“Change of plans,” said Dr. Elizabeth as she bustled in the next morning. “You can forget about the ICD for now. Hurricane Melissa has strengthened to a Category 4 and shifted her course; she’s headed straight for South Florida. We’re going to have to evacuate the whole hospital.”
“What?!” was Nick’s first reaction. He stared at her, stunned.
Elizabeth looked flustered. “I’m sorry,” she said, shaking her head. “I forgot you haven’t been able to watch the news. It’s all they’ve been talking about for the last few days.”
Nick vaguely remembered seeing something about a tropical storm on the TV at the bar on Halloween, but so much had happened in the meantime, he hadn’t given it a single thought since then. “So what does that mean for me?” he asked.
“I called in a favor from a former colleague of mine who works at Emory University Hospital in Atlanta. We’re going to transfer you there. They have a wonderful heart transplant program, and Atlanta’s far enough inland that it shouldn’t be affected much by the storm, no matter what course it ultimately takes. Plus, I know you’ll have at least one friend around for support,” she said, smiling.
It took Nick a few seconds to realize she was talking about Brian. He and Brian weren’t nearly as close as they had been at the beginning of their friendship, but he was sure Brian would come to visit if he knew Nick was in the hospital. Of all the guys in the group, Brian would best be able to understand what Nick was going through because of his own heart condition. It would be nice to have him nearby.
“Yeah, Brian lives like an hour outside Atlanta… but that’s pretty far from here,” Nick replied, frowning. “How will I get there?”
“Air ambulance. You’ll be taken to the mainland by helicopter and then flown from there to Atlanta in a private plane.”
Nick shuddered. He hated flying, especially in small aircrafts, but he supposed there was no other good way to get that far in a reasonable amount of time. Having grown up in Florida, he knew how congested the highways could get during an evacuation.
“Don’t worry,” said Dr. Elizabeth, patting his arm. “You’ll be in safe hands. A flight nurse and paramedic will be with you the whole way.”
She thought he was concerned about his heart. Nick forced a smile and nodded, not bothering to correct her. It made no sense to worry about the helicopter crashing when he was dying anyway, he told himself. What did it matter?
When it was time, Dani helped get him ready for the transport. “I called Lauren to fill her in on what’s happened,” she said, as she flushed his central line. “She sounded pretty upset. I don’t know if she’s planning to go to Atlanta or not, but she did give me Brian’s number so I can call and tell him you’re coming.”
“That’d be great,” said Nick gratefully. “Thanks.”
“No problem,” Dani replied, hanging a fresh bag of fluid on his IV pole. “This should last until you get there.”
“Are there any tranquilizers in there?” Nick asked, only half-kidding.
Dani laughed. “Well, let’s see,” she said, looking at the label on the side of the bag. With the air of a pretentious bartender, she began to describe its ingredients. “This lovely cocktail contains a potent blend of cardiac drugs: a beta blocker to help your heart pump better, an antiarrhythmic to prevent abnormal heartbeats, an ACE inhibitor to control your blood pressure and improve blood flow, and a diuretic to keep your body from retaining extra fluid… but, alas, no tranquilizer. Why, do you want one?”
“I freakin’ hate flying,” Nick admitted.
“Really?” She raised her eyebrows. “I wouldn’t have expected that from a world traveler like you.”
“Yeah, well, I fly when I have to for work, not for fun. I’ve never even been in a helicopter before,” he added.
“I have. It’s not so bad,” said Dani, “but if you’re serious about wanting something to take the edge off, I can ask Dr. Elizabeth.”
“Nah, it’s all right,” Nick said, shrugging. “I’ll survive.” I hope, he added in his head.
“I know you will.” Dani smiled at him. “I’m gonna miss having you around here, you know,” she said, as she moved around his bed, unplugging the various pieces of equipment from and hooking him up to portable versions. “I’m sorry it had to be under these circumstances, but I’m glad I got to spend so much time with you these last couple days.”
“Thanks for taking such good care of me. You’ve been great,” said Nick, smiling back. “I can’t say I’ll miss this place much, though.
“You might once you see the other hospital,” said Dani, arching an eyebrow. Then she broke into another smile that made her brown eyes twinkle. “Just kidding. I don’t blame you one bit. Let’s hope they have phones in their ICU rooms, huh?”
Nick nodded. “A TV would be nice too - just sayin’.”
“I’ve been saying the same thing for years. Blame it on budget cuts,” Dani replied, rolling her eyes. “The decision-makers don’t want to spend their dimes providing entertainment for people who may be too sick to enjoy it.”
“Well, when I get better, maybe I’ll make a donation just for that purpose,” Nick decided. “Not having TVs to help those sick people pass the time is pure torture.”
