Heey :)
I'm back with another chapter. The feedback I back from you is absolutely amazing and I couldn't be more thankful. I try to write as much as possible, but as I said, I'm rarely home.
On another note, one of you had almost the exact same idea as me as to where I should take this chapter, but I'm not going to spoil anything in advance, so you're gonna have to wait till the end… so here you go.
I hope you enjoy :)
PART 3
Will's P.O.V.
The rest of the 5 minute ride to the hospital took forever. The only way to keep myself sane was by counting in rounds of five, trying as hard as I could not to think about my surroundings.
The paramedic was straddling over Jay's limp body, doing chest compressions in order to keep his heart beating. Lucky for me, he had to be gentle, so I didn't have to witness my brother's ribs breaking due to CPR. Small mercies.
The ambo comes to an abrupt stop and the door swings open, revealing my colleagues. They pull the gurney out with both Jay and the paramedic on it, while I follow, carefully squeezing the bag. The paramedic starts listing off all of Jay's vitals, or in this case all of the vitals Jay currently doesn't have.
"Okay, take him to Baghdad" Rhodes orders, making my heart clench. The ambu bag is ripped out of my hands by April and the gurney disappears into the exam room. Rhodes allows himself a brief stop to award me with a concerned look. "Are you okay?"
I give him the rudest look I can manage "No, I'm not okay. My brother's in there, frozen and I've just spent 5 minutes breathing instead of him, so no, I'm definitely not okay." I pause, realizing I've just snapped at Rhodes who has nothing to do with this. "I'm sorry."
"It's okay, Will. I don't blame you" he squeezes my shoulder. "Hang in there."
Jay's team suddenly rushes up to us, almost knocking us over.
"Is he okay?"
"Is he alive?"
"What happened?"
"Where is he?"
Rhodes holds up one hand to stop them from blabbering. "We're currently working on restarting his heart, and I know it sound ba-"
"Wait, hang on. He's dead?" Adam asks looking as pale as death.
"Yes and no" Rhodes replies. "When it comes to hypothermia, we say a patient isn't dead until he's warm and dead."
"English please" Voight says annoyed.
"More often than not, patients aren't actually dead. They're just… frozen, and when they warm up, all of their vital functions come back."
"Okay, so wha-" Antonio starts to ask, but is interrupted by Rhodes.
"I'm really sorry guys, but I have to go. You can wait in the waiting room and I'll keep you updated."
Connor's P.O.V.
How is it that I'm once again standing in the ER and the patient in front of me is my colleague's little brother, Jay Troublemaker Halstead? I'm serious. How does this keep happening? Okay, doesn't matter. I need to make sure Jay survives this otherwise I might as well chop my own head off.
He's already been connected to all of the equipment and scary looking machines in the ER. He's on the vent, inhaling warm and humidified oxygen to hopefully warm him up. I need to figure out exactly how badly hypothermic he is. "Let's get his vitals and temperature. Get the heating blanket and keep the warm IVs going." Everyone's rushing around the bed, checking one thing or another, while I try to process this series of events.
"We got his heart started again, but he's bradycardic. BP's 79/40" one of the nurses announces.
"Temperature's 69.8" April adds.
"What?" I ask shocked. "You mean it's still dropping?" Nobody answers my question. You couldn't make this easy, Jay, could you? "Okay let's get him to the OR and do thoracic and peritoneal lavage" I order, helping the nurses as we get ready to move the younger Halstead.
As soon as we get through the glass door, I bump into Will. "Where are you taking him?" he asks completely freaked out.
"The OR. His temperature keeps dropping, so we're doing a thoracic and peritoneal lavage to hopefully reverse the process" I explain.
"What about ECMO?" Will asks, wanting to help.
"I'm trying to avoid using bypass, but if it comes down to it..." I trail off. "I'll keep you posted."
He nods absently, so I run towards the OR, taking the stairs instead of the elevator to get there as fast as humanly possible.
Will's P.O.V.
"Thor-what?" Ruzek asks once I mention the two medical terms.
"A thoracic lavage means that they're going to place two large chest tubes in, one in the top of his chest and one at the bottom of his back." Al winces. "They're going to pump warm fluids through his chest to help warm him up from the inside, because it's faster."
"That's… horrible" Adam states looking a bit green. "That shouldn't be a thing."
I can't say I disagree with him. It's a really invasive and painful procedure.
"Okay, what about the other thing you mentioned?" Voight wonders.
"Peritoneal lavage is similar to what I've jut explained, except the warm fluids are pumped through his torso in order to encourage liver function."
"Once again – horrible" Adam deadpans. Al gives him a look, though he's probably thinking the exact same thing. Everyone stays silent for a while after that, before Antonio speaks up.
"How bad off is he honestly?"
I'm not sure what to reply to him. I refuse to accept the seriousness of my brother's condition, because then I would have to face all the possible complications and bad outcomes. From a medical perspective, Jay is in for a fight. There's just so many things that could go wrong. "It's Jay. He'll pull through." Yeah. I know this isn't exactly the most honest response, but I can't face the truth just yet.
Al, who happens to have a certain amount of medical knowledge from the army, gives me a very skeptical look, which I dodge by casually looking at the floor and examining the tiles. I know I don't fool anyone, but let's be honest. They probably knew the honest answer to that question, before Antonio even said it. They're detectives after all. And they're most definitely not stupid.
Connor's P.O.V.
"Damn it."
I am going to kill this kid once he wakes up. Seriously. Does he have to make everything so complicated?
