A/N: Thank you once again for reading and reviewing. This chapter deals with medical surgery, so there could be some more "squickiness". I sincerely hope you are enjoying the tale of Hart on Fire. LDB.
Adam stared at the television. Chris looked up at the glowing flat screen. He too saw the images of the five firefighters entering the building. He recognized Captain Hart. He immediately turned back to Adam. "...the six-story building, located on South Spring Street was being used as a homeless shelter. It was in the process of being renovated. Apparently several people were trapped when the roof caved in under the heavy rainfall, aided by the tornadic winds. After the rescue team entered the building, it suddenly collapsed into the heap of rubble you see now. Two more rescue teams from Stations fifty-one and forty, are preparing to search the remains of the South Spring Street Shelter. We'll bring you more as the story develops..." the reporter moved on to narrate more video of damage caused by the possible F4 tornado.
"Adam? Hey Adam? Kitten?" Chris finally said louder trying to get the physician's eyes off the television and focus on him.
Adam looked over at Chris, tears flowed from his red-rimmed eyes, "It... Bret... in..." his words faded as the sadness overtook him.
"I know, I recognized him. I'm sure it looks worse than it is. Remember, he's an expert at his job. He'll come out of this, he will," Chris tried to sound more confident than he was.
"How Chris? Look at that mess! The fucking building fell on him, and the others! How can anyone come out of that?!" Adam sounded he was on the verge of a break down.
"Chrissy is right, Adam. Those guys are professionals, they know what they are doing. You just wait, I'm sure he'll be fine," Evan tried to add his confidence to Chris'. Only difference, Evan believed what he said.
"Why? Why am I not allowed to have happiness in my life? Every time I fall in love, something destroys it," Adam spoke without realizing he was saying this to his former fiancé and the man he cheated on Adam with.
Both Chris and Evan knew Adam was just reacting to the situation. They had made their peace with the doctor. Chris wished he could think of something to say that would ease Adam's mind. He reached over and took Adam's right hand in his.
Adam kept his weeping eyes on the television screen, "... the tornado, an estimated F four was on the ground for nearly an hour as it crossed into the Denver metro area. It missed downtown and skirted the city of Aurora. It's early hours yet, but damage is estimated to be in the millions of dollars. Governor Layfield and Mayor McMahon are currently out surveying the damage... we'll have an update on the rescue on South Spring Street when News Nine continues..." the reporter was replaced by a commercial of sorts. It was a PSA about open shelters and phone numbers of agencies offering help.
Sounds of sirens still filtered in, the sky was now dark, from sunset this time and not a storm.
The beating sounds of Med One taking off filled the air next. "Med One is going out. I wonder if... I was flown here on it... " Adam's words trailed off. He was looking at his beautiful engagement ring, the teddy bear in his arms.
"Adam? Do you want me to call Jay?" Chris asked softly. He felt Adam needed someone closer to him to be there. He figured the Helmsley's would be working full-out down in the Emergency Room.
"I don't want him trying to drive here with all those trees and power lines on the roads. Thanks for thinking about it though. Oh Bret... why? Why?" Adam began to sob in earnest as his thoughts went to a collapsed building on South Spring Street.
Downstairs in the Emergency Room, Hunter had returned to run a full blow Stage Five alert. They had heard about the collapsed building on South Spring Street. They had no idea however, that Bret was involved. Already the Emergency Room was full. All the doctors, interns and nurses had been called in, including Doctors Wade Barrett and Paul Heyman.
"Wade, you supervise the students, I've called in the fourth year class to help with non major wounds. It will be up to you to triage and look for missed serious injuries, and Barrett, I'm watching you," Hunter used his Administrative tone with a sharp warning under tone. As much as he hated it, with Adam out, he needed the British doctor's expertise.
Shawn got the nurses better organized. They had to treat and move; more and more victims were coming in. Med One had gone out, so they would need at least one severe trauma room ready.
Hunter asked Doctor Heyman to take the stage two and three patients along with Doctors Rhodes and DiBiase. Hunter took Doctor Dolph Ziggler and from the Orthopedic Department, Doctor Santino Marella. He wanted an expert on broken bones on hand.
Doctor Helmsley's arrival had been a relief. He along with Shawn quickly brought the chaos into order. Things were now moving along a lot more rapidly and accurately. Hunter sure wished Adam was there.
