Baptized by Fire - Part 2

Camarin trudged carefully over blackened and sopping rubble, all that was left of the two bedroom beach house Justin had lived in for over fifteen years.  Johnny had brought her here to sift through the mess in hopes of finding a few pieces of the past to hold onto.  There wasn’t much.  A piece of a broken trophy from Justin’s high school football days…a set of hand weights…a few sooty dishes which were chipped beyond usability.  A tear slid from Camarin’s eyes when she noticed a metal document frame lying discarded under a soggy piece of fabric she didn’t recognize.  The glass was shattered, and the contents of the frame had been reduced to ash.  She remembered seeing this hanging on the wall above Justin’s desk.  It was his physical therapy license, only a slip of paper, but it exemplified years of hard work and dedication.  She supposed most of what lay beneath her feet was the same.  To the bystander, it looked like nothing more than cinders and dust, discarded trash…meaningless.  But to those who knew Justin well, it represented his entire adult life…every experience, every memory, every hobby and pursuit, every single item in some small way painting a picture of who he was.

In all, Camarin and Johnny spent the better part of the day searching for something they could present to Justin…something that would bring a smile to his face amidst the knowledge that he had lost nearly every possession he had.  They ended up with a small metal lockbox.  What Camarin and Johnny didn’t know was that the only key had been on Justin’s key ring, which was not on his person when he was rescued.  The contents of the box were a mystery to them, and it wasn’t clear whether the box was fire or water proof.  They also managed to collect a watch that Justin never wore, but that Camarin knew had been a gift from his father, the hand weights, some blackened silverware, and a few hand tools.  There had been a few other items which had been the subjects of deliberation, as both Johnny and Camarin went through the painstaking process of deciding whether they were worth keeping.

After loading the precious artifacts into Johnny’s new Rover, Camarin leaned heavily against the door.  “How long do you think it will be before Justin’s ready for some clothes?”

Johnny gazed across the hood of his truck at his half sister.  “That depends, Cam.  He’ll at least need a robe…maybe some sweats or pajamas or something once they get him up and around.  Wanna run over to Sears?”  He hoped that buying some new things would help erase some of the disappointment over everything that had been lost.

“Yeah…thanks.”  Camarin opened the door to the Rover and got in.  Once Johnny was seated behind the wheel, she asked, “How does your hip feel today?”

Johnny was caught slightly off guard by Camarin’s question.  “What?  Oh, uh…what do you mean?”

“Well, you told Dr.—Todd last night that it was stiff.  I just wondered how it felt now…after helping me with this all day.”

“It feels fine.”  Johnny felt a small measure of relief that at least this time he wasn’t lying.  He just chose not to mention to Camarin that the reason it felt fine was because he had just taken a Tramadol tablet with his soda an hour ago.  He pressed down the uneasy feeling in his stomach that he tried blaming on the powerful medication.  But the truth was, it had little to do with some negative side effect.  Johnny was ashamed and more than a little disgusted with himself that he had been relying on narcotics these past few days, a feeling made worse by the knowledge of what Justin would have to say about it if he knew.  He tried reasoning with himself that this was temporary.  The timing was just lousy.  If he didn’t have so much to take care of for Justin…if Hannah didn’t have her brother’s recovery on her mind…he would be able to get the rest his hip needed.  But in the end, any assurance that he could derive from that argument fell flat.  Worse yet, Johnny knew that he was going to have to start rationing the precious pain relief.  Todd had not given him many pills, and he surely couldn’t ask for any more without being subjected to a lecture or a boatload of tests.  And neither of those sounded appealing to him at the moment.  And above all, Johnny could not ignore the persistent niggling in the back of his mind that going back to work as a firefighter might not be in the cards after all.

“That’s good.”  Camarin stared at the passing landscape outside her window.  The sky was dark and it looked like rain.  “When do you have to go back to work?”

“Not until Tuesday.”  Johnny hadn’t mentioned to anyone but Roy and Captain Stanley that Todd had ordered him off work until next week.  For now, Hannah and Camarin assumed that he had just taken some time off to spend with Justin and take care of his affairs.

The siblings rode in silence for a while, listening to the Eagles croon out a song on the radio.  Finally, Camarin spoke again.  “Why don’t you just drop me off at Rampart after we’re done shopping?  You and Hannah should spend some time together.  I can get a cab over to Tag’s apartment.  He can take me and the girls home.”

Johnny switched on the wipers as the first droplets of rain began to spatter against the windshield.  “Cam, it’s already settled.  Once we get to the hospital, Hannah’s going to take the Rover, pick up the girls and take them to our place.  I’ll stay with you until Roy comes to get us later.”

“Roy?”

“Yes, Roy.  Don’t forget Justin’s his friend too.  And Roy’s about as good a friend as anyone can ask for.”

Camarin smiled.  Yes, she had learned that about Roy within the first few minutes of meeting him.  “John…Justin is going to be okay, right?”

Johnny wasn’t sure how to answer.  He didn’t want to fill Camarin with false hope, but he didn’t want her to worry unnecessarily either.  “Andrews said he’s doing better than anyone expected.  The swelling in his airway has gone down…”

“But he’s still not breathing on his own.”  Camarin interjected.

“Because he’s tired, Cam.  Exhausted, really.”  Johnny thought back to his own recovery after his car accident.  While his memories of the first days in the hospital were sketchy at best, he did remember the indescribable fatigue that made even the simple involuntary act of taking a breath seem akin to running a marathon.  “Once he gets some of his strength back, they’ll be able to start weaning him off the vent.”

Camarin tried to take comfort in her brother’s words.  After all, he surely was more knowledgeable about such things.  But, Camarin also knew that intuition was a powerful force.  And pieces of Todd’s honest and straightforward conversation from earlier today rolled around in her head.  “But what if his lungs don’t heal…what if he gets pneumonia, or…”

Johnny gripped the steering wheel a little tighter.  “You can’t get hung up on the ‘what if’s.’  If you do, you’ll only drive yourself crazy.  I know if it were me in that bed right now, Justin would be thinking nothing but positive thoughts.  We owe him at least that much, right?”

“But, Todd said…”

“He had to give you all the possibilities.  That’s his job.  If he didn’t do that, and then something happened…”

“Yeah, I suppose you’re right.”  Camarin sighed.

“I know I am.”  The corners of Johnny’s mouth curved slightly into a half grin as he threw the Rover into park.  “Now, come on.  Let’s go pick out something comfortable for Justin to wear once he starts physical therapy.”

Camarin chuckled as she got of the truck.  “Oh, I can just see that…”

Johnny’s grin widened.  “I’m looking forward to it actually.”

Camarin gave her brother a playful slap.  “Oh, I just bet you are.”  She followed Johnny toward the store.  “By the way, who is Justin’s physical therapist?”

Johnny paused, his expression thoughtful.  “That’s a very good question.”

***

Karen Wilder removed her glasses and took her hair down out of its ponytail, combing it with her fingers.  She was just about ready to tackle the file on top of the paperwork mountain on her desk when the phone rang.  Deciding whoever was calling could speak to her answering machine instead, she began reading over the patient chart in front of her.  After five rings, Karen cursed quietly, realizing she had forgotten to turn the machine on.  Finally, when the relentless ringing continued she tossed her pen down and grabbed the receiver.  “This is Karen.”

“Karen, it’s Todd Andrews.  You’re at the office late.  I thought I would get your machine…”

Karen looked at her watch.  Todd was right about one thing.  It was almost midnight.  “It’s broken.  So, we haven’t seen each other in what…five years?  And all of a sudden you’re calling my office in the middle of the night thinking you’ll be talking to my machine.  Gee, did you miss me that much?”

“Very funny, Karen.  This isn’t a social call.  I need a favor.”

“Well that figures.  Why else would you be calling?”  Karen’s words were meant to tease, but she knew that Todd would recognize the deeper truth behind them.

But Todd refused to play the game.  “I have a patient I was hoping you would work with.  He’s here at Rampart General.”

Karen picked up her pen and began doodling on the edge of her desk mat.  “Why me?  With all the therapists you have on staff over there…”

“Because I need the best, Karen.”

Todd’s comment stopped Karen’s pen in its tracks.  She knew how hard that was for him to say.  “Well what about…what’s his name?  Dustin?”

“Justin.”  Todd corrected.

“That’s right.  Did he leave or something?  You and he have a falling out?”  Karen was remembering the circumstances that led her to leave Rampart and start her own physical therapy practice.  But, she and Todd hadn’t “fallen out.”  Not really…

“No…no he’s still here.”

“Well then why can’t he…”

“Because he’s the patient, Karen.”

***

It had been two days since Justin’s surgery and Johnny and Camarin were in the ICU lounge waiting when they looked up at the sound of the door opening.

Kelly Brackett entered the small room with a smile on his face.  “The tube’s out and he’s asking for you.”

Collective sighs of relief were followed by rapid fire questions.

“So he’s breathing okay?”

“Does he remember what happened?”

“Is he…”

“Hold on.”  Brackett quieted the anxious siblings with a raised hand.  “Dr. Burke is examining him now.  As you know, Justin’s continuing to have bronchspasms, which isn’t at all unexpected at this point.  But, Burke will want to perform some tests and keep a close eye on his lungs for a few days to make sure they’re working and healing properly and that nothing new develops.”

“Right.  Okay.”  Johnny nodded, reminding himself that this was just one step toward a long and probably difficult recovery.  At least it was a step in the right direction.

Brackett continued speaking as the he led the way down the hall toward Justin’s room.  “He’s oriented, but still very groggy.  He remembers the fire.  He asked specifically to talk to you, Johnny.  I’m sure he probably wants details.”

“Well how much should I tell him, Doc?”

Brackett paused just outside the door and crossed his arms over his chest.  “Well, you can’t lie to him, that’s for sure.  So be honest.  Just…try not to upset him too much.  I trust your judgment.”

Johnny blew out his breath and looked down at the floor.  “I’m glad you’re so confident.”  He glanced through the door before nailing down Brackett with brown eyes brimming with empathy.  “He lost everything, Doc.  I don’t know how I would handle that…”

“Not everything.”  Brackett corrected with a wink toward Justin’s fiancée.  “Only the things that can be replaced.  Remember that…”  He rested a hand on Johnny’s back and guided him into the room.  “And, he will too.”

Johnny stood with Camarin and Brackett just inside the door, waiting for Dr. Burke to finish his exam.  Finally, the doctor draped his stethoscope around his neck and scribbled some notes in Justin’s chart while quietly conversing with his nurse.  Then, he turned to face his patient’s visitors.  “Talking is very painful for him, and his lungs are still pretty irritated.  He wants to see you, but keep it brief.  He can have some ice chips or a little water, but nothing else to eat or drink.  I’ve ordered some tests, but they can wait a bit.  Go ahead and let him know you’re here.  He’ll be happy to see you.”

Johnny waited until the nurse and doctors departed before leading Camarin to Justin’s bedside.  He looked down at his friend and thought he looked much better without the plastic tube in his mouth, even if his pale complexion still appeared frighteningly unnatural.  Johnny noticed the rapid, shallow breaths fogging Justin’s oxygen mask, and the perspiring brow that creased with the effort still required in order to draw air through his injured airways.  He lightly rubbed the back of Justin’s hand to let him know he was there.  “Justin?”

Justin recognized the familiar voice immediately and his mind raced with a hundred unanswered questions…questions that he needed the answers to but couldn’t voice.  In fact right now, even the task of opening his eyes seemed insurmountable.  He swallowed painfully against the raw burning in his throat and peeled open his eyes before trying to gather enough breath to even speak one word.  “Hey…” 

Johnny watched Camarin cringe at the hoarse croak that sounded as grating as it likely felt.  The paramedic knew well how painful the effects of smoke inhalation could be, as well as the irritation resulting from having a tube in your throat.  He motioned toward the small cup of water on the table.  “Take it easy.  Cam’s getting you some water.”

“C-Cam?”  Justin hadn’t realized his fiancée was also here, but before he could search for her, he broke out into a fit of stridulent coughing.  Unwilling tears leaked out of the corners of his eyes as he clenched them shut tight and pressed his head back into the pillow, fighting to catch his breath amidst the most unfathomable pain he had ever experienced.

“Easy, Justin.  Take a drink.”  Camarin’s soothing voice filtered into Justin’s awareness, offering him a way out of the dark.  His lips parted and then closed anxiously around the straw he knew would be waiting, agonizing coughs still causing his body to jerk harshly.  When they finally stopped, Justin gratefully accepted the water, allowing the blessedly cool moisture to quench the fire in his throat.  After a few sips, he let out a breathy moan, his whole body shuddering violently for a few seconds before settling.

“Are you cold?”  Camarin immediately pulled Justin’s blanket higher over his body, being careful not to disturb his right leg, which was uncovered, wrapped in bulky bandages, and resting on several pillows.

Justin didn’t answer, but allowed the comforting warmth of the blanket and Camarin’s gentle hands to further calm him.  He knew he had been in a fire, knew about his injuries.  He had already been filled in on most of that, even if some of the information was still a bit fuzzy.  But Justin wasn’t satisfied with the “what’s.”  He wanted to know the “how’s and why’s” as well.  “John…the fire…”  Unable to get enough air to form a complete sentence, Justin’s words were cut off, leaving his eyes the only means with which he could convey his message.

Luckily for Justin, Johnny anticipated the questions.  He knew exactly what was going through his brother-in-law’s mind, not just because of his experience as a firefighter, but because Johnny had gone through it himself after losing his barn to a fire less than a year ago.  “It was an electrical fire.  Cap said it started in the east wall of your living room.  Probably a short.  No way you could’ve known.  Nothing you could’ve done about it.”  He watched Justin’s eyes close as he absorbed this information before answering the question he knew would come next.  “The house was a total loss, man.  Sorry.”

Justin swallowed hard as his breathing quickened.  He supposed on some level he knew this to be the case, but hearing it said out loud brought a finality to the situaion that he wasn’t sure he wanted to deal with.  His chest ached as he fought to control emotion made even more volatile by pain.  Sniffing back tears caused his nose to burn and the sudden intake of air caused him to start coughing again.  His bandaged right arm moved to his left side in an effort to brace his injured ribs.  “Damn…that…hurts.”  Justin gasped out.

Camarin shot Johnny a helpless look as his hand moved to cover Justin’s, helping to support his chest.  “I know…we’ll get you a pillow.”  Even as he said it, he noticed Camarin heading out the door in search of one.  “Do you want me to see if you can have something for pain?”

Justin shook his head, the coughing subsiding to caustic chuffs.  As exhausted as he felt, he knew any more medication would put him out, and he wasn’t ready for that just yet.  Besides, he had a feeling he had already been heavily medicated and figured he should be able to manage his pain, if only this wretched coughing would stop.   Besides, there was something else he needed to know.  He remembered being in his living room, remembered seeing fire.  But after that, it all got a bit jumbled.  “How…”

“Justin, we’ll have plenty of time to talk when you’re feeling better.”  Johnny carefully repositioned Justin’s right arm on the bed, being careful not to disturb the bandages covering his burns.  “You need to rest your lungs…”

Justin’s fingers weakly grappled for a handhold on Johnny’s arm.  “How…did I…get out?”

“We got you out.”  Johnny’s voice was quiet amidst the sound of footsteps.

“Don’t let him fool you…”  Camarin warned as she placed a small pillow over Justin’s left side and helped him to clutch onto it.  “John and Roy dug you out from under a beam and then John put you over his shoulder and carried you out.”

Justin breathed a tentative sigh as pulling the pillow tightly against his chest seemed to offer some marginal relief.  “Really?”  His voice sounded like fingers on a chalkboard, and he was out of breath.

