Justin and Camarin left Rampart around seven a.m. to pick up Tag, Kaya, and Rose and were on the way to his house in Long Beach.  Todd Andrews had spoken with the physical therapist early this morning to inform him he had the day off.  Johnny’s condition remained unchanged, and although both Justin and Camarin were hesitant to leave, they knew it was important to get Tag moved into his new temporary home, and that the girls would need to see their “mother.”

Camarin watched out the window as they made their way south from Johnny’s ranch in the Santa Monica Mountains.  The terrain reminded her of South Dakota’s Black Hills, and she wasn’t surprised this is where Johnny decided to make his home.  As the car turned onto the Pacific Coast Highway, her squeals of amazement matched those coming from the back seat.  Camarin was amazed at the endless expanse of the Pacific Ocean, and she was filled with joy that her girls were able to experience this.  Tag noted that when the Great Spirit made California, he must have wanted people to know all of his creation…from the mountains, to the sea, to the desert.  And Camarin had to agree.  To the north she could still see the towering hills where they had come from.  To the west, she looked down over the seaside cliffs at the rocky and sandy beaches below them.  To the east, she could see the outline of tall buildings standing at attention through the smog. 

“Mama…can we go out into the ocean today?”  Rose spoke from her position on Tag’s lap, her nose almost pressed against the window.

Justin smiled as he caught the sight in his rearview mirror.  “I think the water would be a little cold today.  But my house is right on the beach.  If your mama says it’s okay, you can play in the sand and maybe get your feet wet.”

“That sounds wonderful!”  Camarin was as excited about this as the children. 

They rode on amidst questions and fascinated exclamations as Justin pointed out various points of interest along the coast.  But although he was doing a good job as tour guide and hospitable host, Camarin knew his mind was on Johnny…and his sister. 

“Will Hannah be coming over later?”

Justin took a deep breath.  “I don’t know.  Roy and Jo were trying to get her to go home with them for a while and get some rest.  But, she was refusing to leave.  I can’t blame her, really…”

“No…I guess not.”

Justin turned off the highway and made his way down to a small, remote area where only a few houses stood.  His was one of them, nestled quietly into a small nook carved into a rocky outcropping.  The house was tiny compared to the sprawling mansions that had caused his passengers to “ooh and aah” as they made their way south through Pacific Palisades, but in the way of beach front property, it was what he could afford.  And, since there was only him, and he spent most of his time either out on the beach, in the water, or at the hospital, he didn’t need the space.  There were two bedrooms, enough for Tag to stay until he could get through the fire academy and start making enough money to live in an apartment somewhere.  He shifted into park, and pulled the key from the ignition.  “Well, here we are.”

“Cool, man.  You do live right on the beach.”  Tag was thrilled.  Never in his wildest imagination would he have thought he would end up here.

“Yep.”  Justin’s eyes sparkled.  “There’s nothing like falling asleep to the sound of the waves… can’t beat it.  Although, John would probably disagree.  He likes to hear the crickets and the owls…maybe the occasional coyote.”

“Nah…I think I’m gonna like it here.”  Tag looked around the property and then at Justin.  “Thanks, man.”

Justin smiled.  “Not a problem.”

As Tag and the girls raced off to explore the sand and the surf, Camarin walked more slowly beside Justin, choosing to take her time focusing on every miniscule detail of this new experience…from the salty aroma of the air, to the damp spray on her skin…to the way the sunlight danced on the tops of the waves.

Justin looked over and offered a suggestion.  “You gotta take your shoes off.”

Camarin looked down at her well worn sandals.  “What?”

“Your shoes.”  Justin bent down and removed his own sandals and tossed them aside.  “So you can feel the sand.”  He watched as Camarin followed his lead, his face beaming as he watched this grown woman experience the soft, warm feel of sand between her toes for the very first time, and he was grateful to be the one to be able to give this to her.

Camarin giggled in spite of herself, suddenly feeling younger and more alive than she had in years.  She allowed Justin to lead her down to where the water was lapping at the shore, and she shivered as the cold foam covered her feet, then looked up at him in amazement at the pulling of the undertow.  Finally, feeling exhilarated, but tired from their overnight ordeal, she and Justin sat down on the sand and watched Tag play with the girls.  “You’ll want to set some ground rules.”

“Huh?”  Justin asked the question, then realized Camarin had probably been referring to this teenager he was about to invite into his home.  “Oh…for Tag.”

Camarin was so grateful to Justin, awed that this person who she and Tag had never met, would so willingly offer to take in a young man he knew nothing about.  “Right…did John tell you anything about him?”

Justin’s expression turned to one of anger mixed with compassion.  “Yeah…he filled me in.  Told me about his father, and about the gang he hung around with.  There’s plenty of that around here too…so I just hope he keeps focused on the academy.”

“I hope so too.  Justin…Tag’s a good kid.  He really is.  He’s smart too.  A lot of people wouldn’t realize that because of his circumstances.  He has a lot of growing to do… and I think the fire academy will be good for him.  He’s really excited about it.”

“Well, that’s good then.”

“But…I think it would be a good idea to come up with some house rules…and enforce them.  You have to understand, Tag’s a good kid, but he’s used to coming and going as he pleases.  He’s not used to having to respect any kind of authority.  I’ve spoken with him, and he really appreciates what you’re offering…but, still…”

“Don’t worry, Camarin.  It will all work out.”

zzz

Hannah returned to Rampart after reluctantly agreeing to go home with the Desoto’s for a few hours.  She was left alone in the guest bedroom to get some sleep, but sleep never came as she lay expectantly waiting for the phone to ring.  Roy returned to the hospital with her, leaving Joanne at home.  Chris and Jennifer were due back from school in a little while.  The two noticed Kelly Brackett standing by the nurses’ station as soon as they exited the elevator on the ICU floor.

“Doc?”  Roy got the older man’s attention.

“Oh hi, Roy…Hannah.”  Brackett nodded to the nurse behind the desk and offered one last bit of instruction before turning to face the expectant and noticeably tired eyes of Johnny’s best friend and fiancée.  “Todd Andrews is in with Johnny right now, but he should be finished soon.”

“How is he?”  Hannah asked.

Brackett glanced briefly at Roy, his mouth folding into a thin line before making eye contact with Hannah.  He wished he had better news.  “He’s about the same.  His EKG is still unstable, and we haven’t been able to get his fever to come down.  His chest CT and echocardiogram appeared normal, but he’s still in sinus tachycardia with occasional PVC’s.  I’m certain he suffered a contusion.  On the upside, his blood pressure seems to be stabilizing slightly and his kidneys are functioning.  Bill Johnson has him scheduled for an angiogram of his leg in about…”  Brackett looked at his watch.  “Two hours.”

“Has he been awake at all?”  Memories of the days following Johnny’s hit and run still haunted Roy.  There had been a few times when Johnny awoke looking for his partner and best friend, and became very upset when he was unable to find him.

“He’s stirred a little on occasion.  Usually when his last bolus of pain meds is wearing off.  He hasn’t been communicative.”

Hannah nodded and willed back her tears, cursing her sudden emotional vulnerability.  “Thanks, Kel.”

Brackett smiled.  “You’re welcome.  Look, I’ll be downstairs if you have any other questions.  And…”  He paused while he carefully thought about his next words.  “If you want to stay with Johnny a while, I guess that would be okay.”

Roy nodded a thank you for both of them and he walked with Hannah down the hall toward Johnny’s room.  When they arrived there, they passed Heather, Johnny’s day nurse, on her way out of his cubicle.  She smiled when she saw them.  “He’s sleeping…and he seems pretty comfortable at the moment.  Go ahead in.”

Roy and Hannah entered to find Johnny in about the same position he had been in when they left early this morning.  A cooling blanket was underneath him now, and the room felt warm from the generating electricity.  The oxygen mask had been replaced by a cannula, and too-rapid blips raced across the screen of the cardiac monitor.  Hannah pulled a chair up beside the bed and prepared to use the sponge and the basin of ice water to aid in getting Johnny’s temperature down.  Roy stood at the foot of the bed.

“Hannah, if you want some time alone…”

“Roy, it’s okay.  When he wakes up he’s going to want to see you too.  Why don’t you use this chair?”  Hannah wrung out the sponge and began dabbing it over Johnny’s face and chest, being careful not to disturb the bruises or the EKG leads.

“That’s all right.  I’ll just stand for now.”  Movement from the bed caught Roy’s eye and he quickly moved to Johnny’s right side.  “Johnny?”

Hannah stopped her ministrations and waited.  When Johnny didn’t move again for several moments, she resumed her task.

Johnny felt like he was buried under layers of mud and dirt.  His limbs felt like they were made of lead and no matter how hard he tried to move them, they remained immobile.  He thought he would die of thirst, and something rubbed the back of his throat, making him feel sick.  He was hot and cold at the same time, and his heart was racing as if he had just run five miles.  Then, little by little he became aware of pain.  It started in his belly and seemed to spread downward into his groin and left hip.  His left leg seared and throbbed, while his right one ached horribly from hip to toes.  He wondered if he had been in a building collapse and his lower body was pinned beneath a piece of concrete.  But, the pain that began building in his chest negated that assumption.  It felt as though something heavy was resting there, the pressure squeezing his lungs.  He tried raising his arms to move it away, but they wouldn’t budge.  Where was Roy?  Had he been in the collapse too?  Or was he looking for him?  A faint moan escaped his cracked lips.

Hannah’s hand immediately moved to Johnny’s forehead, and she leaned close.  “John?  It’s all right.  Don’t try to move.”

Johnny’s brow knitted in confusion.  Was that Hannah?  What was she doing here?  He licked at his lips and tried to speak, but no words would come.

Roy picked up the small cup of water that sat beside the bed and held the straw to Johnny’s lips.  At first he didn’t seem to know what to do with it, but then finally his mouth closed around it and he drew in one sip, then another, until Roy took the cup away.  “That’s enough for now, Johnny.”  He glanced at the cardiac monitor and could see the rate increasing.  Placing a hand on Johnny’s arm, he soothed.  “Easy now.”

There he was.  That was Roy, and if he was here, then the rest of the guys would be too.  They would help him.  Johnny moaned again as another spasm of pain hit, and again he tried to speak.  This time he found his tongue felt like it was three times the size of his mouth, but he was able to croak out one word.  “Roy.”

Roy’s eyes connected with Hannah’s.  “Yeah, it’s me.  Hannah’s here too, Johnny.  Why don’t you try to open your eyes for a minute?”

What Roy suggested seemed almost impossible.  But, maybe if he opened his eyes, he might be able to figure out where he was.  Laboriously, he lifted his weighted lids and squinted against the watery blur. 

Hannah smiled as she felt a thousand pounds lifted from her shoulders.  “There you are.  How are you feeling?”

Johnny’s respirations quickened as his pain level increased.  He realized now he was at Rampart… but why?  What happened?  Then, memories of his accident came crashing in like an overpowering wave.  He lost his brakes…they had trouble getting him out…they had to… Johnny’s eyes widened in panic as he remembered Roy telling him they would need to amputate his leg in order to extricate him.  He swallowed hard and gagged against the NG tube.  His leg…if he was here at Rampart, then that meant…he tried to lift his head to see, but the attempt sent a bolt of agony through his skull.  He tried moving his left hand down next…to check…but he couldn’t gather enough steam.  It took all the strength he had in him to voice one word…his eyes locked on Hannah for answers.  “Leg…”

Hannah misinterpreted Johnny’s distress as being from pain alone.  “It’s all right, honey.  I’ll get the nurse…”

But, Roy knew what the fear in Johnny’s eyes indicated.  He had seen it before…in the car last night.  He reached across and gripped his friend’s left hand with his right, and placed a steadying hand on Johnny’s right shoulder, carefully avoiding the central line.  He leaned over and made eye contact.  “Johnny, look at me.  Look at me, John.”  He waited until Johnny’s drug hazed eyes locked on his own.  “Your leg is fine.  We didn’t have to take it.  It’s still there, see?”  Roy moved a hand to Johnny’s left calf and touched it gently.  “Feel that?”  He waited again until he saw his friend’s subtle nod and exhaled loudly when Johnny’s eyes closed in relief, a single tear tracking down his cheek.  “You’ve had surgery, and I know it hurts.  But, it’s okay.”

Tears fell from Hannah’s eyes.  She was so grateful for Roy and acknowledged it with a simple thanks.  When Johnny’s breathing quickened again, and he began moaning almost continuously, she picked up the hand Roy had just let go of.  “What is it, John?  What hurts?”

Roy pressed the call button and stood aside, waiting with Hannah for Johnny’s response.

At the sound of Hannah’s voice, Johnny again opened his eyes to half mast and searched for her.  He wanted to tell her what was hurting him, but it was everywhere at once, and his mouth wouldn’t work to form the sentences he needed to say.  His eyes closed again as his whole body shuddered, causing him to cry out weakly.

Hannah tightened her grip on Johnny’s hand and rested a firm hand on his forehead.  “You’re probably hurting all over, aren’t you?”  She watched him tense his jaw and offer a slight nod.

When Heather entered, she was carrying a syringe.  She moved quickly to the side of the bed, and Roy stepped out of the way.

“He just started coming around.  Talked to us a little, but he’s having a lot of pain.”

“Yes, I can see that.”  Heather guided the syringe into an open port and spoke in nurturing tones.  “Just hang in there a minute, John.  This will make you feel better.”  After the narcotic had been injected and Johnny settled back into sleep, Heather addressed the others.  “What did he say?  Did he seem oriented?”

Roy rubbed the back of his neck.  “It’s hard to say, really.  He knew us, I think.  And he seemed to know where he was.  He was afraid that his leg…”  Roy allowed his voice to trail off, hoping Heather would get his meaning.  He really didn’t want to revisit that again.

“Well, that’s understandable.  I just need to get his temp and a quick vitals check.  Then, I’ll have Dr. Brackett paged.”  Heather began pulling the curtain closed around Johnny’s bed.

Roy and Hannah stepped out for a moment, even though Heather hadn’t asked them to, and they stood together in the hallway.  Roy noticed Hannah had her arms wrapped protectively around herself.  He leaned down slightly, into her field of vision.  “Hey, it’s all right.  That was a good thing.  It means he remembers the accident.”

Hannah turned her face aside and wiped at her eyes with a tissue she had drawn from the pocket of her jeans.  “I know…it’s just…seeing him in that much pain…”

“I know…”  Roy wrapped his arms around Hannah, doing his best to provide the strength she needed.  Johnny’s screams from the night before as they were extricating him still echoed in his ears, and he closed his eyes tightly as if that would block them.  “I know…”

zzz

A while later, Kelly Brackett entered the lounge where Roy and Hannah were waiting.  They had been joined by Hank Stanley and Chet Kelly, who were both hoping for a chance to see their injured friend.  The doctor nodded to the group of concerned faces, poured himself a cup of coffee, and took a seat on one of the vinyl chairs.  “Johnny’s fever has come down slightly and he’s showing more signs of awareness.  He knows where he is and what happened to him.  And, he’s very concerned about the injury to his leg, which I expected.”

“Well what about his leg, Doc?”  Cap shifted his position in his chair, stretching his long legs out in front of him.  “I mean, from what Roy said, there’s still a possibility he could lose it.”

“Hank, there are a host of complications that could occur with an injury such as this.  It’s just too early to know anything for sure.  Bill Johnson is going to be taking him downstairs for an angiogram of his leg soon, to make sure the repairs he did were effective and that the blood is circulating the way it should be.  For now, there are no signs of infection and Johnny appears to have movement and sensation in his toes, which is a good sign.  Todd Andrews will be able to conduct a more extensive evaluation once Johnny’s a little more coherent.  Right now, between the trauma he sustained, and the fever…not to mention the fact that we’ve had to keep him pretty sedated due to the injury to his heart, it’s really too soon to know exactly how well he will recover.”

