A half and hour later Town was nudging Rick awake. "Rick, wake up man, the doctor is coming."
"Huh, Town, where are we, Oh," Rick took a minute to orient himself. A.J., overdose, hospital, screaming monitors. "A.J. is not dead?"
Town was relieved. The short nap helped Rick return to himself. "No, Rick, A.J. is still stable, but the doctor is coming to talk to you. I have to check in with Nixon at the station, I'll be around if you need me."
Rick stood as the doctor approached, "I want to see my brother!" He tried to speak with determination, but felt like all the came out was his desperation.
"Walk with me Rick; we have moved your brother to a room. I wanted a chance to talk to you before you saw him."
"What do you need to tell me?"
"He is still stable," the doctor told him as they stepped into the elevator. "I want to assure you that his condition should begin to improve rapidly before the end of the day but he is in critical condition so we are monitoring him in the ICU."
As the elevator doors opened to ICU and the doctor stepped out, Rick hesitated. He didn't want to know what his brother looked like in critical condition. He followed the doctor to the nurse's station. "Diane, did you check Mr. Simon's room for a chair?" The doctor asked the nurse behind the desk.
"Yes, I did" she replied and turned her attention to Rick. "I'll be the nurse monitoring your brother until 10:00. Please let me know if you need anything or have any questions." Rick nodded his thanks.
The doctor motioned to a room and they walked in together. For the second time that day Rick felt like he had the wind knocked out of him. A.J. was completely motionless except for the movement caused by the ventilator forcing air into his lungs. "Wha.. What… Why is he like that?" he whispered as the doctor guided him to sit in the chair. "I don't understand. Why.. How did this happen?"
"Rick, I will give you as much information as you feel comfortable hearing," explained the doctor. "It's up to you. I can explain everything that happened or just give you basic information about his treatment.
Rick didn't know if he wanted to hear it all. He kept hearing those monitor alarms. "I need to know. Give me everything, please, from the beginning. "
"Your brother arrived in the E.R., unconscious due to the seizure he suffered in the ambulance. We gave him a small dose of an anti seizure medication and a mild sedative but, as I explained, we were hoping to get blood test results before further treatment. The blood test did confirm he had been given PCP. Treating the symptoms of PCP overdose can be a challenge because it is both a depressant and a stimulant. A moderate overdose can cause an increase in heart rate and blood pressure. When you left his room in the E.R. we were dealing with that problem. We had to give him such high doses of tranquilizers that it started to affect his ability to breath and he went into respiratory arrest. At a higher dose PCP can depress breathing and lower heart rate and blood pressure. This started to happen as more of the drug was absorbed from his intestines. So both the drugs we were giving him and the PCP were now depressing his cardiovascular and respiratory systems and he stopped breathing. We knew that drugs that could bring his heart rate back up might set off more seizures so we decided to put him in a drug induced coma. This stopped the seizures, we were able to get him on a ventilator and give him medications that would help regulate his heart rate and blood pressure. Any questions?"
Rick sat with his head in his hands staring at A.J. He was afraid to ask but, he had to know for sure, "How long was A.J. without oxygen?"
"Oh, no, not very long at all," assured the doctor. "Let me explain what we are doing for him now?"
Rick nodded
"Once we bring him out of the coma most of these medical devices will go away. Right now the only medications we are giving him are the ones keeping him in the coma. If necessary we will give him something for his heart rate but, I think we are in the clear for that. We are monitoring his brain with an EEG to make sure he is stays in the coma until we are ready to bring him out. That will have to stay for a while to monitor for seizures. The ng tube in his nose is running into his stomach. We are giving him activated charcoal. This binds to PCP and helps move it out of the body. We are also giving him a nutritional liquid. We will stop that long before we wake him but, but leave the tube in until he is fully awake. The contraption on his legs helps prevent blood clots. They will deflate and inflate at set intervals to help A.J.'s blood keep moving while he is immobile. The cardiac monitor is watching potential heart damage. A.J. is young and in excellent shape so we are confident that his heart is fine. He is unable to breathe on his own right now due to the drugs we are giving him. The ventilator will be doing all the work until we start to bring him out of the coma and then it will assist him until he is breathing on his own. We will have to leave that on until he is awake for a while.
"Good luck with that – A.J. is the most stubborn man I know." Rick began to relax a bit as he started to understand what was happening to his brother.
The doctor grimaced, "We are going to have to put the restraints back on, not just so he doesn't mess with the ventilator but, we don't know what his state of mind will be."
"When do you expect to wake him up?" Rick asked.
"We won't leave him in the coma for very long. We will stop the drugs soon but, it will take a while for him to wake up. I can't emphasize enough that we expect your brother to make a full recovery but, we are dealing with a unique situation. If he was a regular drug user with a typical overdose, I could tell you what to expect. A.J. is not a drug user and he received a very large overdose. The only treatment we have is to continue to protect your brother's body from damage until the PCP is completely out of his system. He may have no more problems by tomorrow morning or he may have some symptoms that come and go for up to several weeks."
"I hope there isn't something he is holding back to make me feel better. Shoot I've been an investigator too long when I start suspecting the doctor of deceiving me." Rick thought. "Can I stay here with him?"
"A.J. may still be a bit agitated when we wake him up so it would be good for you to be here then but, right now I recommend you get some rest. He won't be moving for several hours."
Rick wanted to fight the doctor but, he resisted that urge, he was right. Rick hadn't slept in over 30 hours and he needed to make some calls. "Is there a place I can make a phone call?"
"There is a phone in the waiting room; you are welcome to sleep on the couch so you can stay close by. Don't worry; Diane will come get you if there is any change in your brothers' condition."
"Don't worry, that's all I can do is worry!" Rick thought as he walked to the waiting room