“Yeah.”  Johnny offered, hoping the conversation would end here.

“Th..tha…”  Justin tried, but couldn’t gather enough air to get the word out.  Frustrated, he began coughing again.

Johnny didn’t want Justin to feel he needed to thank him for what he did, although he understood.  “You’re welcome.”  He looked up at the sound of a familiar voice.

“Hi, Justin.”  Todd Andrews stood at the foot of the bed, his expression a mixture of empathy and concern.  “I was going to ask how you feel, but…”

“He’d be feeling a lot better if this coughing would stop, Doc.”  Johnny informed as he stepped out of the orthopod’s way.

“I imagine so.”  Todd rested a hand on Justin’s knee.  “How’s the leg?”

Justin spoke so quickly, his own words surprised him.  “Hurts like…hell.”

The hint of a smile colored Todd’s features.  As much as he hated the fact that Justin had to go through this, he hoped that eventually the physical therapist would be able to see the value of the experience.  After all, a little empathy training never hurt anyone.  “It will for a while.  Do you need anything?”

Yeah, I need to go back in time and fix that fucking short so I wouldn’t have to deal with any of this.  Justin shook his head, too tired and sore to speak…and too leery of the coughing it might cause.

Todd’s brow creased into a grimace of suspicion.  He knew Justin was in pain.  But, he also was aware of his younger friend’s aversion to excessive medicating.  He decided to let it go for now.  He watched as Justin’s eyelids began to droop.  As exhausted as he was, he would likely be able to sleep without aid...at least for a while.  “Okay…”  He gave Justin’s leg a gentle pat.  “Get some rest.  I’ll be back to check on you later.”  With a nod to Johnny and Camarin, the doctor left the room.

“We’re gonna go for a while too.”  Johnny almost whispered.  Justin’s eyes were closed, but his hitched breathing indicated he wasn’t quite asleep.  “We’ll be back.”

“Love you.”  Camarin assured softly as she bent to leave a kiss on Justin’s forehead.

***

“John?  What’s wrong?”  Hannah spoke through the wooden door.  Johnny had just returned from the hospital and after quickly filling her in about Justin’s condition, had made a beeline for the bathroom.

Johnny held back the curse that hovered easily on his lips as his hands searched the collection of small, brown bottles inside the medicine cabinet.  “Nothing!” He called out, as he dropped a nearly full bottle of Demerol into the sink with a loud clatter.  “Just had to go is all!”

Hannah tried to push down her growing concern.  Johnny had been acting funny the past several days.  She had tried to justify it, reminding herself that he had a lot on his mind.  But, it was almost as if he was hiding something.  And her heart fell yet again at the possibilities.  Was there something about Justin’s condition…something dire…that he didn’t want her to know?  Or maybe he was getting cold feet about being a father.  Or could it be he was coming to the realization that the responsibilities of married life were not what he wanted after all?  The sound of water running in the sink signaled that he was finished with the business that brought him here, so she opened the door a crack.  “Are you sure?  You’re not sick or any…”

Johnny had had just enough time to toss the small paper cup he had used to down two of the large tablets into the trash before the door opened.  “I’m fine.”

Hannah pushed the door open a little farther.  “Then, what are you doing with those?”  She pointed to the bottle on the counter.

Johnny could actually feel anxiety swell in his stomach.  Why couldn’t he just tell her he’d been hurting?  She was his wife, for godssake.  It would be the thing to do.  “I found ‘em in the cabinet.  We shouldn’t really have this stuff hanging around.  I was gonna flush ‘em.”

“Just them?”  Hannah took a step toward the cabinet, wondering why he had been in it in the first place.  “I think there are some others in there that…”

“Really?”  Johnny feigned innocence as he slid the mirrored door open and sorted through the assortment of bottles.  “Hey, you’re right.  Here’s some I missed.”  He pulled out another half full bottle of Demerol, some codeine that he couldn’t even remember what injury it had been prescribed for, and a nearly empty bottle of Flexeril.  “I’ll uh…”  He pointed toward the toilet.  “I’ll just get rid of this.”  He walked over and uncapped the Flexeril before emptying its contents into the bowl.

A ringing phone could be heard in stereo, the extension in the next door bedroom competing with the one farther away in the kitchen.  Hannah turned down the hallway to answer it, leaving her husband to his task, doing her best to quell the persistent nagging in her stomach.

Johnny waited until Hannah’s footsteps disappeared down the hall and he could hear her soft “hello” coming from the bedroom before flushing the toilet.  Then, he uncapped the codeine and the Demerol and pocketed the remaining tablets before depositing all four empty bottles into the waste can.

The reflection in the mirror on the way out of the bathroom seemed accusatory.  Johnny stepped a little closer and used the counter to support his weight, willing the recently swallowed narcotic to ease the ache in his hip.  Somewhat sickened by the countenance staring back at him, he took a deep breath and made his way down the hall toward the kitchen.  Hannah was still on the phone, and he knew he’d better get something else in his stomach besides medicine, or he would be sick.  He poured himself a glass of milk and grabbed a handful of Oreos before sitting down at the table to wait for his wife.

When Johnny was on his last Oreo, Hannah appeared in the kitchen.

“Who was on the phone?”

Hannah spoke while pouring herself a glass of milk, figuring she would join her husband.  “It was Camarin.  She wanted to tell me Joanne offered to watch the girls tomorrow.”

Johnny smiled as he popped the whole cookie into his mouth.  “Good ol’ Joanne…”

“Right…”  Hannah agreed.  She studied Johnny’s face carefully.  “How was Justin this evening?”

Johnny chased down the last of the Oreo with a long swallow of milk.  “Well, he’s running a slight fever, which is pretty normal.  Other than that, he seems to be doing a little better.  He was breathing easier, so they switched him to a cannula.  He’s having fewer bronchospasms.  If he keeps doing well, they might move him to the ortho floor tomorrow.”

“A fever?”  It was as if Hannah’s mind became stuck on the first sentence of Johnny’s report.

“A slight fever.”  Johnny reminded.  “Just enough to make him feel crappy.  Dr. Burke said it’s not pneumonia.  They did cultures of his burns and his incision, but they won’t know the results of those for a while.  In the meantime, they’ve started him on a broad spectrum antibiotic.”  He leaned across the table and covered his wife’s hands with his own.  “They’re keeping an eye on it, but it’s nothing to worry about.”

“Okay…”  Hannah sounded uncertain.  “What about you?”

The abrupt change in subject threw Johnny off guard.  “What…who…me?  What about me?”

“I don’t know, John…”  Hannah twirled her glass around in circles, watching the milk ebb and flow like the waves she used to enjoy from her brother’s deck.  “It’s just…you’ve been acting a little…strange…and I can’t help…I just…it’s not the baby, is it?”

Johnny’s heart fell to his feet.  He immediately stood and moved behind Hannah’s chair, wrapping his arms protectively around her shoulders, resting his cheek on her hair.  “Of course not.  Don’t even be thinking things like that.”

Hannah calmed slightly under her husband’s reassurances.  “I can’t help it, John.  You were single for so long before we met, and sometimes…sometimes I worry that…well, that you’re not happy.”

Johnny knelt down beside Hannah, turning her face towards his own.  “I have never been happier in my life.”  When Hannah began to look away doubtfully, he guided her back and stared into her soul with certain, brown eyes.  “Never.”  Then, he leaned in and kissed her.

Hannah smiled.  “Okay.”  She allowed Johnny to help her to her feet.  “Are we still going to see Justin tomorrow?”

“Sure.”  Johnny led Hannah toward the bedroom.  “After I cook the world’s best breakfast for my beautiful wife and Little Gage, here.”  He patted her tummy.

“You?”  Hannah’s eyebrows shot up.  “You are going to cook the world’s best breakfast?”

“That’s what I said, didn’t I?”  Johnny leaned in and spoke to their unborn child.  “Did you hear that?  Your mommy doesn’t think I can cook…”

“I didn’t say you couldn’t cook.”  Hannah played.  “It’s just that I don’t like hamburgers for breakfast.”

“Well, I’m gonna show your mommy…I’m gonna make her eat her words.”  The couple had reached the bedroom, and Johnny ushered Hannah inside, guiding her onto the bed and planting hungry kisses on her mouth.”

“John…”  Hannah tried to pull back, sensing where this was headed, and feeling about as attractive as a watermelon.

“What?”  Johnny sat back, breathless.  “I figured we should get as much of this in now as we can before…before…”  A confused expression appeared on his face.  “You know, we really do have to think of a name for the little bugger.”

“Yes, we do.”  Hannah smiled.

“Anyway…”  Johnny shrugged, and then spoke in between kisses.  “We might not…have as much…time…for this after…”

Hannah hooked her arms around Johnny’s neck and pulled him down onto the bed beside her.  “Anyone ever…tell you…you talk too…much.”

Johnny smiled as suddenly there seemed to be too much clothing between him and his wife.  Yes…he had been told that a time or two.

***

The first thing Justin noticed was stinging.  No…not stinging.  Cold.  Something icy cold on his leg.  An involuntary shiver rocked him from his tenuous hold on slumber and forced a weak protest from his flaming throat.

“Sorry, I didn’t mean to wake you.”

The voice didn’t sound familiar to Justin, but that didn’t come as a total surprise.  He had completely lost track of what day…or for that matter, even what time of day it was.  Did the voice sound like the last nurse who had been in to bother him for this or that?  No matter.  There had probably been a shift change he half-slept through in his drug induced fog.  Keeping his eyes closed, he did his best to ignore this most recent intruder as he tried desperately to return to the blessed escape of nothingness.  But icy pressure on his sore leg pulled him back again.  He opened his eyes and blinked out a scowl that was both confused and irritated.

Seeing that her patient was now awake, even if he didn’t appear altogether happy to see her, Karen offered a warm smile.  “Good morning.”

Justin blinked against the harsh light his eyes were not yet accustomed to and lifted his head in an effort to view his surroundings.  “M-morning?”  His voice was dusky and pained, and he gratefully accepted Karen’s offered sip of water.

“Yep, morning.”  Karen waited until Justin had nodded his fill of the water before setting his cup down on the stand near the bed.  She looked at her watch.  “Seven thirty eight to be exact.”

Justin studied the figure standing over him.  She was wearing blue scrubs, which meant she wasn’t a nurse.  “Who…”

“I’m sorry.”  Karen extended her hand.  “Karen Wilder.  I’m your physical therapist.”

Justin accepted the handshake skeptically, realizing now the cold pressure he felt on and around his leg was the result of some prescribed ice therapy.  Now that that mystery had been solved, he realized it actually felt good, effectively chasing away the annoying ache that had seemed to settle into his entire lower extremity and take up permanent residence.  “My…Where…where did…you come…from?”  He cleared his throat, annoyed that he couldn’t seem to speak one sentence without tiring and becoming out of breath.

Karen smiled again, a warm smile that Justin found both comforting and confident.  “Well, originally from Idaho.  But more recently from a private practice in Encino.”  She made some minor adjustments to the ice packs and pillows surrounding Justin’s right leg.  “How does that feel?”

“Feels great.”  Justin breathed, relieved to be getting some relief from something other than the Demerol and other mind numbing concoctions he seemed to be continually offered. 

Noting that her patient’s expression still seemed somewhat skeptical and bewildered, Karen offered the explanation she figured he was searching for, but was perhaps too exhausted to put into words.  “I’m an old friend of Todd’s.  When he called and said his best physical therapist was laid up with a broken leg, naturally I wanted to come help him out.”

Justin nodded.  “Okay…”  He wondered why, with all of the other therapists on staff at Rampart, Todd had called in someone from a private practice.  After all, a femur fracture such as his was pretty routine.  Unless…there was something Todd hadn’t told him.  He made a mental note to discuss it with him later. 

Any further conversation was temporarily interrupted by Justin’s day nurse, Raeline, who breezed into the room amidst the faint aroma of cherries and almonds.  Justin coughed slightly and pulled his small pillow tight against his sore ribs.

“I’m sorry to interrupt, but it’s time for another blood gas.”  Raeline spoke as she began to withdraw a syringe full of bright red arterial blood from the catheter in Justin’s left wrist.  She noticed her patient looked as if he had just run two back to back marathons.  “How are you feeling this morning?”

Justin did his best to hold back the painful coughs that seemed to stem from sudden irritation in his inflamed airways.  “Just…peachy.”

“I can see that.”  Raeline was sympathetic, but not overly concerned.  Justin’s coughing was normal, and in fact, necessary, in this stage of his recovery.  “I’ll get this to the lab and be back to check on you.  Is there anything you need right now?”

Justin shook his head.

“You’re due for breakfast soon.  I’ll make sure I’m back in time to help you with it.”  Raeline gave a nod to Karen and exited the room.

Karen took a step closer to Justin, as slowly the coughing subsided, and Justin’s breathing returned to its slightly ragged state of normalcy.  Perspiration dampened his brow and his gown, and he was decidedly spent.  “Okay now?”  She offered him another sip of water, which he eagerly accepted, despite the nausea swimming in his stomach.  At his nod, she returned the cup once again and let out a sigh.  “We really need to get that leg moving today, but it can wait until after you’ve had your breakfast and a nap.”

This was news to Justin.  “Wha…t-today?”

Karen nodded.  “It’s been several days since your surgery, Justin.  You’re actually overdue…”

“Right…”  Justin stopped her, closing his eyes and giving his head a slight sideways shake as if to clear the cobwebs.  The last several days had been a hazy blur at best.  Still, the idea of moving his leg right now caused his nausea to paddle a faster stroke.

Karen moved to Justin’s right foot.  “I’m going to do a little passive ROM…”  Feeling her patient’s muscles immediately tense under her fingers, she clarified.  “Don’t worry.  Just your feet and ankles for now.”  She began gently moving Justin’s toes back and forth.  “And…maybe your arms too, if you feel up to that.”

Justin cringed at the idea of having his arms exercised, and the pain that would cause in his injured ribs and sore chest muscles.  As a therapist, he reminded himself of the importance of these procedures, but he was quickly becoming aware of exactly why most of his patients hated to see his smiling face walking through their doors.  “I…I don’t…”

“Well, I see you’ve met Karen.”  Todd Andrew’s voice sounded from the direction of the doorway as he entered the cubicle.  Pulling Justin’s chart from the cradle at the end of the bed, he leaned against the bedrail on Justin’s left side.  “How are you feeling this morning?”

Justin was pretty sure Todd knew how he felt, and he was quickly becoming annoyed by that seemingly neverending question.  “Like I…wanna get outta…here.”

Todd smiled as he flipped open the chart and scanned it.  “Well, if by ‘here’ you mean the ICU…I’m hoping that might happen by later today.  Let’s see how you do with your liquid diet first…”  Todd’s voice trailed off as his brow furrowed in concern.  “You’re still running a temp.”

“I am?”

“Mm-hm.”  The doctor nodded as he turned over a page, reading.  Finally, he closed the chart and held it in front of him.  “Don’t worry.  It’s not high.  And it hasn’t even been twenty four hours on the antibiotics.”  He smiled across the bed at his old friend.  “How’s he doing?”

“So far he’s taking his lumps like a man, but we’ve only just begun.”  Karen offered playfully.

Todd returned his attention to Justin.  “Don’t be taken in by her innocent charms, Justin.  Karen reminds me of an old school teacher I once had…drill sergeant is more of the word…used to slap my fingers with a ruler…”

“Which I’m sure he fully deserved.”  Karen amended.

Brief laughter gave way to honesty.  “Seriously, Justin…Karen will have you back on your feet in no time.  But…first things first.”  He indicated that the therapist should return to her task.  “I’ll let you two get back to work.”  Returning Justin’s chart to its cradle, he addressed Karen.  “Have me paged when you’re finished.”

