"Raise your arm up so that it's even with your shoulder," Aramis instructed d'Artagnan.
"I can't raise it up that high," the Gascon complained.
"Just do it, raise it as high as you can." Aramis ordered, not accepting any excuses. "Good," the medic stated as he watched the younger Musketeer strain to bring his arm nearly to his shoulder.
"I can't go any higher," d'Artagnan said through clenched teeth. Tiny beads of sweat popped up all over the young man's forehead.
"Alright, hang onto my arm," Aramis nodded. "This is probably going to hurt, but we need to stretch out the muscles to prevent them from becoming rigid again. Hang on."
"Arghh. . ." D'Artagnan screamed in pain as Aramis raised his arm to the shoulder and kept going until it was raised above his head.
"I'm sorry, d'Artagnan." Aramis apologized; his eyes conveyed regret at causing the young man so much pain. "I am going repeat this exercise until we get to five, then we will do arm rotations."
"Do we have to do so many? It already hurts, that's just going to make it worse," d'Artagnan growled.
"We have to do this just as Molyneux instructed, d'Artagnan," Aramis answered resolutely. "If you don't exercise that arm it's going to get worse, not better. After the exercises, we will follow with a heated compress for about twenty minutes; it will loosen those tight muscles in your upper arm and get the blood circulating again."
D'Artagnan breathed heavily with dread. "Fine," he nodded with resignation.
"The applied heat will also pull the lactic acid out of your muscle and, therefore, will take away the stiffness. Your arm will feel much better after we are done, I promise. We'll finish up with a nice herbal rub," Aramis smiled.
"Sounds great," d'Artagnan mumbled sarcastically. "Let's just get this over with." The young Musketeer gritted his teeth, steeling himself in preparation of the forthcoming torture.
Porthos was startled awake with the sound of hoarse coughing, the vibrations against his chest shook him from his sleep.
Still half asleep and bone-weary, Porthos shook the fog from his brain; he was momentarily confused as to why he felt so hot.
Is something wrong with me? Porthos wondered, tiredly.
Athos struggled against the arm loosely draped across his chest but still holding him in place. He felt the bile rising in his throat, "I'm going to. . ."
Athos strained as he vomited up the latest cups of herbal tea and water, breathlessly emptying the contents of his stomach into a proffered bowl.
"Hold him up straighter, Porthos," Aramis said abruptly. "Don't let him droop over."
"Hold on, I've go' you," Porthos whispered in his friend's ear.
"God. . . I c-can't do this any-anymore." Athos choked between gasps of breath. He grimaced as he tried to clear his throat, wincing at the pain it caused. "My throat is on f-fire. . . I can't sw-swallow."
"We'll get you some more tea with honey," Aramis offered.
"No!" Athos blurted out, immediately regretting such an impetuous response as it caused more harsh coughs. "No. . . more tea. Not drink-drinking more. . . jus' comes back up. No more."
"I can't let you dehydrate, Athos. I know some of the elderberry and peppermint is making its way into your stubborn system; even as you are vomiting most of the tea back up."
"Damn, my st-stomach h-hurts." Athos pressed his arms hard into his midsection; the muscles ached from the constant straining while coughing and vomiting. "I can't do. . . this any-anymore. . ."
"Yes, you can do this," d'Artagnan retorted quickly. "You can and you will do this, Athos. You have no other option."
Athos groaned deeply as he felt his stomach knotting again as the bile began rise and bubble up to his mouth. At the urge to vomit, he instinctively bent forward—only to be pulled upright by Porthos.
"Can't let ya do 'at, Athos." Porthos restrained the writhing man in his arms.
The sick Musketeer no longer bothered with the bowl in d'Artagnan's hand. He had nothing left in his stomach to empty, though he continued to be plagued with terrible and painful dry heaves, twisting his stomach into knots. He curled up his legs close to his body and allowed his weight to be supported by Porthos behind him. When the dry heaves finished their course, he fell boneless against the body of the large Musketeer.
"I'm sorry, Athos," Porthos apologized in a whisper. "If there was only something more I could do. . ."
"J-just k-kill me now. . . and g-get it over with."
