The group of six were huddled just inside the emergency room entrance like a flock of frightened sheep.
“What the heck is taking so long?” moaned Leighanne, hugging herself tightly as she rocked back on her heels.
“Relax,” said Kevin, wrapping his arm around her. He rubbed her shoulder reassuringly. “The detective said they were on their way. Brian should be here any minute.”
Howie felt for Leighanne. He was antsy himself, waiting for her husband to arrive, wanting to see with his own eyes that Brian was really all right. At the same time, he worried about Nick. They had heard nothing on his condition since Detective Overton had gone into the cath lab to detain Dr. Gravel. “Go back downstairs,” she had urged them beforehand. “Be there for Brian. One of us will come find you and fill you in when we can.”
No news is good news, Howie reminded himself, trying to stay hopeful, but AJ had said it best: waiting was the worst.
Lauren seemed to be having the hardest time. After standing by the door for a while, she wandered away and sat on the floor with her back against the wall and her knees drawn tight to her chest, her head in her hands. Although she had followed the others down to the emergency department to wait for Brian, Howie knew her heart was still upstairs with her husband.
He went over and knelt in front of her, resting his hand on her knee. “I know you’re scared right now,” he said softly. “I am, too. But I really think Nicky’s gonna be all right. He’s resilient. Like a cockroach. You could cut off his head, and he’d still keep crawling around and driving everybody crazy.” Lauren laughed through her tears, and Howie allowed himself a grin. “Seriously, Nick’s had to deal with a lot of crap in his life, but he always seems to come out on top, stronger than before. Why should this be any different?”
Lauren nodded. “I know,” she said, sniffling. “But it does feel different. Nick’s never been through anything like this before. As much as I want to believe he’ll be fine, I just can’t shake the feeling that he’s already dead.”
A chill ran down Howie’s spine. “Don’t say that!” he hissed, shaking his head. “Nick’s not dead.” But her dire premonition had planted seeds of doubt in his mind.
Before he could dwell on them, Howie heard Leighanne gasp. “Here comes an ambulance!” He looked up as the emergency vehicle pulled up to the ER entrance, its lights and sirens turned off. Leighanne hurried out to meet it, Baylee right on her heels. After a moment’s hesitation, the rest of the group followed them.
“Come on,” he said to Lauren, taking her hand. She allowed him to pull her to her feet, and they walked outside together.
Howie held his breath as he watched a pair of paramedics unload a stretcher from the back of the ambulance. After the way Nick had arrived, it was a relief to see Brian sitting upright against the raised head of the stretcher. At first glance, he appeared to be unharmed. He was already wearing a hospital gown, which was drenched with sweat, and his greasy hair was plastered to his pale forehead, but Howie didn’t see any blood or bruises. Before he could get a good look, Leighanne ran to the stretcher and hurled herself at her husband. She buried her head in Brian’s chest and began to sob hysterically. He wrapped his arms around her, stroking her hair as she clung to him.
“Are you okay, Dad?” Howie heard Baylee ask as he came up alongside the stretcher. “Did they do that to you?”
It wasn’t until Leighanne finally let go that Howie saw what Baylee was talking about. Around Brian’s neck was a white collar with a tube sticking out of the front, right at the base of his throat. Howie’s heart skipped a beat when he realized it was a tracheostomy tube. What the hell? he thought, staring at it with wide eyes.
Brian nodded without speaking and briefly closed his eyes. When he opened them again, there were no words needed. Howie could clearly see three weeks’ worth of pain built up in Brian’s watery blue eyes. It broke his heart. Whatever had happened to Brian in the twenty days since the security cameras had caught him walking out of the Key West airport would haunt him for years to come.
“Excuse me, everyone, but we need to get him inside now,” one of the paramedics said, as Brian’s family and friends began to gather around him. “Out of the way, please.” They stepped back to let the paramedics push Brian into the emergency room, following behind the stretcher as it was whisked straight back to an exam room.
Howie, Kevin, AJ, and Lauren waited in the hallway while Leighanne and Baylee went in with Brian. “So help me god, if I get my hands on any one of the sick fucks who did this to him and Nick, I’m gonna fucking eviscerate them and then strangle them with their own intestines,” AJ growled, as he paced up and down the hall.
“Gross, AJ,” replied Howie, giving him a look of disgust. Despite his reputation as the “bad boy” of the group, AJ didn’t have a violent bone in his body, so when he started threatening disembowelment, Howie knew he was beyond angry. Not that he blamed him.
“But delightfully descriptive,” added Lauren, smirking at AJ. Howie was sure she would be happy to help him commit homicide, if it came to that. He wouldn’t blame her, either.
“Excuse me… Mrs. Carter?”
The crooked smile faded from Lauren’s face as she turned around to find a woman in scrubs standing behind her. “Yes?” she asked with a little quaver in her voice.
