More Than Just a Broken Arm Chapter 36/?
Title: More Than Just a Broken Arm 36/?
Author: softballchic34
Characters: Steve McGarrett, Danny Williams
Spoilers: Season 1 episode 20
Rated PG-13 for language.
Disclaimer: I do not own Hawaii Five-0 or any of the characters, nor do I make any profit from this.
Summary: A broken arm is the least of Steve's problems.
It is 9:30 before Dr. Freeman emerges from the automatic doors that separate the ER from the waiting room. He spots the group waiting for Steve McGarrett almost immediately and makes his way over to them. He is very familiar with all of the extended McGarrett ohana. He had countless encounters with the Five-0 team and Mary McGarrett during Steve’s extended hospital stay earlier in the year and Catherine Rollins has joined Steve at nearly every neuro appointment he has had since June.
“Hows Steve?” Catherine jumps to her feet as soon as she spots him.
“Let’s have a seat and I’ll fill you in on Steve’s condition.” Dr. Freeman pulls a chair closer and sits down, he waits for everyone else to follow suit before continuing. “First of all, we stopped the seizure and Steve is stable right now. He presented with what we call Status Epilepticus. I know we have talked about this before and I gave you all some literature to read when Steve was first diagnosed with PTE, but I’ll explain it anyway to make it easier to understand what happened. Essentially, SE is a seizure that either lasts for longer than 5 minutes or seizures that occur close together without a recovery period in between. Steve had two seizures in rapid succession, the first, I’m told, lasted just over 8 minutes and the second started 3 minutes later. Normally, we treat SE first with doses of benzodiazapams and other anti-convulsant drugs. Steve received one dose of midazolam from the EMTs before he was brought in. This helped stop his first seizure and lessened the severity of the second.” He pauses to make sure Steve’s friends are still following his explanation.
“Now since, we have purposely been weaning Steve off his anti-convulsant medications to start to the new drug, I opted to put Steve under general anesthesia to stop the seizures instead of administering more anti-convulsant drugs. Right now, we have Steve intubated to manage his airway and we are going to keep him sedated with Propofol, which is one of the drugs we used to put him under, for a few days to let him rest and recover and to prevent further seizures.”
Catherine gasps, “Steve’s not breathing on his own?”
“Steve’s oxygen levels were low after the seizures and because of the general anesthesia we needed to intubate to manage his airway while he was under since it often represses the respiratory system. To answer your question, Steve is capable of breathing on his own at the moment but we are going to keep him intubated and on the ventilator until we bring him out of sedation to prevent respiratory distress caused by the sedation.”
“Did Steve suffer any brain damage from the seizures?” Mary’s voice is full of fear as she voices her question.
“We won’t know for sure until he wakes up. With SE, brain damage is always a concern; but we did a CT scan, which didn’t show any signs of damaged and his EEG test was good as well. These results are encouraging; but frankly, we won’t know anything concrete until Steve is awake.”
“How long will you keep him under?” Chin questions the doctor.
“Most likely 3 or 4 days, maybe longer. It depends on how quickly the midazolam leaves his system and he gives a clean blood test. After today, I want to start him on the new medication as soon as possible but I don’t want him to be awake for very long without any preventative drugs.”
“I thought Steve had to be clean of all anti-convulsants to start the new drug?” Danny asks, confused.
“He does, the Propofol we are giving him to keep him sedated will prevent any further seizures from happening as long as he is taking it but it won’t interact with the new drug in an adverse way like the other anti-convulsants can.”
“So when will Steve be able to start the new drug?” Danny chimes in with his question.
“I’m hoping by next Friday but it will all depend on Steve’s blood tests. He will have to wake up fully from the sedation before we start and I will keep him under observation for 2-3 more days after we start the drug to make sure he doesn’t have any complications or more seizures.”
“Can we see Steve?” Catherine is anxious to see her boyfriend.
“He should be settled in the ICU by now. I’ll allow you to go two at a time for five minutes each but then you’ll have to leave for the night. You can come back for visiting hours in the morning.” He can see the protests that are about to come and cuts them all off before anyone can voice them. “Steve is going to be deeply sedated for the next few days so he won’t even know if you are here. I know you all want to be with him, but he’s in the ICU for a reason and the nurses need room to work. Besides, none of you will do Steve any good if you are all exhausted and running on empty when he wakes up.” Dr. Freeman’s voice leaves no room for argument and each member of the group nods their understanding. “All right, if you don’t have any more questions I’ll take you to see Steve.”
No one speaks but they all stand wait expectantly for Dr. Freeman to lead the way to the ICU. After the amount of time they spent in the ICU with Steve a few months ago, Danny, Chin, and Kono don’t really need a guide to find the ICU from here but Dr. Freeman is set on escorting them up to the 4th floor where the ICU is.
