Author's Note: Hm, I'm a bit taken aback that this story's already been favorited a few times, when I've only posted 2 chapters out of 6. It may have started with action and a murder mystery, but this is, as I've already stated, a story that centers on medicine, and definitely isn't a fluffy one. This isn't one of those "Pepper playing nurse, Tony being grumpy" fics. But hm, I think this chapter pretty much makes that clear, anyway, so on with the story.
3.
Beep - click - click.
Beep - click - click.
Beep - click - click.
The sounds pervading Tony's slowly waking mind were a combination of familiar and alien.
The first time he actually woke up, he was so convinced that he was still paralyzed and suffocating and dying of the shrapnel sinking into his heart that he just panicked instantly.
He fell asleep almost instantly, too. Drugs could do that to you.
The second time he woke up, he knew he wasn't dying, he wasn't paralyzed, he was breathing on his own, and someone was holding his hand. It had to be Pepper, because it was her voice that kept repeating that it was all right.
He felt much better than before - of course, anything felt better than dying. His chest still felt wrong, both painful and strange.
Cautiously, he opened his eyes. He had never thought he'd be relieved to be able to do that.
His entire upper body was covered in bandages, but something was missing. The glow of the arc reactor would've been visible, had it been there. How the hell was he still alive?
"Tony, just take it easy, you're safe, everything's all right," Pepper was telling him, although there was a strange note in her voice.
Ignoring her, he raised his head to get a better look at his chest.
He saw no less than four blood-colored plastic tubes sticking out of the bandaging below the arc reactor's socket. They lead in pairs into two similarly colored, round devices of some sort lying on his stomach, which were the source of the clicking sounds imitating a heartbeat.
He let his head sink back to the pillows.
This was like waking up in the cave, only it was even worse, if such a thing was possible. The same way the assault had been like Obie's earlier attempt to kill him, and still completely different.
He had to be dreaming, the whole thing must've been a nightmare from the beginning, but he could see and hear and feel it all and it seemed far too real.
He retched, though he couldn't actually get anything out, and realized he was panicking again.
Before he knew it, they had put him under once more.
The third time was the charm, because he already knew what was coming. Pepper was still there, and the scary-as-hell extra plumbing was still on - and most likely in - his chest.
"Hey," he said.
Pepper squeezed his hand a little tighter. "Hey. Welcome back."
"I'm not sure I'm really back," he answered.
She studied him for a while, her face unreadable. "Of course you are. You're alive, you made it, and you're safe now," she recited, sounding like she was trying to reassure herself as well as him.
Tony lifted his hand to touch the tubing in his chest. He was pretty sure the crimson color wasn't just a part of the design. "I'm not sure I'd call this 'alive and safe'. Pepper, I need to know, how bad is it this time?"
"If you feel up to it, I could fetch the doctor, she knows better than I do."
"Go ahead. I'm as ready as I'll ever be," Tony said.
That wasn't entirely true, of course. He felt far from ready. He felt like he'd rather take another tranq shot and go to sleep than hear that he had a week left to live and that he was going to spend it tied to this bed. He also knew that waiting longer wouldn't help at all, so he'd just have to face it. He'd probably need that tranq shot afterwards, anyway.
His new attending was a woman in her early fifties, with graying chestnut hair, lean and even taller than Pepper. An interesting-looking woman, if a bit old, definitely a strong eight.
"Dr. Walton," she introduced herself, and shook his hand. "Glad to see you're feeling better, Mr. Stark."
"Yeah, I'm not dying or having a panic attack right now, I guess you can call that better," Tony answered her sarcastically. "Give it to me straight up. What's happened to me?"
"After that chest device of yours was removed, the shrapnel penetrated your heart. We managed to remove all the shrapnel and repair most of the structural damage, but unfortunately, that wasn't enough. To put it simply, this episode, on top of all the previous trauma you've suffered, left your heart too weak to beat on its own."
"Which means that this Frankensteinian setup is...?"
"A biventricular assist device. BiVAD, for short. Basically, it takes over for your heart. Without it, you'd be dead in a matter of minutes."
"I could've guessed as much."
Like the arc reactor, only far worse, more restrictive and disabling. Useless, except for keeping him alive. This wasn't like Afghanistan. There were no bad guys to fight, no suit to build, and there would be no heroic escape this time. He was completely dependent on outside help. His chest was shrapnel-free, but his heart was in shreds. Talk about irony.
