CHAPTER THREE
ON THE COUNT OF THREE
CAMARO - HONOLULU - O'AHU
Just in time Steve turned the wheel and avoided a collision. The Camaro spun around. Tires screeched on the road. Danny slammed against the door. There was a yelp and then nothing. The black sedan blasted past them as Steve brought the Camaro to an absolute stop.
Steve shot a side glance at his partner and said. "Yo, you okay?" the sight made his heart drop. Danny was out cold. All color had left his face. Shit.
"Hey, Danny?" Steve pulled on his partner's left arm, shaking it until there was a weak mumble. Steve briefly let his head down and sighed with relief.
"Didn't I say, eyes open?" He barked as Danny slowly came to.
"When do we ever— listen to each other?" Danny quipped.
"Good point." Steve noted. He turned the Camaro back around, shifted into gear, and floored the accelerator. Racing toward the hospital, gaining speed every foot of the way.
KING'S MEDICAL CENTER - HONOLULU - O'AHU
Steve hit the brakes and parked the Camaro right in front of King's Medical Center's door. He climbed out and jogged over to Danny's side of the car.
Near the entrance, a man was standing. In his thirties, tall and slim. He was smoking a cigarette, not precisely the kind of image you want people to see outside of a hospital. However, the guy was dressed in surgical greens, covered by a white lab coat, and there was a stethoscope hanging around his neck. Precisely the kind of person Steve was looking for, minus the smoking. He signaled the young doctor. "Hey, I need some help over here!"
The guy tossed the cigarette aside and came running towards Steve. "What do we have?" He immediately inquired.
Steve pulled open the passenger door. "Detective Danny Williams, he took a beating earlier today and now has trouble breathing. He passed out on the way over."
"That's because you— drive like a lunatic." Danny objected, willing to get out of the car by himself.
"That's not the point, okay," Steve argued, grabbing his partner by his arm to help him get up. The doctor jumped in to give more support. Steve turned to the man. "He was shot a couple of months back. The bullet punctured his right lung and caused a tension pneumothorax."
The doctor froze for a moment. He seemed awestruck. "Wait, don't tell me you are the detective. The one that got shot here in quarantine?"
Danny grunted as he straightened. "The one and— only, I hope."
Steve arched his eyebrows astonishingly. Despite the pain Danny was in, he managed to make a witty remark. It put a smile on the doctor's face. "It's a pleasure meeting you."
ER - KING'S MEDICAL CENTER - HONOLULU - O'AHU
Going into the ER of King's Medical Center, the doctor took Danny straight to the treatment bay. An older female nurse joined them. She assisted Danny in getting up on the gurney and started taking his vitals. She shared her findings with the doctor. The dark-haired man was called Dr. Layton. Steve spotted the name embroidered on the doctor's white lab coat. The man had been too busy to introduce himself, and Steve didn't mind. His partner's health was his number one priority, so he preferably had the doctor taking care of that instead of shaking hands with each other.
The doctor helped Danny take off his button-up shirt. Steve could see the pain on Danny's features due to the movement. With his shirt off, Danny leaned back against the gurney. He was breathing slow, his chest barely going up and down. A cold sweat glistened on his forehead, and Danny was as white as the gurney's sheets. It was a good thing he was already lying down because he looked like he could fall unconscious any second. Steve locked eyes with his partner. The baby blues gazed bleakly and drained back at him.
Although Steve was harrowed to see his friend suffer like this, he was glad he had taken him to the ER. Steve crossed his arms over his chest and watched closely as the medical professionals did their thing. The nurse was now busy hooking Danny up to an IV after she had connected him to a heart monitor. Steve studied the numbers on the monitor. The heart rate was elevated. Blood pressure seemed good. Temperature was normal. Saturation levels were low, though. The number blinked in red on the screen.
Dr. Layton noticed it as well. "Let's get him on oxygen, too," he suggested as he slipped on a pair of gloves. The nurse pulled the oxygen tube around Danny's ears and slid the cannula's prongs into his nose. In the meantime, Dr. Layton evaluated the bruising littering the right side of Danny's chest. His dark eyebrows knitted together as he looked at the discolored skin around the incision. Danny flinched as the doctor gently touched the bruise. Dr. Layton apologized but questioned. "Did you have any trouble after the shooting, Detective?"
Steve stepped closer. "No, he's been doing fine," he said but checked with his partner for certainty. "Right?"
"Mm-hmm," Danny mumbled, agreeing.
