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mmmmmm, yes. hot hot hot.

I love when a practitioner gets a little handsy.

hands wrapping around either side of the patients lithe waist, feeling how muscles have stopped fighting, stopped giving resistance against the LUCAS's efforts, stomach soft and unguarded. bulging. maybe he imagines his cock adding to the assault, imagines feeling his cock adding to that rhythmic pulsing of his stomachs. or maybe just the work of the LUCAS is enough.

little kisses pressed around. maybe the doctor is being particularly gentle after all the work he has forced on this beautiful body. fingers stroke back curls from half lidded eyes, and he shuts them with a kiss to the kids that refuse to stay fully shut. kisses to the pulse point that are still outside of mechanical effort. even his femoral, kissing along the cut of his illiac furrows, until his nose is all but buried in dark curls, before pulling back. kisses to the corner of the lips, beside the tube filling the boy's lungs with breath. going oh so gentle. giving this boy all the kisses he will otherwise miss out on.

he might run the ECHO again, if the machine is still in the room. just to see that pretty heart get pumped. it's such a beautiful oddity to him. it's such a beautiful heart. outside of the fact it refuses to pump, it looks pristine. the theory is that the arrest had to due with something electrical. no Joel's of reversal. so seeing that pretty heart is a joy.

when he stops the LUCAS, or more so, when he lets it run to death and then removes it. carefully letting down purpled and bruised wrists from the straps, kissing them oh so softly, before laying them on the bed. then he rubs that destroyed chest. it feels far too soft. it's been pulverized. he doesn't doubt that nearly every rib has been broken. the sternum shattered. it's bruised a myriad of swirling colors. not to mention how the greying of his skin has taken effect. his chest pulses with breaths still being given by the ventilator, the imitation of life still vaguely present. his belly is soft and still, slightly distended from all the efforts force onto his body, aid and fluid collected there over the course of hours.

his thumbs rub over soft nipples and his knuckles rub into that sternum one last time, as if to try and will the beauty from his eternal slumber, paired with some... extra stimulation... as his hand finds the soft cock between his legs. a Hail Mary... of sorts. that's what he calls it anyways.

he technically hasn't called time yet, so maybe he gives a few compressions of his own. just to know that he did. that he tried. that he felt that body breaking under him. that chest submit to him. the sternum sinks in far too deep. he's working on a corpse, but he doesn't stop he pumps away. he compresses over the breaths still entering his chest. the effort gets his hard, cock aching in his pants.

it's not helped when he slathers the boy's lurching chest with conductive gel— the glistening substance has always been more satisfying than those frankly ugly pads. and he's all alone with time to spare to fetch the bottle —using more the necessary. he watches the still monitor for a moment as he presses the paddle into the boy's chest. asystole still. that hadn't changed. he cranks the defib up to it's max settings. pressing the paddles even deeper, ensuring contact is never broken.

he shocks him once. the body spasms hard. his back arches. his hands squeeze shut and his arms pull up to his chest. his face flutters with a false expression of pain, throat spasming to buck the tube. he's so reactive. it's gorgeous. the doctor is even more disappointed they never managed to truly shock him. he would have reacted beautifully when there was still a whisp of life in him.

he shocks again and again, never lifting the paddles. they press into broken ribs relentlessly, sending shock after shock after shock into the dead little heart inside. frying it beyond saving. it never had been. but now he knows for a fact it is done. and watching the body beneath him pulse again and again, spasming violently, is worth it. he goes again and again until the defibrillator is spent and can't independently recharge. soaking up every second of this that he can.

he calls times when he himself is too exhausted and worked up to continue.

and then maybe add a little groping while they get all the gear off too. pulling IVs first, and gently kissing and bandaging each site. soft words cooed as a comfort to the still body. chest wiped of all that gel, a rough towel rubbed over that shattered, bruised chest, but left still glistening. the monitor shut off and leads removed, along with the BP cuff and clip.

finally the ET tube. first he disconnects the ventilator, shutting it off, and then he assesses the tube. it's full of fluid. edema. the gauze ties are cut and the cuff is deflated and it slides out without resistance, dripping, the patients throat gurgling slightly. a little pressure the chest has pink-tinged fluid spilling from his mouth and nose. his kindeys have beyond failed. all that fluid pooling in the lungs. maybe the doctor will spend some time on that, if he had the energy, working the patients chest and abdomen with his head to the side, to pump fluid out, before suctioning him dry. just to have an excuse to spend some extra time with him. groping and assaulting his soft chest and softer belly, working it all out of his patients chest, thrusting hands into him. he can imagine how nice it would feel to have his way with the still body.

with the tube out, maybe he gives some mouth to mouth, kissing the boy firmly, taking in the feeling of his cold, wet lips. of his warm breath entering cold lungs. his hands gently cradling that pretty face and head of curls.

and once he's done have most of his fun, he can formally assess him for death. he knows he is, but it is procedure after all. he looks at the patients chart, his name is Noah. beautiful name for a beautiful boy. he calls his name, rubbing his chest, first with the soft heel of his palm, then again, more firmly, calling them name louder, then a third time, pressing knuckles into the broken sternum, name all but shouted. nothing. no reaction to stimuli. the body remains still and limp. it's unnecessary, and is even frowned upon in other cases, but he does a final stimuli test, squeezing the soft brown, now grey-tinged, nipple of the boy, feeling them between his fingers. he squeezes hard with a twist. no reaction.

then he takes out his stethoscope and listens for a heartbeat. pressing the head of the stethoscope deep into the flesh at each auscultation point. there's nothing. he feels for a pulse in the femoral and carotid, fingers pressing to the latter and his whole hands groping his illiac for the former. he waits longer then he has to, enjoying the sensation as the skin rewarms beneath his hand. still nothing.

there's no effort of respiration, but he waits for that too, passing the moment he is supposed to watch by groping the still chest. listening with his stethoscope, hearing his the chest reacts to a compression, hearing fluid filled lungs gurgle. how the pressure changed causes a miniscule little breath in. and as with everything else. there's nothing. nothing of Noah's own accord anyways.

then it's pupils. he pulls open those grey kids to expose lifeless blue eyes. there's no reaction to the penlight. not a flicker. they don't even roll back. they just stare up at him.

he makes the necessary notes.