He took a few deep breaths, gathering the willpower to ask the rest of the questions he needed to, as much as he dreaded the answers. "What's the prognosis? Am I permanently stuck on life support? How long have I got?"
"The VAD you're on right now is meant to be temporary, from weeks to months, but there are similar devices designed for permanent use. Those could give you a year, even longer. Of course, you wouldn't be able to return to all your previous activities, and there's a significant risk of complications. Your best hope for a more-or-less complete recovery would be a transplant."
All right, that wasn't quite as bad as he had feared. At least he had options. Or rather, he had an option, because living the rest of his shortened life as an invalid wasn't one he was going to consider. Either he got a new heart, or he'd never wear the armor again, which would mean that he could just as well be dead.
"So, a transplant. How do we go on with that?"
"You can leave the details to me. There are several things that need to be checked before we can get you on the transplant list, and you'll be interviewed by a few people as well. I've got to warn you, though: the number of patients needing a new heart is far greater than the amount of donor hearts available. The waiting time can be long."
That wasn't what he wanted to hear. If his only option was an unlikely one, what was the point of clinging to life like this?
"Do whatever you have to, Doc. I'm just going to panic now," he said, and gave in to the wave of despair and disbelief, which drowned him completely and left him gasping for air.
He could hear the doctor calling "Mr. Stark!" and Pepper shouting "Tony!" and the beeps and clicks all messed up, and hands were grasping his and cupping his face, but soon enough, he felt the already familiar effects of some friendly sedative dragging him back to sleep.
Pepper almost wished she could do like Tony, have a life-threatening bout of panic so that someone would have to put her to sleep. But no, as the only one of the four of them still on her feet and at least physically healthy - she would no longer vouch for her mental health - she had no choice but to keep going.
She had dealt with the media, giving out vague news that Tony had suffered a cardiac event of some sort, and was out of action indefinitely. She had dealt with S.H.I.E.L.D. as best she could, which meant that she had delegated the task of dealing with them to Rhodey. She had sat by Tony's bed and talked things through with his doctors. She had barely eaten or slept. Every time she closed her eyes, she'd wake up from nightmares where everyone around her was dying. She hadn't even returned home since the night Tony had been attacked, three days ago. Even though it wasn't a long distance to drive, she had chosen to stay at a nearby hotel instead, just in case.
At least Tony was finally lucid enough to talk. Still, seeing him had been emotionally so draining that she wondered how she'd be able to gather the strength to return to his bedside. Dr. Walton had said that he would sleep for several hours, and she was glad for that.
Her feet carried her to Rhodey and Happy's room - with Tony in the ICU, she'd been able to arrange things so that Happy had taken Tony's place in his previous room.
It was actually soothing to see the two other men after Tony. After all, they were both getting better, and both were probably in a better mood than she was, these days. Out of the two of them, Happy was most likely going to be the first to be discharged. Even though Rhodey's injuries were older, they would take longer to mend.
"How was he?" Rhodey asked cautiously, when Pepper had sat down heavily in the chair between his and Happy's beds.
"Better, in the sense that he wasn't dying or having a panic attack - that's what he said himself," she said, and sighed. "Of course, he did panic when he heard the details about his situation. He's asleep again."
"I guess he's not going to be able to give any details about what happened anytime soon, then," Rhodey said thoughtfully. "I just got a phone call from a S.H.I.E.L.D. agent who asked me about it. They also had news about that explosion at Stark Industries."
"Oh? What kind of news?"
"Tony was right, it was definitely sabotage. They found traces of some really exotic explosive from the wreckage. They're also convinced that this murder attempt and that explosion are related."
"Sure doesn't take a rocket scientist to figure that out," Happy commented. "What about that Arctic incident?"
"That was a month ago," Pepper said. "And wasn't it due to the weather conditions? Tony was flying in the middle of a blizzard, after all."
"Actually, Happy, you could be right," Rhodey said. "It wasn't all about the weather. He had a faulty thruster, and he was never able to figure out what had went wrong with it."
"So, someone's been trying to off the boss for a month. Is he even safe here?" Happy asked.
"If he's not, then I don't know where he'd be. There are four guards posted at his door, twenty four seven. There's a list of hospital staff who are allowed to see him, and they always need to show their ID. No one else gets in," Pepper listed. "If you can think of any ways to make the arrangements better, let me know, and I'll see that it's done."
"I'll think about it," Happy said. "Does S.H.I.E.L.D. have any leads on that son-of-a-bitch who did this?"
