2019-12-14 - How To Save A Life

Lalo lets out a little frustrated sigh when Jeremy Mason is called, turning away and rubbing a hand back over his head. He looks like he might start to get things situated in the room to move the body to the morgue, but just then, there's another code. "What the fuck?" he murmurs -- under his breath and hopefully too quiet for the grieving fiancé to hear -- as he starts quickly out the door, jogging down the hall toward Freddie Aritza's room and only narrowly avoiding another nurse on their way toward Gerome Cary. Or maybe Adina Nejem, who knows?

Dr. Nathan Bowman, normally hunkered down in the ER, is one of the many brought up to the fourth floor recovery wing. Dr. Nathan Bowman, unlike most of the gathered staff, finds himself lingering at the Nurse's station. Four in five minutes isn't exactly unheard of, and on the rougher days of his stint at St. Mary's in San Francisco could pop up every couple of weeks.

But this is not St. Mary's. This is not SF. This is distinctly out of place. Which would by why, despite his most casual of postures, he's muttering very quietly to the coordinating nurse about locking down the floor, getting blood taken from each name on the list ASAP, and politely but forcefully, shuffling any and all family and relations into a waiting room. "I'm going to need a copy of every damn thing we gave them, too. If we're really lucky, this is a terrible coincidence. If we're just lucky, it's a lawsuit waiting to happen."

He doesn't need to mention what 'Unlucky' could entail.

Dr. Tillie Harlow arrives on the floor, from the northernmost elevator. Normally she'd take the stairs, but at this hour the carriages are nearly empty. She pulls her hair up into a quick, still prim chignon, secures it with a pair of pins, and checks her phone for update alerts. She isn't assigned to this floor, and these are not her patients. When two codes went out, she made her way up to talk to the staff.

The four simultaneous going when Dr. Harlow arrives are enough to divert her. A quick glance is traded to Dr. Nathan Bowman. She says nothing. She heads directly for Adina Nejem's room, her heels reporting sharply as she makes her way through, the five-two doctor able to move quickly even in tall heels heels. "Run it down." This, in terse Tillie speak, means the high points of the chart. Name among them, last status, etc. As she snaps on a pair of gloves and leans in to check the patient. When the name of the patient is spoken, her hands don't stop.

"Names of the other codes." When Dr. Harlow asks for information, she expects it to be returned immediately.

When she arrives, nurse Abby removes the Santa's elf hat she'd been wearing to spread Christmas cheer and jolliness, plopping it down on the nurse's station. And her scrubs are Christmas-themed too, because of course they are. The quick succession puts a tiny crease on her brow, a minute worried frown as she glances from the other nurse to Nathan nearby. The worried frown gives way to a determined set of her jaw and a tiny, positive smile. Just because everything is going to heck is no reason to lose heart! So off she goes, redoing her ponytail just a little tighter.

She arrives at Adina Nejem's beside just in time to catch Dr. Harlow's last question. "The first two were Adeline Adesina and Jeremy... oh, Mason. Right now, besides Ms. Nejem, there's Gerome Cary, Edita Aki...yama? And Fred Aritza."

Jacob had been on the fourth floor, visiting a patient from his private practise who was preparing to undergo surgery. A cordial surgery, friendly words of encouragement. "Today's the day, Jason. Once they make an assessment, we should have a.." The first code blue goes off, pulling his attention away, but only for a moment. He's not working for the hospital right now, but being paged in is not unusual, given his attending privileges at Addington Memorial. And then the second one goes off. And then another? He gives Jason a parting word or two before heading to the nurse's station, nodding and asking where he's needed after identifying himself, not waiting for his phone to start buzzing, which it happened to a few moments later.

The ginger doctor nods at the hospital staff congregating around the nurse's station, and then he's being directed towards Freddie Aritza's room, to which he goes with a quick jog, glancing at the vital signs monitor before springing into more meaningful action.

Lalo doesn't waste any time -- he just gets the rest of the way inside, dispensing quickly with the gloves he had on and grabbing new ones in what might be record time. Well, he has been doing this a while. He glances up when Jacob enters the room, but it's very brief before he's heading around the patient to relieve the other nurse of her position and continue the attempt.

