Baptized by Fire  -  Part 3

The next day and a half passed quickly, with the men of A-shift pitching together in shifts to continue work on Justin and Camarin’s business.  Johnny had spent most of his time there, only going home long enough to exercise the horses and do some necessary work around the ranch.  Hannah didn’t mind, knowing how important it was to Johnny to have New Horizon Health Alternatives ready to be up and running by the time Justin was released from the hospital. Still, she couldn’t help but wonder if he was working himself a bit too hard.  She had been noticing some subtle changes over the past few days.  She couldn’t really put her finger on it, but something about him was definitely off.  He was more short tempered than usual and he seemed tired.  Chalking it up to the additional stress placed upon him by his efforts to help Justin, she tried not to worry.

Justin’s condition had continued to improve with the addition of an additional antibiotic to treat his pleuritis.  And talk of the possibility of moving him to the orthopedic floor within another day or two offered the light at the end of the tunnel that everyone had been hoping for.

This morning had been a slow one, with so far, no calls for the squad.  Roy was grateful for the break.  Not only was he a little more tired than usual due to helping out on his days off, but Johnny looked positively exhausted.  The senior paramedic had already had a conversation with Cap, and he agreed that maybe Johnny had been pushing himself a little too hard.  After all, what good did it do to work half shifts when he was going to spend his off time doing physical work at home?  At least at the station, when he wasn’t out on a call, he could relax on the couch and watch some TV.  The two men had made a private promise to keep an eye on the younger man today.  The last thing Cap wanted to do was intervene in Johnny’s personal life, but his safety, and the overall safety of the team, was ultimately his responsibility.  At least Johnny didn’t appear to be having any pain.  So other than being over-tired, at least he didn’t seem to be causing any more injury to his hip.

Johnny sat on the bench in the locker room, staring at the plastic bag in his hands.  A few more days…a week maybe.  By then, the work on the business should be done, the loose ends on the beach property should all be tied, Justin should be well on the road to recovery, and things should calm down.  After the baby comes, Johnny figured, he would take some time off and there would be time to rest.  Sighing heavily, he stuffed the bag back into his pocket, deciding to hold off for now.

“Hey, lunch is ready.”  Roy stepped into the locker room.  He had secretly been hoping he would find Johnny in the dorm napping.

“Okay.  Thanks.”  Johnny stood and followed his partner out into the bay.  Lunch was not to be, however, as the tones sounded before they could make it to the dayroom, finally summoning the squad on its first call of the day.

One call turned into two, then three, with Johnny and Roy not returning to the station until almost seven.  Luckily, all of the runs had been fairly routine, so other than being ready to go visit Justin and then head home for a long night’s sleep, Johnny felt physically no worse for the wear.  Both paramedics were looking forward to the leftovers from Mike’s dinner and Johnny hoped to be able to leave when he was off at eight o’clock.

But, no sooner had Mike placed steaming plates of spaghetti down in front of the two men, the tones sounded again, this time calling the entire station out for a structure fire.  Johnny pushed himself up wearily from the table.  It was going to be another late night.

Cap stopped the paramedics before they could get into the squad.  “John, if you want to just leave now, I can tell county the squad is out of service and request another unit.”

“No, Cap.  I’m okay to stay.”  Johnny insisted as he stepped into the passenger seat.

Cap made eye contact with Roy, who shrugged his shoulders before getting behind the wheel.  The fire was a two alarm at a residence.  At least it didn’t sound too bad.  With any luck, the family would be safely outside, and the fire could be knocked down quickly.  If that were the case, Cap would most likely release the squad, allowing the other firefighters to handle the overhaul.

Roy rolled the truck to a stop along the curb and looked up warily at the large column of smoke billowing from the attic of the three story structure.  Flames were licking hungrily at blackened window panes, casting an eerie glow against the twilight sky.  He jumped out and donned his turnout gear in time to hear his captain say there was a thirteen year old girl unaccounted for.  Within seconds, he and Johnny were in full gear and running toward the house.  Cap watched them go as he barked an order into his handie talkie, noticing Johnny seemed to be lagging slightly behind his partner.

Inside the house, Johnny motioned toward the stairs, his voice muffled through his mask.  “I’ll take the second floor.” 

Johnny moved from room to room, searching each one thoroughly for places a thirteen year old might hide.  Finally, the sound of distant coughing lured him to a bathroom at the end of the hallway.  Johnny entered the room and found the teenager huddled in the bathtub.  A quick assessment revealed that although she had inhaled some smoke, the girl was unhurt.  After removing his mask and offering some puffs of oxygen, Johnny lifted the young girl into a fireman’s carry.  Although she didn’t weigh much, he let out a groan as his hip protested the extra workload.  At about the same time, he was startled by a loud crash that came from somewhere down the hall.

Johnny exited the bathroom and cursed under his breath.  Part of the attic floor had collapsed into the hallway, blocking his way back to the stairs.  Flames were licking the paint off the walls as they danced their way lasciviously toward him.  A right turn took him into a bedroom on the front exposure of the house.  Training assured him there would be a ladder ready at the window.  Johnny sat the teen down on the bed momentarily with a promise to be right back.  Then, he broke out the window with a desk chair.  He looked down and found Roy and Cap standing in the yard, their eyes trained upward.  “Hey!  Up here!”

A quick gesture from Cap was all it took to send two firefighters running with the ladder they had at the ready.  As soon as it was set against the house, Roy made his way up to assist his partner. 

“Here, take the girl!”  Johnny shouted as he coughed.  As soon as the teenager was safely situated on Roy’s shoulders, Johnny replaced his mask and greedily sucked in a few deep breaths of air before letting it dangle again over his shoulder.  As he watched Roy climb down the ladder, he remembered another rescue where he and Roy had both been climbing down the same ladder.  He had sprained his knee in a fall on the stairs, and he remembered knowing a split second after the flashover, that he wasn’t going to be able to steady himself with only one good leg.  That had ended up being his last thought before Roy came careening down the ladder headfirst, knocking both men to the ground.  They had been lucky they weren’t injured more seriously.

This time, Johnny waited until Roy was safely on the ground before climbing out the window.  Less than halfway down, a muscle in his hip cramped, catching him off guard.  He paused for a moment, waiting for it to pass.

“John?  You okay?”

Cap’s voice bellowed out from below him.  Johnny waved his hand, a gesture that was meant to assure his captain that he was not in need of rescue.  After a few more seconds, the cramp subsided.  Keeping his weight on his right leg, Johnny carefully stepped to the next rung.  But, this time, when he shifted his weight, his left leg refused to support him, and a split second later, Johnny could feel himself falling.  Instinctually, the paramedic grabbed for the ladder, making purchase with his left hand.  The action saved him from certain, potentially severe injury.  However, he could feel something “pop” in his shoulder.  Luckily, he was able to latch on with his right hand before an intense pain rippled down his arm, bringing with it a sudden surge of nausea.  Johnny briefly thanked the spirits he hadn’t gotten to eat today.  He rested his head against the rung in front of him, willing his body to stop shaking.

Cap had seen the near fall from his position on the ground.  From where he was, it looked as if Johnny had simply lost his footing.  But, something about his stature told him all was not well.  “John, stay where you are, pal!  I’m coming up!”  He started his ascent before the younger man could protest.

As he got closer, Cap could immediately tell his hunch was correct.  Johnny was only holding onto the ladder with one hand, the other arm cradled tightly against his body.  He placed a steadying hand on his back.  “You okay?”

“Yeah…I’m okay.”  Johnny responded somewhat breathlessly.

“What about your arm?”  Cap asked as he positioned himself securely behind the paramedic.

“I dunno…think I just wrenched it a…”  Johnny’s sentence was abruptly severed by a deep, husky cough.

Cap planted his feet firmly on the rungs, keeping a firm hold on the ladder and on Johnny, concerned the coughing fit might cause both of them to fall.  As soon as the coughs quieted to a more manageable level, he urged Johnny to descend.  “Come on.  Let’s get you on the ground.”  Keeping one hand on Johnny’s back, the captain assisted him down the ladder.

Roy looked up from his work on the teenage girl, who was uninjured, and responding well to oxygen therapy to see Cap guiding Johnny by the elbow, across the lawn toward him.  Every so many steps, the pair would stop, and Johnny would double over coughing.  Roy noticed his partner did not appear to be using his left arm.  “What happened?”  He had not seen Johnny since he had handed off the girl.

“Nearly fell off the ladder, that’s what.”  Cap informed as he helped Johnny to sit down on the yellow blanket near the girl.  “Sounds like he ate some smoke too.”

“Nearly fell?”  Roy wondered, indicating Johnny’s arm.

“Slipped.”  Johnny croaked out.  “Felt something…pop in my…shoulder.”

“Any pain?”  Roy asked, watching as Cap fitted an oxygen mask over Johnny’s face.

Johnny nodded.  “Yeah…hurts like…hell.”

“Wouldn’t surprise me if it’s dislocated.”  Cap guessed as he began to unbutton the metal clasps on Johnny’s turnout.  Then, noticing Johnny’s hand moving toward the mask on his face, he issued a warning.  “Keep that right where it is, pal.”

Johnny winced as he allowed Cap to carefully remove his coat.  He didn’t think his shoulder was dislocated.  It didn’t hurt quite enough for that.  The sharp pain he had experienced earlier had downgraded to a deep ache.  Still, it was bad enough that the paramedic knew he couldn’t pass on a trip to Rampart.

Roy put the finishing touches on the teen’s IV before sliding a bit closer to his partner.  “How did you slip?”

Johnny did not want to mention that his leg had gone out on him, so he fudged a little.  “Missed a rung I think.”

Cap was busy carefully palpating Johnny’s shoulder, eliciting a hiss and a jerk.  “Sorry.”  He looked over at Roy.  “I don’t think it’s dislocated.  Pretty swollen though.”

“She’s doing fine.”  Roy assured the girl’s parents.  “She’s going to need to be checked out at the hospital though.”  Then he moved closer to his partner in order to get a better look at the swelling Cap had described.  “Cap’s right.  It’s not dislocated.  You could have a fractured clavicle though.  I’ll have to cut your shirt so I can immobilize it…”  He reached for his trauma shears.

Johnny pulled of the mask again.  “Oh, come on, Roy!  It’s just a little…”

Cap firmly replaced the mask.  “You just let Roy do his job.”  The captain couldn’t help the tiny smirk that broke out on his face at Johnny’s disgusted expression.  “Do you want me to call another squad, Roy?”

Roy shook his head as he went about cutting Johnny’s sleeve.  “No, but can you get on the line to Rampart?  Let them know we have another patient here?”  He smiled teasingly as Johnny sighed, knowing how much his friend hated being called that.

“Sure.”  Cap moved over to where the biophone was, nodding a smile at the girl and her parents.  “Rampart, this is County 51.”

“Go ahead, 51.”  Brackett’s voice answered.

“Rampart, we now have a second victim.  A paramedic with smoke inhalation and a shoulder injury.  Stand by for vitals.”

Roy had just finished up with Johnny’s blood pressure and handed a slip of paper to Cap before reaching into the trauma box for a large elastic bandage.  “Before I do this, are you sure you’re not hurt anywhere else?  What about your ribs?”  Roy’s hands moved to Johnny’s left side.

Johnny again removed the mask.  “I told you, Roy.  It’s just my shoulder.  I just pulled a muscle or something.  No big deal.”

“Uh-huh.”  Roy deadpanned as he repositioned the mask over Johnny’s nose and mouth.  “Seems to me I’ve heard that one before.”

Cap watched the exchange between his two paramedics with mixed feelings.  While the friendly bickering meant Johnny wasn’t severely hurt, another injury was definitely NOT what the younger man needed right now.  “Rampart, vital signs are…pulse 90.  Respirations 22.  BP 128 over 84.  He’s on 10 liters of O2 and we’re immobilizing the shoulder now.”

“51, does he need something for pain?”

Cap held the phone out and looked inquiringly at Roy who turned to his partner.

“How ‘bout it, Johnny?  It’s your call.”

Johnny’s mind immediately focused on the plastic bag full of tablets in his pocket.  What if they made him take off his pants at Rampart?  They wouldn’t do that just for a shoulder injury would they?  What if they did?  And what if Dixie went through his pockets, collecting his personal effects?  Johnny felt nausea threaten again as he tried to figure out how he could get rid of the contraband he was carrying.

“Johnny?”

Roy’s nudge pulled Johnny away from his anxious thoughts.  “Uh…no.  That’s okay.  It doesn’t hurt that much.”  The truth was, it hurt a lot.  But, Johnny needed to be in control of his faculties.

Since no IV was ordered for Johnny, as soon as Roy finished immobilizing his shoulder, he and Cap helped him to his feet while the ambulance attendants lifted the girl onto the litter.  After a few steps, Johnny stopped in his tracks.

“What’s wrong?”  Roy wanted to know.

“Nothing.”  Johnny insisted unconvincingly as he began moving again.

“You’re limping.”  Roy noticed.  “Did you hurt your leg?”  Then he recognized the familiar saunter.  “You did something to your hip, didn’t you?”

Feeling the heat of both his best friend’s and his captain’s eyes upon him, Johnny decided to level with them.  “I got a cramp in my hip coming down the ladder.  It went away, but when I tried to step down…”

“I thought it looked like your leg went out from under you.”  Cap acknowledged.  “Why on earth didn’t you say something, John?”

Johnny sighed and looked down at his feet, temporarily unable to make eye contact with either man.  “I don’t know…”

“Well, never mind that now.  Just make sure you get checked out at Rampart.”  Cap pointed toward the ambulance.  The attendants had already loaded the litter.  “Should we have them bring over a stretcher?”

“I can walk, Cap.”  Johnny insisted, knowing he was treading on thin ice.  It took a lot to get his captain’s ire up, but he sure hated to be the one responsible for it.

“Roy?”  Cap looked to his senior paramedic, ignoring Johnny’s assertion for now.

“He’s not going to be comfortable on a stretcher with that shoulder.”  Roy noticed Cap already had his arm hooked under Johnny’s good one, helping to support his weight and control his movement.  “Let’s just take it slow.”

The trio made their way the remaining few yards to the back of the ambulance.  Roy hopped in first, then helped Johnny keep his balance, while Cap spotted from the ground.  Finally, the injured paramedic was settled onto the captain’s chair so his shoulder would have some support.

“How are you doing?”  Roy asked, after he checked on his first patient.

“Fine.”

