“Of course,” said Dani with an understanding smile. She unlocked the wheels on his bed and rolled it slowly and carefully as far across the room as the equipment cords could reach, bringing his IV pole and everything else that was portable along with it. She parked Nick’s bed right next to Brian’s, with just a foot of space between them.
“Thanks,” he whispered through the lump that had lodged in his throat when he looked at Brian. Even without knowing exactly what was wrong with his friend, Nick could tell it was bad. A machine was breathing for him, which meant he wasn’t able to breathe on his own, and a maze of wires and tubes surrounded his bed. There was something attached to almost every part of his body - electrodes stuck to his head and chest, IV lines in both arms, a catheter coming out from under the blankets.
“You can touch him if you want to,” Dani told Nick. “Hold his hand. Talk to him. He’s unconscious, but he may still be able to hear you.”
Nick nodded. Reaching tentatively through the tangle of tubes, he took Brian’s hand and held it in his. It was limp, but reassuringly warm. Running his thumb across Brian’s knuckles, Nick couldn’t help but notice the contrast between the healthy pink color of Brian’s hand compared to the sickly gray pallor of his own. At least Brian’s heart was still beating, pumping oxygen-rich blood into his fingers. Nick took comfort in that fact, feeling it was a good indication that Brian could recover from his injuries.
“Hey, bro… it’s me, Nick,” he said softly, as he stroked the back of Brian’s hand. “I’m right here, man. I’m hanging in there, so you hang on too, okay?” He watched Brian’s face closely as he spoke, hoping for a reaction, some sign that his friend could hear him, but there was no response.
“He’s in a deep coma,” said Dani, as if she knew what he was thinking, “so don’t expect him to respond to you, at least not right now. He suffered a severe closed head injury in the crash, and it could take a long time for him to heal.”
“How long?” Nick wondered. “I mean, when do you think he’ll wake up?”
“It’s hard to say. We have to wait for the swelling in his brain to go down before we can get a better idea of what to expect.”
Nick swallowed hard. “So he has brain damage?”
Dani nodded. “The MRI showed a diffuse axonal injury, which can happen when someone’s head is suddenly flung forward or backward and the brain slams into the skull.”
“Like a concussion?”
“Sort of like a concussion, yeah, but this kind of traumatic brain injury is usually a lot more serious.”
Nick sighed and covered his face with his free hand. “This is all my fault,” he moaned, his voice muffled. “He flew down here for me.”
“It’s not your fault,” Dani said firmly, putting her hand on his shoulder. “If anything, it would be my fault for calling him, but I’m not going to blame myself for this, and neither should you. It was an accident. It’s not anybody’s fault.”
“Yeah, but…” He stopped and shook his head. “Never mind.” No matter what she might say to make him feel better, Nick knew the only reason Brian had been riding in that car on that road in the rain was because of him. And if it hadn’t been Brian, it could have been one of the other guys or even Lauren. None of them would have come to Key West had it not been for Nick, and he hated himself, hated his failing heart, for putting his friend in the path of a Category 4 hurricane. He hoped no one else had followed Brian to Florida. “Did he fly down by himself, or was his family with him?” he asked, wondering about Leighanne and Baylee. Brian rarely went anywhere without his wife and son.
“He was alone,” answered Dani, and Nick let out a sigh of relief. At least he wasn’t responsible for harming the whole Littrell family, though he worried Leighanne would resent him for being the reason Brian had been hurt. “His wife has been notified, but with all the airports shut down, she won’t be able to get here anytime soon. Besides, everyone’s been ordered to evacuate.”
“But not us?”
“Nope. I’m not leaving you,” said Dani, patting his arm. “Elizabeth and Rob and I are gonna shelter in place and see you through this.”
“What about Brian?”
Dani bit down on her bottom lip. “Truthfully, he’d be better off at a Level 1 Trauma Center, but he’s not stable enough to be transferred in this weather either. We think he may also have a spinal cord injury that could be made worse by putting him in a bumpy helicopter.”
“Oh god,” said Nick, his heart skipping a beat as he looked back at Brian, whose neck was immobilized by a hard brace that went all the way from the top of his chest to the bottom of his chin. “You think?”
“The X-rays and MRI showed several fractured cervical vertebrae that seem to have compressed his spinal cord,” she explained, “but we won’t know the full extent of the injury until he comes out of the coma.”
“So he could be paralyzed?” Nick’s heart had started to pound, as he considered the possibility of Brian being permanently disabled, confined to a wheelchair for the rest of his life. For someone as active and athletic as Brian, such a fate would be almost worse than brain damage.
“Calm down,” Dani warned him, with a wary look at his heart monitor. “We don’t know anything for sure yet. It’s a waiting game, at this point.”
Nick sighed. More waiting. As much as he hated it, he knew Dani was right. There was nothing else to do but wait. He took a deep breath and held it for a few seconds before he released it, trying to slow his racing heart. It seemed to help. “When did you say the hurricane’s supposed to hit?” he asked her.