"all done beautiful"

he covers him in a sheet. not before giving him one last feel over. one last gentle caress to the face. fixing his curls one last time. covering up that gorgeous nude body. and wheeling him out. his hard cock is hidden where he presses against the bed. he just needs a moment in the morgue to handle himself, to send this beautiful boy off.

he can't risk cumming in him, he's sure to be autopsied due to the sudden and unexplained death. but the doctor will stand next to his bed, uncovering him the second they're alone and the door is "locked for maintenance", taking in that beautiful body, before jerking off over the boys sunken belly with hand hand and feeling his cock with the other. it takes only s few strokes to cum, getting it all over the boy's bruised chest and soft belly. he wishes he could get Noah off one last time, it would she only been fair, but no amount of tugging at his now-warm cock will achieve anything. but maybe he'll go at it just long enough with some cooed words to feel like he could have achieved something had the boy been alive. only then will he say farewell. laying his cock down. wiping his abdomen off. giving the final kisses. covering him up. and leaving.

a handsome boy, 20 or so, soft with muscle, a decent height, shaggy brown hair, is brought into the ER after being found down for an unknown amount of time. one moment he was fine, then he went into a different room then his roommate, and then 15 or so minutes later he was found in the floor pulseless, half on his chest, knees pulled to his chest like he'd writhed before his heart gave out. all his beautiful muscle was limp, softer then ever, his abdomen unguarded as his roommate turned him over and shook him violently. hair falling in his half lidded eyes that gave no reaction to his roommate slapping his cheek and brushing back the dark strands.

his roommate did CPR for 15 minutes while the ambulance wove through their crowded campus city and to their dorm room. he hadn't known CPR, not truly, but he tried, listening to the 911 dispatcher. he'd pumped down down down on his roommates chest. he pumps skittle too shallow here and far too deep there and his posture isn't quite right, his rhythm is too fast whenever the dispatcher isn't counting for him. the only thing right he does is mouth to mouth, pressing his mouth to his roommates without shame.

he's urinated, bladder giving way to the total release of cardiac arrest, his soaked sweatpants clinging to him, to the outline of his cock. his legs splayed and half-arched, putting him on morbid display.

no amount of begging from his roommate has willed his pulse back, not even for a second, not even a stutter. he just lays dead beneath him. body twitching. not quite violently, his roommate isn't working him hard enough for that. but his twitches and spasms and gasps agonally.

and then the paramedics are there. forcing their way into the dorm. pulling the roommate back. the boy's chest is now being assaulted. a paramedic bigger than him in most ways is pumping his weight deep into his chest. his chest collapses, his stomach bulges, his throat pulses and groans lifelessly. the I-GEL a rape on his unconscious throat, forced into him by steady hands of a second paramedic.

his shirt is cut away and abandoned, exposing his already broken chest, milky grey-tinged skin exposed, nipples soft despite the chill spreading through his lifeless body, ribs showing through his flesh. they move to get him on a 12 lead, gloved hands applying the leads to his chest around the hands currently breaking in his sternum.

they're in the 20th minute of CPR, the first minute of good CPR, and anywhere from 25 to 35 minutes that the boy has been down. he is in asystole. not a flicker from that heart of his. firm hands pull out an arm to place a BP cuff and tape a pulse-ox clip. his BP doesn't even register and his sat is a flat 68%.

not with IVs in. not with the emergency IO access. not with his lungs being bagged with constant oxygen, his chest rising and falling at its whims. not with all the meds they pump into him. not with his chest being broken in. not with his roommate calling to him.

nothing changes as he's moved to the backboard. as he's rolled and manipulated like a rag doll. as he's strapped down. as AED pads, all but useless for now are applied to his chest. as the arc of the LUCAS is positioned over him. his hands tied up around it, fingers curling against the plastic, black straps cutting into his wrists. the piston pushed down to his sternum, forceful hands being pulled away, the rubber suction paddle pressed down onto his mottled chest, grays and purples swirling with lifeless bruising, the paddle pushed down with some pressure to ensure each compression his the target depth.

his body pulses with rasps as the machine assaults him. his chest caves. even deeper than before, and now it's pumped in at a perfect mechanical pace and depth. his chest is pumped full of breath every couple of seconds via the ambu bag and I-GEL. lifeless groans leaving him with each compression. his fingers pulsing as the LUCAS causes his shoulders to bob and strain, his IV lines swinging slightly where they run from his arms to the bags of fluids and drugs at use, a purple dual-headed extender hanging from his bicep.

he's carried out of his apartment like that, Lifepak between his legs, one medic bagging, one watching the monitor, prepared to stop the LUCAS at the sign of a potential rhythm, while a third and fourth carry the backboard out to the stretcher, before dropping him in it.

they're a collective of calls and orders, a flurry of movement. drugs being pushed, differentials shouted out, hands manipulating the boy's body like it was nothing. and it really wasn't. he gave no resistance.

in the ambulance, his soiled sweats are cut off, down the side seam of his right leg to get better access to his femoral where a medics hand rests pressed into it, trying to feel for any change in the currently mechanical like that denotes life. it also makes it easier to access the IO placed in his shin, no longer having to bunch his pant leg up. the left is then cut with the fabric being left over his cock to keep from unnecessarily exposing him, giving him an ounce of decency. but the beautiful carving of his pelvis and silky trail of pubic hair is still out for everyone to see.

the medics otherwise keep at it, but there's no change, not a single one in the 20 minutes they've worked on him. not a blip, stutter, or flutter.

the ambulance is just the sound of the LUCAS. the hiss thud click hiss thud click hiss thud click. and the thick sound of the suction being pulled against. and the hiss and gurgle of the ambu bag breathing into dead lungs.

even the crew had fallen quiet. there wasn't much to say. little announcements of a med being pushed here, or a vital update there. but otherwise? the latter half of the 20 minute ride was all but silent.