I look at the scary tubes sticking out of his torso, trying not to think about how painful they must be, wondering what I'm supposed to do. Even though we've just spent a good 15 minutes pumping warm fluids through him, his temperature continues to drop. By now it's clear that he's profoundly hypothermic and despite taking some of the most aggressive measures out there, he's still not getting any better.
By the time we got to the OR, his temperature has dropped down to 67, which is dangerously low. Not that it wasn't before, but still. Every single degree counts. I decided it was best to begin active rewarming as soon as possible, and since setting up the chest tubes for a thoracic and peritoneal lavage would take a while to set up, we also performed the GI tract and bladder lavage, though neither seemed to help.
In case you're keeping score, this leaves us with a total of 10 tubes and catheters sticking out of Jay's body. Two IVs and a central line, two tubes in his chest, two in his stomach, one going directly into his bladder, one down his throat helping him breathe and another one right next to it, pumping water in and out of his stomach. You'd think all of these scary procedures would've helped. But they haven't.
"Dr. Rhodes?" April startles me out of my inner conflict.
"I'm sorry, what?" I ask, having completely zoned out, which is totally and completely unprofessional.
"His temperature's down to 66.4."
"Alright" I inhale very slowly, hoping for a miracle to happen and prevent me from having to do this. It doesn't. "Let's put him on bypass."
Every single person in the OR has a sad look plastered on their face, because we all know the amazing detective, lying on the table and no one would ever wish anything bad on him. Let alone something like this. After a few moments of silence, they resume to rushing around, setting up everything we're gonna need, while I allow myself to be a friend for a second and lean close to Jay's ear.
"You better survive this, Jay, or I'm going to kill you myself" I whisper. "If you're brother doesn't kill me first" I add as an afterthought.
I straighten up and look at my coworkers.
"Let's save his life."
Will's P.O.V.
If it were possible to die from fear and sadness, I'd be dead right now.
Jay's team and I are sitting in the surgical waiting room, while Choi's giving us a terrifying and brutal update on Jay's condition.
"Considering none of the procedures were effective, we're going to have to put Jay on a heart bypass, to hopefully rewarm his blood as fast as possible and reduce the chance for any further damage" Choi explains, though no one except me quite understands him. Lucky me…
By the looks of it, Jay must've been far worse off than I had anticipated. None of the aggressive measures were working, which is why we have come to our absolute last resort. CBP. I'm also well aware of the fact that Jay's in more and more danger every minute.
"Okay, so what exactly is this heart thing?" Ruzek asks, clearly as lost as everyone else.
"A cardiopulmonary bypass is also known as the heart-lung machine. It's a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. Blood returning to the heart is diverted through a heart-lung machine before being returned to the arterial circulation. The machine does the work both of the heart and the lungs, rewarming the blood outside of Jay's body."
Choi waits for a while, letting the information sink in. Voight has an angry look on his face, and it's kinda scaring me. Al is nodding, apparently the only one on track with what's currently happening, if Antonio's, Adam's and Atwater's stares are anything to go by.
"I'm afraid it requires an open heart surgery-"
"Wait, hold on" Voight interrupts. "What? You never said anything about there being something wrong with Jay's heart."
"There isn't" Choi explains. "But I'm afraid this is the only way of helping Jay."
Everyone stays quiet.
"I'm sorry. I know this must be very terrifying and confusing to all of you, but trust me, we know what we're doing. It's the best chance he's got."
Well done, Choi. Way to freak them out even more.
I'm shaking and I can barely breathe.
I just want this to be over.
We're going to place a cannula in Jay's femoral vein to withdraw blood from his body. The cannula is then filtered, warmed, oxygenated, and then returned to the body. We've administered heparin to prevent clotting, and once Jay's taken off of bypass, we'll give him protamine sulfate to reverse the effects of heparin. As I said, the blood is warmed up during CPB and then returned to the body. The warm blood also speeds up the body's basal metabolic rate and increases its demand for oxygen, which is why we're gonna keep Jay on the ventilator afterwards, to help him maintain high oxygen levels."
Even though I know, how bypass works, Choi's explanation is making me sick to my stomach.
"Will?" Choi asks me with evident concern in his voice. "Will, are you okay?"
No.
To be continued…
This chapter turned out to be shorter than I'd hoped, but I guess it's better than nothing. I'm really sorry that I'm leaving you in a horrible spot once again, but I have like five minutes till I have to leave my house, so… I really am sorry. As usual, I'll try to write as soon as possible, but don't expect another chapter for at least the next two days, since I won't be home.
I hope you liked it and that it didn't disappoint you. I am not a doctor (nor will I ever be), therefore I have no clue if any of these procedures are correct. Thank you again for all the positive feedback. By the way, we're at exactly at 111 reviews right now, which is crazy to me. I love seeing how passionate you are about this story. It means the world to me.
Have a nice day. Hope to see you soon.
Love, N
PS1: Dear Lima (if this is your name, otherwise I apologize). Thank you so much for all your reviews. As I mentioned at the beginning of this chapter, you had the same idea as me, advising me to use a bypass, except I put another twist into the story. Anyway, I hope it didn't disappoint you and thank you for reading.
PS2: I honestls appreciate every single pne of your reviews and I don't play favourites ;)
PS3: You can probably tell I'm in a rush, since I keep blabbering XD
EDIT: Dear Victoria.Annxx, thank you for pointing out my mistake with Ethan Rhodes who obviously doesn't exist XD I'm really bad with names, it's honestly embarrassing