by Lexie Davis
She took the soiled hospital gown and sat it in the sink in the room. It got all over his blankets so she pulled those off the bed as well. If she didn’t get some answers, she was going to take charge whether they liked it or not.
Ryker looked miserable as he slumped in the bed, eyes closed. She left him for a moment to get a blanket and found the doctor chatting up a nurse.
“Hey! You have a patient in there that has hyperpyrexia with an adverse reaction to the anesthesia. Not to mention your surgical patient is a recovering drug addict who cannot have a narcotic, so you need to be finding him some medicine that he can take to reduce his pain instead of hitting on the pretty nurse.” She glanced around. “Where is the CNA assigned to his room? He need new bedding since he vomited all over what he had.”
The young doctor moved away from the nurse and toward her. “I prescribed Tramadol. That is the medicine he can have.”
“Tramadol may act like an antidepressant in theory, but it is a narcotic and does bond to opioid receptors in his brain. For a former cocaine addict, that is a recipe for disaster. I don’t know what kind of experiences you had in internal medicine, but in emergency, we had to train community clinics where drug addiction is very high. One woman tried to give me her child for an opioid prescription. While you think one little drug doesn’t mean much to a patient—your patient—you are very wrong. They struggle with addiction for the rest of their life. It’s hard work to get clean and stay clean. Respect your patient’s wishes that they want to remain sober and give them something that will help them. Don’t try taking the fucking easy way out!”
The doctor stared at her like a deer caught in headlights. Ella could feel her patience wearing thin. Lack of sleep had really taken its toll on her.
“Make a call to anesthesiology and psych. You should have an addiction specialist available to give a consult for what medicines are proper for a recovering cocaine addict. Once you understand how to treat your patients, you can treat them properly.”
The doctor lifted the phone and dialed a number. Ella waited while he got a consult for anesthesiology. He then proceeded to call psych. They did have a psychiatrist that specialized in addiction medicine. Both agreed to a consult.
“He was given Tramadol in surgery.”
Ella frowned. “What?”
He pulled up Ryker’s file. “Right there.”
Ella read over the list of medicines given. Tramadol was one of them. How did she miss that earlier? “Shit. I need some bedding for him and myself. It’s going to be a long night.”
Chapter Eight
Ryker had never felt so sick in his life. He was fairly sure he never enjoyed having a doctor for a wife more than he did right now. Moving made his stomach queasy and vomiting was nearly an every-hour thing. He couldn’t even focus on the pain. God, the pain shot up his arm and down his spine like someone took a blow torch to him and lit him up. He’d basically resulted in laying on his side in fetal position begging for death.
“Your fever is down. Your blood pressure looks good.” Ella studied the readouts on the machines. “How’s the stomach?”
“I don’t want to move.”
“The anti-nausea meds should be helping with that.” She rubbed his bare back, soothing him with her touch. “Any symptoms of withdrawal?”
“My arm fucking hurts too much to think about drugs.”
“How high is your pain?”
“Pretty fucking high.”
“I’ll get you something.” She moved away from him and disappeared out the door.
He felt like crying. Damn, he never thought anything could be so bad. When she came back in the room, she walked over to him.
“The doctor will be in here in a minute.”
“Just fucking kill me.” He moved to his back and took a deep breath.
From what he gathered, he didn’t tolerate pain medicine well. Everything was non-opioid and his stomach hated it. It became too damn much and he wanted to consent for something stronger.
Ella sat next to him, rubbing his legs. “You know I’m not going to do that.”
“It fucking hurts.” He grunted. “Goddamn it. It fucking hurts.”
“We’re going to try something else.”
“I don’t want to fucking try something else. I want something that fucking works.”
Ella folded her arms over her chest. “I think you’re experiencing some signs of withdrawal from the medicine used in surgery. It’s disguised and the tolerance you’ve built up is decreasing the effectiveness of the medicine we’re giving you.”