Chet moved closer to the doctor from his position near the window and he stuffed his hands into his jeans pockets nervously.  “But, he will recover.  Right, Doc?  I mean what’s the deal with his heart…what about that?”

Roy craned his neck around so that he could answer his crew mate’s question.  “It’s like I told you already, Chet.  Johnny’s heart is bruised, and because of that, it’s not working effectively.”

“That’s right.”  Kel agreed with a distinctive twitch.  “Johnny’s heart is still beating too fast, and occasionally irregular.  I have him on medications to try to control that, but so far, he’s not responding very well to them.  Being injured and in the ICU is very stressful, and no matter how hard we try to address that, it’s still a factor.  It’s also possible he could get worse.  Sometimes we don’t see the full extent of this type of injury for several days, or even weeks.  I’ve asked Dr. Manning from cardiology to consult with me on this, but unfortunately, there isn’t a lot more that can be done.  The injury just needs time to heal.”

Cap could see that Brackett’s explanation did not sit well with Chet.  And he wasn’t feeling very comfortable with it himself.  “And, what if it does get worse?”

“There are other things we can try, Hank.  Like an external pacemaker, for example.  But let’s wait and cross that bridge if we have to.  It hasn’t even been twenty four hours, and honestly…Johnny’s doing remarkably well, all things considered.”  Brackett watched as his words sank in, then he offered something else.  “Hank, Chet…if you would like to see Johnny for a bit, I’ll allow that.  Just keep in mind that it’s imperative he remain as calm as possible.  So, no more than a couple minutes, all right?”

“Right.”  Cap answered for both men.

Brackett left the room, and then Hannah, who had been quiet, allowing Johnny’s friends the time they needed with his doctor, spoke up.  “Why don’t you two go on down now and see John?  Roy and I were with him earlier.”

Chet waited while Cap stood, and he walked over to where Hannah and Roy were sitting.  “So, is it okay if we talk to him?”

A small smile crossed Hannah’s tired features.  “Sure it is, Chet.  Just try not to startle him.  He’s probably going to be asleep, so try not to wake him.  But, if he wakes up, by all means, let him know you’re there.”

Cap crossed the room and stood behind Hannah’s chair, placing his hands gently on her shoulders.  “How are you holding up?”

Hannah leaned her head back.  “I’m doing okay.”

Cap looked at Roy, as if he wanted his assessment.

“She’s doing all right, Cap.”

Keeping his hands on Hannah’s shoulders, Cap continued.  “Well if you need anything, let me know.  Marie and I will help in any way we can.”

Hannah reached behind her and grasped onto Cap’s hand.  “Thanks.”  Then, she let go and turned around in her chair to face him.  “There is one thing…”

“What’s that?”

Hannah looked down, faltering slightly.  She felt uncomfortable broaching this subject.  “Well…it’s just that…well, I know John’s going to be concerned about this…he’s been away from work a long time already…and…”

Cap knelt down so that he was eye to eye with Johnny’s concerned fiancée.  “Don’t worry about that.  I’ve already talked to the chief.  John will need to recertify as a paramedic in order to come back to work in that capacity, and of course, he’ll have to demonstrate that he can handle the physical aspects of the job…but the department will hold his position.  You can count on that.”

Hannah breathed a sigh of relief, but there was something else.  “Thanks, Hank.  But…maybe this is expecting too much…”  She watched Hank’s expression and found nothing but encouragement there.  “I suppose I should be satisfied that the department will guarantee him a position, but…well…you guys are all like family to him…”

 

Cap’s expression turned to one of deep understanding.  “And you’re worried that he might not be able to return to 51’s.”

“Yes, I am.  And I know it will be on John’s mind too.”

“Tell her about Billy.”  Chet was not about to admit that he had spoken to the young paramedic the day before and that together they had come up with a plan to hold Johnny’s place at Station 51 until he could return.  But, he didn’t want Hannah or Johnny to have to fret over this.

Cap held up a settling hand.  “I’m getting to that, Chet.”  Turning his attention back to Hannah, he thought of the conversation he had with Billy yesterday.  This was almost immediately after he had seen him and Chet secretly conversing in the locker room, and he had a hunch it was Kelly who had come up with the plan.  But, he knew the man would deny it.  “One of our newer paramedics, Billy Hanks, is still waiting for a permanent station assignment.  Right now, he floats from station to station filling in where he’s needed.  He’s agreed to fill John’s position at 51’s until John can return, and then if there’s another open position, he’ll transfer.  If not, he’s agreed to go back to floating until one opens up.”  Cap watched from the corner of his eye the surprised expression of relief that lit on Roy’s face at this news.

Tears fell again as Hannah was reminded of the almost overwhelming generosity of these men.  “Oh, John won’t want him to do that…”

“Well, he won’t have a choice, because it’s already a done deal.  Just cleared it with the chief this morning.”  Hank smiled, remembering the conversation.  The deal had been that if Johnny wasn’t able to return, that Billy would have a permanent spot with the 51 family.  But, he wasn’t about to tell anyone else that.

Hannah stood and faced her fiancé’s captain and friend.  “Thank you.”

Cap moved closer and wrapped his arms around Hannah in a fatherly gesture.  “Don’t mention it.”  Then, straightening, he turned to Chet.  “Well, I guess if we’re going to go see John, we better get a move on.”

“Right, Cap.”  Chet said, as he followed Hank out of the room.

zzz

Chet Kelly followed his captain into the dimly lit room more than a little concerned about what he would find there.  His thoughts trailed back to the tense days following Johnny’s hit and run and the assault he suffered a year later.  It seemed impossible to think that he was here again…wondering whether Johnny would survive the night, this man who, in spite of the endless teasing and bantering they inflicted upon one another, he considered his closest friend.  The peaceful hissing of the oxygen combined with the rapid bleeping of the cardiac monitor, and Chet wondered for a moment why they didn’t turn down the sound.  After all, he was no paramedic, and the too fast rate made his muscles tense.  He couldn’t understand the logic behind supplying Johnny with this constant reminder that his heart was working too hard.  He kept his place behind the tall frame of his superior as the pair approached the bed.

Hank took a moment to absorb the condition of his young friend.  He tried to get past all of the tubes and wires and various medical paraphernalia in order to decipher for himself whether Johnny looked better or worse than he had when they had pulled him out of the mangled Rover last evening.  While he supposed he would have to admit he looked improved, despite the massive bruising that now marked Johnny’s pale form, Cap had his own opinions on the matter.  The truth was, he hated hospitals.  He had since he had spent countless hours at his father’s bedside watching him die from complications that resulted from a vehicle accident much like this one…a fate that could have been avoided if the fire department had been able to extricate him sooner.  Hank had been a junior in high school then with grand dreams of becoming a writer.  A year later, he signed up for the fire academy.  He sighed at the memory and rested his hand on the bed rail.  Sorry, pal…

Chet looked up at Cap’s face and noticed the guilt immediately.  It was the same look he had seen on Roy’s face too many times, and he knew his captain was thinking what they all were.  Surely, there had to have been something they missed…some way they could have gotten Johnny out sooner, and he knew as incident commander, Cap would be taking it especially hard.  Chet cleared his throat and offered a diversion.  “He looks pretty comfortable, don’t you think, Cap?”

An image of Johnny screaming in agony, his entire body shaking uncontrollably as he begged his crewmates for help flashed and disappeared.  “Yeah…he does now.”

Both men were slightly surprised by movement on the bed.  They had been told that Johnny would probably sleep through their visit, and they had been down this road with him enough in the past to know that if he was waking, it was probably due to pain or some similar discomfort.  Cap reactively reached for Johnny’s grasping hand and stilled its movement.  “John?  What’s going on, pal?”

Johnny recognized the voice of his captain immediately.  And he took the same comfort in his presence now as he did when he saw him controlling the scene last night.  Although he didn’t remember much about the accident, he remembered knowing that Cap would make sure he left no stone unturned when it came to getting him out of his Rover alive.  Johnny licked at his dry lips, and swallowed carefully around the tube in the back of his throat.  He did not feel he had the strength to open his eyes, so he left them closed.  “Cap?”  Johnny rasped, the effort of talking causing a dry cough that resulted in a sharp pain in the center of his chest. 

“Easy…”  Cap cringed and allowed Johnny to clasp his hand tightly.  When the coughing spell had passed, Cap motioned for Chet to get the cup of water that sat on the nearby table.  “Do you want some water?”

Johnny did not acknowledge the question and Cap couldn’t be sure if it was because he didn’t understand it or if he simply wasn’t thirsty.  “Chest…hurts…”

 “I’m not surprised, pal.  You’ve got one hell of a bruise there.”  Cap reached over and pressed the call button.

Johnny tried to sort out his various discomforts, but the effort made his head hurt.  His neck felt stiff and he ached all over.  And for some reason he couldn’t quite figure, he didn’t think it was all a result of his accident.  He felt cold and wondered why he wasn’t dressed in a gown.  “Water…”

Chet, who had been waiting cup in hand, placed the straw to Johnny’s lips.  After his injured friend had greedily accepted a few sips, he watched as his eyes fluttered open and he blinked in confusion.

“Ch-Chet?”  Johnny shuddered, then gasped at the pain it caused.  He felt breathless, as if he

needed to take some extra breaths to get some air into his lungs.  But trying only brought on another round of dry coughs, and he squeezed his eyes shut again.

“In the flesh.  Thought I’d stop in and see ya, since you messed up my plans for a welcome back party tomorrow.”

Johnny tried to smile, knowing this was Chet’s way of telling him he cared.  “S-sorry…”

Chet smiled and rested a hand on Johnny’s arm.  “Well, it’s not a total loss.  I already froze the cake.  We’ll just wait and have it when you get back.”

“That’s right,” Cap agreed.  He wondered if Johnny had any idea that it was Chet’s determination that led to the break they needed to avoid amputating his leg last night.  Figuring he probably didn’t, but was not coherent enough to remember much, he made a mental note to make sure he informed him later…even if it would blow the phantom’s cover.

At that moment a nurse entered, looking slightly harried.  She scowled at the two men, wondering who had let them in here and why as she moved to assess her patient.  “Tell me what’s wrong, John.”

Chet opened his mouth to speak, but was quieted by Cap who figured that if this nurse saw two people in the room and was still asking her patient questions, she probably wanted to hear from him.  When there was no response, and she finally turned an inquiring eye toward him, Cap volunteered what he knew.  “He’s been coughing and he complained of pain in his chest.”

The nurse frowned at that information as she thanked Cap for supplying it.  “I’ll need the two of you to step out now, please.  Go to the desk and ask for Dr. Brackett to be paged.”  Turning back to her patient, she began collecting vitals.  “Are you having trouble breathing, John?”

“A…a little.”  Johnny couldn’t quite describe what he was feeling.  His heart was racing and his chest felt like it was being squeezed.

“Well, try to relax.  Dr. Brackett will be here in a minute.”

Almost as if summoned, Kelly Brackett entered the room, pulling his stethoscope out of his lab coat pocket and placing it around his neck in one fluid motion.  “Fill me in.”

“He’s developed a cough and is complaining of chest pain.  His BP dropped a little.  It’s down to 102 over 76.”

Brackett leaned over his patient and listened to his heart and lungs.  Straightening, he frowned in apparent confusion.  “I don’t hear any rales or wheezing.  What kind of cough is it?”

Before the nurse could respond Johnny began coughing weakly again, this time lifting his heavy right arm and trying to brace his injured chest.  Brackett placed a hand over the splinted and swollen fingers.  “Take it easy, Johnny.”  He looked up at the cardiac monitor and watched it closely for any changes.  Satisfied there were none, he turned back to his patient.  “Johnny, we’re going to get a chest X-ray and some more labs.  I don’t think this is pneumonia, but rather a result of whatever virus you’re dealing with.  Your chest pain is a result of your injuries, I believe.  Still, I’m going to have someone from respiratory come in after your angiogram.  You need to start taking some deeper breaths and clearing your lungs.”

As bad as Johnny felt, he didn’t even want to think about someone tapping on his chest and ordering him to cough right now.  “No…”

Brackett twitched in sympathy.  “We’ll keep doing everything we can to make you as comfortable as possible, Johnny.  And by all means, let us know what you’re feeling, okay?”

Johnny nodded almost imperceptibly. 

Brackett gave Johnny’s arm a squeeze as the nurse drew blood for the requested labs.  “Hang in there.  I’ll be back soon.”

zzz

Dr. Brackett entered the small ICU waiting area with a heavy heart.  This was the part of his job that he disliked the most…having to talk to worried family members and friends when the news wasn’t good.  The fact that this patient and the people waiting for news were also friends of his, made things that much more difficult.  He declined Roy’s offer of a seat and a cup of coffee, because he knew he needed to get back to Johnny soon.  “I’m not sure exactly what’s going on with Johnny at this point.  It may be nothing new, but we’ll continue to monitor him very closely over the next few hours.”

Hannah’s voice was tinged with the strain of the past day.  “Hank said he was coughing a lot.”

“He is, but it’s a non productive cough.  His lung sounds are normal.  Dr. Greenberg mentioned that a few of his patients also have coughs, so maybe Johnny hasn’t dodged that bullet just yet.  His chest pain is due to the trauma he sustained, I’m sure.  There were no changes on his EKG.  But, again, we’ll be keeping a close eye on him.”  Brackett looked around the room at the concerned faces, wishing he had more encouraging news.  “Try to remember, Johnny’s injuries are very serious.  It’s nothing short of a miracle that he’s still alive right now.  It’s only been twenty four hours.”

Hannah recognized the subtle phrasing.  It was the same technique she used when she was about to recommend to a client that their beloved pet be euthanized.  She shuddered at the thought.  “He might not make it.”  It was a statement, not a question.

“Hannah, he didn’t say…”  Roy’s intervention was as much for his own benefit as Hannah’s.

“He didn’t have to, Roy.”  Hannah turned back toward the doctor.  “It’s written all over his face.”

Brackett took a moment to collect himself.  He hadn’t meant to be so obvious, but the fact was, he was worried.  And these people deserved the truth.  “You’re right.  The fact is, I’m concerned about Johnny too.  He’s a good man and a good friend.”  He looked around the room, waiting for any response from the others.  Chet Kelly sat nervously bouncing a knee while he stared at the floor.  Hank Stanley leaned back in his chair, his mouth drawn into a thin line, his eyes reflecting his frustration.  Roy sat next to Hannah, the fear on his own face evident despite his attempts to calm her.  The doctor sighed.  “Johnny’s BP started dropping again.  It’s possible there’s some internal bleeding somewhere.”

Hank posed the question that Roy and Hannah were dreading.  “More surgery?”

Brackett didn’t respond, but instead watched as Hannah’s hand went to her eyes and Roy snugged his arm around her.  He knew the two of them already were aware of the implications of this news.  “Yes, Hank.  That would mean more surgery.  But…”

“He wouldn’t survive it.”  All eyes turned toward the sound of Hannah’s resolute words.  There was nothing more to be said.

“I’m sorry.”  Was Brackett’s only response. 

zzz

A few hours later, Justin arrived to find Hannah sitting next to Johnny’s bed.  He left Tag at home and dropped Camarin and the girls off at the ranch.  Roy and the others had already gone home for the night.  He stopped for a moment to smile at his sister before moving his eyes to the bed.  Johnny appeared to be sleeping restlessly, his unnaturally pale skin covered in a fine sheen of perspiration.

