Author's Note: I couldn't leave you with too terrible of a cliffhanger, so you will get the what, but you must wait for the why. Mwahahaha. Plus, the why may or may not be worse than the what. Stew on that! :p
Notes on this chapter: Still Hank's POV for this, since Evan can't really have a POV on anything if he's unconscious, can he? And the idea for Evan's ailment is inspired by a true story (dont' worry, not, like, me or anything - it's not that true).
Happy reading! Ciao, bella.
Hank
Jill meets us in the ER ambulance bay as we unload Evan from the back of the truck. She is shocked to see him on the stretcher, and looks at me with concern. "Hank, Divya called ahead and said you were bringing Evan in. My God, what's wrong with him?"
I explain as best I can while we move, "He's been suffering from back pain for about a week. I treated it as a pulled muscle, but he started bleeding internally this afternoon. I don't know if he further injured himself somehow, like if he fell, or if it just began spontaneously from something else. I have no idea how much blood he's lost, but he's been unconscious for about fifteen minutes now… not reacting to stimuli…"
I help the orderlies swing Evan's stretcher around the corner to the trauma room, but just as I am about to follow through the doors, Dr. Blair, the new chief of the ER, steps in. "Dr. Lawson, we've got it from here – you'll have to wait outside," she says tersely. Turning to a nurse, she gives her orders. "Prep the OR, and call Dr. Kirkland to scrub in. Let's evaluate where the bleed is."
"I want to stay with him," I say firmly.
She shakes her head, unmoved. "That's not possible and you know it. We'll be moving him to surgery in a moment-"
"I can assist, I can monitor his vitals, administer the anesthesia-" I begin to catalogue the duties I could potentially do in order to earn my way into the operating room. I will literally do anything. Anything but sit on my ass while my brother fights for his life. She will have none of it though. I really get the impression she doesn't like me very much.
"You are not employed here Dr. Lawson; you do not have privileges at this hospital," Dr. Blair says firmly. "And that applies now more than ever."
"Dr. Blair, he's just -" Jill begins, but I already have words pushing out of my throat.
"He's my brother!" It's all I can think to say, though unfortunately it comes out much louder than I meant it to. Yelling probably isn't the best way to get what I'm after. But he is my brother. Obvious, yes, but it's the best argument I have.
Dr. Blair responds with equal vehemence. "Precisely! You are the family of the patient – your place is in the waiting room." She lowers her voice a little. "Dr. Lawson, I understand how upset you are. I really do, and I sympathize. We will do everything possible for your brother. But you, personally, are in no condition to be his doctor right now. You're going to have to wait out here. The last thing I want to do is call security on you while a member of your family is in crisis. Please."
Her 'please' is what defeats me. I know all her reasons for keeping me away. They're all sound reasons, and if I was in her shoes I would be saying the exact same thing to the wacko older brother of my patient, even if he did have a medical degree. There's a reason doctors are discouraged from treating their family members - we're too emotionally involved, and we lose our objectivity. My shoulders slump, and I take a few steps back. Jill moves along with me, and once Dr. Blair is convinced of my submission, she turns and pushes through the doors.
Jill and I stand in the hallway together. I feel her hand on my arm, I feel her begin to pull me in the direction of the waiting area, and I hear her speaking, calm and low. "Come on, Hank. Let's go sit down, and you can explain what happened. Just breathe." My feet move, but my eyes are still on the doors. I don't want to go. I promised I'd fix him…
"What if he dies?" I whisper. I didn't want to say it out loud, for fear it might be one of those self-fulfilling prophecies. If I didn't acknowledge it, it wouldn't happen. But since I'm no longer the one in charge, no longer the one doing the saving, my head has been roughly jerked out of the sand.
"He won't," Jill says reassuringly.
"He could…" I swallow. "I didn't treat him for the back pain until today. He was walking, he was okay – just an occasional spasm. I should have taken care of it when he first presented the symptom a week ago-"
"Hank, how on earth would you have known this would happen? Pulled muscles don't cause internal bleeding! You couldn't have predicted it."
"But why did I wait? He said he was fine…"
"That's why you waited. Neither of you thought it was anything big." She grabs my shoulders and makes me look at her. "Hank, Evan will make it. He's young, and he's strong and healthy. He will survive this."
