Chapter Fifteen

01/07/2019. 15:34 hours. Virginia Hospital, Arlington, Virginia.

Dr Stokes had never wanted to bang his forehead against a brick wall as much as he did at that moment. There was never a day went by that he did not question the sheer incompetence of some people who claimed themselves to be professionals. He stole a glance over his shoulder at his sleeping patient. The restraints had been cut away from the young man's bruised and bandaged wrists and ankles. Dr Stokes gently massaged his temples to rid himself of the headache blooming behind them. It was by some miracle that Dr Spencer Reid had not developed any lasting neurological effects from the ECT, or the prolonged seizure for that matter. He had already prepared his harshly worded report to the board of directors at both Bethesda General Hospital, and at North Virginia Psychiatric Facility for even remotely considering such a risky treatment in an individual with epilepsy. It was as clear as day in his medical notes that he had Post-traumatic epilepsy originating from trauma to the temporal lobe. Difficulties managing emotions and behaviour was expected from such a trauma. Not a single person had had the presence of mind to recommence his anticonvulsant regime, and determined the best course of action was to trigger more seizures. And they inappropriately kept him in restraints when mechanical restraint should only be used as a last resort and for the shortest time possible. Dr Stokes had spent enough time on neurology and neuropsychiatry when completing his rotation during residency, to know himself that it was highly inappropriate and unethical. It was embarrassing to the medical profession.

Satisfied that Spencer was comfortable and resting, Dr Stokes crossed the short hallway to the nurses' station and slumped down into the swivel chair with a sigh. He slipped the clear plastic folder labelled REID, S. out from the docket in front of him and peeled back the front page. The tip of his finger slid down the page to the contact number he was looking for. He grabbed the handset to his left and dialled the number, reciting it back twice to be sure. The phone rang three times before a female voice answered.

"BAU Unit Chief Emily Prentiss speaking."

"Ah, Agent Prentiss. My name's Dr Adam Stokes and I'm an ER physician at Virginia Hospital in Arlington. I understand you're the medical contact for Dr Spencer Reid. Is that correct?"

"That's right. What's going on?"

"Has anyone been in contact with you from the North Virginia Psychiatric Facility?"

"Not since this morning to say that Dr Reid had received his treatment and was settled in his room. Why? What's this about?"

"Dr Reid was admitted into our care two hours ago following a prolonged seizure. He's resting comfortably at the moment. This is something that would be better discussed face to face, agent, as I have some very grave concerns that I must address as a matter of urgency."

"I can be there in the next hour."

"Thank you, Agent Prentiss. We'll talk more when you get here. Dr Reid could use a change of clothing and some toiletries as we plan to keep him in for a couple of days for observation."

"Of course. I'll be there soon." Dr Stokes set the phone down and craned his neck over the top of the desk to see Spencer sleeping soundly, chest gently rising, and falling and his head tilted to the side. He quickly jotted down a note into the folder and signed it with a flourish of his wrist before closing the folder and carrying it back to his patient.

01/07/2019. 15:40 hours. FBI Offices, Quantico, Virginia.

Emily chewed her lip and furrowed her brow at her cell phone. To say that she was concerned was an understatement. It made her blood run cold. Spencer had barely been in the psychiatric unit before he had to be readmitted. But the fact that the doctor had concerns that had to be addressed immediately and couldn't be discussed over the phone was frankly terrifying. Trying to slip her stoic mask into place, Emily pocketed her cell phone and made her way down the few steps into the bullpen. She glanced around at her team burrowing through piles of reports. David and Penelope were returning from the break room with steaming mugs of coffee. Penelope clasped her oversized unicorn mug between colourfully manicured hands.

"Guys? I need to talk to you all for a minute," said Emily, desperately trying to hide the tremor in her voice.

"What's going on, Em?" asked JJ, twirling slightly in her chair and peering up at the unit chief. Matt, Luke and Tara shuffled over and perched on nearby desks.

"I've just got a call from Dr Stokes at Virginia Hospital in Arlington. Reid was admitted into their care two hours ago after having a prolonged seizure. He needs some toiletries and clothing as he is being kept under observation for a couple of days." Emily let out a long breath through her nose. "The doctor has some concerns that he needs to address as a matter of urgency and can't discuss it over the phone. I need us to go and collect some stuff from Reid's apartment, and then we need to go over there."

"What do they mean 'concerns'?" asked David.

"He couldn't go into detail over the phone. All he could say was that he had very grave concerns."

