Another spasm grabbed Johnny as he was sitting on the couch. Clutching his lower abdomen the thin paramedic puffed a quick burst of expelled air upwards directing it to his hot and sweaty forehead, trying to release the hair dampened down and sticking to it. It was just another inconvenience that he could do without.

He finally had to admit that he was sick. If he was brutally honest with himself he had known he was sick from the get go but denial and he were long standing acquaintances.  He had been trying to convince not only himself but his partner that he was fine.  He wasn’t lying he told himself, he was fine. Things could always be worse and since he wasn’t worse therefore he was fine. So endith the reasoning according to Johnny Gages’ logic

This time he couldn’t help but whimper as the spasm got more intense and doubling over with the pain and panting wasn’t making a bit of difference. One thing he was sure of though he was in a world of pain.

Calling out for Roy, Johnny once again clutched his abdo pushing in hoping to relieve the pain anyway he could. Nothing was working. His brow was hot and sweaty. In fact he was sweaty all over and his shirt and underclothes were clinging to him.

Roy came into the Rec room, answering his partners pain filled cry,  and saw his partner, his stubborn bull headed partner doubled over to the point of just about kissing his knees, on the couch. Rushing to his side he saw the fevered face and heard the short shallow panting of his friend. Concern and alarm gripped his heart and gently he put a hand to Johnny’s head feeling the heat radiating before he laid it on his fevered brow. “Johnny, can you tell me what’s going on?” Roy calmly said as he slipped into paramedic mode. 

“Pain, Roy, pain…. all over my lower…. abdo going towards my right side. Think it’s my…… appendix. Didn’t think much….. of it at first, ya know . Thought, aarrgh.”   Another painful spasm gripped him and Johnny was taking shuddering breaths as his focus narrowed and he started feeling lightheaded and nauseous with the pain. “ Gonna… be… sick… or pass ….out or both….Ohhh... Great … Spirit…. Help… me”. With that Johnny threw up all over the couch and himself. 

Roy was supporting Johnny as best as he could and wishing that the other guys were there but they had been called out to a fire and weren’t back yet.

“Hang in there Johnny. I’m just gonna call in a still alarm and get the biophone and gear. OK“. Not giving Johnny time to answer Roy raced off to call it in and grab the gear. All the while he was berating himself thinking  “Heck, I knew he was sick. I should’ve been more forceful with him. Why do I let myself be fooled by him? When will I learn, God Johnny, please be alright.”

Johnny was now half crying and half whimpering with the unrelenting pain. The vomiting hadn’t helped. He didn’t feel any better, in fact he felt worse. His abdominal muscles were making their displeasure known at the unwanted contractions from a few moments earlier. Oh God, how he wanted this to be over. Roy had seen how gingerly Johnny sat down on the couch earlier and made enquiries then about checking him out. However Johnny was being a stubborn fool and brushed him off saying he was just a little stiff from using muscles he hadn’t used in a while from his gym workout the day before.

It sounded good and heck maybe it was the truth. OK it didn’t fit in with the slight warmth he felt and queasiness he had but hey, not everything was a major drama and needed attention or Roy playing mother hen. It would all just go away in time. With that thought Johnny settled himself on the couch and Roy went to catch up on revising game plans for his sons little league team in the dorm. Being assistant coach was a role Roy took seriously.

That was three hours ago. Now all Johnny wanted was to take those three hours back and admit he didn’t feel great and maybe by now he would’ve been feeling better than this. Roy returned with the biophone and the trauma box. He laid them at Johnny’s feet and then quickly ran to the kitchen and grabbed a tea towel to clean Johnny down with. Once Johnny was a bit more respectable he obtained his vital signs and then contacted Rampart.

 “Rampart, this is squad 51 calling, come in Rampart.”

“Squad 51, this is Rampart, over.” The dulcet tones of Dixie never sounded as great as they did at that time.

“Rampart, I have a code I, firefighter, age 26, complaining of spasmodic lower abdominal pain, with worsening pain over the right lower quadrant. Patient is diaphoretic, flushed and vomited times one. Rampart be aware that patient is also complaining of light-headedness and nausea. Vitals are bp 120/70, pulse 100, resps 26 and shallow, patient is hot to the touch. Request permission to start an IV and give pain relief as patient is in considerable pain. Also Rampart, please be aware that patient is John Gage, over”

“Squad 51, Commence IV, D5W TKO and obtain temperature. Withhold pain relief at this time squad 51.  Is transport available?”  Asked Dr Early who had taken over the radio.

“Negative on transport Rampart, I will request ambulance as soon as I am able to. Am currently only person on scene. Will commence IV D5W, TKO and obtain temperature, out”

“Squad 51, repeat vitals every 10 mins and report any changes, over”, stated Dr Early.

“10-4 Rampart, out”. Roy then put a thermometer into Johnny’s mouth and explained that he was going to call for an ambulance but while he was explaining this he heard the rumbling of the engine backing into the station. “Hold on Johnny, helps here, OK. I’ll just get the guys to help us, alright.” Not giving Johnny time to reply through the whimpers Roy got to his feet and ran out into the apparatus bay watching the engine come to a stop and the men start to climb down.

