5

Shell-shocked

Peter's blood pressure was up again at 70 to 50 as they arrived at the hospital six minutes later, at the same time as unit Four Charlie. They were met by a full trauma room staff at the doors of the emergency entrance, while Anne and Nicholas wheeled their patient into the cardiac room, CPR still in progress.

Suddenly, they had several people helping them to wheel the stretcher, hold the IV bag, and ventilate. Seeing that Hesam had more assistance than necessary now, Karen peeled off to help Nicholas and Anne. The doctor who took over the ambu-bag from her was Dr Rossi, for which Hesam was grateful, because she was a hands-on, no-nonsense sort of person. There were far too many ER doctors who coped with emergencies a lot worse than any paramedic, but Laura Rossi was not one of them.

"What have we got?" Dr Rossi asked Hesam, as they rushed Peter inside.

"Witnessed shooting while on scene," Hesam told her, running along with the stretcher. "Two bullets, one to the shoulder, one to the abdomen. Fourteen gauge in both ACs; we got about 800 ml of Ringer's into him. At least 1.5 to 2 litres of blood loss. Hypovolaemic shock, entered ventricular fibrillation seven minutes ago, shocked into asystole, back in sinus rhythm after one round of epi and atropine, last BP reading 50 systolic. Lung sounds are good, no intubation attempted."

She peered beneath the abdominal pads covering the wound in Peter's stomach. "That the exit wound?"

"Yeah, it was at close range; both bullets went through."

She nodded. "Did anyone get his blood type?"

A nurse at the head of the stretcher answered, "Yes; B negative."

"I want a CBC and blood gases done. We'll just do an ultrasound scan; there's no time for a CT. Thanks," she said to Hesam.

They were in the trauma room, where he helped transfer Peter to the table before the staff descended on him. Hesam was gently ushered out again, so there he stood in the corridor, still soaking wet from the rain, his jacket caked with vomit and blood, feeling as if someone had suddenly pulled a plug from his brain.

At some point – it might have been a minute, or twenty – Karen walked up to him, and hugged him.

"Nick's gone back to get our rig on Eldridge," she told him. "I'll do the cleanup in yours, OK? Can I leave you with the paperwork?"

Hesam nodded numbly.

She hugged him again. "You did great," she told him. "You did everything right. Don't forget that."

He nodded again. Then he remembered something else.

"What happened to our patient?" he asked. "Our – other patient?"

"They called him dead on arrival. They never got a rhythm back." Her look was apologetic, although Hesam hadn't expected the man to survive. For just a fleeting second, he wondered what would have happened if they'd just left the Chinese man there on Eldridge, scooped up Peter, and run. But then he had to concede it wouldn't have mattered much. Maybe he'd just have held off coding until the trauma room.

Karen waited before going on, "And I guess Simon would appreciate a 'sorry' at some point. He worked like a mule back there, and he's pretty pissed at you."

Hesam blinked, as if he saw her there for the first time.

"Karen – I'm sorry," he said weakly.

"I said Simon. I can deal with being called an old woman. Mainly because I am." She gave him a tired smile and gently slapped his shoulder. "I'll check back after I've finished. To see how he's doing." She jerked her head to the closed trauma room doors, then looked him up and down. "You might try to clean yourself up a bit."

Hesam smiled lamely. "Yes, Mom."

She squeezed his arm again, and turned to go.

He was reluctant to leave, fully aware that Peter might code again in there any second, even if he told himself that there was nothing he could do if that happened.

After a while, he finally went to the EMT room, stuffed his jacket in the laundry, washed his face and hands, and got a fresh shirt from his locker, then sat down at the table with his run form, mechanically filling in the information.

Pt. 28 y/o male, cauc., multpl. ballistic trauma, 1 GSW to shoulder, 1 to abdomen.

Hesam put down his pen and rubbed his eyes. He'd written hundreds, maybe thousands of run reports. He had never written up any that had sounded so wrong.

Hesam was back in the corridor on his way to the trauma room at a quarter to seven, after finishing and handing in his run form. As he approached, he saw that the doors were open, and an icy feeling washed over him at the thought of what this could mean.

He'd seen it before – the ones that had been beyond his ability to save, left on the operating table under a blanket, IVs withdrawn, tube still in place, monitor switched off, the very image of failure. He almost ran the last ten yards until he could see inside.

Nobody was there. There was blood here and there on the operating table as well as a few spatters on the floor, next to medical wrappers and other debris strewn over it. The trauma room looked every bit as the back of an ambulance after a trauma call. The operating table was empty.