“I don’t care.” He clutched the railing. Sweat dotted his temples. “I don’t fucking care, Ella. I’d do a whole fucking gram of coke if it’d get rid of this.”
She took a deep breath. “I’m going to find the right medicine. Just trust me enough to know what is best for you.”
She pulled out her phone and dialed someone. He kept his eyes closed, doing his best to not throw up. His head felt like it weighed one hundred pounds. He was agitated and jittery, but he couldn’t fucking move. He had to simply lay there and suffer.
“I’ll be right back.” Ella left the room.
Ryker decided he’d had enough. He lifted himself up to sit on the side of the bed and watched as his hands shook. Cigarettes always helped. He sat on the side of the bed, hating that his body reacted so harshly. His tolerance was pretty high. He didn’t know how much coke he did the day before he stopped, but it’d been a lot. He was shocked he didn’t overdose.
He stood and the machine attached to him started beeping. Hell, they had a monitor on him now? He unplugged the stupid thing and walked to the bathroom. Turning the shower on, he left it as cold as it would go and stepped inside. He’d been a blubbering idiot during withdrawal before. He stood in beneath the water, doing his best to keep his shoulder away from the stream. His body felt like a truck ran over it, then backed up to run over it again.
Ella opened the door and stared at him as he stood beneath the water. “I called one of my professors. He put me in touch with the chair of the pain management department of the school. I got a concoction to give you that I think will work. Let me hook your IV back up and try it.”
“I can’t move.” He dropped his head down and let the cold water hit the back of his neck. He had bruises on his leg from where the bike fell on him. That fucking hurt too.
“I’ve got you, Ryker.” Ella came toward him and turned the water off. She reached for a towel and wrapped it around his waist. “I’m right here. I’m not going to stop searching until your pain is under control in a healthy way.”
He buried his face in her neck. Ella wrapped her arms around him and stroked his back. She’d become his security blanket. He felt like the biggest baby at the moment and his wife was the only person who could ease that feeling a bit.
“I’ve got you,” Ella squeezed him tighter. “You’re okay. Everything is amplified since you’re experiencing withdrawal too. It feels like it hurts worse than it does.”
“I was shot. It fucking hurts.”
“Maybe. You also stabbed yourself and bounced back like nothing happened.”
“I didn’t have narcotics in my system.”
“I know.” She rubbed his back. “I’m sorry about that. I told them not to, but they did. It’s going to take some time to get out of your system, though I really think it should be gone by now.”
He kept his head on her shoulder while she continued to soothe him. “It wasn’t my fault. Some guy rode up to us and pulled a gun out. I had no time to react.”
“I know.” She pulled back, cupping his head while she looked at him. “Lie back in the bed and we’ll get this new mixture in you. I think it’ll work.
“And if it doesn’t?” He felt the tears. Damn, his vision went blurry too. The last thing he needed was to end up like a blubbering fool. He was so damn close though. Shaky hands. Jitters. Crying.
“I’ll figure something else out.” Ella moved aside. “C
ome on.”
He went back into the room and sat on the edge of the bed. He watched her hook his IV up and kill the beeping noise. The nurse waiting on them had two vials of something. He didn’t care what it was if it worked.
She gave the first needle full and waited.
“How are you feeling?” Ella asked.
“I don’t feel different.”
The nurse tossed the vial and gave him the second needle full. When it hit him, he blinked a few times. Relief wasn’t immediate, but the pain was less intense. He dropped his head back, clutching the blankets beneath him.
“I think we have a winner.” The nurse smiled. “Can you rate you pain for me?”
“No.”
Ella pointed to the emojis on the wall. “Pick a face.”
“The third one.”
“From which side?” the nurse asked.
“Right.”
“A six? That is tolerable. Much better than before, right?” The nurse typed away on her hand-held gadget.
He ignored her. “I need some water.”
“Ice.” Ella pulled his blanket up. “Lay back for me and I’ll go get you some.”
