The nurse shakes her head, "Not at this point. We do need to do an ultrasound."
"Of what? To measure the amount of organ damage?"
"To confirm pregnancy."
Penelope splutters, "What?!"
"The ER has standard lab panels, unfortunately, things do get missed. That is why upon admission to the ICU the team verifies that standard labs were collected. In the ER many panels were run, but primarily to identify sepsis. Our ICU policy, due to the aggressive nature of some of the treatments we administer, is a pregnancy test on all biologically female patients under the age of fifty-five with no history of a hysterectomy."
"I think that there has been a mix up," Penelope insists.
"An ultrasound will easily verify that. Based on the level of stress that Miss Prentiss is under we did not want to extenuate the circumstances."
"Okay."
A technician lowers the siderail of the bed. Penelope counts her own breaths as she watches the nurse fold down the blanket, and fold up Emily's gown. She feels her own heart racing as they squirt green gel onto Emily's skin. The nurse, and the technician work from the side of the bed opposite of Penelope. The image quickly appears.
The room is briefly filled with noise, and then plummeted back into silence again. By the time the nurse wipes the gel away with a washcloth, pulls down the gown, and returns the blanket to it's resting position Penelope is crying. A second nurse swaps her seats as the first leads her into the hallway once again.
"Based on measurements your friend is well into her second trimester."
"I had no idea."
"We have electronic medical records. Based on the information we have from her providers it doesn't look like she attended any pre-natal appointments."
"Were there any scheduled?"
"No."
"You're suggesting that she may not have known?"
"It's possible."
"But the competing needs could increase her risk of dying before she's able to be adequately treated?" Penelope surmises.
"Yes."
"And the sepsis, as well as the treatment could be potentially life threatening to the fetus?"
"Again, that is correct," the nurse nods.
"So, at some point I, as her healthcare power of attorney may have to choose to terminate one, to save the other? Is that what you're suggesting?"
"Those are the current facts, yes."
"And if it doesn't come to that, and she responds well to treatment?"
"Emily could make a full recovery."
"What about the long-term effects on the fetus? Let's just hypothesize that there are lively outcomes for both?"
"The treatment for the sepsis may still have devastating effects on the fetus."
"I am going to go back in there, and try to get some rest, because I'll be damned if I am leaving her side until I can walk her out of here myself."
J.J. rolls into the room early in the morning, with Garcia's luggage, and her laptop bag. She hands her a breakfast sandwich, and a fresh cup of coffee.
"How is she doing?"
"She's critical, but stable. She's been restless through the night. They had to administer a second dose of medication to keep her sedated, because the first started to wear off, and she was trying to extubate herself."
"You should go home, and get to sleep. I'll take over."
Penelope shakes her head, "No. I'm here for the long haul. I already cleared it with the director. It doesn't make sense for multiple people to be in, and out in the midst of cases. I'll work from here."
"Did you get any sleep?"
"A couple of hours. I'll be fine."
J.J. looks over at the hospital bed. The bed reads Stryker at the end, and has about a million buttons, and alarms. Emily lies in the bed with a blanket up to her waist. Beneath the blanket she wears a beige gown with green geometric shapes. A tube hangs from her throat, and connects her to a monitor that artificially stimulates respirations. Penelope has secured her hair into a braid off to one side.
A PICC line connects her to IV fluids that run continuously. A blood pressure cuff, and pulse oximeter monitor her vital signs.
"How is she doing, really?"
"Her temperature is starting to trend down, so that is a good sign. She didn't want to be intubated."
"For obvious reasons."
"I keep talking to her, and telling her that she's safe, and it's just the two of us here. I just have no idea where her mind is travelling to in there."
"What can we do?"
Penelope shrugs, "Nothing. There is nothing we can do for her right now, other than be here for her. Her labs have been all over the place. Right now it's just a waiting game."
"Okay," J.J. nods.
"You should go."
"You'll call if anything changes?"
"I will."
"Penelope?"
"Yeah, J.J?"
"You should call her mom," she points out.
"She's already on her way."
"Good, at least that will give Emily something to fight about."
Three days later Penelope, and Elizabeth are by Emily's bedside. Elizabeth vacates her seat.
"I'm going to go outside, and take a lap around to stretch my legs," Elizabeth announces.
"I'll be right here," Penelope confirms.
Elizabeth leaves the room. The door clicks shut behind her. Penelope watches out the glass as she disappears down the hallway. She scoots her chair closer to Emily.
"Em, I know that you can hear me. You haven't had anything to sedate you in days. I know that you're so tired of fighting. I know that you are locked in your own mind. I need you to hear me. It's time for you to wake up. Your doctor said that your labs are starting to improve. The medications are working. You have to come off the ventilator. If you don't come off soon, they might not be able to get you off. Please."
Penelope sits in a chair next to the bed. She leans over the bed, and her head leans against the side rail, by Emily's hand. She leans back as tears fill her eyes. As she wipes her eyes with a tissue the vent alarm starts going off. Penelope finds Emily's eyes open, and her hand tearing at the tube. Nursing staff enters the room. Penelope expects them to sedate her again. Instead, a doctor enters the room, and they coax the tube out of her throat. She gently touches her hand.
"Emily, I'm doctor Garner. I know that you're scared. I need you to breathe if you want to keep this tube out of your throat, okay? Don't try to talk your throat is really going to hurt. You're here in the ICU. You are safe, and Penelope is right here with you."
Emily taps her hand with her thumb. "We're going to try to keep you extubated, but you are going to have to keep breathing on your own. It is going to feel very difficult."
Eventually, the assorted personnel leaves the room, and Penelope lowers the side rail. She sits on the edge of the bed, and looks at Emily.
"I know that you're going to be pissed, but I had to call your mom. You've been mostly out for three days. You've been very sick."
Emily squeezes her hand.
A few days later Emily has managed to stay extubated, and finally convinced her mother to leave the hospital. Penelope waits in the room as Emily returns from her physical therapy. Penelope watches helplessly as Emily can barely manage to lift her own body weight from a wheelchair to transfer into the bed. They thank the physical therapy assistant, and watch her out the door. Emily scoots to the edge of the bed, and dangles her feet over the edge.
"I want to go home."
"How many feet did you walk today?"
"A hundred."
"You're not ready to go home. You still have at least three more days worth of IV antibiotics. They are still trying to ensure that the pulmonary embolism you developed has resolved."
"I want to go home," she repeats.
"I know that you do. You're not ready. You still have a lot more work to do. You have to stay here so that they can keep a close eye on you."
"A nurse can come in, and give me my medication at home. A physical therapist can do home based services."
"Emily, it isn't that simple."
"Penelope, it's just the two of us. I know that people have been in, and out for days. What is going on? What is really going on? What aren't you telling me?"
"Is there anything that you want to tell me?"
"Penelope, what are you talking about?"
"How are you feeling?"
"I feel like hell. I get winded walking to the bathroom. You already know that."
"They are coming in around two o'clock to do some more… um…" she trails off.
"Some more what? They have poked, and prodded me a million times. Why are you telling me about one more test?"
"It isn't a test. I just need you to mentally prepare yourself."
"Mentally prepare, myself? Are they going to take me for whatever procedure they discussed to remove the blood clot?"
"No. While you were out at PT the nurse came in, and told me that the labs they took at lunch indicate the treatment is working."
"And another thing, why are they so hesitant to do a chest x-ray?"
"That is what we need to discuss."