Roy sighed, recognizing the tone his friend used to indicate he was done talking.  “You gonna be okay like that?”  He indicated the rear facing seat.

“Not like I have much choice, now is there?”  Johnny immediately regretted his surly tone.  He knew Roy was only concerned about him and trying to help.  He thought again about the bag of pills.  It was in his left pocket which meant there was no way he could get to it without contorting his body in such a way that it would go unnoticed.  At least he had a little time to think…

“How bad is your hip, Johnny?”  Roy kept his voice quiet, knowing it was a sensitive topic.

“Not bad.”  Johnny took a hit of oxygen, attempting to stave off a cough.  “Probably just been…doing too much lately.”

“Yeah.”  Roy agreed simply.  He knew how hard that was for Johnny to admit.  After a period of silence, he straightened with a sigh.  “Well, depending on what’s up with your shoulder, you might get some time off to rest.  That’ll give your hip some time to get better too.”

Johnny knew Roy was trying to encourage him, but the truth was his words cut like a knife.  He didn’t have time to rest!  And there was a scarier truth neither man wanted to acknowledge at the moment.  What if there was no “getting better?”  If Johnny could no longer physically carry out the strenuous duties of his job, he would be forced into disability.  That reality was there, floating ominously beneath the surface, threatening to take both men under at the mere suggestion of it.  Johnny rested his head back against the seat and closed his eyes.  His shoulder was throbbing in time with his heartbeat now, and every bump in the road only increased the intensity of his pain.  Finally, he recognized the familiar motion of the ambulance backing into Rampart’s emergency bay.

The doors opened and the attendants unloaded the litter.  Roy looked back at Johnny before stepping down.  “You stay right there.  I’m going to send someone with a wheelchair.”

“Okay…”  Johnny was exhausted, the events of the day taking their toll.  He no longer felt like arguing.  Besides, maybe he could get rid of the stash in his pocket while he was alone.  He reached across and down with his right hand, but the way Roy had his left arm immobilized against his body did not allow him enough room to twist his right arm the way he needed to in order to get into his pocket.  “Dammit.”  He muttered under his breath as he smacked the actionary with his right palm, hissing in pain at the jolt it sent through his injured shoulder.  He looked up to see the ambulance attendants climbing back into the truck, and Dixie waiting just outside with a wheelchair and a smile.

***

By the time Dixie was wheeling Johnny down the hall of the emergency department, Roy had already transferred the care of his “other” patient to Dr. Morton.  Now, he would be free to accompany his partner into a treatment room.  That is, unless Cap called, wanting him to return to the station.  As he approached the grumpy-looking young man being pushed by the unfazed-looking nurse, he suddenly realized he didn’t hear Cap say who would be bringing in the squad.  No matter.  Whoever it was would know where to find him.

“He’s either in pain or in a foul mood.”  Dixie told Roy as she rolled her eyes downward toward their patient.  “He hasn’t said two words since he got here.”

“My guess would be a little of both.”  Roy smiled as he matched pace with Dixie.  “Where are we going?”

“Treatment three.”  Since they had just arrived there, Dixie waited while Roy opened the door, and then held it open for her to push Johnny inside.  “Kel is busy with another patient, but he’ll be here soon.”  She parked the wheelchair and set the brake.  “Come on, tiger.  Let’s get you up on the table.”

Roy took a step forward, ready to assist, but then he remembered something.  “Dix, he’s having some pain in his hip too.”

“Really?”  Dixie stood back and folded her arms, reminding Johnny of the way one of his old schoolteachers would look at him when she was about to give him his last warning before a sound paddling.

When Johnny didn’t answer, Roy filled the nurse in.  “It’s what caused him to fall in the first place.”

“Hmmm.”  Dixie walked over to one of the cabinets and retrieved a gown, placing it on the foot of the exam table.  “In that case, everything needs to come off.”  She knelt down and began untying the paramedic’s boots.

Johnny shifted in his chair, wincing at the pain that sliced through his shoulder.  “Really, Dix.  Todd said it would get sore like this.  I think I’ve just been doing too much.  I’m sure…”

“And I’m sure Kel will want to have a look at it.”  Dixie countered in a tone that let her patient know there would be no further discussion.

Johnny’s mind was working on a last ditch plan to avoid the uncomfortable confrontation he had been beginning to accept as inevitable.  “I think I can get my pants off, if you two want to give me a little privacy…”

“John Gage, as many times as I’ve been your nurse, all of a sudden you’re modest?”  Dixie asked, hands on her hips.

“Well…”  Johnny fudged.  “You see, most of the time when I come through the ER, I’ve been too out of it to really care much about modesty.”  When he saw by the expressions on Dixie and Roy’s faces that they weren’t buying it, he tried another angle, pathetic as it was.  “Besides, I’m married now and…”

“Oh, brother.”  Dixie rolled her eyes as Roy stifled a laugh.  But, she decided to give Johnny a break.  A small one.  “Okay, Johnny.  I’ll go see what’s keeping Kel.  Roy, you help him get into that gown and onto the table.  I’m sure there’s no reason to suspect that Hannah should feel threatened by you.”

Johnny sneered, knowing the jig was up.  There was no way he was going to be left alone.  At least maybe Roy wouldn’t go through his pockets.  There was no reason to, really.  Chances are, he’d be putting his pants back on and going home tonight.  He sighed and closed his eyes as he felt Roy’s hands at his belt buckle.

“Don’t worry, you’re not my type.” 

“Oh, shut up.”  Johnny breathed, too tired now to raise his voice or argue anymore.  He supported his left elbow with his right hand and inhaled sharply through clenched teeth.

Johnny’s apparent discomfort caused Roy to soften his teasing tone into one of concern.  “That shoulder’s giving you a lot of pain, isn’t it?”

“Yeah.”  Johnny admitted.

“Come on.”  Roy rested a hand lightly on Johnny’s back.  “Think you can stand?”

“I can stand.”  Johnny sighed dejectedly as he allowed Roy to help him to his feet.  The room swayed for a second and he grasped onto Roy’s arm for support. 

“Give it a minute.”  Roy waited until he was pretty sure Johnny wasn’t going to fall over before snatching the gown from the table and threading it over his good arm.  He tied the strings loosely behind Johnny’s back and hips before kneeling down to shrug his pants and boxers off.  Then, he helped his friend onto the table, raising the head and adjusting the pillow before raising the entire bed to a level he felt was pretty close to where Kelly Brackett would want it.  Then he covered Johnny up to the waist with a blanket from the warmer.  “How’s that?”

“That’s good.  Thanks.”  Johnny watched as Roy bent to pick up his discarded clothing.  He followed Roy’s movements as he folded the boxers and pants and went to place them on the table near the door.  He breathed a sigh of relief, thinking he had dodged a bullet.  If Roy were going to empty his pockets, it would have made more sense to do it before he folded the pants.  But, then he watched in consternation as the pants accidentally slipped to the floor causing Roy to have to pick them up again.  And when he picked them up, the plastic bag that had been in his pocket fell out onto the tile.

“What’s this?”  Roy wondered as he picked up the bag, holding it up to look inside.  There were several pills in two different shapes and sizes.  He recognized the larger ones.  They looked like the Demerol tablets he used to give to Johnny after he had been hit by the pickup truck.  He wasn’t sure about the others.  “Johnny?”  Roy hoped his inflection did not sound too parental.  He knew if Johnny felt cornered, he would clam up.  Surely there was a rational explanation for why his friend was carrying around narcotics in his uniform.

Johnny exhaled loudly.  There was nothing left to do but come clean.  He knew Roy would see through anything else.  He also knew Roy would not condemn him prematurely.  “It’s Demerol and codeine.”

Roy looked down at the bag and then back at his friend as he moved close to the bed.  “Where did you get this?”

“At home.”  Johnny stared at his lap.  “It was uh...left over from before.”

Roy was quiet for a moment, trying his best to process the situation.  Johnny had said the medication came from home, that it was leftover from before.  That meant it hadn’t been recently prescribed by a doctor.  The fact that he had apparently secretly been taking painkillers, painkillers that he knew full well he wasn’t allowed to be taking while he worked, was one thing.  The real question was why.  Johnny typically did not like to take any medication, especially narcotics, unless he really needed to.  In fact, Roy remembered back to times when Johnny had been in obvious pain and denied it, simply because he didn’t want to take a pill.  It made no sense.  Unless…

Roy’s mind drifted to the many people they had rescued who had been addicted to narcotics.  Many of them had started taking them for legitimate purposes, and then for whatever reason, they began to crave the peace of mind and euphoria the drugs also offered.  And so, they would continue taking them, sometimes making up injuries just to get their hands on them, all because they wanted to feel good…or didn’t want to deal with other, difficult or painful aspects of their lives.  Roy felt confident this wasn’t the case with his friend.  He knew Johnny’s hip had been bothering him, that he had been in to see Todd, and that Todd had ordered him to work half shifts.  But, then he remembered how badly Johnny did not want Hannah to know about his appointment, or the reason for his shorter days.  And he had been dealing with a lot lately between Justin…and the baby…What if…

No, it wasn’t possible.  Not Johnny.  Roy decided to give him the benefit of the doubt.  After all, Cap had seen his leg go out from under him.  “Johnny…has your hip been bothering you that much?”

Johnny swallowed hard.  “It’s been pretty bad.”

“Well, what about Todd?  I thought you went…”

“I did, Roy.”  Johnny’s head was beginning to pound.  This was exactly the conversation he had been hoping to avoid.  “And he gave me some Tramadol.  But, it ran out.  I had this left over at home, so…”

Roy was beginning to put the pieces together.  “And you didn’t go back to Todd, because you were afraid of what he would tell you?  Or…you figured he would tell you you were doing too much and would refuse to give you another prescription because you weren’t following his orders to rest.  Is that it?”  Roy tried to keep the exasperation from his voice, but damn it, Johnny knew better.

Johnny could feel his anger beginning to bubble.  “That’s part of it.  I don’t expect you to understand…”

“I’m trying, Johnny.”  Roy squeezed the bag tightly in his hand for a second before seeming to regain his composure.  He lowered his voice.  “But, you and I both know you could be in some serious trouble for carrying this around, much less taking it while you’re working.  Not to mention, if there’s something seriously wrong…”

“There’s nothing seriously wrong.”

“And you know that for sure?”

“No, I don’t know that for sure, Roy!”  Johnny winced as his pain seemed to increase right along with his stress level.

“Easy.”  Roy soothed.  “Calm down.”  Once this latest wave of pain passed over, Roy continued, doing his best to sound less threatening.  “I’m just trying to understand, Johnny.  I’m concerned…”

“There’s no need to be concerned, Roy.  It’s really no big deal.”

“No big deal?  Johnny…”

Johnny was quiet as he gathered his thoughts.  He was beginning to feel nauseous now, and he didn’t know if it was because of the pain in his shoulder or because of this conversation.  His thoughts flitted from one possible explanation to another before finally settling on the notion that he may as well come out with it.  After all, there were few people on the planet who knew him as well as Roy did, and few people as non-judgmental.  “Okay.  I’ve been having problems with my hip.  You know that.”

“I know.”  Roy recognized the subtle signs in his long time friend that he was about to confide something in him.  He knew he needed to be careful and just let Johnny talk.  Secretly, he hoped Brackett and Dixie would not come back until Johnny was finished, or it might be a while before he got another chance.

“I went to see Todd.  He did the exam…the X-rays…the whole bit.  He gave me some meds and told me to rest.  I tried, Roy.  I really did…”

“But this whole thing with Justin…”

“There was no one else to help him, Roy.  I couldn’t just leave all of it to Camarin.  And he’s helped me out so many times…I knew he’d been concerned about getting the clinic up and running, because money’s been really tight.  There was so much to take care of…and I still had my own things to tend to.”

Roy nodded.  “I think I understand.”

“So I started taking the meds so I could get through the day and do what needed to be done.  I thought I would snap back sooner.  I honestly didn’t think I would need them this long.”

And the more you took them, the more you needed them.  Roy thought it, but didn’t say it.  He knew there was a real possibility his friend was hooked.  Dependent.  He had seen it far too many times.  He knew Johnny had too, and Roy wondered if he could recognize the ominous signs in himself.  It always seemed to start out innocently enough, but Roy had seen enough lives destroyed by substance abuse that a ripple of dread coursed through his veins.  He thought about how exhausted Johnny had been lately, how drawn and peaked his appearance was.  Was it possible he was abusing more than narcotics?  Abusing.  God, it sounded so harsh and impossible.

“But, I promise you, I’m done with it now, Roy.  Believe me, it’s not worth it.”

 Apparently Johnny had recognized the signs.  Roy hated that his friend had been dealing with this problem alone.  How hard this past week had to have been on him…

“I want you to throw those out.”  Johnny pointed toward the bag with a disgusted look.  “Flush ‘em.”  He looked down at his injured shoulder.  “It looks like I’m gonna have to take some time off anyway.  All my hip needs is some rest.  I just wish…”

“What?”  Roy was relieved.  It appeared as though Johnny had come to his senses in time.  He was suddenly grateful for the mishap at the fire.  If that hadn’t happened, it was hard to say how long this may have continued.  Still, he would need to keep a close eye on him without letting Johnny know he was watching…

“Never mind.”

Roy had a pretty good idea what was bothering Johnny.  “Look, if you’re worried about finishing up at Justin and Camarin’s…don’t.  The rest of us know what needs to be done, and we’re all happy to help.”

“But…”

“No buts.  And, if you’re worried about Hannah waiting on you hand and foot…She’s pregnant, Johnny.  It’s not a disability.  But, if it’ll make you feel better, I’m sure between Camarin and Jo…we can work something out.  Jo was telling me Kaya and Rose do a pretty good job with cooking and housework.”

“They’re just kids, Roy.  They shouldn’t be…”

“Well, according to Joanne, they love it.  She said they’ve been having a blast with all the modern appliances.”

Johnny sighed and continued to stare at his lap.

“What I’m trying to say is…don’t worry about it.  I know how you feel about accepting help when all you want to do is be able to help everyone else.  But, this is all temporary.  Justin’s getting better, and you’re gonna be back in the game before you know it.”

“We’ll see about how quickly you’re back in the game, Johnny.”  Kelly Brackett’s voice boomed from the doorway as he entered, followed by Dixie.  “Sorry, we got a little tied up.  How are you doing?”

Roy surreptitiously slipped the bag into his own pocket as he winked at his friend on the bed.  “He’s doing just fine, Doc.”

