Page 95 of Fighting For You

The minutes passed. Ian slept. His chest rose and fell under the hospital gown. The numbers on the monitor held. Heart rate in the seventies. Oxygen steady. Blood pressure stable at the low end but stable. I read them like I'd read a thousand monitors in the department downstairs, except this time the patient was my brother and every number meant whether I got to keep him.

Knox pulled a chair beside mine and sat down. He put his hand on my back, warm and solid, and left it there.

Ian's breathing changed first.

It was subtle. A slight shallowing, a pause between breaths that lasted a beat longer than it should have. I felt it before the monitor caught it. My body went still.

"Ian?"

His eyes didn't open.

The heart rate climbed. Seventy-four. Eighty-one. Eighty-nine. The blood pressure started to drop. I watched the systolic fall from one hundred and two to ninety-six to eighty-eight in the time it took me to stand up.

"Ian." I squeezed his hand. "Ian, look at me."

He didn't respond.

I hit the call button. I was already at the door. "I need help in here! He's decompensating!"

Knox was on his feet. "Nora, what's happening?"

"He's bleeding again." I could hear my own voice and it sounded like someone else's. Calm, clinical, precise. The nurse in me was running the protocol while the rest of me was falling apart. "The repair didn't hold. He's hemorrhaging internally."

The surgical team came through the door. Two nurses, a resident, then McCall. She looked at the monitor, looked at Ian, and started calling orders.

"Get me blood on the rapid infuser. Page the OR and tell them we're coming up. Move."

Sullivan came through the door behind them.

They moved. The room filled with hands, equipment, voices running numbers back and forth. Someone pushed me toward the wall. Knox pulled me against him.

"You need to step back, Nora." Sullivan's voice. The same voice he used on every critical patient. Measured. Controlled. But when he looked at me, something in his face broke for one second before he put it back together. "Let us work."

I stood against the wall with Knox's arms around me and watched them try to save my brother.

His pressure kept dropping. The numbers fell faster than the blood could go in. Sullivan called for more units. The resident was pressing on Ian's abdomen while a nurse hung the next bag. The rapid infuser was running as fast as it could and it wasn't enough.

"Come on," Sullivan said. He was at the bedside with his hands working and his voice steady, but I could see the tension in his shoulders, the set of his jaw. "Come on, Ian."

The heart rate hit forty. Then thirty.

The monitor flatlined.

The sound filled the room. That long, unbroken tone that I'd heard a hundred times in the ER and never once processed as anything other than a clinical event.

Sullivan started compressions. The resident took over after two minutes. They pushed epinephrine. They pushed it again. Sullivan called for another round and the team kept going, and the monitor kept screaming its single flat note into the room.

I don't know how long they worked. It could have been five minutes. It could have been thirty.

Sullivan stopped. He stepped back from the bed. His hands were at his sides. He looked at the clock on the wall.

"Time of death, ten forty-seven PM."

The room went quiet. The team stepped back from the bed. Sullivan stood at the foot of it with his gloves still on, looking at the boy who had been awake and talking an hour before.

Knox's arms tightened around me. I couldn't breathe. I couldn't think. I couldn't make the numbers on the monitor mean what they meant.

I walked to the bed. I took Ian's hand. It was still warm.