Hannah motioned toward the chart hanging at the foot of the bed.  She wanted Justin to know that Johnny seemed to be taking a turn for the worse, but she did not want to discuss his condition too loudly for fear that Johnny would hear her.  She wasn’t sure exactly how much he was capable of understanding at this point, but she was determined to take no chances.  She had already decided she wasn’t going to accept anything less than a full recovery and she expected the same from John.

Justin flipped open the chart and read it carefully.  Years spent deciphering the hieroglyphics and abbreviations allowed the physical therapist to understand Hannah’s discretion.  Johnny’s blood pressure had continued to drop, but so far his labs didn’t indicate uncontrolled bleeding.  He returned the chart to its cradle and moved to the side of the bed opposite Hannah.  His question was directed at his sister.  “How are you holding up?  You look tired.”

“I am tired.  But, I can’t leave, Justin.”  Hannah lightly rubbed the top of Johnny’s hand.  She forced a half smile.  “His temp dropped another degree.”

A lump formed in Justin’s throat.  Leave it to Hannah to focus on whatever positives she could.  “That’s good.”  Justin looked down at the activity on the bed.  Johnny’s breathing and heart rate quickened as he started coming back up from his drug induced sleep.  He rested his hand on Johnny’s forearm, careful to avoid the swollen and splinted hand.  “Easy, John.”

Johnny awoke with a start.  He was no longer aware of time passing and had no idea how long it had been since Hannah and Roy were here.  There was a heaviness in his chest that seemed to be preventing him from taking a breath.  He had a slight memory of someone standing by the bed encouraging him to breathe deeply, insisting that pain was the only thing standing in his way.  He had wanted to yell at that person and tell him that he was trying as hard as he could, but something was preventing him from getting enough air.  Then, Brackett was back, and Johnny wanted to ask him a thousand questions about what was causing him to hurt so much, and what his prognosis was, but he couldn’t get the words out.  To Johnny, it seemed the most helpless feeling in the world…to know in your soul that something seemed seriously wrong and not be able to communicate it.  He allowed his eyes to focus on the figure standing beside the bed, and finally recognized Justin.  He instinctively raised his right hand, the splints making it feel awkward and clumsy.

Justin quickly stopped Johnny’s movement and gently returned the hand to the pillow it had been resting on.  “Good to see you.”

It was then that Johnny became aware of warmth covering his other hand.  Next he felt a soothing caress on his arm at precisely the same moment a familiar herbal scent wafted toward his nostrils.  He tried to allow himself a deeper breath in order to savor the comforting aroma, and was quickly rewarded with another painful round of coughing. 

Hannah rose to her feet, having grown accustomed to this routine.  She held a cool washcloth to Johnny’s forehead and grasped his good hand tightly while talking to him in encouraging tones until the spell had passed, and Johnny lay moaning hoarsely, trying to catch his breath.

“Han…”  Johnny tried to speak, but only succeeded in bringing forth another series of painful hacks. 

“Shh…don’t try to talk now.  I’m here.”  Hannah grasped Johnny’s hand a bit tighter as she watched Justin reach for a cup of water.  “Do you want a drink?”

Johnny shook his head no as he struggled to slow his breathing down.  It wasn’t working, and it frustrated him.  Finally, he sunk back into the pillows, willing the sharp pains in his chest to subside.  After a few moments, he looked up at Hannah with guilt evident in his glazed brown eyes.  “S-sorry…”

Hannah looked across the bed at Justin, confused as to why Johnny was apologizing, then back down at her fiancé, as she willed her demeanor to remain strong.  “You have nothing to be sorry for.”

Johnny resisted the urge to pound his injured hand on the pillow in frustration.  How could Hannah not see?  He had screwed up everything.  He should have gotten the brakes checked at a garage on the way home from the reservation.  She had been looking forward to the wedding of her dreams, and his irresponsibility had changed everything.  On top of that, she had him to worry about, and as much as he was glad to have someone who loved him, he didn’t want her to have to fret over him.  “Wedding…”

Hannah’s heart was a jumble of emotions.  Anger was there, despite her efforts to push it back…anger at the situation, the fates that allowed this to happen.  And anger that Johnny felt responsible for it.  Of course there was disappointment and worry crowding in, mixed with a little guilt of her own.  She had been determined to put up a strong façade for Johnny’s sake, but hearing him now, blaming himself, thinking that he had somehow disappointed her, threatened to cause her carefully constructed wall to crumble.  She leaned close to his ear.  “Now you listen to me, John Gage.  Don’t you worry about that.  We are going to get married, just as soon as you’re better.  Do you understand me?”

A single tear fell from the corner of Johnny’s eye and he closed them.

“John?”

Johnny nodded as much as the NG tube and his stiff neck would allow.

Hannah leaned over and gently brushed his bangs back away from his forehead before delivering a tender kiss there.  Straightening up, she winked at Justin, trying to lighten the mood.  “And I’m going to count on my brother here to have you up and around in time that my dress will still fit me.”

It took a moment for Johnny to process what Hannah had just said.  Something about her dress not fitting.  At first, he dismissed it, his fuzzy brain not allowing full comprehension, but something about the statement didn’t make sense.  He opened his eyes again and found her smiling face.  “Huh?”

It had not escaped Hannah’s notice that during the brief moments of lucidity that she had shared with Johnny since the accident, the subject of their baby had not come up.  She wasn’t sure if bringing it up now was the thing to do, but finally decided giving Johnny one more thing to look forward to could not possibly be a bad thing.  “Roy said he told you last night in the car, but you probably don’t remember.”  Hannah waited a few seconds for Johnny to indicate whether he did.  “I’m pregnant, John.  We’re going to have a baby.”

Johnny’s face broke out into a smile that seemed to leech all of the tension and fear from the room.  “Thought I...dreaming.”

Hannah and Justin could not help laughing out loud.  Hannah rested a hand on Johnny’s cheek.  “No, honey.  You weren’t dreaming.  It’s true.”

Johnny swallowed as a wave of pain threatened to spoil this moment for him.  “When…”

“How does December sound?”

Johnny closed his eyes, trying to comprehend the unbelievable idea that he was going to be a father.  But, his joy quickly turned to apprehension.  Hannah was pregnant, and here she was sitting with him.  When was the last time she had eaten?  How much sleep would she be getting?  Would she try to do too much around the ranch?  Oh my God…what if the brakes failed an hour later and Hannah had been in the car?  What if something had happened to her or the baby?  As guilt and worry trampled through his soul, tension gave way to pain.  It was everywhere, and his breathing quickened along with the blips coming from the cardiac monitor.

Alarm bells went off in Justin’s head and he grasped Johnny’s forearm in response.  “What is it, John?  Something hurt?”

Johnny’s jaw tensed as he gritted his teeth.  He did not want to be drugged again.  He already felt nauseous and hazy from the continuous supply of morphine he was receiving.  “”M okay…”

Justin’s hand sat poised over the call button.  “Do you want me to get the nurse?”

Johnny willed his breathing to slow, but he was finding it increasingly harder to do.  He opened his eyes and looked up at Justin’s concerned face.  “No…”

Justin waited for a moment, determined that if Johnny gave him any reason to override his decision he would have a nurse in here immediately.  But, after a few seconds, Johnny seemed to calm slightly.  Still there was something not right.  “Is there anything I can do, John?  To make you more comfortable?”

Johnny couldn’t think of anything Justin could do, but as pain swelled in his leg, he remembered how close he had come to losing it.  “Leg…”  It was all he could manage, and he hoped Justin would understand what he needed to know.

“Your leg hurts?”  Justin’s hands were immediately reaching and Johnny could feel Hannah’s light touch on the pillows near his hip.

Damn it!  Frustration welled up as Johnny struggled to make himself understood.  He shook his head and hissed at the pain it caused in his neck.  “No…”  The truth was, it did hurt.  But that wasn’t what Johnny wanted to say.  He cursed his inability to communicate.

Previous experience as Johnny’s physical therapist, working with him through various injuries, allowed Justin insight into what was likely on his friend’s mind.  His expression told Hannah that he had it figured out as he leaned in closer to Johnny.  “You just had an angiogram a few hours ago.  Everything looked good.  Todd said the hardware he put in after your hip injury probably saved your leg.”  Justin did not want to fill Johnny with false hope, but he hoped his words would satisfy him for now.  He breathed a sigh of relief when Johnny again closed his eyes and seemed to relax slightly.  But there was still something not right.  Something about the way he was breathing.  “John?  You okay?”

All of a sudden, Johnny was overcome by an incredible feeling of exhaustion.  “Tired…”

“I’m sure you are, John.”  Hannah soothed.  “Why don’t you try to get some rest now…”  Hannah’s words were cut off by the squealing of the cardiac monitor and intense pain in her hand as Johnny’s fingers grasped tightly.  “John?   What is it, John?”

Justin took one look at the racing pattern on the monitor and the pain evident on Johnny’s face, and decided to forgo the call button, deciding instead on a more direct approach.  Moving quickly into the hall, he called out to whoever was within earshot.  “Hey!  We need some help in here!”  He moved back to the bed in time to hear Johnny’s attempts at letting Hannah know what was wrong.  His fear was evident, and his eyes betrayed a feeling of impending doom.  Justin shivered.

“Ch-chest…c-can’t…breathe…”

Justin turned the oxygen up to high flow and grabbed the mask off the wall and fumbled with it, cursing his clumsiness.  He removed Johnny’s nasal cannula and tossed it aside, replacing it with the mask.  Hannah had to restrain Johnny’s flailing arms so he could secure it.  “John, come on now.  This will help.”

Johnny tossed his head from side to side, the pain in the center of his chest usurping anything he might have felt in his neck.  “No…can’t…”

Justin held the mask firmly in place and encouraged his friend to take some deep breaths, but Johnny continued to shake his head.  Hannah leaned closer and tried to get Johnny’s attention.  “John, come on now.  It’s me.  You need to calm down.  Use the oxygen.”  Hannah’s eyes grew wide and she stepped back abruptly.  “Justin, his neck veins are distended.”

“Where the hell is that nurse?”  Justin stormed out and almost knocked over the petite night nurse who had been hurrying toward the room.  She took one look at Johnny and the cardiac monitor and asked Justin to have Dr. Manning, the cardiologist, paged.  Moving toward her patient, she pulled the blood pressure cuff off of the wall.  “You’ll have to leave now.”

Hannah moved out of the nurse’s way, but she stood her ground.  “I’m his fiancée.”

The nurse softened, deciding that if Dr. Manning wanted Hannah out, he would take care of it later.  She quickly pumped up the blood pressure cuff and frowned.  “John?  Can you hear me?”

Johnny could hear his name being called but couldn’t get enough breath to answer.  He thought for sure he was going to die, as the pain in his chest became unbearable and he was slowly suffocated.  He felt himself floating away and he wondered where Hannah was.  Was she still here?

Justin returned and stood by Hannah’s side, holding her hand tightly in his as they watched from the foot of the bed.  He picked up the chart and handed it to the nurse then looked over as Dr. Manning strode into the room.  He was fiftyish and very tall, his size and deep voice making him seem almost intimidating.  Moving toward the bed, he asked the nurse for details while taking in the appearance of his struggling patient.

“BP is down to 72 over 54.  Rate’s up over 140.  Respirations are 44, pulsus paradoxis and JVD.”  The nurse nodded toward Hannah and Justin.  “Apparently he was coherent a few minutes ago.”

The doctor pulled out his stethoscope and placed it into his ears.  “Chest pain?”

The nurse nodded.

Dr. Manning had a pretty fair suspicion what was happening, but he needed to listen to Johnny’s chest in order to confirm it.  “Muffled heart sounds.  He’s in tamponade.  Get me a pericardiocentesis tray.  We’re going to have to tap him.”

Johnny’s eyes flew open at this news and he mumbled incoherently.

“Easy, John.  You’re going to feel better in a few minutes.”  Manning turned and made eye contact with Justin.  “I’m going to ask you two to step out until we finish here.”

Justin nodded as he unwillingly pulled his eyes away from the bed.  “Come on, Hannah.  Let’s give them room to work.”

Hannah began to protest, but quickly conceded.  She knew what this procedure entailed, and she didn’t think she could watch it being performed on Johnny, even though she longed to stay.  She walked quickly to the side of the bed when Manning moved to the sink to wash his hands and whispered words in Johnny’s ear that were only meant for the two of them.  Her own heart felt heavy when Johnny became visibly agitated at her departure, but she continued to follow Justin out into the hall.

Johnny’s chest was quickly covered in betadine and draped for the procedure.  Manning found the pericardial space easily and soon fluid was draining through the catheter and into several collection tubes which he placed on the tray.  “Those will need to go to the lab.  Get me a new set of vitals.”

The nurse quickly gathered the vitals and recited them back to the cardiologist.  “BP is up to 104 over 62.  Respirations are down to 26.”

Manning watched the cardiac monitor closely.  There was still the occasional PVC which he attributed to the contusion, but overall the readout looked better than it had this morning.  “His EKG looks much better.  This must have been building slowly since the accident.”  He leaned in close to his patient.  “John?  I think you’re going to be feeling a lot better soon.”  He watched as Johnny’s eyes fluttered.  “I removed a good amount of fluid from your pericardium which should relieve that pressure you were feeling.  I’m going to leave the catheter in place for a few days in case we need to drain off any more.  Do you understand?”

Johnny mumbled something and tried to raise his hand to his chest.  It felt like someone had stuck him with a red hot poker.

Manning picked up the chart and noted Johnny’s last dose of pain medication.  “Let’s give him 100 milligrams meperidine.  Then set up for a 12 lead EKG.  I want to get a good look at what his heart is doing.  Oh, and give Kel Brackett a call at home.  I know he’ll want to be informed.”

The nurse left the room and returned a short time later with a syringe which she handed to the doctor.  Manning injected the medication into Johnny’s central line and tried again to get a response from his patient.  Johnny’s breathing was still erratic, which Manning attributed to a combination of anxiety and pain.  “John?  That pain should be starting to subside now.  Try taking some deeper breaths for me.”  He placed his stethoscope against Johnny’s chest and listened until his breathing evened out and he was able to take the fuller breaths he had been longing for.  Manning helped the nurse apply the leads to Johnny’s chest and extremities.  “You know the drill, John.  Bunch of sticky patches.  Just relax.”

Johnny felt as if his body was sinking into the bed.  He could not remember a time in his life when he felt so completely exhausted.  Thankful now that he could breathe and his pain had subsided considerably, he drifted off to sleep, oblivious to the goings on around him.

Manning watched the EKG strip intently for several minutes before shutting it off.  “Okay.  Go ahead and unhook him from the 12 lead, but keep him on a monitor.  He’s looking better.”

“Dr. Brackett is on his way in.”  The nurse reported as she began removing the leads from Johnny’s limbs, happy to see her patient resting comfortably.

“Good.  Tell him I’ll be in the lounge.”  Manning scribbled some notes in Johnny’s chart before heading to the waiting area in search of Hannah and Justin.

zzz

Robert Manning sat on a chair in the small ICU lounge, resting a chart on his lap.  “John’s EKG is still showing sinus tachycardia, but the rate has decreased to just over 100 beats per minute and the PVC’s are much less frequent.  I’m pretty certain his heart sustained some bruising when he impacted the steering wheel.  The tamponade had probably been developing slowly.  Because John has suffered multi system trauma and he’s also dealing with some sort of illness, some of his symptoms have been overlapping.”

Hannah nodded.  She understood how medicine could often become a guessing game.  “So, how is he now?”

Manning smiled, relieved to be able to offer some encouraging news.  “He’s doing better.  His lungs are clear and he’s breathing easier.  He’s had some meperidine, and when I left the room he was sleeping comfortably.”

Justin and Hannah released relieved sighs in unison.  Justin stood and shook Manning’s hand.  “Thanks.”  He looked up at the opening door and greeting the doctor who was entering.  “Hey, Doc.”