“Is that so?”  Brackett wondered as he moved closer to his patient.

“Yeah, Doc.”  Johnny looked past the doctor at Roy.  “I feel much better now.”

***

Todd stepped quietly into Justin’s ICU cubicle and picked up his chart.  A certain measure of relief surged through him as he silently viewed the figure on the bed.  Justin’s condition had been upgraded today from serious to fair. His O2 SATS were up to 93 percent on room air, which caused him to graduate from an oxygen mask to a nasal cannula.  The antibiotics continued to work on his fever, which according to his flow chart was just over 100 when it was taken about twenty minutes ago.  And right now, he appeared to be sleeping soundly.

Todd was just about ready to abandon his mission, hating to wake his friend when he seemed to be so comfortable.  But, just as he was about to turn to go, Justin stirred slightly.  Todd waited to see if he would settle back into sleep.  But, Justin’s left leg flexed and stretched beneath the covers and his right hand seemed to move robotically toward his left side.  A faint, scratchy moan indicated that some discomfort was causing him to awaken.

Todd leaned in close, his arms resting on the bedrail.  “Justin?”

Justin seemed to shift his position either in response to Todd’s voice or to relieve his pain, moaning again softly without opening his eyes.

Todd spoke a little louder.  “Justin, I know it’s hard, but try waking up a little more for me.”

Recognizing the voice of his friend and superior, Justin did his best to force his eyes open.  The combined effects of his medications and weakness caused by infection, trauma, and forced inactivity left him feeling sluggish and impossibly weak.  Finally he cracked open his eyes and tried to blink away the blurry haze left behind by so much time sleeping.  Unable to fully focus at first, his eyes continued to blink, roaming around the room briefly, before settling on Todd’s concerned face.

“I knew you were in there.  How are you feeling?”

Justin wasn’t sure how to answer.  He felt miserable, that was for sure.  But, he didn’t feel right saying it.  “I…I don’t know…”

“Here, take a drink.”  Todd picked up Justin’s cup of water and held the straw within reach.

Justin greedily sipped the cool liquid.  The constant supply of pure oxygen left him feeling dry as sand, and his throat was still scratchy and irritated.  But the fact that something as simple as sucking on a straw left him feeling exhausted and out of breath was frustrating.  “Thanks.”

Todd sat the cup back on the bedside table.  “Are you having any pain?”  He raised a suspicious eyebrow.  “And I want you to tell the truth.”

Justin gave his boss and friend an annoyed glance.  “A little.  Not bad.”

Years of honing assessment skills made Todd skeptical, but he said nothing.  “Since you’re awake, I need to do an exam.  See how your leg is progressing.  Okay?”

Justin heard, but his mind was focused elsewhere.  “How long…have I been here?”  He was sure he had asked the question before, but he seemed to spend so much time sleeping, it could be 1980 for all he knew.

Todd spoke as he rolled the covers away from Justin’s right leg.  “You’ve been in the hospital about two weeks.”

“Two…”  Justin was incredulous.  “I shoulda been…on my feet…days ago.”

Todd paused, again leaning on the bed rail.  “If this fracture had been your only injury, you would have been.”

“Shoulda…got me up and…got me outta here.”  Justin’s chest was beginning to feel tight, and his breathing quickened.  “Wouldn’t have…gotten sick…at home.”

Todd sighed.  He knew Justin knew better, but he supposed his memory might be a little fuzzy.  “Justin…you were in no condition to be on your feet, much less go home.  And you know as well as I do that with chest injuries like yours, everything you’ve been dealing with is normal.  I know it’s not pleasant, but…”

“Well, what’s taking…so long?”

Todd took a moment to gather his thoughts, trying to see things from the other side of the bed.  He knew that despite Justin’s years of experience in the medical profession, this was the first time he had ever had to deal with injuries and a recuperation like this.  He was sure it must feel like an eternity to him.  “Actually, Justin, everyone agrees you’re doing remarkably well.  You were in exceptional physical condition before all of this, and that’s given you an advantage.  You’ve been able to fight these complications better than an average person your age.  And although from an ortho standpoint, you’re a little behind the eight ball, I expect that now that your lungs are healing, you’ll be able to work more with Karen, and you’ll bounce right back on schedule.”

Justin hated that Todd was right.  He hated all of this.  Hated being stuck here, feeling vulnerable.  He hated being medicated into oblivion, hated feeling so weak and tired all the time.  He just wanted to be in his own bed with his fiancée, in his own space.  He wanted to be back at work, enjoying the energy that overflowed in him every time he was able to help someone get their life back.  Well, he wanted his life back, dammit! 

Todd could see the emotion that hovered so close to the surface, threatening to spill out if Justin were to speak.  He wished there was something he could say or do that would help him focus on the positive, as Justin so expertly was able to do for his own patients.  While the situation really could have been so much worse, he knew that was not what his patient wanted to hear right now.  And two weeks in the ICU really was difficult for anyone to deal with.  “Just hang in there, Justin.  I’m pretty sure you’re going to be moved to my floor tomorrow morning.  In the meantime, let’s see how this leg is doing.”

Justin nodded his silent assent and watched as Todd moved down to the foot of the bed.  Then, he could feel the surgeon squeezing his toes, checking his capillary refill, before moving his fingers to apply firm pressure to points on top of his foot and the inside of his ankle, checking the pulses there. 

Satisfied that there appeared to be good circulation in Justin’s leg, Todd moved on to assess his nervous system.  He brushed his fingers lightly over his patient’s toes.  “Wiggle those for me.”

Justin did as Todd requested and then felt a sharp pin prick on the ball of his foot, causing him to pull away reflexively.

“Feel that?”  Todd wondered.

“Yeah.”

Todd followed up by lightly stabbing each one of Justin’s toes, as well as several areas on his foot, ankle, and lower leg.  Justin wasn’t able to feel all of them, and became alarmed, until Todd reminded him that some nerve damage was expected and would likely either resolve itself or be so slight it would not cause any long term difficulties.  After successfully palpating strong popliteal and femoral pulses, Todd carefully unwrapped the wide ace bandages from Justin’s thigh and peeled back the bulky dressing covering his stapled incision.

Justin looked down at the fierce looking wound and instantly became nauseous.  While it wasn’t the first time he had seen the long line of staples fastening together swollen and inflamed tissue, it seemed to look worse on his own leg.  Although Justin knew from a clinical standpoint, the wound appeared to be healing well, to him it seemed absolutely vulgar.  “Oh…man…”

Todd watched as his patient broke out into a cold sweat before his eyes, his expression indicating his repulsion yet inability to look away.  “I know it looks bad, Justin.  But, it’s healing great.  Are you okay?”

“Yeah…”  Justin swallowed down the bitter taste in the back of his throat.  “Yeah…I’m okay.  Just…cover that…back up…okay?”

“Sure.”  Todd applied the fresh dressing he had brought with him before rewrapping the ace bandage for support.  “Not too tight?”

Justin shook his head.  “No.”

Todd paused for a moment to remove his gloves before leaning over his patient.  “Justin, I need to move your leg a little.  It’s going to be painful.  Do you need some morphine first?”

The mere thought of moving his leg made Justin want to vomit.  But he also knew how horrible and sick the morphine made him feel.  He remembered back to the times Johnny would complain about it, often denying or downgrading his pain because he insisted just dealing with it was the lesser of two evils.  Although Justin was an advocate of more natural means of pain relief such as heat, ice, and massage, he remembered becoming frustrated with Johnny, unable to understand why he would rather suffer than accept that he needed some easy relief.  Now, the physical therapist understood in full.  “Not right now.”

Todd sighed.  “Okay.  But, if you change your mind…”

“You’ll be…the first to…know.”  Justin gritted his teeth so hard he thought he would break them when he felt Todd’s hands on his foot and lower leg.  Then, as Todd began flexing his foot and ankle, he relaxed a little.  The gentle pull on his calf and shin muscles actually felt good.

Next, Todd moved to the side of the bed.  “I need to see how far you can bend your knee.”  He rested his hands on the joint.

Justin flashed a skeptical look at his doctor.  “Todd, I…I can’t…”

Todd took a step back and crossed his arms in front of his chest.  “Justin, we need to get that joint moving.  Your hip too.  You know that…”

“I know…”  Justin could feel his anger rising.  Todd knew damn well he knew that.  “But, I…I’m not ready.”

“A few minutes ago you thought you should have been on your feet by now.”  Todd reminded.  “This comes first.  You…”

“I know that!”  Raising his voice caused Justin to start coughing.  He braced his ribs tightly with his pillow.

“Justin…”

“Damn it, Todd!”  Justin wheezed between coughs.  “Just…gimme a…minute.”

Todd backed off, refraining from saying another word while he struggled with his own feelings.  He had never given much thought as to how he himself would handle it if faced with an injury such as this, and he imagined Justin never had either.  But, he supposed that if he had, because of his knowledge and experience, he would have expected to be able to handle things fairly well.  The truth was, however, that no one really knew until they had to deal with a difficult situation exactly how they would fare.  Todd guessed that Justin’s frustration possibly had more to do with everything associated with his injuries, rather than the injuries themselves.  He probably felt he should know what to expect, and thus be better able to manage his recovery, not to mention his emotions.

Finally, the painful coughing subsided, and Justin was able to get his breathing under control.  Placing both hands on his injured leg, he took as deep a breath as he could muster without setting off another round.  “Okay.  I’m ready.”

Todd stepped up to the bed once again and gently positioned his hands.  Then, slowly, he began to bend Justin’s leg at the knee.

“Ahhh, shit!  S-stop…stop!”  As many times as Justin had heard patients vocalize in just this way, it sounded alien…not to mention embarrassing….leaving his own throat.  He knew this was going to hurt, but nothing could have prepared him for the agony that ensued.  It brought tears to his eyes, which he immediately wiped away, only to have them multiply and return.  He turned his face away, ashamed to appear so wimpish in front of Todd.

“Okay, we’re done.”  Todd assured as he replaced the covers and smoothed them over Justin’s waist. 

Justin closed his eyes as his emotions continued to add insult to injury.  “Sorry…”

Todd swallowed down the lump in his own throat as he leaned across the rail, ensuring that Justin would hear what he was about to say.  “Hey…none of that.  It’s me, Justin.  You have no reason to be ashamed.”

Justin continued to wipe angrily at the moisture filling his eyes.  He had known Todd for over twenty years.  He trusted him completely.  So, why did he feel like crawling under the bed and never coming out?  “Just…leave me alone.”  As soon as the words left his mouth, he regretted them.  But, there was nothing more he could think of to say now.

Todd knew better than to take Justin’s request personally.  He knew the younger man had felt invincible up until a few weeks ago.  He knew that he felt he should be able to just get up and walk out of here until the simple act of bending his knee left him feeling crushed and defeated.  Todd also knew there was possibly only one person on earth who Justin could talk to who he would feel fully understood what he was going through, one person who just might be able to get through to him and give him some peace of mind.  He glanced at his watch.  It was after eight.  Todd wondered if John Gage would be stopping in for a visit tonight.

“Okay, Justin.  I’ll go.”  Todd pulled Justin’s chart off its cradle and opened it.  “But, I’m going to have your nurse come in and give you some Demerol.  It’s not quite as strong as morphine.  I think you’ll tolerate it a little better.”

Justin sat silently, clutching his pillow to his sore side.  There was no use starting this battle when he felt as if the war had already been lost.  Besides, his chest and leg were throbbing now.  Some relief…and some sleep…would be welcome.

Todd continued to scan the nurses’ notes from the day.  “It says here you’ve been having some soreness in your hips and lower back.”

“Yeah…”  Justin found that for some reason, it was easier right now to think of Todd as his doctor, instead of a friend.  At any rate, he appreciated that Todd was willing to ignore his moment of weakness and move on, business as usual.  “Stiffening up I guess.”

“Well, when you get to the ortho floor, you’ll have a trapeze so you’ll be able to position yourself a little easier.”  Todd closed the chart and clutched it to his chest.  “In the meantime, I’ll send Karen in to work with you for a while, see if some heat and massage might help.”

Justin was sure that it would.  “Thanks…”  Then, he realized someone was missing.  “Todd, is…Camarin here…somewhere?”

“It’s after eight, Justin.  Visiting hours are over.  She’s probably home with the girls.”

“Okay…”  Justin tried to hide his disappointment, longing for the day he could keep track of time again.  He was sure Camarin had been here today, but suddenly it felt like an eternity since he had seen her.

“Do you want me to call her?”  Todd offered.

“No…I’ll see her…tomorrow.”  Justin winced as pain surged through his nerve endings, seeming to attack everywhere at once.  He clenched his teeth to stifle a moan.

Todd recognized the signals immediately.  “I’ll send your nurse in with that Demerol.  Get some rest.  I’ll be back in to check on you before I go home.”

***

In treatment room three, Kelly Brackett was busy conducting an examination of his own.  He carefully cut the immobilizing bandages from Johnny’s upper body and visually evaluated the damage to his shoulder.  There was an area of severe swelling over Johnny’s collarbone that was beginning to turn all shades of purple and red.  “How exactly did you injure your shoulder, Johnny?”

“When I slipped on the ladder…”

“He got a pain in his hip.  His leg went out from under him.”  Roy supplied the information he knew Johnny would be reluctant to give.

“Can you let me tell this story, please?”  Johnny asked, unsure which was more annoying, the fact that his partner was ratting him out, or the fact that he was right.

“Is that true, Johnny?”  Brackett asked interestedly.  “Did your hip give you trouble and cause you to fall?”

“Well, I didn’t exactly fall.”  Johnny pointed out.  “I was able to grab hold of the ladder to stop myself from falling.  That’s when I felt something pop in my shoulder.”

“So you didn’t hit it on anything?”  Brackett asked as he ran his fingers lightly over the bruised and swollen area.

“No…I don’t think so…ouch!”  Johnny exclaimed, pulling away as Brackett’s fingers palpated more deeply, searching for a deformity.

“Sorry.”  Brackett apologized as he folded the sheet away from Johnny’s left leg.  “Your hip looks a little swollen.  Is it painful right now?”

Johnny focused in on his hip, but it was hard to get past the increasing agony in his shoulder and arm.  “It aches a little…maybe.  Not too bad.”

Brackett crossed his arms and exhaled.  “We’ll get some X-rays and see what’s going on.  Is this the shoulder you had the surgery on last year?”

“Yeah.”