the ER is a whole new flurry, fresh faces and fresh hands that think they have a better chance. the stretcher is dragged off the ambulance with a clatter and a thump, the lifeless body in it jostling limply, only held in by the straps.

he's wheeled into a storm of voices, directing his stretcher to a private bay. the backboard lifted and dropped on the bed. the scraps of his sweatpants fall away, cock exposed for a few moments while other things took priority over covering him up. lines and wires are switched over to the hospital's equipment. AED pads changed out for bright orange gel pads. they pull the I-GEL, coated in drool and mucus, dripping down onto his face as it's discarded, and exchange it for an ET tube and hook him up to a ventilator, synching it with the LUCAS, which he isn't separated from, they see no need in halting such good compression.

but quickly, as tests are run and come back, as an ECHO is done on his chest, during and between compressions, all showing a clean bill of health— healthy heart. no plaque, no visible defects, no clots, no free fluid, no damage. nothing in the tests, that isn't the bodies chemical reaction to death and the organs subsequently shutting down, show anything off —other than the fact he's been in cardiac arrest for the better part of an hour now, they grow... dismal.

nothing has worked. no medication, no intervention, no attempt to resuscitate him has been met with a single reaction.

but he's so young. a college student. his whole life ahead of him. none of them want to stop. so they keep running the code, even if all they can do is try and busy their hands with nothing while machines work on the boy, but even that becomes difficult.

for minutes— 5. then 10. the LUCAS battery is changed. then another 35 —a machine pumps a lifeless chest. air fills cold lungs. lungs filling with fluid as his kidneys fail. lungs that gurgle and rasp. the ET tube had to be suctioned clear more then once now, as pulmonary edema comes into play.

Warning: Choking, resus, mentions of nudity, violence

Chapter 1

Alex was lounging cross-legged on the sagging couch, earbuds dangling, one of the cords coiled around a finger. The afternoon sunlight slanted across the apartment living room, hitting the linoleum in sharp, dusty streaks. Jamie sprawled across the floor with a phone in hand, occasionally glancing at Alex with a crooked grin. Taylor hovered near the kitchen counter, arms crossed, watching with a detached amusement that was almost clinical.

“Bet you won’t,” Jamie said, voice low, teasing. “I dare you. Swallow it whole.”

Alex lifted an eyebrow, glancing at the small white compressed sponge on the counter, the kind that expanded in water. “Are you insane? That’s… not food.”

“Come on,” Taylor said, voice soft but insistent. “One bite. Just do it. It’s nothing.”

Alex hesitated, the flat sun catching on the fine sheen of sweat on their upper lip. Fingers trembled slightly as they picked up the sponge. Their roommates leaned forward, eyes fixed, phones recording.

Alex put it in their mouth. Chewed mechanically. Swallowed. A moment of silence followed. Then the spasm began.

A cough tore from Alex’s chest, first sharp, then escalating. Hands clutched at the throat, fingers scraping at the jaw and neck. The couch groaned as they rocked forward, hacking, eyes wide and unseeing. Saliva ran down the corners of the mouth.

Jamie stepped forward. “Alex? Hey, hey—what’s—”

Alex gagged again, the sound wet and irregular, the sponge lodged somewhere deep. Their chest heaved violently, shoulders jerking against the couch cushion. Breaths came in short, shallow bursts. The first panic tremor passed up their arms, through the chest.

Taylor knelt beside Alex, lifting their torso slightly, checking the mouth. The sponge was partially visible, swollen, the edges frayed with saliva, pale and gelatinous. It resisted the fingers.

“Spit it out!” Taylor barked, voice brittle.

Alex shook their head violently, coughing into their hands. The choking was relentless. Each breath pulled in a wet, rasping noise that filled the small room, bouncing off the walls. Lips turned bluish at the edges. Fingernails clawed at the air, scraped the couch, the carpet.

Jamie’s hands hovered uselessly. “Do something—!”

But the body was already engaged in unmanageable trauma. The sponge expanded in the esophagus, a tight, immovable plug, pressing against the windpipe. Each attempt at a breath pulled in raggedly, the sound wet and hollow, the chest rising in chaotic jerks. Sweat slicked hair stuck to Alex’s temple, neck muscles rigid under strain. Their vision narrowed, focus blinked in and out.

Taylor yanked at the jaw, fingers slick, teeth exposed. Gag reflex flared violently, projectile saliva sprayed onto the couch. Alex’s legs kicked weakly, thrashing in short bursts, the toes clawing against the rug, nails digging in. Each breath was a wet wheeze, each cough a failure.

Jamie shouted into the apartment phone, dialing 911, voice high and ragged. “They’re choking! They’re—!”

Alex’s hands flailed weakly now, clawing at the chest, throat, couch cushions. Fingers trembled as cyanosis spread across the lips and fingertips. Their eyes rolled slightly, glassy, unfocused. No sound emerged beyond the rasping, wet wheeze.

Taylor’s knuckles went white as they tried to dislodge the sponge with repeated upward sweeps. The sponge resisted, swelling further under saliva and pressure, compressing the airway. Alex’s body arched unnaturally, gasping, arms flailing, fingers digging into the upholstery. The eyes rolled back; the voice was gone.

Jamie’s voice cracked. “Come on, come on—breathe—please—”

But the body no longer obeyed. The struggle persisted, a rhythm of spasms and failed intake of air. Skin grew mottled, cyanotic. The apartment was filled with wet, rasping coughs and the thud of the body rocking against the couch.

The sirens outside had not yet arrived. Time stretched, punctuated only by ragged gasps, wet retching, and the slow, expanding bulk of the sponge pressing mercilessly against the airway. Taylor’s hands shook, covered in saliva, futilely trying to restore the passage of air.

Finally, Alex’s motions slowed, then ceased. Chest twitched once, twice. A faint, wet sound escaped the throat. No more.

Jamie sank to the floor beside the body, face pale. Taylor sat back on their heels, fingers still poised in the air. Silence, except for the hum of sunlight on the linoleum and the faint ringing from the 911 operator still on the line.

The sponge lay half-eaten, slick, grotesquely expanded on the tongue and back of the throat.

