ER: Into the Fire (14/17)
All disclaimers, notes, warnings and summary are in the Master post: Into the Fire
County General Hospital - 12:39pm
"Peter!" Kerry called as she ran forward. "Peter, he's alive?!"
Benton nodded quickly, barely noticing the others who were surging forward and grabbing the gurney as they ran. "Multiple GSW! Upper left chest, upper left arm, outer right thigh, lower right flank! Open pneumo of the right lung! He's hypotensive! Pressure's 90 palp and dropping! Hypovolemic! Hypoxic! Sats are..."
Peter continued the bullet as they ran, but Abby didn't hear him. Benton's voice blended with Kerry's, Luka's, the howl of the wind, and the roar of the departing helicopter. When her eyes fell on his face, she heard no sounds at all.
He was here.
He was alive.
The nurse in her was assessing his injuries, his pallor, his responsiveness. The nurse in her was watching his chest rise and fall with every squeeze on the ambu-bag she held in her hand. The nurse in her pressed her fingers against his wrist, felt his pulse, counted his heartbeats. The nurse in her estimated how close he was to death.
The woman in her gazed at his face, grasped his hand in hers, and silently begged him to live.
The elevator doors opened, and the occupants burst forth in a rush, pushing the gurney toward Trauma Two as quickly as they could. Randi froze behind the desk when she saw them, covering her mouth with her hand as she watched them rush past her. Memories flashed through her mind of another time, not so long before, when she had witnessed the same thing: so many people, doctors and nurses, frantically fighting to save one of their own.
The same one.
Randi closed her eyes for a moment, and whispered a prayer that they'd be able to save him again.
Kerry swallowed the lump that filled her throat as she ran down the hall, one hand on the gurney that held her friend. She'd always known that there was something special about him, a depth of humanity that so few people seemed to have any more. She'd seen him put through so much by those around him, and by his own hand, but he'd always managed to make it through. She'd seen him live through things that would have killed anyone else, but he'd always managed not only to survive, but also to keep fighting.
As she looked down at his face, at the deep dark circles around his eyes and the deathly pale color of his face, she had to wonder if he could do it again.
How much did he have left?
Had his compassion finally cost him his life?
Luka had to force himself to concentrate on Peter Benton's voice.
If he allowed his mind to wander, he would get lost in all the questions. What did the world have against Carter? Why did these things keep happening to him? How could such a decent man have so many people try to kill him in such a short time?
He kept flashing back to a cold night in February, and another time he had stood over Carter on a gurney. The blood had been everywhere then, but this time there was more. Then, Carter had been able to wake up and talk to them; Luka doubted he'd open his eyes in the trauma room this day.
As he took a deep breath and pushed the gurney through the doors to Trauma Two, Luka had to wonder if Carter would ever open his eyes again.
"All right, let's move him!" Peter barked. "On my count! One, two, three!"
Moving as one, the doctors and nurses lifted Carter from the gurney he was on and laid him on the bed in the room.
Peter tore his jacket off in a rush, throwing it down in the corner as he continued to bark orders. "CBC, Chem 7, UA, EKG, cardiac enzymes, type and cross for six. Get X-ray in here. I want a cross-table C-spine, chest and pelvis, right thigh films, and a head and neck series. And get a Foley in." Everyone jumped into action, and Peter allowed himself a second to glance down at Carter's still face. "You're gonna make it, buddy," he whispered, squeezing the young man's arm. To the room, he shouted, "Somebody get me a chest tube tray! Betadine and sterile drape. Start a central line and hang two on the rapid infuser."
The nurses started moving about the room quickly, rushing to take vitals, grab equipment, and respond to orders.
"What about the source of that bleeding?" Luka asked from across the table, catching a glimpse of the blood-soaked gurney as it was pulled from the room.
"Give me a second," Peter snapped back, throwing the scalpel down on the tray next to him and grabbing the tubing. A few seconds later, he called out, "All right, it's in." As he pressed his stethoscope against his young friend's chest, he looked to Luka and asked, “How's that central line coming?"