"I can't lose him," I say, my voice cracking all around my larynx. The thought of an Evan-less world terrifies me. I'm on the verge of tears. "I heard him on the phone – he was so scared, and he was in so much pain… I could barely listen to it without screaming along with him. I don't even know how long he was suffering like that before my father got there and called me."
"Your dad is the one who found him?" Jill asks, surprised.
I nod numbly. "Yeah, I was out with Divya… seeing patients. We still had one more stop we were planning on making before we went home."
"Thank God your dad was there."
I freeze. I had never thanked God for anything regarding my father before in my life. I bristle at the idea. Why on earth should I-?
Suddenly I feel like a bucket of ice water has been thrown on me. I was so ready to blame Eddie for Evan's sudden illness based on assumption that I purposely ignored the biggest concrete truth of the entire situation: Eddie was the one who called me. Not Evan, because Evan couldn't, because he was physically unable to find a means of communicating his distress to me. Evan would still be lying on the floor in the guest house right now, and I would probably be just now leaving my last client of the day, if Eddie had not been there.
"Hank!" Jill and I both turn and see Divya and Eddie walking briskly towards us.
"What's the word?" Divya asks, pursing her lips together tightly after she speaks.
"They're moving him to surgery," I say, my eyes on Eddie. I'm trying to read him, analyzing every blink, every swallow, every word he says and their inflections.
"Did they find out what's wrong with him?" he asks me, furrowing his brow.
"No, not yet. They're probably going to go in, find the source of the bleed, fix it, and then do an exploratory to get samples to test and see what caused it."
Eddie reached up and rubbed his face with his hands tiredly. "God… I was not expecting this today. I didn't know what I was going to do." He pauses and looks at his hands. I see that they are trembling a little bit. "I'm actually shaking. I've never seen anyone in so much pain before-"
"What were you even doing at the guesthouse in the first place?" I break in, looking for at least one answer.
"I… I just wanted to see if Evan wanted to grab a late lunch. I tried calling his cell phone to let him know I was coming, but when he didn't answer I left a message. Then, I thought I would just drop in since it was on the way. You boys never lock the door, so I just kind of wandered in and… and there he was, just lying there… I didn't know if he had fallen, or if someone had broken in and attacked him… you boys really should lock the door at that place…" he trails off, as he sees me taking deep breaths. I'm shaking too, my hands squeezed into fists at my sides. He looks at me warily, like he expects me to punch him in the face the way I did a few weeks ago the first night he 'just wandered' into Boris's guesthouse.
"Do you know what you've done?" I ask in a quiet voice.
I can feel Eddie immediately tense up, and with an insulted fervor in his voice, he retorts, "Hey, now you wait just a minute here! I know you hate me, Henry, but you can't pin this on me. How dare you! I didn't DO this to Evan, I had no idea-"
"You saved his life!" I interrupt.
He wasn't expecting me to say that. Hell, I wasn't expecting to say that either, especially given how I felt when I first saw Evan unconscious on the floor with him nearby. He was fully prepared to have it out with me on who was to blame for Evan's illness, believing that I was accusing him of causing the whole incident and indignant that I would have the gall to say so to him. So upon hearing my declaration that he is the reason Evan is still alive, Eddie is stunned into silence, then he stammers, "N-no… no, I didn't. I didn't do anything… only what you told me on the phone… I'm no doctor, I-"
"If you hadn't been there… if you hadn't found him when you did… Eddie, I wasn't headed home yet. By the time I would have gotten there, he… he would have already bled to death…" My voice breaks. My hatred is just futile now. I've been loathing every minute of his presence in the Hamptons, in Evan's life. But the fact is, if he hadn't been there today, my brother would never have made it to the hospital alive. He would have died there on the floor, alone. I can't run away from it. Against every feeling and opinion I have of my father, I suddenly find myself embracing him tightly as tears finally erupt from my eyes. "Thank you… from the bottom of my heart, thank you…" I can barely get the words out as my defenses come down and I just… break.
I feel my father's arms reach up, a bit hesitantly at first, then tightening around me as he realizes I am not pulling away. "Ssh… it's going to be okay, son… he's going to be okay…" I hear him whisper, though I know he isn't confident. He was there after all. For the first time in twenty years, he was there... and he saw it all.
