A/N: Hope you like this chapter, please read and review!
Chapter 2: Triage
7:00pm:
The ambulances were pulling up, sirens screeching, four in all. The emergency room doctors began splitting up into pairs for triage.
The doors popped open as Carter and Gallant approached, and paramedic Dwight Zadro rolled out the stretcher carrying the Secret service agent. "35 year old male, driving the vehicle. Passed out at the wheel, suspected MI. Cardiac arrest at the scene, but we revived him. BP's 90/70, pulse weak and thready. GCS 9."
"Get an EKG, CBC, chem-7, and page surgery. Elizabeth!" Carter yelled.
Corday jogged up as the stretcher was wheeled inside. "We may need to hold for the OR. Trauma one, let's go!" As Carter led the first team inside, Doris Pickman pulled Leo out of the second ambulance staffed by Weaver and Chen. "54 year old male, flail chest and head lacerations. May have a concussion, but he's responding well to stimuli and is showing signs of consciousness. GCS is 10, we have him on 100% oxygen. BP's 80/65, pulse is 70."
"We've got this one." Weaver told the female paramedic. "Chen, let's set up for a chest tube, then see if we need surgery. Let's also check his pulse ox the second we get him on a monitor. Trauma Two."
Meanwhile, Toby climbed out, and Lily approached. "Sir, can I help you?"
"Um.." Toby looked at his arm, which was drenched in blood. He couldn't help but remember the last time the staff rushed into an ER.
"Why don't you come inside and we'll get that stitched up?"
Lily gently led Toby inside as Kovac yelled, "I've got the next one." The doors pulled open, and Josh was pulled out on a backboard. Kovac didn't know it at the time, but it was a situation eerily similar to Rosslyn. "Joshua Lyman, 41 year old male, chest and back pain, possible broken ribs, history of chest trauma."
"Chest trauma?" Kovac repeated.
"He was shot in the chest about two years ago." said Donna as she was helped out of the ambulance by the paramedic. Kovac took a look at the young woman. She seemed to have bruises, but that was about all.
"Were you in the car?" She nodded.
"Are you all right?"
"Yes." Donna replied. All the while, they were pushing Josh's gurney into the now-chaotic ER.
"Let's get him to Exam 1. All right, why don't you have a seat over there, and someone will come find you when there's news." Abby said as she followed the gurney, directing Donna towards Chairs.
Meanwhile, CJ was pushed in, a splint on her arm, followed by Sam, who was holding a gauze pad to his head in an attempt to control the bleeding.
"I'm really fine." CJ insisted. "I need to make sure everyone else is OK. And I need to brief the press."
"I want to X-ray your arm. The press will wait." Pratt told her. "Frank, page Radiology. And what's open?"
"Exam 3."
"All right, let's move you. Mr. Seaborn, I'm gonna have Lily here take you over to Sutures, and someone will be in shortly to stitch you and Mr. Ziegler up." Sam nodded as Lily brought over a wheelchair, and CJ was pushed by Pratt over to Exam 3.
…
Trauma Two:
"Sir?" Dr. Weaver said, addressing Leo. "My name's Dr. Weaver, this is Dr. Chen, we're gonna take care of you. What's your name?"
Leo struggled to speak. "L-Leo...McGarry."
"Mr. McGarry, do you have any allergies to medications we need to know about?"
He shook his head.
"Do we need to intubate?" Chen asked.
"No, he's making good respiratory effort on his own. Set up for the chest tube. Mr McGarry, we're going to put a tube in your chest to hopefully help you breathe a little easier."
"Pulse ox is 91." Lydia reported after checking the monitor.
"All right. Mr. McGarry, this is going to be painful, but it's necessary." Dr. Chen said as she readied the chest tube. About thirty seconds later, they got the tube in, and Leo gasped and coughed.
"Good, good." Weaver said. "How does the ThoraSeal look?"
Chen held up the contraption responsible for gathering blood from the chest tube. "300 cc's."
"Sats are dropping." Lydia said, looking up at the monitors, which were now beeping rapidly. "Resps are up. He's in distress."
