Notes: Thank you for your reviews for chapter 17 and 18

Chapter 19: Trials and tribulations

Wednesday late morning

The incidents in the morning had left Lisbon feeling very tired and on edge, so after the conversation with the doctor a couple of hours ago, she had returned to the room assigned by the hospital just so that she could get some rest. The morning was chaotic, to say the least.

On the other hand, Jane was showing an improvement in his vital parameters after all the strain his body went through in a short span that morning.

100 – Heart rate 128/87 – BP 97 – O2 Saturation 22 – Respiration

The nurse made a note of the parameters on her chart and then proceeded to call one of the doctors on the team for further instructions.

Wednesday noon

As per the doctor's instructions, the hospital's portable CT scanner was wheeled into Jane's room. The specialty of this portable scanner was that the patient didn't need to be moved or repositioned for the scan; instead, the gantry (ring-shaped part of the scanner) moved over the patient for the scan. The radiographer positioned the machine over Jane's bed and began the scan. It was a chest CT scan. The doctor, a nurse, and a medical attendant were on standby for any unforeseen circumstances. The scan was completed in 15 minutes without a hitch.

Lisbon's presence wasn't required, so the nurse hadn't woken her up, sensing that she must have been tired. Lisbon, even though tired and anxious, had slept peacefully knowing that there were enough SWAT agents on the floor. In her sleep she dreamt of Jane. He was seated on his couch, but the couch was on the edge of a hill where there was a deep valley on one side and a beautiful garden on the other side. He simply sat there looking lost while looking at the deep valley.

(The conversation takes place in the dream)

"Jane, what are you doing here? We have been waiting for you back at the office."

"I'm thinking Lisbon..."

"About what?"

"Life, my family, and Red John."

"Red John? Why Jane? Has something happened?"

(Jane smiled.) "You're asking me this, Lisbon?"

(Lisbon looks perplexed.) "Stop with the guessing game Jane, tell me what's going on."

"It's Charlotte's birthday, and I want to visit her."

(Lisbon panicked.) "Jane... Charlotte is …"

(Jane sighed and smiled again.) "You can say it, Lisbon… Charlotte is in heaven. I don't have a gift yet; will you help me find a gift for her?"

(Lisbon was freaking out.) "Jane, stop playing with me. Do you realise what you're saying?"

"Yes, I do. I'm tired, Lisbon; I feel I can't keep up with Red John's games anymore. Can you please finish the chase on my behalf?" Jane looks at Lisbon with tired and pleading eyes.

Lisbon was speechless.

"This is not the way Jane, and you know it. You are brave, and you're the one who's going to find the bastard and kill him. Remember you told me this a few years ago? He is yours, and you have to finish what he started."

"But what about Charlotte? It's her birthday tomorrow."

Lisbon was at a loss for words. She truly didn't know what to say to him.

"C'mon Jane, we will figure this out, but right now you have to come with me, okay?"

Lisbon gently pulled Jane towards her and walked with him to the garden. They walked a few steps and then Jane collapsed out of the blue.

At this moment, Lisbon woke up with a fright. It took a few moments for her to realise that it was only a dream, but it all felt too real to her. She splashed some cool water on her face to try and forget the dream. She wiped her face dry, drank some water, and walked towards Jane's room. On entering Jane's room, she was relieved to see him in much better shape than before. His parameters had returned to normal after all.

Just then, Dr. Evans entered the room with another doctor and a nurse from the medical team.

"Agent Lisbon, we performed the CT scan a little while ago and from the initial looks of it, Mr. Jane is showing an improvement. His lung has reinflated and the drainage is down to a sufficient level, so we can remove the chest tube today."

(Lisbon's face brightened) "That's great! But I sense there's more to this?"

"Yes, ideally we remove the chest tube when a patient is conscious, but considering yesterday's breathing trial, we don't want to take any chances, so we will have to remove his chest tube under general anesthesia."

"So, you mean like a surgery?"

"Well, it's a bedside procedure, but as this will require general anesthesia, we require you to sign the consent forms."

"Are there any risks to this procedure?"

"Technically there should be none, but with a chest tube removal there's always a little bleeding. He will also be under general anesthesia in addition to the current sedation, so his breathing will be closely monitored. General anesthesia causes respiratory depression, so it will be a time-sensitive procedure. To minimize the chances of an overdose, we are going to start reducing his sedation now, so that by the time he's ready to go in for the procedure, there will be a very minimal level of sedation active in his system."

"At what time will he be taken for the surgery and for how long will the procedure last?"