“Put it in your patient satisfaction survey,” she said, handing him a piece of paper and a pen. “And if you don’t mind, I’d love an autograph at the bottom to remember our time together.” She flashed him a big grin.
Nick laughed. “Like you could forget.”
She smirked back at him. “Yes, Nick, the night we spent together was definitely unforgettable.”
His smile faded as he realized their conversation had taken on a flirtatious tone. It wouldn’t have been a big deal under different circumstances, but considering the fact that they’d both been unfaithful with each other, he felt guilty about it.
“What are you gonna do as far as the storm goes?” he asked, wanting to change the subject. “Are you evacuating too?”
She shrugged. “If I had my way, we wouldn’t. I’d rather just ride out it out here-”
“Spoken like a true Floridian,” Nick said with a grin.
“-but Rob wants to leave. I think we’re gonna go up to my grandparents’ place in Gainesville.”
“That’s probably a good plan. Good luck getting there.”
“Thanks.” She smiled and patted his hand. “Good luck to you too. You’re gonna get through this, you know.”
“I hope so,” he said, feeling his heart flip-flop in his chest. For a few minutes, he had actually forgotten why he was there. He decided would miss having Dani around to distract him. He hoped the nurses at the new hospital were as friendly as her - and it wouldn’t hurt if they were also as attractive.
“You will,” she assured him again. After a pause, she added, “This is probably inappropriate, but I really just want to give you a big hug right now. Do you mind?”
He smiled. “Of course not,” he said, opening his arms. “C’mere.” As she bent down to embrace him, he leaned forward, letting her wrap her arms around him. He patted her on the back, catching a whiff of sweetly-perfumed soap under the smell of disinfectant that clung to her hospital scrubs.
“Well, Mr. Carter, you ‘bout ready to blow this joint?” Nick’s heart skipped a beat as he recognized Rob’s voice. Dani released him and straightened up quickly as her husband sauntered into the room, wheeling a gurney along with him. “The chopper’s on its way, so we’d better get going,” he said, as he rolled the gurney right up next to Nick’s bed and lowered the side rail. “You wanna scooch on over here?”
“Sure,” said Nick shakily, hoisting himself off his bed and onto the gurney. His heart was racing - whether from exertion or being startled by Rob, he wasn’t sure. He could feel it hammering against his ribs as he tried to relax, taking deep breaths of oxygen from the portable tank Rob placed between his legs.
Dani was in the midst of hanging the heart monitor on the side of the gurney when she suddenly frowned. “Your heart rate just shot way up,” she said, looking up at Nick. “Are you feeling okay?”
“I’m a little light-headed,” he admitted.
Rob was already reaching for the stethoscope around his neck. “He’s also diaphoretic,” he told Dani, as he stuck it into his ears and slid the round end down the front of Nick’s gown.
“What does that mean?” Nick asked weakly. He definitely didn’t feel well now; the room around him was starting to go a sickly shade of green. Not again, he thought with a sense of dread.
“Sweaty,” said Dani, still frowning. “You look pale all of a sudden, too.” She picked his hand up off the gurney to check his pulse.
A high-pitched alarm went off on the heart monitor. “Multifocal PVCs,” said Rob, ripping the stethoscope out of his ears. He lowered the head of the gurney so Nick was lying flat. “He’s not stable enough to be moved anywhere right now, let alone flown in a friggin’ helicopter. Page Elizabeth,” he added, punching the red button on the wall behind Nick’s bed. “Let’s get him back into bed before he crashes. On my count: one… two… three.” He and Dani grabbed the sheet underneath Nick and used it to haul him off the gurney and onto the bed.
“What’s happening now?” Nick asked, feeling helpless and frightened as his heart fluttered uncontrollably in his chest.
Dani lowered the head of the bed and leaned over him, looking directly into his eyes. “You’re having another arrhythmia,” she said, her hand on his shoulder. “Hang in there. We’re going to help you.”
“He’s in V-tach,” Rob said suddenly, as the monitor sounded another alarm. “Get the crash cart; we need to cardiovert him.”
“He still has a pulse,” protested Dani. “Try lidocaine first; that worked last time.”
“All right, go for it, but I’m gettin’ the crash cart,” Rob replied. While he went to retrieve the red cart from the corner, Dani rolled her eyes at Nick.
“What does he know?” she muttered, as she drew up a dose of the drug into a syringe. “This is going to work.” She injected it straight into the central line in the side of Nick’s neck.
But that time, it didn’t seem to make any difference. “He’s still in sustained V-tach,” said Rob, watching the rhythm on the monitor. “You want him to arrest? ‘Cause he’s going to if we don’t do something. We’ve gotta cardiovert him.”
Dani sighed. “Okay, fine, you win.” She turned to Nick. “Your heart didn’t respond to the drug; it’s still in a dangerous rhythm. We’re going to use the defibrillator to give your heart a shock that should reset its rhythm and get it beating right again.”