"Ain't nobody killin' ya, Athos. You quit that kind of talk," the large man growled. "Don't go there."
Athos let his heavy head droop, his body now sapped of all its strength. Beads of sweat dripped from his face onto Porthos' arm.
D'Artagnan leaned Athos' head back against Porthos' shoulder and frowned deeply. He used a damp cloth to wipe away the slick layer of sweat from the lieutenant's face, burning red with fever.
Aramis offered a fresh cup of tea to Athos' lips. "Here, drink a sip of this."
Athos tried to pull away. "No, no more. . . can't drink any. . . anymore."
Aramis remained patient, knowing he would have to convince his stubborn patient the tea was for his own benefit. "I put extra honey in here to help soothe your raw throat. I also changed the tea to ginger root to confuse that catarrh bug wreaking havoc on your insides."
Athos managed a crooked smile, quickly followed by a long, drawn-out groan of pain. "Mmm," he drew in a ragged breath.
"D'Artagnan, hold his head up for me while I help him with this." Aramis held the cup to Athos' lips and tilted the contents into his mouth. "Come on, all you have to do is swallow and we'll do the rest."
Athos didn't struggle but allowed the tea to flow down his raw and burning throat. "Good, a few more sips. . . slowly. Keep going. . ." Aramis coached.
Athos finally had enough and turned his face away, unable to handle anymore. He let his eyes slide closed, and fell asleep with his head still supported in the hands of d'Artagnan.
D'Artagnan laid Athos back against Porthos' shoulder gently. Looking at the man acting as Athos' pillow, d'Artagnan noticed the sheen of sweat on the large man's neck and the beads of perspiration dotting his forehead. "Let me get you some water," he chuckled.
Aramis took a cool, wet cloth to Porthos' face and neck, washing away the sweat. "Mmm, that feels nice, thanks." The large Musketeer gratefully accepted the cup of cold water d'Artagnan offered him and drank it down in one quick gulp.
"Do you want more?" d'Artagnan asked, to which Porthos shook his head no.
Aramis smiled as he finished his cooling ministrations on Porthos.
"'Mis, could you get that we' again? I'd like to put it 'round my neck for a bit." Porthos let out a long huff of breath. "I feel as hot as Athos but without the fever."
Aramis frowned and shook his head as he removed his hand from Athos' forehead. "His fever is climbing, which is why you are getting so hot sitting back there, Porthos," the medic stated with concern.
"D'Artagnan, let's start sponging Athos down with cold, wet cloths. After we are finished, we will use the wet cloths as cold compresses, one around his neck and the other draped over his chest; it should help bring his body temperature down. I don't want to have to make use of the cold water bath, but I will if we can't get his fever down soon."
Aramis and d'Artagnan set out sponging down the fevered body with repeated returns to the bowl of cold water, refreshing the cloths quickly warmed by his hot skin. After finishing, they left the cold compresses in place to do their job at fighting the spiking fever.
"Do you think we can lay him down so Porthos can get a break?" d'Artagnan asked.
"No, I'll keep holdin' him." Porthos shook his head, dismissing the suggestion. "We lay 'im down, he'll vomit and tear out his stitches or he'll choke again. Nah, I'm fine back 'ere."
Porthos settled himself against the wall and closed his eyes, entirely exhausted. His breathing soon fell into an even rhythm as he went to sleep.
At seeing his two friends resting, Aramis was overcome with fatigue himself. Rather than resisting, the medic decided to take advantage of the moment by lying down on the cot to rest.
I just need a few minutes. I only need a few minutes. . . I'll sleep just a few minutes. . . Athos needs me.
D'Artagnan observed Aramis' haggard and worn appearance with great worry. He took notice of the pale complexion and the sweat beading on the medic's forehead. His heart sank low in his chest. He closed his eyes with memories of when Aramis took off his mask, breathing life back into Athos' body.
"No, not you too, Aramis." D'Artagnan sadly shook his head. "How are we going to take care of Athos and now you too?" Looking around at his sleeping friends, he sunk into the bedside chair completely exhausted and weary. "Someone, please wake me from this nightmare," the young Gascon muttered to himself. "God help us," he closed his eyes and joined his brothers in sleep.