Alex was still, except for the faint, shuddering movements of residual panic in the lungs.

Outside, the ambulance sirens screamed closer.

Chapter 2

The ambulance doors banged open. Alex was slumped sideways on the couch, still, but not entirely unresponsive. Their chest quivered in tiny, wet spasms. Fingernails were mottled blue. Saliva and sweat coated the face. The sponge—partially dislodged, still grotesquely swollen—pressed into the throat.

Paramedics arrived first: Riley, the taller one, uniform damp from sweat and stress; Morgan, shorter, precise, gloves snapping as they stretched them on.

“Code three,” Riley said flatly, voice low but urgent. They scanned the room quickly: the sponge, the couch, the two other roommates—Jamie pale on the floor, hands clasped together.

“Airway,” Morgan said, kneeling beside Alex. Fingers probed, slick with saliva, attempting to sweep the sponge free. Alex’s hands shot up, clawing at their throat, jerking violently. A wet rasp tore from their chest—a desperate, strangled noise.

Riley lifted the torso slightly, adjusting the head for a jaw-thrust. “Gag reflex intact. Partial obstruction,” Riley noted clinically. Eyes flicked to Morgan.

Morgan tried repeated sweeps. The sponge was resilient, swollen past what fingers could grasp. Alex’s spasms intensified. Legs kicked weakly, heels thudding against the linoleum. Each attempted breath came as a wet, high-pitched wheeze. The cyanosis spread across lips, fingertips, and the exposed earlobes.

Jamie’s voice broke. “Please… don’t—”

“Not now,” Riley said flatly. They snapped the suction tubing into place, inserting it into the mouth with precise movements. A wet, gurgling sound filled the small apartment as foam, saliva, and small clumps of sponge were dragged up. Alex gagged violently, the head snapping back. Their chest arched in a stiff, violent curve.

Morgan grabbed a bag-valve mask. “Riley, clear airway as I ventilate,” they instructed. Pressing the mask over Alex’s face, they began slow, forced breaths. The chest lifted minimally, obstructed still. A rasp escaped with each push of air.

Alex’s hands flailed, clutching the mask for a moment, then slumping against the couch. Tiny tremors ran through the legs. Fingers scraped against the linoleum. The eyes rolled back intermittently, unfocused, darting.

“Give me suction—again!” Riley barked. Fingers plunged, dragging partially dissolved fragments from the airway. Each attempt triggered a violent gag, a wet cough, and sputtered froth. The sound was metallic, wet, and choking.

Morgan adjusted the mask. “BP?” Riley asked, glancing at the monitor.

“Unable to get a cuff reading,” Morgan said, eyes scanning cyanotic extremities. Heart rate on monitor: 130, erratic. O2 sat: 72%.

Riley nodded and reached for the laryngoscope. The blade slid past swollen tissue. The sponge was lodged higher than expected, pressing against the epiglottis. With a quick, forceful motion, Riley attempted to grasp it with Magill forceps. Alex’s body arched sharply, a wet rasp tearing from their throat. The forceps barely held a portion; the rest resisted, jiggling with each attempted removal.

Morgan pressed the bag harder. Each forced breath caused the chest to lift unevenly. The sponge shifted slightly, scraping raw against mucosa. Alex gagged, coughing fluid and bits of sponge onto the linoleum and into the suction tube.

Time blurred into motion: suction, bag-valve mask, repeated sweeps, chest heaving. The sound of gagging and wet rasping filled the room. Cyanosis deepened, fingers stiffened, the tongue coated in foam.

“Let’s prep for RSI,” Riley said. They reached for the medications: sedative, paralytic, emergency intubation kit. “Need to control the airway, or we lose them.”

Morgan nodded, sliding IV into a vein that rolled. Blood flashed briefly beneath the skin. Alex’s body twitched violently with a spasm of choking. Each attempted breath was ragged, wet, almost hollow. The couch groaned beneath the violent rocking.

Jamie flinched back, hands covering the mouth, staring at the metallic, wet chaos unfolding.

Riley gave the sedative. The body went slack, almost unnaturally limp. Morgan performed laryngoscopy again. The sponge had moved slightly with gravity and suction, but only partially. With a sharp, precise motion, a large fragment was extracted. A wet splat hit the linoleum. Alex’s chest heaved once, twice, weakly.

“Bag them. Gentle. Heart still racing,” Riley instructed. Minimal air entered the lungs, chest rising unevenly. Fingers flexed reflexively in the cyanotic hands.

A cough erupted again, involuntary, wet, ragged. The remaining sponge shifted slightly, scraping raw mucosa as it pressed against the trachea. Alex arched, a single, violent motion. Jaw thumped against the couch. Eyes rolled back.

Morgan shouted over the rasping, “Riley—we’re losing O2 fast. They’re crashing.”

The monitor beeped: 58, then 52. SpO2: 65%.

Riley’s hands moved with cold precision. “Prepare to intubate—now. No hesitation.”

The room became a theater of mechanics and noise: suction roaring, bag-valve mask compressing, fingers slick, scraping against wet mucosa, wet coughs tearing from the lungs. Each failed breath, each rasping gasp echoed off the walls.

Alex’s spasms slowed, weaker, chest trembling. Cyanosis spread into ears and shoulders. Fingertips stiffened, nails darkened. Each minute was a battle with gravity, saliva, and the stubborn sponge.

Outside, sirens continued to scream. Inside, the room smelled of antiseptic, sweat, and saliva. The mechanical rhythm of attempted life persisted. But with each wet, ragged gasp, it became clear: this airway was no longer fully salvageable.

Chapter 3

The ambulance rocked over uneven asphalt, tires thumping in rhythm with the pounding of sirens. Inside, Alex lay on the stretcher, limp but intermittently convulsing in shallow spasms. Cyanosis had spread from lips to ears, fingertips rigid and mottled. The sponge had been partially dislodged, but residual obstruction continued to resist suction and ventilation.