“No,” Nick moaned, shaking his head as he imagined how much that would hurt. “Please don’t.”
“We have to, honey - trust me. Your heart can’t keep beating like this for long. If we don’t correct the arrhythmia right away, you could go into cardiac arrest again. We have to do this. Do you understand?”
Tears welled in Nick’s eyes as he nodded. He had never felt more terrified. “Just don’t let me die,” he whimpered.
“Nick, we are not going to let you die,” Dani replied fiercely. “We’ve done this hundreds of times. You’re going to be just fine. I’ll give you something to knock you out for a few seconds while we deliver the shock so you don’t remember it.” She drew up a syringe full of milky white liquid and injected it slowly into his IV. “Try to relax.”
Yeah, right, thought Nick anxiously, as he waited for the medication to work its magic. He wished his heart would slow down on its own, but it kept galloping like a racehorse gone rogue.
Dani pulled down the front of his hospital gown as Rob fired up the defibrillator, attaching extra electrodes to Nick’s chest so it could track his heartbeat. “Ready when you are,” Nick heard Rob say to Dani, as he held up the paddles.
Nick felt his eyelids growing heavy as the drug took effect. The last thing he remembered was seeing the pair of paddles looming over him before the room went black.
***
Nick’s eyes rolled back into his head as Rob pressed the button on the defibrillator. When the synchronized shock was delivered, Nick’s body twitched atop the bed. His hands curled into tight fists as he flung them toward his face, a typical reaction to being cardioverted. But a second later, his arms fell limply to his sides, as his heart stopped beating and began to fibrillate.
Dani had been studying the monitor, waiting to see what the shock would do. Her breath caught in her throat as she watched the tall waves suddenly flatten into a random series of tiny ripples. The jagged line that ran across the screen looked more like a child’s scribble than a waveform. “He’s in V-fib!” she exclaimed, as the alarm sounded to alert them to the fact that their patient’s heart was no longer pumping blood, but merely quivering inside his chest. Without medical intervention, Nick would be brain dead in a matter of minutes.
“Start CPR,” said Rob. “I’ll get the defibrillator ready.”
A rush of adrenaline shot through Dani’s body as she lowered the bed, laced her fingers together, and leaned over Nick, planting her hands firmly in the center of his chest. She pushed down hard and fast, knowing she needed to do it at least a hundred times per minute at a depth of two inches to be effective. Despite her denial, she couldn’t help hearing his song in her head. “Even in my heart… I see… that you’re not being true to me…” It was surreal to be performing chest compressions on a pulseless Nick Carter as “Quit Playing Games (With My Heart)” played in her brain, but it was how she had learned, and even now, it helped her keep the beat.
“Charged to two hundred,” Rob announced. “Clear!”
Dani stood back, lifting her hands off Nick’s body, as Rob leaned over him, pressing the defibrillator paddles to both sides of his chest. She watched his body jerk again as the shock was applied; then she went right back to pumping his chest.
“Keep up the compressions for another two minutes,” said Rob, as he set the paddles aside. “I’ll start ventilating him. Where the hell is Elizabeth?” He smacked the blue code button on the wall as he reached for the resuscitation mask.
Elizabeth arrived less than a minute later. “What happened?” she asked, as she hurried into the room.
“He went into V-tach while we were transferring him onto the gurney,” Rob explained from the head of the bed, where he was bagging Nick. “We gave him a dose of lidocaine, but it didn’t work, so we tried cardioversion at fifty joules, which triggered V-fib.”
“How long has he been down?”
“Just a couple minutes.”
“Have you given him any meds?” Elizabeth wanted to know.
“Not since the lidocaine,” replied Rob.
Dani listened to their conversation without contributing, keeping her focus on delivering high-quality compressions. Her arms were starting to get tired, but she didn’t slow down. Her heart raced, fueling her with adrenaline as she continued fervently pumping Nick’s chest. She was determined to keep going until Rob told her to stop.
“Let’s pause for a rhythm check,” her husband said after another minute had passed. “Hold compressions, please.” Dani took her hands off Nick’s body and turned her attention to the cardiac monitor. She watched the jagged line flatten for a second, then jump, slowly transforming into a recognizable waveform. “Sinus rhythm,” said Rob triumphantly. Dani felt herself sag with relief.
“He’s got a strong radial pulse,” Elizabeth added, as she palpated the artery in Nick’s wrist. “Nice work. Now let’s make sure he doesn’t arrest again.”
As they moved around the bed, administering oxygen and medications to keep his heart beating, Dani bent down by Nick’s head and put her mouth next to his ear. “I told you we wouldn’t let you die today,” she whispered. “And when you wake up, you won’t remember a thing.”
***