“Sure.”

Todd returned to Justin’s side long enough to give his hand a squeeze and a promise to return once his therapy session was over.

***

“Come on, Justin, you need to eat some of this food.”  A frustrated Hannah held some cherry flavored Jell-o on a spoon in front of her brother’s tightly closed lips.

“That gelatinous…muck…is not…food.”  Justin insisted.

Hannah sighed and returned the spoon to the bowl.  “Then, how about some of this broth?”

“All I can…taste is…grease.”  Justin shook his head in refusal.

Johnny became involved now.  “Look, man, I know it’s not what you’re used to eating…”

“Do you…want me to get…sick?”  Justin’s expression was so sincerely pitiful, the others immediately backed off a notch.

“Of course not.”  Hannah affirmed.  “But, if you want to get out of here, you need to eat.  Maybe they could give you some phenergan…”

“No.”

Johnny shot his wife a sideways glance and a quick back and forth movement of his hand which meant ‘don’t even go there.’  He moved closer to Justin’s side.  “Trust me, Justin.  No one knows better than me how crappy this food tastes.  You don’t have to eat everything.  Look, the Jell-o’s not too bad.  Is there another flavor…”

“Do you…know what that…shit is made out of?”  Justin wished his family understood the way Camarin did…that after years of eating a certain way, this abrupt change would undoubtedly be harsh on his system…not to mention his psyche.

“Mostly I try not to think about it.” Johnny grinned, attempting some levity.

Justin turned his head to the side and pulled his pillow tighter against his chest.  His lungs felt heavy and tight, and this conversation was quickly rendering him exhausted.  “Just tell…Cam to…bring some…lemongrass soup…”

Hannah made quick eye contact with Johnny as she pushed Justin’s table and tray to the side.  “We’ll check with Dr. Brackett, okay?”  She secretly hoped it would be all right.  After all, Justin and Camarin’s recipes were likely much healthier than anything prepared in the kitchen at Rampart.  

Seemingly satisfied with that promise, Justin drifted off to sleep.

Johnny and Hannah remained in the room with Justin as he dozed, and mutual concern etched their faces when they noticed his breathing seemed to become more strained even as Raeline again breezed into the room on a mission.  A faint wheeze appeared to begin deep in Justin’s chest on every inhale and continued through his upper airways on the exhale.  The couple stepped back to allow room for the nurse to work.

 “Dr. Burke wants him back on a mask.”  Raeline informed quietly as she gently began removing Justin’s nasal cannula.

“What’s going on?”  Johnny wanted to know.

“He’s only satting at around 89 to 90 percent on the cannula.  That could be the reason for his headache and nausea.”  Raeline frowned at the uneaten meal on Justin’s tray and the increased wheezing sounds coming from his lungs.  After setting the oxygen flow at ten liters, she gently affixed the mask to her patient’s face, which caused him to awaken and raise his hand toward this new intrusion.  “Easy, Justin…”

Johnny moved in closer now, on the opposite side of the bed and gently grabbed Justin’s hand.  “Your sats are too low, man.  That’s probably why you feel so crappy.  This’ll help.”

Too tired to argue, Justin gave in and allowed the cool, moist air to soothe the rawness in his lungs.

From somewhere to his left, Johnny continued his bedside coaching.  “That’s it…just breathe.”  He motioned for Hannah to pick up where he had left off as he followed Raeline to the door.  “His breathing seems to be getting worse.  What’s happening?”

“Probably another bronchospasm.  He’s still having them off and on.  We’ve been letting them resolve on their own as long as they’re mild.”  The nurse looked at her watch.  “He’s due for a breathing treatment in an hour, but if it doesn’t get better, I can have Dr. Burke paged.”

“Yeah…okay...”  Johnny watched Raeline leave, reminding himself that his brother-in-law was being closely monitored and was receiving the best of care.  But that knowledge did little to quell the growing nausea in his own stomach that became worse with every raspy sounding breath coming from the bed.  He glanced at his watch and frowned.  He had to meet with Justin’s insurance claims representative today, and later he had some things to help Camarin with at the business.  Anxiety caused an unwelcome tightness in his chest that seemed to be rapidly followed by an angry twinge in his left hip.  He fingered the small plastic bag in his jeans pocket.  “I uh…gotta use the restroom.  Be right back.”

Justin wasn’t even aware of Johnny’s departure in his struggle to breathe.  He opened his eyes and noticed Hannah sitting by the bed, her expression concerned.  “Han…”

Hannah reached through the bedrail and held onto Justin’s hand.  “Don’t try to talk now.  Just rest and let your lungs calm down.”

But there was something that Justin wanted to know.  He wasn’t sure why suddenly it came to the forefront of his mind and became so important, but he wanted to know.  “The fire…were you…able to…save…anything?”

Hannah fought back tears.  There hadn’t been much, and Justin had been told this before.  She figured he might be hoping the original report had been a mere figment of his fuzzy, post trauma imagination.  “Not much.  We’ll talk about all of that later…”

“John said…my lockbox…”

“Yes, Justin, there’s a lockbox.”  Hannah used the bedrail to pull herself to her feet in order to plant a steadying hand on Justin’s damp forehead.  “Rest now and try to get your breathing under control.”

But if anything, Justin’s wheezing was becoming worse.

“You…shouldn’t be…here.”

Hannah’s alarm increased with the rate of Justin’s whistling breaths.  “Justin…”  She reached for the call button and pressed it.

“Too many…germs…”

That was her brother.  Always trying to protect her, and now presumably her unborn child, even at his own expense.  “Justin, please…”

***

Johnny leaned over the sink and splashed cold water over his face so many times, he didn’t even notice that he was no longer alone.

“Johnny?”

The familiar voice snapped Johnny to attention and he quickly straightened, sliding his hand into his pocket to ensure that the plastic bag was indeed there and safely out of sight.  “Hey, Roy…how long have you been here?”

Roy avoided the question as he gave his partner an assessing once over.  The dark rings under Johnny’s eyes and his sunken expression spoke volumes as to the amount of stress his friend was under.  Roy knew that Johnny had his hands full taking care of his own affairs as well as Justin’s, not to mention the hours spent here at the hospital.  He also knew what some others did not:  That there was a possibility that Johnny’s physical well being might not be one hundred percent up to par.  Roy and Joanne had been doing whatever they could to help, concerned that Johnny might have too much on his plate, especially since he would be returning to work in just a few days.  But in the end, what could be done?  Roy knew that if he were in his younger friend’s boots, he would be doing the same thing.  Still, he couldn’t deny that there was something unnerving about finding Johnny alone in the men’s room, obsessively splashing water on his face.  “You okay?”

“Yeah…fine.”  Johnny cleared his throat and accepted the paper towel Roy offered.  “Just…a little tired.”

“Uh huh.”  Roy nodded.  After a few seconds of somewhat awkward silence, Roy spoke again just as Johnny had been about to leave the room.  “Look, Johnny…”

“Roy, just save it, okay?”  Johnny immediately regretted his choice of words.  He knew Roy was only speaking out of concern.  “That didn’t come out right…”

“It’s all right.”  Roy assured.  “I really don’t know what I was going to say anyway.  Just…promise me you’ll at least try to get some rest before work on Tuesday.”

“I will.”  Johnny turned to leave.

“And, Johnny…”

“What?”

Roy sighed and chewed his bottom lip, as he often did when he was stewing about something.  “If you weren’t…feeling up to working…you’d uh…let Cap know, right?”

“Of course I would.”  Johnny figured Roy was remembering the last shift they had worked together, the one where Johnny had almost asked Cap if he could leave early.  “But, I’m feeling fine now.  Just needed a few days off is all.”

“Right.”  Roy agreed skeptically.  After all, it wasn’t as if Johnny had spent those days resting with his feet up on the couch.

“Well, uh…I better get back to Justin.”  Johnny pushed open the door.

“Right.  I’ll meet you down there.”  Roy promised as he watched Johnny disappear from sight.

***

“Take it easy, Justin.  Dr. Burke is on his way.”  Raeline did what she could to calm her agitated patient.  Justin’s wheezing had given way to uncontrolled coughing that seemed to leech all the pain from his fractured ribs and magnify it tenfold.  The more distressed he became, the harder it was to catch his breath, until finally violent coughs caused his stomach to spasm.  Since he hadn’t eaten anything, he was only able to bring up a small amount of fluid before practically convulsing in dry heaves.

Hannah stood beside the bed, wanting nothing more than to hold her older brother and take all of his discomfort away.  But, there was something about seeing him like this that seemed to render her immobile.  Her whole life, Justin had always been the protector…invincible.  In fact, Hannah could not remember a time when Justin had dealt with any affliction other than a head cold.  Seeing him in such a vulnerable state was unnerving.  She was relieved to see her husband enter the room, followed by his partner.

“What’s wrong?”  Johnny asked, spying the somewhat stricken expression on Hannah’s face.

“He…he um…”  Hannah knew exactly what was going on with her brother, knew how to explain it in full detail, using proper medical terminology.  But right now, she couldn’t form the words.  Her eyes filled up with tears.

“Come on, Hannah.”  Roy led Hannah out of the room and down the hall toward the lounge with the assurance that Johnny would take care of Justin and let them know when he was feeling better.

Back in the room, Johnny placed two extra pillows behind Justin’s back in an effort to sit him up straighter and ease his breathing, while Raeline continued to hold the emesis basin in front of his mouth.  He stepped away when Dr. Burke entered the room and listened as the doctor and nurse conversed briefly.

Placing his stethoscope in his ears, Dr. Burke looked over his shoulder at Johnny.  “I’m going to lean him forward a bit.  Can you help support him?”

“Sure.”  Johnny moved close to the bed and supported Justin’s upper body, alarmed at how limp it seemed.  It was as if Justin had lost every remaining ounce of strength he possessed in his struggle to breathe.  “It’s okay, man…it’s okay…”  He whispered near Justin’s ear as he watched the doctor move his stethoscope over his back.

“Okay, let’s sit him back.”  Dr. Burke instructed as he helped Johnny resettle Justin against his pillows before looking across the bed at the nurse.  “Get me an amp of epi and some albuterol.”  He turned his attention back to his patient as Raeline left the room to retrieve the requested medications.  “Hang in there, Justin.  We’ll have you feeling better in a minute.”

“Another bronchospasm?”  Johnny assumed.

“Yes.  It isn’t unexpected at this point.”  Speaking for Johnny’s benefit as well as Justin’s he addressed the latter.  “Your air passages are still pretty hypersensitive, so anything that could be a potential irritant…dust, perfume…has the ability to set this off again.  As everything continues to heal, it should become less frequent.”

Johnny’s mind focused in on the word ‘should.’  He knew there was a good chance Justin would always experience some degree of difficulty, possibly even developing asthmatic type reactions to things he had no sensitivity to before.  He made a mental note to remind Hannah and Camarin to be wary of wearing any scented products in Justin’s presence for now, and hoped that Dr. Burke would take similar action with Justin’s nurses.

Burke accepted the syringe full of epinephrine from Raeline and quickly injected it into Justin’s left thigh.  The results were almost instantaneous as the adrenaline worked to relax Justin’s constricted airways.  His coughing began to quiet down and his wheezing became less pronounced.  Relieved, Justin closed his eyes and did not even move when his oxygen mask was removed and replaced with one with a nebulizer which would deliver the inhaled bronchodilator.

“That’s better.”  Burke replaced his stethoscope and placed it on Justin’s chest.  “Try taking some deeper breaths for me.”

Justin heard the doctor’s request, but knifelike pain in his left side prevented compliance.  And he was too tired to allow himself to care much about it.

Burke looked up at Raeline.  “Push five milligrams MS.”

“No…”  Justin’s protest was weak and breathy, but his intent was clear.  He could feel the vice like tightness in his chest releasing, and he knew he would be okay if he could just have a few minutes to let the albuterol do its work.

“Justin, you need to be taking deeper breaths so this medicine can get where it needs to go.  Pain is preventing you from doing that…”

Johnny didn’t mean to interrupt Justin’s doctor, but he figured he knew his brother-in-law just a bit better than the well meaning pulmonologist.  “I know how you feel about all these meds, Justin.  But it’s only temporary.”  Hearing himself speak the very words he had been internally using to rationalize his own use of narcotics over the course of the past few days almost caused bile to rise in his throat.  “You want to get better and get out of here, right?”

Justin seemed to ponder Johnny’s question for a moment before nodding weakly without opening his eyes.  The truth was he was in pain…a lot of it…more than he had ever imagined was possible.  He hated admitting to himself that he really did want the sweet relief a little morphine could offer.

Burke nodded to Raeline and within minutes, Justin was breathing…and resting…more comfortably.  After a final listen to Justin’s chest, Burke issued a few more orders to his nurse.  “Let’s get a portable chest Xray.  I want to make sure that pneumo hasn’t increased.”  He picked up Justin’s chart and began jotting down some notes.  “Call respiratory and cancel his afternoon breathing treatment.  Continue with the albuterol for another ten minutes, then keep him on ten liters humidified O2 and get a blood gas.  Page me when you get the films and the lab results.”

After Burke left the room, Johnny released the breath he hadn’t realized he had been holding.

“He’ll probably sleep for some time now.”  Raeline told the somewhat shell shocked paramedic as she removed the extra pillows from behind Justin’s back and lowered the head of the bed slightly.

Johnny had no doubt that what the nurse had said was the truth.  Justin was beyond spent, and would likely sleep the afternoon away, provided his lungs continued to cooperate and his pain remained under control.  He carefully brushed Justin’s saturated bangs away from his eyes.  “Get some rest.  I’ll bring Camarin by later on.”  After allowing his hand to linger for just a few seconds, Johnny headed toward the lounge.

***

It was Monday morning.  Johnny sat nervously in the chair in Todd Andrews’ exam room wondering if he was going to be able to pull off what he was about to try pulling off…and despising himself for even considering it.  It had been a week since Justin was admitted to Rampart, and nearly a week since Johnny’s appointment with Todd, the appointment where he was told to stay off his feet as much as possible.  Todd had given him some Tramadol at that appointment, a small amount, since he didn’t think Johnny would need it if he followed his orders to rest.  Johnny had burned through it in only two days.  At the time, he figured it was the ridiculously strenuous activity at work that caused his hip to ache so severely, and that since he wasn’t working, he would just use the medication to get through the next several days.  After all, there was a lot to take care of for Justin…a lot of chauffeuring and visiting to be done…a lot of tedious affairs to attend to.  He certainly couldn’t leave all of that to Camarin.  And then there were the responsibilities at his own home.  Hannah couldn’t be expected to shoulder the load at 32 weeks of pregnancy.  Worse yet, Johnny wasn’t even able to tell his wife about his appointment with Todd, because then she would have insisted he get the prescribed rest, which only would have caused more problems.

So, Johnny did what he had to do to get through the first two days.  The only problem was, his pain didn’t end after two days as he had planned.  In fact if anything, it got worse.  Having used up all the Tramadol, and unable to ask Todd for more without courting more trouble than he wanted, Johnny scavenged the leftover narcotics from his medicine cabinet, again telling himself it was only temporary, that a week off work would do the trick.  He knew he should just admit defeat.  Tell Hannah what was going on and hang out on the couch watching football and game shows for a few days.  But, there was so much that needed to be done for Justin…and so much that needed to be done around the house.  Johnny knew that if he didn’t take care of it while he was off and had the chance, it would only be harder later.  Besides, Justin was having a pretty rough time.  Johnny figured the least he could do was take care of everything outside the hospital that he could, so that his brother in law could have some peace of mind.  He remembered how much of a difference that had made for him when he had been hospitalized…the glorious relief he felt knowing Roy and Justin…and even Kelly Brackett were taking care of the ranch…and Hannah.  Johnny knew it could only aid in Justin’s recovery, so he kept on…doing what he had to do…telling himself it was only temporary…and every day that passed by, cringing at the notion that he was becoming dangerously more like his father with each bitter pill that he swallowed.