“No.” He gasped. “I can’t breathe.”
Ella reached for him just as he blacked out.
****
“I know you did the best you could do.” Maggie’s voice was a comfort to her even though she felt like a failure.
The one pain medicine he seemed to tolerate, he was allergic to. They went back to square one. Ryker nearly died because of her and the emotional toll it took damn near had her breaking down at the hospital.
“I don’t know what to do.” She took a deep breath. “It seems like we’ve tried everything.”
“Keep trying,” Maggie encouraged. “There’s got to be something.”
Ella spent the rest of the afternoon talking with all her doctor friends. Some were in school. Some were in her residency program. She even reached out to her new boss to see if he could lead her in the right direction.
It hurt to go in his room and see him like that. One moment he was lifeless. The next moment he was in pain. He didn’t sleep. He didn’t eat. She knew he lost weight because of the ordeal. He wanted to go home and she honestly did too.
“I think we’re going to transfer him to a hospital in Atlanta.” Ella told the hospital staff. “I want him to be prepared for transport. I’ve already made the arrangements. They’re expecting us.”
“We’ll get the orders ready.”
She tried her best.
The long drive back to Atlanta seemed to take longer. Vampire made arrangements to have Ryker’s bike brought back to the city so she didn’t have to deal with that. It hurt to see him suffer. It hurt even worse that she couldn’t help him. She did her best to tell herself that pain management wasn’t her specialty. She knew enough for trauma and emergency care. She didn’t know everything. It didn’t help though. She felt like she should know everything. That it was her responsibility to know since her husband depended on her to take care of him.
She nearly killed him.
The ambulance pulled up at the emergency entrance and she found a parking spot nearby. Her new coworkers rushed to take Ryker in and she walked in as calmly as she could behind them.
“What’s going on?” Dr. St. John asked as he approached a trauma unit.
Ella gave him the stats of Ryker’s case while they both walked to the trauma unit. He didn’t say anything as the team moved around him, checking his levels and drawing blood. She stood back, feeling the effects of the previous night and that day.
“Ella?” Dr. St. John glanced over at her. “You did a good job. Addiction is difficult to treat in all aspects of medicine. You fought for him, and with pain medicine it’s trial and error a lot of times. You didn’t know he was allergic to that drug. You did everything right, including the treatment for anaphylactic shock.” He glanced up from the tablet he held. “Stop beating yourself up about it.”
She nodded.
“Go have a seat in the waiting room. I’ll come get you when we’ve got him stabilized.”
She left the trauma room and made her way back to the waiting area. Pulling out her phone, she dialed her father.
“Hey. I tried calling you a while ago. Where are you?”
“Hospital.” Tears leaked out of her eyes. “I’ve been in hell for the past night and day.”
“What’s wrong? Are you okay?”
“Yeah. It’s Ryker.” She blinked a few times. “He got shot accidentally. I told them not to give him narcotics in surgery and they did. Now he’s dealing with serotonin syndrome as he goes through symptoms of withdrawal. He’s in a lot of pain. I also accidentally gave him a drug he was allergic to and he went into anaphylactic shock. I had to jump in to save his life and it scared the hell out of me.”
“Which hospital are you at?” She told him. “Mom and I will be there in a minute. Are you in ER?”
“Yeah.” She sat back in the chair. “We just got here. We’ve been in Mississippi.”
“Do you need anything?”
“No.”
“Sit tight. We’ll be there in a moment.”
Ella hung up and propped her head up on her hand. She couldn’t stop seeing him lifeless before her while she treated him. She ended up intubating him before the doctor even got there. She blew out a breath. Her nerves were shot. She shook as much as Ryker had. If she didn’t calm down, she was going to be sick.
Her parents got there fairly quick and Ella stood to hug her father. He held her while she cried against him, doing his best to soothe her. Maggie wrapped her arms around both of them and kissed Ella’s cheek.