Brackett nodded.  “I thought so.  I’ll have Todd Andrews paged too.  Since he did some work in there, he should probably take a look.  I’m sure he’ll want to evaluate the hip pain anyway.”

“I’m sure.”  Johnny sighed, not wanting to think about the lecture that was forthcoming.

Brackett pulled out his stethoscope.  “Let me listen to your lungs one more time.  How does your chest feel?”

“A little tight.”  Johnny admitted, as he rubbed his hand lightly over his sternum.

The room was silent while the doctor listened intently for several minutes.  “I’ll order a breathing treatment too.  You’ve got a little wheezing going on.  Dix?  Put him back on oxygen.  Four liters by cannula.  I’ll be right back.”

Johnny looked up at Dixie as she positioned the nasal cannula behind his ears.  “Hey, Dix?  Do you know how Justin’s doing?”

Dixie smiled.  “The last time I was up there, he was sleeping.  Kel said they may move him to the orthopedic floor tomorrow morning.”

“That’s great!”  Johnny grinned, knowing this meant Justin was doing better.  “Thanks, Dix.”

“You’re welcome.”  Dixie countered.  “Now, if you’ll excuse me, I’m going to go see what’s keeping that portable X-ray unit.”  She began walking to the door before turning to Roy.  “Do you want some coffee?”

“Maybe later.”  Roy answered, watching the nurse leave the room.  “Right now…”  He started, taking the bag of pills out of his pocket and giving it a shake.  “I need to make a visit to the men’s room.”  He moved toward the door, but was stopped by a voice from the bed.

“Thanks, Roy.  For not saying anything.”

“No problem, partner.”  Roy assured.  “As long as you keep your end of the bargain.”

“You got it.”  Johnny promised, resting his head back against the pillows.

***

Todd Andrews stepped out of Justin’s room with the intent of finding his nurse so that he could order the medication he had promised.  Then, he planned to talk to Justin’s physical therapist, Karen.  But, he was stopped just outside the door.

“Dr. Andrews.  Just the man I needed to see.”  A somewhat excitable nurse impeded the orthopod’s progress with a hand on his arm.

“Oh?”  Todd raised a curious eyebrow, looking past the woman toward the horseshoe shaped desk at the center of the ward.  He recognized Justin’s evening nurse sitting there.

“Yes, doctor.  I got a phone call from Dixie McCall in the ER.  She said to tell you that John Gage was just brought in, and they need you for an orthopedic consult.”

“Thank you.”  Todd’s voice was tinged with urgent concern as he moved quickly past the nurse, stopping briefly at the desk to give his orders before getting on the elevator.

Unbeknownst to Todd and the nurse-messenger, Justin had overheard part of the conversation just outside his door.  The words John Gage, ER, and orthopedic consult followed by Todd’s hasty departure filled Justin with dread.  He tried to get the attention of the woman at the door.  “Hey…”  He pounded the bed in frustration at the weakness of his voice.  Taking a deep breath and gathering every ounce of strength he possessed, he tried to generate some more volume.  “Hey!”

Justin’s second entreaty captured the nurse’s attention and she entered the room.  This wasn’t her patient, but he was obviously in some distress.  She glanced at the name plate on the top of his chart.  “Mr. Quinn?  What can I do for you?”

“You said…”  Justin was painfully out of breath, which only served to fuel his frustration.  It seemed the simple act of shouting one word had been enough to start him wheezing.  “John Gage…in the…ER…”

The nurse moved to Justin’s side.  She didn’t like the way he was breathing.  “That’s right.  Do you know him?”

“Yeah…”  Justin puffed.  “Friend of…mine.  What…what happened…to him?”

The nurse shook her head, growing increasingly concerned.  “I…I don’t…”

“He…okay?”  Obviously he wasn’t if he was in the ER.  But, Justin hoped that whatever the injury was, it wasn’t severe.  Normally the ER doctors would not call in an orthopedic surgeon for a minor sprain or fracture.  But then, Todd and John had a history…

The nurse pressed the call button and reached for the oxygen mask on the wall.  “I don’t have any details, Mr. Quinn.  You seem to be having some trouble breathing…”

“Dammit.”  Justin rasped, as he continued to breathe roughly.  The wheezing was becoming more severe now, and he could feel himself starting to black out.

“I have your Demerol right here…”  Justin’s nurse, Betty, assured as she hurried into the room.  She thought maybe her patient had hit the call light because his pain was getting worse.  “Sorry, I got a little tied up…”  Betty stopped, surprised to see the other nurse trying to coax the oxygen mask over Justin’s nose and mouth.  She plopped the tray she had been carrying onto the table and moved in to assist.  “What’s wrong?”

“He’s having trouble breathing.”  The nurse informed as she continued to fight with the mask.  “Mr. Quinn, you need this…”

Betty took the mask from the other woman, knowing what Justin’s problem was.  “I’ll get this.  He’s having a bronchospasm.  Go have Dr. Burke paged.”

The somewhat flustered nurse hurried out of the room.

Betty spoke in comforting tones as she tried to get Justin to accept the mask, but he wasn’t having it.  He continued to push it away, struggling for enough air to tell Betty what he needed to know.  “She…she said…”

“Justin, calm down now.  Let’s get your breathing under control.  Then, we can talk.”

But Justin continued to fight.  He knew he was about to be medicated, and that this bronchospasm would leave his already exhausted body helpless to fight sleep.  He wanted to know about Johnny before that.  If he were working here, and not a patient, he could walk straight down to the ER himself and find out what was going on.  This was just one more piece of freedom being stripped away, and Justin hated it.  “John…Gage…ER…”

Betty had no idea that Johnny had been brought into the ER as a patient.  She knew him well, having been his nurse during a few of his stays in the ICU.  She also knew he and Justin were good friends.  “You want me to call John for you?”

Justin shook his head, clearly angry at his inability to communicate.  As far as he was concerned, his lungs had lousy timing.  “He’s…hurt.”

The other nurse returned to the room in time to overhear Justin’s words.  Spying the confused expression on Betty’s face, she filled her in.  “He overheard me telling Dr. Andrews that he was needed for a consult in the ER for a patient named John Gage.  Apparently…he’s a friend of his.”

Understanding dawned on Betty’s face.  She knew that stress could bring on an incident like this, and Todd had told her that her patient was already having some anxiety.  “Okay, Justin.  I’ll make some calls and find out about John, but first we need to take care of you.”  She held the mask in front of him.  “Okay?”  At Justin’s nod, she affixed the mask to his face.  “Try to slow your breathing.”  Looking up at the other nurse, she directed her to get a blood pressure.

Julius Burke strode into the room, unfurling his stethoscope as he walked.  After being filled in by the nurses, he helped Justin lean forward so he could listen to his lungs.  After moving his scope around on Justin’s back, he straightened, draping the instrument around his neck.  “Let’s get him some albuterol.”  Waiting until Betty left to carry out the assigned task, he leaned onto the bedrail in order to address his patient.  “I’m not hearing any increase in fluid, Justin.  Just a lot of dry wheezes.  Remember, we talked about this being likely for a while.  Any irritation to your lungs…cold air, certain odors, stress…they can all trigger a bronchospasm.”  What Burke chose not to voice at this time was that it was possible Justin’s lung sensitivity could be permanent.

Justin nodded, too overwhelmed by his effort to breathe, his increasing fatigue, and his concern over Johnny, to answer.

Betty was back with the albuterol and she quickly attached the nebulizer to Justin’s mask, causing him to wince at the bitter taste.

Everyone in the room watched as within seconds, Justin’s breathing evened out and the whistling heaves quieted, becoming less frequent before disappearing altogether. 

“Do you want some diazepam, doctor?”  Betty wondered, concerned about her patient’s level of anxiety.

“He’s not going to need it.”  Burke assured, knowing that Justin was on the verge of collapse.  “Help me lean him forward.”

When Betty complied, she saw immediately what the doctor meant.  Justin was so worn out now, he was not even making an effort to help in moving his body.  Instead, he slumped forward, and Betty found herself supporting his weight.  After another listen to Justin’s lungs confirmed that this latest crisis had passed, Burke helped Betty settle the exhausted man into a comfortable position.

“Go ahead and give him that.”  Burke pointed toward the Demerol on the tray and watched as Betty slowly injected it into the empty port on Justin’s central line.  “He’ll sleep a while now.”

Betty breathed a sigh of relief.  She had just come on shift a little over an hour ago, and knowing that her patient’s condition had been upgraded, she had been anticipating a quiet night.

“I…I’m sorry…”  The younger nurse stammered.  “I didn’t know the patient in the ER was his friend…”

“Which is why we need to remember to use a little more discretion.”  Burke reminded, not unkindly.  “If you were speaking loudly enough to be overheard by a patient, you were speaking too loud.”

“Yes, doctor.”  The nurse agreed meekly as she left the room.

“I’ll call downstairs and see what I can find out, but…”  Betty looked at the now-peaceful figure on the bed.  “What if it’s bad news?”

Burke sighed, as he finished scrawling some notes.  “Well, you can’t really keep it from him.”  He returned the chart to its cradle and headed out.  “Have a good night.”

“Yeah…”  Betty continued to watch over her patient, her thoughts drifting to another patient down in the ER.  She was surprised the other nurse didn’t know who Johnny was, as most of the young nurses at Rampart were very familiar with him.  Of course, the paramedic was married now, and hadn’t been flirting like he once did.  Betty smiled at the memory.  She was fond of Johnny, but she hoped that whatever injury he had sustained, wouldn’t bring him to the ICU.  “I hope it is a good night.”

***

Johnny could feel his muscles tense involuntarily at the sight of Todd entering the treatment room. His eyes met Roy’s warily before smiling a bit nervously.  “Hey, Doc.”

Todd’s heart fell at the sight of the man on the exam bed, his obviously bruised and swollen shoulder partially hidden by a towel and a bag of ice.  This family didn’t need anything else on its plate.  “Good evening, John, Roy.  Kel tells me you had a little mishap on this last call.”

“Almost made it ‘til quittin’ time, huh?”  Johnny quipped, hoping that letting the orthopod know he had at least been following his orders to work half shifts would soften the frustration he was sure to have over his somewhat less-than-stellar compliance in everything else.

“Yeah…almost.”  Todd removed the ice pack and towel and completed a quick exam, stopping when gentle manipulation of the joint caused Johnny to hiss in pain.  “Hurts quite a bit, huh?”

“Not so much until you started moving it.”  Johnny hated when doctors did that.  Of course it was going to hurt when Todd started pushing and pulling on it.

Todd replaced the ice with a smile.  “We’re probably looking at a sprain.  But, I’ll need to see the films to know how bad.”

“Right.”  Johnny figured as much.  He wondered what was taking the X-rays so long to arrive.  Suddenly he just wanted out of here as soon as possible.

“Now…”  Todd closed Johnny’s chart and held it to his chest.  “Let’s talk about your hip.”

Johnny sighed, as he made brief eye contact with Roy.  There was no use trying to hide anything now.  “When I was on the ladder…it kinda…gave out on me.  That’s what made me fall.  Well…almost fall.”

Todd nodded thoughtfully.  “Gave out on you.  Because of pain?”

“Yeah…I guess so.”  Johnny watched as Todd peeled back the sheet covering his left leg.  “It’s sorta been bothering me a lot lately…”

“I figured as much.”  Todd stated as he ran his hands over the slightly swollen joint.

“You did?”  Johnny asked, somewhat surprised.

“John…”  Todd stopped his examination and looked at his bewildered patient.  “It’s part of my job to know this stuff.  I’ve noticed some things lately that made me think maybe you’ve been having a little more trouble than you were letting on.”

“But…you didn’t say anything.”

Todd smiled.  “I figured the truth would come out sooner or later.”  After a pause, the doctor leaned a little closer, genuine concern coloring his voice.  “The question is…”

Before Todd could hint at his suspicions, the door opened, and Brackett entered, carrying an envelope.  “Films are ready.”

Todd gave Johnny a look that meant this conversation would continue before following the other doctor over to the viewing board.  Together, they snapped several pictures up onto the small screen.

Back at the exam table, Johnny looked up at Roy and whispered nervously.  “He knows.”

“What?”  Roy was caught slightly off guard by Johnny’s comment, having been busy watching the action on the opposite side of the room.  “Johnny…”

“About the drugs, Roy. I don’t know how he knows, but he knows.”

Roy couldn’t help but smile at his friend.  He could be so paranoid sometimes.  “Well, is that such a bad thing?  I’m sure it’s not the first time he’s ever come across something like this…”

“But this is me, Roy.”  Johnny whispered, as if this explained everything.  He looked past his partner to make sure this conversation wasn’t being overheard.  “What if…”  Johnny stopped himself as the two doctors approached the table.

“It’s an A/C separation, John.”  Todd supplied.  “It doesn’t look too bad.  I think you’ll be safe from the knife this time around.”

“That’s good.”  Johnny sighed in relief.

“That is…IF you follow my instructions to the letter, of course.”  Todd added.

“Of course.”  Johnny agreed.

Brackett smiled, clearly also relieved at this bit of good news.  “Well, Johnny, I’m going to leave you in the good hands of my colleague.  I have sick people to see.”  After a brief nod to the others in the room, the doctor departed.

Todd continued to explain his planned course of treatment for Johnny.  “I’ll fit you with an immobilizer.  You’ll have to rest your shoulder for a while.  It’ll be at least two weeks before you can expect to go back to work.”

“Doc, what about his hip?”  Roy asked.

“There’s no new injury.”  Todd informed.  “It’s just like I told you before, John.  You’ve obviously continued to stress the joint too much.  It needs rest.  Since you weren’t able to rest it adequately while continuing to work, if I were you, I’d take advantage of the time off you’re going to need because of this shoulder separation.”

“Okay, Doc.”  Johnny’s good shoulder slumped in defeat.  “You’re right.  I have been doing too much, what with Justin…”

Todd nodded, having figured already that taking care of Justin’s affairs had been a major focus lately.  “I know.  And I understand wanting to help Justin.  But, you know as well as I do how he would react if he knew you were causing injury to yourself over it.”

“Yeah…do I ever.”  Johnny admitted.  He knew that Justin would react in exactly the same way he would if the situation were reversed.  At least everything was pretty much taken care of now.  As much as he hated having to be on the injured list again, Johnny was actually looking forward to a few weeks off.