No one speaks a word on the way up to the ICU until Dr. Freeman breaks the silence as they step out of the elevator. “Another thing I forgot to mention is that Steve must have either fallen right before the seizure started or hit his left arm hard on something during the seizure because his left wrist is broken.”
“That’s the same arm he broke in his fall. Did he re-break the healed fracture?” Danny asks.
“It is the same arm, but no, he broke his wrist this time. When he broke his arm back in April he fractured the radius and ulna about midway between the wrist and elbow. Steve broke his scaphoid during the seizure, it’s a carpal bone in the wrist between the thumb and radius. It is a fracture we commonly see when someone falls on their outstretched arm.”
“Steve just can’t catch a break.” Kono says and shakes her head in sympathy for her boss.
“The good news is, its a simple fracture that didn’t require surgery or even setting. We casted Steve’s wrist and thumb and he should heal completely in about 4 weeks.”
They come to a stop outside of one of the glass cubicles in the ICU. “5 minutes each. No longer.” Dr Freemen says sincerely. “After you each see Steve, I want you all to go home for the night. You can come back in the morning during visiting hours. I wont restrict your access to Steve during visiting hours in the next few days, meaning if the nurses aren’t in tending to Steve, two of you can be in there at a time with him; but when the nurses are in providing care you have to step out. Understood?” He gives them all a stern look as they voice their understanding of his orders with no arguments.
“Why does Steve have an NG tube?” Catherine questions as she observes Steve through the glass wall. The privacy curtain isn’t pulled shut so they can see Steve through the glass enclosure. He looks horrible with tubes and wires coming out of him from everywhere there is an opening for them. He has electrodes attached to his forehead and there are even a few stuck to his scalp through his hair.
“We have to make sure Steve’s stomach is empty to reduce the risk of him regurgitating bile and aspirating it. It’s a normal precautionary measure whenever we have a patient on a ventilator.”
“Catherine you go first on your own. Mary and I will go together and Chin and Kono can go together.” Danny squeezes Cath’s shoulder, he knows that Catherine is the one who needs to see Steve the most after the stress of witnessing his seizures.
“Thanks Danny.” Catherine takes a deep breath and prepares herself to go in to see her boyfriend. Catherine enters the room and observes her boyfriend from up close. He looks even worse than he did from the hall, his skin is pale, he has tubes all over, there is the NG tube coming out of his nose that leads to a canister by the bed, the lower part of his face is obscured by the ventilator and and the holding mechanism that wraps around the back of his neck; Steve isn’t wearing a gown, but has a blanket pulled up to his armpits, so she can see the central line IV that is going into the artery under his clavicle, there are also heart monitor leads connected to his chest. He has another IV leading into his right arm, along with a blood pressure cuff around his bicep, his left is casted and propped up on a pillow next to him, and she can see the clear tubing from the foley snaking from under the sheets to the collection bag hanging on the side of the bed. She shudders and thinks to herself that Steve is going to hate that tube when he wakes up.
Catherine gently picks up his right hand and gives it a squeeze before she leans over to give him a kiss on the forehead. “God, Steve. You scared the crap out of me today. Don’t ever do that again.” She chides him gently, still holding his lax hand. “I have to go now and let the others have a turn to see you before we are all kicked out for the night. You just rest and get better.” She places his hand back by his side and gives him another kiss on the forehead while caressing his hair. She leans over further and whispers into his ear. “I love you, Steve. See you tomorrow.”
-H50-
It is almost midnight by the time Catherine and Mary get home from the hospital. The house is quiet when they enter. There are pieces of the small area rug that sits in front of the front door lying all over the entry way and there are scratches in the paint on the front door. In the haste to get Steve to the hospital, Catherine forgot to put Bo in his kennel before she left with the EMTs. Normally Bo does ok on his own for a couples hours but Catherine figures Bo was worried about Steve and may have had some separation anxiety after all the excitement in the house earlier. Bo is lying at the bottom of the stairs. He perks up when the door opens but puts his head down again and whines when he doesn’t see Steve enter.
Catherine goes over to the depressed puppy and gives him a good petting. “Steve will be ok, Bo. He just needs to rest a little at the hospital for a few days before he comes home again.” She knows Bo can’t understand a word she is saying and she feels a little ridiculous talking to the dog like this but she can’t help it. It makes her feel a little better. She doesn’t have it in her to chastise him for tearing up the rug, if she gets mad at him now, he isn’t going to know why she's mad anyway. “Let’s go for a walk. You haven’t been out in hours.” She grabs the leash from the table by the front door and hooks it onto Bo’s collar.
The go for a short walk, just long enough for Bo to do his business before they return to the house, neither of them are in the mood for anything longer. Catherine cleans up the shredded rug when they get back and makes a mental note to buy a new rug and some paint for the front door. After she grabs a quick bite to eat she heads upstairs for the night. Bo follows Catherine up to the bedroom and rather than take his usual place on his dog bed by Steve’s side of the bed, he lies down on the rug next to Catherine’s side. He seems to know his master isn’t coming home tonight. The look on his face about breaks Catherine’s heart.