"All right, change of plans. 20 of etomidate, 100 of sux." Weaver ordered.
"We're gonna intubate?" Chen asked.
"No, you are." Weaver told her.
"Are you sure?"
"Yes. ET tube, let's go."
…
Josh was rolled into Exam 1.
"All right, one, two, three, lift." Kovac said as he moved Josh over, assisted by Abby and Chuny. "Let's order a chest film, blood gas, CBC, and cross table C-spine. Mr. Lyman, do you have any pain besides your chest?"
"Just my back." Josh explained. "Donna...where's Donna?"
"She came in with you?" Kovac asked. Josh nodded as best he could without moving his neck.
"She's out in the waiting room." Kovac assured him.
"Is she your girlfriend?" Chuny wanted to know.
"Assistant." Josh croaked out.
As Abby cut away his clothing, Kovac noticed that his chest had obviously been operated on. A long scar-telltale for open-heart surgery-extended down his entire breastbone.
"Mr. Lyman, have you had open-heart surgery before?" Donna's words as she had climbed out of the ambulance came flooding back to him: He was shot in the chest about two years ago.
"Rosslyn." Josh said quietly. The music and sirens in his head were growing louder.
Kovac leaned in. "What was that?"
"Rosslyn."
Suddenly, Kovac had a flashback to two years earlier. He didn't know too much about American politics back then, but he did remember hearing about the attempt on the President's life. And the critical injury of one of the President's senior staffers…
Suddenly, Abby turned. "Oh, my God, he's that Joshua Lyman." Abby remembered the events at Rosslyn, too, but hadn't put two and two together.
"Page Corday." Kovac told her. "He might need to be opened up just to check for damage." He knew that if the sternum was weakened, even minor bruising could re-damage whatever careful work had been done by the cardiothoracic surgeons in DC. "And maybe check with that assistant. See exactly what was done."
Abby nodded, then stepped out of the room.
…
Trauma Two:
Leo had been successfully intubated, and Lydia was checking his vitals.
"Blood pressure's up. Sats 95%. He's stable."
"Okay, let's get a CBC, chem-7, chest film, and run a crit. Does he have any family?" Weaver ordered.
"Um...I'm not sure. I can ask around. All the guys in the ER know him." Chen responded.
"Go see if Dr. Corday's available, or if she went up with the guy in Trauma One. I want Surgery to evaluate."
Suddenly, Lily walked in. "I need someone in Sutures to stitch up the two walking wounded."
"Go, I've got it from here." Weaver urged. Chen hesitated, then nodded and followed Lily out to Sutures.
"Just be forewarned, these two are sniping at one another about something. It's going to be quite interesting." Lily told her. Chen pushed open the door to find Sam and Toby going at it.
"I'm just saying, education is the silver bullet, Toby." Sam told his friend, while holding a fresh gauze pad to his head.
"I understand that, Sam, but that does not mean that we have to spend the entire campaign harping on something that the President's not going to get to for two years anyway." Toby shot back, a pressure bandage on his lacerated arm. "And I certainly did not expect to hear the President raving about an education plan that we don't even have yet!"
Chen sighed. This was going to be very interesting. "Evening, gentlemen, I'm Dr. Chen. I'll be taking care of you…"
…
Abby walked into Chairs and located the blonde woman she had seen earlier. "Are you the woman who came in with Joshua Lyman?"
Donna, looking very worried, stood up the second Abby walked into the room. "Donna Moss. Is he OK?"
"He should be fine." Abby reassured her. "I just have a question for you."
"What is it?"
"Do you know the extent of his injuries at Rosslyn?"
Donna's eyes widened. "You know about Rosslyn?" She didn't think Josh would've been able to tell them.
"To be honest, I remember when it happened, but I didn't put two and two together until a few minutes ago."
Donna nodded. "The bullet punctured his lung and damaged his pulmonary artery."
"All right, I'll tell the doctor. They may need to do exploratory surgery and make sure nothing was damaged."
"But he's going to be OK?"
"That's the hope." Abby replied. She looked at Donna curiously. "So, you're his assistant?"