"...And so there has been no word yet on the five firefighters who were in the building as it collapsed. Members of the secondary rescue team have removed four bodies from the debris. It is assumed they were all residents of the shelter," the reporter spoke in a grim tone as footage of the four bodies covered in white sheets appeared on the screen.
"They are all dead! Why don't they just say it! Bret's dead! I forced him to go! It's my fault!" Adam wailed again. He felt his heart crumbling like a dry cookie.
Chris and Evan didn't know what to do. It was time for them to go down and wait for their cab. Jericho knew Adam well enough that he would tell them to go, but he thought he'd try. "Don't worry Adam. We'll stay here with you. You shouldn't be alone," Chris said simply as Evan nodded in agreement. He was as anxious as Chris not to leave Adam.
Adam shook his head, "No. I appreciate it, I really do, but don't miss your cab on my account. They'll be giving me meds soon anyway, they force me to sleep," his tone, was tear filled but instant.
Chris nodded, "knew you'd say that. Alright, but please, call if you need a friend, either of us," Chris said softly with a squeeze to Adam's hand.
"I will. Thank you, both of you. Just... pray, please pray for a miracle..." Adam stopped before he broke down in tears again.
Chris and Evan left. Adam felt useless lying in the bed while he was needed downstairs. He got an idea. If he could get down to his office, he could change into scrubs and at least help. He couldn't do much with one hand, but he could do triage or get things for people. Adam turned off the TV. He got up and went to the bathroom. He carried his IV bag carefully. He just had to wait for the nurse.
Sure enough it worked like Adam hoped it would. When the nurse came in, he told her he was in the bathroom for a longer "visit". She asked if he needed any help. Adam said no, very quickly. The nurse then said she'd come back later and that dinner would be served in half an hour to hour. It was delayed due to the storm. Adam then heard her leave. He had the advantage most patients didn't, he knew the hospital like the back of his hand.
Adam left the bathroom after disconnecting the IV from the needle in his arm and went to the door of his room. He peeked out, it was as he thought, the hallways were full. Visitors had come to see if family member patients were okay, and the nurses were busy with evening meds. He opened the door and took ten steps across the hall to another door. It was a door to the stairs the staff used. Luckily it was empty. He went down to the first floor.
When Adam got to the first floor, he had another lucky break. The door of the stairwell was four steps from his office. He only had one fear, his office would be locked. Adam hoped in the chaos someone had left it unlocked. It wasn't unusual for the phone in his office to be used during staged alerts. He got lucky, his office was open and empty. He locked the door behind him.
Adam didn't know how far he'd actually get but if Bret was brought in, he wanted to be there. He felt Hunter would understand. He changed into his spare scrubs and white doctor's coat. He was startled as he heard the key in the lock. He thought about hiding under his desk, but that was childish.
Wade walked into the office he once shared with Adam. His new office was further down the hall, so it made sense for him to use the phone in this office. Adam was a bit surprised to see Wade. If Hunter called him in it must be worse than he thought.
Barrett was just as startled to see Adam standing by the desk, ready for work. Wade quickly shut the door behind him, "what are you doing here?"
"I should ask you the same," Adam said rather shortly. He didn't mean to snap, he was just startled at having been caught.
"Stage five. I'm helping the students. I'm here to call in a few more. Hunter called me in, but I don't think he wanted to. He'd rather have you in there helping him," Barrett explained. He was worried about Adam's health.
"I need to be here..." he went on to explain about what he'd seen on the news. "... so if Bret is still alive and comes here, I have to be here for him," Adam tried to stop the tears, but he couldn't, they flowed freely. His eyes looked so sad.
Wade's heart went out to his colleague. A week ago, he would have welcomed this chance, but now, he just wanted to help Adam. Maybe he could somehow repay Adam's kindness. "Oh Adam, I'm speechless. You can't go out there. Hunter will kill you, and I don't even want to think about what Shawn would say. Look, stay here. I'll tell them this phone is... off or something. If Bret is brought in, I'll come get you. We'll deal with the Helmsley's then. That's the best I can do," Wade said honestly. He truly wanted to help and he too was worried about Adam and Bret.
"You'd do that for me? After everything?" Adam asked in a skeptical tone. He still didn't trust Wade, at least not completely. For all he knew, Wade could turn around and use this against him.
"Yes, I will. Trust me, please? I know I don't deserve that from you, but I promise I'll do just as I said," Wade's eyes and tone showed his honesty.