-H50-
Catherine and Mary spend the whole weekend at the hospital. They rotate shifts sitting with Steve with Danny, Chin, and Kono until the Five-0 Task Force gets a case and they have to leave.
Steve’s condition doesn’t change over the weekend. They keep him sedated and on the ventilator, rolling him over every two hours to prevent pressure sores. Cath and Mary spend their time together in Steve’s room trading stories on their tough Navy SEAL. Mary tells Catherine stories about Steve when they were kids while Cath tells her about Steve while he was at Annapolis and tells her about some of Steve’s more interesting but not classified SEAL missions along with some PG stories about Steve when they have been on leave together in varying parts of the world.
Monday, both Cath and Mary have to go back to work. They are reluctant to leave him by himself all day but Catherine doesn’t have any leave left and Mary can’t afford to take time off work since she is a new employee and also can't afford to skip any of her classes. Steve would kill her if he wakes up and finds out that she dropped out of school and lost her job because of him, even if she did it and it wasn’t because of him. He is so proud of his little sister for trying to turn her life around.
Everyone spends as much time at the hospital with Steve as they can when they aren’t working or in Mary’s case, in class. As soon as Catherine is done at the base every day she heads to the hospital to spend time with Steve every evening until the nurses kick her out.
Wednesday she arrives at the hospital to find Dr. Freeman and a nurse in Steve’s room. She has to wait until the doctor exits before she can ask what’s going on.
“Is Steve ok?” her voice is filled with worry and concern.
Dr. Freeman gives her a smile. “Steve is doing just fine. We just removed the ventilator and dialed back on the sedation. He should start to come around in an hour or two.”
Catherine lets out a relieved breath. “What about his blood test? Does he still have the Midazolam in his system?”
“There are trace amounts of it still. We will continue to flush his system out with IV saline but at the same time I am going to keep him on a minimal dose of the sedative to try to prevent more seizures until we start the new medication. I think by Friday he should be clear to start the knew medication as long as he’s not having any major effects from the SE.”
“Like what? I thought you said there wasn’t any brain damage.”
“Steve’s latest scan and EEG don’t show any obvious damage but like I said the other night, we can’t be sure until Steve is awake. While this was a serious event for Steve, it was relatively mild compared to other cases of SE I have seen. I don’t anticipate any major side effects but until Steve is awake, we won’t know for sure.”
Catherine nods her understand and prays that Steve will be fine when he wakes up. “He will be awake soon then?”
“Propofol is a short acting drug and once we stop it, it doesn’t take long for patients to wake up. I’d say Steve will be awake within the next two hours or so. But remember, he is going to be really tired and groggy so don’t be concerned if he isn’t completely with it when he wakes up. It will take some time for him to get it together.” The doctor can see how happy she is at the prospect of Steve being awake soon. He gives her a smile, “Go sit with Steve, make sure to call for the nurse when he wakes up. She will page me and I’ll come in and assess him.”
“Thank you, Dr. Freeman.” Catherine is grateful that he is Steve’s doctor. The man is compassionate and has a great bedside manner and a talent for explaining things in a way that is easy to understand, even if you don’t have a medical background.
-H50-
It is an hour and a half later when Steve finally starts to come around. Catherine first notices the change in his heart rate; the steady blips on the monitor speed up. Then his breathing changes, his slow even breaths give out to quicker, shorter breaths as he starts to shift a little restlessly.
“Steve can you hear me?” She squeezes his hand and caress the side of his face. She is glad that most of the tubes and wires are gone. He just has a nasal canula under his nose and the leads for the heart monitor snake out of the neck of his gown. The central line is gone, leaving him with just the IV in his arm. The only other tube sill attached is that of the foley catheter.
Steve shifts some more but doesn’t respond to her voice. “Steve? Can you hear me? Wake up, babe.” she commands again and is rewarded with a groan. Cath smiles, “That’s it, Steve. Open your eyes and wake up.”
She can see Steve struggling to open his eyes. He swallows hard and winces at the pain in his throat from the ventilator tube that has taken up residence there for the last five days. Steve finally manages to crack his eyes open to little slits.
“Hey Sailor. Welcome back.” Catherine smiles at him and gives him a kiss on the forehead before pressing the call button clipped to the side of the bed.
“Cath.” He gives her a lazy half smile, “Wha’ happ’nd?” Steve manages to rasp. his throat is raw and his voice is barely a whisper.
“You’re ok, Steve. You had a nasty seizure but your gonna be ok. Dr. Freeman will be here soon to check you over. How are you feeling?”
“Hmm. Tired.” Is all Steve manages before his eyes slip closed again. He is so tired. All he wants to do is sleep.