“Cap, I need your help in the Rec room, Johnny’s sick and I need an ambulance dispatched here straight away” Roy quickly stated before turning to go back to Johnnie’s side. Captain Stanley followed Roy into the room followed by Marco, Chet and finally Mike. There was Johnny now lying on his side with his knees curled up tight and vomitus on the floor and down the couch. He was panting and groaning more loudly now. His face was flushed and his eyes closed. With his dark hair plastered to his fevered face he looked a picture of abject misery and was obviously very sick and in pain.

“Mike, get on the phone and call in a still alarm and then get an ambulance here. What else can we do for ya Roy?” Captain Stanley said as he anxiously took in the scene.

“I’ve already called in the still alarm and contacted Rampart, but I need that ambulance called and then clean Johnny up a bit before the ambulance gets here”, Roy said all this while removing the thermometer from Johnnies mouth. “Well, looks like you’re working up a fine temperature there, junior.  Its 102.2.”

Johnny just groaned louder and grabbed his abdomen again turning his knuckles white with the pressure. Suddenly he relaxed his legs and his grip over his abdomen loosened and with a shuddering breath he opened his eyes and calmly told Roy the pain was easing, it didn’t hurt so much anymore. Both men knew what that meant and it was this unspoken reality that registered between the two men that Johnny’s appendix had just burst and time was of the essence. Deftly Roy inserted the IV and commenced the D5W. Then he took Johnny’s vitals again and got on the biophone to Rampart.

“Rampart, this is squad 51, do you read? “

“Go ahead, Squad 51.” Replied Dr Early, it was about ten minutes since their last conversation so he was expecting an update.

“Rampart, Johnny’s temp is 102.2; his new vitals are bp 110/60, pulse 113, and resps 32. Rampart Johnny just reported pain has eased somewhat. He remains diaphoretic, hold on Rampart, Johnny has just vomited again. Dr Early could hear Roy in the background reassuring Johnny….you’re gonna be alright junior, hold on, ok, here lets just wipe that up, guys can you see to Johnny for me, ta.  Rampart , vomit contains bile like liquid and abdomen remains rigid with some distension noted. IV fluids in progress. Ambulance has been called but not here yet. Will update in ten minutes, over”. Roy wiped his brow. Things had just turned ugly.

“Squad 51, increase IV fluid to 500 cc/hour. Continue to monitor, contact again if change in vital signs and when ETA is, Rampart out”.

“10.4 Rampart”. Roy quickly adjusted the flow meter and increased the fluids running into Johnny’s arm.

Marco was holding the IV fluid bag up high to help with the flow and was quietly murmuring a prayer in Spanish.

Cap was standing over Johnny with his hands by his side restlessly making fists and then relaxing again, there wasn’t a lot he could do. “Mike get back on that phone and find out how long that ambulance will be. Roy, do we need to get him into the hospital now or wait till the ambulance comes? I’m not an expert but even I know that this lack of pain isn’t right if it’s his appendix. Has it burst?”

With that Marco and Chet’s head swivelled to their captain in shock and then to Roy to see his answer. 

Roy looked at Johnny and holding his hand simply nodded his head and replied “It looks that way Cap. The sooner we get Junior into hospital the better. The longer he has that rotten appendix in him the more likely he is to develop serious complications. How long before the ambulance gets here Mike?”

“There’s been a demand for ambulances due to a major multiple MVA on the other side of town and none are available right now, apparently Johnny will have to wait but he’s next on the list. They think about another 20 to 40 minutes Roy.  Can he wait that long?”

Mike quietly said but the anxiety in his voice was plain to hear.

“Cap, I really don’t think we can afford to wait that long. Johnny needs to be in theatre right now. We’re already 20 minutes too late. We could always use the hose bed on the engine.”

“Right, Chet go get the stokes. Mike, get on the phone and cancel that ambulance.

Marco, you just... just continue holding that bag. Roy contact Rampart and let them know what’s happening. I’ll put us 10.8 to Rampart and tell them what’s happening here. Johnny, you hang in there pal and that’s an order!”

Johnny just lay there looking at Cap and wishing that he was anywhere else but here. He knew he was going to have an operation and he wished that he was currently unconscious, cause no matter how much he knew he needed to have it done he was not looking forward to being sliced open. In all honesty he wasn’t looking forward to many things in his immediate future right now. He was one sick man and another stay at Rampart was staring him in the face. Damn, he had finally managed to hook up a date with that cute nurse, Patricia, from paediatrics for tomorrow night. That won’t be happening now. Oh, life was just great. Just another typical day in the life of John Roderick Gage, geeze, what Spirit did I hack off to have a life like this Johnny thought to himself?

Chet was back with the stokes; Mike hung up the phone and promptly made his way over to the couch. Cap came next after hanging up the microphone to HQ dispatch. All waited for Roy to direct the proceedings. Roy replaced the biophone and administered the 5mgs MS as ordered by Dr Early, into the port of Johnnys’ cannula. “There you go junior, that will help with the ride into Rampart ok, I’ll be right by your side.”

With the precision of a well-oiled machine the men of Station 51 gently got Johnny into the stokes and then carrying their fallen comrade helped him into the back of the engine. Johnny tried his best but little groans and whimpers escaped his lips as he was jostled over the hoses. Roy climbed up beside Johnny with the biophone and set about to take another lot of recordings. Marco climbed up too and held onto the bag of IV fluid.