What follows are the longest four hours of my life.
I sit dumbly in my chair, utterly drained. Divya has been calling our clients with appointments for the rest of the week, either rescheduling them or getting a referral for them. Dad has called Mrs. Newberg and told her about the situation, and I wonder how long it will take before the gossip begins. Between her and her circle and all the clients Divya is calling, it won't be long before the better part of the Hamptons knows that Evan R. Lawson, CFO of HankMed, the doctor's brother, nearly died today.
Jill has instructed her assistant to call her the moment Evan is out of the OR. Once that happens, she will personally take me back to the recovery ward to see him. I'm the only one who can get away with it, since I am both Evan's emergency contact, physician, family, and his medical proxy. I'm itching for that moment, even though I don't know whether he will be able to talk, or even if he will wake up at all tonight. Of course, this might all be moot if Evan doesn't survive the surgery.
Finally… finally… at about 8 PM, Jill is paged to the nurses' station. She answers the call and I look expectantly at her. As soon as she hangs up, she returns. I stand up quickly, as though I was in court awaiting my sentence. Dad and Divya have joined me, and all three of us seem about ready to jump out of our skin. Please let Evan be alright…
Jill smiles. "The surgery just finished. They're moving Evan to the recovery room right now. From what I gathered, it went very well."
"Evan's still with us?" Eddie asks, determined to get her to say the actual words.
"Yes sir, he's alive, and he came through it beautifully."
I had no idea that the three of us had such massive lung capacity, because we all simultaneously let out a huge breath we've been holding, possibly since we arrived. The sudden burst of exhalation sounds overly loud, and we all giggle a bit nervously, giddy with the influx of new oxygen. "What happens next?" Dad asks.
"Well, he'll be monitored in the recovery room for about an hour or so, make sure he's weaned off the anesthesia properly, and then he'll be moved into the ICU. Hank, we can go back to the recovery room right now." She looks apologetically at Dad and Divya. "I'm sorry guys, but you'll have to wait just a little longer. Once he's settled into his room, you'll be able to visit for a few minutes, though I should tell you he might be pretty out of it for the next few days."
I am anxious to go see my brother, but as I see my father sink into his chair and put his face into his hands, murmuring "Thank God… thank God…" over and over, I pull myself back for just a moment and kneel in front of him.
"Dad…"
He lifts his face, his eyes rimmed with red, startled by my closeness. I continue, "He made it."
He nods and gives me a teary smile. He places his big, warm hand on the back of my neck. "He did, didn't he? Go on, get on back there," he smirks a bit. "You know you're dying to… I'm fine, I just need a... a moment to compose myself. You know, I'm going to need a stiff drink when this is over." I return his smile. God, I think I'll need one, too. Or five.
Jill escorts me into the recovery room. Just outside, there is a tall, blond doctor in scrubs giving instructions to two nurses. "Dr. Kirkland!" she calls, and he looks over to her. Kirkland. That's the surgeon's name Dr. Blair had spoken of. "Dr. Kirkland, this is Dr. Hank Lawson. He's the brother of your patient," she pauses and Dr. Kirkland holds out his hand. I see he's been sweating. I hope the perspiration stains are from the long hours and the surgical activity, not from… stress.
"Hank Lawson of HankMed, eh?" He smiles at me. "I've heard of your concierge business."
"How is Evan?" I ask immediately, not particularly wanting to get into the specifics of my business. I think many doctors at this hospital frown on the sort of thing I'm doing, since it takes patients away from them. If he has any ill feelings towards me for my job or my clientele, I'd rather not know about them until after I get an update on Evan's condition.
"He's doing well. He's very lucky to be alive." Don't I know it.
"Can you tell me what happened? Where was the bleed?"
"It appears one of his adrenal glands ruptured."
What? "WHAT?" I'm completely aghast. Holy hell. I was not expecting that. I'm absolutely floored. "How did that happen?" Glands don't just rupture on their own... lifting a golf bag wouldn't do this.
"Well, we're working on the whys of it. We removed the gland entirely and sent it to pathology. I put a rush on the labs and the bloodwork; hopefully we'll have the results for you by tomorrow morning."