A nurse pages Dr. Freeman as soon as Catherine tells her Steve is awake and the doctor shows up less than five minutes later. He puts Steve through a barrage of tests before declaring him no worse for wear and lets them know that he will be back again in the morning to check on Steve. Catherine is relieved to hear that Steve isn’t suffering any ill effects from the SE.
Steve is sleeping now, Dr. Freeman ordered a dose of a mild pain reliever after Steve complained of a headache. “Steve is doing fine, Catherine. He should sleep through the night now and will be much more lucid tomorrow. We will move him to a regular room late tomorrow morning. You should go home and get some rest.”
“I’m just going to sit with him for a while longer and then I’ll go home.” She starts to turn towards Steve’s ICU cubicle before she remembers her next question, “Oh, Dr. Freeman? Tomorrow after Steve is moved to a regular room, is it ok if I bring Bo by to visit him?”
“I don’t see why you can’t. Bo is a service dog so as long as you put his vest on him nobody will give you any trouble. Besides, I think it will do Steve some good to see Bo.” Bo had been Steve’s main concern once he was awake a little more when Dr. Freeman had been checking Steve over.
She smiles and thanks him before he leaves. Catherine is glad she has tomorrow and Friday off since she is supposed to work the weekend at the base. It will be nice to be able to spend her off time with Steve since he will actually be awake.
Catherine keeps one hand over Steve’s and uses the other to text their friends to let them know that Steve woke up and is fine. She also tells them that he is going to sleep through the night so they should wait until tomorrow to visit.
Catherine sits back with a smile and watches her boyfriend sleep. She glad to see him free of most of the tubes and knowing that he is actually sleeping and not sedated makes all the difference.
A couple minutes later there is a soft knock on the door. She looks up to see Mary entering.
“I got your text.” Mary said, “I had just pulled into the parking lot when you texted so I figured I would at least come up here and check in. Steve’s really ok?”
Cath nods and smiles, “Yeah, he was a little out of it but Dr. Freeman said Steve passed all his tests with flying colors. No signs of brain damage any where. He did have a headache though so Dr. Freeman gave him something. Between that and the lingering effects of the Propofol, he should sleep through the night.”
“Thank God. I was terrified Steve wouldn’t come out of this without brain damage. I read all those pamphlets from the doctor and it scared the crap out of me the way they talked about all the bad things that could result from SE.”
“I know. Dr. Freeman said it wasn’t as bad as it could have been and aside from a residual headache Steve has no other problems. They are even going to move him to a regular room before lunch tomorrow.”
“Steve will be happy about that.”
“Yeah, I’m off tomorrow and Friday. I was planning on spending the next couple days at the hospital with him. Are you working tomorrow?” Cath can’t remember Mary’s schedule off the top of her head.
“No, I’m off tomorrow but I have class from one to five tomorrow. I’ll spend the morning here with him and then come back after class if you don’t mind.”
“Mary, you are Steve’s sister. You have just as much right as I do to spend time with him. In fact if you want to spend a couple hours with just the two of you, so you can have some sibling bonding time, let me know and I’ll make myself scarce for a couple hours.”
“That really means a lot Catherine, but you don’t have to do that.”
“Steve really regrets not making more of an effort to keep in touch with you after you guys were sent to the mainland. He’s so happy you are back on the island though. He’s really proud of you.”
“Well it isn’t entirely his fault we lost contact for so long. I didn’t really make an effort either. And even if he had called, I probably wouldn’t have answered.”
“At least you have each other now. I’m going to head home for the night, take Bo out. You stay with Steve for a while.” Catherine stands and gives Steve a gentle kiss on the cheek before she gives Mary a quick hug and heads home for the night.
Catherine arrives home fifteen minutes later. She is greeted by a sullen Bo. He is happy to see her but has been lacking his usual excitement since Steve was taken to the hospital. “Hey Buddy. Should we go for a walk?” Cath clips his leash to his collar and heads out the door with him. They take a long walk together. Catherine feels bad for Bo, he has been a little neglected over the last few days since Steve has been in the hospital. Sure he’s being walked a fed regularly but he hasn’t been getting as much attention as he is used to. And while he likes everyone in Steve’s ohana, Steve is his favorite person and not having Steve around is having a negative effect on him.
After their walk, Catherine takes Bo into the back yard to play a game of fetch with him before she heads inside for a shower and a bite to eat. Bo follows her everywhere and waits patiently by the bathroom door while she is in the shower. He has taken to sleeping on the floor by Catherine’s side of the bed in Steve’s absence so she moved his dog bed so he at least has a comfortable place to sleep.
“You wanna go see Steve tomorrow, Bo?” Cath asks the dog as she rubs behind his ears from her position lying on the side of the bed. Bo’s ears perk up at the mention of Steve’s name. “We’ll go tomorrow afternoon after Steve’s moved to a regular room, ok Buddy?” Bo woofs and wags his tail as if he knows what she is saying. Catherine smiles and runs her hand down his soft back. She is so glad she was able to talk Steve into keeping Bo all those months ago.