So now here he sat.  Waiting for Todd.  Hoping that with the help of the two Demerol tablets he took an hour ago, that he would be able to convince his orthopod that he was feeling better and was ready to go back to work…and wondering what he was going to do if he didn’t actually feel better before his meds ran out.  Nausea burned in his stomach, and Johnny knew it wasn’t just a side effect from the narcotic.  He despised dishonesty.  And now, here he was, lying to everyone he knew.  The justification that he was doing this for the greater good was beginning to wear thin, leaving behind anxiety and self loathing.  His head snapped up at the sound of the door opening.  Apparently he had been too deep in thought to notice the preliminary knock.

“Sorry, John.  I didn’t mean to startle you.”  Todd walked into the room wearing jeans and his favorite UCLA sweatshirt and took his seat on the stool facing his patient.  Johnny’s chart was waiting on the small ledge beside him, and Todd opened it, checking the vital signs his nurse had gathered before his arrival.

“That’s okay.  Just…lost in thought, I guess.”

“Well, that’s understandable.”  Todd knew that Johnny had a lot of things on his mind, not the least of which was Justin’s condition, which didn’t seem to be getting much better.  It had been a week, and Justin was still in the ICU.  They still had not been able to pinpoint the source of his fever, he continued to have frequent bronchospasms, and as a result of his inability to rest well, his fractures were not healing as readily as they should.  In addition, there was now a concern that some of the alveoli in Justin’s lungs might have incurred irreversible damage.

After a few moments of silence, Todd closed the chart and leaned forward, resting his elbows on his knees, his expression curious.  “So…how’s it going?”

Johnny pointed at the emblem on his doctor’s shirt.  “Great game Saturday.”

Todd smiled, not minding taking a little time to chat about his favorite team.  “Yeah…yeah it was.  Did you see that touchdown pass Harmon made in the last ten seconds of the first half?  Eighty yards!”

Johnny smiled and looked down at his lap.  “Caught it on the eleven o’clock news.  That was pretty amazing.”

“Guy’s got great hands.  And I heard he maintains a 4.0 average.  He could go to med school…become a surgeon.  But…he’s a communications major.  Go figure.  Probably end up as an actor or something.”

“Yeah…probably.”

Despite the small talk, Todd could sense that Johnny wanted nothing more than to get through this exam and get on with his day.  So, he cut to the chase.  “So, how’s the hip treating you?”

Johnny’s hand moved down to the area in question.  “It’s uh…it’s doing a lot better, Doc.”

“Yeah?”  Todd stood and moved the stool out of the way with his foot, moving closer to his patient.  “Well, that’s some good news.  Stand up for me?”

“Sure.”  Johnny did as he was asked, fully aware that Todd would be scrutinizing his every feature…watching for any tell tale stiffness or facial grimaces.

“Well, that was a lot easier than it was last week.”  Todd took a step back and crossed his arms.  “Let me see you walk around a little.”  Satisfied that Johnny appeared able to do so without any difficulty, the doctor moved on.  “Feels good?”

Johnny shrugged.  “Yeah.”

Todd moved behind Johnny then, resting the palms of his hands on the tops of his hip bones, checking to make sure they appeared equal.  “Looks good so far, John.  Go ahead and take off your jeans and shoes and hop up here for a minute.”  He patted the paper lined table beside them.

Normally Todd would have left the room while Johnny removed his clothing, but today he stayed.  Johnny was sure it was because the doctor wanted to see if he could carry out these tasks without difficulty.  Suddenly Johnny wished he had worn his loose fitting sweatpants and a pair of slip on shoes, but he found he was able to complete his task without difficulty, thanks to the numbing power of narcotics.

Once Johnny was on the table, Todd took him through a series of exercises designed to gauge muscle strength, flexibility, and range of motion.  After Johnny had completed all of them with ease, Todd moved to the paramedic’s left side and carefully moved his boxers aside so that he could examine the area in question.

Johnny concentrated on breathing as Todd’s hands palpated his tender joint.  A few times, the doctor’s hands found a sensitive spot, and Johnny thought his jaw would break from the pressure of gritting his teeth.  He could actually feel his heart beating in his throat when he opened his eyes and noticed Todd’s frown of concern.

“Looks like there’s still a good bit of swelling here, John.”

Johnny pushed himself up onto his elbows.  “Really?”

“Uh huh.”  Todd rested the back of his hand over the most swollen area, assessing for heat.  “You’re sure you’re not having any pain?”

“I’m sure, Doc.  I feel fine.”  Suddenly the walls of the small exam room seemed threatening, and Johnny wanted nothing more than to get out of there…now.  “So, can I go back to work tomorrow?”

Todd extended a hand and helped pull Johnny up into a sitting position.  “Not so fast, John.  Are you still taking the Tramadol?”

Johnny’s throat felt like it had suddenly been clamped off.  Here it was.  The big lie.  He cleared his throat.  “Uh…no…just the ibuprofen.”  There.  At least it wasn’t a total lie.

“Okay.  You can keep taking that until it runs out.”  Todd took a step back and opened his chart.  Something wasn’t adding up here, and he wasn’t sure just what.  He had certainly seen his share of patients who were dishonest with him about their level of pain…particularly athletes who were anxious to get back into the game.  But despite the stories he had heard from some of his colleagues in the ER, Todd knew John Gage had always been pretty straightforward about his symptoms…at least with him.  He also knew Johnny wasn’t the type to mask symptoms with drugs.  Yet, Todd couldn’t shake the feeling that his patient was hiding something, which made what he was about to say taste bitter.  “John, I can’t find any reason not to clear you for work tomorrow.”  He took a step toward the exam table, figuring he would give Johnny one more chance to come clean…that is, if he had anything to come clean about.  “You’re sure you’re feeling up to it?”

“I’m sure, Doc.” 

Todd sighed and picked up his pen, scribbling something on a small notepad.  “Okay.  But, I want you to work half shifts for a while.”

“But, Doc…I…”

“Half shifts, John.”  Todd insisted, as he handed him a note to give to his captain.  “You’ve been resting this week.  You need to ease back into your routine slowly or that pain could come right back.”

Johnny accepted the note with a sigh, wondering if Todd could see right through him.  “Okay, Doc.  Thanks.”

“You’re welcome.  Go ahead and get dressed.  I don’t need to see you again unless you start having problems.  But, John…”

“Huh?”

“You’ll let me know if you’re having problems, right?”

Johnny grinned a lopsided grin.  “Sure, Doc.”

***

“Welcome back, Gage.”  Chet offered a greeting before joining his shift mate at the table.

“Morning, Chet.”  Johnny retorted after taking a long sip of his coffee.

Hank Stanley entered the kitchen. “Gentlemen, don’t forget we have a tower drill at 1300 hours today.  And Kelly, the latrine could use some attention.”

Chet downed the last of his coffee and headed in the direction of the rest room while Marco started preparing breakfast.  “Make sure you save me some.”

“Don’t worry, Chet.”  Marco promised.

Mike walked in then and offered his own welcome back greeting to Johnny, followed by a concerned question.  “How’s Justin doing?”

“Yeah, John…”  Cap leaned back in his chair.  “Roy’s been keeping us updated, but…how are things going?  Is he out of ICU yet?”

“No…”  Johnny shook his head and pushed his suddenly bitter tasting coffee away.  “I was just there last night, and there’s no talk of moving him any time soon.  His fever’s up, his lungs are still pretty rocky, and he’s miserable.”

“Sorry to hear that.”  Marco spoke from his position at the stove.  “Chet and I tried to stop in and see him a few days ago, but they wouldn’t let us in.”

“I let him know that, Marco.”  Roy assured. “He appreciated that you tried, but really…he’s not much in the mood for visitors right now anyway.”

“That’s too bad.”  Cap mused just before the tones sounded, summoning the engine crew to a dumpster fire.

Finally alone in the station, Roy stood and poured Johnny and himself another cup of coffee.  “So, are you sure you’re up to this?”

“Up to what?”

“I think you know what I mean.  Your hip?”

“Yeah well…” Johnny took a sip of his fresh coffee.  “It’s fine now.”

“You’re sure…”

“Yes, Roy.  I’m sure.  It was never that big a deal anyway, and this is exactly why I didn’t want to tell anyone.  Because I knew you’d make it a big deal…like you are now.”

“I’m not making it…”  Roy sighed, not feeling in the mood to argue, and feeling a little guilty that he seemed to be giving Johnny the third degree.  “Never mind.”

“Oh, and by the way…Hannah thinks I’m working half shifts because I wanted more time to take care of things for Justin.  So please don’t say anything…”

“You didn’t tell Hannah yet?”

Johnny was getting annoyed now.  “No I didn’t, Roy.  She has enough to worry about with Justin and the baby…I just…didn’t see any reason to…”

“Okay…”  Roy understood completely.  If it had been Joanne’s brother in the hospital…if Joanne had been seven months pregnant…he would have done the same thing.  “I won’t say anything.”

The two paramedics finished their coffee in companionable silence until finally dispatch sent them on their way to a ‘man down’ on Sepulveda.

***

“His respiration rate is up to 28, his latest blood gas shows his SATS are down to 85, and his CO2’s increasing.”  Penny, Justin’s day nurse, gave her report to the doctor she had just had paged.

Burke took in this discouraging bit of information as he made his way to the bed and leaned over his patient, frowning as he placed his stethoscope against his chest.  It was apparent that Justin was struggling, his somewhat exaggerated and uneven respiratory effort painting a grim picture.  Realizing that Justin wasn’t even drawing enough air into his lungs to effectively complete an exam, and wondering whether he was unable or was simply tiring from the effort, Burke prompted him a bit.  “Justin?  Can you open your eyes and look at me a minute?”

Justin had been feeling like he was trying to suck a thick milkshake through a straw that had a hole in it.  Frustrated that he couldn’t seem to get enough air to sate his body’s hunger for oxygen, he was beginning to tire and give in.  He was aware of someone speaking to him, but he couldn’t make himself care enough to put up much of an effort to comply with his request.  Besides, he felt hot, he was in pain, and he really just wanted everyone to go away and leave him alone.

Burke waited a few seconds and was rewarded only with a hitched moan and a slight turn of Justin’s head.  He sighed and tried again.  “Come on, Justin.  Try taking some deeper breaths for me.”

Kelly Brackett walked into the room, having heard the page and wanting to know what was happening.  Spying Penny standing to the side of the bed, and Burke busy listening to Justin’s lungs, he quietly picked up the flow chart from its cradle and began scanning it.  He looked up at the sound of Burke’s concerned voice.

“Bilateral rales in the lower lobes, slightly worse on the left side.  Probably pneumonia.” 

Brackett sighed, frowning.  “That would explain the fever.”

“Can we talk outside for a minute?”  Burke asked as he took the chart from Brackett and hastily scribbled some notes.  Before following his colleague out into the hall, he issued some orders to Penny that included a portable chest X-ray, some new meds, and a breathing treatment.

Once they were safely out of their mutual patient’s earshot, Brackett wondered what else the pulmonologist was suspecting.  “Julius?”

Burke glanced through the observation window, pausing to gather his thoughts for a moment before speaking.  He was aware of Brackett’s relationship to this patient and his family.  “He’s heading into respiratory failure, Kel.  His gas exchange continues to be inadequate, he’s tiring…”

The corner of Brackett’s mouth twitched as he heard Burke spell out what he already knew.  “If we aggressively treat the pneumonia…”

“You know I’ll do that, Kel.  We’ll run his labs, increase his antibiotic, switch it if necessary, but the bottom line is…”  Burke hesitated, rubbing the back of his neck with his hand.  “If there’s no improvement soon, I’m going to have no choice but to intubate him, put him back on the vent.  And I’m concerned…”

“That he may not come off of it.”  Brackett finished the sentence, knowing already what the other man feared, that the damage to Justin’s lungs would make it that much harder to fight this infection, that if he went back on the ventilator, there was a real possibility he would become dependent upon it.  He thought of the physical therapist’s family and friends…his friends.  How would he tell them Justin might have to spend the rest of his life on a vent?  Although Justin was reaching middle age, Brackett wondered if the man had given much thought as to what his wishes would be under those circumstances.  After all, at 44 and in excellent physical condition, it seemed a bit premature.  Brackett was only a few years older, and he hadn’t made any plans for such an event as this.  Maybe it was time he should.

Burke didn’t need to verbally affirm Brackett’s statement.  The look on his face voiced his agreement.  Still, he wanted to hold onto hope.  “Let’s take it one step at a time.  We’ll get his lab results, start him on a stronger antibiotic…”

“There’s something else you should know.”  Penny did not make it a habit to interrupt two doctors during a consultation.  But, she had some information that she felt they needed to hear.

“What’s that?”  Burke asked.

Penny’s eyes travelled from one doctor to the other.  “A little while ago when I was in with Justin…he told me that he thought he would do better if he could stop taking all his meds…that they were no good for him and they were making him worse.  He was pretty adamant about it…said he would be better off at home…”

Brackett sighed.  “I can’t say that I’m completely surprised by that.  Justin’s into a lot of alternative…”

“There’s more, doctor.”  Penny continued.  “He told me he wanted to refuse his meds.  All of them.”

“He did what?”  Brackett fumed.  He knew Justin preferred a natural approach to things, but surely he wouldn’t jeopardize his well being in this way.

Penny shook her head.  “Just like I said.  He said he didn’t want any more meds.  I was hoping someone would be able to talk him out of it.”

“Well you can be assured that someone will!  Of all the…”

Burke took this moment to intervene, doing his best to calm the other doctor’s escalating ire.  “He’s hypoxic, Kel…confused, not thinking clearly…and with SATS like that, probably irritable as hell.  Anyway, he’s in no position to refuse anything at the moment, so let’s just let it go for now.”

“You’re right,” Brackett conceded, his mind picturing what Todd Andrews’ reaction would be if Justin actually did refuse his meds.  He almost smiled.  “But be sure to let us know if he refuses again.”

“Right away, doctor.”  Penny assured before making her way to the nurses’ station to call radiology.

***

Hannah squared her shoulders as she stepped off the elevator into the busy emergency department at Rampart.  When her scanning eyes did not immediately spot the object of her search, she stopped by the base station.

Dixie McCall looked up from the chart she was updating and smiled at her pregnant friend.  She knew who Hannah was looking for, and knew about the conversation that would soon take place.  The nurse tried to swallow the lump in her own throat at the thought of it.  “Hi, Hannah.  Kel’s expecting you.  He’s in his office.”

“Dix?  What’s this about?”  Is Justin okay?”

Dixie sighed as she put down her pen.  “Kel will explain everything to you.”

Her friend’s discretion caused fear to ripple through Hannah’s veins.  Although she understood, she knew if there was nothing to worry about, Dixie would have said so.  Hannah recognized the nurse’s quiet demeanor, she had seen it before, and always when she was worried about something…or someone.  She nodded and walked down the hall to Brackett’s office.  One knock on the door was all it took before a gruff voice invited her to enter.

Brackett stood up at the sight of Hannah and circled around his desk to greet her.  “Hello, Hannah.  Why don’t you have a seat?”  He gestured toward an orange plush chair.

“Is your news so bad that I need to be sitting for it?”  Hannah challenged, already sure that it was.