"Almost in," Luka answered, glancing up at Abby. "Abby? Abby!"
Abby jumped slightly, jolted out of her silent thoughts. "Yeah?"
"Hang two units," Luka said, and Abby nodded, grabbing the bags of blood and attaching them to the central line. As she finished hanging them from the I.V. pole, Cleo burst through the doors.
"Abby!"
"What?" Abby asked, not bothering to look up from what she was doing.
"Abby, I need you," Cleo began.
"I'm busy!" she returned. "Find someone else!"
"No, Abby, I've got a 17 year old in active labor at 34 weeks, with a bullet in her stomach. I need you."
Abby looked at Carter, feeling herself torn. Should she stay and try to help and save her best friend's life? Or should she go and help a terrified teenage mother-to-be, one of the reasons he was lying there in front of her? She looked up at Peter, and saw in his eyes an understanding of exactly what she was feeling. She shook her head silently; she couldn't leave him now, not when there was such a great chance that she'd never see him again if she did.
Luka watched Abby from across the table. He felt a small pang of jealousy at her loyalty, but pushed it away quickly. Carter was her friend. Leaving him would have been hard for any of them at that point; it had to be twice as hard on her.
"Go, Abby," Kerry finally ordered, breaking the silence without looking up from attending to the bullet wound in Carter's thigh. "Cleo needs you. Go."
Abby's eyes widened, and she glanced back down at Carter again. Impulsively, she reached out and gripped his hand once more. "I'll be back," she whispered. Then she turned and followed Cleo out of the room, only pausing for a second in the door to take one more look at his face.
"All right," Peter said, shaking his head to clear his thoughts. "What's his BP?"
"80/50," Haleh answered.
"Crit?"
"30."
"Damn it!" Peter looked down, moving his hands up and down Carter's torso, trying to find the source of his continued bleeding. The sheets on the gurney were soaked through, and the blood was beginning to drip onto the floor. "Where the hell is it?"
"Could it be the one in his back?" Kerry asked.
"It's on the wrong side."
"An exit wound from his chest then?" Luka suggested.
"I looked. I couldn't find one," Peter answered. "Roll him, let me check again."
The doctors and nurses moved into position quickly and shifted Carter up onto his right side as Peter inspected the young doctor's back. "I don't see anything," he mumbled. "There's so much blood... I can't tell where it's coming from…"
"Somebody call for some X-rays?"
Peter nodded his head as he watched everyone else lay Carter back down and step out of the room. "Take them quickly."
The radiology tech lined up the portable machine for the first shot and glanced up at Peter, who had only taken a step or two away from the gurney. "Aren't you going to leave?"
Peter shook his head, his eyes focused on Carter's still form.
"Well, are you at least going to wear a...?"
"Just take the damn X-rays!" Peter commanded shortly.
"All right, all right. Shooting!" Moments later, the rad tech grabbed all of his slides, and started to push the X-ray machine back into the hallway. As everyone filed back in, he called out to Peter. "Have these for you in five."
"You've got three!" Peter answered, stepping back to Carter's side and leaning down once more to look for the elusive bleeding wound.
"Belly is clear," Luka announced, after doing a sonogram on Carter's abdomen.
"What about his heart?" Kerry asked, pressing her stethoscope against Carter's chest.
"No, it's not his heart. Internal bleeding isn't the problem!" Benton roared. "If it were internal, it wouldn't be all over the floor!"
"Peter, calm down!" Kerry snapped.
"What's the matter, Peter? Lose something?"
"Robert…" Kerry began, her tone one of warning.
"Why isn't he upstairs yet?" Romano asked, walking up to stand beside Peter.
"We've got a bleeder that we can't find," Benton answered reluctantly.
"Well, these might help." Romano held up the X-ray films he held in his hand, then turned and slapped them up on the light board quickly. Kerry and Peter walked to stand beside him.
"There's the bullet in his thigh," Kerry observed, pointing. "No fracture, no major vessels damaged."