TBC
Author: softballchic34
Characters: Steve McGarrett, Danny Williams
Spoilers: Season 1 episode 20
Rated PG-13 for language.
Disclaimer: I do not own Hawaii Five-0 or any of the characters, nor do I make any profit from this.
Summary: A broken arm is the least of Steve's problems.
It is 9:30 before Dr. Freeman emerges from the automatic doors that separate the ER from the waiting room. He spots the group waiting for Steve McGarrett almost immediately and makes his way over to them. He is very familiar with all of the extended McGarrett ohana. He had countless encounters with the Five-0 team and Mary McGarrett during Steve’s extended hospital stay earlier in the year and Catherine Rollins has joined Steve at nearly every neuro appointment he has had since June.
“Hows Steve?” Catherine jumps to her feet as soon as she spots him.
“Let’s have a seat and I’ll fill you in on Steve’s condition.” Dr. Freeman pulls a chair closer and sits down, he waits for everyone else to follow suit before continuing. “First of all, we stopped the seizure and Steve is stable right now. He presented with what we call Status Epilepticus. I know we have talked about this before and I gave you all some literature to read when Steve was first diagnosed with PTE, but I’ll explain it anyway to make it easier to understand what happened. Essentially, SE is a seizure that either lasts for longer than 5 minutes or seizures that occur close together without a recovery period in between. Steve had two seizures in rapid succession, the first, I’m told, lasted just over 8 minutes and the second started 3 minutes later. Normally, we treat SE first with doses of benzodiazapams and other anti-convulsant drugs. Steve received one dose of midazolam from the EMTs before he was brought in. This helped stop his first seizure and lessened the severity of the second.” He pauses to make sure Steve’s friends are still following his explanation.
“Now since, we have purposely been weaning Steve off his anti-convulsant medications to start to the new drug, I opted to put Steve under general anesthesia to stop the seizures instead of administering more anti-convulsant drugs. Right now, we have Steve intubated to manage his airway and we are going to keep him sedated with Propofol, which is one of the drugs we used to put him under, for a few days to let him rest and recover and to prevent further seizures.”
Catherine gasps, “Steve’s not breathing on his own?”
“Steve’s oxygen levels were low after the seizures and because of the general anesthesia we needed to intubate to manage his airway while he was under since it often represses the respiratory system. To answer your question, Steve is capable of breathing on his own at the moment but we are going to keep him intubated and on the ventilator until we bring him out of sedation to prevent respiratory distress caused by the sedation.”
“Did Steve suffer any brain damage from the seizures?” Mary’s voice is full of fear as she voices her question.
“We won’t know for sure until he wakes up. With SE, brain damage is always a concern; but we did a CT scan, which didn’t show any signs of damaged and his EEG test was good as well. These results are encouraging; but frankly, we won’t know anything concrete until Steve is awake.”
“How long will you keep him under?” Chin questions the doctor.
“Most likely 3 or 4 days, maybe longer. It depends on how quickly the midazolam leaves his system and he gives a clean blood test. After today, I want to start him on the new medication as soon as possible but I don’t want him to be awake for very long without any preventative drugs.”
“I thought Steve had to be clean of all anti-convulsants to start the new drug?” Danny asks, confused.
“He does, the Propofol we are giving him to keep him sedated will prevent any further seizures from happening as long as he is taking it but it won’t interact with the new drug in an adverse way like the other anti-convulsants can.”
“So when will Steve be able to start the new drug?” Danny chimes in with his question.
“I’m hoping by next Friday but it will all depend on Steve’s blood tests. He will have to wake up fully from the sedation before we start and I will keep him under observation for 2-3 more days after we start the drug to make sure he doesn’t have any complications or more seizures.”
“Can we see Steve?” Catherine is anxious to see her boyfriend.
“He should be settled in the ICU by now. I’ll allow you to go two at a time for five minutes each but then you’ll have to leave for the night. You can come back for visiting hours in the morning.” He can see the protests that are about to come and cuts them all off before anyone can voice them. “Steve is going to be deeply sedated for the next few days so he won’t even know if you are here. I know you all want to be with him, but he’s in the ICU for a reason and the nurses need room to work. Besides, none of you will do Steve any good if you are all exhausted and running on empty when he wakes up.” Dr. Freeman’s voice leaves no room for argument and each member of the group nods their understanding. “All right, if you don’t have any more questions I’ll take you to see Steve.”
No one speaks but they all stand wait expectantly for Dr. Freeman to lead the way to the ICU. After the amount of time they spent in the ICU with Steve a few months ago, Danny, Chin, and Kono don’t really need a guide to find the ICU from here but Dr. Freeman is set on escorting them up to the 4th floor where the ICU is.
No one speaks a word on the way up to the ICU until Dr. Freeman breaks the silence as they step out of the elevator. “Another thing I forgot to mention is that Steve must have either fallen right before the seizure started or hit his left arm hard on something during the seizure because his left wrist is broken.”
