Gil slept solidly for hours, his battered body needing the rest desperately, and his mind needing an escape from the battering of emotions that had rained down on him in the couple of hours he had spent with the doctors. In need of her own emotional respite, Candy left the hospital, collecting Sammy, Hank and Lucy and heading for the park. A long walk would do both her and the dogs a world of good.
…
Andrea Thistle spoke softly to her patient as she drove the last screw home and then put aside the drill. She glanced at the anesthesiologist, concerned for the vital signs and general health of the woman, who had been put through the mill. He nodded at her, and she signaled Zachary to take x-rays. Her assistant put the pictures up on the screen and she looked at him pointedly, an eyebrow raised.
"It looks perfect," he said, his index finger tracing over the lines of their work. "Man there's a lot of metal there," he whistled. "She'll set off the scanners at the airport if she travels anywhere."
"So will her husband," remarked Andrea, preparing a suture kit. "He's got plenty in his shoulder now too." She set tiny, deft stiches, her hands working delicately to minimize any scaring as much as possible. "Get those images of her knee up," she instructed, "I want another look before we decide what to do." As Zachary hurried to as he was bid, Andrea hummed to herself and murmured soothingly to her patient, telling the unconscious woman all about the success of her husband's shoulder surgery.
…
It was nearly dinner time when Gil woke, coming to his senses much quicker than before as he registered the movements of a nurse at the side of his bed. She saw his eyes open and smiled brightly, revealing brilliant green irises and a hint of mischief.
"Doctor Grissom, welcome back to the land of the living!" Gently she helped his into a semi-sitting position.
"Just Grissom," he replied, taking stock of his physical state.
"Well then, Just Grissom, how are you feeling?"
"Tired, sore, a little groggy." He peered at her name tag; Jenni.
"On a scale of one to ten, where's your pain at right now?" she asked, adjusting his pillows to make sitting as easy as possible.
"Which pain?" he asked dryly. She smiled and settled an extra blanket over his legs as he shivered slightly.
"Why don't you tell me what hurts, worst to least," she suggested, making notes on his apparent mental faculties and other physical injuries.
"My shoulder is an eight, so is my arm. My chest is a seven and my head a six. Everything else just aches, somewhere around a four or five."
"Ok, well this should help, and it won't make you very sleepy either." Jenni administered a dose of something Doctor MacAndrew had prescribed, and then checked for a pulse in the fingers of his injured hand. Finding it nice and strong she smiled, the gentleman really didn't need any more complications in his life right now, and a blood clot would certainly have that effect.
"What can you tell me about my wife?" he asked, breathing a little easier as the pain medication quickly took effect. Jenni noticed with satisfaction that he relaxed back into the pillows, no longer holding his body stiffly in an effort to alleviate some of the pain.
"I know she's out of surgery and in recovery, as of about," she paused and looked up at the clock, "fifteen minutes ago." Gil sighed, and Jenni observed the look of relief glide over his face. "Doctor Thistle will be up to talk to you in about half an hour."
"When can I see Sara?" he asked, desperation in his features.
"Doctor Fielding is trying to arrange for you to share a room, but she's still classified as a higher trauma level, so it will be at least tomorrow before you get moved in together."
"How long am I going to be here?" he asked, blinking slowly.
"A while," she replied, adjusting the IV port on his arm. "You have a serious concussion; you don't even get to try standing up until tomorrow evening maybe. You can't tolerate sitting straight up for more than a few minutes, and you definitely can't look after yourself right now. Not to mention the fact that you have a risk of pneumonia and there are three drains in your shoulder and upper arm that have to come out before you're allowed to go anywhere. And I can tell you're dizzy and nauseous, even if you refuse to say anything about it." He glared at her, and she laughed.
"I slipped some anti-emetics into your cocktail here," she told him, lightly tapping his arm above the IV port. "Under any other circumstances they wouldn't let you out of this bed, let alone the room, but I think we might be able to swing a little trip to the other side of the unit after we visit Doctor Kelvin and your little girl later."
"We?" he raised an eyebrow.
"I'm under strict instructions from Joan to keep a very close eye on you; now that you're awake I can see what she means, you give me the impression that you might try and stage a prison break if I don't pay close enough attention." She smiled sympathetically when he winced sharply as his good hand cramped up, and gently kneaded the muscles, loosening them.
"Have you heard anything new?" he asked, eyes closed against the pain. "About my daughter?"
"No," was the kind reply. "But until you see the specialist, I think no news is good news." He nodded, and sighed with relief as his fingers relaxed.
