The surgery had been a success, but rather than reassure him, the the so-called “safeguard” implanted inside his chest put Nick on edge. After he’d been brought back to his room, he lay still in bed, listening to the steady blip of his heartbeat on the monitor and waiting to hear it suddenly speed up or slow down, as it had in the days before. How long would it be before his dying heart went into another dangerous arrhythmia that, when detected by the ICD, would result in a painful shock? To Nick, it was just the calm before the storm, both literally and figuratively.
“I feel like I’m in the movie Speed,” he confessed to Dani, “but instead of a bomb on a bus, there’s one inside my chest. If my heart goes above a certain number of beats per minute, it’ll engage… and if it drops below fifty, it’ll explode.”
“Wow… well, that’s one way of putting it,” replied Dani, with a raise of her eyebrows. “It’s not necessarily about the rate, though; it’s about the rhythm. As long as you have a regular heartbeat, you have nothing to worry about. The pacemaker will start firing to force your heart to beat faster or slower if needed, but you won’t feel any pain from that. The impulses are so small that most people don’t even notice them, but the ones who do say it just feels like a fluttering in their chest. The defibrillator will only deliver a shock if your heart goes into a chaotic rhythm where it isn’t beating correctly and can’t pump blood, at which point you’d probably be unconscious anyway and wouldn’t even feel it.”
Nick appreciated her reassurance, though it didn’t completely relieve his anxiety about the ICD. At least he wasn't in much pain from the procedure. The left side of his chest was sore, and they’d put his left arm in a sling to limit the movement on that side, but besides that, he felt pretty good. The painkillers certainly helped.
On the other side of the room, Brian seemed the same as he had been before Nick’s surgery - no worse, but no better either. He was still unconscious and unable to breathe on his own, but his heart beat steadily, supplying his body with the oxygenated blood it needed to stay alive. “Hang in there, Brian,” Nick told him from time to time, hoping he could hear the words of encouragement and wishing they would help him wake up from his coma.
“It’s getting pretty bad out there,” Dani commented when she came in to check on them both. “Rob’s been up on the roof, watching the storm roll in. Typical guy.” She rolled her eyes as she wrapped a blood pressure cuff around Nick’s right arm. “No offense.”
He chuckled. “None taken. I get it, though. Us guys can’t resist going outside to see a good storm. Must make us feel manlier or something.”
She shook her head, removing the stethoscope from around her neck and sticking it into her ears. “So stupid,” she said, as she pressed the end of the stethoscope to the crook of his elbow and inflated the cuff until it was tight around his arm. Then she was quiet for a few seconds, listening carefully as she let the cuff deflate. “One-ten over seventy.” She smiled as she noted the numbers on Nick’s chart. “That’s right in the normal range.”
“Does that mean my heart’s getting better?” he asked hopefully.
Dani’s smile faded. “It just means the interventions seem to be working. The medications are keeping your blood pressure under control, and the pacemaker is helping to regulate your heartbeat. Your condition’s stable for now.”
With a sinking feeling, Nick understood what she was trying to tell him without actually saying the words: his heart wasn’t going to get any better and would probably get worse. All he could hope for was that the treatments would keep him alive long enough to undergo a transplant.
“Well, at least something’s going right,” he replied, trying to stay positive in spite of this depressing realization. “Do you think I could try getting up again so I can go call Lauren?”
“Sorry,” said Dani, shaking her head. “Dr. Elizabeth still wants you to stay in bed while you recover from your procedure. Besides, the phone lines went down a few hours ago.”
Nick sighed. “Damn. When do you think I’ll be able to talk to her?”
“I don’t know. That’ll depend on how you’re doing when the phones are working again, whenever that may be.” Dani moved behind his bed to put the blood pressure cuff back into its holder on the wall. “Didn’t you say you had been in a hurricane before?” she asked, changing the subject back to the weather.
Nick recognized her attempt to distract him from dwelling on how much he missed his family, but he played along anyway. “Yeah… I was actually down here for Hurricane Dennis. I think that was what, like, 2005?”
“Sounds about right,” said Dani, reemerging with a digital thermometer in her hand. “Same year as Katrina.”
Nick nodded. “Yeah, it was 2005 because I remember it was right before the Never Gone tour.”
“That’s right!” she replied, smiling. “I was at the first two shows on that tour - West Palm Beach and Tampa.”
“Oh wow, were you really?”
“Yep.” She bent down beside him, easing the thermometer into his ear. “That was the summer before I started college. I was still living with my family in Fort Myers then. We didn’t have to evacuate for Dennis.”
“No, I don’t remember it being that bad. They did order an evacuation for the Keys - well, for tourists, anyway - but I was friends with the commissioner of Key West, so I was allowed to stay.”
“Ah, I see how it is,” said Dani with a wink. When the thermometer beeped, she took it out of his ear and checked the temperature readout. “Ninety-nine on the nose.”
Nick smirked. “Does that make me hotter than 98 Degrees Nick?”
“Nick Lachey?” She laughed. “Oh, hands down. Don’t go getting any hotter than that, though,” she warned, wagging her finger at him. “Then we would worry about you having an infection from your ICD, and you definitely don’t want that.”
“Nope, definitely not,” Nick agreed. He knew he shouldn’t be flirting with her, but it felt like nothing but harmless fun now. Their hookup on Halloween night had been a one-time thing, a mistake made under the influence of too much alcohol. It hadn’t meant anything, and it wouldn’t happen again. Even if they weren’t both married, Nick doubted a beautiful woman like Dani would want to date a man who was dying of heart failure, Backstreet Boy or not - especially when he was one of her patients. She was only flirting back because it was harmless fun for her, too.