Riley held the bag-valve mask in place, forcing breaths into the chest. Each compression of the bag caused a wet, rasping wheeze to escape Alex’s throat. Morgan’s hands were slick, fingers coated in residual saliva and mucous as they readjusted IV lines and monitored vitals. Heart rate flickered—120, 118, 115—then dipped sharply to 92. Oxygen saturation hovered precariously at 68%.

Jamie and Taylor followed in the rear, silent, watching the rhythmic chaos of motion and sound. Jamie’s hands clutched the rail, knuckles white. Taylor’s face remained tight, almost clinical, as if studying rather than grieving.

“Transport to ED, full trauma alert,” Riley said into the radio. Their voice was flat, precise, carrying the weight of procedure over panic.

Inside the stretcher compartment, Alex’s body arched slightly, a spasm triggered by a wet, choking cough. Fingers clawed at the mask and chest straps, nails digging into the padded vinyl. The throat convulsed violently; the residual sponge shifted slightly, scraping raw against mucosa. Saliva and froth sprayed thinly, collected immediately in the suction tube.

Morgan adjusted the jaw thrust. “We’re losing tidal volume—need deeper suctioning.” Fingers moved deftly, sweeping and scraping, extracting small fragments. Each attempt triggered a violent gag, chest jerking with reflex.

Alex’s legs flailed intermittently, knees kicking the stretcher sides. Cyanosis deepened, skin mottled in stark contrast under the harsh fluorescent light of the ambulance’s interior.

Riley glanced at the monitor. Heart rate now 78. SpO2: 62%. “Prepare for RSI on arrival,” they said flatly, voice clipped. “We’ll need controlled airway immediately. ICU notified.”

The ambulance hit a bump. Alex’s head snapped back. A wet rasp tore from the throat, coughs bubbling violently. The sponge moved slightly with the shift of gravity. Riley readjusted the mask, pressed the bag firmly. Each compression of the lungs produced minimal chest rise. Fingers flexed weakly, nails darkened.

Morgan grabbed the suction again. A wet splatter landed on the stretcher pad. The sound was sharp in the confined space. Alex’s chest arched once, twice, spasming uncontrollably. Cyanosis crept into shoulders and upper back.

Jamie whispered to Taylor, voice barely audible over sirens and mechanical motion. “Are they… going to make it?”

Taylor didn’t answer. Eyes stayed fixed on Alex’s flailing extremities, the tight arc of the chest, the rasping, wet coughs.

The ambulance turned sharply, momentum throwing the body sideways. Alex’s head tipped, jaw smacking against the rail. A wet gurgle emerged. Riley corrected the position, sliding fingers gently but firmly behind the neck, adjusting the airway, pressing the bag harder. Each compression produced the same shallow, rasping lift.

“Vitals?” Riley asked.

Morgan tapped at the monitor. Heart rate 70, irregular. O2 sat 59%. “Dropping fast.”

Riley’s eyes narrowed, precise. “Prepare for rapid sequence intubation. This is going to be messy. ICU ready?”

Morgan nodded, hands flexing around suction and airway tools. The stretcher rocked again. Alex arched violently with a wet, choking cough. Saliva, mucus, fragments of the sponge were drawn immediately into suction, but the airway remained compromised. The chest lifted slightly with forced breaths, then sagged back down. Fingers twitched weakly, nails darkened further.

The hospital came into view: pale walls, entrance doors sliding open, lights flashing. Paramedics adjusted the stretcher, tightened straps, checked lines and suction, keeping bag-valve mask pressed firmly.

As the doors opened, Riley and Morgan exchanged a clipped glance. “ICU team ready,” Riley said. “Let’s move.”

Alex remained partially convulsing, cyanotic, body wet with sweat and saliva, airway still precarious. Each movement on the stretcher produced wet rasping sounds, the faint scraping of the residual sponge against mucosa. The mechanical rhythm of forced breaths and suction continued, uninterrupted, clinical, detached.

The gurney rolled through fluorescent hallways, alarms intermittently shrieking from monitors in distant rooms. Alex’s chest arched again, a weak, wet cough escaping. Cyanosis stretched into the neck and shoulders. Hands twitched feebly against the restraint straps.

Riley called out to the ICU team. “Airway critical. Partial obstruction. Need immediate intubation and suction. Bagged prehospital. Prep RSI.”

Morgan adjusted lines and suction. A fragment of sponge had shifted, scraping raw against mucosa. Alex’s spasms increased briefly with reflexive coughing, fingers clawing weakly, then slowed as exhaustion overtook them.

Chapter 4

The ICU was too bright. Overhead lamps spilled white across every metal surface — the rails, the instrument trays, the curve of the ventilator mask. Alex lay in the center of the light, a pale outline against sheets that were already creased from the weight of hands and movement.

Riley and Morgan rolled the stretcher straight to Bed 3. The waiting team had already gathered — nurses in lead aprons, a respiratory therapist with tubing in hand, a doctor pulling gloves tight against the wrists. Orders flickered between them like static.

“Partial airway obstruction. Sedated. Bagged in transport,” Riley reported, voice low but crisp.

“Vitals?”

“Dropping en route. We’re not moving air efficiently.”

The team closed around the bed. The sound of the room changed — a shift from street sirens and hallway echoes to the electronic hum of the ICU, where everything had rhythm. Monitors clicked into place, sensors adhered to skin, and the screen filled with jagged green.

Alex’s chest moved irregularly, each rise shallow, delayed. The ventilator test breath produced a soft hiss, like air escaping a tire. One of the nurses adjusted the pressure, eyes on the monitor, lips pressed thin.

“Bag-mask off,” said Dr. Chen, the attending. “Let’s see what we’ve got.”

The mask came away. Alex’s jaw hung slightly open, lips parted but motionless. A faint rattle of air slid through the throat — a dry, resistant sound that didn’t belong in the living.

“Suction,” said Morgan, stepping back to make space.

The respiratory therapist passed the line forward. The hum of suction started, steady and low. Chen watched the screen, eyes moving from waveform to waveform. “Pressure is low. We’re perfusing poorly.”

The nurse, Anita, began pressing fluids into the IV line, slow and deliberate.