Dr. Layton grabbed a tablet and scanned the chart. He scrolled through it but seemed puzzled. "Who was the attending physician?"
"Doctor Keller." Danny recalled. — Miraculously fast, in Steve's opinion.
The doctor faced the nurse. "All right, page Dr. K," with that order she left the room. The man in surgical scrubs took the stethoscope from his neck. "Let's have a listen in the meantime, okay?" Dr. Layton moved his stethoscope around Williams' chest, frowning. "Poor breath sounds on the right side," he mentioned as he did a step back and peered around the hustling ER. "Mike, I need a chest X-ray." He shouted.
An emergency radiologist came jogging toward treatment three. He pulled up a portable X-ray machine and prepared it for the procedure.
"Step back, please." Dr. Layton instructed Steve, taking a couple of steps back himself.
"Clear." The radiologist warned and pressed a button.
After a couple of seconds, he pulled the machine away. A black and white image popped up on the screen. As Dr. Layton studied the new imaging, Steve caught sight of another doctor coming their way. He recognized the seasoned physician. The doctor that had taken care of them when they were in quarantine a couple of months back. The man had guided Steve through treating Danny after he was shot as well. Steve liked the guy.
Dr. Keller entered the treatment room, putting on gloves. "Detective, we weren't supposed to see each other for another week," he greeted. The doctor's words automatically spiked Steve's level of concern. He wanted to ask, but the doctor continued. "What's going on today?"
The younger doctor pointed to the imaging. "Small pneumothorax on the right side."
Dr. Keller sighed. "So much for staying out of trouble," he approached Danny. Surveyed the bruising himself. "Anything else? Broken ribs, maybe?" He asked his fellow doctor.
"No, and I doubt the blow is the cause. It's a common problem to have a recurrence after the first Pneumothorax episode. Particularly, within the first six months." Dr. Layton concluded.
"That's right," doctor Keller agreed and focused back on Danny. "We'll put in a chest tube, and we're going to admit you upstairs, okay?"
"No— no hospital stay." Danny insisted. Steve knew Danny hated hospitals, but he seemed desperate this time.
"Detective, if we do nothing, you're at risk for another tension Pneumothorax," Dr. Keller informed. "Now, I don't think I have to explain to you how dangerous that is."
Danny scrambled more upright. Pain flitted across his features. He tried to hide the wince of pain, but Steve didn't miss it. "It's not that— bad. I just need to catch— my breath— that's it."
Steve shook his head. The doctors would be fools if they believed even one word of that. "Danny, it will just be a couple of days." Steve attempted but was directly cut off by his partner.
"This weekend's Charlie's— first— soccer game. I'm not going to— miss that," Danny said winded. He stared at the doctor's with pleading eyes. "There has to be another option." Steve should've known it had something to do with Danny's kids. They were more important than his own health.
Dr. Layton suggested. "We can aspirate and put in a one-way valve tube."
Dr. Keller shot a questioning look at his younger coworker. "That is not protocol."
The younger doctor shrugged. "Right, but it won't require him to be admitted."
"Screw protocol. You can do what— ever you want to me— as long— as I can walk out of here tonight." Danny stated with a hint of hope.
Dr. Layton nodded. "Okay. Get me a small chest tube with a Heimlich valve," he told the nurse before turning back to Danny. "We're gonna numb you up, give you something for the pain, all right?"
"Hold on," Doctor Keller stopped the nurse from handing over the requested equipment. He looked down at Danny. "How's your breathing? Last week you said sharp pain flared up in your chest while inhaling."
This was the second time the doctor indicated that there was more to this situation. It even made Steve's aneurysm face appear. His eyes flicked confused from doctor Keller to Danny. "Last week?" He asked.
"Commander, I need you to wait outside." Dr. Keller insisted. The nurse was instantly in front of Steve. Encouraging him to leave the treatment bay by leading him out.
"Danny?" Steve hoped his partner wouldn't blindside him.
"Go— m'fine."
With those words, Steve got whisked away.
TREATMENT THREE - ER - KING'S MEDICAL CENTER - HONOLULU - O'AHU
Dr. Keller readjusted the stethoscope around his neck. "Detective, if you ask me, you should be on suction, but it's your choice and this valve will do the trick too. However, you will need to come back to have it switched out in a day or two, all right?"
"Okay— but my lung's — not gonna collapse, right?"
"Can't promise you that, but if you feel like you're gonna pass out or if there's any chest pain, you need to call 911, immediately."
"Got it."