"It's 12:45 pm right now, he'll be taken in at 3 pm. This allows us time to reduce the sedation slowly and safely. The procedure shouldn't take more than 45 minutes. After the procedure, he will be in recovery for about 60 minutes. We will monitor him closely for the next 24 hours to observe if the removal of the chest tube has gone well, i.e. there are no air leaks or bleeding. He will also undergo a chest x-ray 3 hours after the procedure to confirm that there are no leaks or complications. If the chest x-ray comes back clear, we will try a breathing trial tonight."

"Sounds good." Lisbon said with a slightly shaky voice. She signed the consent forms and handed them over to the nurse."

Dr. Evans advised the nurse to reduce the sedation by 5ml. The nurse complied. They left the room and Lisbon once again found herself worried for Jane. She stepped out of the room and decided to call up Cho. Rigsby, Cho and Van Pelt were at the office awaiting further instructions.

"Cho, it's Lisbon. How did it go with Hightower?"

"Hey boss, Hightower sent the body to our autopsy lab. The reports will be out tomorrow. Rigsby and I have also seen the video. What do you want us to do?"

Lisbon sighed. "Jane will be undergoing a surgery a couple of hours later to get the chest tube removed."

"That's great news boss, but something's going on, right? What's the matter?"

Lisbon sighed again. "I'd like you to come over to the hospital."

Cho understood and didn't ask any further questions. "I'm on my way boss."

"Cho, meet Hightower before you leave, you will be escorted by SWAT for your safety."

"Got it. See you soon." Cho hangs up the call.

(20 minutes later, Cho walked into Jane's room)

"Cho, thank you for coming."

"No worries boss. What's going on with Jane?"

"Come with me," says Lisbon.

They both walk towards the room assigned to the CBI by the hospital.

"So, Cho today after the surgery, if everything goes well, there will be another breathing trial to see if Jane can breathe with minimal assistance from the ventilator."

"So that's good, isn't it?"

"The thing is Cho, there was one trial yesterday but he didn't clear it. He also went into respiratory distress today morning. That's why I'm worried. He scared me today."

"What brought it on? Did the doctor give any reason?"

"Yes, it seems the secretions from his trachea were on the higher side for a while, so that caused an obstruction in his airway and caused low oxygen levels. He had to be manually ventilated for a while." Lisbon said in a choked-up voice.

Cho sighed and held Lisbon's hand. "Hey, he's going to be okay. He will make it through the surgery and trial just fine. I have a feeling he will." He gave her shoulder a little squeeze to show his support.

"Thank you, Cho I really hope so." Lisbon wiped away the tears forming in her eyes.

"Have you eaten anything since morning?"

"No, I haven't Cho. I'm starving."

"Let's get something at the pantry." They got a coffee and a couple of sandwiches each and brought it back to their room to eat it in peace. They discussed about the safe house assigned to them over their coffee and sandwiches. Lisbon was grateful to have some company after a long time.

It was almost 2:30 pm; Lisbon and Cho made their way towards Jane's room. Lisbon went in and held Jane's hand. "Jane, it's me. Good news, your chest tube will be taken out in some time. You will feel so much better soon." She tried to sound cheerful.

And then, a little hope … she felt Jane's hand giving her hand a light squeeze. She was thrilled to feel his squeeze! Finally, some hope that her words were getting through to him.

Cho stepped closer to Jane. "Hey Jane, this is Cho. Heard you're getting better. I'm glad man. See you after your surgery." Cho held Jane's hand too and felt Jane's fingers move beneath his. It made him a little emotional. This didn't go unnoticed by Lisbon. She smiled and gave Cho a little rub on his back to show her support. Cho was always the stoic one, so for him to show his emotions was a big deal.

Lisbon and Cho stood in silence looking at Jane, hoping he could feel their strength.

Just then, two attendants came to the room along with Nurse Sandra.

"It's time to take Mr. Jane for his surgery. The surgery is on this floor itself, so you may wait in your room. Someone from the team will inform you when the procedure is complete."

"Thank you, Nurse Sandra."

Jane was wheeled out of his room. Lisbon and Cho, walked beside his bed till the doors of operating suite. Lisbon gave Jane a little kiss on his forehead and off she saw him go down the hallway …

In the operating room Jane was carefully moved from his bed to the operating table and was positioned on his left side so that the doctors could take out the chest tube from his right side. The dressings were carefully removed along with the sutures that were holding the tube in its place. The tube was then clamped to prevent any air leaks. While the ventilator was doing the work of exhaling for him, the tube was gently yet firmly pulled out in a smooth motion. Pressure was applied immediately to the incision with a sterile dressing to prevent any air leaks and bleeding. The incision was then sutured and a final dressing was applied over the incision.

Lisbon and Cho were busy chatting when a nurse came to inform them that the procedure was complete and Dr. Evans wanted to meet them. Both of them immediately followed the nurse to the operating suite.