“That’s the same arm he broke in his fall. Did he re-break the healed fracture?” Danny asks.
“It is the same arm, but no, he broke his wrist this time. When he broke his arm back in April he fractured the radius and ulna about midway between the wrist and elbow. Steve broke his scaphoid during the seizure, it’s a carpal bone in the wrist between the thumb and radius. It is a fracture we commonly see when someone falls on their outstretched arm.”
“Steve just can’t catch a break.” Kono says and shakes her head in sympathy for her boss.
“The good news is, its a simple fracture that didn’t require surgery or even setting. We casted Steve’s wrist and thumb and he should heal completely in about 4 weeks.”
They come to a stop outside of one of the glass cubicles in the ICU. “5 minutes each. No longer.” Dr Freemen says sincerely. “After you each see Steve, I want you all to go home for the night. You can come back in the morning during visiting hours. I wont restrict your access to Steve during visiting hours in the next few days, meaning if the nurses aren’t in tending to Steve, two of you can be in there at a time with him; but when the nurses are in providing care you have to step out. Understood?” He gives them all a stern look as they voice their understanding of his orders with no arguments.
“Why does Steve have an NG tube?” Catherine questions as she observes Steve through the glass wall. The privacy curtain isn’t pulled shut so they can see Steve through the glass enclosure. He looks horrible with tubes and wires coming out of him from everywhere there is an opening for them. He has electrodes attached to his forehead and there are even a few stuck to his scalp through his hair.
“We have to make sure Steve’s stomach is empty to reduce the risk of him regurgitating bile and aspirating it. It’s a normal precautionary measure whenever we have a patient on a ventilator.”
“Catherine you go first on your own. Mary and I will go together and Chin and Kono can go together.” Danny squeezes Cath’s shoulder, he knows that Catherine is the one who needs to see Steve the most after the stress of witnessing his seizures.
“Thanks Danny.” Catherine takes a deep breath and prepares herself to go in to see her boyfriend. Catherine enters the room and observes her boyfriend from up close. He looks even worse than he did from the hall, his skin is pale, he has tubes all over, there is the NG tube coming out of his nose that leads to a canister by the bed, the lower part of his face is obscured by the ventilator and and the holding mechanism that wraps around the back of his neck; Steve isn’t wearing a gown, but has a blanket pulled up to his armpits, so she can see the central line IV that is going into the artery under his clavicle, there are also heart monitor leads connected to his chest. He has another IV leading into his right arm, along with a blood pressure cuff around his bicep, his left is casted and propped up on a pillow next to him, and she can see the clear tubing from the foley snaking from under the sheets to the collection bag hanging on the side of the bed. She shudders and thinks to herself that Steve is going to hate that tube when he wakes up.
Catherine gently picks up his right hand and gives it a squeeze before she leans over to give him a kiss on the forehead. “God, Steve. You scared the crap out of me today. Don’t ever do that again.” She chides him gently, still holding his lax hand. “I have to go now and let the others have a turn to see you before we are all kicked out for the night. You just rest and get better.” She places his hand back by his side and gives him another kiss on the forehead while caressing his hair. She leans over further and whispers into his ear. “I love you, Steve. See you tomorrow.”
-H50-
It is almost midnight by the time Catherine and Mary get home from the hospital. The house is quiet when they enter. There are pieces of the small area rug that sits in front of the front door lying all over the entry way and there are scratches in the paint on the front door. In the haste to get Steve to the hospital, Catherine forgot to put Bo in his kennel before she left with the EMTs. Normally Bo does ok on his own for a couples hours but Catherine figures Bo was worried about Steve and may have had some separation anxiety after all the excitement in the house earlier. Bo is lying at the bottom of the stairs. He perks up when the door opens but puts his head down again and whines when he doesn’t see Steve enter.
Catherine goes over to the depressed puppy and gives him a good petting. “Steve will be ok, Bo. He just needs to rest a little at the hospital for a few days before he comes home again.” She knows Bo can’t understand a word she is saying and she feels a little ridiculous talking to the dog like this but she can’t help it. It makes her feel a little better. She doesn’t have it in her to chastise him for tearing up the rug, if she gets mad at him now, he isn’t going to know why she's mad anyway. “Let’s go for a walk. You haven’t been out in hours.” She grabs the leash from the table by the front door and hooks it onto Bo’s collar.
The go for a short walk, just long enough for Bo to do his business before they return to the house, neither of them are in the mood for anything longer. Catherine cleans up the shredded rug when they get back and makes a mental note to buy a new rug and some paint for the front door. After she grabs a quick bite to eat she heads upstairs for the night. Bo follows Catherine up to the bedroom and rather than take his usual place on his dog bed by Steve’s side of the bed, he lies down on the rug next to Catherine’s side. He seems to know his master isn’t coming home tonight. The look on his face about breaks Catherine’s heart.