Brackett grimaced slightly and leaned back against the front of his desk.  “I just thought you might be more comfortable sitting, considering…”  He pointed toward Hannah’s bulging stomach.

“Right.”  Hannah looked down and moved her hand lightly over the tight lump, her dread temporarily replaced by joy.  But then as quickly as it came, it flitted off again, like a skittish bird desperately seeking seed with a hungry cat nearby.  She lowered herself into a chair.

“How is everything going with the baby?”  Kel asked, because at the moment it seemed like the thing to do.

“Fine…just fine.”  Hannah offered.  “But, you didn’t call me here to talk about the baby.”

“No…”  Kel twitched as he crossed his arms in front of him.  “No, I didn’t.  I called you because you’re Justin’s next of kin and…there are some questions I need to ask you.”

“His next of…oh my God…”  Hannah’s mind raced with a hundred different scenarios while simultaneously thinking of Jonas and her parents…even though she knew what Brackett meant, that she was the closest blood relative, the only one available at the moment to make any decisions regarding Justin’s care, she wondered what sort of bad karma had seen fit to hang this tremendous burden across her shoulders.  And at the center of her jumbled mind laid one foreboding thought.  If Brackett was looking for Justin’s next of kin that meant her older brother was not able to make decisions for himself.  “Justin…is he…”

Brackett sighed heavily, hating the conversation he needed to have, hating even more that it was this particular family he needed to have it with.  “I won’t lie to you and tell you everything’s okay, because I’m sure you’ve figured out that much already.  Justin’s developed pneumonia, Hannah.  We knew this was a possibility…”  The doctor stopped speaking at the sight of the tears welling up in Hannah’s eyes.  He held out the box of tissues from his desk and waited until she accepted one before continuing.  “We’ve changed his antibiotic, he’s had a breathing treatment, and he’s due for another one in about an hour.  Dr. Burke and I are doing everything we can at the moment, but Justin’s lungs are just not working properly.  He’s not absorbing enough oxygen, his carbon dioxide levels are too high…he’s going into respiratory failure.”

Hannah swallowed this information.  She had a feeling she knew where this conversation was headed.  “Is he awake?  Can I talk to him?”

Brackett also knew that Hannah likely knew what questions he needed to ask, and was hoping for a chance to talk to her brother before answering them.  “He’s hypoxic…confused.  He’s conscious, but he’s not very coherent.  If his SATs don’t improve in the next hour or so, a decision is going to have to be made about putting him back on a ventilator, a decision that Justin won’t be able to make for himself.”

“What decision?  Can’t you just…”  Even as the words left Hannah’s mouth, she knew they were just wishful thinking.  With the damage to Justin’s lungs…her thoughts mirrored the doctor’s next words.

“With the damage to Justin’s lungs, if we put him back on the vent, it’s likely he would become dependent on it.  So, we need to know…has Justin ever said anything about what his wishes would be in a situation like this?”

“You mean…”  Hannah had to clear her throat in order to get the words out.  “Has he ever said anything about whether he would want to live on…on…”

“Would he want to linger on life support for an undetermined amount of time?”

“I…I don’t…”  Hannah stared at the floor, shaking her head.  Surely Kel couldn’t be expecting her to give him an answer right now.  She needed time to think…to talk to Johnny…to Camarin…to her parents…

“It could be weeks, Hannah…or months…some people have survived for years…”

“Or he could get better.”  Hannah insisted.

Brackett took a moment before answering, not wanting to extinguish the faint glimmer of hope lighting Hannah’s eyes just yet.  “He could.  But Dr. Burke and I have discussed this.  We both feel that if it comes to that…if Justin’s breathing continues to deteriorate, his chances of…”

“He wouldn’t want that.”  Hannah said softly.  “He wouldn’t…”

“Has he ever talked to anyone about it?  Do you know if he has anything in writing?”  The last thing Brackett wanted was for Hannah to make any rash decisions.

“He’s only 44!”  Hannah almost shouted.  What did the doctor expect?  It was unfair to expect someone Justin’s age, especially someone who worked as hard as he did at being healthy and fit to have plans in place for something like this.

“I know.”

The doctor’s two words spoke more about Brackett’s level of understanding than an entire speech would have accomplished.  Hannah allowed them to hang in the air while she did her best to absorb all of this.  Then finally, uneasy acceptance began creeping in.  “I don’t know if he’s ever talked to anyone about it…he’s never said anything to me.”

“Why don’t I leave you alone for a while…you’re welcome to use my phone to call Johnny or your parents…I can have someone send Camarin downstairs…”

“No.”  Hannah shook her head and looked up at the doctor, her eyes telling him she had already made a decision.

“There’s still some time, Hannah.  Why don’t…”

“No, Kel…I…”  Hannah hesitated, looking down for a moment.  “Anyone who knows Justin…he…he would never want that.”

“Are you sure, Hannah?”  Brackett’s voice was uncharacteristically subdued.

“I’m sure.  He would never want to spend his life that way.  He would rather…”  Hannah’s words were cut off by an unexpected sob.

It was hard to follow the cardinal rule of not getting emotionally involved when the patient…and his family…were good friends.  But Brackett forced himself to maintain his professional detachment.  “Okay then.  I’ll let Dr. Burke know.”  He rested a hand lightly on Hannah’s shoulder, allowing it to linger there for a few seconds before heading to the door.  “You’re welcome to stay here as long as you want.  Make some calls.  Then, come on upstairs and see Justin.”

Hannah nodded her thanks, waiting for the sound of the office door closing behind the doctor and friend before letting loose the dammed up emotion that was bursting for release. 

***

“John?  The phone’s for you, pal.”  Hank Stanley kept his voice quiet, knowing the paramedic was resting after a particularly grueling rescue in which he’d had to burrow through a confined maze of debris after a gas explosion.  Roy had offered to go in, but had reached a dead end that was too tight a fit for him, and that even Johnny felt claustrophobic squeezing through.  The captain wondered if Johnny was feeling the physical effects of the ordeal, but he had only admitted to being tired, and since that much was a given, Hank had left it alone.

“Huh?”  Johnny asked sleepily from his bunk before his captain’s words fully registered in his Demerol infused consciousness.  “Oh…right, thanks.”  He pulled himself off the bed and walked toward the bay, trying to ignore Hank’s scrutinizing glare and the ache in his hip.

“Why don’t you use the extension in here?”  Hank pointed toward the phone on the desk before leaving the room.

Johnny waited until he was alone and picked up the receiver.  “Hello, this is John.”

“John, it’s Hannah.  Justin’s not doing so well and Kel just called me down here to…”

“Whoa…whoa…slow down…”  Hannah sounded upset, and Johnny could feel a protective anger beginning to surface.

“Okay.”  Hannah took a steadying breath.  “Kel called me down here to talk to me about Justin.”

“Down where?  Are you at Rampart?”  Johnny had been under the impression that Hannah had planned to pick up Camarin and visit Justin later this afternoon, so that they would be there when Johnny got off work.  Something had obviously changed.

“Yes…at Rampart.”  Hannah went on to explain that Justin’s condition had taken a turn for the worse.

“Why did he call you?”  Johnny was beyond perturbed.  He thought he had let Brackett know that he wanted to be notified first of any change in Justin’s condition.  Had the doctor tried to call when he was out on a call?  And the ER had been so busy, he hadn’t even seen Brackett the few times they had been there. 

“Because I’m his sister…”

“I know you’re his sister, but…”

“Because I’m his next of kin, John.”

Hannah’s words stopped Johnny in his tracks.  If Brackett was contacting Justin’s next of kin… “Hannah?  What’s going on?”

“They needed me to make a decision about what Justin would want if…well, if he’d want to go back on a ventilator.  Kel asked me if Justin had ever talked about it.”

“He hasn’t to me.”  Johnny couldn’t believe what he was hearing.  Apparently Justin’s doctors did not hold much faith in his ability to be weaned off the vent again should he have to go back on it.

“Me neither.”

“Well for God’s sake it’s not something you talk about…”  Realizing he was yelling, and thus adding to Hannah’s stress, he immediately regained his composure.  “I’m sorry.”  He looked at his watch.  It was almost three.  “Look, I’m off in five hours.  But, maybe Roy and I could come down there now and we can talk about…”

“I already took care of it, John.”

“You did what?  What did you tell them?”

“I told Kel that…”  Hannah paused and Johnny could imagine her doing her best to remain stoic, even as she was questioning her decision.  “That Justin wouldn’t want to go on life support if there was any chance he would remain on it for a long period of time.  I told him he would rather…”  Hannah’s voice caught, still unable to say the words.

Johnny slammed his fist on the desk.  Damn Kelly Brackett for putting Hannah through this!  “He should have called me!  You‘re pregnant.  You never should have had to…”

“Being pregnant doesn’t change the rules, John.  I’m still Justin’s legal next of kin.”

“Well, what about your mom and dad?”  Johnny knew he was being irrational, but it angered him that Hannah was having to deal with all of this alone.

“I’m here, John.  You know how it works.  Besides, I wouldn’t want mom or dad to have to…it was hard enough for me.”  Hannah waited to see if Johnny would respond.  When he didn’t, she added, “I called you to let you know what’s going on and to see if maybe you could come down here.”

“Of course…let me just go talk to Cap…”

“And to ask you if you thought I made the right choice.”

Johnny’s mind pictured images of Justin’s constant smile, his upbeat personality and inherent zest for life.  Then those images were replaced by ones of a weakened body, completely devoid of its former soul, wasting away in some long term care facility.  He pictured Camarin dutifully caring for Justin’s every need, day in and day out, and he imagined how Justin would feel about that.  It couldn’t be any clearer that Hannah had done the right thing.  “You absolutely made the right choice.”

“Then why do I feel so guilty?”  Hannah could no longer hide her emotion from her husband.  She felt like she had just personally ordered her brother’s execution.  Her big brother, the one who had always been so eager to protect her…to fix anything that was wrong in her life.  And now that he was the one who needed fixing, what did she do?  Told them to pull the plug.

Johnny felt himself becoming overwhelmed by the sound of Hannah’s distress.  Suddenly he needed to be at Rampart thirty minutes ago.  “Hannah, just…don’t cry, okay?  Go find Dixie…or someone.  I’ll be there as soon as I can.”

“Okay.”  Hannah sniffled.  “Love you.”

Johnny closed his eyes and squeezed the receiver so hard his fingers went numb.  “Love you too.”  He waited for the connection to break before slamming down the phone with a loud clang.  A strong spasm chose that particular moment to charge through his hip which only added to his ire.  With one sweep of his arm, he managed to send everything on top of the desk flying across the dorm.  “Damn it!”

Chet had been in the bay doing his best to make it look like he was not deliberately trying to overhear Johnny’s phone conversation.  But, the loud crash and expletive caused him to intervene, concern for his friend’s safety overriding any shame that could come from being caught eavesdropping.  He entered the dorm to find Johnny leaning on the desk, using both hands for support.  His face was red and he was breathing heavily.  “Everything okay, Gage?”

Of course…Chet.  Johnny hesitated, not sure what he wanted to say, waiting for the pain in his hip to subside enough so that he could move without inviting more hassle.  Finally he shook his head and pushed away from the desk so hard he nearly knocked the shorter firefighter down before he slammed his way through the swinging door which led to the bay.  “No, Chet.  It’s not.”  He reached into the squad and pulled out the canteen full of water he had stashed there earlier.  Spying Chet following him, he ordered, “Go tell Roy to come here.”  After he was sure that Chet was in the dayroom, Johnny took a quick look around to be sure he was alone.  Then he reached into his pocket and pulled out a small plastic bag.  He fished two Demerol tablets out of the mix and swallowed them with some of the water.  He had just enough time to return the canteen before Chet returned, flanked by Roy and their captain.

“Johnny?  What’s going on?”  Roy was concerned.

“Come on, we need to go to Rampart.”  Johnny opened the passenger side door and got in.

Cap leaned into the open window.  “John, if you need to take the rest of the day off…”

“No, Cap.  I’m fine.  Besides, we need supplies.”

Cap straightened up, making eye contact with Roy as he moved to the driver’s side.  No words needed to be exchanged as both men communicated their understanding that Johnny had gotten some bad news and needed to be with Hannah and Justin. 

Cap tapped the roof of the squad as Roy got behind the wheel.  “See you when you get back then.”  He knew that if after getting to Rampart, Roy felt Johnny would not be fit to work the rest of the day, he would let him know.

Roy started the engine and looked over at his friend.  “Wanna talk about it?”

Johnny simply stared straight ahead, his jaw tensing as it often did when he was about to explode.

“Didn’t think so.”  Roy admitted as he pulled the squad out of the bay.

***

“Come on, honey.  You can do it.  Take a breath.”  Camarin willed her voice to remain steady as she quietly encouraged.  Justin had stopped responding to her long ago

From behind closed lids, Justin could see comforting light.  No, not light really.  More like a familiar warmth that seemed to offer the rest he craved.  But then he heard that soft voice again, the voice that kept pulling him back to the place that was full of pain and exhaustion.  He tried to ignore it, but there was something about it that made him feel like he had to obey.  He gasped in a breath full of air that rattled the fire in his chest, bringing with it the urge to cough.  Except he was too weak to cough, so he panted in shallow huffs until he exhausted himself again.

“Justin, please…”  Camarin placed a hand on Justin’s fevered forehead.  She had seen enough death in her lifetime to recognize the ominous rattle emanating from her fiancé’s lungs.  And standing here watching Justin’s brow wrinkle from some unknown discomfort caused her own chest to tighten in response.

“His periods of apnea are becoming longer and more frequent.” 

A voice from the doorway startled Camarin.  She looked up to see Todd Andrews standing there.  “Todd?  How long have you been here?”

“A few minutes.”  Todd moved toward the bed.  He had heard a page go out for Dr’s Brackett and Burke and had a feeling he knew what it was about.  He had watched Justin’s condition deteriorate seemingly right before his eyes over the past several hours, and it just didn’t seem fair.  As an orthopod, his job usually involved fixing people.  A dislocated shoulder here…a broken leg there...Todd didn’t have to deal with the darker side of medicine very often.  Sure, there were the occasions where he had to break the news that a college football player’s NFL dreams went down the drain along with his torn ACL.  Or other times when he had to inform hopeful parents that their son or daughter would never walk again.  But death…that was something he didn’t have to deal with nearly as often as some of his colleagues.  And he preferred it that way.  And worse, this was Justin…and Justin’s friends and family…and that just left a sour taste in his mouth.  Justin was finally getting married…opening the business Todd knew he had dreamed about for years.  He was happy.  It wasn’t fair.  But then, Todd mused, since when has life…or medicine for that matter, ever been fair?

“I hope they can do something for him.  I can’t…I  mean it’s hard to watch him…”  Camarin’s voice trailed off.  She wasn’t sure if Justin could hear her, and she certainly didn’t want him to think she was giving up hope.

Todd wrapped his hand around Justin’s cool, dusky fingers.  “They’ll make sure he’s comfortable.”  The orthopod was not yet aware of the conversation Kelly Brackett had with Hannah.

“Todd.”  Julius Burke burst into the room and acknowledged the other doctor.  Justin’s nurse followed him.  One look at his patient was all it took for the pulmonologist to realize an exam wasn’t necessary.  “Where’s Brackett?”

“Right here.”  Spoke Brackett as he entered the room.

“He needs to be intubated, Kel…right now.”

Todd gave Justin’s hand a final squeeze and got out of the way, meeting Camarin at the door.  A moment later, a page summoned him to the orthopedic floor, and he looked at Camarin apologetically.  “It’ll be okay.  He’s in good hands.  I’ll be back to check on him as soon as I can.”

