44, resps holding at 30."
M'Benga moved down to assess Kirk's shin and ankle while McCoy surveyed the femur break.
"How's it looking down there Jeff?" The CMO questioned while manipulating Jim's pelvis and recently dressed arterial bleed, making sure everything was stable.
"I can set the mid shaft dislocation but I'm gonna let you do the ankle." He responded after prodding around a bit. There was no room for egos nor mistakes in a trauma situation, especially because this was their chief in command on the floor, and Jeff delegated his abilities accordingly.
McCoy nodded. "Alright, let me set the femur first, then you set the midshaft fracture. We're risking some serious nerve damage here the longer we let these proximal breaks sit so let's get them set and get him into the OR stat."
"Doctor, I'm not feeling any distal pulses, popliteal is weak at best." A nurse reported after several attempts of searching for the minuscule beats around Jim's foot, ankle, and knee.
"Alright, check it again after each fracture has been reduced." He responded simply.
"BPs up to 74/50."
The medical team just followed McCoy's lead; they trusted his expertise profoundly.
Bones placed his hands expertly around the warped femur and ordered one of the nurses to provide some traction just above Jim's knee. He skillfully applied pressure and wrenched his hands violently as the limb lopped back into a seemingly normal alignment. The sound had been disturbing, but it was done.
Bones stood up and let two nurses file in beside him to stabilize Jim's upper leg with several splints as he moved to Jim's foot that had just been de-booted.
One down, two to go.
M'Benga went through a similar procedure as he placed his gloved hands on either side of the warped shin. He yanked at the extremity until the ends of the fracture lined back up again. "Proximal tibfib's been reduced, check distal pulses."
Leonard was assessing the ankle dislocation as he scanned the limb for any arterial occlusions. He determined he could set it but shook his head in dismay. "Damn it Jim, what a mess." He mumbled to himself.
"What about the hip dislocation? Want me to take a look?" M'Benga asked as McCoy prepped to reduce the warped limb down by him.
He shook his head no.
"I don't want to risk dislodging a possible unstable pelvic fracture without eyes in there. We'll reduce the hip in the OR."
M'Benga nodded back before turning over his shoulder. "Prep the board for transport, we're almost ready."
Bones took in the bluish tinge of the foot and the white colored skin above the dislocation. Jim had been talking with them for several minutes before they got him beamed up, and was unconscious for a few minutes before they even made contact. The longer that limb went without blood and oxygen, the more tissue death there would be and the more permanent the damage became. He had to hurry.
McCoy checked for pulses in the foot once more, confirming there were none and tightened his hold on the joint above and below the damage. With the aid of two nurses, the CMO was able to reduce the ankle back to a seemingly normal alignment, his toes now parallel with his shin versus out to the side.
"Alright wrap it and let's move him! His hip and pelvis need to be stabilized tightly."
The team worked swiftly as they moved in with the backboard. Jim was tipped up onto his side towards his injured leg while the board was moved in behind him. Bones kept a strong hand on Kirk's shoulder and neck while he helped position the backboard and then rolled his friend gently back onto the stretcher.
"Let's go!" He shouted and the team lifted and sprinted out of the room towards Sickbay, headed straight for the operating room.
All he could see was darkness.
There was a gentle beeping off to his right that was increasing in volume as he climbed closer to full consciousness. His body felt heavy, and frankly, beat to freaking hell. He could feel tightness along his hair line with a dull pulse thumping beneath.
Stitches.
He gently wiggled his fingers on his right hand and felt a similar tightness with an incessant burning sensation along his palm. His ears were throbbing and his eyelids wouldn't open when he tried to lift them.
As Jim's memory began to de-fog, his heart jumped as he recalled the frightening fall he had taken. He thought he was going to die. Yet here he was, alive and kicking…
Jim shot his eyes open and lurched up to a sitting position, instantly looking down at his legs. The sudden movement caused him to gasp as he pulled at all the cuts and sore muscles littering his body.
"Jesus Jim!" Bones shot upright from the chair he was lounging in and locked a falling Jim between his hands, one hand on his chest, one on his back.
Jim's eyes had scrunched shut as his equilibrium shifted and his breaths instantly became rapid.
"Hey, calm down, you're alright, you're on the Enterprise."
Kirk's vision wouldn't clear fast enough though, and he made a desperate reach for his leg, fumbling and tapping at where his thigh should be. Bones instantly understood the man's panic and moved in closer to his captain.
"Your leg's fine, we repaired all the damage, now lie back." McCoy shot his eyes to the monitor with the rising vitals before locking them back on his captain. "Jim, you need to take some breaths for me."
There were rushing footsteps and shifting of surfaces, but Kirk was not satisfied. He continued to fumble over the sheets as he panted, unable to find the leg he was promised was there. His vision wouldn't clear either which made his heart rate spike in his search for it.
"Doctor McCoy?"
"I got em, prep 5 CCs of Haldol."
Bones wrapped an arm behind Jim's shoulders and supported his body to his chest.
"Jim, just breathe." He reached his left hand down and quickly picked up Kirk's fumbling hand, leading it instantly to the dressed thigh and pressed it against the limb.
"See? It's right there. Feel it? You feel it?"
"Haldol's prepped."
Kirk's breathing quieted for a moment as his fingers tentatively curled into the tender flesh that was indeed his leg. His vision began to clear after he got some fuller breaths in and he locked his eyes down to the sheets.
"You see? Good as new." Bones kept his hand firmly against the back of Jim's, helping the man curl his fingers around his limb and slide it down towards his knee. Jim calmed further, slowing down his desperate breaths as he allowed his body to lean heavily into the doctor's supportive posture.
Jim huffed out, scrunching his eyes shut in pain as his body melted into the CMOs hold. Bones let go of Jim's hand and slid himself out from behind Kirk's now pliable body, guiding him onto his back again.
"You okay, kid? You with me?" Bones reached for the monitor and saw the improving but still altered vital signs blinking wildly above him.
Jim shifted his shoulders to his left and reached down to touch his leg again. "Hurts." A smirk pulled at the edges of his lips and he chuckled weakly.
Leonard's brow furrowed before he moved in close to Jim and lifted one of his eyelids, checking for a pupillary response. Jim grimaced away from the light. "I'm gonna up your pain meds now. You still dizzy?"
Jim chuckled again, his eyes stayed shut as his body grew more tired. With effort, he worked to scrunch his toes and to his utter delight, the piggies curled. Jim groaned at the pain that shot through his leg before closing his eyes and settling. Another smile pulled at the corners of his mouth.
"Thank God." He whispered as he began to drift off.
"You're a sadist." Was the CMOs response, but Bones knew why Jim had said it, and it had nothing to do with the amount of pain he was in.
"You're not the only one that's good at their job. Have a little faith." Bones patted Kirk's chest before brushing a hand through his hair to clear his eyes from the golden locks. He helped settle him on his back, propping the leg up with two foam pillows.
Jim yawned before cracking his eyes open and locking them on his friend's. "Thanks Bones." Was all he could muster before sleep took him under.
The nurses had left at some point during the exchange once they saw their patient had indeed calmed down.
Bones simply nodded as he settled himself back into the side by chair, picking up his PADD and tossing his legs up on the edge of Jim's biobed.
He exhaled as he took in Jim's still form on the bed in front of him.
"I'll be here when you wake up."
END