"I assume you still didn't inform your partner?" Dr. Keller said, his tone matching with his facial expression.
"There was no need to— worry him— until now, right?" Danny replied.
"Well, something tells me that you wouldn't be here if you told him."
Danny wasn't really up for a lecture." Yeah, let's just get— it over with, no?"
Luckily, Dr. Layton didn't waste another breath and started scrubbing Danny's chest clean with antiseptic liquids. Then he injected some medication to numb the area. He waited a minute, probably for the meds to kick in, but there was barely any numbness. "Ten blade?" Dr. Layton extended his hand, so the nurse could hand over the scalpel. Once it was handed over, the doctor used the knife to make a small incision on the pectoral muscle. Cutting the old scar right back open. The pressure was horrible, but Danny managed to keep the cursing to himself.
Blood gushed out, and for a moment, Danny was sure he was going to pass out. His eyes were glued to the ceiling when he heard the scalpel get dropped onto a metal tray. Danny figured the worst part was over. He couldn't have been more wrong. In a split second, the relatively painless procedure changed into a grueling one.
Dr. Layton began to insert a thick, hard plastic tube between Danny's fourth and fifth rib. The tube, however, was larger than the space between the two ribs. That's when the doctor started pushing the chest tube in with great force. Danny could no longer stay quiet. He let out a pained grunt, and son of a bitch were the words that accompanied the wail of pain.
"Sorry, I can't seem to get it in." Dr. Layton apologized but kept pushing and prodding the tube with an enormous amount of pressure.
After several efforts at forcing the chest tube through the incision and into the chest cavity, Danny tuned out. Dark spots danced before his eyes. His heart was pounding; the vital monitors beeping erratically. He struggled for a breath of air, and instead of feeling any kind of relief, the pressure became even worse. Danny was lost in his own misery when someone took the oxygen away from underneath his nose and replaced it with a mask covering his nose and mouth. It did give more support, but that was up until a large, metal tool that looked like a giant pair of scissors popped up in his sight. Danny's eyes went wide. This was no good. The end of the tool was slightly blunted, and only by looking at it, Danny knew it was going to hurt even more.
"You need to push harder." Doctor Keller instructed his fellow doctor. It was the one thing Danny wished he hadn't heard. He really didn't need to know there was even going to be more pressure. Now that he knew, Danny braced himself. He grasped a handful of sheets, his fingers interlaced with the fabric.
Dr. Layton grasped the tool's handles with both hands and placed the blunted end inside the incision. He then bore down with his full weight upon Danny, trying to dig a hole into his chest. The doctor swayed the tool from side to side and in a circular motion. It was like he was trying to dig a beach umbrella into the sand on a hot summer day. The pain was beyond any pain Danny had ever felt. The injections were the only barrier of protection, but those hadn't reached deep enough to offer much help, that was for sure.
The young doctor was still digging with vigor into Danny's chest when he sighed frustrated and looked up at Dr. Keller. "I'm through the pectoral muscle, but there's no way I'm penetrating the chest wall."
"Let me try." Dr. Keller replaced Dr. Layton's spot and started prodding the tool. "There's too much scar tissue," doctor K concluded and placed his hand on Danny's shoulder. "Danny, I'm sorry this is going to hurt, but we really need to get that tube in, do you understand?"
Too tired and in too much pain, Danny just nodded to give his consent. There was no point in stopping now. Both doctors were probably thinking the same because the two men grabbed hold of the scissor tool straight away, and they placed it back into the incision. The doctors then prepared a countdown. On the count of three, both men gripped the scissor tool tightly and pushed down with the force of their combined weights.
After seconds of their sustained push, Danny felt an additional spike of unbearable pain. He was about to lose consciousness when he heard a weird popping sound. He was too lightheaded to even ask, but Danny hoped that the popping sound meant they finally made it through.
Another wave of dizziness rolled over Danny after another shock of pain. But that's when Dr. Keller said the redeeming words. "We're in."
Danny stared down at his chest. Just in time to see the chest tube getting inserted. It seemed to slide, reasonably smoothly, into the newly formed hole in his chest. No wonder because Danny guessed the hole was big enough to swallow the entire island. At least that's how it felt. Finally, as the tube almost completely disappeared into his chest cavity, there was a huge relief of pressure. More blood streamed out, actually quite a lot. However, Dr. Keller cleaned it up before it could drip onto the floor. For some reason, Danny's eyes locked on the bruising. It had turned even darker than when he arrived. That wasn't an odd thing considering they had been poking around in his chest for what felt like hours.