“Good.  Then that’s settled.”  Todd pulled a pad out of his pocket and began jotting down some orders.  “I’ll be back with that immobilizer.  I want you to call my office and make an appointment for a week from tomorrow.  And, I’ll write you a prescription for some ibuprofen and some tramadol…”

“No.”  Johnny shook his head as he pushed the offered prescription away.

Todd tried to read into the meaning behind the one word refusal.  If it hadn’t been for other subtle clues he had noticed over the course of the past week, the doctor might have simply thought Johnny was refusing the offer of narcotics because he didn’t feel he needed something so strong to manage his pain.  But, Todd couldn’t help but suspect there was something more to his patient’s apprehension.  The last thing he wanted to do was talk him into taking drugs if he had been using them as a crutch as of late.  “No?”

“I…”  Johnny looked down.  “I don’t want the tramadol.”

The tension in Johnny’s features was obvious.  Todd had seen this sort of situation enough times that he recognized the signs.  He didn’t want to confront Johnny, but part of his job was to recognize the tenuous clues which suggested a potential for substance abuse, and then do his part to defer and counsel.  He just never imagined he would be going down that road with this particular patient.  “Roy, could you leave us alone for a minute?”

“It’s okay, Doc.”  Johnny assured.  “Roy already knows everything.”

Todd spoke quietly, feeling fairly confident in his supposition, but still plagued by a tiny shred of doubt.  “You never threw out those old meds, did you?”

Johnny continued to avoid Todd’s gaze as he shook his head.

Todd knew that a lecture about the evils of drug dependency was not in order here.  It was obvious that the paramedic had already recognized the potential of his actions and had already chosen to put an end to it.  Whether that decision had been made solely on his own, or with a little help from the friend standing at his side was irrelevant right now.  Besides, Todd knew exactly what the man’s motivation had been.  He did his best not to sound patronizing.  “It’s no secret you’ve had a lot to deal with these past few weeks, John.  And I know you know there were probably better ways to handle it…”

“Doc…”  Johnny was clearly uncomfortable with this conversation, but he was thankful that at least Todd seemed to be treading lightly.

“And, I honestly can’t say I wouldn’t have done the exact same thing in your situation.”

Todd’s statement came as a surprise.  Johnny looked up at last.  “Really?”

“Desperate times, desperate measures.”  Todd shrugged.  Then, he ripped up the piece of paper in his hand and deposited it into the trash before reaching for his prescription pad again.  “I’ll write you a scrip for the ibuprofen.  As long as you rest, you shouldn’t need anything stronger.”

“I will, Doc.  I promise.”  And Johnny meant it.

“Good.”  Todd smiled as he handed over the paper.  “By the way, Justin’s doing well.  He’s being moved to the ortho floor in the morning.”

“We heard.”  Roy replied.  “That’s great!”

“I guess it’ll be up to Kel whether or not you go home tonight…”  Todd indicated the nasal cannula Johnny was still sporting.

“He already said I could…as long as my lungs calm down after my breathing treatment.”

“Great!”  Todd was genuinely happy that Johnny hadn’t been severely injured.  “RICE therapy for your shoulder and your hip, John.  After that, if it feels better, you can use heat.  I’m sure Hannah will see to it that you’re properly pampered during your recuperation.  And I don’t want to see you here for at least a day or two.  Justin will have enough people on the ortho floor welcome wagon.”

“Right, Doc.”  Johnny smiled as he imagined the attention Justin would surely receive from his friends and colleagues on the floor he normally spent so much time on.  He would be well cared for, that much was certain.

Todd left the room, leaving Roy and Johnny alone again.  Roy was the first to speak.  “Well, I better go give Cap a call and let him know what’s going on.”  He started out, then stopped, looking back.  “You okay?”

Johnny felt as if a tremendous weight had been raised off his shoulders.  So why, then, did a small bit of anxiety continue churning in his gut?  “Yeah…I’m good.”  He watched as Roy exited, then leaned back against his pillow with a sigh.

***

Dixie was gathering her purse and other belongings, preparing to go home, when the internal line on the base station phone began to ring.  She picked the receiver up quickly.  “Emergency Department, Dixie McCall speaking.”  Her features morphed from knowing smile to frown as she listened to Betty’s voice on the other end.

Joe Early listened to the one sided conversation from his spot across the desk.  He waited until Dixie hung up to inquire about the content of the call.  “Who was that?”

“It was Betty up in ICU.  Apparently Justin found out Johnny was brought in, and she promised him she’d call and find out what happened.”  Dixie spoke as she pulled some hand cream from her purse and began applying it.

“How did he find out?”  Joe wondered.

“You know…good news travels fast around here.” Dixie said a bit sarcastically.

“Well, at least it is good news.  Kel just told me it was only a sprain.”

“Yes, thank goodness.”  Dixie returned the small bottle of lotion to her purse.  “But, Betty said Justin was pretty worried about it.  I’m going to take a walk up there and personally deliver the good news.”

“Okay, but don’t take too long.”  Joe smiled devilishly as he lowered his voice and leaned across the desk.  “I’ve got a bottle of cognac with our name on it.”

“That sounds heavenly, doctor.”  Dixie breathed with just the slightest coy flutter of her long eyelashes.  “I won’t be long.”  And with that, she made her way to the elevator.

At the ICU nurses’ desk, Betty appeared a bit flustered as she spoke with another one of the nurses.  She looked up at the sound of the elevator door opening and breathed a sigh of relief as Dixie stepped off.  “I’m glad you’re here.  Ever since Justin heard that John Gage was brought into the ER, well…”

“Don’t worry, Betty.  I’ll talk to him.”  Dixie promised as she started down the hall.

Betty followed alongside her, explaining the events since Todd had left Justin’s room.  “He’s been pretty anxious in general, too much time in ICU I guess.  But, this really got him worked up.  He’s supposed to be moved off of here in the morning, but I’m afraid of a relapse.  He’s so exhausted…and he’s had some Demerol.  But, he just won’t settle down and go to sleep.”

“Thanks, Betty.”  Dixie sighed heavily as she stepped quietly into the cubicle.  Justin’s eyes opened immediately upon her arrival and he shifted uncomfortably.

“See?”  Betty tilted her head toward the bed before walking over to stand beside it.  “Dixie’s here.  Now you can relax.”

Dixie appreciated the almost protective way Betty had with Justin.  It had been the same with Johnny when he had been her patient here.  “That’s right, Justin.”  She looked up at Betty with a nod that meant she had the situation under control and the other nurse could go attend to other duties.

Justin was so tired he felt physically ill.  But, his nerves stood at attention, refusing to allow him rest.  His mind seemed to be racing while his body left him feeling weak and depleted.  He supposed this was what anxiety felt like.  It reminded him of the way he felt after Abby died.  He remembered being unable to concentrate on anything else, how he would lie awake at night staring at the ceiling, praying for the escape of sleep.  Finally, his mother had given him one of her tranquilizers, and he had felt ashamed, as if he should have been able to handle his emotions better than that.  It was the same way now, and that only added to his frustration.  “Dix…”

Dixie spoke gently as she grasped onto Justin’s hand.  “I hear you’ve been asking about Johnny.  I came up to let you know he’s fine.  He has an A/C separation.  It’s not bad.  In fact…”  She glanced at her watch.  “He’ll probably be going home soon.”

Justin swallowed against the tightness in his throat, relieved at this information, but still full of questions.  “How…”

“He was on a ladder.  He slipped, I guess, and grabbed on to keep from falling.”

“Slipped?”  Justin knew Johnny had had his share of bad luck, but one thing he was not was clumsy.  Especially on the job.

“He’s fine, Justin.”  Dixie smoothed back the long strands of blond hair from Justin’s face, admiring his handsome features, surprised that after all these years, he could still cause her insides to stir.  “He wanted to come up and show you for himself, but Todd threatened him with bodily harm if he even so much as thought about it.”

Dixie’s comment forced a smile from Justin at last.  “I believe it.”  He allowed his eyes to close.  Dixie’s hand felt good brushing his forehead.  He began to relax a little and found himself wishing that the nurse would stay for a while.

“Now, how about you?  Is there anything you need before I go?”  Dixie asked.

Justin tried to think.  His ribs were sore, and his back and leg ached with a vengeance.  The Demerol he had been given earlier did nothing but make him feel stuporous and foggy, not to mention a little nauseous.  He felt uncomfortably warm, and wondered if his fever was up again.  And then there was that annoying tightness in his chest whenever he inhaled.  But, Justin knew there was little Dixie could do about any of that.  Well, maybe just one thing.  “Just…stay for a…minute?”

Justin’s plea hit Dixie unexpectedly.  She had been expecting him to be the tough guy, like he had on every other occasion she had visited him.  But, this time there was an edgy desperation to his voice, which she knew could be in part to his overwhelming exhaustion as well as the medications he was on.  But, it managed to awaken the part of her that she had been able to keep so hidden all these years.  The part of her that sometimes still wondered ‘what if.’  She thought of Joe, waiting downstairs to drive her home to the apartment they shared not far from the jazz district.  For the past several months, the kind doctor had made her happier than she’d ever been.  And she had no regrets about what might have been with Justin.  But, suddenly, and to her surprise, honoring Justin’s request…staying here with him until he fell asleep…became the most important thing in her world.  “Sure.”  She reached up and turned off the small light above the bed, so that the only light in the room was filtering in from the hallway through the observation window by the door.  Next, she pulled the curtain around the bed, making it as dark as was possible.  Then, she continued gently stroking Justin’s forehead.  “Everything’s okay now.  Go to sleep…”

Justin felt his limbs relax into the mattress.  He found there were still a few niggling thoughts bouncing around behind his eyes, but it wasn’t long before those thoughts drifted into the absurdity of dreams and he was floating…

Dixie waited until Justin’s breathing evened out and became deeper.  She could feel his muscles untense beneath her hands, but she continued on for several more minutes until she was sure he was sleeping soundly.  Then, she leaned down to kiss his forehead, but stopped herself, settling for a light caress of his face, his shoulder, then his arm.  She allowed her hand to linger there for a moment before past memories intermingled with present joy, bringing a smile to her face.  “Good night, Justin.”

Justin pulled his cobalt blue 1948 Chevy convertible alongside the curb and beeped the horn.  A quick look in the rearview mirror confirmed that his hair was gelled perfectly.  He looked down and brushed a few stray pieces of lint off of his letterman’s sweater before tossing the football, which he only just now realized was still in the front seat, into the back, not really caring where it landed.

“Hi, Justin!”

Justin looked up to see Abigail running toward the car, her pleated skirt billowing in the breeze, exposing layers of net petticoats and causing freshly fallen leaves to scatter. He smiled a wave at Mrs. Delaney, who was standing inside the front doorway, allowing the dimples the women seemed to find so endearing to win him a few points with his girlfriend’s mother.  “Hey, Abby.  I missed you.”

“Missed me?”  Abigail teased as she settled herself into the passenger seat.  “You just drove me home from school three hours ago.”

“Three hours is a long time.”  Justin bantered as he threw the car into gear and drove off down the tree-lined street.  It was mid-October and the leaves were just beginning to turn.  Several yards sported elaborate Halloween panoramas while others were decorated less garishly with pumpkins, Indian corn, and scarecrows.

“I got a letter from Tommy today!”  Abby reported excitedly.  Tommy was her older brother who had been drafted in June to serve in the Korean war.

“Really?”  At seventeen, Justin often thought about what might happen next year when he was forced to sign the draft.  Although he knew he would serve his country proudly if ever asked to do so, he worried about how his family would fare without him.  Hannah was so attached to him, and Jonas did nothing but cause trouble for his parents.  Not only that, but Justin had dreams of becoming a doctor, getting married, and having a family of his own, dreams that included Abby.  His parents had assured him that college might help him avoid induction into the service, but Justin knew there were no guarantees.

“Yeah!  Guess he’s doing okay.”  Abby went on to tell Justin all about the contents of the letter on their drive to their favorite pizza shop.  It was Friday night.  There was no football game this week, so the couple was enjoying a rare night out. 

Justin parked the car and paused for a kiss before exiting.  Abby was quiet for a moment, as if in thought.  Then she whispered discreetly, as if giving away some forbidden secret.  “Guess what?”

“What?”  Justin smiled.  Abby looked beautiful in the dim lamplight from the pizzeria’s small parking lot.  Her blonde hair was almost glowing and there was a mischievous glint in her grey-blue eyes that Justin found irresistible.

“My parents are going out.  They won’t be home until midnight.”

“Oh, really?”  Justin was pleased at the implied invitation.  It was rare that he ever got to spend much time alone with Abby.  He hardly ever took her to his house, because he knew Hannah would be clamoring for his attention and Jonas would say or do something stupid.

“Yes, really.”  Abby closed her eyes for one more kiss.

Justin exited the car and sauntered around to open the door for his date.  Nat “King” Cole could be heard coming from the open door of the restaurant.  The air was ripe with the scent of autumn intermingled with mouthwatering Italian spice.  And Justin couldn’t have been happier…

***

Roy picked up the pay phone receiver just as he heard his name being called from somewhere around the corner.

“Roy?  Hey, Roy!”

After replacing the receiver, Roy turned to see Chet Kelly approaching at a rapid clip.

Chet stopped, slightly out of breath.  “Cap said Dwyer called off and he can’t get a replacement, so the squad will be out of service for the rest of the shift.  But, I gotta get back.  So, if you want, I can take you back now for your car.”

Roy was relieved at this news.  He knew Johnny would likely be discharged, and he hadn’t been sure how he was going to get him home, knowing there would be a protest at the suggestion of calling Hannah to come get him.  “Yeah, that’d be good.”

“How’s Johnny?”

Roy couldn’t help but smile at the other man’s obvious concern for a man he pretended so hard to despise.  “He’s fine.  Separated his shoulder.  He’ll be outta work for a few weeks, but I guess it coulda been worse.”

“Yeah…”  Chet’s voice took on the tone it harbored when he was about to weave a tale.  “From what Cap said, Gage came pretty close to falling about fifteen feet onto a solid concrete walkway.”  He shook his head.  “That woulda been bad news…”

“Yeah, Chet.  That woulda been.”  Roy started moving in the direction of the treatment room where he had left Johnny.  “I’m gonna let Johnny know I’m leaving.”

“Can I come too?”  Chet asked, reminding Roy of an eager child.

“I don’t think it’ll be a problem.”  Roy assured as he pushed open the door.  Johnny was at an incline on the table, using a hand held nebulizer while a respiratory therapist looked on.  “Hey, partner.”