Chet got into the squad and followed the engine in. He would leave it there for Roy, while he returned to the station with the engine. The engine would be back on call after dropping Johnny off.  Roy would have a bit of time before HQ could find a replacement.

Johnnys’ blood pressure continued to drop and his pulse kept climbing. He was getting shocky and both he and Roy knew it.

Dr Early increased his fluids to go stat and ordered a second line in with another bag of stat Ringers. Johnny just managed to get out that he was going to be sick again when he was quickly rolled onto his side so that he wouldn’t aspirate. There wasn’t much to come up but the prolonged dry retching following the small amount of emesis brought tears to Marcos eyes. He didn’t like to see his friend in so much pain.  As if in answer to his prayers, Johnny passed out following his last vomit just as the engine pulled up to the Emergency doors. It was an unconscious Johnny that got wheeled into Treatment room 3, five minutes later.

He was transferred onto the table and Dr Early was there with Dixie and student nurse Sharon. An oxygen mask was put on Johnny’s face and set to 6L. Dixie went about getting vital signs and Sharon helped to undress Johnny, exposing his abdomen for Dr Early.

“Joe, bp is down to 80/45, pulse is weak and thready, rate 126, resps are shallow and 38. Temp 103.8 axilla. “

“Replace the D5W with plasmanate and run it stat. I want a CBC, chem 7 and haematocrit done. Also cross match 4 units and have them standing by. Contact OR and tell them we have a ruptured appendix coming up stat. We can’t afford to muck around down here. His abdomen is rigid, shiny and distended.  He’s already in shock, I don’t want sepsis to compound the issue and we’ve already got enough to contend with. Ah, Johnny, you’re doing it to us again my friend. Why can’t you do things the easy way and keep it that way.” With a fond sigh Dr Early patted Johnny on the shoulder and started his way out to the waiting men of station 51. While he told them what was happening, two orderlies went into Johnny’s room with a gurney. A short while later, they came out with Johnny and headed to the elevators. Sharon followed them out holding the tubes of blood and went off in the direction of the lab. “That’s my cue to go, gentlemen” stated Dr Early.

Captain Stanley turned to Roy and stated that they had to go back in service but he could wait for a bit in the hospital while a replacement was found for Johnny. He then asked Roy to keep them updated on Johnny. With that he turned on his heel and walked out to the engine with the rest of the guys following with down casted heads.

Chet came up to Roy and with watery blue eyes gave Roy’s arm a squeeze.  “He’ll be alright Roy, you’ll see. Johnny will bounce back and before you know it none of the chicks here at Rampart will be safe and knowing Johnny he’ll be biting at the bit to get out before long.” Then he dropped the keys to the squad into Roy’s hand before he too turned and made his way to the engine.

Dixie came out of treatment room 3 after tidying it up and saw Roy standing numbly in the hallway. “Come on Tiger; let’s have a coffee, my treat. It looks like you could use one”. Linking her arm through Roy’s she led him away to the Doctor's Lounge.

***********

Meanwhile up in the OR Johnny was being prepped for an emergency laparotomy. He was intubated and Joe was just putting scalpel to skin. He was met by a purulent discharge and blood in the peritoneal cavity. After suctioning the ruptured appendix was located and removed. His abdomen was washed out several times and a nasogastric tube was inserted by the anaesthetist and secured. Two hours later one unconscious John Gage was wheeled into Recovery.

Dr Early came back downstairs to find that Roy had returned to the station an hour ago as a replacement for Johnny had been found and that Roy was currently on a rescue and talking to Dr Brackett over the radio at the base station. After the end of Dr Bracketts transmission the mic was handed over to Dr Early. “Roy, Dr Early here, thought you’d like to know Johnny is out of surgery. He’s still very sick and will be going to SICU. He’s in recovery now. You were right his appendix had burst. I’ll tell you more when you come in.”

“Thanks Doc. I appreciate the news. I’ll make sure to tell the guys. We’ve all been kinda worried about him, Squad 51 out."

*************

20 minutes later one Roy DeSoto entered Emergency with his patient. Dr Brackett was there to receive the patient and quickly dismissed Roy, directing him to his office to see Dr Early.

“Roy, take a seat and I’ll fill you in about Johnny” Joe Early said, “He’s in SICU. His appendix had done a good job at contaminating his peritoneal cavity. I washed his abdomen out with an antibiotic wash but there’s no guarantee that he still won’t develop peritonitis, in fact it’s a given certainty. He also has a high chance of developing a paralytic ileus. We have inserted a nasogastric tube, which is on low suction and he has 2 abdominal drains in. He’s also not going to be a happy camper when he finds out he’s got a Foley in. We are closely monitoring his vital signs right now. He’s not out of the woods but his chances get stronger with every passing hour. His blood pressure is still very low and I’m concerned that Johnny may be prone to some renal impairment due to this. We are watching his renal function very closely. There is also the certainty that he may have septicaemia. His length of time from rupture to removal of the appendix would almost guarantee he has it. We have taken blood cultures and will be monitoring him closely. We’ve got cooling measures in place as he’s still sitting around 104.9 degrees. I’ll be honest with you Roy, it could go either way. Only time will tell. I’m sorry the news couldn’t be better but you know Johnny, he never does things by half. He’s young and very fit so he has a very good chance of coming through this just fine. Once we get on the right side of his sepsis we will find that everything else will subside. We aren’t going to intubate him unless we have to. Would you like to see him?” Joe Early got up from the corner of the desk he had been sitting on and together Roy and Dr Early made their way up to SICU to see Johnny.