Something he sees has his brow furrowing even more deeply, though -- and that's saying something, because he was already frowning pretty deeply, considering the circumstances. It makes him look kind of angry, though that might just be how his face looks generally. "Mr. Mason was foaming at the mouth, too," he says as he starts compressions.

Flip. Flip. Dr. Bowman flips his way through the handed over clipboard, skimming and scanning once he's back in business-mode. The Hospital could be physically falling down at the brick work and goddamnit Abby would still get a quick smile and a wink. It just took longer this time due to the hat.

He's on page three when he hastily tucks the board under an arm and wheels around on his heels (And, for some reason, deciding he absolutely needs to buy a pair of Heelys) to beeline for the room he saw both Dr Harlow and Nurse Reed head for, throwing casual and attempted looks of reassurance and whichever staff he just so happens to pass on the way before a slightly wayward mess of his upturned hair peers in through the doorway to Adina Nejem's room, where Abby gets the second wink of the day. Technically it's the eighth, but long shifts make numbers fuzzy.

"Sprout Piñata."

That would go directly to Dr. Harlow. Not a question.

"Copy! Sprout piñata confirmed." The names fell from Abby's lips like pieces of a puzzle locking into place. Tillie's hands continue to work. There's the pause of perhaps ten seconds, in which her hands never stop moving. As the first responding nurse jumps in with information. "I recognizrd her name." She didn't have a part in the surgery itself, but she watched part of the harvest. Keeping those skills sharp. And it's nice to see death lead to something hopeful now and again. Like saving lives.

"Hold compressions." Tillie checks the carotid pulse. Nothing. "Resume." This hospital is small. it doesn't have enough code teams to handle four simultaneous codes. She steps around the bed to say, "Switch with me. Rest your arms." She moves in to take over compressions. "Nurse Reed, manage the airway if you please —" Little suction and an ambu bag should help, though evidence of a tainted donor suggest the heart is probably done.

Though the paperwork generally uses a donor number, Dr. Harlow says, "Carmichael." Carmichael, J. Died 10 days ago from a brain hemorrhage after a car accident. There's the faintest of scowls just marring her forehead. It smoothes a moment later. This is a mechanical problem. Her hands are good with mechanical problems.

"Sprout piñata," Abby repeats, just barely above her breath, nose wrinkling very slightly as she shoots a bemused look, darting between Nathan and Tillie, stepping out of the way. "Yes, Doctor," she says as she circles around the bed to take her place near the head and secure the ambu bag, adjusting the mask over the patient's face and squeezing to pump air in as directed, focused on the task at hand, eyes shifting to watch Dr. Harlow at work. An eyebrow arches slightly as she listens, mouth crooking slightly to the side in thought. Not too deep, just deep enough to wander while she focuses on the task at hand.

Jacob affirms to the questioning nurse, more of an aside than anything, "Yes. Winters." This wouldn't have been his first time at the hospital, but probably hadn't spent so much time here that he'd be recognized by more than a handful of staff by first glance alone.

Jacob looks on as Lalo resucitates their patient, moving around to take a look at the chart at the foot of the man's bed, examining it briefly before setting it back down. "..whatever it is, it seems to be spreading quick, so we're going to have to get a handle on it. Contamination issue, maybe? Are any staff down?"

Time's short in situations like these. So he lights up his glimmer, placing a hand over the patient's leg to attempt to see what the problem is. And it's nothing good. "Nervous system..?" A shrug to himself. Then speaking to Lalo, "Let's get his airway sorted and get him stable."

Lalo doesn't quite look relieved when the patient's heart starts beating again, but it's something close to it. They're certainly not out of the woods yet, though, and he looks up to Jacob at the question. "Not that I've seen," he says, "but who the hell knows. If I start foaming at the mouth, just stick me with some pentobarbital and move on, yeah?"