Rhodey shook his head. "I'm afraid not. They've checked all the security camera data, and they have clear pictures of the man, but they haven't been able to identify him. That's really weird, because they should know every single person in this country."
"If Tony could tell something..." Pepper suggested.
"It might help. You could ask him the next time he's awake?"
"I'm not sure that's a good idea."
The truth be told, she was sure it was a bad idea, but she wanted that sick bastard caught and punished for what he'd done to all of them, so the next time Tony was awake, and she was there with him, she tried to ask him about the assassination attempt.
All he managed to tell her was that the attacker had been a man about his age who had introduced himself as Dan. As soon as he tried to go into detail about what had happened, he started getting so agitated that she had to grab his shoulders and yell at him to stop thinking about it. At least they didn't need to sedate him this time.
She kept him company until late in the evening, and he seemed to be doing better. She offered him the arc reactor back. He didn't get worked up about it, just shook his head and told her to keep it.
Things only went wrong when she decided to leave for her hotel room. She said "Good night, Mr. Stark," and all of a sudden, he grabbed her hand in a vice-like grip, gasping, his eyes wide, asking her to swear she'd never, ever say that to him again.
Nevertheless, when he had calmed down and she finally did leave, she walked to the hotel feeling cautiously hopeful. Maybe he would be back to his old impossible self, sooner or later. She was actually able to catch a few hours of sleep that night.
Over the next few days, Dr. Walton set the transplant process in motion, and Pepper could see Tony growing more hopeful, too. She was amazed at how placidly he took the battery of tests they needed him to go through as a part of the process. Then again, she knew how hard it was for him to be this dependent on others. The idea that he could be back to normal someday seemed to make his life worth living again. There were no more panic attacks, and he even cracked a few jokes about the admittedly grotesque-looking life support system he was on.
Six days after the murder attempt, Pepper was sitting in the cafeteria with Happy, who was still in the hospital, but already on his feet, when Dr. Walton called her, and said that they needed to talk immediately.
"Bad news, I'm afraid," the doctor began straightforwardly, as soon as Pepper had entered Tony's room. "There's no way to sugarcoat it: the transplant committee has decided not to list Mr. Stark as a candidate for a heart transplant."
"What? Why?" Pepper said, dumbfounded.
Tony was just staring at the doctor, a look of utter disbelief on his face.
"A history of substance abuse, a way of life that's unsuitable for a transplant recipient and is unlikely to change, and a clearly unstable psychological profile."
"That's ridiculous!" Tony spoke up. "Substance abuse? They only give hearts to teetotalers?"
"Mr. Stark, there's a difference between a drink every now and then, and drinking that's heavy enough to show up in liver function tests. You may not accept the fact yourself, but you're borderline alcoholic."
Tony didn't seem to be listening to her at all, although he was staring at her with a look that Pepper could only describe as murderous. "An unsuitable way of life and an unstable psychological profile... Bullshit!"
"Mr. Stark, you've got to understand, the way they see this, the risk that you'll end up getting yourself killed or seriously injured again is too high. Looking at your medical history, that's not an unreasonable concern. They simply can't afford to give you a heart, when there are so many others who need one, and are far more likely to live long, happy lives."
"But... But that's..." Pepper stuttered. "How can they do this? This is Tony Stark we're talking about, for God's sake! Iron Man!"
Dr. Walton shook her head. "Being a celebrity doesn't earn him extra points. Neither does money."
"You never even mentioned that this could happen," Tony said, the anger on his face slowly giving way to despair.
"I never said it was certain that you'd get listed. I expected you to understand that the tests and interviews could reveal something that would disqualify you."
"You should've just let me die."
"Please, Mr. Stark," Dr. Walton said quickly. "This isn't a death sentence. There are other options -"
"Which might give me an extra year as a cripple? I don't care. I don't want to live like this."
"Tony, you should listen to the doctor," Pepper tried.
"You know, Mr. Stark, most other people who are on a VAD are immensely glad to be alive. For someone saved from certain death, you sure seem ungrateful," Dr. Walton said. She was starting to sound angry as well, her professional manners cracking for the first time since Pepper had met her.
"I should've died in Afghanistan a year ago," Tony said, his voice flat. "I've been living on borrowed time ever since - and now I'm not even living anymore."
Tony was breathing hard, and Pepper half expected him to start panicking once again, but instead, he just shook his head in a resigned manner, lay back on the pillows and closed his eyes.
"Just leave me alone. Both of you," he said.