This was good news, Hesam told himself, even though the queasy feeling in his gut wouldn't go away. It had been little more than half an hour since they'd rushed Peter in there. Even in a worst-case scenario, if he'd coded again that very minute and hadn't been brought back, they'd still be working him. They hadn't called him. They couldn't have.

He half-heartedly looked around for someone who could tell him more – half-heartedly because he still wasn't sure he wanted to know what had happened.

A nurse came past and saw him standing there, and was kind enough to explain. "They've taken him up to the surgery ward, five minutes ago, I think."

"You know anything else?"

She shook her head. "I'm sorry. But if he's up there by now and not down here, that probably means he's haemodynamically stable, at least."

He thanked her, and took the elevator up to the surgery ward. He was quickly told which operating theatre Peter was in, and settled to wait in another corridor, before another set of doors.

Hesam leant against the wall, then sat on a chair, got up again, walked back and forth a couple of times, and sat on the chair again, only to jump up once more several minutes later. Over the last sixteen hours, he'd taken a couple of naps in the driver's seat in between calls but hadn't slept otherwise. Still, although his eyes were burning with tiredness, and the bunkroom beckoned, he knew he couldn't have slept now.

It was the pointlessness of it all that got to him most. Those guys in the car had gone to great lengths to kill a man who had been almost dead anyway, and had possibly killed another just trying to help, whose only mistake had been standing in the way.

If he'd been religious, he'd have prayed. Being rather scientific-minded, he mentally went through the numbers. Peter had been gone for thirty-five seconds. Half a minute of oxygen depravation, alleviated at least slightly by CPR. In all likelihood, not enough for brain damage, so if he survived, he'd stand a chance of a full recovery. Only 10 per cent of asystolic patients made it to the hospital alive. Of those, statistically, only every third would make it out again. 50 per cent of patients coding once coded again later, with the chances of surviving dropping drastically.

Looking at it, being religious probably would have been the smarter choice.

No, he told himself. Peter wasn't a statistic. They'd taken some rather aggressive measures to compensate the blood loss, which had been the reason for the cardiac arrest in the first place, and with his blood pressure up again and stable now, he'd pull through.

He had to.

After about an hour, Hesam realised with a start that their shift was over. It was hard to imagine it had only started sixteen hours ago. He experienced a very brief, very remote moment of uneasiness at the idea that he probably should have gone out there again, or, at least, asked permission to head in, until he realised he couldn't have – it must have taken Karen ages to clean the rig.

Word had gone round that one of the paramedics attached to the hospital had been shot while on duty, and at irregular intervals, Hesam was joined by other personnel, mostly EMTs and paramedics in between calls, or a couple of nurses, sharing his lonely watch for a few minutes. None of them spoke much, conversations usually being limited to "Anything new?" – "No," accompanied by a pat on the shoulder. Anne Kraszewski was there at one point, as were Karen O'Neill and Nicholas Greentree and Jerry DuPont. Simon Blumenthal was nowhere to be seen.

After a while, however, he found that the "no" turned into a hopeful "no" rather than a foreboding "no". If Peter hadn't died yet, there was an increasing chance he wouldn't. At least that was what Hesam told himself.

He kept oscillating between the chair and his spot at the wall, walking back and forth between them, sometimes sitting, sometimes leaning, without really noticing what he was doing. In the ambulance, at least, he had been able to do something, had reeled down a routine that he had worked a few dozen times. Here and now, there was nothing at all he could do, and he felt utterly useless as well as helpless. There was a clock on a wall in a corridor around the corner, but after a while, Hesam didn't look at it any more.

The doors finally opened at a few minutes past nine. Hesam caught a glimpse of Peter, pale, unconscious, with an endotracheal tube in place, being wheeled past on a gurney. While this meant that he was alive, the tube, at least, was not a good sign, as it meant that they didn't trust him to breathe on his own yet. Hesam cast a helpless glance after the knot of people around the gurney, and then intercepted one of the nurses exiting the operating room.

She recognized him, so, thankfully, didn't need much persuasion to tell him the details. "He's stable," she said. "He sustained damage to internal organs, and the ruptured vena cava probably was what gave you the greatest trouble, but surgery was successful, though he'll need a CT scan and probably another surgery later. Dr Byrd decided to keep him on mechanical ventilation for the time being. Hopefully, he'll be able to do without by tonight."

"Any – signs of permanent damage?" Hesam asked.

She shook her head. "It's too early to tell," she said sympathetically. "We'll soon know."