"Alright, I'll trust you, but if you fuck this up, I'll punish you severely. They will be looking for me. You haven't seen me... got it? You come get me the second you see Bret," Adam's tone was sharp and warning, his eyes flashed, filled with tears.
"I promise, and I haven't seen you. The second I see or hear anything about Bret, I'll come back," Wade said with a nod as he turned to leave, he locked Adam in the room. He knew Adam could unlock it from the inside without a key.
"I'm sorry it took so long, the phone in Adam's office is on the fritz. The extra students are on the way. One of them said something about Captain Hart..." Wade went on to repeat what Adam had said, under the guise of a student telling him.
"Oh no! Buddy! Adam! We have to tell him!" Shaw was highly upset at the news.
"Why don't we wait till we know something for sure. He's probably sleeping and doesn't know," Hunter said thoughtfully. Why upset Adam, then leave him. They had too much to do in the Emergency Room.
"You're right. If we get a minute, I'll go peek in on Adam," Shawn said with a nod of confirmation. They hurried back to what they had been doing.
So many injured people were being treated. Things from simple bruises and cuts to sadly, fatal injuries. One man had been brought in, but nothing on earth cold have saved him. A C-SCAN revealed all two hundred and seven bones in his body were broken. As far as anyone knew it was probably a medical first. The man had tried to run to a shelter and was carried away by the tornado. It was estimated he was tossed over a mile in distance.
Adam sat in the dark office. He could hear all the hustle and bustle going on. The doctor part of him wanted to be out there, helping people. They fiancé side of him was broken and heartsick. He just wished there was a way he could hear some kind of news about Bret.
"DOCTOR HELMSLEY TO THE HELIPAD! STAT! DOCTOR HELMSLEY TO THE HELIPAD! STAT!" came over the hospital paging system. Fear gripped Adam's heart; was it Bret?
Adam heard Hunter's voice, "Come on Shawn, sounds bad!" then he heard the sound of the doctor and nurse running down the hall to the elevators. Adam said and waited with bated breath.
It was while Shawn and Hunter were gone when the nurse from the Orthopedic Department, came down to the Emergency Department. Wade happened to be the first authority figure she saw. Wade was almost in front of the door to Adam's office.
"Doctor Copeland isn't in his room. I thought, knowing him, he might have snuck down here and tried to work. Have you seen him?" the nurse asked in an anxious tone. How could she have "lost" a patient?
"No, I haven't seen him. He would be hard to miss down here. And see, his office is locked," Wade rattled the door handle to prove his point. He then continued, "Maybe he just went for a walk around, popped in to visit someone? You know how kind-hearted he is," Wade suggested, he hoped the throw her off the trail.
"But he unhooked his IV! He wouldn't have done that for a simple walk around. He would have walked with the pole, it has wheels you know!" She was upset and her tone reflected that. She was truly worried for both the missing doctor and her job.
"I don't know what to tell you. Maybe he went to the cafeteria, maybe he was hungry. I know dinner was delayed," Barrett again tried to make a suggestion.
"Well, maybe. I might not want to wear an IV to the dining room, unappetizing," she said thoughtfully. Maybe that was where Adam had gone. "I'll try there, but if you see him, please sit him down and page me, Michelle, from Ortho. I'll come back here after checking the cafeteria. Thank you, Doctor," she said as she turned to hurry off to the cafeteria.
Wade unlocked the door, but he didn't come in. Adam wondered if it was a signal. He crept to the door to listen. Wade saw what was coming down the hall, he spoke a little loudly as the group approached, "is that Captain Hart?"
Adam's heart stopped when Hunter said, "yes". He waited a few minutes, the longest few minutes of his life. He wanted everyone's attention focused elsewhere before he appeared. Finally when he felt like enough time had passed, Adam worked his way into the trauma room where his future husband was being treated.
There was a flurry of activity. Hunter looked very, very worried. "It's an artery! He's bleeding out! We've got to operate, now! Shawn, GO!" Hunter barked at his husband.
Adam didn't care after that if he was seen, he rushed to Bret's bedside, "What's wrong with him, Hunter?"
Hunter looked at Adam, he couldn't worry about why the injured physician was there, "he was trapped. His right arm was under some concrete, it cut into an artery. He's going to surgery. He also needs blood!" Hunter said hurriedly as he packed and wrapped the bleeding cut. He only had a short time to repair the damage.