Romano looked at the X-ray and nodded. "Good news times one," he said.
"There's the one in his lung," Peter said. "It doesn't look like it hit anything else, and it's just sitting there."
"Good news times two," Romano replied. "Our dear Dr. Carter seems to have gotten lucky."
"So where's the other one?" Kerry asked, her eyes darting back and forth between the X-rays.
"Where are the cross-table films?" Peter demanded, realizing that they were missing.
"Right here," Romano answered, pulling down the clear X-rays to make room for them.
"Oh my God," Kerry breathed.
"Holy shit," was Romano's reaction.
"Damn it!" Peter cried out. "It's in his arm! How the hell did it get there?!"
“Is it in an artery?" Luka asked from across the room.
All three returned to Carter's side quickly, and Peter lifted Carter's arm as gently as he could. He found it immediately once he knew where to look. There was a large hole, bleeding profusely, in the left side of his chest, directly under his upper arm. "What the hell... ?"
"It must have ricocheted," Romano said from across the gurney.
"Did it hit the axillary?" Luka asked.
Kerry glanced back at the X-ray. "I can't tell. It's possible though."
"I should have found that," Peter declared, berating himself for his oversight.
"Beat yourself up later, Peter," Romano ordered. "You, Kovac, pack that off. He's stable enough. We're taking him up right now."
Luka grabbed a pile of four-by-fours and pressed them against the side of Carter's chest.
"Kerry, call vascular. Have them meet us upstairs."
Kerry nodded and grabbed the phone as the doors to Trauma Two were slammed open, and the assembled personnel erupted into the hallway, heading back to the elevators.
Abby looked up from her patient when she saw them pushing Carter past the door to Trauma One. She closed her eyes and said a prayer, her mind repeating the same phrase over and over again. ‘Please don't leave me. Please don't leave me now.'
Again, she pushed her own fear away, took a deep breath, and opened her eyes. "It's all right, Kristin," she said to the girl on the gurney in front of her. "You're doing great. Just one more push, and you'll be all done…"
County General Hospital - 12:39pm
"Peter!" Kerry called as she ran forward. "Peter, he's alive?!"
Benton nodded quickly, barely noticing the others who were surging forward and grabbing the gurney as they ran. "Multiple GSW! Upper left chest, upper left arm, outer right thigh, lower right flank! Open pneumo of the right lung! He's hypotensive! Pressure's 90 palp and dropping! Hypovolemic! Hypoxic! Sats are..."
Peter continued the bullet as they ran, but Abby didn't hear him. Benton's voice blended with Kerry's, Luka's, the howl of the wind, and the roar of the departing helicopter. When her eyes fell on his face, she heard no sounds at all.
He was here.
He was alive.
The nurse in her was assessing his injuries, his pallor, his responsiveness. The nurse in her was watching his chest rise and fall with every squeeze on the ambu-bag she held in her hand. The nurse in her pressed her fingers against his wrist, felt his pulse, counted his heartbeats. The nurse in her estimated how close he was to death.
The woman in her gazed at his face, grasped his hand in hers, and silently begged him to live.
The elevator doors opened, and the occupants burst forth in a rush, pushing the gurney toward Trauma Two as quickly as they could. Randi froze behind the desk when she saw them, covering her mouth with her hand as she watched them rush past her. Memories flashed through her mind of another time, not so long before, when she had witnessed the same thing: so many people, doctors and nurses, frantically fighting to save one of their own.
The same one.
Randi closed her eyes for a moment, and whispered a prayer that they'd be able to save him again.
Kerry swallowed the lump that filled her throat as she ran down the hall, one hand on the gurney that held her friend. She'd always known that there was something special about him, a depth of humanity that so few people seemed to have any more. She'd seen him put through so much by those around him, and by his own hand, but he'd always managed to make it through. She'd seen him live through things that would have killed anyone else, but he'd always managed not only to survive, but also to keep fighting.