Kelly Brackett stepped into the room and offered short greetings.  The nurse had called him at home to apprise him of this latest development and he wanted to speak with his colleague in private.  “Bob?  Can I see you out in the hall for a minute?”

Manning acknowledged the others, then followed Brackett outside. 

Brackett got right to the point that had been eating at him ever since he had spoken to Johnny’s nurse earlier.  “I really dropped the ball on this one, Bob.  Johnny was exhibiting several symptoms of tamponade when I checked on him earlier this evening…shortness of breath, chest pain, narrowing pulse pressures…but I attributed them to other causes.”

“Very easy to do under the circumstances, Kel.  He has a lot going on.”

Brackett sighed and crossed his arms.  “I suppose you’re right.  How’s he doing now?”  He started walking toward Johnny’s cubicle, not feeling any better about his oversight, but not really wanting to discuss it further with Manning.

Manning handed the recently updated chart to the other doctor.  “I removed almost 500 cc’s of fluid from John’s pericardial sac.  Almost immediately his pressure stabilized and his tachycardia improved, along with his respiratory effort.”

Brackett flipped open the metal cover and scanned over the notes.  “He’s still throwing PVC’s?”

“Yes, but they’ve decreased in frequency.  I think you were right on with your myocardial contusion diagnosis.  We’ll need to watch him closely for a few weeks.”

“Right.”  Brackett watched as Manning made his way down the hall toward the elevators before moving into Johnny’s room and replacing the chart in its cradle.  He studied the monitors closely for a moment before leaning over his patient and resting his stethoscope on his chest.  Brackett could not believe he had apparently missed the tell tale muffled heart tones that would have been the key indicator that Johnny had fluid around his heart.  He thought back to his earlier examination and tried to mentally compare his findings then with what he was hearing now.  Was there a difference?  Then his mind went back over the various other diagnostic procedures he had ordered and performed.  How had he overlooked this?  Taking a step back, he draped his stethoscope around his neck and watched Johnny sleep.  His color was certainly better and his perfusion was much improved.  While relieved, Kel’s mind kept drifting to the “what ifs.”  What if Manning hadn’t been here?  What if Johnny had gone into cardiac arrest?  What if…

Brackett rested his hand over Johnny’s and spoke softly so he wouldn’t wake him.  “I made a mistake, Johnny, and I’m sorry.”  Giving the hand a light squeeze, Kel lingered beside the bed for a few moments before making his way downstairs to his office.

zzz

Joe Early stepped into room 127 a little after 3 a.m. not expecting to find his friend and colleague there, wearing jeans and a sweatshirt, his well worn cowboy boots propped up on the desk.  “Kel?  You’re not supposed to be here until seven.”

Brackett looked up, bleary eyed.  “I’ve been here since just before midnight.  John Gage went into pericardial tamponade.  Damn good thing Robert Manning was here or we may have lost him.”

Joe could sense a self deprecating tone in Kel’s voice and he took a seat across from him on one of the crushed velvet chairs.  “Well, that’s not too surprising, given his injuries.”

“Well that’s just it, Joe.  I completely missed it.  Almost all the classic symptoms were there when I examined him before I went home.”

“Kel…”

Brackett rose to his feet.  “No, Joe!”  He paced the room slightly before leaning a hand on the desk and looking intently down at the kindly, if slightly confused, face of his friend.  “Look,  I’ve been sitting in here thinking…I’d like you to take over Johnny’s care.”  When Joe began to speak, Kel cut him off.  “Joe, I’m serious about this.”

“I know you are.”  Joe fingered his bracelet.  “The question is…why?”

“I’ve been spending a lot of time out at his place, helping out, riding the horses…we’ve become pretty close friends.”

Joe smiled fondly.  “I remember when you thought John Gage was an immature kid.  In fact, if I remember correctly, it took you two a long time to even be able to stand being in the same room together.  So, now you’re friends.  What’s wrong with that?”  Joe knew very well what Kel was getting at, and he was determined to diffuse it.

Kel sighed in exasperation.  He knew what Joe was up to.  “What’s wrong is that I’m obviously allowing our friendship to cloud my judgment.  There was no way I should have missed that tamponade, Joe.  A first year resident could have spotted it.”

“Did his X-rays or CT show a buildup of fluid?”

“No…but…”

“What symptoms was he having that you think you should have been able to sort out?”

“Well, for one thing, his blood pressure was dropping…”

“Which could have indicated a bleed or sepsis or about ten other possibilities.”

Kel rubbed his forehead, thinking.  “He complained of pain in his chest.”

“Slamming into a steering wheel will tend to cause that…”

“And…he was short of breath.”  Kel was not backing down easily.

“Kel, come on!  I think you’re beating yourself up too much over this.  The films were negative.  Under the circumstances, those three symptoms could have been a result of several different things…”

“And it’s my job to explore all of them, Joe.  Johnny suffered severe blunt trauma to his chest.  I should have at least ruled it out.”

Joe changed tactics slightly.  “Isn’t Robert Manning on this case?  What does he think about it?”

Kel scowled.  He didn’t appreciate being backed into a corner.  “He agreed that Johnny’s symptoms could have been attributed to other conditions.  But…”

“No buts about it, Kel.  Johnny has an unexplained fever, he was exposed to an as yet unidentified illness, he has a host of sites that could harbor infection, he’s had major surgery, an internal bleed, multiple fractures…should I go on?”

“Listen Joe, I know what you’re trying to do…”

 

“What I’m trying to do is get you to be sensible.  So, you’re not infallible.  Hannah and Roy and Justin…everyone close to Johnny…they trust you.  They’re counting on you to get him through this.”

“They’re counting on me to be thorough, and not miss pertinent symptoms.”  Kel quickly corrected.

“They’re counting on you to do your best.  And I know they wouldn’t be happy if you turned his care over to me or to anyone else.”  Joe waited a few moments to allow his words to sink in.  Then he added, “Now, why don’t you tell me what’s really bothering you?”

Brackett returned to his seat behind the desk and raised a quizzical eyebrow.  “What do you mean?”

“This isn’t just about missing a diagnosis.  There’s more to it than that.”

Kel stared at his friend for a while.  He couldn’t help but feel a bit angry, even though he knew Joe was only grilling him because he cared.  Brackett wasn’t a man who shared his feelings easily, and he was not used to doubting his skills as a doctor. Before he started spending more time at Johnny’s ranch, he devoted most of his time to the hospital or to research.  As a result, he wasn’t used to having close friends, and that had been okay with him.  Now, he felt like he was walking into new and unexplored territory, and it scared him.  He didn’t really want to talk about it, but he knew that Joe would manage to worm it out of him one way or another.  “Joe…when I saw Johnny in that car last night…I really thought we had lost him.  I can’t even begin to describe what was going through my mind as I got ready to amputate his leg, but one look at him and you would have known.  If we hadn’t gotten him out of that car when we did, he would have died.  No doubt about it.  It’s a miracle he made it to the hospital.”

“But he did, and you were a big part of the reason for that.”

Kel continued without acknowledging Joe’s comment.  “And my God, Roy…I couldn’t even look at him, Joe.”

An uneasy silence hung in the room.

Brackett looked up at Joe, his eyes reliving the horrors of the previous night.  “I’ve been Johnny’s doctor a long time, Joe.  But last night…I don’t know…something…changed.  Maybe it was because I was at the scene,  was subjected to the raw reality our paramedics face every day…the part we can choose not to think about or deal with as we wait by the base station for them to bring us our neatly packaged patients.”

Joe’s voice was soft and understanding.  “Or maybe it’s because you care, Kel.  And you’re a little closer to this one than most.  These weren’t random victims you went out in the field to treat.  It was Johnny…and Roy…”

“And Justin…and Hannah…Joe, I don’t think I’ve ever been hit so hard with the unfairness we see in this profession.  This should be the happiest week of their lives…a wedding, a baby…”

Joe sighed and rubbed his nose as he stared at the floor.  There was nothing he could say.

Kel took a moment to gather himself before his emotions could get the better of him.  Then, he looked back at Joe and revealed the thing that had been bothering him the most…the thing that hadn’t stopped niggling at his heart since he spoke with the nurse several hours ago.  “Joe, I get sick to my stomach thinking about how I would break the news if Johnny doesn’t make it…”

“Kel…”

“No, Joe.  Let me finish.  That would be bad enough, but if I had to tell them he didn’t make it, because of a mistake that I made…”  His voice trailed off before his emotions could betray him. 

Joe stood and walked behind Kel’s chair, placing a supportive hand on his shoulder.  Both were startled by the shrill ringing of the phone.  After allowing a few rings, Kel cleared his throat and answered it.  “Brackett.”

“Good morning.  This is Chelsea Bihl from the lab at USC.  I’m sorry about the hour, but I know you wanted to be informed immediately once we had some information on the labs you sent us on John Gage.”

“Yes, I did.  What did you find?” Kel covered the receiver with one hand and whispered to Joe.  “It’s USC.”

“Well, I’ll send over my full report by courier first thing this morning.  But, it looks like your patient has been infected with rickettsia typhi.”

“Typhus?”  Brackett’s concerned gaze met Joe’s and he watched as the gray haired doctor immediately headed toward his bookshelf.

“That’s what I said.  First case I’ve ever seen in my career, although my sources show that outbreaks have occurred in southern California in the past.  Should we notify the health department?”

“Yes, we’ll need to make them aware of it.  I’m sure John picked this up while he was on a trip to South Dakota recently, but there’s a chance others could have been exposed.  Are there any recommendations for treatment?”

“A three week course of antibiotics is recommended.  Tetracycline, as long as there are no allergies or other contraindications.”

“Well that’s good news.  We’ve already started him on tetracycline.  Thanks for the information.  We’ll be in touch.”  Kel hung up the phone and accepted the heavy medical book Joe was handing him which had already been opened to the proper page.  “Tyhpus…Johnny really knows how to keep us on our toes, doesn’t he Joe?”

Happy to see Kel immersed in Johnny’s care again, he sat down.  “Yes he does.  The good news is, it’s treatable.  Johnny’s bound to be pretty miserable for a while, but at least we know what he’s dealing with.”

Kel spoke as he perused the pages of information.  “Let’s just hope he has the strength to fight it.  It’s a pretty vicious disease.”

“Right, and without his spleen…”  Joe exchanged a tense look with Kel and noticed he was dialing the phone.  “Anyone you want me to call?”

“Yeah, could you call Roy for me?  And ask him to let Justin and Johnny’s sister know.  I’ll call Hannah myself, but first I need to call Dr. Greenberg in South Dakota.”  Kel listened to the ringing of the phone, waiting for the doctor to answer.

zzz

It was just after five a.m. and Todd Andrews sat in his office reading a chart, and mentally preparing himself for a surgical procedure he would be performing in a few hours.  There was a knock on his door, and he spoke without looking up from his work.  “Come in.”

“Todd?  Can I talk to you for a minute?”

Andrews finished the sentence he was writing, recognizing the voice at the door.  “Sure, Justin.  Have a seat.”

Justin sat down in one of the chairs facing Todd’s desk, his left knee nervously bouncing.  He had worked for Todd a long time, long enough to be solid friends, yet for some reason, whenever Justin sat across the desk from his “boss” he couldn’t help feeling a bit on edge.  He respectfully waited for Todd to finish whatever it was he was working on.

Laying his pen down on the desk, and leaning back in his chair, Andrews scanned the physical therapist’s appearance critiquingly.  His hair was mussed and his chin sported a fine growth of stubble.  The scrubs he wore were wrinkled, as if they had been slept in, but dusky circles beneath tired blue eyes contradicted that assessment.  “You’re here early.”

Justin glanced at his watch, suddenly realizing he had no idea what time it was.  “Yeah…I guess I am.”

Andrews sighed and shook his head.  “You were still here when I left last night.  You never left, did you?”

Justin became defensive.  “I did, Todd!  I took Hannah home a little after midnight.”

Andrews waited for Justin to elaborate.  He didn’t.  “And?”

“And then I came back.”  Justin added quickly.  “But, I had some work to catch up on…”

“Justin, when was the last time you got any sleep?”

“I’m fine.”

“That wasn’t what I asked you.”

Justin felt his cheeks burning.  He had not come in here for the third degree, although he supposed he probably deserved it.  That didn’t make it any easier to swallow.  “Look, Todd.  I’ve caught a few Z’s here and there.  It’s been a long couple of days.”

Andrews softened slightly.  He supposed the past few days had been pretty rough on his friend.  And Justin had come here of his own accord, which meant he must have had something he wanted to talk about.  “Okay, Justin.  What’s on your mind?”

Justin looked down at the folder he held in his lap.  John’s folder.  He rubbed absentmindedly at a tight muscle in his neck as he spoke.  “Todd, I’ve spent the past several hours going over John’s chart.  And…I’m just not sure what to do with him.”

Andrews’ eyebrows popped up in surprise.  It wasn’t often his best physical therapist admitted he was stumped.  “Well, at the moment there’s not much you can do, Justin.  You know that.  Some passive ROM, ice and heat therapy…”

“No, that’s not what I meant.”  Justin blew out a sigh of frustration.  For the past several hours, he had paced his office trying to come up with a treatment plan for his best friend.  He didn’t know why it was so difficult, and that was what frustrated him.  In his twenty-plus years in this line of work, he had built up sort of a reputation for being one of the best physical therapists in the area, undoubtedly the best Rampart had to offer.  He was humble about it, of course, often blowing off any accolades that wafted in his direction.  And in all those years, he had certainly helped his share of patients with multiple trauma.  He had helped John get back on his feet on more than one occasion, assisting him in the rehabilitation of a hip fracture, a severe shoulder injury, and an injured quad.  Those times, John’s determination and desire to get back to firefighting had helped make Justin’s job that much easier.  But this time…Justin was trying hard not to let his own fears and uncertainties cloud his confidence, but he was finding it a continual challenge.  There was more at stake now.  This was no longer just about helping some fireman be able to continue in his career.  This now involved his sister, her baby…Somewhere along the way, John had transformed into Justin’s brother, and the father of his niece or nephew.  That raised the bar a little bit, and Justin’s biggest concern was that he would be letting his family down.

Also, Johnny’s combination of injuries would make rehabilitation challenging to say the least.  The right knee and foot fractures were routine enough, but with the muscles and ligaments in John’s other leg so badly damaged, that complicated things.  Both legs would need some major therapy if John was to ever be able to walk normally again, much less return to work.  Then, there was the matter of the fractured and dislocated fingers on Johnny’s hand.  That would make it extremely difficult to get him on his feet, since Johnny would not be able to grip a crutch or a bar, and thus would not be able to help much in supporting his own weight for a while.  And add to that the fact that John was recovering from major abdominal surgery and the injury to his heart…he would have to lose both catheters before he could even move around too much.

The more Justin tried to come up with a schedule or a time line, the more he realized he needed to speak with Todd.  For the first time in his career, he felt overwhelmed, as if maybe he wasn’t the right man for the job, and that both frustrated and frightened him.  His conflicted mind began this argument about an hour ago.  He didn’t know if he could help his friend, but he didn’t really trust anyone else to do it either.  Finally, exhausted and spent, he made his way down the hall to Todd’s office.  But now that he was here, he didn’t even know where to start.  And that was the problem.

“I just…I know what I can do right now.  But, as far as the complete rehab picture…I don’t know where to start, Todd.  I just…maybe you should get someone else…”

Andrews stopped him right there.  “I don’t think you really want me to do that.  And frankly, I don’t think it’s in John’s best interests either.”

“I know…It’s just…God, I don’t even know how to explain it!”  Justin was on his feet now.  Pacing.