"It wasn't supposed to be like this," he murmured softly, more to himself than Jenni. "We lost two, and they said that was it, we would never have another chance. She's so treasured, and she doesn't even know it. I can't even hold her and tell her. Sara hasn't even met her, doesn't even know she's here," his voice cracked slightly as Jenni kept hold of his hand, hoping to sooth him. "She's in a box, a box… like she's some kind of … of science experiment! I spent decades with my head in a microscope until Sara made me look up and see the beauty in the world; we both worked for years to put criminals away and make a difference." He trailed off, lost for words, his anguish clearly visible in the stormy depths of his troubled eyes.
"I'm sorry," said Jenni quietly, struck once more by the harsh realities of life that were seen all too often in the Emergency Medicine department. After a moment, she asked, "Are you hungry?" He nodded agreement, fighting off a yawn that made his head ache and his shoulder throb. With a promise to be right back, Jenni left him to his thoughts.
He stared at the Monet on the wall, wondering what Sara would feel when she woke. He supposed it would depend on how much medication she was on and how lucid her mind was. If she was coherent, she would panic. After they had lost Max, she had suffered recurring nightmares for weeks, waking confused, terrified and distraught. He had folded her in his arms every time, tight against his chest in an effort to make her feel safe and secure. Somehow he doubted they would let him share her bed here. He wanted to see her more than anything, right now in order to reassure himself that she was still here, still with him.
He had spent years being disgusted, appalled and occasionally shocked at the stupidity, carelessness and lack of responsibility humanity was capable of, but never before could he remember hating as he now did. His blood felt cold, his chest was tight and his stomach rolled with blind rage as he struggled to breathe. The knuckles of his good hand crunched and turned stark white under his light summer tan as he clenched the blanket, trembling.
"Hey now, what's this?" Jenni was back, bearing a pot of green Jell-O which she promptly abandoned on the table and perched herself on the edge of the bed. "Are you prone to panic attacks?" he voice was gentle and soothing. He gave a quick, tense shake of his head, which made a wave of pain spread fiercely down his neck, shoulder and arm, and a groan subsequently escape his lips.
"May I try something?" she asked. He looked at her and blinked, giving the tiniest of nods. Murmuring away in a steady, pleasantly low tone, Jenni placed a hand on either side of his head and began to apply pressure steadily in some areas and fleetingly in others. Her fingertips moved over his temples, forehead, jaw and skull, lingering in places and moving rhythmically over others.
His breathing slowed, his body relaxed and a good deal of the pain subsided. When he opened his eyes and stared at her in astonishment she smirked and sat back.
"Wow," he mumbled.
"Feel better?" she asked, reaching for the Jell-O.
"Where did you learn that?" he wanted to know, taking a hesitant spoonful of green goo.
"I get dreadful migraines, and my girlfriend is a massage therapist in the orthopedic rehab unit. She tried it one day on me and the effect was amazing. I specialize in head trauma care, and a few months later I had a patient who had repetitive panic attacks after waking from a coma. I tried the massage a last resort, and it worked. Lena and I have been working on different variations ever since, for migraines, panic disorders, amnesia, centralized pain relief in bed-bound patients, even in aiding coma recovery."
"It's not like a traditional massage," he commented.
"No, we found that multiple sensory stimulation is the key, hence the song I was humming, and the different levels of pressure. The low light levels in here help too."
"Fascinating, and thank you," he managed a small appreciative smile that quickly morphed into a grimace as he ate another mouthful of lime flavored slime.
"I'm sorry," she apologized, "It's all they would let me give you for now." He wrinkled his nose and continued to eat; the food felt good in his stomach, regardless of the revolting assault on his taste buds.
He had just finished when a lady in emerald green scrubs under a white lab coat came in. She was a pixie of a woman, with royal blue eyes more domineering than a glacier and hair so red it looked like the crown of her head was aflame; an odd contradiction on one face, until she stepped closer and he got the feeling she could both silence a room, or engulf it in fire, with a single look.
"Doctor Grissom," she began, in a voice far softer than he would have imagined, based on her exterior appearance.
"It's 'Just Grissom'," interrupted Jenni with a grin. The woman looked at the nurse and raised an eyebrow that looked as though it could slice clean through flesh with more ease than a scalpel. Gil swallowed carefully, eyes on Jenni, but she just smiled at the doctor and continued changing the IV bag.
"Well then, Grissom," continued the doctor, "My name is Doctor Andrea Thistle, but like you I prefer just Thistle."