************

He looked dreadful. Roy didn’t think it was possible to look deathly pale and flushed at the same time. Yet Johnny was managing to pull off that look with a fine art. Pumps were pushing fluids and a cocktail of antibiotics into a central line anchored to his neck. An A line was recording his blood pressure which hovered over the 85 systolic mark. Diluted urine, the little that there was, was collecting in an hourly measure catheter bag. Oxygen via a Hudson mask misted over every few seconds. Johnny was still breathing fast and shallowly with an occasional deep breath at times followed by a grimace. He looked like he was at deaths door.

Roy prayed that no one answered. Cooling blankets were draped up to his chest. He saw tubes coming out from underneath and watery bloody discharge collected into bags hanging from the side. Dark bile like fluid was collecting in the wall suction unit. Johnny had so many wires and tubes going into and out of him, Roy didn’t know where to stand without knocking something. The heart monitor showed sinus tachy. While in the room a nurse entered with the latest blood gases result.

“Repeat his ABGs in another four hours nurse and inform me of the results straight away. His results are a little off base from the high resp rate Roy, if it keeps up we will need to intubate him to control his rate. It’s just another complication we can do without. Has he woken up yet nurse?” asked Dr Early.

“Briefly, he mumbled that his side hurt, called for Roy and then went back to sleep” The nurse replied. She waited dutifully in case any further instructions where forthcoming and then left the room when Dr Early thanked her and notated on Johnny’s chart that Roy was to have full access at any time – day and night, seeing as he was next of kin and the only family that Johnny had.

“He…he looks real bad” Roy said before taking hold of Johnny’s hand under the cooling blanket. “Who would’ve thought appendicitis could’ve caused all this. Oh, Junior why couldn’t you have just let me look you over like I wanted too. You could’ve avoided all this. Hang in there, Junior and promise me you’ll fight and get better.”

Roy felt a small squeeze on his hand and looking at Johnny’s face saw a smile twitch at the corner of his mouth. “Junior, are you awake? Can you hear me, junior?” Roy waited but there was no further response.

“We best let him get some sleep, he’s gonna need all the rest and strength he can get over the next few days to fight this thing and get back on his feet” Dr Early said before walking to the door. Roy let go of Johnny’s hand and holding the handi talkie close to his chest swung round and joined Dr Early in the corridor.

**************

Back at the station the atmosphere was subdued after Roy had brought everybody up to speed on Johnny’s condition.  Mike made meatloaf as no one felt that hungry and it was good cold as it was hot.  The squad got two more runs which didn’t require a trip to Rampart and Bernie, Johnny's replacement turned out to be a worse card player than Johnny and got lumbered with the dishes.

Roy had just got off the phone to Joanne, telling her all about Johnny when the phone rang. It was Dr Early to let them know that Johnny hadn’t responded as well as they had hoped to the antibiotics and cooling measures and was now intubated as his ABGs were worse. He hoped this was only a temporary measure until Johnny turned the corner. They were adding in another antibiotic to see how that would go. His renal function remained low and his blood pressure was marginally better. His temp was holding at 104.2. Once again only time would tell as it was still early days, no pun intended stated Dr Early towards the end of his conversation with Roy. Hopefully tomorrow they would have a better picture of things and fingers crossed there would be some improvement.

****************

Five very weary firemen got up with the sound of the wake up tones going off. The crew of 51 hadn’t slept that well. Bernie was feeling refreshed. There had been no call outs overnight and he had slept very soundly. He had not only snored but talked very loudly in his sleep; waking the guys several times through the night.

Chet complained that he would’ve felt more rested if he had been fighting a three alarm fire instead of waking up every hour due to Bernie’s snoring and talking. Truth be told they were all thinking of Johnny and had had difficulty getting to sleep. Roy was even hoping for a call out or two so that he could go check on Johnny. So after handing over to B shift the guys headed off to the hospital before they parted ways for the rest of their two days off.

************

“Ah, Roy, I was just going to call you” Dr Early said when he spied Roy and the rest of station 51 getting out of the lift.  “Johnny has spiked a fever of over 105 and his abdomen remains rigid. We are gonna go back in and do another wash out. It looks like little pockets of infection might be causing our young man some problems. I won’t lie to you Roy, Cap, gentlemen,” Early said acknowledging the crew of 51, “but in Johnny’s current state he may not pull through. His blood pressure remains low and his immune system is already weakened. However if we don’t go in, then I can guarantee that Johnny won’t make it. The infection is taking over and we need to be more assertive in treating this instead of combating the symptoms as they manifest themselves. I want to stop these symptoms before it’s too late. I’m sorry I didn’t have better news for you Roy, but it was always a waiting game. As Next of Kin I need you to sign his operation consent. A stunned Roy duly signed the consent and sat with Johnny along with his fellow colleagues as everything was put in place for Johnny’s second trip to the OR within 24 hours.