Andrews waited a few minutes, carefully planning his next words, unsure how they would be received.  “Justin…I really think that maybe if you went home…got several hours of uninterrupted sleep…”

“Todd…”  Justin’s tone told his superior he knew where this was going, and he wasn’t pleased.

But Andrews didn’t seem to care.  “You’ve been under a lot of stress, Justin.  And you’re sleep deprived.  Now, it’s impossible to think clearly under those circumstances.  You’re the best man for this job, and I think you know it.  You’ve always been able to come up with creative solutions for challenging cases in the past, and I have no reason to doubt you’ll do the same with John.  While it’s true his combination of injuries means he’s in for a long, difficult recovery, you’ll be helping him every step of the way.  John will be counting on you to help him…and so will Hannah.”

“Todd, that’s not fair.”

“But, it’s true.”  Andrews allowed some time for his comment to sink in.

Justin said nothing, but collapsed back into the chair in resignation.

“But you need to take care of you first.”

“I’m fine, Todd.”  Justin rubbed his forehead, unconvincingly.

Andrews would not play the “boss” card.  Not yet.  But, if Justin did not take his advice to get some rest by the end of the day, he would have no choice.  He smiled as a gesture of truce.  “Have you looked at yourself lately?”

Justin smiled in return.  Todd was a good friend.  “That bad, huh?”

“Well, let’s just say I hope you’ve decided to take the day off.  Can’t have you scaring the patients.”

Justin rubbed at the back of his neck.  “Okay…okay, Todd.  I’ll go home in a little while and get some sleep.  But, I want to check in on John first.”

“Fair enough.”

There was another knock at the door, and then it opened a crack.  Brackett peeked in and noticing Justin there with Todd, he quickly excused himself.  “Oh, I’m sorry.  I didn’t mean to interrupt.  I can come back later…”

“Come on in, Kel.  I think we’re pretty much done.”  Andrews looked at Justin for approval and received a quick nod.

Kel stepped in.  “Well, actually I wanted to talk to both of you, so you’ve saved me some legwork.”  He took a seat in the chair next to Justin.

“Is this about John?”  Justin asked.

“Yes it is.”  Kel leaned back, hooking his ankle over his knee.  “It seems our mutual patient and friend has been infected with rickettsia typhi, better known as typhus.”

Justin ran his hand backward through his hair.  Great.  More good news.  “Well how the hell did he pick that up?  On the reservation?”

“Yes, Justin.  I spoke with the doctor at the clinic there.  Apparently they’ve had an outbreak.  He’s pretty certain it’s the endemic form, probably being spread by rat fleas.”

Justin shivered, disgusted that John had been exposed to such a seemingly vile disease.  And it spoke volumes about the conditions on the reservation…the place where John had been born… and Camarin.  “Well, how serious is it?”

Kel sighed as his brow furrowed into a worried squint.  “Well…normally someone Johnny’s age, in reasonably good health would have no trouble fighting the infection with the help of a lengthy course of antibiotics…”

Andrews picked up on Brackett’s train of thought immediately, and was pretty sure Justin had too.  “But, John’s immune system is already compromised.”

“Right.  And his body has a lot to concentrate on right now.  This is just one more thing…a thing John definitely doesn’t need.”  Justin felt sick.  Not only was there another wrench being thrown into the gears, but now there was a frighteningly real possibility Justin would not even need to concern himself with John’s rehabilitation.  He would be lucky to survive.

Brackett shifted in his seat, and crossed his arms.  “Well, it complicates things.  That’s for sure.”

“Well, what are you doing for him?”  Justin wondered.  Then, he thought of something else.  Just how contagious was this?  Hannah was pregnant.  “And what kind of precautions…”

Brackett had been well prepared for that question.  “The recommended treatment regimen includes the antibiotics we’ve already been giving Johnny through his IV.  We’ll continue those for about three weeks.  So far, he seems to be responding well.  His fever has come down.  As far as isolation procedures…I spoke with the health department, and we don’t believe it’s necessary.  Because Johnny has the endemic variety of the disease, he was infected through a carrier.  Also, he never developed a rash.  The possibility of him passing this on to another person is extremely slight, almost nonexistent.  Still, Hannah may want to be careful, at least until Johnny’s been on the tetracycline for at least a week.”

Justin rubbed his eyes, imagining what Hannah’s reaction would be when she found out her baby was exposed to typhus…or John’s for that matter.  “So, forgive me, Doc.  I don’t know much about typhus.  What exactly is John dealing with here?”

“Typhus is a very tenacious infection.  It has a tendency to hang on for a while, hence the long course of antibiotics.  The symptoms include severe headache, severe joint and muscle pain, nausea, chills, cough, light sensitivity, and a high fever.  A rash is sometimes present, and Dr. Greenberg informed me that his patients up there have been presenting with one.”

“But John isn’t.”  Justin confirmed.  “But, you’re sure it’s the same thing?”

“Yes, Justin.  It’s possible because John has a slightly different genetic makeup than the full blooded natives on the reservation that the disease has manifested in a slightly different way.”  Brackett uncrossed his arms and leaned forward slightly in the chair.  “At any rate, he’s going to be pretty miserable, and it may be difficult to sort out exactly what’s what because of overlap from his other issues, but we’ll do our best to relieve his symptoms as they occur.”

Justin leaned forward, elbows on his knees, shaking his head.  “Man…”

Andrews felt sorry for his friend.  “Justin…it really doesn’t change anything as far as John’s rehabilitation schedule.  It will be several weeks before he can even do any light weight bearing…”

“If he makes it that long.”

Andrews was not used to hearing Justin sound so despondent.  “Where’s that famous Quinn confidence?  That’s what John needs to see right now.  You can’t go in there and…”

“Don’t you think I know that, Todd?”  Justin was on his feet again, and embarrassed by his sudden outburst, he turned around, holding his hand to his throbbing forehead.  Maybe he really did need some sleep.  “Sorry…”

“It’s all right.”  Andrews watched Justin as he stood with his eyes tightly closed, his hand still on his brow.

Brackett was noticing the same thing.  “Justin…are you feeling all right?”

Justin opened his eyes and shook off his weariness, realizing he probably wasn’t painting a very pretty picture of himself.  “I’m okay.  Just a headache, that’s all.  A cup of coffee is all I need.”

“And then you’re going home, right?”  Andrews reminded him.

Justin gave Todd his best I-don’t-need-a-babysitter-look.  “Right, Todd.  Right after I see John.”

Brackett exchanged a cautious look with Andrews.  “I need to look in on Johnny too.  Why don’t you go ahead now?  I need to talk to Todd for a bit, and then I’ll be down.”

“Okay.”  Justin headed toward his office to gather what he would need for John, trying to convince himself he would not be the subject of Brackett and Andrews’ conversation.

zzz

Justin re-secured the Velcro straps on the rigid knee brace and positioned an ice pack on top.  The swelling had gone down considerably since yesterday, so Todd would probably be casting the injured joint later today.  Justin moved to Johnny’s right foot next, gently squeezing the toes to check capillary refill.  Adjusting the pillows surrounding it, he positioned another ice pack there before moving on to Johnny’s left leg.  Todd informed Justin yesterday that he would be applying a compression bandage to Johnny’s thigh once the surgical incisions healed.  From the looks of the seepage on the bulky bandages, and the activity inside the surgical drains, it would be a while before Todd was able to do that.  Another ice pack gingerly positioned there, and then Justin stepped back, looking at his watch.  The ice needed to stay on for twenty minutes.

Justin’s eyes traveled over all the various tubes and wires connected to his friend until they settled on the purple-red-black bruising that covered most of Johnny’s chest and wrapped around his left side.  Justin was eager to begin some range of motion exercises on Johnny’s upper limbs, as well as some chest physiotherapy, to help speed the healing of what he knew was a very painful, slow healing injury.  The ribs would heal readily enough, but the sternal fracture was another story.  Justin had aided in the rehabilitation of quite a few in his career, and he cringed at the often long, sometimes agonizing process.  Even if that had been the only injury Johnny had sustained, they would have their work cut out for them.  Justin couldn’t help but notice the shallow depth of Johnny’s breathing, even in sleep, and he hoped Johnny would somehow manage to avoid pneumonia.  He had been just about to head back to his office to change, when a faint moan stopped him.

Johnny became aware of familiar sounds first…the beeping of the heart monitor, the hissing of oxygen.  Sounds were followed by the pungent antiseptic aroma hospitals were famous for.  God, how he hated that smell.  He tried swallowing in an effort to bring some moisture to his parched mouth, but sudden nausea caused him to gag on the nasogastric tube that rubbed the back of his throat. 

And then there was pain.  In too many places to allow him the ability to separate it.  Johnny was pretty sure his neck hadn’t felt this stiff the last time he was awake.  And then there was the annoying ache in his right shoulder.  Where had that come from?  It felt like someone had plunged a knife into the center of his chest and was twisting it every time he inhaled.  And his lower body felt as if someone had fed it into a threshing machine, as a thousand different pain sensations ebbed and swelled from his navel to his toes.  Aching…throbbing…stinging…each varying in intensity and duration.

Johnny raised a hand weakly and moved it toward his chest, in an effort to seek out at least one source of his torture, only to have it intercepted on the way by a familiar, comforting grip.  The hand wasn’t delicate enough to belong to Hannah, so it had to be either…

Justin understood Johnny’s need to explore his injuries, but he was concerned he might dislodge his arterial line or IV, or disturb the catheter sutured just under his breastbone.  He slowly returned Johnny’s arm to his side.  “Hey…hey…easy, John.  Try not to move around.”

Justin…Johnny wrapped his fingers weakly around the offered hand, allowing its steadying warmth to ease some of his agitation.  He basked in the strength of his friend’s presence, savoring the sensation of Justin’s thumb gently rubbing the back of his hand.  He tried to fall back asleep, but his discomfort was increasing, preventing the return to oblivion he so desired.

Justin picked up on Johnny’s unconscious pain signals immediately.  The increasing heart rate, the rapid and strained respirations, and the squinched up brow.  Without letting go of his hand, Justin carefully rested a hand on Johnny’s forehead.  “What’s wrong?  You having pain?”  He already knew the answer.

To say he was having pain was a gross understatement.  The fact was, Johnny had never felt pain like this, not even after being hit by the car, or being nearly beaten to death by Jonas.  He needed relief, and he needed it soon, but he despised being drugged and unable to keep track of time, or of what was happening to him.  The last thing he remembered was Hannah kissing him goodnight.  How much time had passed since then?  He knew he had been in an accident, and he vaguely remembered his doctors, some familiar, some not, explaining to him what his injuries were and the results of various procedures.  But his brain was too fuzzy to recall much of that now.  His mind was full to overflowing with random unanswered questions…How badly damaged was the Rover?  Had anyone else been hurt?  How were Camarin and the girls doing?  Where was Tag?  Would he lose his leg?  Would he go back to work? How long would he be in the hospital?  But topping the list were a hundred questions about the baby.  Where was Hannah?  Johnny forced open his eyes, and tried to blink away the haze of pain and fever.  He tried to speak, but all he could manage was another moan.

Taking the moan as a ‘yes’ Justin’s hand moved toward the call button.  “I’ll get your nurse.”

“N-no…”  Johnny finally managed, his voice hoarse and chalky.  “Wait…”

Justin looked down into questioning eyes.  He did not want to wait.  He wasn’t sure if Johnny was aware, but with the injury to his heart, this was not the time to be refusing pain meds.  As if reading his mind, Justin answered the most important question.  “John, Hannah’s at home.  She didn’t want to go, but she was exhausted, and I talked her into it.”  He wanted to tell Johnny Hannah would be back later, but in light of the conversation he’d just had with Brackett, he didn’t want to make a promise he might not be able to keep.

Johnny struggled to keep his eyes open and focused on his friend.  “”Kay…what…what’s goin’ on?”

Justin was slightly confused by the question.  Figuring Johnny was inquiring about his condition, he did his best to update him.  “You were in an accident.  Do you remember?”

Johnny was becoming frustrated.  His pain was quickly becoming overwhelming, but there were so many things he needed to know.  “Anyone else…hurt?”

“No, just you.”

Johnny closed his eyes, and took a moment to process Justin’s answer.  He remembered losing his brakes and silently cursed himself again for not checking them sooner.  He was relieved at least he hadn’t caused injury…or worse…to someone else.  “What’s the…damage?”

Justin smiled as he surreptitiously pressed the call button.  “To you?  Or to the Rover?”

“Both.”  The word came out as a harsh croak, prompting a straw to suddenly appear at Johnny’s lips.  He gratefully sipped the water Justin offered, allowing it to quench his seemingly inexorable thirst.

“The Rover’s totaled, John.  Sorry.”  Justin watched as Johnny’s eyes closed dejectedly.  It was just a truck, nothing but steel and plastic, an organized bundle of parts.  But, Justin knew Johnny and that Rover had been through a lot together, and losing it would be akin to losing a close friend.  He resisted the urge to tell his friend that ‘cars can be replaced’ or that he could ‘get another one,’ instead allowing Johnny this moment to mourn.  Finally remembering Johnny’s other request, Justin added, “You, on the other hand, can be fixed.”

Johnny forced a smile.  “Good to…know.”  But, can I be fixed good as new?”  He remembered fragments of information supplied by doctors, nurses, Hannah, Roy…but he couldn’t determine if it was real or imagined.  He was just about to ask Justin to elaborate further when Dianne, his nurse, entered the room, followed by Dr. Brackett.

Brackett acknowledged the physical therapist with a look that clearly meant, ‘what are you still doing here’ as he pulled Johnny’s chart out of its cradle.  “How are you feeling, Johnny?”

Justin noticed Johnny staring up at him imploringly, before releasing his hand and stepping back in order to give Dianne room to work.  “He’s having a lot of pain, Doc, but he wants to be filled in on his condition.”

Brackett closed the chart and moved to Johnny’s side.  He had already supplied this information once before, but he would supply it again, just as soon as he issued an order to Dianne.  “Seventy five milligrams meperidine.”  Turning his attention back to his patient, he leaned his hands on the bed rail.  “Johnny, you’ve got a fractured sternum and some fractured ribs.  Dr. Manning and I believe you have a myocardial contusion.  You went into tamponade last night, and he drained some fluid from your pericardium.  That’s why you have a catheter in your chest.”

Johnny blinked disbelievingly.  He was not aware of the catheter.  He tried to move his hand toward it, but again, it was intercepted, this time by Brackett. 

“Careful, Johnny.  You have an IV and an arterial line in that arm.”  Brackett repositioned Johnny’s arm at his side and nonverbally indicated to Justin that he should keep it there.  Justin complied by gently grasping onto Johnny’s hand again.

Johnny’s curiosity over his other injuries was temporarily forgotten as another discomfort surged, eking its way to the forefront of his mind.  He tried to swallow it down, and gagged again on the nasogastric tube.  “Feel…sick.”  Just getting two words out was almost an insurmountable task.

Brackett was not overly concerned at this development.  After all, nausea was a common side effect of the medications Johnny was on, and it was also a symptom of typhus.  Still, it warranted further exploration.  Peritonitis was a real possibility.  “You won’t get sick, Johnny.  You have an NG tube.  Your nausea might be a result of your medication.”  He began palpating Johnny’s upper abdomen.  “Any pain here?”

“No…”

Satisfied Johnny was not showing any signs of peritonitis, Brackett completed his exam.  It was time to let Johnny know what he was dealing with.  “Johnny, you were infected with typhus while you were on the reservation.”  Dianne was back with the requested medication, and Brackett accepted the syringe, injecting it slowly into the open port on Johnny’s subclavian line.