"Push five of morphine." Dr. Keller ordered the nurse. Danny rolled his head to the left. A syringe was pushed into his IV. He watched the fluid making its way into the back of his hand. They could've done that sooner, Danny thought to himself. Only seconds passed before he felt the acute pain and burning sensation in his chest subsided. The medicine made him drowsy, causing his eyelids to feel heavy. With no energy left to fight the heavy feeling, Danny closed his eyes and drifted off.
WAITING AREA - KING'S MEDICAL CENTER - HONOLULU - O'AHU
Steve checked his watch. It was coming up at half-past eleven in the evening. He had been waiting for almost forty-five minutes now. Tani and Junior had arrived a little after Steve and Danny did. The young team-members had been sitting in the waiting area when Steve was sent out of the ER. Steve sat down next to them, and they accompanied Steve during the wait. However, when the minutes changed into half an hour, Steve told them to go home. Tani had tried to disobey the order, but Steve made himself clear that there was absolutely no need for both of them to stay. Steve figured it wouldn't be much longer anyway. Except it did.
Watching the minutes tick by on his watch, Steve was done waiting. He jumped up from his seat and marched over to the nurses' station. He was about to demand an update when Dr. Keller appeared through the double sliding door.
The doctor evened the stethoscope around his neck as he approached. "Commander, if you want, you can go back to your partner."
"Thanks, Doc," Steve said but wondered what had taken so long. "Is he all right?"
Doctor K stayed silent as if he was contemplating his following words. "Well, the procedure didn't go as smoothly as it should have," he began, getting Steve's full attention. "There's a concerning amount of scar tissue from previous procedures that made it difficult to puncture the chest wall. However, we did manage to get the tube in place, so as long as he takes it easy for a couple of days, he should make a good recovery."
"Wait, what?" perplexed Steve shook his head. This was all new information to him. "A concerning amount of scar tissue? What does that mean? Will it affect him somehow?"
"Commander, it's been affecting Detective Williams for months now," the doctor notified. "He has been back several times since the shooting. The scarred tissue is causing discomfort while breathing, and because of that, he's experiencing pain in his chest."
The information hit Steve like getting slapped in the face with a flat hand. "You're saying he's been in pain for months?" he placed his hands on his hips, let his head down for a second but then looked back up at the doctor. "How? I mean, he never complained about it or seemed to be in pain. Otherwise, I would've noticed it, right?" As the words left his mouth, Steve sighed. Danny never complained about it. He always complained, but about things that weren't important. If something really was bothering him, Danny didn't complain about it. He kept his mouth shut, so nobody would worry about him. Steve knew that. Except for this time, he missed a big one.
Dr. Keller continued. "It doesn't surprise me that you didn't know. He's taking quite some medication to suppress the pain. Making it easy for him to hide and for you to miss."
Steve scratched the back of his head, trying to process this conversation. "Is there anything you can do about it?"
"We already tried a bunch of things, like Corticosteroid injections and physical therapy. Both have not been very effective. Normally I'd wait a year before even suggesting surgery, but looking at the severe amount of scarring and how it's interfering with his health, I did consider revision surgery as the next step. Except in his current condition, we can't do such a thing."
Steve didn't fully understand. "Why can't you do it?"
"At this point, the surgery will do more harm than good," the doctor paused. "To begin with, his lung would have to be fully inflated again. Now that's going to take two days tops. But if we do the surgery right that second, there's a twenty to sixty percent chance that his lung collapses again. If it does, the procedure's effectiveness will be undone because we would have to open the chest wall again to reinsert the tube. Knowing those statistics, I'm not sure if that's a risk worth taking. Especially in Detective Williams' case."
Steve shot the doctor a quizzical look. "Why's that?"
"Commander, his lungs have suffered some serious damage over the years. I'd say that Sarin poisoning alone is quite the trauma, so when you add exposure to a deadly bioweapon and a bullet puncturing the lung, it's definitely damaging. With that knowledge, I can't guarantee a good outcome."
"So, he'll be in pain then?"
"We'll keep managing the pain with medication, maybe higher the dosage if needed. I'll discuss it with him when we remove the chest tube. The placement was pretty rough, so we've given Detective Williams some morphine. When he's feeling up to it, we'll discharge him."
— TBC / HAWAIIFIVE0 —
A\N: What's next? You'll find out on Thursday!
There's a lot more to come with this story, but I'll always love to hear what you think of it!
Thank you for reading!