"That can't be good," replied Tara, crossing her arms over her chest. Emily shook her head, dark hair swaying. JJ frowned, fingers curled under her chin in thought.

"Whatever the situation, whatever he may or may not have done, we need to remember that Spence is our family," responded JJ. Emily straightened up and squared her shoulders.

"Wheels up."

01/07/2019. 17:05 hours. Virginia Hospital, Arlington, Virginia.

Despite the looming stature of Virginia Hospital, it was a fairly modern looking building with clean walls and windows that gleamed in the sunshine. It was renowned for being a state of the art facility specialising in various aspects of medicine, but primarily neurology. Two black government issue SUVs trundled into the expansive parking lot and parked side by side in adjacent bays. David, Emily, Penelope, and Rossi exited one car, whilst Tara, Matt, and Luke climbed out of the other. Kevin Lynch had offered to cover technical analyst duties so that Penelope could be with her 187, her junior G-man.

On entering the hospital, Penelope immediately made a beeline for the gift shop with a clear warning from JJ not to go overboard whilst the others ordered takeout coffees for themselves. The group were standing chatting casually amongst themselves when Penelope returned laden with a bag and foil balloons. JJ shook her head and laughed.

"Garcia? What did I say?" chuckled JJ.

"I am spoiling my baby boy, and there's not a damned thing any of you can do about it!" responded Penelope indignantly. She was like a walking rainbow with the colourful foil balloons, her blue geometric print dress, blue leopard print wedges and hair bows. Penelope pouted at JJ and barged past her towards the emergency department, wedges tapping in time with her rhythmic steps. Tara raised her eyebrows.

"Dr Stokes won't know what hit him when that hurricane lands," said Tara with a laugh and shake of her head as she watched Penelope's retreating form. With their cups in their hands, and an extra cup for Spencer, the team followed the technical analyst to the emergency department.

Arriving in the department, Penelope was already in a heated debate with the woman based behind the reception desk.

"I need to know where Spencer Reid is!" barked Penelope. Emily rested her hand gently on Penelope's shoulder and eased her away from the desk. The frazzled receptionist glanced up at Emily, then at the group behind her in business attire. Emily slipped her credentials out of her blazer pocket and held them up.

"My name's SSA Emily Prentiss. I was called to come by Dr Stokes regarding Dr Spencer Reid." She slid her wallet back into her pocket.

"What's his date of birth?"

"Twelfth of October 1981."

"Ah, yes. He's in bay two. Dr Stokes should already be there."

"Thank you." Penelope fired a narrowed glare behind her red-rimmed spectacles at the receptionist before following the team to the area signposted as the observation bays. The bays themselves were small cubicles surrounded by flimsy paper curtains. Bay two had the curtains closed. Emily grasped the edge of one of the curtains and peeked around the side to see a tall, handsome man in a white coat leaning over the gurney, shining the light of a pen torch into heavy-lidded eyes. He turned his head at the sound of the curtain hook on the rail.

"Agent Prentiss?" asked the man, sliding his pen torch back into the breast pocket of his coat. He had soulful brown eyes and neatly coiffed brown and dark blonde curls. The doctor reached out a hand to Emily, sliding the curtain back slightly with the other hand to allow the other agents in.

"I'm Dr Stokes. I spoke with you on the phone." Emily nodded, her eyes fixed on the doctor as though she was entranced by him.

"Yes. This is my team, uh and Dr Reid's team." Dr Stokes nodded and indicated for the others to gather around the gurney. Spencer was barely awake, but his eyes were open, gazing at the faces of his friends, his family. A small smile quirked at his top lip. The exhaustion and confusion remained evident, but those hazel pools still held a lingering sadness behind them. He lifted his hand from the blanket and waved weakly at them.

"Hey, guys," croaked Spencer, his mouth dry. A nasal cannula sat under his nose and EKG wires hung out of the collar of his gown. A new IV had been inserted into the back of his left wrist and was hooked up to a bag of saline that hung on the stand next to the bed. Fresh bandages had been applied to his arms. He had slightly reddened circles on his temples.

"Thanks for coming, agents. As you know, Dr Reid underwent electroconvulsive therapy this morning. Now, one of the things that I have learned in neuropsychiatry, is that ECT should never be used in patients with a diagnosis of epilepsy. It is clearly documented in Dr Reid's medical notes dating back to last year that he has Post-traumatic epilepsy as a result of his brain injury. So, it is understandable that he went on to have a seizure lasting almost six minutes. His blood pressure and oxygen levels were dangerously low and his heart rate was high."