“I’m Dr. Webber,” the woman introduced herself. “I was called in to assist with Nick’s procedure. We just finished up a few minutes ago, and Nick is resting comfortably in the recovery room.”
“So he’s alive?” said Lauren, sagging with relief. Howie felt his heart lift, as if a heavy weight had been removed from his chest.
Dr. Webber nodded. “If you’ll come with me, I can fill you in more on his condition.”
“Yes, of course.” Lauren, Howie, and AJ followed her down the hall to the same private waiting room where they had been before. The doctor shut the door and invited them to sit down. That was when Howie knew not all the news on Nick was going to be good.
Dr. Webber took a deep breath as she turned to face them. “Unfortunately, there was a complication during the ICD extraction,” she began. Howie heard Lauren draw in a sharp breath herself. He put his arm around her, bracing himself for the bad news. “As Dr. Gravel was pulling out one of the wires that went into Nick’s heart, it tore a small hole in his vena cava, the vein that returns deoxygenated blood to the heart. Blood began to leak into the sac surrounding Nick’s heart. The accumulation of fluid compressed his heart and kept it from being able to beat properly, which caused him to go into cardiac arrest again.”
“Holy shit,” AJ swore softly, as Howie’s own heart seemed to sink back into his stomach. He had known as soon as he’d made the connection between the man who had kidnapped Brian and the cardiologist operating on Nick that something was going to go wrong. Detective Overton must not have gotten there in time to prevent Dr. Gravel from trying to kill her patient.
“But he’s alive, isn’t he?” asked Lauren in a high-pitched voice. Howie could feel her whole body shaking against his. “You said he was alive.”
“Yes, he is alive,” Dr. Webber confirmed, “but in critical condition. We had to open up his chest in order to repair the damage and restore circulation. This involved putting Nick on cardiopulmonary bypass - a heart-lung machine - to pump oxygenated blood through his body while we worked on his heart.”
“Were you able to fix the problem?” Kevin wanted to know. He spoke calmly, but his face was very pale. Deep creases appeared in his forehead as he frowned in concern.
Dr. Webber nodded. “We patched the hole, drained the blood from the pericardium, and removed the device as planned. But we haven’t been able to get Nick’s heart beating well enough to wean him off bypass yet. We’re giving him medication to help it pump better, but so far, his heart hasn’t responded. It’s been weakened by the infection and will need time to rest and recover.”
Howie swallowed hard. “So he’s on life support?”
“Technically, yes, but bypass isn’t intended to be used outside the operating room. We can’t leave him on the heart-lung machine for longer than six hours or so because of the risk of complications,” the surgeon explained, “but I’ve called in a team from Miami to hook him up to a special type of bypass machine called ECMO, which stands for extracorporeal membrane oxygenation. Basically, it works the same way as bypass, but can be used for much longer, up to a month. This will hopefully allow Nick’s heart to heal while his body fights the infection.”
Lauren took a shuddering breath and let it out slowly, looking down at the floor as she absorbed everything the doctor had told them. She didn’t say anything, but Howie imagined she was thinking the same thing he was. Nick still had a long, hard road ahead of him. Far from the happy reunion they had hoped for, his return felt like the start of another nightmare.
“Why Miami?” Kevin wondered. “Is that not something y’all can do here?”
Dr. Webber shook her head. “We’re a small community hospital; we don’t have the capabilities to perform ECMO at our center. As soon as Nick is stable enough to be transferred, the team will fly him by air ambulance back to Miami, where they can provide the more advanced care he needs.”
They nodded, exchanging worried glances. “When can we see him?” Lauren was the first to ask.
The surgeon seemed to hesitate. “We don’t normally allow visitors into the recovery room, but under the circumstances, I’ll let you come back with me for a few minutes, Mrs. Carter.”
“Thank you,” Lauren replied softly, raking her long hair away from her face as she rose to her feet.
As the others started to stand, too, Dr. Webber held up her hand and added, “I’m sorry, but the rest of you will have to wait until he’s been stabilized.”
“That’s okay,” said Kevin, catching first Howie’s and then AJ’s eyes. “We can go check on Brian while Lauren’s with Nick.”
The other guys nodded in agreement. “Give Nicky our love,” Howie told Lauren, pulling her into a tight hug. “Tell him we’re praying for him.”
“I will,” she said, sniffling. “Will you pass along the same message to Brian for me?”
He smiled and nodded, patting her back before he let her go. “You bet.” Then they parted ways, Lauren disappearing around a corner with Dr. Webber, while Howie, Kevin, and AJ walked back up the hall to Brian’s room.
After the news about Nick, Howie felt heavy-hearted, yet hopeful. The worst is over now, he told himself, trying to think positive thoughts. Nicky may not be out of the woods yet, but at least he’s away from those people. He’s safe here, and he’ll be in good hands in Miami. He’s going to get better. He has to.
***