Johnny could feel the cool medication snaking its way into his shoulder, and within seconds, his pain became more bearable.  The narcotic caused his already exhausted eyelids to droop, but he forced them open, unwilling to succumb to sleep until he had some more answers.  “Typhus?”

“Yes, Johnny.  Now, I don’t want you to worry.  You’re already on the recommended antibiotic, and you’re responding well.”

Johnny was losing his battle at staying awake.  “Easy…you to say…”

Kel pulled out his stethoscope and nimbly changed the subject.  “How’s your pain now?”

“Better…”  Johnny’s eyes slid closed and he forced them back open.  He knew he wouldn’t last much longer.  So tired…but I still have more questions…

Brackett leaned over and listened carefully to Johnny’s chest, his mouth twitching concernedly at his shallow breathing.

Johnny winced when the stethoscope diaphragm pressed against a particularly sore spot.  “Hurzta…breathe…”

Brackett straightened and removed the instrument from his ears.  “I know, Johnny.  Give the meperidine some time to work.”

“Tired…”  Johnny’s eyelids became too heavy to hold open, and he gave in to sleep.

Brackett spoke to Justin as he peeled back bandages, checking Johnny’s extensive array of paraphernalia before moving on to his various incisions.  “He’ll probably sleep for several hours, Justin.  And I’m sure Roy will be in before long.  You’re going home, right?”

Justin tried not to be annoyed by the doctor’s concern.  “Yes I am, as soon as the ice comes off, which will be in about…” he looked at his watch.  “Ten minutes.”

“Okay, good.”  Brackett jotted standing orders for phenergan in Johnny’s chart.  “Todd said he would be making rounds down here before he goes to the OR.  You uh…may want to be gone before he gets here.”

Justin said nothing as he watched Brackett leave.  Then, he sat back down in the chair and watched his friend sleep.

zzz

Hannah sat in the recliner facing the large picture window that overlooked the corral and offered a panoramic view of the purple-gray mountains behind it.  It was Johnny’s favorite chair, and sitting in it almost made her feel as if he were holding her.  She shivered slightly, but not from cold.  Kelly Brackett had called her an hour ago to inform her that Johnny had been diagnosed with typhus, and while he had told her not to worry about exposure, to herself or to the baby, he had advised that she not visit Johnny for at least five days.  Five days.  She had been without him for twice that while he was in South Dakota, and it had seemed like an eternity.  Pulling her legs in tightly under her, she swallowed back tears.  She never knew it was possible to love someone so much it hurt.  She longed for the night her bed would not seem so cold and empty.

And she thought of Johnny.  All alone in the ICU.  Sure, he was being well cared for, and she knew that Justin, Roy, and Johnny’s other friends would see to it that he had company.  But, Hannah knew that Johnny would be missing her presence as much as she was missing his.  She only hoped that it wouldn’t negatively affect his recovery.

Roy had stopped by on his way to Rampart.  He assured Hannah that he would stay with Johnny most of the day.  Justin called when he got home, and let her know that Johnny had seemed more aware during the early hours of the morning, and was sleeping comfortably when he left.  All of these reassurances should have made her feel better, but all Hannah could think about was how much she wanted to see her fiancé. 

Camarin stood in the archway that led from the kitchen to the living room.  She noticed Hannah sitting on the recliner facing the window, her eyes closed.  Thinking she was asleep, Camarin walked quietly toward her bedroom where the girls were busy playing with some paper dolls Justin bought for them yesterday.  She was surprised when Hannah’s voice cut through the dim room.

“Good morning, Camarin.  How did you and the girls sleep?”

Camarin smiled and took a seat on the chair next to Hannah’s.  “Fine.  Thank you.  I can’t tell you how much I appreciate your letting us stay here.”

“Well, you’re family.”

Camarin nodded.  “You’re right.  Hannah…I want you to know…I can’t think of a woman more perfect for my brother.  I can see that you love him very much.”

“Yes, I do.”

“And, he loves you too.  Very much.”

Hannah did her best not to cry.  She had done enough of that over the past 36 hours, and she really didn’t want to start again.  It was bad enough that she felt like a big, miserable mess of hormones.  Add to that this latest news about Johnny...

Camarin could see this conversation was upsetting Hannah, so she changed the subject.  “Is it okay if I use the phone to call Justin’s place?  To check on Tag?”

“Sure.  The number is on the pad by the phone.”

Camarin started to get up, but then sat back down.  “You know, that was really nice of Justin to let Tag stay there by himself.  I mean…a teenage boy, with Tag’s history…”

“One thing you’ll learn about Justin…he’s got a huge heart, and he trusts people unless they give him a reason not to.”

Camarin leaned forward slightly.  She had already noticed these and other admirable qualities in the handsome physical therapist.  “It’s all he needs, you know?  Tag…he just needs someone to…give him a chance.”

Hannah smiled through a yawn and a stretch.  “Well you can count on Justin to give him that.  And don’t be surprised if he sort of…takes Tag under his wing a bit.  If it’s one thing my brother loves to do, it’s fix things.  I just hope he doesn’t drive Tag crazy.”

Camarin got up from her chair, laughing.  “Well, I don’t know about that.  But, I know Tag appreciates what he’s doing for him.  At least he better not take advantage of it, or he’ll have me to deal with.”  She headed toward the phone.

Hannah got up and headed to the kitchen as well.  She swallowed down her prenatal vitamin with some orange juice, slid into the pair of old shoes she kept by the back door, and slipped her coat over her shoulders.  Then, she walked out to the barn.  There was a lot of work to be done.

zzz

Roy stepped out of the elevator into the ICU and started down the hall toward Johnny’s room.  It was nearly noon.  He had hoped to get here sooner, but an unexpected phone call from Vince Howard had delayed him.  Vince called to tell him that the man from Johnny’s insurance company who had gone over the Rover had contacted him informing him that foul play may have been involved in Johnny’s accident.  Vince told Roy that he had an appointment with the man later in the day, and that he would let him know the details once they became available.  Vince also said that if he felt it was warranted, he would place a guard on Johnny’s room at Rampart.

Roy’s stomach had been churning ever since the conversation with Vince.  The only person he knew of who would have cause to hurt Johnny was Jonas Quinn, and he was safely behind bars.  But what if he knew someone on the outside?  Roy tried not to think about that.  He was stopped as he approached the horseshoe shaped nurses’ station in the center of the ward.

“Roy?”  It was Betty, Johnny’s day nurse.  “Stop over here for a minute, would you?”

Roy stepped up to the ledge and looked at the nurse expectantly.  “Betty?”

Betty closed up a chart she had been working on, and looked up at the waiting paramedic.  “Roy…I just wanted to let you know before you go in to see Johnny.  Well…he’s having a pretty rough time of it this morning.”

Alarm bells started going off inside Roy’s head.  The last he had heard, Johnny seemed to be doing better.  “What do you mean?”

“Well…”  Betty looked as if she was uncertain how to continue.  “For one thing, Brackett increased his antibiotic and it seems like the typhus symptoms are really coming to a head now.  Brackett said that was normal, as the infection starts to work its way out of Johnny’s system, but he’s been pretty miserable.  His fever’s up a little too.  Also, Dr. Andrews put a cast on his leg about two hours ago, and he had a really hard time with that.  I don’t know Roy.  He’s just can’t seem to get comfortable.  He’s not resting well.”

“Well, what does Brackett have to say about it?”

Betty sighed.  “Well, he’s concerned, of course.  It’s not helping him.  But, it’s really not unexpected.  Oh, there’s one more thing.  John’s been worried about Hannah and the baby.  Dr. Brackett and I have both tried to convince him that the chance of either of them being affected by the typhus infection is small.  But, he’s been fretting about it anyway.  I’ve spent most of the morning in there with him, but now that you’re here…well, maybe you can calm him down.”

“Yeah…maybe…”  Roy smiled at Betty and headed toward Johnny’s room.

Roy stood just inside the cubicle and took in his friend’s appearance.  Johnny was sweating, his stilted breathing almost painful to watch.  He had been turned slightly to his right side, and several large, fluffy pillows supported his back and extremities.  His right leg was encased from mid thigh to ankle in a fresh, white cast, and Roy cringed at how bulky and uncomfortable it looked.  He stepped up to the bed and leaned on the side rail.  “Hey, Johnny.”

Johnny forced his eyes open at the sound of the familiar voice, weakly raising his splinted hand.  He waited until he felt the familiar warmth of Roy’s hand on his forearm, before returning the hand to its pillow and staring up at his partner with pleading eyes.  “Roy…”

“Hey…”  Roy rubbed Johnny’s forearm soothingly.  “We don’t have to have a conversation if you don’t feel up to it.  I’m here now, and I can stay all day.  Why don’t you try to get some rest?”

But Johnny was not appeased.  “Roy…tell Hannah…stay…away…”  On some level he knew that a good portion of his misery was a result of his accident, but Johnny could never remember feeling this miserably sick, not even when he had been infected with the Koki fever virus.  As much as he missed Hannah, he already felt pangs of guilt that he may have unwittingly passed this affliction on to her, and worse yet…to their baby.

Hearing Johnny pleading with him to keep Hannah away tugged at Roy’s heart.  He knew how hard that was for his friend to ask.  “Don’t worry, Johnny.  I just saw Hannah.  She’s fine, and the baby’s fine.  She sends her love, of course.  And, she misses you.  But she’s fine.  Try not to worry.”

Johnny closed his eyes and moaned pitifully as a particularly jagged pain pierced his skull.  It seemed as if agony was everywhere, relentlessly hunting him down and finding him, despite every effort being made to escape.  “Make sure she…stays…home…and that’s she’s…not doing…too much…”

Roy grasped Johnny’s forearm.  “Okay, Johnny.  I promise.  Now, come on.  This isn’t helping you.”

“Trying…Roy.”  Johnny swallowed repeatedly.  “Feel…really…bad…”

The desperate tinge coloring Johnny’s words told Roy that his friend was quickly reaching his limit.  “Is the pain bad, Johnny?  Or do you just feel sick?”

“Both.”  Johnny’s legs were both killing him again, and now he was being bothered by a deep ache in his right hip.  He instinctively tried changing his position, but there wasn’t much he could move without causing himself further misery.  “Roy…can’t…stand this…”

Roy knew how hard that was for Johnny to admit.  He reached over and pressed the call button.  “Okay…okay.  Just lie still.  Betty will be here in a minute, and we’ll see what we can do, okay?”

Johnny didn’t answer, but he took some comfort in Roy’s presence.  If anything could be done, he knew Roy would see to it that it happened.

Betty walked in within seconds at a fast clip.  She knew that Roy would not summon her unnecessarily.  One look at Johnny left no doubt as to why she was called.  “Oh, John.  You really are having a rough time, aren’t you?  What’s hurting?”

What isn’t?  “My…my legs.”

Before Betty had a chance to page someone, Todd Andrews strode into the room.  He was somewhat taken aback by Johnny’s level of discomfort.  “John?  What’s going on?”

Johnny looked up at Roy, his expression indicating he was done answering questions.

“His legs are really bothering him.  And he’s not feeling good.”  Roy filled the orthopod in.

Andrews flipped open Johnny’s chart.  “Well, that much I can see.”  He scanned over the chart, frowning.  Johnny had just had his normal dose of medication thirty minutes ago.  Yet, it was obvious he was in significant pain.  “Betty, let’s try giving him 50 more milligrams meperidine.”  He turned his attention back to his patient.  “John?  Just hang in there a minute.  We’ll get this under control.” 

Betty returned seconds later with a syringe and injected it into Johnny’s central line.  Then, she stepped back to observe her patient’s reaction.  “There, Johnny.  Better?”

Johnny tried to imagine the narcotic making its way through his bloodstream, numbing nerve endings on its way.  “Yeah…better…”  But, no sooner had the words left his mouth, pain exploded in his lower extremities, seemingly even worse than before.  Frustrated, he cried out.  “Aaaah!  Not…working…”

Andrews shot Betty a tense look.  “Page Dr. Brackett.”  He moved to the side of the bed, and rested a hand on Johnny’s shoulder.  “John, I think maybe you’ve built up a resistance to meperidine.  I want to check with Dr. Brackett before I prescribe anything else.  I promise you, we’ll take care of this, okay?”

No it wasn’t okay.  Johnny only wanted some relief so he could sleep.  “Really…hurts…”

Roy stepped in now, prompted by the emotion in Johnny’s tone.  “I know it does.  Doc will be here soon.”

As if summoned, Kelly Brackett burst into the cubicle.  Betty had already filled him in on what was happening.  “How much meperidine has he had?”

Todd spoke without taking his eyes off Johnny.  “He’s had a total of 125 mgs in the past thirty minutes.”  After allowing a second for this news to sink in, he offered.  “Morphine?”

Brackett shook his head, remembering the reason why he had prescribed meperidine to Johnny in the first place.  “No, he doesn’t react well to large doses of morphine over several days.”  Turning to Betty, he ordered, “Let’s go with pentazocine.  Start with 30 mgs.  We’ll see how he does on that.”

Brackett read Johnny’s chart and jotted down his latest order.  When Betty returned with the requested medication, he injected it himself.  Everyone in the room breathed a sigh of relief when Johnny began calming, the beeps on the heart monitor decreasing in tempo dramatically.  “How’s that, Johnny?”

“Thaz…good…”  Johnny allowed his eyes to close.  He took stock of himself as he drifted between consciousness and sleep.  This new drug didn’t seem to be quite as effective as the meperidine, but it relieved his discomfort enough that he could already feel himself succumbing to his overwhelming exhaustion.  Right now that was all he cared about.

Roy stepped out to allow Johnny some privacy while Betty and the doctors completed their exams.  Then, he tip toed back in and took up residence in the hard plastic chair he had grown accustomed to.  He watched the even rise and fall of Johnny’s chest, his previously distressed expression now peaceful in sleep.  Blowing out a breath, he leaned forward, resting his elbows on his knees.  Man, Johnny…I’m getting too old for these bedside vigils.  Let’s make this the last time for both of us, okay?

zzz

Tag sat at the bar in Justin’s small kitchen, going over the information Hank Stanley had dropped off on the Los Angeles County Fire Department’s academy.  His mind ambled back to Chaz, his “friend” on the reservation, and he silently thanked the spirits that unlike the other youth, he had gone to school and learned to read.  Tag took a long swig of his soda and realized he had likely learned more about friendship in the past few days, than Chaz had been able to offer in years.

As Tag’s eyes scanned over the training schedule, his pulse quickened in excitement.  He couldn’t wait to embark on what seemed to be such an exciting career.  But, his heart fell when he noticed the tuition requirements.  The fire academy cost more than any amount of money he had ever seen in his life.  Johnny had offered to pay for it on the condition that Tag sign papers promising he would pay him back after he became assigned to a station, but Tag didn’t feel quite right about that.  As grateful as he was, he was determined to find a job now so that he could begin paying Johnny back right away.

He glanced at the clock on the wall and hopped down from his stool, making his way down the hall until he stood outside Justin’s bedroom.  He raised a hand hesitantly and paused before rapping on the door.  “Mr. Quinn?  Mr. Quinn, I’m sorry to bother you, but you told me to wake you at noon.”

Justin pushed his disarrayed covers back and crawled wearily from the bed.  He opened the door and smiled at the young man appreciatively.  “Thanks, Tag.  And I told you to call me Justin, remember?”

Tag nodded respectfully.   “Yeah, I remember.  I wanted to thank you again…you know, for letting me stay here by myself and all.”

Justin began walking down the hall.  “I’ll tell you what.  You can thank me by coming with me out to John and Hannah’s today.  I’m sure there’s a lot of work to be done, and the horses will need exercised.”

“Sure, no problem.”