My relief has been almost completely dissolved by confusion and more worry. "What about his kidneys? Are they ok? The renal artery wasn't damaged by this was it?" I realize I have never done the various tests required to see if Evan and I are compatible matches for organ donation. We're the same blood type, so I can always give blood or a lobe of my liver, but the kidney criteria are a little more complex. I thought about it once, when I first began med school, but I dismissed it with the assumption that of course we were matches for each other – we're brothers, aren't we? But sometimes siblings aren't compatible donors. I should have made sure years ago – it's the responsible thing to do…
"Dr. Lawson," Kirkland says, attempting to get my attention again. "Of course, we'll be monitoring his kidneys carefully over the next few days, but so far they are both functioning fine. The renal artery was not damaged."
"Oh, thank God!" Ok, then… but the minute we're out of the woods I'm doing those tests.
"He's stable now, and we're transfusing him one more time to be safe before we move him to the ICU."
"One more time? How many transfusions has he had?"
"I think it adds up to about twelve units of blood given while he was on the table." My jaw drops. Kirkland says it so casually, so matter-of-fact. How can it be so easily described, when that amount of blood is enough to refill Evan's body nearly one-and-a-half times? He lost that much? Kirkland rubs his face. He appears exhausted. "I tell you, it has been a long while since I've had to do an operation like that. When I opened him up, it looked like a shotgun wound in there." I blanch further at that. Good God. Just… geez.
Jill sees how discomfited I am, and steps in. "Thank you, Dr. Kirkland. We appreciate the information."
I shake myself out of my thoughts – thoughts centered on blood that should have been circulating in Evan's body properly but somehow stepped out of bounds – and offered my hand one more time. "Yes, Doc, thank you so much."
He offers me another smile, and says, "It's my job. I'll be in early tomorrow to check him, and hopefully I will have those lab results for you. Then we'll get Evan on the road to recovery. The worst is over." He casually claps me on the shoulder, and steps away.
Jill brings me to the curtained area where Evan has been deposited after his surgery. "I'll let you two have some privacy," she says gently.
"Hey Jill, will you tell Dad and Divya everything's ok? I'll tell them the gory details as needed, but you might want to explain the rupture to Divya so that she knows what's going on. My father won't understand all of that, so let me explain it to him myself."
"Sure thing."
"And, um… don't mention the whole "like a gunshot wound" metaphor…"
"That's probably best."
I pull the curtain open and step over to the bed. Evan looks even worse than I expected. His skin is impossibly pale, his lips only slightly pinker than they had been in the ambulance. He looks as though he has literally been bled dry. Which he sort of has. His body appears a bit swollen from the fluids various tubes are providing. It's not alarming, but on Evan's slight frame, the puffiness is definitely noticeable. But he is breathing evenly with the help of the nasal cannula's oxygen, and the wires connecting him to the machines monitoring his temperature, blood pressure, heart rate, and morphine level produce reasonable numbers and signals. For the moment, at least, does not appear to be in any pain. That will all change, of course, as the anesthesia begins to wear off. I sit down and reach for his cold hand, absently massaging his fingers to warm them up. I'm mentally perusing all my medical books, recalling everything about the adrenals, those small endocrine glands that sit atop the kidneys. They, along with the thyroid, are the glands with the greatest blood supply per gram of tissue. And this incident proves it.
I still can't wrap my head around him needing twelve units. Twelve. Evan's body was filling up with blood, seeping from the inexplicably broken gland, more and more, and it would have continued until... I have to stop dwelling on that. But the lapse in my circular thinking has caused another thought to enter my head, and it is something I'm not certain I want to acknowledge: Evan looks like Mom.
I mean, Evan and I resemble each other. You see us and you can tell we're brothers. But we have our physical differences, and the truth is I look a bit more like Eddie, and Evan takes after Mom the most. I've always known that, and I believe he does, too. His coloring is just like hers – the dark hair, fair skin, and the light eyes, the slender build (although Evan is much taller) – and even the way he smiles, the sort of lopsided way one side of his upper lip curls a fraction of a second before the other side… that's from Mom, too. It's never really bothered me before today. I knew the resemblance was there, but it wasn't important enough to think about fully. Plenty of children resemble one parent more than the other. But now, I'm looking at Evan lying on that bed, so pale and fragile-looking, and with the wires and tubes, and it's like a flashback to Mom's hospital bed. Even his hair – near the end, when she had decided to stop the chemotherapy treatments because they were no longer doing any good, her hair had grown back a little bit. By the time she died a few months later, she had a head of tight, dark curls.