**************

Roy called Joanne after Johnny had been taken into the OR. He was going to stay at the hospital as it was still touch and go. Joanne would be joining him as soon as she got the kids off to school. Marco and Chet went to the hospital chapel and lit a candle for Johnny then sat down and started to pray for their little brother. Mike and Cap called their wives and told them what was happening. They too were coming to the hospital.

 Within an hour the family of 51 sat around the OR waiting room in various states of anxiety. Conversations which were full of questions and answers at the arrival of the wives settled down into random quiet murmurings between couples with an occasional cough and snuffle on the seats. Otherwise it was predominantly quiet.  They all knew that their family may be losing a cherished member. The baby of the family at that.

While everyone was recalling their own memories of Johnny and offering up silent prayers the ticking of the clock on the wall showed that two and a half hours had elapsed and still no word on how Johnny was doing. Roy was starting to pace. Surely the wash out should’ve been finished long ago and they would’ve had some news. What could be taking so long? Roy didn’t like this one little bit, no sirree, not one little bit. Another fifteen minutes passed and then the door to the room opened.

Chet and Marco entered. They had gone back to Johnny’s room thinking that he would be back in his room by now only to be told he was still in the OR. Now Chet and Roy were both pacing. Finally Cap had to tell them to sit as the room was not big enough for one, let alone two people to pace. So Roy took up chewing his thumb nail instead and Chet started playing with his moustache. The room grew quiet and tense again. Joanne couldn’t take it anymore. She asked rather loudly if anyone wanted a coffee. Several people jumped at hearing her. Their startled expressions displayed the depth that they had succumbed to in their private reveries and thoughts of their little brother.  Marco was just about to offer to help Joanne when Drs Early and Brackett walked through the door.

“He’s alive but it was touch and go there for a while. Hell, he did go. We had to shock him twice but we got him back. We found several sites of infection. We thoroughly cleaned them up and had to remove a small portion of his bowel by the appendectomy site as it was necrotic. We think that if Johnny can make it through the next 48-72 hours he has a good chance of walking out of here. Having said that the next 24 hours are critical. We don’t think there is any permanent damage to his heart from the cardiac arrest and we know that his oxygen levels stayed high throughout so any fear of brain damage is minimal. But we won’t really know anything until he’s off the vent and awake.

We will be keeping him in a drug induced coma over the next few days and then we will take it from there. We think that we have found the source of the sepsis and that should start to recede. He’s on some pretty powerful antibiotics which we hope will help him to get over this quicker. The blood cultures aren’t back yet but we have him on broad and narrow spectrum antibiotics.  His kidney function remains on the good side of borderline. His blood pressure needs assistance right now with some drugs to keep it up but I’m picking that as he starts to improve these can be tapered off. We’ve also commenced him on TPN as he needs more energy to handle the demands his body is placing on him right now. Lord knows he’s not got much energy reserves to fall on, that boy’s like a whippet. “

Little laughs and muffled giggles were heard around the room after that comment. It seemed to be the catalyst that broke the silence. Next minute there were questions galore from everyone, including the wives. One by one the questions were answered and then the doctors retreated downstairs after a quick trip back into recovery to check on Johnny.

**********

Johnny was transferred to ICU. The steady beeping and humming of all the machines was lulling Roy into a hypnotic state. He was tired. It had been a stressful 24 hours. So much had happened. It was hard to believe that it had happened.  But if he wanted proof he just needed to look at Johnny lying in the bed. Blood was dripping in slowly into a line in his arm. The central line was hooked up to the TPN, blood pressure medication, IV antibiotic and a colloid drip. He also had a glucose/insulin drip standing by, to combat the blood sugar increase from the TPN, if it was needed. The vent hissed every 4 secs and Johnnies chest would gently rise then fall as the bellows moved up and down. Regular glances at the catheter showed some slight improvement with his urine output. He was passing 20mls/hr, better than the 15mls/hr from yesterday.

Johnny was still deathly pale but he wasn’t so flushed looking. He was clammy to the touch and still had a fever but it was slowly coming down. Slow being the operative word. He could handle 103.7. It was all good. Now all Johnny had to do was get through the next 72 hours. Dear God that seemed daunting. OK, break it down. Just get through today Johnny, Roy fervently prayed and then we will deal with the next day and then the next day. Roy got up and stretched his legs. It was going to be a long day. Joanne had gone home to look after the kids from school. The guys had gone home with promises to ring if anything happened. Roy wasn’t surprised to find Cap back in the ICU waiting Room. A nurse came and informed him that he was there. Roy went out and met Cap in the waiting room.

“I, ah, couldn’t settle. I felt that as his captain I had to be here Roy. He’s one of my men. Being here feels right. How’s he doing?” Cap asked.

“Why don’t you come with me and see for yourself, Cap. There’s no real change but then again that’s a good thing if you ask me cos there’s been no deterioration either. I guess you could say he’s stable. Only time will tell”. Roy was explaining to Cap as they made their way back into Johnny’s room.