Bret looked so pale and lifeless. Adam grabbed his lover's left hand, it was cut and bruised, but not too badly. He bent down and kissed Bret's pale lips. "I'm here, Bear, I'm here. Please baby, don't leave me. Don't you dare fucking leave me!" Adam said through the falling tears.
"Doctor Helmsley, we're out of whole blood! What are we going to do?" Natalya the nurse asked in a very worried tone. She was the daughter of Jim Neidheart, Bret's fellow Captain at Station 51.
"Look for anyone with... get this... AB negative. That's his blood type," Hunter said with a sigh. Bret had one of the rarest blood types, he could give blood to anyone, but he could only receive his own blood type. The tornado had drained the blood banks of all the Denver hospitals like a savage vampire.
"You don't have to look. I have it. Let's get him to surgery," Wade said in a non heroic tone. It was just a matter of fact. It wasn't the first time his having rare blood had helped someone.
"Great. Let's go. Adam follow..." Hunter said as they rapidly pushed Bret's gurney to the elevators. Surgery was also on the second floor, in the opposite wing of the Orthopedic Department.
"Adam, I want you to go back to your room. You ought to be spanked. I see you hoped to work..." Hunter paused as he and Wade got the gurney onto the elevator.
"NO, Hunter. I want to watch, from the theater, please, oh Hunter, dear God, please?!" Adam was close to getting on his knees and begging.
"Fine, fine, but you get your fucking IV hooked up, or I'll have you tied to your bed, I mean it. I don't want you sick on top of this," Hunter replied as the elevator stopped. Shawn was waiting with Michelle, as the doors opened. Shawn helped with Bret while Michelle blocked Adam.
"Hunter said I could..." Adam was interrupted by Michelle.
"I know. Shawn was sure you wouldn't go back to your room. I'll set up an IV in the theater, come on, Doctor Copeland," Michelle said in a soft, caring tone.
Shawn had run into Michelle, asking about Adam. Shawn explained about Captain Hart. He also said Adam would insist on watching the surgery and that Hunter would say okay, he was right.
Michelle took Adam to the operating theater. It was the same one the students used when observing a surgical procedure. Adam sat in the front row. The nurse re-hooked a fresh IV bag to the needle port in Adam's right forearm, after she removed the cap.
"Well, at least being a doctor you knew to cap the entry port. I brought another port and needle just in case, but this looks fine. You know, Doctor Copeland, you could have gotten me in a lot of trouble," Michelle said in a bit of a chastising tone as she finished with the IV.
Adam flushed a bit, he hadn't thought of that. Michelle was right though, letting a patient "escape" wasn't good. "I'm sorry Miss Michelle. I honestly didn't think of that. I wouldn't have let that happen. I promise you. At first I just wanted to go see if I could help, then I saw about my fiancé on television. I had to go see if he was in the ER. I'm sorry I was a bad boy," Adam spoke seriously, there was no humor in his voice.
"I'm sorry about Captain Hart. You know he's in the hands of the best surgeon in the hospital. Try not to worry too much, Doctor. Remember, you're not a well man yourself, you are fighting a massive infection. Stress isn't good for you," Michelle said in a more worried tone as she put a blanket over Adam.
"Thank you Miss Michelle. Again, I am sorry I vanished on you. Please, if it's your belief, pray for Bret," Adam said as the tears filled his eyes again as Bret was wheeled into the operating room. Even from where Adam was sitting, Bret looked so weak and pale.
"Shawn told me what he knew about Captain Hart's injury. They had just gotten into the building when they heard it start to collapse. Captain Hart pushed his team out of an opening in the back wall, but just as he was half way through the opening, the building fell. He managed to get out before it completely collapsed, but a piece of debris knocked him down, his right arm was trapped under some concrete. It sliced into his arm and cut the artery. His team worked like dogs to get him free, but a piece of re-barb anchored the concrete to the ground. They had to wait for the other team to bring the jaws of life to pry the concrete slab up enough to slide his arm out. The Med One team did what they could. Thank God, Doctor Barrett has the same blood type," Michelle finished telling Adam what Shawn had told her. The Med One team had gotten the story from Lieutenant John Cena.
Adam's tears subsided a bit, "are the others alright?" he didn't want any of his new friends from Station 51 to be hurt either.
"Banged up, but nothing serious. They are probably in the ER by now. Doctor Copeland, would you like me to sit with you during Captain Hart's surgery?" Michelle asked with a caring smile.