Donna smiled softly. "Yes, for about five years now. Why?"
"Nothing, just curious." Abby said, shaking off her gut feelings that told her there were more than platonic feelings between the woman she had just met and her patient. "I'll keep you updated."
Just then, the women's conversation was interrupted by a group of Secret Service agents who entered. Ron Butterfield led the pack.
"What in the world?" Abby muttered, more to herself than anybody else.
Abby walked over to Frank and Haleh as the Secret Service was beginning to clear the Admit area. "Do you know what's going on?"
Haleh shrugged. "Your guess is as good as mine. I was working here after the guy in Trauma One went up to surgery, and the Secret Service guys came in here and said they needed to seal the entrances."
"The only time they ever do that is when-" Frank started.
Just then, the doors opened again, and a group of agents came through the doors, with two very famous people in the middle.
Abby's mouth dropped open slightly. "Is that the…"
"President of the United States." Haleh finished, a little shocked.
…
Jed Bartlet strolled into the waiting room, and walked right up to the woman that Abby had just been talking to. Donna, she thought her name was.
"Are you all right?" he asked her.
"Yes, sir." Donna told him.
Abbey Bartlet, meanwhile, had marched right up to Frank. "Can any of you tell me the conditions of my husband's Senior Staff?"
"Um...ma'am, Madame First Lady, I don't quite know what everyone's condition is, but I can certainly find out."
Abby watched with amusement as Frank tripped over his own words. He was completely starstruck.
Finally, Abby decided to save the poor man from further embarrassment. "Dr. Bartlet?" she said, hoping she didn't sound as nervous as she felt and praying she got the First Lady's title right.
"Yes?"
"Abigail Lockhart. I'm the Nurse Manager here in the ER."
"Nurse Lockhart, it's a pleasure." Abbey said, sticking out her hand. "What are the odds I meet someone with the same name as me?"
"The honor's all mine, ma'am. Aside from a couple of exceptions, most of the victims suffered minor injuries. Two are being stitched up, one's got a broken arm," she read off the board, "and the other three are being treated for more serious injuries."
"What other injuries?" Abbey asked forcefully.
"The driver of the car's going up to surgery for a suspected MI. Leo McGarry's being treated for a flail chest."
"Is he intubated?"
"Appears to be." Abby replied, craning her neck to look into Trauma Two. "That reminds me. Dr. Weaver, his doctor, was wondering earlier if he had family."
"A daughter, Mallory. She lives in DC, I can get you the number. We've known the McGarrys for years."
"Yeah, actually, that would be great."
"Now, what about Josh Lyman?"
"He's being x-rayed now. I can have Dr. Kovac, his attending, come and speak with you." Just then, she noticed Corday walking into Josh's room. "Why don't you have a seat, someone will be out shortly." She wanted to clear up the surgical aspect of Josh's case before worrying anyone.
"Thank you very much, Nurse Lockhart."
"My pleasure, Dr. Bartlet, ma'am." She showed Abbey into Chairs. Donna stood up right away.
"Hello, Dr. Bartlet."
"Are you all right, Donna?"
"Yes, ma'am."
"Donna, why don't you get something to eat? It might be a while still before we know anything." The First Lady suggested gently. Abby watched with interest at the level of concern the President and First Lady had for the young woman.
The younger woman hesitated, then nodded, walking over to the vending machines.
"Wait." Abby said. She had noticed something. Abbey Bartlet also looked concerned.
Donna spun around. "What is it?"
"Are you limping?"
"What?"
"Are you limping?" Abby asked a little more firmly.
"I-I must've twisted my ankle in the accident. I'm sure it's fine." Just then, Donna's foot gave out, and she ended up on the floor.
"Okay, I want you to get x-rayed. Frank, bring me a wheelchair." Abby called out.
As Ron Butterfield (who had heard the collapse) and Frank helped her up and into the wheelchair, Donna couldn't help but shake her head in disbelief. How did she not realize that her leg was injured?
A/N: And there's chapter 2! As I said before, this story is not going to be very long, maybe 3-4 chapters. Hope you enjoyed this chapter!