Hank pulled up the other chair in the room and sat next to Roy. Roy took him through all the equipment attached to Johnny and explained about all the tubes and drains coming out from Johnny and what they signified with regards to his condition. The two men sat in companionable silence and watched their brother who lay very still in bed.  The nurse came in every hour to record Johnny’s output and vital signs. His blood sugar was starting to get slightly elevated and she connected the glucose /insulin infusion and set the insulin accordingly. Another hiss was added to the machine symphony in the room.

The men watched her leave and Roy reassured Hank that it wasn’t uncommon for some people to have insulin infusions with TPN. They settled back in their chairs and took up their vigil.

The next thing they knew, Johnny’s nurse was back and putting blankets over them. They had both fallen asleep. Cap got up and stretched and made enquiries about getting coffee.

Roy accepted the offer and snuggled into his blanket a bit more. The nurse smiling said that Johnny seemed to be improving. Both Roy and Cap were surprised to see they had slept for several hours. Roy’s stomach rumbled and they both decided to go to the cafeteria to grab a bite before it closed. Over a plate of cottage pie and a cup of coffee the men sat there quietly eating and discussing current affairs. Once their hunger was satisfied they headed back to Johnny’s room.

The nurses had put Johnny onto his side and pillows were propping him from behind keeping him in place.  He had been washed and bed linen changed. The machines maintained their symphony and recorded that Johnny was holding his own. All things considered it was encouraging. All he had to do was get through the night with no hiccoughs.

 Roy and Cap got themselves comfortable and ensured that they weren’t in the way as they knew they were been given a lot of leeway from the nursing staff. It was a night of little snatches of sleep, nurses coming in every hour.

Roy and Cap helped the nurses to reposition Johnny a couple of times through the night. By daybreak Johnny started to show the first real sign of turning the corner. His temp dropped a whole degree and his blood pressure was picking up and now registered 100 systolic. They were weaning his blood pressure meds back.

Drs Early and Brackett were pleased with what they saw. Johnny was making his way through the first 24 hours. Dr Early had preliminary reports from the blood cultures that Johnny was on the right combination of antibiotics.

Captain Stanley went back home after the Doctor's had done ward rounds and went to bed to get a decent sleep. Roy phoned Joanne and spread the good news. They were one day down with two to go. Even though the news had been good the Doctor's reiterated the need for them all to be cautiously optimistic. Johnny still wasn’t out of the woods.

****************

Joanne came to the hospital shortly after 10 am and paid a quick visit with Johnny. Feeling encouraged by what Roy was telling her. Johnny did look better from the last time she had seen him yesterday.

Feeling heartened by this she gave Johnny a kiss on his forehead and noticed he didn’t feel as hot as before. “Roy, does he feel cooler to you?” Joanne asked.

Roy placed his hand on Johnny’s forehead and commented that he did indeed feel cooler. “Hopefully the cooling blankets will be removed soon. It looks like the antibiotics are working. Keep it up Junior. You’re doing great”. Stifling his second yawn in as many minutes

Joanne encouraged Roy to come home and get some sleep.  The nurses promised to phone if there was any change - good or bad.

************

Roy woke up later in the afternoon. The sun was streaming in through the crack in the curtain and hitting the opposite wall. He could hear little Jennifer accusing Chris of poking his tongue out at her.

Then Joanne’s voice could be heard telling the children to settle down and be quiet before they woke their father and for Chris to apologise to Jenny.

Quietness ensued for all of a few minutes when he heard a loud wail coming from Jenny and muffled voices of Joanne and Jenny being consoled. Giving up on getting anymore sleep and not wanting to be awake all night, Roy got up and slinging a robe over himself he made his way downstairs.

He was met with Jenny sitting on Joanne’s lap sporting a bandaid over her elbow where she had slipped on a lego block and grazed it on the tiled floor.  Giving his wife and kids a kiss and a cuddle he made his way into the kitchen to get a cup of coffee. Confirming with Joanne that the hospital hadn’t phoned he called up Rampart and got through to ICU and spoke to Johnny’s nurse. Johnny was still listed as seriously ill but stable. Roy informed the nurse he would be popping in later that evening.

*********

The next day as A shift all lined up for roll call Roy saw who his partner was for the next 24 hours and tried to put a positive spin on it. It could be worse he thought, he could be doing a 48 hour shift with Brice.

After roll call they all migrated into the kitchen to have a communal cup of coffee together and hear the latest on Gage. Roy had phoned ICU before leaving to go to work.

Brice listened impassionately as Roy explained that Johnny had made great progress yesterday. He no longer had the cooling blankets. His temperature was now down to 100.4. His renal function and blood pressure were on the up and up and they had stopped the vasopressor helping his blood pressure.  He still had all the drains and drips. The doctors held great hope that he could be weaned off the ventilator if he continued to show improvement. Roy was hoping to pop up to see Johnny throughout the day when they were in the hospital. 

After securing their supplies Roy made a quick dash up to ICU, taking the handi talkie with him. Dixie met him as he entered the Unit.

“Dixie, what a surprise! Are you checking on Johnny? I’m just doing a quick check myself before I get called out” waving the handi talkie in front of him.

Dixie and Roy made their way into Johnny’s room. He was looking better. There was a bit of colour in his cheeks not put there by fever. A couple of lines were gone and his arms were drip free. There were two less machines by his bedside.