Camarin nodded, afraid that if she spoke the tears would come, and she was determined to stay strong.  Years of strife on the reservation had jaded her to the point where she could remain stoic in even the direst of situations, but she was finding it almost impossible now.  She had never felt the depth of emotion for another human being as she felt for Justin.  It was new to her, and she felt more than a little lost.  She also found herself feeling bad for Todd.  She knew this past week had not been easy for him either, even if he, too, had managed to construct a hard shell around himself for the rest of the world to see.  It seemed unfair that he now needed to tend to another patient when she was sure he would have rather stuck around to see Justin through whatever, good or bad, was going to transpire in the next few minutes. 

Camarin watched, slightly detached, as Brackett and Burke conversed, then she stepped out of the way to allow Brackett past her.  Burke was busy listening to Justin’s lungs now, and the nurse was getting a set of vitals.  Camarin found herself wondering if John was here yet as she spoke a silent prayer to the spirits.

***

Johnny entered the ICU visitors’ lounge to find Hannah exactly where the nurse at the horseshoe shaped station had told him she would be.  She was standing facing the large window on the far wall that overlooked the parking lot.  She looked over her shoulder at the sound of the opening door and breathed a smile of relief that her husband had arrived.  Hannah would be at a loss to explain it, but even the most impossible burden seemed lighter whenever he was around.

“Are you okay?  I came as quick as I could…”  Johnny moved to Hannah’s side and wrapped protective arms around her.

“I’m fine.  I feel a little silly actually…”  Hannah leaned into Johnny’s embrace, her nose detecting the now eerily comforting aroma of smoke.

Johnny pulled back.  “What do you mean you feel silly?”

Hannah sighed.  “You didn’t have to come all the way down here.  I’m okay.  It was just…I guess I just wasn’t quite prepared for that discussion with Kel…”

“Well, of course you weren’t!”  Johnny’s affirmation was interrupted by the opening door.  As if summoned, Kelly Brackett stepped into the room, the mere sight of him seeming to ignite the smoldering anger that had to be taken out on someone.  “And you…”  Johnny pointed his finger accusingly as he moved toward the figure at the door.  “What the hell did you think you were doing?”

“John…”  Hannah went after her husband.

“Johnny, wait…”  Brackett took a defensive step backwards, his hands raised in a placating gesture.

“You know what I mean, Doc.  What did you think you were doing upsetting Hannah like that?  I thought we agreed that you would call me if…”

“Now hold on just a minute, Johnny.”  Brackett suddenly understood.  “We did have an agreement.  I did try to call you earlier, but you were out on a run.  I figured I would talk to you when you brought your patient into Rampart, but things got busy and I didn’t have a chance.  Besides, the only person legally able to…”
 
“I know…”  Johnny’s voice was considerably calmer and quieter now.  “I’m sorry, Doc.  It’s just…”  Brackett’s firm, yet understanding hand on his shoulder made it clear there was no need to finish his sentence.

“I know too, Johnny.  It hasn’t been an easy week.”  After a pause, the doctor continued.  “I was just in to check on Justin.  His breathing is deteriorating.  His SATs are continuing to drop, he’s disoriented…the effort of breathing has exhausted him to the point where he’s giving up.  He’s in pain, and we can’t give him any more analgesic because that would further suppress his respiratory drive.”  Brackett paused once more to allow Johnny and Hannah time to process this latest bit of information and to give them time to prepare for his next statement.  “It’s time to make a decision.”

Hannah’s hand found Johnny’s and tightened around it.  “You mean about the vent…I thought we…”

“We talked about whether Justin would want to linger for an undetermined amount of time on life support, because there’s a very good chance, with the damage that’s been done to his lungs…that it will be difficult, if not impossible to wean him off of the vent in the event he goes on one…”

“And now it’s time.”  Johnny guessed.

“I’m afraid so.”  Brackett clarified.  “If we don’t intubate now and put Justin on mechanical support, he’ll eventually stop breathing altogether.  And then…”

Hannah closed her eyes in an effort to hide the tears that were forming there, but the action sent one tracking rebelliously down her cheek.  “If he goes on the vent…he’ll be more comfortable…”  It wasn’t a question.  Hannah was putting things together in her mind.

“There’s no question about that, Hannah.”  Brackett agreed.  “He would be under light sedation.  We would be able to give him more medication for pain…”

Johnny suddenly felt the room spin in a nauseous swirl.  While he understood and fully supported Hannah’s supposition that Justin would not want to linger on a vent for the rest of his life, the thought of his brother-in law lying there confused…in pain and feeling like he was slowly suffocating…made his head swim.  His hand left Hannah’s grasp then and raked over the top of his head, grabbing at his hair.  “Just do it.”

“What?”

“John…”

Johnny looked up at the others, incredulously.  “Why are we even talking about this?  Justin…he’s…”

Hannah placed a steadying hand on Johnny’s shoulder as she directed her next question to Brackett.  “He’s only been on the new antibiotic for a few hours.  There’s still a chance he could get better, right?”

“Of course.”  Brackett’s eyes squinted with compassion.  He did not want to be a pessimist, but he also did not want to fill this couple’s heart with false hope.  “But Dr. Burke has seen a lot of patients with lung injuries like Justin’s.  The chances…”

“As long as there’s even a tiny chance he can get better, then we have to hold onto that.”  Hannah affirmed with confidence as she wiped the remaining tears from her eyes, determined now to erase all negative thoughts from her mind as far as her brother’s recovery was concerned.  And equally determined to see to it that everyone else did the same.  If Justin’s condition did not improve, then they would cross that bridge when they came to it.

Brackett smiled a half smile as he collected both of Hannah’s hands in his own.  “Okay.  We’ll go ahead and intubate.  I’ll be back to let you know when you can see him again.”  After a nod in Johnny’s direction, the doctor left the room.

A moment of silence followed before Hannah finally spoke again.  “If he doesn’t get better, John…if they can’t wean him off…”

Johnny pulled Hannah into his body until her forehead rested against his shoulder.  “I think we’re both in agreement about what needs to happen in that case, Han.  But, Justin’s gonna get better.  He’s too damn stubborn not to.”

Johnny’s comment had the desired effect, causing Hannah to laugh as she pulled away again.  “You got that right.  He always has been.”

“And…”  Johnny lightly touched Hannah’s chin, raising her eyes to meet his.  “If it were you or me in that bed right now…you know he would refuse to think anything but positive thoughts.  So…I’d say we still owe him at least that much, right?”

Hannah nodded as tears threatened again.  “Right.”  Then she noticed someone was missing.  “Where’s Roy?”

“Probably on his way up.  I asked him to give us a few minutes alone.”  Johnny opened the door and looked out into the hallway.  There was Roy, all right…holding a very emotional Camarin as she cried.  Johnny watched until he saw Roy look up and make eye contact with him while he continued to whisper words of encouragement.

Johnny figured Camarin’s tears flowed with both relief and fear.  Remaining silent, he placed a hand on her back and waited until she turned to face him.  Then he led her into the lounge where the four of them awaited Brackett’s return.

***

Todd pulled back the bulky bandage covering Justin’s surgical site and examined the healing incision.  “This is looking good.  I think we’ll leave it open to the air for a little while.”

Camarin agreed.  “Yes.  I thought it was looking better too.  How long until the staples can come out?”

Todd spoke as he arranged Justin’s covers.  “Probably at least another week…”  His statement was cut off by the strident squealing of the vent alarm.  Apparently the repositioning of Justin’s leg had caused enough pain to rouse him from his sedated slumber.  Todd reached to silence the alarm before leaning over his patient.  Justin’s eyes flew open wide as he gagged around the tube in his throat.  “Hey, calm down, Justin.  You’re on a vent.  Don’t fight it.”  He waited until Justin’s fearful blue eyes seemed to recognize him and he relaxed enough to allow the ventilator to mechanically regulate his breathing.  “Good…that’s it.”  Todd planted a steadying hand on Justin’s arm.

Justin continued to look around the room.  The air being forced in and out of his lungs felt strange.  He recognized Camarin…and Todd.  It was obvious he was in Rampart’s ICU, but he was a little fuzzy on the details of what happened and how he got here.  Forgetting the tube in his throat temporarily, he tried to speak, only to clamp his eyes shut in frustration as the effort set off the alarm again.

And again, Todd shut it off.  “It’s okay, Justin.  Just try to relax.”  And again Todd waited until Justin was able to do that, even though his eyes remained full of questions.  “Don’t try to talk.  I’m going to ask you some questions, and I want you to blink once for yes and twice for no.  Can you do that for me?”  Todd smiled as Justin purposefully blinked one time.

So, the doctor continued.  “Okay, good.  Do you know who I am?”

Blink.

“Do you know where you are?”

Blink.

“Do you know why you’re here?”

Now that was a bit less clear.  Something about a fire…and surgery… Justin blinked two times and waited for his trusted boss/friend to fill him in.

“There was a fire at your house and you had a bad fall.  You’ve had some damage to your lungs from the heat and smoke and you developed pneumonia.  That’s why you’re on a ventilator.  You fractured some ribs and also had surgery for a femur fracture.  You’re healing well.”  It was a half truth for now.  The reality was, Justin’s fractures were not healing as rapidly as expected.  Also, his lungs were still iffy, and he was far from being out of the woods there.  But, Todd decided to be positive, remembering the many discussions he and Justin had shared about the power of attitude on the body’s will and ability to heal.

Justin closed his eyes then, memories of the past week returning to him now in bits and fragments.  Now that he was somewhat more oriented, he noticed a deep ache in his right leg that seemed to throb all the way from his hip to his toes in randomly undulating waves.  But overriding that was the sharp spasm in his chest which wrapped itself completely around his left side, and which seemed to be getting worse with every forced breath.  Since Todd still had a firm hand on his right arm, Justin tried moving his left hand toward the pain, but the events of the past week left his muscles feeling frail as a sick kitten.  All he could manage was a slight flop of his hand off the bed and back again.

“Careful, Justin.  You have an arterial line in that arm.”  Todd warned, then noticed Justin’s brow was knitted in discomfort.  “Are you having pain?”

Justin forced his eyes open long enough to blink once.  He heard Todd promise some relief in the form of Demerol, and a fleeting memory of a nurse trying to talk him out of refusing his medications passed through his brain.  He suddenly felt nauseous, and inexplicably weak for accepting Todd’s offer of narcotics, but at this moment, pain was holding him prisoner, and Justin was willing to do whatever it took to escape.

A few minutes later, something cool moved through his right shoulder, and following quickly on its heels was blessed relief.  Justin opened his eyes and did his best to smile at the lovely face now hovering over him.

“Feeling better now?”  Camarin asked as she gently brushed Justin’s hair out of his eyes and back over his forehead.  She smiled in relief at the one blink she received in response, and her smile grew bigger over another discovery.  “He doesn’t feel so warm now.  I wonder what his temperature is.”

Todd smiled back.  “I noticed that too.  I’ll send his nurse in to check.  Looks like those antibiotics may finally be working.”

Camarin nodded, hope and relief seeming to spill over from her heart.  It had been almost three days.  Three of the longest days of Camarin’s life.  Three days where hope seemed to inch farther away with each passing hour.  “He’s really been fighting the vent too.  Especially since his last breathing treatment.”

“That’s a good thing.  It means he’s trying to breathe on his own.  Has Burke said anything about trying to start weaning him?”  Todd kept his voice low.  It appeared as if exhaustion had won the battle for Justin’s senses, and he was sleeping. 

“He hasn’t been in yet this morning.”  Camarin informed.

“Okay.”  Todd made some notations in Justin’s chart.  “I’m going to go talk to Justin’s nurse.  I’ll be back later.”  He canted his head toward the bed.  “He’ll probably sleep for a while now.  Why don’t you get something to eat?”

“I will later.”  Camarin pulled her hand-knit sweater tighter around her shoulders.  “John and Roy were going to try to stop in this morning.  I want to be here when they come.”

Todd gave the woman an assessing once over.  Camarin had dark rings under her even darker eyes, and her hair, while not unkempt, was pulled into a haphazard ponytail.  He wondered when she had last gotten any sleep, and how much she had been eating.  He also knew an interrogation was not what she needed from him.  Justin’s family would see to it that she took care of herself.  “Things are looking good, Camarin.  Really.”

“I know…”  Camarin watched Justin sleep as the vent continued to breathe for him.  She didn’t want to become too excited too soon.  “Thanks, Todd.”

***

Later that evening, Johnny and Roy made their way to Justin’s room for their second visit of the day.  They had been able to stop in this morning as promised when they made their supply run, but they had been too busy all afternoon to make the trip upstairs.  They were, however, able to glean updates from Dr. Brackett when they hurried in and out of the ER between calls.  The best news of the day had come just a few hours ago.  The paramedics had brought in an elderly woman who had fallen while working in her garden, and had just enough time to learn that Justin had been extubated and taken off the vent.  But, before they could make their way upstairs to see for themselves, they got beeped out to a multi vehicle accident on the freeway.  It was after ten now, and Johnny wondered if Camarin or Hannah would still be here.  He was officially off shift, and he waited patiently for Roy by the base station while he told Dwyer he would take the radio with him upstairs and meet him in the squad if they got a call.  Then, he and Roy headed for the ICU.

When the pair arrived at Justin’s cubicle, the night nurse, Angela, was just walking out.  She smiled when she noticed the familiar duo.  “Oh, hi guys.  He’s sleeping, but I guess you could go in for a few minutes.”

Johnny looked past Angela into the room.  The bandages covering Justin’s burns looked as though they had just been changed, his right leg was wrapped in bulky ace bandages, and he still wore an oxygen mask.  “How’s he been doing?”

Angela was glad to be able to deliver some encouraging news.  “Better.  Everyone was pretty surprised at how quickly he came off the vent.  His fever’s down, he’s breathing much better now.  But, he’s really weak.  He’s done nothing but sleep.”

“Well, I guess that’s what he needs.”  Roy stated.

“Yep, it is.”  Angela agreed.  “Buzz if you need me.”  And with that, she walked down the hall toward the nurses’ station.

Inside the cubicle, Johnny stood at the foot of the bed.  He picked up Justin’s chart and began reading through it.  He was relieved to see that it did in fact appear his brother-in-law was on the mend.  “His SATS are up to 90 percent.”  He whispered.

A moan from the bed interrupted Roy’s response.  It appeared that Justin was waking, and in some distress.  Roy was closer to the bed, so he moved to Justin’s left side.  “Easy, Justin.  You’re all right.  Go back to sleep.”

But, Justin couldn’t go back to sleep.  A nagging pain, which had been plaguing him in wakefulness for days, had suddenly seemed to increase in intensity.  He had felt this pain before, many times, but on those occasions, he had been able to drift back into blissful slumber.  Not this time.  And it brought with it an almost instinctual panic.  Another croaky moan erupted from his tired throat as he tried to move his hand toward the source of his torment.  But it felt like it weighed a hundred pounds.

Sensing Justin’s dilemma and obviously increasing anxiety, Johnny moved quickly to the opposite side of the bed.  “Justin, it’s John.  What is it?  What hurts?”

Each inhalation seemed to bring with it increased agony and it felt like someone was twisting a dull knife in Justin’s left side.  He remembered someone…Todd maybe…telling him he had some fractured ribs.  Maybe that’s all it was.  No…no, this was different.  Worse.  This pain seemed to spread through his chest all the way through to his back, across his shoulders, even into his throat.  Finally he gathered enough strength to bring his right hand up and he clutched frantically at the fabric of his gown.  “Chest…”  He managed to croak out through his raw, irritated vocal cords.

Concerned that Justin would disconnect his monitor leads, Johnny grabbed onto his hand and felt it squeeze tightly in response.