As she looked down at his face, at the deep dark circles around his eyes and the deathly pale color of his face, she had to wonder if he could do it again.
How much did he have left?
Had his compassion finally cost him his life?
Luka had to force himself to concentrate on Peter Benton's voice.
If he allowed his mind to wander, he would get lost in all the questions. What did the world have against Carter? Why did these things keep happening to him? How could such a decent man have so many people try to kill him in such a short time?
He kept flashing back to a cold night in February, and another time he had stood over Carter on a gurney. The blood had been everywhere then, but this time there was more. Then, Carter had been able to wake up and talk to them; Luka doubted he'd open his eyes in the trauma room this day.
As he took a deep breath and pushed the gurney through the doors to Trauma Two, Luka had to wonder if Carter would ever open his eyes again.
"All right, let's move him!" Peter barked. "On my count! One, two, three!"
Moving as one, the doctors and nurses lifted Carter from the gurney he was on and laid him on the bed in the room.
Peter tore his jacket off in a rush, throwing it down in the corner as he continued to bark orders. "CBC, Chem 7, UA, EKG, cardiac enzymes, type and cross for six. Get X-ray in here. I want a cross-table C-spine, chest and pelvis, right thigh films, and a head and neck series. And get a Foley in." Everyone jumped into action, and Peter allowed himself a second to glance down at Carter's still face. "You're gonna make it, buddy," he whispered, squeezing the young man's arm. To the room, he shouted, "Somebody get me a chest tube tray! Betadine and sterile drape. Start a central line and hang two on the rapid infuser."
The nurses started moving about the room quickly, rushing to take vitals, grab equipment, and respond to orders.
"What about the source of that bleeding?" Luka asked from across the table, catching a glimpse of the blood-soaked gurney as it was pulled from the room.
"Give me a second," Peter snapped back, throwing the scalpel down on the tray next to him and grabbing the tubing. A few seconds later, he called out, "All right, it's in." As he pressed his stethoscope against his young friend's chest, he looked to Luka and asked, “How's that central line coming?"
"Almost in," Luka answered, glancing up at Abby. "Abby? Abby!"
Abby jumped slightly, jolted out of her silent thoughts. "Yeah?"
"Hang two units," Luka said, and Abby nodded, grabbing the bags of blood and attaching them to the central line. As she finished hanging them from the I.V. pole, Cleo burst through the doors.
"Abby!"
"What?" Abby asked, not bothering to look up from what she was doing.
"Abby, I need you," Cleo began.
"I'm busy!" she returned. "Find someone else!"
"No, Abby, I've got a 17 year old in active labor at 34 weeks, with a bullet in her stomach. I need you."
Abby looked at Carter, feeling herself torn. Should she stay and try to help and save her best friend's life? Or should she go and help a terrified teenage mother-to-be, one of the reasons he was lying there in front of her? She looked up at Peter, and saw in his eyes an understanding of exactly what she was feeling. She shook her head silently; she couldn't leave him now, not when there was such a great chance that she'd never see him again if she did.
Luka watched Abby from across the table. He felt a small pang of jealousy at her loyalty, but pushed it away quickly. Carter was her friend. Leaving him would have been hard for any of them at that point; it had to be twice as hard on her.
"Go, Abby," Kerry finally ordered, breaking the silence without looking up from attending to the bullet wound in Carter's thigh. "Cleo needs you. Go."
Abby's eyes widened, and she glanced back down at Carter again. Impulsively, she reached out and gripped his hand once more. "I'll be back," she whispered. Then she turned and followed Cleo out of the room, only pausing for a second in the door to take one more look at his face.
"All right," Peter said, shaking his head to clear his thoughts. "What's his BP?"
"80/50," Haleh answered.
"Crit?"
"30."
"Damn it!" Peter looked down, moving his hands up and down Carter's torso, trying to find the source of his continued bleeding. The sheets on the gurney were soaked through, and the blood was beginning to drip onto the floor. "Where the hell is it?"
"Could it be the one in his back?" Kerry asked.
