Disclaimer: I don't own ER, or any characters you recognise.
Hi all! Thank you some much for all the wonderful reviews! This is the final chapter of this fic, I hope you've enjoyed reading it as much as I have writing it!
I was going to post this last night, but my internet is being a piece of ****! Thanks for your patience.
Just to make this clear - I have no medical knowledge, just way too much time to search the internet. Sorry for any inaccuracies.
Enjoy!
It is three years before Ray returns to the ER, and no one is expecting it.
Neela is now a surgical attending, and due to a no show ER attending she is covering for the night shift. She is sitting tiredly at the admit desk with several other ER staffers, including Luka and Sam, when a call comes in over the MICN, Sam is quick to answer it. "County General."
A moment later the paramedic on the other end tells her. "We're bringing in an end stage ALS patient from Lakeside Hospice, difficulty breathing despite continuous bi-pap."
Sam sighs; they're already overstretched, and now they're going to spend the night keeping a terminal patient alive a bit longer, prolonging his pain. But none the less, she says. "What's your ETA?"
"We're pulling up now." Is the answer, and Sam, Neela and Luka rush out into the freezing night to meet the ambulance.
As Pickman and Zadro pull the gurney out of the back of the ambulance, Neela looks down at the patient as she asks the paramedics. "Do you have a name? He looks …familiar, maybe we've treated him before?"
For the first time in the run, Pickman actually takes the time to look at the chart given to her by the hospice, and as she does, her jaw drops, and she lets out a strangled cry. "Oh god."
They all look at her strangely, wondering what's going on. Zadro asks his partner. "Who is it Doris? What's going on?"
"His name's Dr Ray Barnett. He used to work here, right?"
"Ray?!?" Neela says, shocked as she leans over their patient, and sure enough, now she is really looking it is obvious to her, it's him, a lot thinner, weaker, but definitely him.
Luka takes control of the situation when it is clear to him that Neela can't. "Okay people, let's get him inside. Trauma two." He then looks down at Ray, and upon seeing that his eyes are open, Luka tells him. "It's alright, Ray. We're taking care of you."
Once they are in the trauma room, and initial vitals and labs have been done, Sam puts Ray's computer in front of him, giving him a means to communicate.
Luka asks her. "What's that for? There's no way he can type."
"It was sent in with him. There's a speech synthesiser program. You can try to find out his wishes, there's no DNR on file." Sam answers quickly before returning to her duties.
Luka and Neela sit down beside the gurney, and Luka starts of by asking a simple question. "Ray, do you know where you are?"
Ray blinks several times, and as soon as the computer starts a pre-programmed message, they know that he isn't lucid, his oxygen levels are too low.
While Neela stays at Ray's side, watching over him, Luka asks Sam. "Is there a next of kin to contact?"
Sam flicks through the file before she answers. "There's a pager number for his legal guardian, and a handwritten note to call his mother when he isn't expected to live more than a few more days."
Luka runs a hand through his hair. "Call both of them. Without a trach he probably won't live through the night."
Neela turns to them, and asks. "Well why aren't we doing a trach then? There's no DNR, we do everything we can."
Fair point, but. "You know how these cases go Neela. Very few patients actually want to prolong it by being put on a vent."
An hour later, Ray's stats have dropped to near non-existence, his guardian hasn't arrived, and Neela won't wait any longer. "We've got to trach him. We can't just watch him die!"
"I know, Neela." Luka reluctantly agrees before turning to Sam and ordering her gently. "Get a trach tray, and call RT for a vent."
By the time Kerry, Ray's legal guardian arrives from the airport, with Henry in tow, Neela has put in the trach, and Ray is connected to a ventilator.
She goes over to the desk, and nearly gives Frank another heart attack as she snaps loudly. "Frank."
Frank spins around, and looks at his former boss. "Dr Weaver? What're you-"
Kerry interrupts him by saying. "Where's Ray? Who's treating him?"
"Trauma two. Neela and Kovac just put him on a vent." Frank tells her, still slightly stunned by her reappearance.
Kerry swears under her breath, before she rushes towards the trauma rooms, pulling Henry behind her.
Neela is checking on Ray when Kerry comes through the doors at a near sprint, and demands. "What the hell are you doing?! He doesn't want this!"
Neela turns around, and looks at Weaver in shock as she says. "You knew?"
"Yes." Kerry says more softly, seeing the tears in her former colleague's eyes. "He got sick almost four years ago, asked for my help."
"Why didn't he tell me?" Neela says with a slightly hoarse voice.
Kerry sighs sadly as she says. "Ray didn't want to be a burden on you, he loved you. Look, I'm sorry but, why did you do a trach? He has an advanced directive. This is exactly what he didn't want."
Neela looks on the verge of tears as she says. "I didn't know. It wasn't in his chart."
Kerry mutters something that her son shouldn't ever hear her say, and then tells Neela. "The hospice has had a lot of new staff recently; these sorts of things keep happening …he didn't even want to be brought in." She pauses far a moment before she asks. "Please take him off the vent, this isn't what he wanted."
"His mother is on her way, once she arrives, and I see the papers, I will do it." Neela says sombrely, struggling to maintain some semblance of composure.
Kerry nods, and sits down beside Ray's gurney to wait.
Three hours later, the whole ER staff, everyone who knew Ray gathers in Trauma two as his mother arrives, and Neela prepares to disconnect the ventilator.
In the room, Neela looks to Kerry and Ray's mother for approval, and after seeing them nod, she injects a sedative to Ray's IV line before she turns to the ventilator, and shuts it off before turning back to Ray, and takes away the life persevering tubing.
Neela then kneels down slightly beside Ray, and runs her hand through his hair as she whispers "I love you, Ray. I'll never forget you." just as the monitors show a flat line.
Ray has died.
The End.
Thanks for reading, I hope you enjoyed it!
I'd love to hear your thoughts on the final chapter!