-H50-
Catherine and Mary spend the whole weekend at the hospital. They rotate shifts sitting with Steve with Danny, Chin, and Kono until the Five-0 Task Force gets a case and they have to leave.
Steve’s condition doesn’t change over the weekend. They keep him sedated and on the ventilator, rolling him over every two hours to prevent pressure sores. Cath and Mary spend their time together in Steve’s room trading stories on their tough Navy SEAL. Mary tells Catherine stories about Steve when they were kids while Cath tells her about Steve while he was at Annapolis and tells her about some of Steve’s more interesting but not classified SEAL missions along with some PG stories about Steve when they have been on leave together in varying parts of the world.
Monday, both Cath and Mary have to go back to work. They are reluctant to leave him by himself all day but Catherine doesn’t have any leave left and Mary can’t afford to take time off work since she is a new employee and also can't afford to skip any of her classes. Steve would kill her if he wakes up and finds out that she dropped out of school and lost her job because of him, even if she did it and it wasn’t because of him. He is so proud of his little sister for trying to turn her life around.
Everyone spends as much time at the hospital with Steve as they can when they aren’t working or in Mary’s case, in class. As soon as Catherine is done at the base every day she heads to the hospital to spend time with Steve every evening until the nurses kick her out.
Wednesday she arrives at the hospital to find Dr. Freeman and a nurse in Steve’s room. She has to wait until the doctor exits before she can ask what’s going on.
“Is Steve ok?” her voice is filled with worry and concern.
Dr. Freeman gives her a smile. “Steve is doing just fine. We just removed the ventilator and dialed back on the sedation. He should start to come around in an hour or two.”
Catherine lets out a relieved breath. “What about his blood test? Does he still have the Midazolam in his system?”
“There are trace amounts of it still. We will continue to flush his system out with IV saline but at the same time I am going to keep him on a minimal dose of the sedative to try to prevent more seizures until we start the new medication. I think by Friday he should be clear to start the knew medication as long as he’s not having any major effects from the SE.”
“Like what? I thought you said there wasn’t any brain damage.”
“Steve’s latest scan and EEG don’t show any obvious damage but like I said the other night, we can’t be sure until Steve is awake. While this was a serious event for Steve, it was relatively mild compared to other cases of SE I have seen. I don’t anticipate any major side effects but until Steve is awake, we won’t know for sure.”
Catherine nods her understand and prays that Steve will be fine when he wakes up. “He will be awake soon then?”
“Propofol is a short acting drug and once we stop it, it doesn’t take long for patients to wake up. I’d say Steve will be awake within the next two hours or so. But remember, he is going to be really tired and groggy so don’t be concerned if he isn’t completely with it when he wakes up. It will take some time for him to get it together.” The doctor can see how happy she is at the prospect of Steve being awake soon. He gives her a smile, “Go sit with Steve, make sure to call for the nurse when he wakes up. She will page me and I’ll come in and assess him.”
“Thank you, Dr. Freeman.” Catherine is grateful that he is Steve’s doctor. The man is compassionate and has a great bedside manner and a talent for explaining things in a way that is easy to understand, even if you don’t have a medical background.
-H50-
It is an hour and a half later when Steve finally starts to come around. Catherine first notices the change in his heart rate; the steady blips on the monitor speed up. Then his breathing changes, his slow even breaths give out to quicker, shorter breaths as he starts to shift a little restlessly.
“Steve can you hear me?” She squeezes his hand and caress the side of his face. She is glad that most of the tubes and wires are gone. He just has a nasal canula under his nose and the leads for the heart monitor snake out of the neck of his gown. The central line is gone, leaving him with just the IV in his arm. The only other tube sill attached is that of the foley catheter.
Steve shifts some more but doesn’t respond to her voice. “Steve? Can you hear me? Wake up, babe.” she commands again and is rewarded with a groan. Cath smiles, “That’s it, Steve. Open your eyes and wake up.”
She can see Steve struggling to open his eyes. He swallows hard and winces at the pain in his throat from the ventilator tube that has taken up residence there for the last five days. Steve finally manages to crack his eyes open to little slits.
“Hey Sailor. Welcome back.” Catherine smiles at him and gives him a kiss on the forehead before pressing the call button clipped to the side of the bed.
“Cath.” He gives her a lazy half smile, “Wha’ happ’nd?” Steve manages to rasp. his throat is raw and his voice is barely a whisper.
“You’re ok, Steve. You had a nasty seizure but your gonna be ok. Dr. Freeman will be here soon to check you over. How are you feeling?”
“Hmm. Tired.” Is all Steve manages before his eyes slip closed again. He is so tired. All he wants to do is sleep.
A nurse pages Dr. Freeman as soon as Catherine tells her Steve is awake and the doctor shows up less than five minutes later. He puts Steve through a barrage of tests before declaring him no worse for wear and lets them know that he will be back again in the morning to check on Steve. Catherine is relieved to hear that Steve isn’t suffering any ill effects from the SE.