Roy pressed the call button.  “Is it your ribs?”

Justin shook his head.  “I…I don’t…”

“Looks like too much pain for that.”  Johnny did not mention his concern.  Justin still had a healing pneumothorax.  If it had suddenly increased in size, it could be causing this amount of misery.  But, Justin wasn’t exhibiting any of the other classic symptoms.  Johnny’s eyes moved to the monitor screen above the bed.  Apparently Justin noticed this.

“How do I…look?”  Justin chuffed out between stilted breaths.  He wasn’t certain he was having a heart attack, but he figured this sure as hell must be what one felt like.

It took Johnny a moment to realize Justin must be referring to his EKG.  “Huh?  Oh…it looks good, Justin.  Just a little tachy.”  Actually ‘a little’ was a bit of a stretch.  Justin’s heart was beating at around 130 times per minute.

Angela entered the room and hurriedly moved past Roy to pull the blood pressure cuff off the wall.  “What’s wrong?”

“One minute he was asleep, and then he woke up with pains in his chest.”  Roy filled Angela in.  “Want me to go out and have a doctor paged?”

“Would you?”  Angela asked, and at Roy’s departure, she wrapped the cuff around Justin’s arm and began squeezing the bulb.  After it deflated, she pulled the stethoscope from her ears.  “142 over 90.”  Leaning over her patient, she spoke slowly and clearly.  “Justin, I need you to show me exactly where it hurts.”  She watched as Justin’s hand moved over his entire chest before finally resting over an area just to the left of his sternum.  “What kind of pain is it?”

Justin turned his head to the side, frustrated at the necessary questions. 

Angela knew that Justin merely wanted relief and answers, but she continued coaching.  “Sharp?  Or is it like pressure?”

On some level, Justin recognized the importance of this interrogation, but right now he was having trouble sorting out one sensation from another.  Had his brain not still been suffering the ill effects of too little oxygen, he might have been able to tell Angela that it was a sharp pain, that it was more focused in his left side, that it was most likely a pneumothorax, or a pulmonary embolism, or some such affliction.  But right now, all he could manage was another frustrated moan.

“Okay…okay, Justin.  Just try to relax.”  Angela looked up at the sound of the voice behind her. 

“Roy filled me in already.  Let me in there.”  Julius Burke bustled past Johnny, stethoscope in hand.  In one swift motion, the instrument was at the ready, and the doctor listened intently to Justin’s chest.  Satisfied that his patient’s left lung was still intact, and that Justin, although obviously in pain, did not seem to be suffering any increased respiratory distress, Burke tried to get to the bottom of this problem.  “Justin, slow your breathing down and tell me what you’re feeling.”

Justin thought his head would explode.  What did his doctor expect him to say?  He gritted his teeth and practically choked on his words.  “Hurts…God…hurts…”

Burke issued an order to Angela.  “Ten milligrams MS.”

Justin shook his head emphatically.  He didn’t want to be medicated.  He didn’t want his senses dulled until he knew what was happening to him.  He’d be damned if he was going to let Burke just put him to sleep without knowing.  “No…”

“Here’s the deal, Justin.”  Burke’s voice became a notch more authoritative.  “I need you to take some deeper breaths for me, so I can do a proper exam.  Now is not the time to be refusing medication…”

“No!”  Justin wondered how he could get his point across to these people.  He wanted pain relief…that much was certain.  He just wanted to know what was going on first.  But, it took all the strength he had to shout out that one word.

“Yes.”  A new voice at the door startled everyone.

Burke looked up at Todd Andrews and wondered how long he had been standing there.  “Todd?”

Todd directed his next order at Angela.  “Just do it.  Go ahead with the MS.”

Angela’s eyes darted nervously from one physician to the other.  “But…”

“Just do it.”  Todd’s tone left no room for further discussion. 

Now Justin was getting angry.  Not only was this pain threatening to send him over the edge, but how dare Todd override his decision?  He was coherent enough to refuse pain meds.  That was his right.  Besides, he wasn’t refusing…not really.  “Todd…”

“Enough, Justin.”  Todd moved into the spot Angela had just vacated.  “Do you hear me?”  Todd paused to allow Justin to make eye contact with him.  But in those eyes, Todd could see anger quickly being replaced by fear and uncertainty.  He placed a hand on Justin’s forehead and softened his tone.  “We’re going to figure this out.  I promise.  And, then we’re going to take care of it.  But, you need some relief here.”  He accepted the syringe full of morphine from Angela and injected it himself.  After a few seconds, he released the breath he had been holding when Justin finally seemed able to relax, and his breathing slowed.  A quick glance at the heart monitor showed his rate stabilizing as well.  “There…better?”

Justin nodded.  He did feel better, but he could feel the narcotic’s characteristic pull on his senses.  No matter.  He refused to sleep until he knew what was happening.  He was supposed to be getting better, not worse.  “Todd, I…”

“Shhh.  Don’t talk for a minute.”  Burke placed his stethoscope on Justin’s chest again, and listened carefully.  “Deep breath.”

Justin took a tentative breath in, and was relieved he was able to do so with little difficulty.  There was still that annoying tightness, but at least that wasn’t new.

“Again.”  Burke had a hunch, and he was searching for something specific.  This time, he found it.  Leaving his stethoscope where it was, he closed his eyes in order to listen harder.  “One more time.”

There it was.  And with it, Burke had a tentative diagnosis.  He removed his stethoscope and straightened.

“Julius?”  Todd wondered what his colleague had found.

“A friction rub.  Over a small area, but very distinct.”  Burke spoke for all in the room to hear, but he leaned over his patient, and made eye contact.  “We’ll get an X-ray, run some tests to be sure, but…I’m  pretty sure it’s pleuritis.”

“Pleuritis?”  Johnny parroted.

“Yes.”  Burke clarified.  “Inflammation of the pleural lining. It’s not too surprising, really.  It’s probably been developing for some time.”

“Well, what can you do for it?”  Johnny was certainly familiar with the condition, but it wasn’t something he encountered every day.

“Well…”  Burke began, draping his stethoscope around his neck.  “If my diagnosis is correct, and if the chest X-ray shows any fluid accumulation, I’ll perform a thoracentesis.  Depending on the results of that, we may need to change his antibiotic or add a new one.  Otherwise, rest…pain management…normally, it just has to run its course.”

Todd gave Justin’s hand a squeeze, thankful that it didn’t appear his friend was facing a more ominous affliction.  Justin would be miserable for a while.  That was certain.  But it could have been much worse.  “See, Justin?  Nothing to worry about.  Now why don’t you get some rest?”

Justin couldn’t believe everyone seemed so accepting of this when he felt like he was just about at the end of his rope.  How long had he been hospitalized?  A couple of weeks, right?  And he hadn’t even been released from the ICU yet.  He was exhausted to the core, but he couldn’t rest.  “Todd…”

“Get some rest, Justin.”  Todd repeated.  “We can talk later.”  He gave a nod to Burke and Angela as they left the room to discuss the tests the pulmonologist wanted to order.

But Justin was persistent.  “But, Todd…why…”

“Why what?”  Todd noticed an urgency in Justin’s expression.

“Why…”  Justin raised his hand off the bed and let it fall back down in frustration.  He had wanted to smack something with his fist, but he didn’t have the energy.

Luckily, Todd was skilled at reading his patients…especially this one.  “What, Justin?  Why did you get pleuritis?”  He waited for a response, but received none.  “It makes sense.  Chest wall trauma…pneumonia…”

“Dammit, Todd!  Why…I need to…need to get…outta here.”  Justin’s breathing was becoming erratic and he was breaking out into a sweat.

“You need to calm down.”  Todd warned.

“Don’t…don’t tell me…what I need.”  Justin’s tone became more emotional as he struggled to communicate what was bothering him.  He was angry that Todd seemed to be placating him like he would a difficult patient.  He had it wrong.  He wasn’t trying to be difficult.  “So much to…do.  Gotta…”  Justin closed his eyes as pain began to break through morphine-fortified walls.  “The house…gotta finish…the business…get it…going…”

“Justin, you can’t be worried about any of this right now.”  Todd knew his words were falling on deaf ears.  Of course Justin should be worried.  Who wouldn’t be?

“Not enough…money…we’ll lose…lose the…business.”  Justin was quickly tiring.

By now, Johnny had heard enough.  He took a step forward.  “You’re not going to lose anything, Justin.  You don’t need to worry.”

“John…”  Justin wanted to say more, but he had exhausted his strength.  The tightness in his chest was becoming stronger now, and he was beginning to wheeze.

Johnny spoke quietly as he moved closer to the bed.  “I’ve been in contact with your insurance company.  I explained your situation, and they promised to expedite your settlement.  They said you should have it in about a week.  Since the fire was accidental, and your property has increased in value since you bought it, the check will more than cover the remaining mortgage.  You should have enough to pay off a chunk of the mortgage on the business too, make a down payment on another house, or use it for whatever else you want.”  Johnny paused a moment before continuing.  “And all your bills are all current, so you don’t need to worry about that.”

“My…”  Justin was not aware Johnny had been taking care of all of this.

“Yeah, man.”  Johnny watched as Justin absorbed this news.  “Oh, and I also called your teacher…Mr. Yun.  He was sorry to hear about what happened, and promised to come in and see you as soon as you’re out of ICU.  He went on and on about how much he appreciates your interest in traditional Chinese medicine, and he told me to let you know he would meet with you privately when you’re up to it, so you can finish your classes.”

Todd raised an eyebrow at Johnny as he continued on.  He hadn’t thought about it until now, but it was almost eleven o’clock, and the paramedic was still in uniform.  Hadn’t he ordered him to work half shifts?  Not only that, but Johnny had apparently been busy taking care of Justin’s affairs over the past week.  While Todd appreciated all he had done, it was becoming obvious that Johnny had not spent the week resting as he had said.  He decided to tuck this information away until later, but in the meantime, he was determined to keep a closer eye on his young patient.

Justin wasn’t sure what to say.  He was relieved and embarrassed at the same time.  He decided to try speaking again.  “John…you didn’t…have to…”

Johnny smiled, completely aware of every conflicting emotion going through Justin’s head right now.  He gently squeezed his hand.  “I know I didn’t have to.  I wanted to.  Think of it as returning a favor.”

“John…”

“John’s right, Justin.”  Todd chimed in.  “You helped him out a lot when he was the one in the bed.  Now, I guess, he figures it’s his turn.  But…”  He smoothed the covers over Justin’s legs.  “Right now, you need your rest.  I have a nice private room waiting for you up on my floor, and I expect you to be moving into it in another few days.”

Justin sighed and closed his eyes.  It was too much of an effort to keep them open any longer.  Returning a favor…He would need to talk to John some more about that later.

***

Out in the hallway, Todd surreptitiously watched Johnny as he made his way to the lounge where Roy was waiting for him.  Armed now with the knowledge that the man apparently hadn’t been resting as much as he had claimed, the doctor wondered whether he was disregarding his orders to work half shifts.  Although he had never personally known Johnny to be noncompliant, and although he was pretty certain the fire department would not allow him to work against a physician’s advice, he wondered if short staffing, perhaps, had goaded the paramedic, and the department, into allowing his orders to slide.  The orthopod assessed silently, watching Johnny walk.  At least he didn’t appear to be any worse for the wear.

Johnny looked up and caught Todd’s eye just before he pushed open the door to the lounge.  His hand moved seemingly on its own to the small, plastic bag of pills in his pants pocket, and he fingered it nervously, feeling inexplicably exposed.  Clearing his throat, he looked away and entered the room.  Roy and Dwyer were sitting in two of the upholstered chairs, drinking coffee.

“Justin may have pleuritis.  They’re gonna be doing a thoracentesis, and running some other tests.  I think I’ll just stay here with him tonight.  I can hitch a ride home with Hannah tomorrow when she comes in.”

Roy downed the last of his coffee and stood up, slightly relieved at this tentative diagnosis.  He had not heard any news since he left the room to page a doctor.  “Are you sure you don’t want me to run your Rover here in the morning?”

“No…it’s okay, Roy.”  Johnny yawned, stretching slightly and feeling an unwelcome twinge in his hip.  “I want to be here when Hannah and Camarin get here anyway.”

“Ok then…if you’re sure…”  Roy wasn’t entirely happy with this idea.  Johnny looked exhausted.  At least his hip didn’t seem to bother him much today, but Roy figured spending the night on one of Rampart’s uncomfortable chairs might alter that fact.  After all, he was no stranger to all night vigils, and he remembered waking up feeling as though he had spent a few hours on a medieval torture rack.  But with that realization came understanding.  There had been nights Roy had been urged, advised, cajoled, even threatened by various people to go home, and that still did not sway him from his determination not to leave his partner’s side.  It sounded as if Justin would be in for a rough night.  Of course Johnny would want to be here for him.

“I’m sure.  I appreciate you guys staying, but why don’t you go back to the station now and get some sleep while you can.”

Dwyer stretched and let out a tired groan as he rose from the chair and tossed his cup into the wastebasket near the door.  “I was getting ready to do a little of that right here.”

Johnny smiled a small smile.  “You’ll be more comfortable at the station.  That is, if you can put up with Chet’s snoring all night long.”

“Thanks for reminding me.”  Dwyer bemoaned.

Roy was watching Johnny as he rocked back and forth with his right hand in his pocket.  He couldn’t quite put his finger on it, but he thought his friend seemed…off.  Jittery.  Like he was anxious about something.  Finally deciding that he wasn’t used to seeing Johnny having to deal with a loved one in the hospital, and chalking it up to his ordinarily hyperactive nature manifesting itself in different ways under stress, he dismissed it for now.  After all, Johnny had a lot on his plate.  “Okay, well…call the station if you need anything.”

“Okay, I will.”  Johnny assured, knowing he wouldn’t.  He followed Roy and Dwyer out of the room and bid goodbye at the elevator.  On his way back to Justin’s room, he was cornered by Todd, who had been standing at the nurses’ station.

“Hey, John.  Wait up a minute.”

Johnny stopped where he was and stared down at his boots for a moment before turning.  This was ridiculous.  He needed to just flush the rest of these pills.  Flush them and deal with whatever pain decided to torment him.  He hated feeling as if everyone he knew was scrutinizing him.  But then, wasn’t that part of the reason he had been relying on the pills in the first place?  To control his pain, so people wouldn’t be focused on his problem?  “Yeah, Doc?”

Todd spoke as he moved toward Johnny.  “I saw Roy and Dwyer leave.  They get a call?” 

“Nah.  I told them to head back to the station.  I’m gonna hang out here tonight.”  Johnny felt his muscles relax slightly in relief.

“Ah..okay.”  Todd nodded as the two walked down the hall together.  “I have to admit, I was a little concerned earlier.  I thought you were still working.”

Crap.  So he was scrutinizing.  Johnny sighed.  Well, I guess that’s sorta his job.  “Well, I did end up working later than I was supposed to.  See, we got called out to an MVA just before eight, and Dwyer wasn’t there to relieve me yet…”

Todd stopped walking and turned to face his patient.  “It’s okay, John.  I understand.  It’s not an interrogation.  I suppose when that late call comes in…”

“Yeah.  Not much I can do about it.”  Johnny was just about to go into Justin’s room when he was stopped by another question.

“How are you going to get home?”

What the…who the hell died and made Todd my personal keeper?  Johnny fidgeted and shifted his weight from side to side, avoiding eye contact. “I’m going to stay here tonight.  With Justin.  Hannah will be here in the morning, and she can take me home.”