~§~
D'Artagnan was awakened by the splashing of vomit over his boots and the painful groaning of Athos as he retched again and again all the healing tea in his stomach. The sour smell soon permeated throughout the room, crinkling the noses of the two nearest.
Despite d'Artagnan's understanding of Athos' condition, he couldn't help the scowl of disgust as he eyed his boots now covered in the vile liquid. He rolled his eyes dismissively and shook his head. He can't help it, it's not his fault, the Gascon reminded himself.
D'Artagnan turned his attention to the commotion on the bed. Porthos strained against the incessant struggles of Athos as he attempted to double over while gagging and retching. The Musketeer lieutenant cried out in pain as he gasped for breath; finding his breath lacking, it only caused the panic to increase.
Aramis was awakened by Athos' cry and rushed over to the bedside to help hold the writhing man upright. "Stop struggling, damn you." Aramis blurted more abrasively than he meant. He's sick, he can't help it. What is wrong with you, Aramis?
"Hold still, Athos!" Porthos growled while trying to control the agitated man in his arms.
"Aramis, he's turning blue!" d'Artagnan yelled.
"D'Artagnan, go fetch Doctor Molyneux, now," Aramis shouted. "Quick!"
The young Gascon ran out of the room to the infirmary, not bothering to shut the door behind him.
Aramis sat on the edge of the bed and carefully draped Athos across his lap. He began pounding on the choking man's back with hard slaps to dislodge the vomitus in his lungs, fully responsible for robbing the man of his breath.
At last, some bubbly red liquid drooled out from Athos' mouth to dribble down Aramis' leg. The hand that had fisted Aramis' pant-leg in panic, suddenly went limp and hung loosely over the chair.
M. Molyneux and d'Artagnan returned to the room in time to see the hand falling limp; the sight of which induced panic in the young Gascon. "Aramis, what's wrong? What's happened to Athos?"
"Lay him down on the floor," Doctor Molyneux ordered, ignoring d'Artagnan's questions.
The doctor laid his head on Athos' chest to listen and watch for signs of breathing. He sat up and reassuringly nodded his head. "He is breathing, but. . ."
The physician's pronouncement allowed everyone to release the breath they were holding in one loud cry of relief, until they realized the hesitation.
"But what, doctor?" Aramis asked nervously.
M. Molyneux placed his ear to Athos' chest once again, frowning as he listened to the wheezing and rasping sounds accompanying every breath. "His breathing is quite labored. I hear wheezing noises in his lungs, which suggests congestion in one or both lungs. The bloody sputum could mean that the infection has settled into his lungs."
"What does that mean for Athos?" Porthos asked.
"The sputum could be a benign symptom of congestion clogging his lungs and his body is simply forcing it out; or it could be early symptom of infection, such as bronchitis," Molyneux explained.
"Well, he aspirated on his vomitus—twice now." Aramis informed the doctor. "He also stopped breathing . . ."
Molyneux looked at Aramis in surprise, realizing that his mask was missing. "Where is your mask?"
"I had to remove it when Athos stopped breathing; I had to perform mouth-to-mouth resuscitation on him," Aramis answered neutrally. "It was either that, or watch him die. I sure as hell wasn't going to watch him die."
"Oh dear. . ." M. Molyneux allowed his shoulders to slump forward as his head drooped. "You know what that means, Aramis," he stated quietly.
"Yes, doctor, and I fully accept the consequence." Aramis declared, somewhat defiantly.
Molyneux sighed, nodding his understanding. "How long ago did this happen?"
Aramis looked to the other two as they each shrugged. "Doctor, we've lost all track of time in here. I couldn't tell you if it was day or night outside. . ." He closed his eyes, pinching the bridge of his nose. "It happened several hours ago. How many hours?" he shrugged wearily. "I don't know.
"Alright, it's fine." Molyneux tried to smile. He noticed the ashen and fatigued appearance of the medic, surmising the illness had already begun working on his system. Observing Athos closely, he watched the rise and fall of the patient's chest and huffed in amazement.