With that happy thought expressed, he nods once at the direction to get the airway cleared, and he tips his head at one of the other nurses toward the patient, giving up compressions as he grabs a laryngoscope from the crash cart to intubate. Once that's done, he hands the bag off, too, and continues, "On to the next?" He's already mostly out the door as he says it, though, in the direction of Edita's room.

You're welcome to think Nathan is a terrible doctor, considering that up to this point he has done absolutely nothing to aid any of these patient in stabilizing. It'd definitely be a fair assumption for any of the bystanders on the fourth floor, as well as the family members politely shuffled to a waiting area.

But Dr Bowman trusts the medical staff, and stabilizing to buy time is worthless if that time is wasted. That'd be why, when Sarah tells him that 'nerds in the lab are being stubborn', he's back on his heels once more and sprinting away. And yes, he once again so wishes he had a pair of Heelys.

Lab Nerds, Meet Dr. Bowman. Dr. Bowman, meet Lab Nerds. Lab Nerds, meet Dr. Bowman, ER Physician and ruler of that room when need be's angry face. "Run it. Now. Or the next person to ask shall be my wife."

Not 'Dr. Harlow.' That means it's serious.

Tillie is a small woman, petite, fine-boned. And she gives chest compressions like that woman's failing heard personally offended her by stopping, putting her whole weight behind each one. She looks across the patient's body, gaze on Nurse Reed. What she's thinking she doesn't say. At least not all of it. "All of the patients are organ recipients." She doesn't say tainted donor, because those words, once out, are out, and they're hard to control, and legal gets very upset when they're hard to control.

The monitor blips at a pause in compressions. Just as Adina is revived, the surgeon uses a couple of nearby tissues to wipe her mouth and chin, touch light. She says something quietly in Arabic. Does the woman speak it? Perhaps not. But a comforting, warm word on the chance that she does is the first thing she'll hear upon her heart beginning to beat again. It doesn't even matter that she likely won't remember it. "Let's suction off this fluid and get her on oxygen to supplement." She nods to Abby, steps down, and makes her way to the phone.

Like she heard her name being invoked many doors away, she picks up and dials an internal extension. The lab phone rings a few beats after Dr. Nathan Bowman finishes his sentence. The person who picks up doesn't get a chance to hello, to introduce themselves, no. Dr. Tillie Harlow says into the phone, in her softened little British accent and normally professional, sibilant-yet-pleasant tones. "It takes one phone call to replace the contents of the basement through third floor vending machines with sprouted, organic, salt free healthful options. Would you like to walk four flights of stairs or ride a family filled carriage for unsalted seaweed chips?" The question hangs in the air. Dr. Tillie Harlow hangs up. If she has to go down there in person, Cheetos aren't the only thing she's going to take away.

Abby exhales in apparent relief when Adina's vitals bounce up, but the instability keeps the relief short-lived. She has to stay focused, but a a soft hum escapes her at the sight of the foam dripping down from the patient's mouth. She lifts the mask as it fills up, wipes the patient chin, quickly snatches her hand before reaching for suction. "I wonder if they're all like this," she wonders out loud with a small shrug and a questioning look in Tillie's direction.

Then, she clears the patient's airways, regulates the oxygen and affixes a mask in place for now, keeping an eye on the monitors, a foot tapping as she waits and watches for the time being. "The timing doesn't make sense, even if it's all the same..."

Jacob smirks at Lalo's suggestion. "If it takes you down, I'm not sure there'll be anyone else left standing." The nurse is very nearly the same height as the ginger doctor, but Lalo's considerably more muscled. Seeing Freddie mostly stablized, he nods to the nurse's suggestion, and follows him out towards Edita's room.

"I have a suspicion that this one's gonna be foaming at the mouth as well. Is the bloodwork not back yet?" Not that he'd be in any position to overhear the battle of Bowman and Harlow versus the lab team's obstinance, but his anxiety over the current medical crisis has him looking for answers wherever they can be found. As soon as they can be found.