Johnny acknowledged his crewmates with a wave as he sucked in another lungful of bitter steam.

“Aw, man…”  Chet commiserated.  “I hate that stuff.” 

Johnny nodded in agreement as he pulled the mouthpiece away briefly.  “Me too, but I guess it’s better than not being able to breathe.”

“Breathing is overrated.”  Roy quipped as he watched Johnny inhale another hit of the strong bronchodilator.  His remark earned him a sneer from his partner.

“Tell that to Brackett.”  Johnny commented with a cough.

“Chet’s taking me back to the station to get my car.  Then I’ll be back.  Dwyer called off and I guess Cap couldn’t get a replacement, so the squad’s out of service for the night.”

“Oh, man…”  Johnny began before inhaling through the plastic mouthpiece with a wince.  “Tell Cap I’m sorry about that.”

“I wouldn’t worry about it.”  Chet appeased.  “Not your fault Dwyer called off.”

“Did Brackett say whether he was keeping you or not?”  Roy wondered.

“As long as this…”  Johnny held up the mouthpiece in his hand.  “…does its job…he said I could go home.  I was thinking I would go up and see Justin and wait in the lounge ‘til Hannah comes in the morning.  Then, she can take me home.”

“You’re supposed to go home and rest, Johnny.”  Roy reminded.  “Besides, you heard what Andrews said.  If you go anywhere near Justin’s room for the next day or two…”

“I heard what he said, Roy.”  Johnny handed the nebulizer mouthpiece to the respiratory therapist, indicating he was finished.  “But I can rest in the lounge.  There’s a couch in there.  I’m not having Hannah come out this late to get me.”

“I figured as much.”  Roy said.  “Which is why I was planning to take you home.”

Knowing there was no use in arguing, Johnny conceded to Roy’s plan.  After all, it made sense.  “I guess that’d be okay.”

“Well, now that that’s settled, we better get going.”  Roy followed Chet to the door.  “I’ll be back in about a half hour.  Is there anything you need from the station?”

“Yeah…just grab my clothes if you don’t mind.”  Johnny cleared his throat, trying to swallow away the aftertaste of the acerbic concoction he had been forced to inhale.

“You got it.”  Roy promised.  Then, noticing the look on Johnny’s face, he added, “I’ll see if Dixie can bring you a soda or something.”

“Yeah…thanks.”  Johnny continued his grimacing.

“Take care, Gage.”  Chet said as he and Roy left the room.

***

Slightly before noon the next day, Justin was being transferred to his room on the orthopedic floor, as promised.  Todd accompanied him on the ride from the ICU.  “I arranged for a private room for you.”  The doctor informed.  “339.”

Justin gave a soft snort of contempt.  He knew damn well why Todd had chosen that room, and it had nothing to do with the view.  It was as far away from Justin’s office as could be, and still be on the floor.  “Great, Todd.  Thanks.”

Todd stood to the side as the orderlies pushed open the wooden door on the southeast end of the ward, allowing room for Justin’s gurney to enter.  Justin was both surprised and embarrassed at the scene inside.  The room had been decorated merrily with balloons and streamers in various colors, and just about every nurse, physical therapist, and miscellaneous staff member who knew and worked with Justin stood around the bed to welcome him.  While he knew he should be flattered at the gesture, every supportive and encouraging word just caused him to want to crawl under his covers and sleep until he could go home. 

After Justin was transferred to the bed, Todd shooed the last of the well meaning friends out into the hall and back to work, and helped his patient settle into his new surroundings, making sure the trapeze was adjusted correctly and the call bell, bed controls, and television remote were within reach.  He looked at his watch.  “Your lunch should be here soon, and Karen will be in at one.  How are you feeling?”

Other than feeling ridiculously exhausted from his trip up here, Justin didn’t feel too bad.  “I’m all right, I guess.”

“How’s the back?”  Todd asked as he picked up Justin’s chart.  “Karen said she stopped in last night, but you were sleeping so soundly, she didn’t want to wake you.

“Yeah, well…that’s what happens when you drug me into oblivion, Todd.  Can’t get much accomplished in the way of rehab…” Justin grumped as he grabbed firmly onto the trapeze hanging near him, as if testing its sturdiness.

“Well, technically, it wasn’t me who drugged you.”  Todd reminded, as he closed the chart.  “But, are you going to tell me you’re not feeling at least a little better after that good night’s sleep?”

Justin sighed as he gripped the bar and attempted to shift his position.  “I guess…Aah!”  He cried out as a sharp pain rippled through his ribcage and a familiar deep throbbing seemed to encompass his entire right leg.

“Breathe, Justin.”  Todd urged as he pried the bar from his patient’s white knuckled grip.

Justin hadn’t even been aware he was holding his breath.  He allowed Todd to loosen his hand and tried to settle himself, exhaling slowly and cautiously, eyes closed.  “Damn.”

Todd waited until Justin was able to focus again before meeting his eyes.  “Better?”

“Yeah…”

“What was hurting?”

“My…”  Justin shook his head.  “Dammit everything, Todd.”

“If you need some Demerol, I can…”

“No.”

“Justin…”

“I said no, Todd.”  Justin scowled.  “I just…just gimme some time to adjust here.”

Todd sighed.  “Okay.  But, if you change your mind…”

“Yeah, yeah…I know.”  Justin closed his eyes again and clutched at his sore ribs, willing them to settle down, all the while fully aware of the continued throbbing in his leg.  At least it was going away…maybe.  He felt a pillow touch the back of his hand, and he accepted it, pulling it close against his left side.  “Thanks.”  He eyed Todd somewhat begrudgingly.

“No problem.”

Both men looked up at the sound of a knock followed by the door opening a crack.  Todd walked over to see who was there.  “Well, hello.  Look who’s here.”

Justin looked over to see Camarin and Hannah entering.  While he was happy to see them, he wished he felt more up to a visit.  Still, maybe some company over whatever sludge they decided to feed him for lunch would be welcome.  Then, Karen would be in.  Justin had felt confident he could talk her into trying some toe touches with him today, but right now the only thing he wanted was a massage for his taut muscles and some strategically placed heat packs.  By that time, a much desired nap would be in order.  “Hey!”

“So how does it feel to be on the ortho floor?”  Camarin wondered as she leaned over the bedrail and planted a kiss on Justin’s parched lips.

“It’d feel better if I weren’t in the bed.”  Justin admitted, eyeing the small bag Camarin was carrying.  Then he noticed his sister, standing with one hand on her lower back.  “You look like you’re about ready to pop.”

“I feel like I’m about ready to pop.”  Hannah concurred, knowing that the change in subject was intentional.  Her brother was not one to enjoy being the center of attention.

“How’s John?”  Justin asked.

Todd had been just about ready to leave, but he decided to stick around at least long enough to find out whether Johnny was following his orders to rest.

“Well, you know him.”  Hannah smiled fondly.  “He’s grumpy, but he’s doing what he’s supposed to.  At least he better be.”  When she had left Johnny, he had been resting on the couch watching The Price is Right, his elbow propped on a pillow and his leg elevated.

“Good.”  Todd nodded.  “Looks like you’re in good hands, Justin.  I’ll be back later.”

Justin winced as another wave of pain coursed through his body and then settled.  “So, how are you two managing?  With John hurt now and…”

Justin’s apparent discomfort was not lost on Hannah and the eye contact she made with Camarin told her she was thinking the same thing.  “We’re managing fine, Justin.  We have plenty of help, don’t worry.”

“You’re my little sister.”  Justin reminded.  “It’s my job to worry.”

“And as much as I appreciate that...”  Hannah started as she lowered herself into a chair.  “I’d rather you concentrate on getting better.”

“Are you kidding me?”  Justin asked incredulously.  “It’s all I think about.  I can’t wait to get out of here.”

“Yes, I know…”  Camarin agreed.  “And as much as the girls and I miss having you around, just don’t rush it.  You’re in good hands here with Todd…and Karen.  You’ll be back on your feet in no time.”

“Yeah…” Justin sounded unconvinced.  Although he had seen Camarin every day since he’d been admitted to the hospital, the first week was mostly a blur.  Now that he was more coherent, and one step closer to being released, he realized just how anxious he was to get his life back.  Impatience gnawed inside him as the throbbing in his leg increased again.

“What’s wrong?”  Camarin’s eyes darkened in concern.

“Nothing’s wrong.”  Justin lied, knowing his fiancée could see right through him.

“Justin, if you’re in pain…”

Justin resisted the urge to snap out.  He hated feeling this on edge all the time.  Generally easy going, it was alien to him.  “I’m fine.  Just a little sore, but that’s normal.”

Camarin looked over her shoulder at Hannah, wanting her confirmation.

Hannah wasn’t sure what to say.  “It’s normal, yes.  But, Justin, if you need something, I’m sure…”

“Look, I don’t need anything.”  Justin insisted.  “Trust me.”  He reached for Camarin’s hand and latched onto it.  Then, he glanced at the sack she still held in her hand.  “What’s in the bag?”

Camarin smiled.  “Well…I figured maybe you might like something a little tastier for lunch today, so I talked to Dr. Brackett…and he said it would be okay to bring you this.”  She handed the bag to Justin, who quickly looked inside and pulled out a small plastic container holding a fresh salad and another holding a bagel with some hummus spread on it.

“Oh, man…”  Justin beamed as he eyed the appetizing food.  “Now this is exactly what I need.  This will help get me on my feet and out of here.”  He looked up at Camarin who seemed so pleased to please him.  “Thanks.”

“You’re welcome.”  Camarin leaned in for another kiss.  “Dr. Brackett said I could bring you meals.  So if you have any special requests…”

Justin spoke through a mouthful of food.  “This is great, Cam.  What would I do without you?”

Camarin laughed, so glad to be able to do this one simple thing to make Justin happy.  “Well, I’m sure Hannah or John could have seen to it that you were properly fed…”

“Yeah, but they don’t get it like you do.”  Justin said, taking another bite of salad, savoring the finely chopped fresh ingredients he knew Camarin had painstakingly prepared just for him.

“I get it.”  Hannah joked.  “I don’t like half that stuff you eat.  But, hey, if it makes you happy…”

Justin wanted to go into an explanation of why the foods he chose to eat were beneficial for good health.  But he didn’t.  It had always been fodder for joking between him and his sister.  She preferred more traditional foods, and she was an excellent cook.  That made John happy, and that was fine with him.  Still, sometimes Justin wished they understood better why he ate the way he did, and would at least make some attempt to follow suit.  It was only because he cared about them, after all.  “Hey, you know that book…”  His voice trailed off.  Justin had been thinking of a book he had which explained how the Chinese would use diet and food as part of an overall plan to heal various disorders.  But, it had surely been lost in the fire.  “Never mind.”

But Camarin knew exactly what book he was thinking about.  “I picked up another copy yesterday.  I’ve been reading it.  Do you want me to bring it in?  We can talk about what foods would be best for you to eat and what you should avoid…”

“That’d be great.”  Justin was so thankful for Camarin.  She not only understood his chosen way of life, but she seemed to embrace every new idea with openness and excitement.

“My shipment of herbs came in too.  I wanted to talk to Todd or someone about brewing you some teas, but we have to be careful with the medicines you’re taking.”

“Yeah, right.”  Justin made a mental note to start refusing his medications as soon as possible.  He knew he would get better without them, and this visit from Camarin only fueled his enthusiasm.  For the first time in days he felt optimistic about getting out of here soon.  He knew he would never be discharged until he was able to ambulate and his lungs were all but completely healed.  But, by the minute he was feeling more confident that he could get to that point soon and then finish his recuperation at home, his way, where he knew he could return to health that much faster.  After all, the rehabilitation portion of recovery was his specialty.

Justin finished his lunch and continued his visit.  Karen showed up promptly at one and it was then that the women departed with a promise to return later.  The physical therapist picked up Justin’s chart and read over it thoroughly.  “So, how are you doing, Justin?  You up for some exercises today?”

“Yeah.”  Justin replied eagerly.  “How about some toe touches?  I need to get out of this bed…”

“Whoa there…”  Karen voiced as she returned the chart.  “I think we both know you’re not quite ready for that.”

“Says who?”  Justin was not trying to be obstinate.  But he really did despise the idea of another therapist being in charge of his care.  Where did Todd get this woman anyway?

Karen sighed and moved closer.  “For one thing, your muscles are all still very weak from being stuck in bed for two weeks.”  She began folding back the blanket and sheet covering Justin’s legs.

“Which is why I need to get out of it.”  Justin reminded.  “I need to get my strength back.”

“And you also know there’s a right way and a wrong way to do it.”  Karen reminded.  “This comes first.”  She began gently moving Justin’s right leg, stopping when he cried out in pain.  “What’s wrong?”

Justin panted through the strong spasm that had just gripped the weakened muscles in his thigh and rapidly started spreading through his hip to his lower back.

“Justin?”  Her patient’s level of pain and lack of response was alarming.

“I’m fine…”  Justin chuffed.  “Just a…cramp.”

“Where?”  Karen asked, wanting to give Justin the chance to tell her, but she could see the twitching in the large muscle on top of her patient’s thigh, and her hands moved there automatically.  “Quad?”

Justin nodded, continuing to breathe rapidly through clenched teeth.  He allowed Karen’s expert hands to gently massage and stretch the seizing muscle until the worst of the pain began to dissipate.  He had to admit, she obviously knew what she was doing.

Karen continued her ministrations while quietly assessing Justin’s posture for other tell-tale clues.  “Your back too?”  At Justin’s conceding nod, she knew immediately this session was over before it had even begun.  And she knew he knew it too.  It wasn’t uncommon for a therapy session to be cancelled or cut short due to pain or muscles that simply refused to cooperate, and in those instances it was always best to treat the spasms, allow the patient to rest, and try again tomorrow.  But, Karen knew that fact would only cause frustration for this particular patient.  “Here, let’s get you on your side.”

It was a tedious and difficult process, with Justin’s muscles continuing to tighten and injured ribs that grated with every movement.  But, finally Karen was able to help him find a comfortable position on his left side.  Then, she discreetly positioned the covers to provide privacy while allowing her access to do her job.  She carefully rested her hand over Justin’s lower back and could feel the contractions beneath her palm.  “Oh yeah…you’ve got some nasty spasms going on here.”

“Tell me about it.”  Justin growled, then stifled a whimper as another strong cramp took hold.