“Honey, I told you that you did all you could do.” Maggie smoothed her hair back. “I know it’s got to be hard.”
Pat hugged Ella tighter. “It’s okay.” He kissed her temple. “It’s okay.”
“When is the last time you slept?” Maggie asked as she urged Ella to sit. “You look exhausted.”
“I am.” She laid her head on her mom’s shoulder. “I feel so bad.”
“Did you know he had an allergy?” Pat asked.
“No. He’s not allergic to anything.”
“Then you’re not to blame.” He stared at her. “It happens sometimes. He’s not the first person. You’re not the first doctor. You reacted just in time to save his life. If he didn’t have you, he’d probably be dead. And that statement applies to more than one occurrence.”
She sniffled. “I don’t know.”
“I do.” He pulled her to him and kissed the top of her head. “What the hell was he doing in Mississippi?”
“I don’t know. It wasn’t something criminal. He got shot in some freak accident.” She stood. “Some guy pulled a gun on him. Shot him in the chest before he could do anything. Vampire said they had to lift his bike off him so they could get him in the ambulance. They caught the guy that shot him though. He’s in jail.”
“Well, that’s one good thing.” Maggie stared at her.
“Ella?” Ella turned to see Dr. St. John coming toward her. “He’s stabilized. We’re admitting him for observation. We’ve got him on a drug concoction that seems to be doing the job. No reactions. No narcotics. He’s relaxed and we’ve taken the intubation out. He is still on oxygen right now since he’s got a low pulse oximeter reading. You can see him if you’d like. He’s groggy, but I think he’s lucid enough to know you.”
Ella nodded. “I’ll be right back.”
She followed her boss to the trauma unit and breathed a sigh of relief when she saw him. He had his eyes closed. She walked toward him and gripped his hand.
“Hey,” Ella tried to smile. “How do you feel?”
He opened his eyes and pulled her to him. She tried to move the railing on the gurney since it pressed into her stomach, but the lever was out of reach. Dr. St. John came around to help her.
“Where the fuck am I?”
“Atlanta.” She smoothed his hair back. “
Nothing good was happening in Mississippi.”
He closed his eyes. “You left me.”
“No, I didn’t. I’ve been here the whole time.”
“I woke up and you were gone.” He opened his eyes. “Don’t leave me.”
Ella kissed his forehead. “I’m not going anywhere.”
The orderlies came in the room to collect him. Ella stepped back.
“I’ll follow you up.”
He blinked a few times. “Promise?”
“Yes.” She smiled. “I promise.”
They took him out of the room and Ella bent over, forcing herself to take a deep breath.
“You need some oxygen?”
She shook her head. “A shot of whiskey.”
“I’d tell you where I keep the good stuff, but you haven’t worked here long enough to know that kind of info.”
She smiled. “Thanks for everything.”
“All in a day’s work.” He pat her back. “Get some sleep. You’re not doing anyone any good by running on fumes.”
“How did you come up with the drug concoction?”
“I didn’t.” He pointed at the men standing at the nurses’ station. “We have a pretty awesome team. They stood there and debated for a good ten minutes on what to give him before making orders. They also conferred with the head of the department. They knew what they were talking about.”
They walked together toward the desk. “Don’t beat yourself up about it. You know emergency medicine. Not pain management. I know you tried. I saw the records. They put ‘wife’ next to everything you ordered. I also know that when it came down to it, you stepped in and did what you were trained to do. Your quick judgment and knowledge led to him still being alive right now. You’re a good doctor, Ella. I’m a smart man and I did my research on you. I don’t hire idiots to be on my team.”
She nodded. “Thank you.”
“Get something to eat and crash upstairs with your husband. I get the feeling he loves you very much and wants you around. That’s way more than I can say about my wife when she came through those double doors.”
Ella left him to find her parents. “They admitted him tonight. We’ll see how it goes. Thanks for coming by. I really needed some support.”