“He’s made a lot of progress in the last 12 hours from when I was here last. Even the ECG machine has been disconnected. “He really had me worried Dixie. I don’t know what it is about him but there’s something that makes you want to protect him. He’s more than just my partner, he’s wormed his way into my heart and become part of my family.  You know, I have been getting phone calls from firemen as far away as Pasadena to see how he is. He’s liked by a lot of guys. They all send him get well wishes. Any further idea when the ventilator will be removed?”

“Not till later today maybe. Joe has stopped the sedation so he just needs to get it out of his system then they will see how he does when he’s more awake. It’s all looking very positive so far Roy“. Dixie leant down and gently moved his bangs away before placing a kiss on his brow. “You concentrate on getting better tiger” Dixie told Johnny before leaving.

Roy and Dixie shared the lift down to the ER and met up with Brice and Dr Early. “Ah, just back from seeing our star patient I believe” Dr Early was saying as he twiddled his bracelet on his wrist. “I’ve got great hopes that he will be extubated by the end of the day if he keeps improving like he is. We’ll keep him in ICU another day and if he stays stable we will move him into a step down unit. He still has a long way to go before he will be up and running. I think by then we will all be wanting him to go home. Given how quickly he gets bored I think I will book my vacation to coincide about then” chuckling to himself Dr Early walked away to go grab a coffee, hoping to get more than three mouthfuls before he was needed again.  

***********

Brice gathered up supplies and started to make his way out to the squad. “Come on DeSoto, we can’t be dillydallying all day. We have a duty to fulfil to the good citizens of L.A.“

Rolling his eyes heavenward, Roy gave Dixie a smile and wave as he left. Yes it was going to be a long day Roy thought to himself.  Brice replaced the mic having made them available as Roy started up the squad to return to the barn. 

“Really, DeSoto, if you do insist in seeing Gage every time we come to the hospital I will be forced to put a complaint in about your dereliction of duty”. Roy couldn’t believe what he had just heard. He decided to run it through Cap and even the Chief if he had to, to ensure that he wasn’t contravening any regulation that he wasn’t aware of.  

The men were all eager to hear how Johnny was doing. While Roy was bringing them all up to speed Brice put the supplies away in their appropriate compartments. Cap gave Roy carte blanche to visit Johnny when he was in the hospital as long as he kept the handi talkie with him and it didn’t interfere with his duties to the community at large. Cap told Roy he would have a word in Brice’s ear to help clarify this situation.

 Somehow the long day just got shorter again Roy thought as he made his way to clean the dorm. Brice just gave Roy a scowl after leaving Caps office. “I will follow the edict of the Captain and the Chief on this DeSoto but it doesn’t mean I approve. Should I find that you delay any delivery to treatment to the citizens of Carson I will lodge a complaint rest assured.”

It was back to being a long day. Roll on 0800hrs became Roy’s new mantra.

************

Johnny was stirring and getting restless in the bed by mid-afternoon. Dr Early was paged to ICU and upon entering Johnny’s room saw Johnny opening his eyes and breathing over the vent setting the alarm off. He was looking confused and in pain. He quickly reassured Johnny by explaining what was happening. Once Johnny was calm enough Joe removed the vent tube and offered Johnny a few ice chips. “I’m sorry Johnny but you’re nil by mouth for the foreseeable future. Your bowel has stopped working and we need to keep the nasogastric tube in while you have a paralytic ileus. “

Johnny went to answer but his throat was too dry and sore. A harsh rasp came out but little else. Johnny tiredly nodded his head to convey that he understood. He was struggling to keep his eyes open now. Dr Early charted regular analgesia for Johnny before leaving the room. He called Station 51 and told the Captain the latest news.

On the next run that took Roy and Brice into the ER, Roy made his way up to see Johnny.

He was sleeping peacefully with his arm slung over his head. Several of his lines connected to his central line were tangled around his arm. Roy set about disentangling the lines, Johnny slept through it all and so Roy left a note for Johnny propped up on the bedside table and then quietly slipped out of the room and headed back down to the ground floor. He was talking to Dixie when Brice walked up surprised to see Roy in the ER and not up with Johnny.

“I had to stop and change a flat tire. I thought you would have been taking advantage of my unavoidable delay and be visiting Gage, DeSoto. I take it you have visited him and are ready to go. Shall we? Nurse McCall”.  Brice said as he nodded his head in her direction before turning and heading out to the exit.

“I’ll catch ya later Dixie. Somehow I don’t think my chariot will wait for me” Roy replied as he hot tailed it to the squad.

Dixie let out a husky chuckle as she watched Roy scuttle out the door.  Life certainly wasn’t boring when it came to her paramedics. Roy and Johnny were her favorites.  Of those two she had Johnny just slightly tipping the scales. Not that she would ever tell anyone that. Her time of musing was cut short as the base station radio started beeping. Dixie got off her stool and answered the radio.

THREE DAYS LATER

Johnny was lying in bed looking out the window from his room on the surgical ward. He was bored but knew he was a long way from going home. He still had the foley catheter and nasogastric tube in along with the abdominal drains. He was still getting TPN. His bowel was still taking a holiday. Johnny was feeling depressed with the whole state of affairs. Any movement hurt and it didn’t help that he was being weaned off heavy doses of analgesia in the hope it would help to kick start his bowel again.