“Sometime tomorrow night. But don’t worry; we’ll be all right,” she replied, flashing him a reassuring smile. “The hospital was built to withstand a Category 5, and we have backup generators and plenty of fuel, in case the power goes out. We’re on the third floor, so we shouldn’t be affected by flooding. We’ll be just fine.”
She thought he was worried about the storm. But Nick was only worried about Brian.
***
Dr. Elizabeth came in a while later. “Hi, Nick. I hear Dani’s already filled you in on what happened yesterday. How are you feeling now?” she asked, as she removed her stethoscope from around her neck.
Nick didn’t know quite how to answer that question anymore. “All right, I guess,” he replied with a shrug, deciding the way he felt was all relative. At the moment, he felt better than he had the day before, when his heart was beating out of control, but not as well as he had prior to it failing him in the first place. He was weak and tired and slightly nauseous, his chest hurt, and his head ached, but Dani had already noted his complaints on his chart, so he didn’t see the point in repeating them. He was still better off than poor Brian.
“Any pain, palpitations, or trouble breathing?” Elizabeth probed, rubbing the round end of the stethoscope over the palm of her hand before she slipped it under the neck of Nick’s hospital gown.
“My chest is a little sore,” said Nick, “but otherwise, no, not really.”
“Yes, I bet it is. Deep breath, please.” She pressed it lightly to the left side of his chest and listened for a few seconds, closing her eyes to concentrate on what she heard. When she was finished examining him, Dr. Elizabeth pulled a stool over to his bed and perched upon it. “I want to revisit the conversation we had a couple of days ago, about the implantable defibrillator.”
His stomach lurched. “You still think I need one?”
“After yesterday, I’m even more convinced you do,” she replied. “You almost died from another lethal arrhythmia that, thankfully, responded to defibrillation. If that had happened outside the hospital, I don’t think you would here be talking to me right now… not unless you had an ICD that could have automatically done what our code team did and delivered a shock to reset your heart’s rhythm.”
Nick’s blood ran cold, as his heart skipped a beat. The thought of having such a device inside his body still bothered him, but he could tell Dr. Elizabeth wasn’t going to back down until she had talked him into it.
“Think of it as a safeguard, like built-in backup for your heart,” she continued. “It can’t prevent another episode of cardiac arrest, but it could protect you if one were to happen after you’re discharged from the hospital. The pacemaker would constantly monitor your heartbeat to make sure it’s not too fast or too slow, and the cardioverter-defibrillator could correct a dangerous rhythm before it became fatal. It could make the difference between life and death.”
He glanced at Dani, his mouth going dry again. She gave him an encouraging nod. Looking back at Dr. Elizabeth, Nick asked, “How does it get put in? Would I have to have open-heart surgery?”
“Not at all,” Elizabeth replied. “We would make a small incision on the left side of your chest, right under your collarbone, and create a ‘pocket’ of space beneath the skin in which to place the pulse generator - that’s the computerized part that contains the battery and controls the device. We would also thread a couple of wires called leads through your veins and attach them to your heart. It sounds complicated, but it’s actually a pretty minor surgical procedure that isn’t usually performed under general anesthesia. We would give you a mild sedative instead of putting you all the way under.”
Nick ran his hand over his chest, trying to imagine what it would feel like to have a piece of hardware implanted inside it. “Does it hurt?” he asked.
“We would numb the area with a local anesthetic, so you wouldn’t feel any pain during the procedure itself. Most people are sore for a few days afterwards, but once they recover, they don’t even notice the device unless it has to deliver a shock.”
That was the part Nick was most worried about, though he supposed living through a shock would be better than dying without one. Reluctantly, he made what he hoped was the right decision. “Okay,” he agreed. “I’ll do it.”
Dr. Elizabeth looked relieved. “Excellent. I’ll schedule the implantation procedure for this afternoon.”
Nick raised his eyebrows. “This afternoon??” he repeated, his heart rate accelerating with anxiety.
“With this storm on the way, I’d rather do it sooner than later,” Dr. Elizabeth replied. “If we were to lose power, it may be awhile before we’d be able to perform any surgery, and I don’t think we can afford to wait.” She patted the back of his hand. “We’ll all feel better knowing your heart has that safeguard in place as we prepare for the hurricane.”
He swallowed hard. “Yeah, I guess so.”
When Elizabeth left, Nick looked across the room at Brian’s bed again, wishing he was awake. If there was anyone who could have reassured Nick he had made the right choice - or helped him realize it was the wrong one - it was Brian. In a way, Brian had been there before, having made the difficult decision to undergo heart surgery himself. Their circumstances were different, but the uncertainty was the same. Nobody else in Nick’s life could know what that fear felt like better than Brian.
“Please wake up, Frick,” he whispered. “I need you.”
***