"Yeah," Lalo admits with a little snort of dry amusement, despite the circumstances, "right? I'll try not to die this time. Feel like we're gonna be out of drawers downstairs soon." Again, maybe not the most pleasant thought, but he actually sounds kind of like he's gotten a second wind. Stabilizing a patient who was coding does give you a more optimistic outlook on the general state of things, even if there's a zillion other codes to deal with.

Oh hey, like the one right here. "Here we come to save the day," he says with a nod to the other nurse, and while he doesn't quite sing it, there's a little upward inflection on the 'day,' certainly reminiscent of Mighty Mouse as he starts compressions again.

Dr Bowman, eventually, gets his paperwork.

A small pair of reading glasses are pulled from the top pocket of his coat, perched up at the bridge of his nose to take in the results. It involves a lot, a lot of flipping back and forth, including more than a couple of glances up to the Techs, face a little incredulous as the question of "And you're sure this is right? This can't be right." is uttered multiple times.

But they don't budge. The results say what the results say.

Dr Bowman beelines to the phone that oh-so-recently received a call to send one out of his own. It's not directed to a single handset, though. This would go hospital-wide announcement style, his voice a little tinny from the speakers mounted up towards the ceilings. "Dr Harlow, Nurse Reed, Nurse Martinez. Alpha-Eight-Two Nine. Thank you!"

Well, that's easy enough. Eight two? - Rabies.

Nine? - Unspecified.

'Thank you! - Gloves, masks, RabAvert and a prayer.

The petite, dark-haired doctor returns to Adina's bedside, opposite Abby. She's just reaching out to touch the patient again when the call goes out over the hospital intercoms. She glances up briefly. 82 - okay. 9? Her eyes narrow slightly. To say that's atypical would be understating it. Act now, puzzle that later. She takes a half step back from the patient, but puts a gloved hand on her arm, a reassuring touch of the woman is still conscious enough to feel it.

"Masks, gloves, mix gently, administer." This is, of course, to Abby, doser of medicines, holder to the meds cabinet key code, injector of all things. Mainly she's thinking how did this slip the screen and 'do we even have enough of the vaccine on hand?' She pulls her current gloves and steps away from the bed to acquire a mask, re-glove. Unless Nurse Reed has any questions (which is unlikely, given the nursing staff is excellent and this is more in her realm), Dr. Harlow steps out to assist one of the other teams in stabilizing patients. They're stretched thin up here.

Abby lifts her head, turning towards the speakers, and blinks. "Oh, boy." She takes a step back from the patient's bed, glances down at her frothy gloves. She peels them off, methodical and carefully, and disposes of them before backing away for a quick spritz of disinfectant and a change of gloves and a mask.

"Yes, Doctor. But it doesn't make sense," she comments calmly as she affixes the mask, glancing over with a small squint and a crease between her eyebrows, "They're different ages, different everything, and they all code a few minutes apart just like that? It doesn't add up." She clicks her tongue behind her mask in disapproval at the lack of sense of the universe and it all, then wanders off to fetch the supplies as they come in, eyes smiling at Sarah from above her mask.

Jacob goes through the same motions as he had before - checking the vital signs monitor, the chart, etc. In truth, emergency situations as this aren't his native environment. He's grown used to the slow yet steady pace of his own practise, stressful situations such as this not often seen since his residency. As such, he mostly allows Lalo to do his resuscitation thing, since it clearly worked so well with the last patient.

The physician will occasionally call out for adrenaline, airway assistance, and whatnot in order to get this poor woman back to something approaching this side of stable. The code, at least not addressed to him, makes him look around the patient's room for an explanation, but seeing the rest of the staff mask up tells him the most important bit. Shit. And he does the same, masking and gloving up. And then Sarah fills him, intentionally or not, when she tells him how much of the vaccine they have in. "Rabies? That doesn't.. oh, hell."

Lalo looks up at the intercom when there's the little bell that indicates someone's about to speak. When the actual words come, though...well. "What the fuck?" He's already said it, sure, but it bears repeating under the circumstances. He then looks around quickly, as though he's expecting someone to pop out from behind an ECMO machine and yell, 'Gotcha!'