The pair arrived in the kitchen area and Justin was pleased to see that Tag had been looking at the information Hank brought over.  He indicated the various brochures scattered on the bar.  “So, what do you think?”

Tag explained how excited he was about his upcoming training, and how he wanted to try to find a job.  He accepted a carton of milk from Justin, who was in the process of preparing some lunch, and sat it down on the bar.

“Are you sure that won’t be too much for you to handle, Tag?  Attending the academy and working at the same time?”

Tag thought about his father and what he had endured on the reservation.  Compared to that, this should be a cake walk.  “No, sir.  I don’t.  I want to be able to pay my way.”

Justin smiled.  He was filled with respect for this young man with the troubled past, and was only too happy to do for Tag what Johnny’s aunt had been able to do for him when he was about the same age.  “Well, then first thing tomorrow we’ll start beating the streets.”

“Beating the streets?”  Tag was not familiar with the phrase.

Picking up on this, Justin retracted his comment.  “Never mind.  We’ll do some job hunting.  Maybe Hannah will have a newspaper and we can start looking through the help wanted ads.”  Justin thought as he sat out the fixings for sandwiches.  The fire academy did not require a high school education, and Hank had already assured Tag that the department would work with him while he studied for his G.E.D.  He was reasonably sure Tag could get hired at a fast food place or a gas station without his diploma.  His thoughts turned to Camarin.  She would be job hunting too.  Justin wondered what kind of education she received on the reservation, and whether prospective employers would even consider it.

Small talk was exchanged during lunch, and Justin chuckled at some of the questions Tag posed about the modern conveniences he took for granted.  After the dishes were placed in the dishwasher, the two headed out to Justin’s Mercedes for the trip to Johnny’s ranch.

zzz

Camarin stood inside the barn door with her arms crossed, watching Hannah clean the horse stalls.  She was concerned the pregnant woman was doing too much, but reasoned staying busy was her way of dealing with her worry over John and her disappointment over not being able to see him.  “Hannah…let me help with that.”  She was relieved to hear a car pulling up.  Maybe Justin could talk some sense into his sister.

Hannah wiped the sweat off her brow.  She was exhausted already, and she had only just started.  “It’s okay.  It’s easier for me just to do it than to explain how John likes it done.  Can you ride?  You could help with that if you want…”

“Hannah…”  Justin crossed the straw covered floor quickly and removed the pitch fork from Hannah’s hands.  “What are you doing?”

“I’m taking care of the ranch, Justin.  What does it look like I’m doing?”  Hannah’s tone was more tired than annoyed.

“And there are plenty of people to help you with it, so you shouldn’t be overdoing it.”

Hannah looked over to see Tag and Camarin already turning Hope and Rhiannon out into the corral.  “I’m not overdoing it.  This just needed done, and…well, I figured…”

Justin looked over his shoulder, making sure the others were outside.  Turning back to Hannah, he placed his hands on her shoulders.  “Look, Han.  I know you’re concerned about John, and I know you want to be with him right now.  But, if you hurt yourself or the baby, that’s not going to do anything to help him…or you.”

“I know…”  Hannah parked herself on a hay bale.  “The truth is, I’m so tired all the time.  I just wanna do something, you know?”

Justin smiled as he hefted a load of straw onto the pitchfork.  “Well, since I’ve never been pregnant, I’ll take the fifth on that one.  But, I think I understand.”  He tossed the straw and stood for a moment, resting his hand on the tip of the handle.  “What about your practice?  Do you have any patients to see today?”

“No, I cancelled all my appointments for the next few days.  With Camarin and the girls here, I didn’t want to spend all my time working…”

“Uh huh.  Right.”  Justin had a feeling Camarin and the girls had nothing to do with Hannah’s decision.

Camarin started back inside and stopped in her tracks, momentarily taken aback by the sight before her.  Justin was using the pitchfork now, perspiration already beginning to glisten on well muscled arms that twitched and flexed from exertion.  His dark green tee shirt clung to his body in places, and Camarin couldn’t help but notice how his faded Levis fit his lower body just right.  Slightly surprised and embarrassed to feel her face flushing, she quickly looked away, wiping her hands on her thighs.

Hannah noticed Camarin’s apparent distress and smiled knowingly.  “You ready for Red?”

“Excuse me?”  It wasn’t that Camarin didn’t hear.  She was distracted.

Justin took a break from his task and looked over toward the door where Camarin was standing.  There was just enough of a light breeze to cause long shiny tendrils of hair to waft gently across her bronzed skin.  Justin swallowed in an attempt to get his mouth to work.  “Uh…Red.  The horse.  Hannah wondered if you were ready to take him outside.”

Hannah raised an eyebrow toward her brother and couldn’t help but notice the way he was admiring her houseguest appreciatively.  Tag was inside now, and she looked in his direction, both almost laughing out loud when his expression indicated he sensed what she did.  Yet Justin and Camarin appeared oblivious to each other’s attraction. 

Camarin stepped aside while Tag led the mighty animal outside.  She allowed her gaze to linger on Justin for a few seconds longer before speaking.  “Well!  I guess I’ll go for a little ride.”

Justin watched as Camarin turned and started walking toward the corral.  Then, he threw down his pitchfork and followed her.  “Wait!  I’ll go with you!”  Almost as an afterthought, he turned back toward his sister.  Truthfully, he had momentarily forgotten she was in the room, although he would never let her know that.  “And you!  Take a break.  Go inside and lie down for a while.”

Hannah waited until she knew Justin could not see her, and then she leaned back against the wall, unable to control her laughter.

zzz

Cap stepped into Johnny’s cubicle to the sound of soft snoring.  He couldn’t repress a smile at the sight of Roy, slouched uncomfortably in a plastic chair, arm draped haphazardly through the bed rail, chin to his chest, sleeping.  Deciding he would try not to wake him, he moved as quietly as he could to the opposite side of the bed. 

God, he looks awful.  The unwelcome thought popped into Cap’s head as he took in Johnny’s appearance.  Although his young friend was sleeping, he seemed far from comfortable.  He was perspiring heavily, and his breathing was labored.  Restless shifting of limbs was halted by soft moans and incoherent mutterings as Johnny’s attempts at movement produced pain which did not allow him the rest he needed, but did not bring a full return to consciousness. 

A sound from the chair startled the captain.  “Roy?”

Roy wearily scrubbed the sleep from his eyes.  “Hi, Cap.  When did you get here?”  He looked at his watch.  Six thirty p.m.  He wondered when Justin would be here.  Or was he here already and I slept through it?

“Just now.  Have you been here all day?”  Cap remembered that Roy had mentioned coming over first thing in the morning.

Roy yawned.  “I got here around just before noon.  Johnny’s not having a good day…”

“Well, that much is obvious.”  Cap looked back down at Johnny.  “What’s going on?  I thought he was doing better.”

“He is, really.  It’s just that he’s been having a lot of pain, and apparently he built up a resistance to the pain medication he was on, so Brackett and Andrews are trying something new.  It’s not working as well.  They’ve got him on the maximum dose, and it’s helping some, but  it’s making him sick.  So, they’re giving him more anti-nausea meds to deal with that, and that just makes him wanna sleep, but then he can’t really sleep well.  He’s been pretty miserable all day.”

Cap shook his head.  “Boy…Isn’t there anything else they can give him?”

“I don’t…”  Roy’s words were cut off by a particularly distressed moan.  He stood up in response and grasped Johnny’s forearm.  “Johnny?  What’s wrong?  Is it getting bad again?”  They had been through this routine too many times today.

Johnny tried to ignore the increasing pulsing and throbbing in his left thigh so he could settle back into a half-sleep.  But it was no use.  Frustrated, he blinked his eyes open and tried to focus on the two figures leaning over him.  It was then that he became aware of an unbelievable crawling sensation.  He looked down at his body to see if he could make out the source of this new torture and he gasped in horror at what he saw.  Insects.  Some sort of large beetle, maybe a cockroach.  Hundreds…no thousands of them.  They were climbing up the sides of the bed, skittering their way across every inch of his flesh, biting and pinching in a frenzied swarm.  He tried shaking them off his limbs, and pain erupted from every nerve ending.  His eyes grew wide with fear. “Aaaaaahh!”

“I’ll get the nurse!”  Roy sprinted out of the room, leaving an uncharacteristically flustered Cap to deal with whatever was bothering Johnny.

“John, it’s Cap.  Can you look at me?”  Cap was doing his best to keep his own fears in check.  Johnny looked positively terrified, and didn’t seem to be responding to his voice.  “John?”

Roy was back in less than a minute with Heather and Joe Early in tow. 

Joe had been speaking with a nurse about another patient when he saw Roy’s frantic dash out of Johnny’s cubicle.  He moved quickly to the bed.  “Johnny!  Can you hear me?”

Johnny’s body thrashed in panicked jerking movements.  “Aaaugh!  Get ‘em off!”  He squeezed his eyes shut tight, and the others in the room couldn’t tell if it was because he was hurting or because he was frightened by something.  “Get ‘em…off!”  His voice was desperate and tight with pain and exhaustion.

Joe eyed the heart monitor concernedly.  Whatever was going on…a head injury they missed, feverish delirium…he would need to act quickly.  “Johnny, it’s Joe.  Get what off?  Tell me what you see.”

Joe?  Joe Early?  “Everywhere…crawling…”  Johnny’s face pinched into another disheartening scream.  “Aaaah!  God!  Get ‘em off me!”

Joe snapped an order at Heather.  “5 milligrams diazepam!”  Then he laid a firm hand on Johnny’s forehead.  His eyes were open and unseeing.  “Johnny, listen to me.  You’re having some sort of hallucination.  There’s nothing crawling on you.  You’re going to be fine.”

“No!”  Johnny’s head moved weakly to the side in a feeble attempt to fight off the unwelcome intruders.  “No…” 

Heather injected the sedative and all waited until Johnny’s struggling ceased and he settled into sleep, still mumbling about his ordeal.

Cap was the first to break the silence.  “What in the hell was that?”

Joe kept his eyes trained on Johnny for a few moments before answering.  Satisfied, that he was resting now and that he hadn’t caused further injury to himself, he offered his guess.  “Some sort of visual and tactile hallucination.  I’ve seen this sort of thing before in people with certain types of brain injuries…and also in heroin addicts.”

“Well, I don’t think it’s heroin.”  Cap looked down, relieved to see Johnny resting. 

Joe smiled.  “Neither do I.  I’ll order a skull series to see if there’s anything there that may have been missed.”  He looked back at Heather.  “Get his temp.  This seemed more like a hallucination than fever delirium, but we can at least rule it out.  And have Dr. Brackett paged.”

Roy had been silently thinking, chewing his bottom lip in concentration.  He watched the curtain close in front of his eyes as Heather pulled it around the bed, giving her patient some privacy.  “Doc?  Could pentazocine cause a reaction like this?”

“Pentazocine?”  Joe’s eyes squinted in confusion.

“Yeah…They switched Johnny’s medication this morning.  They’ve been giving him pretty high doses of it around the clock.  I don’t think he’s ever taken it before…”

Joe rubbed absentmindedly at his nose.  “It’s a possibility, Roy.  Pentazocine’s side effects are very similar to those of heroin.  I’ll run some other tests just to be sure, but I wouldn’t be surprised if Johnny’s reacting badly to the new drug.”

“Well, what then?”  Cap asked.  “The other stuff they were giving him wasn’t working.”

“Don’t worry, fellas.  We’ll get it straightened out.”  Joe looked up expectantly at Heather who was pulling the curtain open again.

“101.4” Heather returned the thermometer to the small jar beside the bed.

Roy felt at least one weight lifted off his shoulders.  “That’s lower than it was this afternoon.”

Brackett burst into the small room then, curtly acknowledging the others before consulting with Joe.  “Gentlemen?  Could you step out for a few minutes please?  We won’t be long.”

Roy and Cap nodded silently and slipped out into the hall.

zzz

Justin and Camarin ambled down the hall and were surprised to see Roy and Cap standing outside Johnny’s room.  Justin peeked in and noticed the curtain was closed, blocking his view of the bed.  “What’s going on?”

Roy pointed down the hall.  “Why don’t we go down to the lounge, and I’ll fill you in.”

Once inside the lounge, Camarin couldn’t contain her curiosity.  “Is John worse?”

Roy rubbed at the back of his neck.  “Not exactly.  Dr. Early thinks he’s had a reaction to the new pain meds he’s on.”

“New pain meds?”  This was news to Justin.

Roy went on to explain the circumstances surrounding the switch to the new drug and then added what he and Cap had just witnessed as well as Joe’s opinion on the possible causes for Johnny’s hallucinations.

Justin paced the floor, thinking.  “Well, morphine is out…and Demerol too.  What else is there?  I can’t think of anything that would be strong enough…”

Camarin looked at the others concernedly.  “All these drugs…are they good for John to be taking?”  Camarin was not naive enough to think that Johnny did not need some intervention, but she couldn’t help but be wary of these synthetic concoctions she knew little about.

Justin stopped pacing long enough to address Camarin’s concern.  “Well, he does need some help right now.  I have to admit, I don’t like the fact that John’s been taking so many narcotics that he’s building a resistance.  I’ve been doing some studying…I’d like to try…”

Justin’s suggestion was interrupted by Kelly Brackett’s entrance.  “Johnny’s fine.  We’re running some tests to rule out a brain injury, but Joe and I are almost one hundred percent certain this was a reaction to the pentazocine.”

“Well, what does that mean, Doc?”  Hank wondered.

Brackett accepted a cup of coffee from Camarin with an appreciative smile.  “It means we won’t give him any more.”

Roy’s stomach tightened.  “But…he’s still having so much pain.  What are you…”

“That’s what I need to talk to you about, Roy.  Since you’re still listed as the one to make Johnny’s medical decisions, I need your permission to try a new non narcotic pain reliever that just came on the market.”

Roy felt as uneasy as the others looked.  “Well, what is it?”

Brackett took a seat in one of the chairs.  “It’s called Tramadol.  It’s been used successfully in anesthesia, and has just recently been marketed as an analgesic.  It’s experimental at this point, and unfortunately, there’s not a lot of information on possible side effects or contraindications.”

“I don’t know, Doc…with the condition Johnny’s in…I just don’t know if you should be experimenting…”

Brackett nodded, understanding Roy’s hesitation.  “I know what you’re thinking, Roy.  And I don’t blame you, but I wouldn’t be recommending this if I didn’t feel it was safe.  You know we’ll monitor Johnny’s condition closely.”  When the doctor saw that the others still did not look convinced, he added, “Look, I honestly don’t know what else to try.  The only other alternative would be to use something that wouldn’t be strong enough to manage his current level of pain.”

Roy sighed, purposely avoiding eye contact with the others.  He knew it would be up to him, and he didn’t like holding Johnny’s life in his hands.  “Doc…I trust you.  If you’re telling me you think it’s safe…”

Brackett smiled assuringly at Roy and the others.  “I really do.”

“Then, okay.”  Roy hoped fervently that he had not just signed a warrant issuing more suffering for his friend.

Brackett stood and emptied his cup into the small sink.  “Thanks, Roy.  Johnny’s sleeping right now.  That diazepam Joe ordered is doing its job.  We’ll wait until he comes around and is having pain again to try the tramadol.”

“When do you think that will be?”  Justin wanted to be here.

Brackett crossed his arms thoughtfully.  “It could be several hours.  My advice to all of you is to go home and get some sleep.  We’ll call you and let you know how he does.”

After Brackett’s exit, Cap stretched and looked at his watch.  “Well, I may as well go home.  Tell John I hope he’s feeling better and I’ll see him soon.”  The captain knew at least one of the other three in the room would be spending the night.