For a moment, nothing changed. The beeping continued — fast, shallow, regular. Then a tremor ran through Alex’s chest, subtle but visible, like a muscle twitching under ice. Another followed, stronger. The hands, resting loosely against the sheet, flexed and jerked.

“Seizure?” someone asked.

“No,” Chen said. “Hypoxia. They’re trying to breathe.”

The tremor became a convulsion. Alex’s spine arched, neck tightening against the mattress. The sound that followed was not a gasp or a word but something between — a muffled, dragging intake of air that cut itself off halfway through.

“Airway still obstructed,” Riley said, stepping forward again. “We can’t oxygenate like this.”

“Okay, let’s intubate. Prep.”

The team moved with mechanical precision. The laryngoscope’s metal flashed under the lights. A nurse handed over tubing, cap removed with a quick twist.

“Hold steady,” Chen said. Morgan braced Alex’s shoulders. The blade slid past the tongue; the doctor’s face stayed expressionless. “Visualizing cords…”

A pause. Then, quietly: “Tissue’s swollen.”

The monitors began to scream. Oxygen saturation dropped. Heart rate — 78, 64, 52.

“Code blue,” Chen said evenly.

The phrase hit the room like an impact. A nurse pressed the alarm. A second team arrived within seconds, pushing the crash cart. The air thickened with motion: gloves snapping, drawers opening, instruments sliding across trays.

Riley climbed onto the stool beside the bed. “Starting compressions.”

Hands interlocked, steady, rhythmic. The bed shuddered under each push.

“One, two, three, four…”

Morgan handed off syringes. Adrenaline, saline, epinephrine. Orders came fast, answered faster.

“Airway secured?”

“Not yet.”

“Then keep ventilating. Alternate with compressions.”

The ventilator hissed; the rhythm of the bag matched the cadence of the chest compressions. The sound was mechanical, unhuman — breath forced, chest pressed, breath forced again. The monitor’s tone rose and fell in a warped pattern, somewhere between a heartbeat and static.

Outside the glass, the hallway had filled with silhouettes — staff from other wings, watching through the transparent barrier. Their reflections layered over the room like ghost images, doubling every motion.

Inside, time had narrowed to a pulse.

Chen’s voice remained calm, the only still point in the noise. “Riley, rotate out. Anita, take over compressions. Keep rate steady.”

Riley stepped back, chest heaving from exertion. Anita took position, elbows locked, shoulders above her hands. The bed moved under her weight.

Alex’s body responded only in motion — the blunt rise and fall, the slight shift of the head with each compression. The pupils were dilated, still. The ventilator hissed again.

“Pulse check,” Chen said.

Hands froze. The room fell silent except for the long electronic hum.

“No pulse.”

“Resume.”

The rhythm began again, relentless.

Morgan glanced at the clock, murmured, “We’re eight minutes in.”

“Continue,” Chen said. “Prepare atropine.”

Jamie and Taylor stood outside the glass, watching. The light from the ICU turned their faces gray-blue. Jamie’s eyes were wide, unfocused. Taylor’s hands were in fists against the window ledge, not touching the glass, just hovering.

Inside, the movements stayed precise. Compressions. Ventilation. Medication. The entire sequence repeated with surgical monotony.

Chen inserted a second airway, a smaller tube this time. The ventilator tone changed pitch slightly — a higher hiss, sharper.

“Minimal improvement,” the respiratory therapist reported. “No spontaneous effort.”

The monitor beeped irregularly — a few spikes, then a flat space, then another spike.

“Sinus brady,” said Morgan. “Maybe a pulse.”

“Check again.”

Fingers to the carotid. A beat — faint, then gone.

“Continue compressions.”

Time became elastic. Ten minutes, then fifteen. The team worked without speaking now, the routine so ingrained that communication was muscle memory.

Anita’s arms shook from fatigue; Riley replaced her silently. The crash cart drawers stood open like ribs.

Another round of medication. Another set of compressions. The bed creaked. The monitor continued its erratic stutter.

Chen finally said, “Let’s pause. Rhythm check.”

The ventilator hissed one final time. Everyone froze.

The screen showed a faint, wavering pattern — not a line, not yet a rhythm, just a fragile movement of light.

“Electrical activity. But no pulse,” Morgan said.

“Continue for two more rounds,” Chen replied.

The motions began again, slower now, steadier. Riley counted under his breath, each number matching the shift of the shoulders, the mechanical lift and fall of the chest.

Outside the window, the hallway had emptied. The spectators were gone. Only the reflection of the ICU lights remained, stark rectangles in the glass.

Inside, the only sounds were the soft thump of hands against bone, the hiss of the ventilator, and the faint hum of electricity in the overhead fixtures.

After the next pulse check, there was no change. The line on the monitor stayed faint, flickering like something half-remembered.

Chen didn’t speak for a long moment. The team waited, hands still, gloves creased and shining under the lights.

“Keep monitoring,” she said finally. “Don’t disconnect yet.”

Riley stepped back. Morgan adjusted the tubing, wiped condensation from the mask. The ventilator exhaled softly, the sound almost indistinguishable from breathing.

For the first time since the code had started, the room was quiet. The air smelled faintly of antiseptic and heat.

Outside, the corridor lights dimmed for the night shift.

No one said a word.

The machines kept running.

There's something so hot about placing a pulse ox clip on the tongue that just does something for me. placing it is so intimate, Another reason to get your hands in someones mouth. The mouth is one of my favorite areas of focus in resus, So maybe that's part of it. Their tongue is cold and limp and showing signs of distress related to cardiac struggles and hypoxia. The wire is hanging down. Both the clip and the wire nearly get in the way, but in a way that gives me butterflies. I'm a "give me all the gear" type of person. So it's perfect. Mouth-to-mouth and clearing the airway get's a tad more complicated. There's a new aspect of movement to compressions: the bobbing of their tongue and the clip against their lip, the wire bouncing and pulling as their body rocks. And even a new essence of desperation, it's so unorthodox, maybe it's the only thing you have, And you have to make it work? Or perhaps excitement? A new toy? A well-loved one that still gives you a thrill?