Unfortunately for them all, that does not happen. He'll have to feel bad about the mouse reference at some point, but that's later. Maybe he'll be dead by then.

He continues compressions until one of the other nurses has masked and gloved up, and then switches off with her to do so himself. He gets them on just as Sarah gets into the room with the medication. "Thanks, linda," he says, though he pronounces it 'leen-dah,' not Linda, like he doesn't know her name. He takes the tray, moving as quickly as possible toward the bed without spilling it and making it enough for only one day instead of two. He starts to mix, and once it's done he looks up to the other nurse. "Keep her still," he says, before he gets ready to inject.

When Dr. Bowman finally returns, (The lab techs needed soft reassurance that no, kale was not in their future, please stop crying) he's finishing off a small packet of cheese flavored chips, licking some of the residue from the tips of his fingers and shoving the empty packet in one of his coat pockets before actually hunting down a pair of nitrile gloves and convenient face-mask. Freddie would be the port of call, passing by Gerome's room without so much of a 'How do you do' to the nursing staff in there, but absolutely making a mental note of numbers. And Organs.

And dosages.

Someone's going to have to yell at the hospital administration at the end of his shift.

"In another town, that's quite true, Nurse Reed." Tillie secures the mask and pulls on fresh gloves. "This is Gray Harbor, however, and our complications are decidedly localized and nonstandard." She frowns very faintly, her thinking aligned with Dr. Bowman's regarding administration & the transplant coordinator for these cases. She steps into Gerome's room... just long enough to confirm and call time of death. She swallows, lingers there for a moment, then changes her gloves again. Her movements are spare, controlled. "Take a moment, nurse. You did all you could." She's not personally familiar with the nurse in question, but she knows this staff. Dead weight doesn't last at Addington Memorial Hospital, mainly because its dodge dice suck and the town is hungry.

Tillie makes her way into Freddie's room, entering just behind Dr. Bowman. "You smell of artificial powdered cheese flavoring, husband." Jesus, it's like the woman can smell junk food at twenty paces. "I never like to say hello with an injection to the spine," she begins, "but one needs must." She lays a hand briefly on Mr. Aritza's shoulder, nods to a Dr. Bowman to help turn and secure him. To non-glimmery types, it may look like she's taking four seconds in prayer. She isn't. When she administers the injection, her placement is precise, hands unwavering, and the needle hits the right spot on the first try. She injects the full dose.

Abby watches the movement into the other rooms, then accepts the dose of vaccine with a small smile, eyes squinting above the mask. Vaccine in hand, she heads back into the room. First, she checks the patient's vitals, then heads to the small cart in the corner to prepare the the dosage, vial and syringe in hand. "It's perfectly normal, just one of those very odd coincidences," She reassures another nurse in passing, then herself, injecting the contents of the syringe into the vial before gently moving it around to mix it up.

Once it's mixed and back in the syringe, she affixes a new needle as she makes her way to Adina's bedside. "You'll be fine. Things are just a little strange right now. Okay, they're very strange, but it could be a lot worse," she confides in the patient, keeping her voice soft and soothing. Even the little conspiratorial whisper at the end. Even if the patient's unconscious. "I could be half-cat, half-person, for example. We definitely wouldn't want that."

Then, raising her voice, she signals another nurse to help her roll the patient onto her side and help secure her in place, prepping the injection site and tilting her head, gloved fingers tracing the spot. It takes her a moment or two before settling on a site and calmly inject the vaccine.

The ginger doctor grits his teeth at the situation. Not enough vaccine to go around. He looks around him - there's certainly no shortage of those in the room with the shine, though at different brightnesses. His recent encounter at the charity jello fight/auction/whatever it was had been making him reconsider his prior strict stance of no glimmer in public, not ever.. and hell, an outbreak of rabies is probably good enough reason to cause alarm, if those here react poorly.

He'll wait until Lalo prepares to inject their patient, and then grips onto Edita's leg, as if he's helping to hold her still as well - but in fact, his glimmer flares as he sends curative energies towards Edita just as the injection begins. His eyes close, reddish brows furrowing with the effort.