The one consolation was that Patricia had been in to see him several times and was still keen to go out with Johnny when he was back on his feet again. There was a knock on his door and then Roy and Joanne entered bearing gifts. More magazines to help whittle away the hours as well as find-a-word puzzle books. Hopefully they would fill in several long hours and help ward off the boredom.

“How are you sweetheart?” Joanne asked as she gave Johnny a kiss on his cheek.

‘You’re looking better. Still no tummy rumbles yet? You will be wasting away to nothing if you keep this up”.

“I’m doing alright, I’m doing alright” Johnny stated. 

“OK, who are you and what have you done with Johnny?” Roy jokingly asked.

Johnny threw Roy a puzzled look, causing Joanne to stifle a giggle. “What do you mean Roy?”

“Johnny I’ve never known you yet to be content to just lay still once you start feeling better. Normally you’re complaining of boredom and begging to be released home”.

“Well Roy, it may have missed your notice but I’ve still got more tubes in me than my TV set. Also I have only managed to walk from here to the chair beside the bed. Even I know I can’t go home yet. Really Roy I wonder about you sometimes. Geeze, hard to believe you’re a paramedic. Hummph!”

‘I’m sorry Johnny I was only joking”

“That’s OK Roy. Truth be known I was only thinking before you walked in about when I would be going home but realised I wasn’t fit for discharge yet. I know; you don’t need to look like that. I’m not always impetuous ya know. I’m a very mature man.” Johnny said with his hand splayed across his chest. Settling back in the bed, making sure he protected his tummy from any sudden movements, Johnny got himself comfortable for a nice visit with his friends.

Two hours later Roy and Joanne were making their way out having seen Johnny start to tire.

The next day faint bowel sounds were heard. “Well, Johnny, it looks like your bowel has come out of retirement. It’s faint but it’s there. We will cap the nasogastric and see how you cope. We will start you off on a liquid diet from tomorrow all going well. The drains have slowed down considerably. I’m happy for them to come out today too.  Yes, before you ask we will take the catheter out too. However the TPN will stay for now. Despite all our endeavours it looks like you’ve lost a bit of weight on us Johnny. You can’t afford to lose anymore but somehow I think that you will given the nature of your injury and your metabolism. You will have to have a structured diet for a while before you can go back to a full diet. We had to take out a few inches of your bowel so no spicy or stodgy foods. We will give you high calorie and protein drinks to help put that weight back on while you’re on a restricted diet.  How does that all sound?” enquired Dr Early.

A big smile was the only answer he needed before Johnny had even replied. “ Doc, have I ever told you that you’re my most favorite person in this place!”

“Johnny Gage, did I hear correctly. Does that mean that I’m not your number one favorite person anymore?”

“ Aw, Dixie. You‘re my most favorite nurse but right now the Doc here gets full honours as I’m losing all my drains and tubes today. Well all but two. But ya know what that means. I get to go home soon. “Johnny was bubbling over with excitement.

“Well, hold your horses there cowboy. You still have a bit to go before you’re anywhere near fit enough to go home. But it will happen. Just be prepared for the long haul, alright” Dr Early placed his hand on Johnny’s shoulder alarmed at feeling the jutting out of his bones.” I’ll go and write up the orders for those drains and let you talk with your favorite nurse for a while. I’ll see you downstairs, Dix. Catch ya later Johnny”. With that Joe Early left the two friends to have a quick natter during Dixie’s coffee break.

Roy walked into Johnny’s room and was met with a new man. Johnny had perked up no end. Being drain free and able to move around more freely gave Johnny a new lease on life. He was sitting in the chair facing the sun. Johnny was stretched out with a pillow resting on his lower abdomen. The capped nasogastric tube was dangling down his front. He swivelled his head when he heard the door swoosh open. “Roy, come in, come in. How are ya pal?”

“All the better for seeing you’ve lost most of your fashion accessories.  More to the point, how are you Junior? What did Doc Early say?”

“I’m on the mend. Next stop home. ETA unknown. However I’m not too concerned about that as it’s all just a matter of time. I start drinking tomorrow if all goes well I get to start to eat again soon. It’s odd but given that I haven’t eaten for a week I’m not hungry. You just missed the guys. Cap is coming tonight according to Mike. He had some chores to do. Man, I have ta tell ya Roy. I wouldn’t want to relive this last week in a million years. But having my friends by my side all the way really helped me through it. I want to thank ya for always being there for me. I really appreciate it”

“You’re welcome Junior. It goes without saying that I’ll be here for you through thick and thin. You’re more than a partner to me, you’re the younger brother I never had. “ Roy told Johnny as he pulled up another chair looking out to the sun filtered site of Ramparts’ landscaped entrance and the road beyond.  

Roy took a good look at Johnny’s profile. His cheekbones were a little more pronounced and he looked smaller in the chair with his legs propped up and a pillow over his tummy. He was slightly pale but no longer sported the colour of fever on his face. His hair was in need of a cut but that would be another struggle for another day. Right now Roy was just content to sit here with Johnny looking out the window and talk of mundane things like the latest gossip from work and Chris and Jenny latest news from school.  Roy gave out a con tented sigh thinking that life was good, Johnny was on the mend and in time would be back by his side in the squad.

The End

Posted to Site 1/6/16