“Okay…easy…”  Karen soothed as she began to stretch and massage, her hands seeming to find all the right places.  “This is a really bad one.  If you want, I think Todd left standing orders for some flexeril…”

“No, just…see if this works first.”  Justin didn’t want to give in and take the muscle relaxant, but at this point he wanted nothing more than for this pain to go away.  He knew Karen wouldn’t even attempt to get him on his feet while this was going on, and he cursed his body’s betrayal.

Karen continued kneading until finally she could feel Justin relaxing.  Then, she continued a bit more for good measure.  “How’s that?”

“Better…thanks.”  Justin now completely understood why every good therapy session was followed with a good massage.

“I’ll get you some heat packs.”  Karen promised.  “Sorry, but I don’t think we’re going to be able to do much more today.”

“Yeah…I know, dammit.”

“Tomorrow’s another day.  We’ll give those muscles a chance to calm down and try again.”  Karen apparently knew the importance of remaining positive and giving her patients something to look forward to.

But, unfortunately, Justin was privy to the tricks of the trade.  He knew that if he didn’t get some much needed exercise, he wouldn’t be getting on his feet.  He knew that it was protocol to wait a day after an event like this, and that any additional stress on his muscles right now would only provoke another attack.  But now he found himself questioning some of the rules.  He would never take a chance with a patient, that much was sure.  But, this was him.  And as long as he had some control over his own body, he figured he would try again later.  After all, he knew what exercises he needed to do.  He didn’t need Karen to tell him that.  “Yeah…okay.”

“I’ll be back.”  Karen assured as she left the room to retrieve the promised hot packs.  When she returned, she found Justin in the same condition she had left him in, sort of an anticipatory tension.  The cramps that had been plaguing him had calmed down, but it was as if he was afraid to move a muscle for fear they would return even stronger than before.  “Here, let’s try this.”  She said as she carefully placed one hot pack on Justin’s right leg, another on his hip, and one on his lower back, holding them in place with some strategically placed pillows.  “How’s that?  Not too hot?”

Justin was amazed at how Karen seemed to know every spot where he was hurting.  “Feels good…”  His words slurred into his pillow as the heat seemed to seep into his tired muscles, soothing even the deepest aches away.

“Think you can sleep now?”  Karen asked.  “Or do you need something?”

But there was no answer.  Justin was already snoring softly.

***

Hannah and Camarin dropped by Joanne’s to get the girls, then Hannah dropped them all off at New Horizons.  She watched as Kaya and Rose followed Camarin into the building, excitedly bombarding her with tales of their adventures at the Desotos’.  The interaction left Hannah wondering about a conversation in which Camarin had confided in her that she was not able to have children of her own, and she wondered if she had shared this information with Justin yet.  While Hannah knew Justin would be a wonderful father to Camarin’s girls, it seemed a shame he would not have children of his own.  But, Hannah knew Justin was deeply in love with Camarin, and that made her glad.  For a long time, she wondered if he had ever really gotten over Abby.  But, seeing him and Camarin together left little room for doubt about that.  She eased the Rover into gear and headed home.

Arriving at the ranch, Hannah parked the truck and slowly ascended the deck stairs, a feat that was becoming more difficult by the day.  She paused on the deck when she felt a soft flutter in her belly, followed by a well placed kick.  Smiling, her hands moved to where she had felt the tiny foot make contact.  It wouldn’t be long now until she and John would get to meet this new addition to the family.  Hannah stepped inside and deposited her keys on the hook inside the door.  “John?  I’m home.”  She called out in the direction of the living room.

When there was no answer, Hannah walked into the living room and stopped with a smile.  Johnny was in the same place she had left him, and he appeared to be sound asleep.  Happy that her husband appeared to be following doctor’s orders for a change, she softly padded over to the TV and turned it off.  Then she went back out to the kitchen to start thinking about what she would make for dinner.  She couldn’t wait to tell Johnny about her visit with Justin, encouraged that he seemed to be doing better.

***

Justin yawned and stretched, effectively placing his arm in position to wrap around Abby’s slender shoulders.  He felt her shiver slightly at his touch.  “How long will your parents be gone?”  He asked, his expression letting his girlfriend know he was happy they were alone.

“They said midnight.”  Abby answered.  She could feel her heart racing in her throat and wondered if Justin noticed.  She couldn’t believe this insanely handsome football player was interested in her.  It almost seemed too good to be true.

Justin glanced at his watch and snuggled closer, his eyes boring into Abby’s.  “It’s only ten now.  We have two hours.  What do you wanna do?”

There were a lot of things Abby could think of that the couple could do, but none seemed so enticing as continuing to cuddle on the couch like they were right now.  “I kinda like this…”

“Yeah?”  Justin feigned surprise.  “Just this?”  He caught a whiff of Abby’s perfume and could feel his body stirring in response.

“Well…”  Abby’s eyes darkened slightly.  “What else did you have in mind?”

“Oh, I don’t know…”  Justin continued to work his charm.  “I thought maybe a little of this…”  He leaned in for a kiss which Abby returned hungrily.  Feeling playful, he pulled away.  “You like that, huh?”

Abby was feeling flushed and managed a breathy, “Yeah…”

“Well, in that case, how about a little of this?”  Justin asked as he leaned in again, and this time, the innocent kissing they had often enjoyed gained momentum…

“Mmmm…”  Justin moaned.

Todd looked up from the chart he had been writing in at the foot of the bed.  Noticing his patient seemed to be waking up, he tried speaking to him.  “Justin?  Something wrong?”

“Mmmm, no….nothing’s wrong, baby.”

Todd’s eyebrows rose in surprise and amusement.  Figuring Justin was dreaming, he said nothing, and turned to go, bumping into the tray table and causing a clatter.

Startled awake by the sudden noise, Justin opened his eyes.  “Wha…Oh…hey, boss.”

“Sorry I woke you.”  Todd apologized.  “Sounded like you were having a pretty nice dream.”  He couldn’t avoid the knowing smile that curled the corners of his mouth.

“Huh?”  Justin thought for a moment, trying to grasp onto the quickly dissipating dream state he had been in before it vanished forever.  “Oh, yeah…it was a nice dream.”  Justin frowned.  While it was true that the memory of Abby was comforting and pleasant, he wondered why he was dreaming about her now.  And he couldn’t help but feel a twinge of guilt over it.

Todd looked at his watch.  “You’ve been asleep for a while.  How do you feel?”

Justin was about to say he felt fine, but stopped himself in order to take stock.  He knew Todd would see right through the automatic response.  “I’m feeling pretty good.”

Todd eyed his friend suspiciously, but there was no evidence to indicate Justin wasn’t being truthful.  “No pain?”

“A little.  Not bad though.  I’d give it a 2.”  Justin knew Todd would want a number, so he figured he’d supply it.

Todd smiled.  Leave it to Justin to make rating his pain sound like an Olympic event.  “I’ll let you rest, then.  You slept through dinner, so I’ll have someone bring you a tray.  Or, was Camarin planning on bringing you something?”

“No…when she was in earlier I told her to stay home with the girls tonight.”  Since Justin was doing better, he was starting to feel a little guilty about how much time Camarin had been spending at the hospital.  He was certain the girls had to be missing her.

“Okay, I’ll send an aide with some food, then.”  Todd promised.  “It smelled like meatloaf.”

“Oh, goodie.”  Justin quipped, then thanked his boss before he left. 

***

Several hours later, Justin lay in bed unable to sleep.  His session with Karen had gone well today, but it had ended in an argument.  Justin had tried to convince her that he was ready to try taking a few steps, that he knew his body, and felt confident it was time.  Karen, however, disagreed.  Finally Todd had been paged in order to put an end to the altercation, and he informed Justin that Karen had only been acting under his specific orders.  This did not sit well with the injured physical therapist.

Justin reached for his watch, wincing as his still tender ribs protested the change in position.  It was almost three a.m.  Todd would have gone home at least three or four hours ago.  And, the nurses on the floor had been leaving him alone for the most of the night, now that he was doing better.  He pressed the button on the bed control until he was sitting almost straight up.  Then he lowered the bed, threw back his covers, and used the side rail to help him slide down and turn until he was sitting on the edge.  The room was uncomfortably cool, and Justin was grateful for the sweatpants Camarin had brought for him and helped him put on earlier today.  He wished now, however, that he had also taken her up on her offer to help him into the T-shirt she had also brought.  Even a gown would have been welcome as being out from under the blankets was causing his bare skin to feel chilled and a deep ache to settle into his healing ribs.

Unfettered now by IV’s or a foley catheter, and armed with an inhaler to ward off any stubborn remaining bronchospasms, Justin knew the only obstacle standing in the way of his being able to go home was his ability to transfer himself to a wheelchair and take at least a few steps with a walker.  Figuring the only way to prove to Todd and Karen that he was ready was to show them, Justin decided it was time to make an attempt.

He lowered the bed some more until his left foot rested on the floor.  He was still not able to bend his right leg enough to do the same with that limb, but Justin knew that was okay.  He would pull himself up on his uninjured leg anyway.

As confident as Justin was that he would be able to cross the distance between the bed and his wheelchair, which sat only a few yards away, he knew the effort of actually getting onto his feet would be daunting due to the muscle weakness in his good leg that prolonged bed rest had left behind.  He sat perched on the edge of the bed, wishing he had a walker.  Then he got an idea.  Spying the chair by the bed, he thought if he could somehow get it just a little closer, he could turn it around and use the back of it to push himself up and help support his weight.  He reached around and found the lever for the bed rail and engaged it.  With the rail lowered, he used his arms to inch his way toward the head of the bed, his ribs and atrophied muscles groaning with the exertion.  Finally, he was able to stretch his left leg just far enough to hook the arm of the chair with his foot and pull it close to him.  By the time he had the piece of furniture in position to act as a walker, he was panting and sweating from the unaccustomed activity.

No matter.  He had come this far, and now he was committed.

***

Nurse Stephanie Morris yawned and looked at the large clock on the wall behind the nurses’ station.  It had been several hours since she had checked on Justin, so she decided to make her way down to his room to see if he needed anything.  It was a task she didn’t mind in the least as she had always had a soft spot for the handsome physical therapist.  She whistled a tune as she breezed down the hall, but she was not prepared for what she saw when she opened his door.

Justin lay on the floor, his long limbs askew, one hand gripping the wooden leg of the chair he had tried to use earlier for support.  At first, Stephanie thought her patient was unconscious, but then she heard a faint, almost inaudible moan.  She quickly knelt down at his side.  “Justin?”  She wrapped her fingers around his wrist and could feel his rapidly beating pulse.  It was then that she noticed he was shivering.  “What happened?  How did you get on the floor?” 

“I…” Justin groaned as another chill shook his body, causing the muscles around his injured ribs to spasm.  He was so cold.

“Easy…”  Stephanie soothed.  “I’m gonna get some help.”  She stood and opened the door.  Spying another nurse nearby, she called out to her.  “Hey, Mia!  Is Dr. Andrews still here?”  She remembered seeing the doctor go into his office about an hour ago after having received a last minute page to the ER at the end of his shift for a consult.

“I’m not sure, why?”  Mia approached Justin’s room curiously.

“Go check.”  Stephanie ordered.  “If he’s not here, get Borchardt.  Justin fell.”

“He what?”  Mia looked into the room to see for herself.  “How did…”

“I don’t know.  Just go!”  Stephanie watched Mia as she hurried down the hall toward Todd’s office.  Then, she turned her attention back to her patient, grabbing a blanket from the cabinet and draping it over his shivering form.  “Help’s on the way, Justin.  Where do you hurt?”

Answering that question seemed to take too much effort.  Justin was a melting pot of negative emotions.  He was angry and embarrassed…and frustrated that he probably had just set his recovery back.  He cringed at the lecture he was sure to get from Todd when he arrived in the morning.  “Jus’…help me…get…get b-back in…bed.”  He tried unsuccessfully to push himself up, for about the hundredth time since he had fallen.

Stephanie did her best to still Justin’s efforts, a feat that didn’t prove too difficult.  “I don’t think you should be trying to move.  Just relax.  I’ll be back in a minute, okay?”  She stood and retrieved a blood pressure cuff, knowing a set of vitals would be the first thing the doctor would request when he got here.

 As if on cue, Todd Andrews barged into the room, and turned on the light before kneeling at Justin’s side.  “What the hell happened?”

Justin squinted at the sudden brightness.  He had never in his life been simultaneously so glad and so loathe to see someone.  “I…I fell.”

“I can see that.”  Todd searched the room for clues.  Spying the lowered bed and side rail, the cast aside covers, and the out of place chair, it didn’t take a detective to piece together what had happened here.  He started running his skilled hands over Justin’s limbs, checking for new injuries before turning his attention to his recently repaired leg.  Todd could tell it was causing Justin a great deal of pain and his greatest fear was that the fracture had been forced out of alignment or worse yet, had re-fractured around the titanium rod he had placed.  At least the staples seemed to be intact, as there didn’t appear to be any blood on Justin’s sweatpants.  “Do you hurt anywhere besides your leg?”

Justin’s left side jagged mercilessly.  “M-my ribs…”

Todd’s hands moved immediately to Justin’s left side, where even the slightest amount of pressure proved excruciating.  “Easy…Did you hit your head?”

“No, Todd…”  Justin shifted his position, eager to get off the cold floor.  “Just…help me get back in bed.  I’ll be okay.”

Todd ignored the request and looked at Stephanie.  “Did you get vitals?”

“Yes, Doctor.  Pulse is 100 and BP is 138 over 86.”

Todd sighed.  “Call radiology and tell them to send up a portable.  And find me some orderlies to help get him back into bed.”

“Yes, Doctor.”  Stephanie hurried out of the room.

Todd grabbed two pillows from the cabinet and positioned them under Justin’s head.  “Better?”

“Yeah…”  Justin winced as the throbbing in his leg seemed to increase.

“Hurts, doesn’t it?”

“Todd…”  Justin was not in the mood for the dressing down he knew was coming.

“I’m not going to ask you what you were doing out of bed, Justin, because I already know.  I just hope you’ll believe me now when I tell you you’re not ready to be walking.”

While Justin was grateful that Todd didn’t appear angry with him, he knew he had to be frustrated.  At least he wasn’t treating him like a naughty child.  “I know…I just…I just wanna…”

“Get out of here.  Get your life back.  I get it, Justin.  But you know better than most that these things take time.  And you know that too much too soon is only going to set you back and give you the opposite of what you want.”