"No, thank you. I'd like to be alone now. I'll go back to my room... after... go, please?" Adam asked as he bit back more tears. He just wanted to be alone.
"Alright, Doctor. I will pray for Captain Hart. Stay warm and call if you need anything," Michelle said as she left the operating theater.
When he was alone, Adam sniffed deeply. He knew Bret would want him to be brave and not sit there crying like a baby. Adam watched as Wade was wheeled into the operating room. He was hooked up to a transfusion IV. Wade's blood would be pumped from his vein, into a filtering IV bag, then Bret would be connected to the "out" going transfusion line. It could take anywhere from one to four hours. Depending on how much blood Bret had lost.
By the way Bret looked, Adam estimated that with the surgery, he would be there at least six hours. Adam also knew, the first fifteen minutes would be the most anxious. Any allergic reactions Bret might have to Wade's blood would occur within the first fifteen minutes of the transfusion.
During the process, Wade's vitals would be monitored, like his temperature, blood pressure, and heart rate. After words, the worst he could expect would be some bruising where the needle was inserted. Depending on how he felt, Wade might be kept in for a night to keep an eye on him. Barrett would also get all the orange juice and cookies he could hold.
Bret would also be carefully monitored, not only because of the transfusion, but repairing an artery was very delicate work. It wasn't a matter of just sewing it back together. Hunter would have to clean out any debris, even microscopic bits of dust. He would operate using a microscope that would make it easier to see everything.
Adam flicked on the monitor, he wanted to be able to hear what went on during the surgery. There was also a video monitor, but he had a good view and the video wouldn't show any close-ups, after all there wasn't a class watching.
Hunter and Shawn, along with nurse Beth Phoenix, entered the operating room. Doctor Vicki Guerrero and her team had come in with Bret. She had been monitoring the firefighters vitals. Her face was grim behind her mask.
Wade was wide awake, and would remain so, even though he was dressed like a surgical patient. He wore a mask and a "shower" cap made of the same green gauze material of the surgical scrubs.
"He's very unstable, Doctor Helmsley, I hesitate to put him under too deeply. I would recommend a light general and heavy local, " Doctor Guerrero said in a serious tone. Bret's vitals were very weak and shocky. His body had suffered a lot of trauma, even though he only had the one injury. He'd lost a tremendous amount of blood before he was freed from the concrete.
"The X-rays are done," Shawn said as he punched a few buttons on a wall mounted computer screen. X-rays had been taken when Bret was brought into the surgery. The results were now on the screen.
"My God, Buddy is lucky. All that concrete and the arm isn't broken? That re-barb must have stopped the slab before it could crush his arm," Hunter said in a tone mixed with amazement and doctor's thoughtfulness.
"God was watching out for him. I just hope you can repair the artery. Come on, let's get going," Shawn said softly. It was hard to know their dear friend's life depended on them.
The Helmsley's glanced up at Adam. They both gave masked hidden smiled to the one they looked on as a son. Adam gave a return smile and nod. He trusted no one but Hunter and Shawn to be there.
Adam turned when he heard the door to the theater open. He nearly started to cry when Jason came down the steps and sat next to him.
"Chris called you didn't he?" was all Adam could think of to say. He was so pleased to see his brother. Jay held his arms out to Adam, over the arm of the movie theater style seat. Little brother curled up in big brother's protective arms, being careful of the IV.
"Yeah, then right after, Shawn and Hunter tore out of the driveway. Heath said I should come, so here I am. I would have come anyway. I'm not going to let you be alone right now. How is he?" Jason explained as he gently stroked Adam's brow.
Adam sniffed, "not good Jay Jay..." he went on to explain what he'd seen on the news and heard from Michelle and what was going on in the operating room. "...so, now we wait," Adam finished his story.
With all that had happened, from the time Michelle had brought Adam to the operating theater fifteen minutes had passed. It seemed more like hours to Adam.
"He'll be alright, Addy. He'll be alright," Jason cooed softly in his brother's ear. All he could do was be here and take care of Adam.
"Alright, Doctor Guerrero, I'll take your advice. Time; nine twenty-seven pm, begin," Hunter gave the orders for the operation to start.
While Doctor Guerrero began the light, general anesthesia, Hunter administered the heavy local anesthetic to the area around the wound just above Bret's wrist. It was the area where his gloves and turnout coat met. How he escaped with no broken bones was a miracle.