"My wife," he said, immediately, realizing this was who he had been waiting for.
"Will be moved from Recovery to ICU soon," she said calmly.
"How," he began, impatient and desperate to know more.
"Sara came through surgery well," said Thistle, placing a calming hand on his knee. "Everything I set out to do was achieved, and she is on track for recovery."
"What," he couldn't help but interrupt again.
"Sara's right leg took a heavy impact in the crash, resulting in multiple injuries." Thistle took a sheet of paper out the notes she had carried in with her and showed him a skeletal diagram of the leg. "The ankle has what is called a trimalleolar fracture; which means three fractures, here, here and here." Thistle pointed to ankle joint where the tibia and fibula met the smaller bones of the foot. Taking a pen, she drew a line and series of cross hatches. "This is where I secured a plate with pins to stabilize the bone." Thistle paused, watching him for signs that he wasn't following her; finding none, she continued. She drew a series of x's on the bones of the lower leg, three on the tibia and two on the fibula.
"These indicate fractures," Thistle tapped the marks with her pen, "and these three," she pointed to two tibia marks and a corresponding mark on the fibula in line with the lower tibia mark, "presented as open fractures. That means the bone,"
"Penetrated through the skin," finished Gil, feeling sick. "Was Sara conscious at any time after the accident?"
"No, she was unconscious at the scene when paramedics arrived, and bystanders who responded as soon as the accident happened reported that both you and your wife had been knocked out by the impact. Since her arrival here, and the subsequent emergency surgery, she has been kept in a medically induced coma."
Gil felt a sigh of relief ripple through him with the knowledge that Sara had not been subjected to that kind of agony. Reading his expression accurately, Thistle nodded reassuringly.
"She's not in any pain, she won't remember the last few days at all."
"Good! Her leg?"
"Ah yes, I used titanium rodding inserted through the center of the bone, here and here, to stabilize the bones. The rods are permanent, and I felt necessary because of the severity and location of the fractures. The bones need to be structurally sound because their weight-bearing responsibilities."
Thistle pulled another diagram out of her file; this one showed a knee and upper section of the lower leg.
"Now the tricky bit," she said, once again marking x's on the paper. "During the crash, something impacted the passenger side front end hard enough that the frame of the car broke apart and effectively trapped Sara's lower leg. In the process it pierced the skin in two places, and caused catastrophic damage to the knee. This is called a lateral tibial plateau fracture- right here at the head of the tibia where the weight load on the bone is the greatest. There are also associated tearing injuries to the medial collateral ligament, the anterior cruciate ligament and the posterior cruciate ligament." She paused, looking at him once again, carefully searching for signs of emotional overload. He gave a weak smile, recognizing what she was doing.
"Now for the good news," she promised, drawing yet more lines on her paper. "This is the repair work to stabilize the bone; the knee ligaments can't be repaired," she tapped her pen, "The ACL is here, that's the MCL and this is the PCL. I can do nothing about the ligaments for a least a month; the swelling needs to go down first."
"But it will mean further surgery," said Gil flatly.
"I'm afraid so, yes. I fully expect the bones to heal well, and I'm optimistic that the next surgery will restore Sara's knee to its former state. At the very least I would expect her to be able to function normally; run, walk and swim and so on."
"Is that it?" he asked, wearily.
"For her leg, yes."
"What else?"
"I looked at the x-rays of her skull fracture, and I don't believe any intervention is necessary. The wound on her left shoulder is also on the road to recovery; remarkably there was very little damage commensurate with the size of the glass shard. The cephalic vein was pierced, but not severed, and the surrounding muscles required stitching, but there was nothing more serious. The glass applied pressure to the vein, stopping most of the bleeding until it was removed. I looked at Doctor Fielding's imaging of the repairs, but there is nothing better I could do."
"So her shoulder will be fine?"
"I would expect so, yes. Her leg will require extensive rehabilitation and physical therapy, but provided there are no complications, I would expect that within about a year her leg will be functioning as it needs to."
Gil nodded, leaning back slightly and briefly closing his eyes.
"How long until she wakes up?" he asked. Thistle tapped her pen, considering.
"Well, Doctor Fielding and I decided that keeping her sedated for another twenty four hours would be beneficial; it's a lot milder than the level we've kept her at until this point, but the extra time to allow her body to settle will help get the healing process started. The surgery went well, but her blood pressure dipped several times, and she's requiring assistance with keeping her oxygen saturation levels where they should be. Tomorrow afternoon, providing all is well, we will stop the administration of the sedatives and allow her to wake on her own."