"It's on the wrong side."
"An exit wound from his chest then?" Luka suggested.
"I looked. I couldn't find one," Peter answered. "Roll him, let me check again."
The doctors and nurses moved into position quickly and shifted Carter up onto his right side as Peter inspected the young doctor's back. "I don't see anything," he mumbled. "There's so much blood... I can't tell where it's coming from…"
"Somebody call for some X-rays?"
Peter nodded his head as he watched everyone else lay Carter back down and step out of the room. "Take them quickly."
The radiology tech lined up the portable machine for the first shot and glanced up at Peter, who had only taken a step or two away from the gurney. "Aren't you going to leave?"
Peter shook his head, his eyes focused on Carter's still form.
"Well, are you at least going to wear a...?"
"Just take the damn X-rays!" Peter commanded shortly.
"All right, all right. Shooting!" Moments later, the rad tech grabbed all of his slides, and started to push the X-ray machine back into the hallway. As everyone filed back in, he called out to Peter. "Have these for you in five."
"You've got three!" Peter answered, stepping back to Carter's side and leaning down once more to look for the elusive bleeding wound.
"Belly is clear," Luka announced, after doing a sonogram on Carter's abdomen.
"What about his heart?" Kerry asked, pressing her stethoscope against Carter's chest.
"No, it's not his heart. Internal bleeding isn't the problem!" Benton roared. "If it were internal, it wouldn't be all over the floor!"
"Peter, calm down!" Kerry snapped.
"What's the matter, Peter? Lose something?"
"Robert…" Kerry began, her tone one of warning.
"Why isn't he upstairs yet?" Romano asked, walking up to stand beside Peter.
"We've got a bleeder that we can't find," Benton answered reluctantly.
"Well, these might help." Romano held up the X-ray films he held in his hand, then turned and slapped them up on the light board quickly. Kerry and Peter walked to stand beside him.
"There's the bullet in his thigh," Kerry observed, pointing. "No fracture, no major vessels damaged."
Romano looked at the X-ray and nodded. "Good news times one," he said.
"There's the one in his lung," Peter said. "It doesn't look like it hit anything else, and it's just sitting there."
"Good news times two," Romano replied. "Our dear Dr. Carter seems to have gotten lucky."
"So where's the other one?" Kerry asked, her eyes darting back and forth between the X-rays.
"Where are the cross-table films?" Peter demanded, realizing that they were missing.
"Right here," Romano answered, pulling down the clear X-rays to make room for them.
"Oh my God," Kerry breathed.
"Holy shit," was Romano's reaction.
"Damn it!" Peter cried out. "It's in his arm! How the hell did it get there?!"
“Is it in an artery?" Luka asked from across the room.
All three returned to Carter's side quickly, and Peter lifted Carter's arm as gently as he could. He found it immediately once he knew where to look. There was a large hole, bleeding profusely, in the left side of his chest, directly under his upper arm. "What the hell... ?"
"It must have ricocheted," Romano said from across the gurney.
"Did it hit the axillary?" Luka asked.
Kerry glanced back at the X-ray. "I can't tell. It's possible though."
"I should have found that," Peter declared, berating himself for his oversight.
"Beat yourself up later, Peter," Romano ordered. "You, Kovac, pack that off. He's stable enough. We're taking him up right now."
Luka grabbed a pile of four-by-fours and pressed them against the side of Carter's chest.
"Kerry, call vascular. Have them meet us upstairs."
Kerry nodded and grabbed the phone as the doors to Trauma Two were slammed open, and the assembled personnel erupted into the hallway, heading back to the elevators.
Abby looked up from her patient when she saw them pushing Carter past the door to Trauma One. She closed her eyes and said a prayer, her mind repeating the same phrase over and over again. ‘Please don't leave me. Please don't leave me now.'
Again, she pushed her own fear away, took a deep breath, and opened her eyes. "It's all right, Kristin," she said to the girl on the gurney in front of her. "You're doing great. Just one more push, and you'll be all done…"