And picture a pretty limp mouth, slackened and pulled wide open, soft, greying lips forced to curl around the intrusions. There's an endotracheal tube jammed down their pretty throat, snagging to one side where the ambu bag or the vent tube is lying, pulling at the corner of their lips, tied tightly in place with gauze or held with tape. Or maybe there's a tube holder around it? Maybe a bit of both, the gauze and tape came first, and no one bothered to pull it away when the holder came. It doesn't matter what, it's not going anywhere. Then there's an oral airway jammed next to it. It'd first been used to try and hold the resusee over until you could get an airway in them, and now it's being used as an impromptu bite block and guide for the suction catheter. It's also guaze tied in place, not going anywhere. And the cherry on top? a slack, hypoxia-tinged tongue hanging out of their mouth, pulled by the weight and gravity of the plastic bit clipped to it, glowing a faint red as it tries to track the satuarion of oxygen in the poor things blood. To track a pulse.

And the process is the best part. Your resusee still beneath your efforts. Hands, maybe gloved, lacking friction in the slickness, reaching into their cold mouth with urgent speed and precision, your intrusion is rough, not as gentle as it could be, taking hold of their tongue just long enough to clip it and leaving it hanging from their lips, drool and spittle flecking down their lip and chin. Their tongue is varying shades of unwell, from a dull grey to a chilling blue to a haunting purple. The oximeter monitor reads nothing, just little dashes where numbers should be, no pulse, no saturation detected.

And then the tubes, all in quick succession. Jamming the oral airway in just long enough to puff a few breaths into their stubborn lungs, so they don't drift too far away. And then it makes for a good guide for the endotracheal tube, alongside the scope that clashes against it in your rush to slide it along their stretched tongue. Then the ET tube follows, woven past the airway and the wire, clip scraping against it, with as much grace and brutality as the rest of it all, until it's slipped into place, cuff inflated. It's displacing the clip ever so slightly, pushing the tongue further out of their mouth. Gauze and tape wrap around it. Tied and stuck down messily. A holder slid in place eventually, when your work becomes too much for anything else to handle.

I could hardly breathe both from the pressure she was exerting directly over my heart to the sensations she was stirring in my body. I gasped as she gripped my shaft and began to jerk me to the speed of my racing heart. My chest was heaving as she crushed me, forcing my heart to struggle in half of the space it needed to beat. I felt each beat slamming my restricted chest. I was getting dizzy, short of breath as my heart began to skip hard and throw pvcs. She was milking me. The surges of adrenaline slamming my unruly heart were too much. I groaned and gasped choking from the pressure and absolute ecstasy. My heart violently slammed, I groaned and cried out as my vision blurred and tunneled. She dropped to her knees in front of me and the sudden release of pressure on my chest unleashed the beast within. I could feel the orgasm tear through my body as she jerked me vigorously. The undulations of my rigid cock spraying her face. I choked, huffed and gasped as my heart jerked and shuddered, violently throwing PVCs and painfully spasming into arrest. I wretched against the wall, clawing at it, my head thrown back facing the ceiling, I slid down the wall as she finished milking me. My last convulsion leaving me twitching on the floor. She leaned over me and began CPR. My chest heaved with each compression as she pumped my heart back to life.

The cold linoleum pressed against my bare back as her palms slammed against my sternum again—*one-and-two-and-three*—rhythmic as a piston. Sweat dripped from her jawline onto my chest, mingling with the sticky mess she’d coaxed from me moments before. Her eyes held no panic, only fierce concentration. *This isn’t how it’s supposed to end*, I thought hazily, watching the fluorescent lights blur above us.

. I felt the drag of her zipper against my thigh before she straddled me, her heat searing against my skin. "You don’t get to die," she hissed, leaning close enough that her breath scorched my ear. "Not until I say."

Her hips rolled downward, swallowing me whole while her palms slammed into my sternum again—*thump-thump-thump*—a brutal counterpoint to the wet clench of her body. Each compression forced air from my lungs in ragged bursts, but my cock throbbed harder, trapped between the hammer of her rhythm and the anvil of her need. She rode me like vengeance, sweat-slick and relentless, her eyes locked on mine.

"You feel that?" she gasped, fingers digging into my ribs. "That’s your stubborn heart fighting. Remember how." Her mouth crashed onto mine, stealing what little breath I had left. The kiss tasted like salt and desperation—no panic, just raw command.

Her hips drove down harder, forcing me deeper as her palms hammered my sternum. *Thump-thump-thump*. Each compression slammed my spine against the floor, rattling my teeth. But deeper still, my cock pulsed inside her, trapped and throbbing with every jarring impact. Blood roared in my ears—not just from fear, but from the brutal rhythm she forced upon us both.

"I'm going to compress your heart," she growled, sweat dripping onto my lips, "until it remembers how to beat on its own." Her gaze pinned me—no mercy, only furious purpose. Her thrusts weren't pleasure; they were punishment. A demand for survival. My vision swam, but I felt it—the ragged flutter beneath her hands, fighting against the suffocating dark.

Her palm slammed down—*thump*—forcing air from my lungs in a choked gasp. Simultaneously, her hips drove me impossibly deeper. The friction wasn't erotic; it was raw, a grounding wire against the static filling my skull. "Feel that?" she demanded, her voice rough as gravel. "That thud? That's *me*. That's my rhythm. Borrow it. Steal it. *Own it*." Her fingers dug into my ribs, anchoring me to the agony and the ecstasy tearing me apart.

I knew, with terrifying certainty, that if her hands lifted—if that brutal cadence faltered—my heart would collapse. Not just stop. *Fold*. Like wet paper crumpling in on itself. The thought wasn't panic; it was cold, hard physics. Her compressions weren't just restarting my heart; they *were* my heart. Each impact hammered the fluttering mess behind my ribs into something resembling order. Blood surged—not just to my groin, trapped and pulsing within her, but to my starving brain. Colors sharpened. The sterile smell of antiseptic cut through the sweat and sex.