Justin closed his eyes, too ashamed and too frustrated to answer.  Of course Todd was right.  As the throbbing in his leg seemed to dull to a low roar, he started to become impatient.  The floor was cold, he was beyond uncomfortable, and he really wanted to get back into bed.  “Todd, I…” He shifted his weight in another attempt to sit up, which was quickly stifled.  “I really think I’m okay.  If you just help me up…I think I can…”

“I don’t want you on your feet, Justin.  At all.”  Warding off the protest he knew would be forthcoming with a simple hand gesture, he continued.  “So we’re going to wait until I have some help.  Now, if there’s anything I can do to make you more comfortable while we’re waiting…”

“I’m cold.”  Justin hated sounding so pathetic, but his ribs were killing him.  And shivering wasn’t helping the matter.

Todd started to stand.  “I’ll get you a gown.”

“There’s a shirt in the drawer there.”  Justin pointed.

Todd wanted to ask why Justin wasn’t wearing it, but he held his tongue.  Apparently his expression betrayed him, however, as Justin was able to read his thoughts.

“I wasn’t planning on…ending up...on the floor, Todd!”

“I know you weren’t.”  Todd did his best to sound patient.  He knew Justin had to be feeling pretty embarrassed right now.  He started to reach for the T-shirt but thought better of it and grabbed a gown instead.

“I have a shirt…”

“I know you do.  Humor me.”  The fact was, Todd wanted to be able to conduct a more thorough examination once Justin was in bed, and that would be easier to do with his patient in a gown.  He almost laughed out loud at the scowl that crossed Justin’s face as he helped him thread his arms through the sleeves.

“Why don’t you go home?  It’s gotta be what…five a.m. by now?”  Justin couldn’t help but feel guilty that Todd had stayed so late because of him.

Todd looked at his watch.  “Just about.”  Then he smiled to ensure Justin knew his next comment wasn’t meant to criticize.  “But, thanks to certain…non-compliant patients who don’t stay in bed…I have a little more work to do before I can leave.”

“Sorry, boss.”  Justin looked down at his lap.

“It’s okay, Justin.”  Todd assured.  “You’re not my only patient, you know.  I have some other things to catch up on too, things I was working on before this happened.  I was already here several hours late.”

“Right.”  And now I just gave you one more thing to add to the pile.

“I’m going to have Stephanie give you a shot of Demerol.  I want you to be able to rest.”

Justin wanted to protest, but he wasn’t feeling up to the discussion he knew would ensue if he refused.  And truthfully, his pain wasn’t settling like he thought it would once he was back in bed.  “Okay.”

Todd was a little surprised.  He had expected Justin to refuse, was armed with a speech explaining how his recovery might go faster if he got enough sleep and avoided unnecessary stress.  Apparently Justin was having more pain than he had admitted.  Or…he was feeling defeated and falling into a state of depression.  Time would tell.  He gave his patient and friend a thorough once over with his eyes, but came up empty.  He turned to Stephanie.  “50 milligrams IM.  See how he does on that.  I wrote orders for 25 more if he needs it.”  Then smiling at Justin, he added.  “I’ll let you decide what muscle you’d like it in.”

“Gee, thanks.”  Justin sneered as he watched Stephanie depart.  A slightly uncomfortable period of silence followed before he finally said, “Thanks, by the way.”

“For what?”  Todd wondered.

“For not lecturing me.  I know you wanted to.”

Todd sighed.  “Justin…”  Then he stopped.  “Well, maybe I did…just a little.”

“I figured as much.”  Justin shifted his position and was stopped by a sharp spasm of pain that seemed to tear through his ribs and steal his breath away. The playful banter stopped in an instant.

“Easy…”  Todd grabbed onto Justin’s hand and allowed his friend to grip firmly in return.  “Breathe, Justin.”

Stars seemed to explode in front of Justin’s clenched eyelids.  And an eternity passed before he felt like he could do what Todd had requested.  “God…”

“You won’t want to move too much for a while.  Those ribs are going to be pretty painful.”  Todd looked up at the sound of the door opening and watched as Stephanie hustled to the opposite side of the bed, syringe in hand.  “Go ahead and put it in his hip.”

Once the shot was administered, Todd continued to hold onto Justin’s hand.  “Give it about five minutes, Justin.  Then you should start feeling a lot better.”

“Yeah…okay…”  Justin couldn’t believe how much he was hurting.  He couldn’t recall too much about the first few days after the fire, but certainly his ribs hadn’t been this painful.  Certainly he would have remembered that.

“I’ll be back in to check on you before I go.”  Todd promised, then looked at Stephanie.  “Have me paged if he can’t sleep.”  He knew the nurse would see to it that Justin was well cared for.

***

Justin awoke with a start.  It only took a few seconds for him to realize what had pulled him from the much welcomed sleep he had been enjoying.  Pain.  Worse than anything he had ever imagined.  And with it the feeling that he couldn’t catch his breath.  Feeling like he was dying, and doing his best not to panic, he grasped frantically for the call button, which he had a foggy memory of Stephanie leaving within his reach.  Locating it at last, he pressed it firmly, as if he could somehow summon aid more quickly by pushing it as hard as he could.

Stephanie regarded the light above her patient’s door with concern.  Justin had been sleeping soundly when she last checked on him, and she had expected him to rest for several hours.  She stood up and started down the hall, nearly running into Todd Andrews.

“What’s up with Justin?”  The orthopod asked as he walked toward the room.  He had been on his way home when he saw the light come on.

“I don’t know.  He was sound asleep ten minutes ago.”  Stephanie followed Todd through the door.  Both were immediately concerned at what they saw.  Justin was obviously in great distress.  He was perspiring heavily, breathing fast, writhing against some unknown discomfort, and his eyes were wide with fear.

Todd grasped Justin’s wrist and found his pulse racing.  “Justin, talk to me.  Tell me what’s going on.”

“I…I don’t…”

“What hurts?”  Todd could see that Justin was registering unbelievable pain, and he was already formulating some theories.

“My…”  Justin’s whole body jerked as his pain suddenly seemed to become even more severe.  “God...that hurts…”

“What hurts?”  Todd motioned for Stephanie to hold off on obtaining a blood pressure until they knew a little more about what was going on.

Justin gasped and tried to catch his breath, but it seemed as if that was becoming more difficult by the second.  “My…back.  Under my…shoulder blade…”  He jerked again as the pain became even more intense.

Todd frowned.  Sub-scapular pain could mean a lung injury.  Or intra-abdominal bleeding.  And Justin had just re-injured his ribs.  “Left side?”

Justin nodded.

“Did this come on all of a sudden?”

“Yeah…”  Justin gasped.  “Woke me…up.”

“What kind of pain?  Sharp?  Dull?”

Justin was becoming desperate for Todd to stop asking questions and do something.  “Stab…” Another gasp.  “Stabbing.  Please, Todd…”

Todd swallowed down his own fear and emotion, willing himself to remain calm.  He knew Justin needed some relief, but he didn’t want to cut any corners.  “Does it radiate anywhere?”

Justin closed his eyes.  Another question.  Although on some level he knew they were important, he wanted to scream.  He had to think about that one, though.  This pain seemed to be all-consuming.  He nodded as his hand moved to his sternum.   “Chest…pressure…”

Todd made brief eye contact with Stephanie before planting a steadying hand on Justin’s right shoulder and asking one more question.  “Are you having trouble breathing, Justin?  Or is it just a lot of pain?”

“Can’t…breathe…”  It seemed to be getting harder by the second.  Justin felt about ready to black out.

Todd nodded knowingly.  He quickly removed his leather jacket and tossed it onto the nearby chair as he pressed the call button.  Then he addressed Stephanie, who he figured was probably jumping to the same conclusions.  “Could be a tension pneumo or he might have thrown a clot.  Get me a BP.”  He turned the oxygen on the wall to fifteen liters and placed the mask on Justin’s face, frustrated, but not surprised at his patient’s resistance.  “Hey…quit fighting me, Justin.  You need to keep this on.”  After a brief tussle, Justin seemed to tire, and he quit struggling.  Todd let go of the mask, noticing with increasing concern his friend’s grayish pallor and marked diaphoresis. 

As soon as Mia opened the door, Todd hit her with a question.  “Who’s the thoracic on call?”

“Uh…I’m not sure.”

“Well, go find out and have him paged STAT.  Then, get back here.”  Todd pulled back Justin’s covers and examined his right leg for any redness or swelling, finding none.

“BP’s 100 over 70.”  Stephanie reported.

“Damn it.”  Todd muttered, grabbing Stephanie’s stethoscope.  “Draw blood for a d-dimer.”  He listened carefully to Justin’s heart and lungs, noting a slightly erratic rhythm and noticeably diminished breath sounds on the left.  “And let’s get an EKG going.”  He began percussing the right side of Justin’s chest, then the left, noting the hyper-resonance he knew often accompanied trapped air.

Stephanie hurried to complete the ordered tasks, nearly knocking over Mia, who was entering the room with a report.

“Dr. Michelini is the thoracic on call.  But, he’s tied up down in the ER, and it’s going to take him at least fifteen minutes to get up here.”

Shit!  Todd had nearly yelled it out loud, but managed to retain his calm demeanor for Justin’s sake.  “Okay.”  He was about to tell Mia to call for a portable X-ray, but was stopped by his now-panicking patient.

“T-Todd…”  It was a struggle to get the one word out.  Justin felt like he was being suffocated and he grasped blindly, until he found Todd’s hand and latched on.

Todd noticed the tell-tale nasal flaring and accessory muscle use that accompanied severe respiratory distress.  A closer look revealed that Justin’s jugular veins were distended.  The surgeon traced the outline of Justin’s trachea with his free hand and found that it had shifted toward the right, meaning one of Justin’s fractured ribs had managed to tear a hole in his lung, and so much air had become trapped in the left side of his chest, it was pushing his heart and other internal structures over to the right side of his body.  A quick glance at the cardiac monitor showed a rate of 140 with PVC’s.  And Justin’s lips were beginning to turn blue.  There was no way he could wait for Dr. Michelini.  Todd spoke over his shoulder as he began rolling up his sleeves.  “Get me a chest tube tray.”

Mia immediately left to retrieve the requested materials.

“Looks like a tension pneumo, Justin.”  Todd explained.  “Hang in there.  I’ll take care of it.”

Stephanie locked eyes with the orthopedic surgeon.  She wondered how many chest tubes he had placed in his career, and how long it had been since he’d done one.  “Do you want some lidocaine?”

“No time.”  Justin would soon go into respiratory and cardiac arrest if he did not act now, and Todd hated that he wouldn’t be able to wait for a numbing agent to work before this procedure.  Not only that, but while placing a chest tube was a relatively simple concept for a surgeon, Todd had not placed one since his residency.  He broke out into a cold sweat.  And as he washed his hands, he checked in the mirror to make sure his face exuded the confidence he did not feel.

Mia returned with the tray and she helped Todd into a pair of surgical gloves as Stephanie removed Justin’s gown, positioned his left arm above his head, covered his left side in betadine, and draped him with sterile sheets.

Todd was fairly certain Justin was no longer coherent enough to wonder about his ability to perform this procedure and that was fine with him.  Now he could only hope the nurses didn’t notice his hand shaking as he picked up the scalpel off the tray.  He mentally reviewed the steps.  Locate the intercostal space between the 4^th and 5^th ribs…make a one inch incision…separate the tissues with a hemostat… “We ready?”  He waited until he received confirmation from Mia and Stephanie, then he made his incision, faltering only slightly at Justin’s flinch.  “Sorry, buddy.  Now comes the tough part.  Hang in there.”

Todd cursed to himself as he used the hemostat to work his way down to Justin’s rib.  There was no doubt this was causing a great deal of pain, as was evident from his patient’s squirming and tortured vocalizations which Todd found increasingly harder to tune out.  “Keep him still, damn it.”  He waited until the nurses had a good grip, then he did his best to put Justin at ease.  “I know this hurts, Justin…I’m just about there…”  Relieved that he had finally reached the pleural space, Todd applied steady, firm pressure to the hemostat, causing it to pop through the pleural lining into Justin’s chest cavity. 

The cry of agony that Justin somehow found enough breath to voice at the intrusion brought bile to the back of the orthopod’s throat.  “Okay…that’s it…”  Todd spoke soothingly as he worked quickly to insert the tube against the sudden rush of released air.  “Worst part’s over…try taking some deep breaths…”

Todd continued to work, suturing the tube in place and then wrapping some Vaseline covered gauze around it before covering it with a sterile dressing.  He was grateful that the nurses had taken over coaching Justin to take deep breaths in order to help his lung re-inflate.  Once he was finished, he peeled off his gloves, the sight of the blood saturated bed linens suddenly making him feel unsteady on his feet.  Thank God that was over.  And it appeared to have worked.  Justin’s color was improving, his heart rate was stabilizing, and he was breathing more easily.  “Get an IV started.  Normal saline.  I want him on IV levofloxacin.  And let’s get an ABG and a chest X-ray.  And change these linens.”  He leaned over his patient and scrutinized carefully.  “Justin?  Can you look at me?”

Justin’s eyes followed the sound of Todd’s voice until they rested on his face.  “Hey…”  He still felt breathless and his entire side throbbed in time to his elevated heartbeat.

“How are you feeling?”

“B-better…”  At least he no longer felt like he was dying.

“How’s the pain?”  Todd’s eyes creased in concern.  Justin’s discomfort was so tangible his own side seemed to ache.

“Hurts…”  Justin held nothing back in admitting it.  He had never experienced anything like this in his life.

“We’ll get you something for that in a minute.”  Todd promised, then looked up at the opening door.

Dr. Michelini entered in a controlled rush.  “Todd?  You paged me?”

“Yeah.  Left side tension pneumothorax.  He couldn’t wait.”  Todd indicated the chest tube.  “Not bad for an old sawbones, huh?”

“I’m impressed.”  Michelini knew the relationship between Todd and Justin and knew this procedure had to have been difficult for his colleague.  “You okay?”  He asked discreetly.

“I’m fine.  But once these nurses are finished, you could give my patient here a once over.”

“You got it.”

Todd updated Justin’s chart, then left him in the capable hands of Dr. Michelini.  He knew Justin would rest now, and he knew he should go home and get some much needed rest himself.  But even though it was irrational, Todd felt afraid to let the injured physical therapist out of his sight.  So, with explicit instructions that he not be disturbed unless it pertained to Justin, Todd retired to his office and stretched out on the couch…and tried to sleep.

***

Part 4