Todd couldn’t shake the feeling that Johnny was hiding something.  Either he was in pain and not letting on…no, it wasn’t that.  At any rate, as his doctor, he was finding it harder to shroud his uneasiness.  “If you need a ride home, I’d be happy to…”

“No.”  Johnny raised his hands.  He couldn’t believe Todd wanted to drive him home now.  “That’s okay.”  He was getting annoyed.  He glanced into Justin’s room and could see Angela talking to him in soft tones as she adjusted his pillow.

“I talked to Burke.  Justin’s X-ray showed a small accumulation of fluid.  He’s on his way up right now to do a thoracentesis.  After that, Justin will probably sleep all night.  These chairs are so uncomfortable, John, and I know you probably have things to do tomorrow.  Why don’t you just let me take you home?  It’s no trouble, really.”  Todd was trying not to sound like a mother hen, and he hoped Johnny realized he sincerely wanted what was in his best interests.  Besides, if he could get him to agree to a ride home, maybe he could talk to him on the way…

Johnny’s jaw tightened.  Why couldn’t Todd just leave him alone?  Even though he sounded genuine and unassuming enough, Johnny couldn’t shake the uneasy feeling he was being watched.  Still, he figured the doctor had a point.  His hip was beginning to ache with more fury now.  Spending the night on the chair in Justin’s room would probably leave him stiff as a petrified tree by morning.  He braced an arm on the door frame and spoke without looking back at Todd.  “I want to stay at least until after his thoracentesis.  Then, let’s see how he is.  If you’re still here, maybe I’ll take you up on that ride.”

“Okay, good.”  Was all Todd offered as he followed Johnny into the room, passing Angela, who was on her way out, likely to retrieve the supplies Burke would need.  “How are you doing?”  He asked Justin as he approached the bed.

“Been…better.”  Justin was able to grunt out just two words before he broke into a husky round of coughing.

“Easy…”  Johnny winced in sympathy, knowing full well how painful that cough was.  And along with Todd, he stood by helplessly, waiting for it to subside.

Tears leaked from Justin’s eyes as the harsh coughing assaulted every nerve ending in his body.  Fire tore through his chest in waves as if there were an enraged dragon inside him, battling to break through its bony prison.  “God…”

“I know, man.”  Johnny commiserated.  “I know it hurts.”  He placed a hand over the oxygen mask as if to remind Justin to use it.  “Try to catch your breath.”

Gradually…slowly…the coughing became more subdued until it finally stopped.  Justin pressed his head back into his pillows, completely spent.  “Shit.”

“Yep.”  Johnny agreed.  What good was it to placate Justin with promises that it would get better?  Johnny remembered how annoying that could be.  Of course it would get better, but that did nothing to soothe the agony he was feeling now.  And no matter how soon that relief would come, it was never soon enough.

Justin appreciated Johnny’s straightforwardness, his unpatronizing manner.  Too tired to speak, and too afraid it would set off another round of coughing, Justin weakly raised his right hand and felt it immediately gripped with sturdy support.

“Justin, Burke’s on his way back.”  Todd spoke with practiced reserve.  “Your chest X-ray showed some fluid in your pleural space.  A small amount.  He’s going to do a thoracentesis, and send a sample to the lab.  While he’s there, he’ll go ahead and drain off the rest of the fluid.  With that tear in your lung, you don’t need any additional pressure.”  Todd leaned closer, leaning on the bedrail for support.  “Sometimes…after they drain the fluid, the pain is worse.  So, it’s okay to ask for more Demerol if you need it.”

Justin rubbed lightly at his chest.  “Todd, you…know how…”  He stopped, feeling a tickle he was afraid would evolve into a cough.

“Yes…”  Todd agreed.  “I know how you feel about all these medications.  I also know…that you need to be able to rest if you want to get better.  This is a painful condition, Justin.  It’s okay to admit you need a little help right now.”

Justin wanted to give Todd a piece of his mind.  What the hell did he think?  It wasn’t that he didn’t want to admit he was having pain.  Well, maybe it was…a little.  It was the way the medications made him feel…dulling his senses and his inhibitions, keeping him in an almost constant state of nausea and dizziness.  He hated that he didn’t feel in control of himself.  What embarrassing things had he said or done in front of his friends, family, and colleagues?  Aside from that, how many times had he tried to impress upon his patients that relying on pain medications for too long became detrimental to the healing process?  He knew Todd agreed.  As much as Justin knew he needed relief, he couldn’t stop the niggling thoughts in the back of his mind that maybe, just maybe, he would feel better if his physical therapist would work with him more, and they would cut back on the constant supply of drugs.  Maybe he wouldn’t have gotten pneumonia if he hadn’t been too sedated to think about breathing.  Maybe he’d be on his feet by now.  Justin sighed, fighting back the all too familiar tickle in his chest before it could turn into something worse.  Thoughts and frustrations were all tangled up in his head, and he was at a loss to explain to Todd or Johnny what was on his mind.  Thinking about that only frustrated him more.

Johnny could sense that Justin was upset, and he had a pretty good idea why.  He remembered back to his own hospitalizations, the frustration and helplessness he had often felt.  Most of his time in the ICU was a hazy blur now, but he remembered how disorienting it had been waking up in pain, only to be medicated right back into unconsciousness, how one day became the next with no sunset or sunrise to signal its passing.  Time became irrelevant with his only waking thoughts full of stress and worry.  Again, he struggled to find something that would offer some comfort, but everything that came to mind felt maudlin, or worse yet, mockingly trite.  So instead, he tried some redirection.  “Chet and I are gonna put the finishing touches on the paint in your office tomorrow.  That blue trim you picked out works great!”

“Yeah?”  Justin appreciated the gesture, even though the thought of everyone but him completing the work on the business made him want to vomit.  Still, at least it was getting done, and that was a relief.

“Yeah.”  Johnny went on.  “And wait’ll you see what Hannah and Cam did with the reception area.”

“Hannah?”  The mention of his sister’s name made Justin wonder whether he had missed the birth of his niece or nephew.

“She mostly supervised.”

“Oh…”  Justin coughed a little, gladly accepting a small pillow from Todd to hold against his chest. 

Before anything more could be said, Julius Burke and Angela arrived, wearing sterile, blue gowns over their clothing.  Burke nodded toward Todd and Johnny while Angela began setting up for Justin’s thoracentesis.

Johnny took this as his cue to leave, and he leaned in close to Justin’s ear.  “This’ll be over before you know it.  I’ll be back when you’re done.”  He avoided eye contact with Todd as he made his way out of the room.  His hip was beginning to ache mercilessly now, and he hoped his attempts at hiding his pain were successful as he made his way back to the lounge, where he dropped a quarter in the soda machine slot and waited for a can of Pepsi to fall into the tray.  Bending over to retrieve the soda was out of the question as his muscles seemed to protest that idea, so after some creative contortions he hoped could not be seen from the large window by the door, Johnny was finally able to snatch up the can and pop the tab.  Keeping his weight canted to the right, he leaned against the small counter where the coffee pots and supplies were kept and reached into the plastic bag in his pocket, fishing around until he had what he needed.  The fact that he had to take the narcotic more frequently lately was worrisome.  Was he developing a tolerance to the drug, or had he managed to injure himself?  The thought that something could be seriously wrong, and that he had been masking the symptoms, plagued him sorely even as he slid the tablet into his mouth and swallowed it with a long draw of soda, the resulting burp tasting bitter on his tongue.

***

“Are you going to stay?”  Burke asked Todd as he readied himself for the procedure he was about to perform.

Todd looked down at Justin.  “Do you want me to?”

“Can you?”  Justin inwardly berated himself for how desperate the request sounded.  He knew this was a routine procedure, that there was nothing to be concerned about, and he cursed his baser instincts for overriding his educated brain.  The truth was, he was afraid.  And the worst part of that was, he had no idea why.

“Sure.”  Todd smiled as he gave Justin’s shoulder a pat.  Turning his attention back to the other doctor, he assumed, “Guess I better suit up then.”

Burke pointed toward the cart on which Angela had laid out the supplies.  “There’s an extra gown under there.”

Todd slipped the gown on and tied it behind him before washing his hands thoroughly in the small sink in the corner.  Then, he donned some gloves and returned to Justin’s bedside in time to hear the pulmonologist explaining what he was going to do.

“Normally, we would have you sit up for this, Justin.  But, I think you’ll do better lying down.  How’s your pain right now?” 

“Not bad.”  Justin cleared his throat, which was still slightly sore from being intubated.  “Worse when…I cough.”

“I’m sure.”  Burke looked across the bed at Todd.  “I need him on his right side.  That gonna be okay?”

Todd thought for a moment.  “Should be.  His incision is healing well.  Let’s try putting a pillow under his leg.”

“Okay.”  Burke prepared to help maneuver his patient into the required position.  “Justin, let us know if you’re too uncomfortable, and we’ll try something else.  All right?”

A nod was the signal the two doctors and a nurse needed in order to roll Justin onto his side.  It was a painful and somewhat tedious process as long limbs were positioned, and pillows were strategically placed.  Once Justin was settled, his gown was removed and Angela covered his left side with betadine and sterile drapes.

Todd stooped down so that he could make direct eye contact with Justin.  “How’re you doing?”

“Just want this…over with.”

Burke spoke from his position behind Justin as he pulled on a pair of gloves.  “It’s important that you remain still for this, Justin.  Are you sure you’re not having any pain?”

Justin’s entire chest was aching, and he thought this position was about the worst possible one they could have placed him in as far as his right leg was concerned.  The tender incision, which stretched from hip to knee, stung and pricked, and his hip muscles felt as though they would spasm any second.  Under normal circumstances, he knew he could deal with it, but the idea of a muscle cramp coming on while Burke had an eight inch needle stuck in his side, did not sound pleasant in the least.  “Leg…hurts.”

Another pillow and a slight repositioning resulted in only marginal relief.  Finally, Angela was ordered to administer a small dose of morphine, and then Justin was ready to go.

“I’m going to inject the lidocaine now, Justin.  You may feel some stinging.”

Justin was floating too heavily on a cloud of morphine to focus too much on why it felt like an entire horde of yellow jackets had just decided to attack his left side at once.  It was far too tiresome to try to figure out how the medication he had just received had managed to control his pain, yet the lidocaine still stung with a vengeance.  For a brief instant, he shuddered, as the thought of what this would feel like if he hadn’t been medicated skittered through his mind.

“You okay?”  Todd noticed Justin trembling slightly.

“Yeah…cold.”  Justin wasn’t sure why the lie.  It was as if he had no control over what was coming out of his mouth.

“Hang in there.  That should be getting numb.”

Burke’s voice sounded miles away, as if he was standing at the end of a very narrow tunnel.

“Okay, Justin.  Here comes the stick.  You might feel a little pressure.  It’s important that you try not to cough or take a deep breath until I tell you, okay?”

“Yeah…okay…”  Justin’s words were slurred and he let out a low hiss as the needle entered his side.  He couldn’t feel pain, just an intense pressure as Burke had described.  It was unlike anything Justin had ever experienced before, and if someone were to ask him later, he would have no idea how to describe it.  Suddenly, just the idea of what was happening caused him to break out into a cold sweat.

Todd noticed something was wrong immediately.  Justin’s color blanched and beads of perspiration broke out on his forehead.  The hand he was holding felt clammy even through his glove, and Justin was beginning to pant into his oxygen mask.  “Hey, what’s going on?”  Todd asked of both his colleague and their patient.  “Justin?  Talk to me.”

Burke stopped advancing the needle.  “Feeling nauseous?”

Justin nodded, eyes closed.  He could feel his heart beating wildly on the sides of his neck.  He hated himself for appearing so weak in front of these men, and he cursed his own body for betraying him.

“How about some diazepam?”  Todd suggested, wondering if Justin would welcome it at this point or if it would further fuel his agitation.

Burke nodded toward Angela.  “Go ahead.  Two and a half milligrams.”

“No…please, Todd…”  As heavenly as peaceful oblivion seemed right now, Justin’s need for some control and the desire to stay awake and aware battled with his body’s disloyalty.

Todd spoke in soothing tones even as the ordered medication entered Justin’s veins.  “Just enough to help you relax.”  He continued on until Justin’s grip on his hand loosened and his breathing slowed.  “There we go…”  He nodded across the bed.

“Okay, Justin…almost done.”  Burke finished advancing the needle and then he pulled back on the plunger, collecting fluid from Justin’s pleural space into several tubes which he handed to Angela to be placed on the tray.  He was reaching for one more when Justin began to cough.

“Easy.”  Burke rested a hand on Justin’s side near the insertion site.  “You’re probably going to feel like coughing for a while.  That’s normal.  Just try to hold off for me for another minute or two.”

Todd watched as Justin continued to cough softly.  He wondered if he had even heard, much less processed what Burke had said.

With the last bit of fluid removed, Burke placed a sterile dressing over the puncture site and stepped back, removing his gloves.  “All done.  We’ll get these to the lab and get another chest X-ray and see where we are.”  He leaned over his patient and gently squeezed his shoulder.  “You did great.  Just rest now.”

Thinking Justin was asleep, Todd began to pull away, but a quiet moan stopped him.  He squeezed Justin’s hand a little harder as he carefully helped Angela adjust his blankets.  “It’s over, Justin.  You can go to sleep now.”  Todd waited and watched a long while, thinking about the years he and Justin had worked together, how he had often envied the younger man’s strength and vigor, not to mention his perpetually positive attitude.  It was hard seeing him like this.  Todd finally left the room, hoping that this would be the worst of it, that there would be no more complications and Justin would be well enough to move to the orthopedic floor soon.  Once that hurdle was cleared, Todd knew Justin would fight to get on his feet and home as soon as he possibly could.  He reached the lounge and pushed open the door, hoping that Johnny would accept that ride home they had talked about.

***

Hannah stood with both hands supporting her lower back and smiled with admiration.  “That looks great, guys.”

Johnny’s head snapped up from his work on the baseboards of Justin’s office.  “Hannah, you shouldn’t be in here around all these fumes.  I thought you and Camarin were going to finish up outside.”

“As a matter of fact…”  Hannah began as she moved slowly around the room.  “We’re finished outside.  We wondered if you guys were ready to break for lunch.  I packed a basket full of fried chicken.”

Chet plopped the paint roller he had been using into the tray and wiped his hands on a kerosene soaked rag.  “Sounds good to me.”  Then, he looked back at Johnny.  “I hope you appreciate this woman, Gage.”

“More and more every day.”  Johnny affirmed as he stood up.  A groan was forced from his throat as a sudden cramp caused his hip to stiffen and he almost stumbled, leaning one hand on the wall for support.

Hannah moved toward her husband, concerned.  “John?  You okay?”

Johnny waved her off.  “Yeah…yeah, I’m fine.”

“What happened?”  Hannah placed a hand on Johnny’s arm, preventing his movement.  “Maybe you should…”

Johnny turned to face Hannah, taking her hands in his.  “Hannah…it’s nothing.  I was on that floor for over an hour painting baseboards.  My leg just stiffened up a bit.  That’s all.”

Chet had been looking on, not wanting to intrude on the couple’s conversation.  He wasn’t sure he bought Johnny’s assertion that his leg was ‘just a little stiff.’  “Want me to go get Roy?”

“Chet!”  Johnny’s look shot daggers at his friend.

Hannah decided Johnny was likely right.  After all, his left leg had been through a lot in the past few years, and it did have a tendency to become stiff and sore.  “No, that’s okay, Chet.”  She leaned in for a quick kiss.  “I think the only thing this guy needs is a hot shower and a massage.”

Chet left the room, shaking his head.  “Like I said, Gage.  I hope you appreciate this woman…”

“Oh, I do, Chet.”  Johnny leaned in for another kiss.  “I do.”

***

Part 3