Evan's not Mom. I have to repeat this to myself a few times. I cannot tell anyone I thought that, or they'd think I was crazy or morbid or seeing ghosts… Evan is not Mom.
Shortly after I sit down, I see Evan beginning to stir. He gives an involuntary whimper, and I instinctively tighten my grip on his hand. "Ev? You with me?" I murmur. Evan responds with something incomprehensible as his body begins to become aware of pain. His eyelids flicker. "Hank?" he manages to whisper upon seeing me, what I'm sure is the blurry image of his older brother by his side.
"Hey buddy," I say softly, giving him a wobbly smile and gently gripping his shoulder.
"Hey," Evan slurred, attempting to blink away the fog.
"You're in the hospital, Evan. Try not to move around too much. You just came out of surgery."
He lazily looks around him, and I suppose deciding it's too much effort, closes his eyes again and grunts, "I lived? Yaaaay, me." He sounds so tired and looks so beaten, yet there is just the tiniest trace of light in his voice. The Evan-spark is still there. Even though it's a terribly dramatic and serious situation, I choke out a laugh in spite of myself. Unfortunately, I realize quickly that my laughter is mixing with tears, and from the way he opens one eye to look at me I am sure that I sound on the verge of hysterics. I try to pull myself together, but I can't erase the lingering smile that he's still able to sound like Evan. "What surgery…?" he asks with effort.
"You… you had massive internal bleeding. It looks like one of your adrenal glands ruptured."
"Oh," Evan murmured, trying to follow the explanation. His eyes keep drifting closed, but he's still making an effort to figure out what's been going on. "That doesn't… sound good." He winces a little bit. "Why'd it… pop? That's not… usual... is it?"
"No, it's definitely not usual for a gland to 'pop.' They're running some tests to figure out why it happened. The main thing is, it's out now, you're all fixed up and you're doing great. You just need to rest now and get your strength back."
"OK…" Evan shivered. "'M freezing…"
"Here, let me grab you another blanket. You lost a lot of blood, so your circulation probably got a little wonky."
"Wonky… medical term?" He's teasing me. He nearly died and now he's poking fun at my slang.
"From the Latin." I give a faint, half-hearted smile, playing along as I hurriedly grab an extra blanket off of an empty bed nearby. I gently tuck it around his swollen body, careful not to accidentally bump or jostle the bed or the patient. "That a little better?"
"Uh-huh…" Evan nodded slightly, squeezing his eyes shut to awareness. "Tired…"
"Yeah, I bet."
"'M I allowed to go to sleep?"
"Yes, you're allowed," I say, taking his hand again. He squeezes it tightly. "We'll be moving you to a room in a little while, but you can go to sleep now."
"Will you stay with me?"
"Of course," I say quietly. Maintaining my contact, I bring my other hand up to his head, resting it on those curls that he got from Mom. Somewhere beneath my fingers, I can just barely feel the edges of a scar, the result of a collision with a scuba tank in Cuba. I had to use his hair as a replacement for stitches, and it wasn't entirely pleasant. My touch is considerably more gentle this time. "I'm not going anywhere."
"Knew you'd save the day," Evan murmurs, already halfway back to sleep, morphine dripping into his veins and easing the pain. I frown a little, because technically I did not save the day… far from it. I won't correct him now though. He'll learn soon enough how ineffectual I was today.
For now, I lean down and say, "Love you, Evan." I had promised inwardly that I would say it if he survived. Here he is, in front of me, drugged up, in pain, tired out of his gourd, and weak from blood loss, and most likely will remember nothing of this later on… but he's alive.
"I know… Love you, too, Hank," he whispers, trailing off as he falls asleep once again.
To Be Continued...
Author's Note #2: I'm sure we have all pictured Evan and Hank's mother in various capacities, and wondered what actress would play her if we were ever treated to a flashback scene of the boys' childhood. And I'm sure everyone pictures her a bit differently (I bet it would actually be really interesting to see who we would cast and why), but in my mind, I picture someone with Evan's coloring, and for the purposes of this story, I have cast Lisa Edelstein in my brain as Mrs. Lawson. That's just me though. :p