"Dr. Evans…"

"Agent Lisbon, Agent Cho the procedure went very well and Mr. Jane is now in recovery. He'll be here for approximately an hour after which he'll be back in his room."

"Thank you so much doctor."

Lisbon and Cho heaved a sigh of relief. At least something went well today.

Wednesday evening

At 5:00 pm Jane was brought back to his room. He looked so much better without that tube sticking out from his chest. Lisbon and Cho were relieved to see their friend improving.

Lisbon and Cho spent the next 3 hours of waiting by Jane's bedside taking alternating shifts in his room and resting up for what could be a long night ahead. At 8:00 pm the x-ray was taken and thankfully, everything seemed alright; no air leaks and no oedema in the lungs. Lisbon teared up with joy at the good news, but she was anxious about the breathing trial.

Wednesday night

Dr. Evans felt confident that Jane would be able to sustain the breathing trial this time as he seemed to be doing okay after the removal of the chest tube. The sedation was gradually lowered till 10 pm. Nurse Sandra was assigned for the trial and Lisbon could remain in the room while the trial was going on. The anesthesiologist was also present in the room.

By 10:15 pm all the sedation was stopped and the ventilator settings were changed. The face mask delivering oxygen was changed to a nasal cannula so that the doctor could assess Jane's responses to the trial. The ventilator was going to provide only minimal support through the trial. The anesthesiologist proceeded to ask her first question to Jane.

"Mr. Jane, if you can hear me, can you open your eyes?" (There was no response)

After a few minutes, the doctor tried again; this time she moved a little closer to his bed.

"Mr. Jane, I am Dr. Jade Smith. Could you try to open your eyes for me? You're safe, you're in a hospital." (Jane's eyes flickered a little, but he couldn't yet open them.)

"Keep trying, you're safe here" Dr. Smith repeated in a soft voice.

After a few moments of efforts, two green pools opened and Dr. Smith found herself looking into the soulful green eyes of CBI consultant Patrick Jane.

"Mr. Jane, I am Dr. Jade Smith. Squeeze my hand if you can see me." (Jane managed a weak squeeze around her fingers.)

"Very good!"

Next, the doctor shone a tiny penlight in Jane's eyes to check his pupil response. His pupils constricted appropriately in response to the penlight. The doctor then asked him to follow the penlight's movement while she slowly moved it from the right to the left and then from the left to the right to track his eye movements.

She was satisfied with what she saw. 12 minutes had passed since the trial had begun and Jane was holding his own.

90 – Heart rate 128/90 – BP 96 – O2 Saturation 25 – Respiration

The doctor continued observing him over the next 5 – 7 minutes. Jane's eyes weren't open, but so far, he had been responsive to the doctor's questions. Lisbon was emotional, but she tried her best not to show it and stayed seated, anxious not to disrupt the trial.

Jane was holding his own and it was now over 22 minutes since the trial began.

The doctor asked Jane if he could wiggle his toes. (He didn't wiggle them) She was surprised, so she tried asking him again and paid close attention to his vitals to see if he was in any distress. The vitals did show some change.

102 – Heart rate 136/90 – BP 94 – O2 Saturation 28 – Respiration

"Mr. Jane, if you're in any pain, squeeze my finger." (Almost immediately, but weakly Jane grasped at the doctor's finger.

"Nurse, increase his pain medication by 2ml/l STAT."

After increasing the pain medication, the doctor waited for a minute to see if his vitals showed any improvement. (There was only a slight change.)

100 – Heart rate 134/89 – BP 94 – O2 Saturation 27 – Respiration

The doctor decided to break protocol and asked Lisbon to join in.

"Agent Lisbon, would you mind giving me a hand?" (Lisbon was surprised, but quickly agreed.)

"Ye…yes, how can I help?"

"Would you mind talking to him and see if you can help him feel relaxed?"

Lisbon walked to Jane's bedside. His breathing was a little shallow and there was only a light sheen of sweat on his face; so, nothing to show he was in major distress, but the doctor wanted her to talk to him to calm him down, so she was going to do her best.

Holding his hand in hers, she began ...

"Jane, it's me Lisbon. Can you hear me?"

She saw his brows furrow, and his attempt to slowly open his eyes.

"Good Jane, good. I'm here for you, okay?"

And then, the unthinkable happened…He nodded! A very weak nod, but it was an attempt to communicate. The atmosphere in the room suddenly felt a little lighter due to this development.

Lisbon was thrilled to see him respond, so she continued …

"Hey Jane, just a little while longer, okay? You're okay." (She squeezed his hand)

Hearing the words – 'you are okay' made Jane feel safe again, because he had now opened his eyes and he found himself staring into Lisbon's kind green eyes…