"And how is he now?" asked Emily.

"Blood pressure and oxygen levels are coming up nicely. MRI scans on Dr Reid's brain have shown no lasting damage from this seizure. His short term memory is intact and there doesn't seem to be any neurological effects, which is exceptionally lucky. He's still very drowsy, which is to be expected. He also has an intense headache which is a known side effect of ECT. This brings me back to my concerns…" Dr Stokes glanced down to see that Spencer had fallen asleep. His chest gently rose and fell and his head was slightly turned to the side. A lock of hair had fallen over his face.

"First of all, Bethesda should have never suggested ECT as an emergency treatment for suicidal ideation, especially when they had his medical records. North Virginia should have also checked these before administering the treatment. Secondly, both hospitals have neglected to provide Dr Reid with his anticonvulsant medication that they had on file. Given the situation that he has most recently been in, it is safe to assume that he has not had his medication for close to seven days.

Finally, Dr Reid was in restraints when paramedics arrived on scene. My understanding is that he was restrained from surgery, and remained in them until paramedics cut them off. Mechanical restraint must only be used as a last resort and for as short a time as possible. This man has been restrained for much longer than is necessary."

"He was presenting as violent when he went to the ER," responded Luke.

"That may be so, however they should have been removed once he'd had his treatment and was on the ward. Anyone who has had ECT does not pose a risk to anyone. When he presented as subdued on waking, he should have been released immediately, however the staff say they did not have authorisation to remove the restraints before the psychiatrist assesses. All staff working in psychiatry are aware of the guidelines around the use of mechanical restraint. Once he started seizing, the restraints should have then been removed, however the staff failed to do this. Because he was cuffed when he had his seizure, Dr Reid developed substantial bruising to his wrists and ankles, and he opened up his wounds on his arms. We have stitched the wounds again."

"So, what happens now?" asked David.

"We need to keep Dr Reid in for observation for the next couple of days. We need to be sure there's no lasting effects from the ECT, the seizure, or the reopening of his wounds. Now, I agree that Dr Reid needs some intensive trauma therapy, however I feel this would be better managed by staying with someone and seeing a therapist. His trust in mental health services will be diminished now. I can provide you with some therapists who specialise in neuropsychiatry. Difficulties in managing emotions and behaviour are expected effects from a brain injury affecting the temporal lobe. I only ask that you're patient with him. If he needs space, at least observe from a safe distance. I am submitting a formal report to the board of directors at both Bethesda and North Virginia highlighting my concerns and recommendations for future practice. He has been through a massive amount of trauma in a short time. He needs the people he loves around him."

David straightened his shoulders and puffed out his chest. His dark eyes met Emily's in mutual understanding.

"He's staying with me. I'm not taking no for an answer either. I've been through this with the kid before. I know how to deal with him. I will get him the best therapist out there. I'm not leaving him alone. Never again."

JJ appeared to be lost in a world of thought as she gazed at Spencer's sleeping form. She glanced up to see Emily handing over the bag of clothing, toiletries and books that she had gathered from Spencer's apartment to Dr Stokes. JJ chewed on the tip of her thumb. She was unable to help but wonder why the Director had been so willing to send Spencer into the prison where Warden Michaels worked. He would have known about Michaels' brother and Spencer's involvement in the case. Surely he would have known that Michaels would want revenge? Tara appeared to catch on to JJ's thoughtful grimace.

"What's on your mind?" asked Tara, gently resting a hand on JJ's shoulder.

"Emily said that the Director threatened Reid's job if he didn't do the custodial work. He had spoken to Michaels. He would have known about Michaels' brother and Spence's involvement in the case. He would have to have known that Michaels would want revenge on the agent who locked away his brother. Not only that, the Director sent him into a place that he knew would trigger Spence's PTSD." Tara frowned and her breath caught in her throat at the premise. JJ was right. The Director definitely seemed to have it out for their resident genius. The question was - what? Tara averted her gaze to David who was clasping one of Spencer's hands in both of his. Penelope was on the opposite side, tucking a stuffed bear under Spencer's bandaged arm and tying the balloons to the metal rails on either side of the gurney. Somehow, she suspected that the ordeal was far from over, and they would need to protect Spencer at all costs. Protect him from the Director, the Director's reach, and himself.