"Kind of ironic isn't it, my left hand, Bret's right arm, aren't we a pair?" Adam spoke with a wry, tear filled laugh. It would be a couple of minutes before the intense operation began.
"Well, together you'll have a good pair of working hands. At least you're not left-handed," Jay tried to keep the mood as light as possible. He knew how "fragile" Adam could get sometimes.
"Time; nine thirty pm, surgery begin," Hunter said aloud. The surgery would be recorded for legal reasons, just like every other surgery.
"Ready, Wade? You're doing a very good thing, I'm very proud of you," Shawn said to the Englishman. He was proud of Wade. He knew Barrett could have kept his mouth shut about his blood type, especially with all that had happened earlier.
"Go ahead, take as much as you need. I only hope for Adam's sake, Captain Hart will be alright," Wade said honestly as he watched his blood go up the tube to the filter bag. Soon the red liquid would go down the other tube and into Bret's blood depleted body.
"Fuck, this cut is full of debris. Shawn we need to flush with ten percent saline, STAT, he's still bleeding like a stuck pig," Hunter ordered in a very worried tone. He was extremely concerned about Bret. Shawn was used to Hunter's tone in the operating room, he never let it phase him.
Shawn nodded to Beth. It was her job to get Shawn what ever he needed, and Shawn's job to relay those things to Hunter. Shawn handed Hunter a large syringe filled with a mixture of saline, water and liquid antibiotics. While looking through the high-powered, extremely sensitive electron microscope Hunter planned his course of action. As Hunter expertly washed the wound, Shawn used gauze sponges to dry the firefighter's skin. Even without the microscope, Shawn could see how dirty the cut was.
"Doctor Helmsley, you need to speed things along if you can, his temp is one hundred two, pulse rate is forty, pressure is eighty over sixty," Vicki called out the latest readings from the monitors.
"That's awfully low, come on Hunter, come on," Adam muttered under his breath. His head rested on his brother's shoulder.
"I'm sure he's doing all he can," Jason said softly and confidently. He hoped this wasn't too much stress for his little brother.
"Thank you Doctor Guerrero. Keep me posted. It's a bit low, but not to the worrisome level yet," Hunter replied to the Anesthesiologist, then continued, "Doctor Barrett, are you doing alright?" he asked over his shoulder.
"I'm fine Doctor Helmsley, just fine," Wade replied as his blood continued to flow from his vein into Bret's. He of course, was feeling a bit light-headed, but that was normal. Some orange juice and he'd be fine. He just kept Adam's stricken face in his mind. He wanted to see the man happy again, if Bret needed every drop of his blood, he could have it.
"Doctor Helmsley, Pulse is thirty, pressure is eighty over fifty, he dropping rapidly, shock getting worse," Vicki sounded even more worried.
"I'm finally ready to start with the ligatures, this vein is pretty ragged, it's going to be long and tedious. Shawn, more Novocaine, Doctor Guerrero, decrease the anesthetic. That should help his blood pressure, fever?" Hunter asked as took cut lengths of suture thread, ready to be tied around the broken artery.
"Yes, Doctor Helmsley, it will, for a bit anyway. Fever the same," Vicki replied. During a surgery, the doctors always addressed each other "formally" for clarity on the recording. She made the requested adjustments to her machine. She then kept her eyes on the monitors.
"Hemostat," Hunter ordered as he held out his hand. Shawn firmly placed the tool in his husband's hand. The hemostat is used in many surgical procedures to control bleeding. That's why it's common to see the first incision lined with hemostats to close the blood vessels waiting for ligation during the first phase of surgery. The hemostats pivot easily and have locking teeth that allow for adjustments in holding pressure.
Hunter clamped both ends of the severed artery. He would line the torn artery with a small tube in Bret's arm as a "makeshift" artery to replace the damaged vein. "Ligature," Hunter called out. Shawn placed one of the suture threads, held by another hemostat into the surgeon's hand.
Jason was actually paying attention and listening to the operation. He just didn't understand anything Hunter was saying. Maybe if he asked his brother to explain, it would give Adam's mind something else to focus on.
"Adam? Um, what's a ligature?" Jason asked in a curious tone. He still stroked the top of his brother's head as it rested on his shoulder. His shirt was wet from Adam's silent tears.