"Where are you taking him?" Hesam wanted to know.

"Intensive care. – That's down on level 2," she added, with a slight smile at his expression. "I thought you worked here."

"I don't work here. I work out there. Unless my partner gets shot, all I get to see of this place is the ambulance bay, the ED, and the crappy soda machine in the EMT room."

He regretted his tone instantly, thinking of the way he'd treated Simon, and wondered how many of the Mercy Heights personnel would still be talking to him after today.

She told him she needed to be off, and left, but at least he was under the impression that she was giving him credit for an extremely stressful day.

Hesam remained in the corridor for another couple of minutes before he finally took the elevator down to level 2, and spent some time finding the right department. He didn't go into the room where Peter lay, but took some comfort simply watching Peter's vital signs on the monitor through the Plexiglas window for a while. They looked a lot better than they had at any point in the ambulance.

"Hesam?"

Hesam turned at the sound of a female voice, and saw Emma Coolidge coming from the elevator, her eyes wide as she hastened towards him. She cast a look through the window and turned back to Hesam. "Nurse Zhao just told me. You were there, weren't you? What happened?"

Hesam gave her a short account, but left out the details, such as Peter vomiting on him. These things were between patient and paramedic. Or, in this case, between partners.

"Did they get them, do you know?" Emma asked quietly when he had finished.

It took him a second to even understand the question. He had never wondered who the men in the pickup and been, or whether they'd been caught. It was an aspect of his job that simply didn't matter. What mattered was getting injured people to the hospital alive. And more often than not, he transported the bad guys just as he did the good guys, and simply didn't care which was which, because it was inconsequential for the task.

"I have no idea," he said truthfully.

Emma looked through the Plexiglas again. "Will he be OK?" she asked.

He was a medic, she had a degree in medicine, so they both knew that the answer wasn't that easy, but all he did was nod, and she didn't ask further.

"Did someone call his family?" she wanted to know.

Hesam cast her a puzzled glance. The thought hadn't even occurred to him. There was so much about the aftermath of an emergency that he'd never had to deal with. "Do they normally do that in triage?"

"They should."

Hesam had only met Peter's mother once last summer, when she had planned to meet him after work, only to find out that, just because a medic's shift ended at seven, it didn't mean he was free at seven. That night, it had nearly been half past eight. She'd never tried again.

Emma looked through the window uneasily, but didn't speak. "Hey," Hesam said, "I'll go ask if someone called, OK?"

She showed no reaction, and he mentally kicked himself. He gingerly tapped her shoulder, and repeated his words as she turned to face him.

Emma nodded, and looked him over. "You look terrible," she said.

Hesam gave a hollow laugh. "Why, thanks."

She shook her head. "I mean, how long have you been up?"

Before he could answer, he saw her glance past him at the corridor with a strange expression on her face, and turned to see what had distracted her.

Obviously, Angela Petrelli had been informed. She looked very composed as she approached, hardly any different than the only other time Hesam had met her, as if there was no difference in waiting for one and a half hours for her son to come off shift – or coming to see her son in Intensive Care after having been shot. Hesam felt uneasy around her, although he thought that it might have something to do with some remnants of Peter's blood and puke remaining on his pants and shoes. The same could not be true for Emma, but Hesam got the impression she was even less comfortable with the situation than he was.

Emma wished Angela Petrelli a very quick good morning, murmured that she needed to be at work, and excused herself, hurrying back to the elevators. Hesam awkwardly shook Angela's hand. He wasn't quite sure if she even remembered him. He wanted to tell her something reassuring, but there was nothing he could think of – recounting the whole story to Emma had been bad enough; Peter's mother was the last person he wanted to tell about the ordeal her son had just been through.

To Hesam's relief, she didn't seem to mind when he left her there, alone with her son.

He tiredly walked back and took the elevator down to ground level. Nurse Hammer was in there when he entered, and she gave him a sympathetic look and a pat on the shoulder.

He went back to the EMT room without really knowing what to do there. The room was empty. Hesam got himself a cup of coffee, drank half of it, and tipped the other half into the sink. He started slightly when he saw a diluted blood smear on the white ceramic surface, and scrubbed at it until it came off.

It could have been anyone's, he told himself.

He stood there for another quarter hour before he finally told himself to stop. It wouldn't help Peter if he kept prowling the hospital, waiting for news he didn't want to hear. The best news here was no news at all. Judging by the sympathetic glances and words he'd been given in the last few hours, he felt fairly sure someone would at least text him if something happened.

And he didn't think he could stand another pat on the shoulder.