Grissom had been in surgery for nine hours and 40 minutes. Two hours into the ordeal, the lead doctor had come out of the OR to brief them on a litany of Grissom's injuries: severe concussion, broken left fibula, broken left radius, two broken ribs on the left and two on the right, punctured left lung, severe blood loss with some internal bleeding caused by his fall at the Firth home. All these things might have been survivable, even en masse.
"Our real battle is with infection," Dr. Roger Bly told them. "The wound in the left chest was caused by a sizeable shard of broken glass. It penetrated the chest wall and lodged near his heart. I have no idea where it came from."
"He was in the Lake Mead Rec Area, riding his bike," Brass said. "I suppose it could have been a piece of road debris thrown off somebody's tire."
Bly nodded. "What it is and how it got there are not my biggest concerns," he said. "The overt damage done by the glass wasn't that severe, relatively speaking. What the shard of glass carried into the patient's body is what's trying to kill him. A bacteria is at the core of all this. It got into his system and has affected every nick, cut and scrape he sustained in the fall. Most critically, it's affected his heart."
"How?" Sara asked. Her mouth was desert-dry and she was having trouble generating saliva.
"You all may know, you all probably do know, there are membranes surrounding our organs," Bly said. "The membrane that surrounds the heart is called the pericardium. When the pericardium becomes inflamed by a bacterial pathogen, the result is pericarditis. It is a rather easy situation to treat and control with the administration of antibiotics."
"Then Grissom's gonna be fine?" Nick said.
Bly tipped his head, a gesture of contradiction. "If left untreated, or misdiagnosed and mistreated, as it was in this case, simple pericarditis can escalate. Fluid begins to build within the pericardial sac, constricting the heart and causing severe pain radiating to the neck, the shoulders, the back, the chest, and so on. This is called purulent pericarditis. Even with proper treatment, the mortality rate at this point is between 40 and 75 percent."
Sara gasped. Bly wasn't finished.
"If the situation escalates further, into suppurative pericarditis, the mortality rate approaches 100 percent."
Sara felt Brass put an arm around her waist to support her.
"And this is where Grissom is?" he asked.
"He appears to be hovering in stage two, on the edge of stage three," Bly said. "I'm sorry. If he'd been brought in immediately, he'd be home right now feeling pretty good."
He paused, and Sara sensed there was more. She didn't think she could take any more.
"You know," Bly continued, looking directly at Sara. "I know Jim Firth. He used to be a good doctor, and I know his intentions were to help your husband. But everything he did was wrong. Little things. Big things. All mistakes that arise from not having current medical knowledge. Like taping broken ribs. We don't do that anymore because it can lead to serious pulmonary complications. Leaving that damned piece of glass in him. I don't know why he didn't put Dr. Grissom in a hospital immediately. This tragedy was so avoidable."
Sara swallowed hard. "So what are you going to do to help him?" Sara asked. She heard a demand for action in her tone.
"We're prepping him for surgery now. We'll insert a tube to drain the pericardial fluid and then begin direct intrapericardial injections of 250,000 units of Streptokinase."
"Did the antibiotics he got from that pseudo doctor do him any good?" Brass said.
Bly shook his head. "Not much. It was the wrong antibiotic in doses way too small. And the delay in getting the proper treatment, well, you know."
"What are his chances?" Sara asked.
"Poor," Bly said. "Approaching zero."
Sara felt Brass increase his support as she sagged. She accepted his help to a chair.
"So you're giving up," she said softly.
"Does it sound like we're giving up?" Bly said. "We're going to fight like hell for him."
Sara tried to smile but couldn't make those facial muscles work.
"But there's no hope," she said.
"I think we need to be realistic," Bly said. "But we never forget one thing. The only force that trumps hope is death. And we're not there yet."
xxxxxxx
When Grissom was settled into a bed in the Cardiac ICU, Sara was permitted to have 10 minutes with him. Nothing had changed. Not his condition. Not his odds.
What odds? What was less than zero?
A respirator breathed for him. One IV hydrated him. Another fed him. Another dripped a medical cocktail into his arm. A catheter ran from under the thin hospital blanket covering his lower body to a urine collection bag hooked low on his bed. Electronic pickups blossomed from patches dotting his body. Monitors beeped in cadence with the hiss of the respirator. And a tube that poked out of his chest worked to drain the hundreds of milliliters of pus that had pooled around his heart.
Sara groaned for him. She entwined her fingers through his and bowed her head.
"Oh, Griss, how did we come to this?" she whispered. "Why did we come to this? Everything about us was so right. So much promise. So much to look forward to." She felt a tear track down her face, saw it splash onto his arm. She willed herself not to cry. She wanted to stay strong and positive for him. If he could hear her, she didn't want him to hear sobs. She would cry in private.
She saw the heavy sterile bandage over his left breast and laid a gentle had on it. This was where it started, with a fucking piece of litter. Somebody drinks a beer, carelessly tosses the bottle out the window. It shatters on the pavement, begins to collect bacteria. And the next thing you know, it gets launched into her husband's chest and leaves him lying on the razor thin edge between life and eternity.
"Don't leave," Sara whispered to him. "I need you to stay. We haven't had our life. It's not your time. I love you."
It's not your time.
It's not your time.
I love you.
A nurse entered and quietly told Sara it was time for her to leave.
"I'm not going," Sara said.
"You have to, Mrs. Grissom. "He needs to rest."
"I really don't think I'm bothering him."
"It's the rules."
"I don't care."
"I'll get the doctor."
xxxxxxx
When the nurse found Dr. Bly, he was talking to Brass. The nurse explained the problem.
Bly shook his head and started to excuse himself. Brass stopped him with a hand on the arm.
"Let me tell you something about Sara," he said. "If she doesn't want to go, it's a fight you won't win if you try for the next five years."
"We could have security take her out," Bly said.
"But you won't."
Bly sighed deeply. "Of course not."
He turned to the nurse.
"Have an orderly put a cot in there," he said. "Her presence isn't going to hurt him any more than he's already been hurt. And maybe it'll help." He shrugged. "It's a stupid rule, anyway."
xxxxxxx
A/N: I know I've been posting so far without author's notes, and I intended to continue that, but I need to tell everyone something. There are two chapters remaining after this. One short and the other quite long. I hadn't intended to post everything today, but I'm going to because I won't be able to tomorrow. Rather than make you all wait until late Wednesday, I thought I'd just dump the rest on your heads today. I hope you don't mind. D;-