"What is it, doctor?" d'Artagnan asked.
"In medical journals I have read of mouth-to-mouth resuscitation but I have never seen it performed on a patient." He looked to Aramis and shook his head. "At the risk of sounding repetitive. . ."
"I know, I missed my true calling." He finished the doctor's thoughts with a weak smile.
"Indeed you did, Aramis. Imagine the impact you could have in teaching others your skill. Imagine the people you could help. . ." his voice trailed.
"Doctor, can we just focus on helping Athos right now?" Aramis politely reminded the physician why he was called into the room, directing his head toward the patient lying on the floor.
Molyneux took a limp hand of Athos to check the pulse in the wrist. He placed a hand on his forehead. "What have you been doing to treat his fever?"
"We've been sponging him down with damp cloths and using cold compresses around his neck and chest. I've been giving him elderberry and also ginger root tea to help bring down the fever, but he usually vomits it back up again. Nothing is working," Aramis sighed.
Molyneux gazed at the patient on the floor for a time, his brow furrowed as he stared at the unmoving form. He leaned over then placed his knuckles on Athos' sternum, twisting down hard on the chest.
Porthos and d'Artagnan watched, horrified and confused at what the physician was doing. Aramis just sadly shook his head.
"That's what I thought," the physician sighed softly.
"Aramis, what is he doing, what's wrong?" Porthos roared, getting angrier by the second.
"It appears that Athos has fallen into a coma." Molyneux answered after he finished confirming his suspicions.
"Bloody hell," Porthos cursed with a growl.
"Oh God. . ." d'Artagnan gasped. He turned to Aramis, his brow knitted as he watched his friend visibly pale.
"Hold on, a coma is not necessarily bad in Athos' case." Molyneux tried to ease the worries of the men. "A coma may be the only way his body will have a chance to heal. He is just too worn out—too wounded and too sick—his energy is too depleted to continue taking that continuous onslaught of suffering."
"Alright, so how is a coma a good thing, doctor?" d'Artagnan asked.
"Athos' body has sought out a way to shut down in order to rest and regenerate itself. He has suffered more than any man should with his many ailments and his body literally cannot withstand anymore. The coma is a survival mechanism. Without the vomiting and the coughing, Athos can finally get the much-needed rest his body requires for healing."
"How long will he be in a coma?" Porthos asked, worry etched deep in his features. "Is there a way to wake him up?"
"A coma has both good and bad aspects, Porthos. It is good, as his body will finally be allowed to rest and heal; but I cannot determine how long he will be unconscious, nor can he be forcibly awakened. He will have to emerge from the coma in his own good time and when his body is ready," Molyneux answered.
"That is if he will emerge from his coma, you mean doctor," Aramis retorted angrily. "The truth is, Athos has slipped into a coma and he may never wake up. With everything he has gone through and has survived up until this point—it will all be for nothing."
Suddenly, Aramis felt dizzy as his ears started ringing and his vision began fading to black. He wavered back and forth, then stumbled sideways trying to right himself. Finally, the medic went limp and fell forward, unconscious. Porthos was instantly on his feet to catch Aramis before his body hit the floor.
A/N:
The term 'coma', from the Greek koma, meaning deep sleep, is used in the Hippocratic corpus (5th century BC) and later by Galen (second century AD).
The term is found again in De anima brutorum (1672), by Thomas Willis (1621–1675). In this influential journal, lethargy and coma are mentioned as "the sequence indicating increasingly deeper forms of unresponsiveness and deep sleep."
Thomas Sydenham (1624–1689) mentioned the term 'coma' in several cases of high fever in his medical journal (Sydenham, 1685).
A coma may develop as a response to injury or severe illness—this allows the body time to cease action and heal injuries or illness before waking. It therefore could simply be a compensatory state in which the body is not expending energy and is resting and healing itself. The severity of a coma depends on the underlying cause.
A coma can occur with oxygen deprivation as well, as it is essential for brain function. Oftentimes after CPR, survivors of cardiac arrest fall into comas. Oxygen deprivation most likely occurs with drowning and/or choking.