Thistle paused and shuffled her papers, then looked at him.
"She's doing alright," she assured the tormented husband. "She is making progress, it just seems very slow right now, but really, considering it's only been a few days, she's doing great." She pulled out another diagram, this one of a shoulder.
"Now then, your shoulder and arm has possibly enough metal in it now to rival Sara," she said, scrawling marks once again. She considered for a moment before continuing. "Well, maybe not that much, but you will set off a metal detector. The scapula right here?... that was fractured, which is very unusual, as is the severity and misalignment of the bone. The clavicle along here… that was fractured twice and also misaligned. My assistant was mightily impressed with the angle of the bone fragments. I have to say; you and your wife have enriched his education dramatically."
"I'm so glad we could help," replied Gil, his tone a dry as the Sahara Desert.
"Hmm, well, we used pins here, here and here, and screwed a plate into the clavicle from this x to this one." Her pen was scribbling again, and he found himself wondering if the x's and lines were going to go on forever. His attention wandering slightly now as he wearied, he listened as she continued on. A fracture at the anatomical neck of the humerus, several in the radius and ulna, for which he now had a titanium rod in each bone. She talked about various simple breaks in the wrist that would heal with immobilization, and some muscle damage. The supraspinatus muscle in the shoulder had suffered an acute tear, and the corresponding nerve had been damaged. He caught one or two other muscle names before she stopped, peering at him.
"You need a nap," she said firmly, settling him back into a lying position. He tried to protest, to tell her that he needed to go and see Sara, and their baby. His traitor body had other ideas though, and before he could help it, he was out for the count.
…
Wanting to check on her post-operative patient, Thistle walked into Sara's room only to be greeted by pandemonium. Three nurses were crowded by the bed, frantically adjusting machines and medication inputs.
"What's going on?" demanded Thistle, her eyes sweeping over the screeching monitors.
"Blood pressure's dropping and tachycardia is rising," Sheila Watkins called as she examined the patient's airway. "Oxygen saturation has plummeted; she was fine until about three minutes ago, right after they brought her in from recovery." Thistle tossed her notes unceremoniously onto a counter out of the way and grabbed a pair of gloves.
"What did the anesthesiologist give her?" she demanded, listening to Sara's chest and peeling back her eyelids. A second nurse hurried to the monitor, searching the electronic patient records.
"Her lips are blue," muttered Sheila, just as the heart monitor let out a shrill, continuous beep.
"Shit," cussed the third nurse, a young man named Nilo who had joined the unit six months ago after graduating in Oregon.
"Get a tube in now," ordered Thistle, jerking her head at Sheila. "You," she nodded at Nilo, "compressions."
"Propofol," came the call from the computer.
"Get adrenalin," instructed Thistle, "this is a hypersensitive reaction." She looked up a Sheila, "Have you got that airway yet?"
"Two seconds… yep, I got her. We got you honey, you're going to be just fine," Sheila soothed, attaching the bag and squeezing air into her patient's lungs. Annette thrust the vial at Thistle, rattling of the Propofol stats from Sara's notes. The doctor pushed the drug into the IV port as Nilo kept going with chest compressions.
They waited; the air so thick with tension that Sheila felt the hairs on the back of her neck prickle. Finally the heart monitor fell silent for a moment before settling back into a rhythm. Thistle let out a breath she hadn't known she was holding, and turned to Annette.
"Get Doctor Christopher Pike back down here now, he's an anesthesiologist; I need him to change the sedation method." The nurse nodded and left; Thistle looked up at the monitors. "She's settling back down, but we need to put her back on mechanical ventilation. Sheila, I want a chest x-ray to see if there is any lung damage. There's got to be a reason for this breathing issue beyond the initial blood loss. Nilo, call a respiratory specialist to come and see her. Who's the attending physician?"
"Doctor Blackman, but she hasn't seen her yet; this happened less than five minutes after she arrived, we were still settling her in," Sheila began to tidy up the mess resuscitation had left.
"Hmm," Thistle was thoughtful as looked through the history of the various monitors. "What's the issue here sweetheart," she murmured softly, "you're doing so well, and that husband of yours is very anxious to see you. We'll get to the bottom of it; we don't need to stress him out any more than he already is. If he could, he'd be out of that bed of his and at your side before his nurses could blink, I'd wager."
"X-ray in ten minutes," said Sheila.
"Blackman said she'll be here in five," reported Nilo.
"Good, let's get her patched up and back in the land of the living. She's got a little girl to get to know."