When she was finished with Nick, Dani went to Brian’s bedside next. She left the curtain open so Nick could watch her work. He lay back, admiring the way her ass looked in her teal scrubs as she leaned over Brian. Even though he was unconscious, she still took the time to introduce herself before she began poking and prodding him. “Hi, Brian, I’m Dani, your nurse. Can you open your eyes for me?”
Nick studied Brian’s face closely, but his eyelids didn’t even flutter. Dani put her hand on top of his head and pushed her thumb against the top part of his eye socket. “What are you doing to him?” Nick asked her, watching with a frown.
“Applying a painful stimulus to see if it’ll get him to open his eyes,” Dani replied. “It’s part of an assessment called the Glasgow Coma Scale that we use to monitor a patient’s level of consciousness. Since Brian’s not opening his eyes, even in response to pain, he gets a score of one for the first category. The higher the score, the better.”
“What’s the highest score he could get?” Nick wanted to know.
“A four, for that category.”
“Oh.” He felt disappointed, knowing how much Brian would hate getting such a low score. “C’mon, Bri,” he urged, appealing to his best friend’s fiercely competitive side. “Open your eyes, bro. You can do it.”
Dani waited for a few seconds, watching, but when Brian’s eyes remained shut, she shook her head. “He would have gotten a three for opening them to the sound of your voice, but not this time,” she said regretfully. “Keep talking to him, though. He may still be able to hear you, even if he can’t respond.”
Nick nodded, but it was hard not to be discouraged by Brian’s bleak condition.
“Normally I would assess his verbal response next, but since he’s intubated, he won’t be able to speak anyway, so I can’t score the second category,” Dani explained, continuing to narrate her way through the assessment. “The last category is Motor Response, which is also tricky to score in someone with a spinal cord injury. Brian may not be able to move or feel some parts of his body below a certain point, so I’ll focus on his face.” She leaned over his bed again. “Brian, can you raise your eyebrows?” she asked, slowly and clearly, but there was still no response; Brian’s forehead stayed smooth. Behind the breathing tube, his face was totally blank.
Nick missed the funny faces Brian loved to make. It was eerie to see someone who had always been so animated lying there like a corpse, expressionless and still. He had to look at Brian’s chest rising and falling beneath the blankets and listen for the steady blip of the monitor to reassure himself that Brian was still breathing, that his heart was beating, that there was still some life left inside him, even if it didn’t show on the outside.
“He’s not responding to my commands, so I’m gonna try to cause enough discomfort to make him move,” said Dani. Working around Brian’s neck brace, she began by pinching him hard in the place between his neck and shoulder, just above his collarbone. When that didn’t work, she made a fist and rubbed the middle of his chest with her knuckles, as Nick had seen her do to his last roommate. Brian didn’t so much as flinch, which made Nick think he wasn’t much better off than the woman who had flatlined in his bed. “No response to painful stimuli, so he gets a one in that category as well,” Dani concluded. “That means he has a GCS of two out of a possible ten.”
“Twenty percent?” Nick grimaced. “That’s not good.”
Dani shook her head as she entered the numbers into Brian’s chart. “No, it’s not. He’s still in a deep coma.”
“At least he didn’t get a zero.”
“The lowest score for each category is one, so no one can get a zero. Technically, even a dead body will score twenty percent,” Dani pointed out. “Sorry-” She paused, biting down on her bottom lip. “-that was probably more than you needed to know.”
Nick sighed, as reality set in. Brian’s condition wasn’t just “not good.” It was bad… really bad. “No, it’s okay, you can be honest with me. Is Brian gonna die?” he asked.
“I don’t know,” Dani admitted. “It depends on how he does over the next few days. We’ll keep giving him this assessment and hope his scores improve. If they don’t, it means he may never come out of the coma.”
Nick swallowed hard. He couldn’t face the possibility of losing Brian. The only thing worse than the grief was his guilt. If Brian died, it would be Nick’s fault, and nothing Dani or anyone else said could convince him otherwise. How could he live with himself, knowing his hospitalization had led to his best friend’s death?
Not for long, he thought, looking down at his dusky blue nail beds. While Brian’s condition could still get better, Nick’s was only going to get worse. They were both fighting for their lives… but at least they didn’t have to do it alone.
“Can you please put my bed by his again?” Nick asked Dani.
“Sure,” she agreed. She came around to the right side of his bed and rolled it toward Brian’s, until the cords connected to the equipment on the wall were almost taut.
Without warning, the room was suddenly plunged into total darkness. The overhead lights went out, and all the monitors turned black. Nick’s first thought was that Dani had pushed his bed too far, accidentally pulling something unplugged. Then he remembered the hurricane and realized it was a power outage.
“Don’t panic,” he heard Dani say. “The generator should kick in any second.”
Nick had no reason to panic, until it occurred to him that the life support machines relied on electricity to run. Without power, Brian wouldn’t be able to breathe.
He rolled painfully onto his left side and reached blindly toward the other bed with his right hand, groping around in the darkness for Brian’s. When his fingers finally brushed against bare skin, Nick grabbed hold of his friend’s hand and held on tight. “Hang on, Bri,” he said, giving it a squeeze.
It took less than ten seconds for the emergency standby power to be activated, but to Nick, it felt like an eternity. Finally, the fluorescent lights flickered on, and the machines and monitors came back to life, filling the room with a familiar cacophony of blips and beeps. Nick had never been so glad to hear those sounds. Watching Brian’s chest rise and fall along with the rhythmic hiss of the ventilator, he felt an overwhelming sense of relief. “You’ll be all right now,” he whispered, relaxing his grip on Brian’s hand.
Up until that point, weather had been the least of his worries. But the storm was just beginning.
***