Adam moved his head and looked at his brother, his eyes were red and still tear filled. He could tell that Jason was honestly curious. Well, it would take his mind off things to explain what was happening.
"Well, a ligature is a piece of suture thread that's tied around blood vessels or other hollow tubes like the urethra, to shut it off. Hunter will clamp the artery perpendicular to the vein with a hemostat. Next he will secure it by ligating it, using a piece of suture. He'll tie it around before dividing the structures or in this case, the artificial artery before releasing the hemostat. It's knotted so it won't come undone of its own free will. It's very tedious, the artificial replacement tube has to be exactly right and the ligatures tied so that the artery won't leak. Eventually new tissue will form and encase the tube. It kind of like fixing a leak with duct tape, only a lot more complex," Adam sounded more like a teacher than a doctor or better yet, a doctor who was also a teacher, like Hunter.
"Wow, I actually understood that. You could teach Adam. So that's why he using that microscope thingy. That must take a lot of control and really steady hands," Jason said in a truly impressed tone. He was even prouder of Adam than before. He knew sometimes Adam got to perform during a surgery.
"Yes, it does. I just hope my hand heals. I'm going to go on and do my full surgical qualification next fall. Bret supports it. Oh Jason, what will I do if... I was finally happy, finally I know real love. I can't lose him, I just can't," the physician's tears flowed again. Adam knew Bret would be disappointed in him for crying, but he couldn't help it.
"Damn it, these artery ends are so frayed. I'm going to make clean cuts, the tube will fit better, but, I'll need a longer piece. Beth get me a three-inch, then I can trim if needed," Hunter stated in a sharp tone. He'd hoped to do the insertion faster but chances were the artery would leak. He just hoped Bret's vitals held while he took extra time. Speed wasn't always an option, even in a dangerous situation.
Beth went to prepare the requested piece of new artificial artery. It would take a few minutes, as it would have to be unwrapped, cut, then sterilized again. While she did that, Shawn prepared the new ligatures. Hunter took four steps to Wades surgical gurney.
"You hanging in there Doctor Barrett? Light headed? Dizzy? More than abnormal, I mean?" Hunter asked in a concerned tone. He like Shawn was also proud of Wade.
"Just a bit, but nothing some juice won't fix. Just take what you need. Worse damage than you thought?" Wade asked in a tired sounding voice.
"Yes, but this will work. I just hope I have time. I'll keep you in overnight, you may need a glucose drip for a couple of hours or so..." Hunter was interrupted by a very frantic Doctor Guerrero.
"Doctor Helmsley! His pressure is dropping sixty over fifty and falling!" the Anesthesiologist was controlled but frantic.
Both Shawn and Hunter moved back to Bret. Hunter checked, the artery was still closed by the hemostats, but one cut off artery wouldn't cause that rapid of a loss in blood pressure. Bret's fever hadn't spiked. Yes, Bret had been shocky, but under control. Hunter had no foreseeable reason for Bret's sudden and rapid down turn.
Beth had the new artificial artery replacement ready. Hunter debated, but decided to go ahead with the surgery. "I'm going to continue. Doctor Guerrero, lighten the anesthetic again," Hunter barked in command. He rapidly began the delicate operation, Shawn at his side.
Adam sat up, he was on the edge of his seat. He was absent-mindedly chewing on his right hand. He didn't feel Jason rubbing circles on his back. Jay could hear his brother muttering begging prayers. He was pleading with God to spare Bret.
Hunter was working as quickly as he dared. It was extremely tedious and not something that could be rushed or the artery would leak.
"His pressure is down to forty over ten, we're loosing him, we're loosing him! Thirty over twenty! Thirty over ten! He's flat lined!" Doctor Guerrero said in a panicked voice.
The Captain's heart had stopped beating. The machines were sending off loud warning beeps. Hunter stopped the surgery.
"Crash cart, NOW! GODDAMN IT! MOVE!" he nearly screamed his orders at Shawn. The nurse had frozen in place for a moment. When Hunter's yell reached his ears Shawn was back in full nurse mode. He dashed over and brought the cart with the defibrillator and the medicines needed to re-start Bret's heart.
Wade Barret was in shock, not medically, but mentally. As he lay on the gurney, he turned his head to look up at the theater seating area.
Jason was carrying his brother out of the room, the IV bag in his teeth. Adam needed help. He'd passed out when Bret had crashed. His last words before he fainted were, "Bret's dead!"