“Right, Cap.”  Roy waved a goodbye and deposited himself on the sofa.  “You two gonna stick around a while?”

Justin looked at Camarin and received a nod of confirmation.  “Yeah, I guess so.  You?”

“Yep.”  Roy leaned back and folded his hands in his lap, wondering when Johnny would get around to listing Hannah or Camarin as his legal next of kin, at the same time relieved they did not have the burden on their shoulders he was carrying right now.

zzz

Justin looked down at his sleeping friend and thought about their friendship thus far.  Sure, there had been barbeques on the beach, and fierce bowling competitions, and more than their share of days spent on the couch, drinking beer and watching football.  But, Justin couldn’t help but think about plans they’d talked about…of camping trips and trail rides.  Johnny was going to teach Justin how to rock climb and Justin was going to tune up the pair of dirt bikes he had in storage so they could take them for a spin.  But, it had seemed as if there was not enough time, or that the unlucky injuries Johnny had sustained over the past few years had gotten in the way.

Now, Johnny was about to be married…to become a father.  While Justin couldn’t be happier for his friend, or for his sister for that matter, he couldn’t help but wonder if he were losing something special.  He was sure that there would still be opportunities to spend time together, doing “buddy” stuff, but things would never be quite the same.  All of a sudden Justin started to feel very alone.  Dismissing it as selfishness, he pushed the feeling out of his mind.

“He doesn’t look comfortable to me.”

Camarin’s soft voice startled Justin out of his thoughts.  He noticed the evidence of tension tightening Johnny’s features, even in sleep, and had to agree.  “Well, he’s sedated, but he could still be aware of pain.  It’s hard to know, really.  And, there’s only so many positions he can lie in.  I’m sure some of his muscles are really starting to stiffen up.  He could even be developing some bed sores.”

Camarin’s eyes softened in understanding.  “And you’re standing there wishing you could make it all go away.”

“I hate feeling helpless.  You know?”  The words left Justin’s mouth before he could stop them.  He was not usually so open about his feelings, and he had no idea why he had blurted that out, but he couldn’t seem to stop himself.  “There’s just so little I can do for him right now…”

“I have a feeling you’re already doing more than you know.”  Camarin stepped around the bed so that she could stand beside Justin.  There was just something about this man that seemed to pull her in, and she was helpless to know why.  Outwardly, he appeared confident and sure, but Camarin suspected there was a lot more to the mystery.  And she wanted nothing more than to investigate. 

Camarin and Johnny had talked about the revelations he had received…how it seemed their papa had set certain events in motion…led Hannah to John…led John to the reservation.  Could it be possible that Justin was part of his plans?  That he was trying to make up for past sins by offering his daughter a man who could provide for her…take care of her…love her?

Deciding not to get her hopes up, after all Justin might not feel the same way, Camarin tried to make conversation.  “Justin…back in the lounge…you said something about…well, that you’ve been studying…”

Justin spoke without taking his eyes off Johnny.  “Yeah…I’ve been studying alternative methods of pain management…acupressure and herbal therapies…it’s very interesting.”

“I would be interested to learn more. I was known as a medicine woman on the reservation.  I kept many herbs used in healing.  This knowledge was passed on to me by my mama.”

Justin remembered reading references to Native American medicine in his studies, but he supposed he had assumed it was a lost art.  He really hadn’t given much thought to the possibility that Camarin would be familiar with it.  This information only served to increase his already overwhelming curiosity about this exotic woman.  “Really?”

“Yes.  I would love to teach you what I know.”

The conversation was halted by a moan from the bed, followed by a weak question.

“Who…who’s there?”  Johnny awoke to pain and the sound of hushed voices, one male and one female.  He couldn’t quite make them out.  They sounded as if they were traveling through water.  He wanted to open his eyes to see, but they were being held closed by some heavy invisible force.

Camarin’s hand moved to Johnny’s forehead immediately.  “Shhh, sumanitu.  It’s me.”  He’s really warm.

“C—Camarin?”  Johnny moved his head toward the sound of the voice.

“Yes, it’s me.  Justin is here too.”

“How are you feeling, John?”  Justin took a step closer to the bed. 

“I…I don’t…”  Johnny’s tongue felt thick and clumsy.  “Kinda…fuzzy.”

“Well, you’ve had some diazepam.  You’re probably still feeling the effects.”

Johnny’s brow creased in confusion.  “Di..Diaz…”

Justin decided to leave out the part about the insects.  “Don’t worry about it right now.”

Johnny tried to relax back into sleep, content in the presence of his sister and friend, but as he made his way farther and farther out of the murky fathoms of his sedative hangover, pain began in his temples and slithered its way through heavy limbs, squeezed the air out of his chest, and wrapped itself constrictively around his hips and legs.  “Hurts…”

Justin pressed the call button.  “What hurts, John?  What can I do?”

Johnny was hard pressed to offer a suggestion.  The pain was everywhere, and it went beyond a simple repositioning of a leg or massaging of a tight muscle.  “Noth…nothing…need…something…”

This was how Justin knew Johnny was really hurting.  He never requested pain medication unless he really needed it, and sometimes not even then.  “Okay…hang in there a sec.”  He looked up and noticed Heather walking in, carrying a syringe.  ‘His pain is pretty bad again.”

“I had a feeling when you hit the light, so I was ready for you.”  Heather spoke soothingly to her patient as she swabbed the open port on his central line.  “I’ve got what you need right here, John.  You’ll be feeling better in no time.”  As she was injecting the new drug, she directed Justin.  “Brackett wanted to be paged when I gave him this.  Can you...?”

“Sure.”  Justin headed for the nurses’ station, his stomach twisting in anxiety over whether the tramadol would work or worse yet, what type of undesirable side effects it might produce.  He took care of the page, then noticed Roy walking down the hall toward him. 

“What’s going on?”

Justin followed Roy’s quick pace to Johnny’s room.  “John’s awake.  Heather’s giving him the tramadol.”

The two concerned men rushed into the room, out of breath, and expecting the worst.  They were stopped in their tracks by Camarin and Heather’s smiling faces.

“Sleeping like a baby.”  Heather reassured.

Roy’s gaze traveled from the heart monitor above the bed down to Johnny’s sleeping form, which for the first time all day, looked comfortable.  “It worked.”

Camarin agreed.  “Sure seems like it.  John was so relieved…he was actually smiling.”

Justin ran his fingers through his hair.  “Well, I’ll be damned.”

Justin and Camarin said their goodnights, while Roy took up residence in the chair by the bed.  He decided to stay for a few hours to make sure Johnny continued to react positively to the new medication.  Brackett breezed by the exiting pair as he made his entrance.

Back in the lounge, Camarin began gathering her things.  “At least John seems to be resting well.  I feel better about leaving now.”

For reasons that both confused and terrified him, Justin was not ready to drop Camarin off at the ranch and go home.  He looked at his watch.  It was after ten.  He had an idea.  “Camarin…you said Hannah was going to take care of getting the girls to bed tonight?”

“Yes, she did.  It was really sweet of her.”

Justin smiled.  “Well, think of it as practice.”

“Right.”  Camarin laughed softly.

What are you waiting for?  Just say it.  “Camarin, I was wondering…I have all those books on alternative pain management back at my place.  Would you like to come over for a while and talk some more about it?  We could have something to eat…”  Justin spoke without taking a breath.

Camarin couldn’t help but notice the somewhat awkward stammer, so she decided to cut Justin a break.  Besides, this idea was almost too good to be true.  “I’d love to.”  Then, realizing in her giddy state she had almost forgotten about Kara and Rose, she amended, “As long as it’s not too late.  The girls…”

“Will be just fine with Hannah.  But, don’t worry.  I’ll make sure you get home at a decent hour, Miss Raven Skye.”

“Okay, Mr. Quinn.”  A smile lit Camarin’s face as she followed Justin out of the lounge.   

zzz

Justin couldn’t help but feel a bit uneasy on the drive back to his place.  With Tag spending the night at the ranch, he and Camarin would have the place to themselves.  He tried to remind himself that this wasn’t a date.  It was just two people with similar interests spending some time together.  Wait a minute…  Justin’s stomach knotted, realizing that it had been so long since he’d been on what could be construed as an actual “date” that he had a skewed definition of the term. 

He threw his jacket over the back of the couch, and headed for the coffee table and the stack of books he knew he would find there.  He motioned for Camarin to follow him.  “Have a seat.  Unless…would you like something to eat or drink first?”

Camarin stood at the large window which in the daytime, offered an ocean view.  She turned at the sound of Justin’s voice.  “Actually, I thought it would be nice if we sat out on the sand.  Is there enough light out there to see?”

“Uh…sure.  I mean…no.  Not really.  But, if you want, we can just talk for a bit.  I can tell you what I’ve read, and you can teach me about what you do.”

Camarin smiled.  “There’s a lot I’d love to teach you.”

“Oh…oh good.  Okay, well let’s go then.  I’ll get a blanket.”  Justin started for the closet.

“For what?”

“To sit on.  So we don’t get all sandy.”  Justin said matter of factly.

Camarin had actually been looking forward to the cool, silky sensation of the sand between her toes again, but she said nothing.  Apparently, sitting on a blanket was the thing to do.  She could always put her feet off the edge.  “Okay.”

Justin opened the door which led to the deck, and led the way down the steps onto the sand.  There, he spread out the blanket and waited for Camarin to sit down.  “Are you hungry?  Can I get you something?”

Camarin kicked off her sandals and dug her feet into the sand.  “Maybe just something to drink.”

Justin slid out of his own sandals and placed them near the blanket.  “Well name your poison.  I’ve got water, Pepsi, tea, coffee, beer…oh, and I think I may have a bottle of wine or two.” He could feel a certain stirring at the sight of Camarin on the blanket.  She was in the process of slowly unraveling her hair from its tight braid, causing it to fall free in soft, loose waves.

“I can’t remember the last time I’ve had wine.”

Justin shook himself from his trance.  “Okay.  Wine it is then.”

Camarin leaned back onto her palms, listening to the sound of the surf, breathing in the brackish air.  She felt as though she had stepped into some sort of dream, where every sense was filled with new and exciting experiences.  She had often wondered about Los Angeles, had pictured it in her mind.  But the reality far outdid anything she could have ever imagined, and it excited her.  She felt invigorated.  She knew that very soon she would need to begin looking for a job and a place to live.  There would be much work to be done, but right now, she wanted to bask in the moment, absorb every detail into her pores.

Justin returned with a wine bottle in one hand, two glasses in the other, and a corkscrew in his mouth.  He allowed Camarin to take the glasses from him and he sat down.  “Hope you like Cabernet.  It’s all I had.”

Camarin watched as Justin expertly pulled out the cork.  “I don’t think I’ve ever had it.”

“It’s one of my favorites.  It’s got sort of a smoky quality with hints of black currant and vanilla.”

“Sounds wonderful.”

Justin chuckled as he poured.  “Well I’m glad you think so.  I’ve never been able to get your brother to try it.  He told me he eats enough smoke at work.  He doesn’t need to drink it too.”

Camarin laughed as she held the glass under her nose, savoring the bouquet.  Tentatively she took a sip.  The taste was unlike anything she had ever experienced.  She couldn’t necessarily say it was good, but there was something…seductive about it.  She watched as Justin sampled his.  “Mmmm.”

“Glad you like it.”

The two sat in silence for several minutes, drinking their wine.  It wasn’t an awkward silence, but instead it offered a comfortable retreat from the stress and exhaustion of the past several days.  Finally, Justin spoke.  “So, you’re a medicine woman.  Tell me about that.”

“I wouldn’t even know where to start.  What I know I learned from my mama.  She learned from her papa.  The knowledge has been passed down through generations.  The Lakota believe that healing takes place when focus is placed on the whole person.  When something is out of balance, illness or injury take over.  By treating the whole person, and restoring balance, healing can occur.”

Justin sipped his wine.  “It’s fascinating.  And, I’ve seen it happen so many times with my patients.  Medicine is about more than treating symptoms.  You have to really get to know what makes a person tick, what’s going on inside their head, what emotional issues need resolved.  I know a lot of people I work with would scoff at the idea of using flowers and tree bark as medicine.  But, as far as the whole concept of restoring balance…Well, I would challenge any of them to a debate on that subject.  And, your people, as well as people in other parts of the world, have been using this approach to medicine for centuries.”

Camarin nodded thoughtfully.  “I’m not going to say it doesn’t have its limitations.  I’ve seen people on the reservation die because they would not see the doctor at the clinic and take advantage of the white man’s medicine.  But, I’ve also seen people respond to Lakota medicine, who could not be helped at the clinic.” 

“Sounds like the key is…to find a way to work together.”  Justin’s blue eyes found Camarin’s brown ones and held on.

Camarin could feel heat rising from somewhere deep inside until a flush spread over her cheeks.  “Yes…together…” 

Justin looked away.  “So!  I’ve been thinking about taking a course on acupressure.  Have you heard of it?”

Camarin shook her head as she intentionally moved closer to Justin.  “No.  Why don’t you tell me about it?”

Justin tried to push down his rising attraction toward this woman, but his body had other ideas.  He silently cursed its betrayal.  The last thing he needed was to become involved in a relationship right now.  Especially with Camarin.  What would people think?  What would John think?  And there were Kaya and Rose to consider.  “Uh…Well, it’s a traditional Chinese healing art.  It uh…”  God, Camarin was so distracting.  Her hair rippled around her shoulders and the moonlight reflected off the ebony tresses.  Her deep, brown eyes stared into his with a mixture of genuine interest in the discussion…and attraction.  And her scent…Justin couldn’t quite place it.  He didn’t think it was perfume, but it had a seductive, earthy quality, like the sage covered desert at sunrise.

Camarin shivered.  The way Justin was looking at her right now shook her to her very core, his efforts to deny the burgeoning magnetism between them making him that much more alluring.  “Justin?”

“Huh?”  Justin had momentarily forgotten what he had been talking about.  Shaking it off, and forcing himself back on task, he continued.  “I’ve already tried out a few techniques that I’ve read about, but I thought I should do it right…take a class…get certified.  It’s all about restoring balance by applying pressure to certain points on the body.”

“Really?”  Camarin’s mind puzzled over what Justin was saying.  While it seemed a little foreign, she reminded herself of the power of touch, and its often uncanny healing properties.  “Show me where?”

Justin swallowed hard as Camarin moved impossibly closer, so close he could practically feel electrical energy rising from her copper skin.  Talk about strong chi, he thought randomly as he tried to gulp enough moisture into his mouth to continue speaking.  “Well…”  He picked up Camarin’s hand and turned it over, placing his fingers over the crease on the inside of her wrist, in line with her little finger.  “Stimulating this point can…uh…”  He watched as Camarin’s eyes followed his to his hands touching her.  Then, before he knew what was happening, he felt her arm slip from his grasp, her hands moving up his arms to his shoulders.  Staring into her eyes, Justin found them wild with need and stained with bitter secrets.

It was beyond either one’s control now, as both Camarin and Justin gave in to years of suppressed longing mixed with a raw desire they could no longer deny.  Camarin closed her eyes as she allowed herself to be lowered onto the blanket, Justin’s warm breath coursing over her neck and shoulders as he worked to move her calico blouse out of his way.  Giving herself completely over to this man felt like the most right thing in the world, although even if it hadn’t, she could not have stopped him now.  Camarin breathlessly returned Justin’s hungry kisses as she moved her hands to his chest, scrambling at the buttons on his shirt, needing to get at the flesh underneath.

Seconds later, Justin found his mark, causing Camarin to gasp slightly before relaxing under his gentle strokes.  Then, quickly and urgently, tenderness gave way to vigorous yearning, reciprocal passion surging in tandem with the steadfast cadence of the waves.

Part 5