Steve is sleeping now, Dr. Freeman ordered a dose of a mild pain reliever after Steve complained of a headache. “Steve is doing fine, Catherine. He should sleep through the night now and will be much more lucid tomorrow. We will move him to a regular room late tomorrow morning. You should go home and get some rest.”
“I’m just going to sit with him for a while longer and then I’ll go home.” She starts to turn towards Steve’s ICU cubicle before she remembers her next question, “Oh, Dr. Freeman? Tomorrow after Steve is moved to a regular room, is it ok if I bring Bo by to visit him?”
“I don’t see why you can’t. Bo is a service dog so as long as you put his vest on him nobody will give you any trouble. Besides, I think it will do Steve some good to see Bo.” Bo had been Steve’s main concern once he was awake a little more when Dr. Freeman had been checking Steve over.
She smiles and thanks him before he leaves. Catherine is glad she has tomorrow and Friday off since she is supposed to work the weekend at the base. It will be nice to be able to spend her off time with Steve since he will actually be awake.
Catherine keeps one hand over Steve’s and uses the other to text their friends to let them know that Steve woke up and is fine. She also tells them that he is going to sleep through the night so they should wait until tomorrow to visit.
Catherine sits back with a smile and watches her boyfriend sleep. She glad to see him free of most of the tubes and knowing that he is actually sleeping and not sedated makes all the difference.
A couple minutes later there is a soft knock on the door. She looks up to see Mary entering.
“I got your text.” Mary said, “I had just pulled into the parking lot when you texted so I figured I would at least come up here and check in. Steve’s really ok?”
Cath nods and smiles, “Yeah, he was a little out of it but Dr. Freeman said Steve passed all his tests with flying colors. No signs of brain damage any where. He did have a headache though so Dr. Freeman gave him something. Between that and the lingering effects of the Propofol, he should sleep through the night.”
“Thank God. I was terrified Steve wouldn’t come out of this without brain damage. I read all those pamphlets from the doctor and it scared the crap out of me the way they talked about all the bad things that could result from SE.”
“I know. Dr. Freeman said it wasn’t as bad as it could have been and aside from a residual headache Steve has no other problems. They are even going to move him to a regular room before lunch tomorrow.”
“Steve will be happy about that.”
“Yeah, I’m off tomorrow and Friday. I was planning on spending the next couple days at the hospital with him. Are you working tomorrow?” Cath can’t remember Mary’s schedule off the top of her head.
“No, I’m off tomorrow but I have class from one to five tomorrow. I’ll spend the morning here with him and then come back after class if you don’t mind.”
“Mary, you are Steve’s sister. You have just as much right as I do to spend time with him. In fact if you want to spend a couple hours with just the two of you, so you can have some sibling bonding time, let me know and I’ll make myself scarce for a couple hours.”
“That really means a lot Catherine, but you don’t have to do that.”
“Steve really regrets not making more of an effort to keep in touch with you after you guys were sent to the mainland. He’s so happy you are back on the island though. He’s really proud of you.”
“Well it isn’t entirely his fault we lost contact for so long. I didn’t really make an effort either. And even if he had called, I probably wouldn’t have answered.”
“At least you have each other now. I’m going to head home for the night, take Bo out. You stay with Steve for a while.” Catherine stands and gives Steve a gentle kiss on the cheek before she gives Mary a quick hug and heads home for the night.
Catherine arrives home fifteen minutes later. She is greeted by a sullen Bo. He is happy to see her but has been lacking his usual excitement since Steve was taken to the hospital. “Hey Buddy. Should we go for a walk?” Cath clips his leash to his collar and heads out the door with him. They take a long walk together. Catherine feels bad for Bo, he has been a little neglected over the last few days since Steve has been in the hospital. Sure he’s being walked a fed regularly but he hasn’t been getting as much attention as he is used to. And while he likes everyone in Steve’s ohana, Steve is his favorite person and not having Steve around is having a negative effect on him.
After their walk, Catherine takes Bo into the back yard to play a game of fetch with him before she heads inside for a shower and a bite to eat. Bo follows her everywhere and waits patiently by the bathroom door while she is in the shower. He has taken to sleeping on the floor by Catherine’s side of the bed in Steve’s absence so she moved his dog bed so he at least has a comfortable place to sleep.
“You wanna go see Steve tomorrow, Bo?” Cath asks the dog as she rubs behind his ears from her position lying on the side of the bed. Bo’s ears perk up at the mention of Steve’s name. “We’ll go tomorrow afternoon after Steve’s moved to a regular room, ok Buddy?” Bo woofs and wags his tail as if he knows what she is saying. Catherine smiles and runs her hand down his soft back. She is so glad she was able to talk Steve into keeping Bo all those months ago.
TBC