Her rhythm shifted, subtly. Less piston, more drumbeat. *Thump-thump-thump*. "Listen," she commanded, her voice stripped bare, raw as exposed nerve endings. Her hips rolled, a slow, deliberate grind against my trapped cock. It wasn't arousal anymore; it was synchronization. A primal metronome. "This beat. Mine. Borrow it." Her palm slammed down again, perfectly timed with the downward thrust of her pelvis. "Feel it hammering *here*?" Her other hand slid from my ribs, fingers splaying possessively over my sternum. "Until it echoes *here*."

"Come on, baby," she breathed, the words a ragged whisper against my sweat-slicked skin. Her forehead pressed against mine, slick strands of her hair sticking to my temple. "Come back to me." Not a plea. A demand. A summoning. Her eyes, inches from mine, held a terrifying clarity – the focused intensity of a surgeon holding a failing organ. "You don't get to drift." Her next compression wasn't just forceful; it was *insistent*, vibrating through bone and muscle, demanding a response from the quivering jelly beneath. "You feel that thud? That's me. That's my fist on your heart. Claim it."

My lungs burned, a vacuum screaming for air she wasn't giving me. The instinct to inhale was primal, overwhelming – a drowning man clawing for the surface. But the mechanism was lost. My diaphragm lay inert, paralyzed by the aftershocks of ecstasy and terror. *How?* The thought was a frantic spark in the haze. *How do I fill my lungs?* It felt like trying to recall a language spoken only in dreams. The simple, autonomic act of breathing was a shattered puzzle. My mouth opened in a silent, desperate O, but nothing flowed in. Only the brutal rhythm of her hands driving air *out*. Panic, cold and sharp, began to crystallize the edges of my vision. The fluorescent lights overhead fractured into blinding shards.

Her voice cut through the fog, sharp as broken glass. "Stop fighting the compressions!" she snarled. Her hips lifted slightly, breaking the suffocating seal, then slammed down again, timed perfectly with the next palm-strike against my sternum. *Thump-thump-thump*. The jarring impact forced a thin, wheezing gasp from me – not a full breath, but a ragged sip of precious oxygen. It tasted metallic, laced with adrenaline and the ghost of her sweat. "That's it," she hissed, relentless. Her eyes bored into mine, fierce and unforgiving. "You *need* the recoil. Let the chest *rise*. Air follows." Her rhythm shifted infinitesimally, holding the compression fractionally longer before releasing, creating a tiny vacuum. "Feel it? *Now*." Her hips rolled, a slow, deliberate grind against my trapped cock, anchoring me to the agony and the desperate need for air. It was a brutal physics lesson: her hands compressed my heart, her movement forced my diaphragm down, and the recoil *had* to pull air in. Survival depended on yielding to her rhythm.

How long had I been down? Seconds? Minutes? Time was a slurry of panic and compression. The fluorescent lights above swam, strobing with each jarring *thump*. Her face was etched with strain, strands of damp hair plastered to her temples, but her focus was absolute. No tremor in her arms, no hesitation in the piston-drive of her palms. She wouldn't give up. Not her. Giving up meant folding, meant wet paper crumpling. It meant oblivion. A cold dread seeped through the haze – if those hands lifted, even for a second, the fluttering mess beneath my ribs would unravel completely. My existence was tethered to the brutal cadence she imposed: the hammer-fall of her hands, the deep clench of her body, the fleeting, agonizing recoil that promised air. Her rhythm *was* my heartbeat now.

"Focus!" Her voice cracked like a whip, jerking my drifting gaze back to hers. Her eyes were dark pools of furious intent. "Not on the lights. Not on the floor. On *me*. On this." Her hips rolled, grinding deep, a counterpoint to the next compression. *Thump-thump-thump*. The connection was visceral, undeniable – the pressure forcing blood through choked arteries, the friction sparking a low, dangerous thrum deep in my core. "Feel it pushing? Feel it pulling?" she demanded, her breath hot against my cheek. "That vacuum? That's your invitation. *Take* it." She released the compression fractionally slower, deliberately, letting the recoil linger. My chest expanded involuntarily, a shallow, desperate gasp tearing into my raw throat. Oxygen, sharp and metallic, flooded my starving brain. It wasn't enough, but it was proof. Proof I wasn't gone yet.

Her rhythm intensified, becoming less machine, more primal dance. Each downward thrust synchronized perfectly with the heel of her hand driving into my sternum. *Thump-grind-thump*. The brutal mechanics blurred into something else entirely. The agony in my ribs fused with the electric friction building within her, within me. Her eyes widened, pupils swallowing the fierce determination, replaced by a sudden, startled recognition. "Oh," she breathed, a sound halfway between shock and surrender. The grinding pressure deep inside her shifted, intensified, became irresistible. Her next compression wasn't just forceful; it was convulsive, driven by the wave cresting within her own body. At the exact moment her hips bucked wildly against mine, her hand slammed down with final, crushing force.

Air. Not a gasp, but a roar. It tore into my lungs like a dam bursting, raw and cold and impossibly sweet. It wasn't the gentle inflation of recovery; it was a violent reclaiming. My chest exploded outward against her palm, forcing her hand up as my diaphragm seized, dragging in oxygen with desperate, gulping heaves. The sound was ragged, wet, animal. My vision didn't clear; it *shattered* into blinding white static, obliterating the fluorescent glare. Every nerve ending screamed – the scrape of linoleum on my back, the slick heat clamped around me, the brutal ache in my chest, the overwhelming flood of air burning through starved tissue. The orgasm wasn't a separate event; it was the detonation triggered by that first lungful. It ripped through me with seismic force, a convulsion that arched my spine off the floor, tearing a ragged cry from my raw throat.

Her cry mingled with mine – a sharp, startled sound ripped from her throat as the involuntary clench of her own climax synced with my violent release inside her. Her rhythm shattered. The compressions stopped. Her hand flew from my sternum to brace herself against my chest as her hips bucked wildly, riding out the aftershocks that pulsed through us both. Her eyes, wide and momentarily unfocused, locked onto mine. Sweat dripped onto my lips. Her breath came in frantic, shallow pants. A wild, triumphant grin flashed across her face, fierce and fleeting. "You," she gasped, her voice rough, triumphant, "*bastard*."

The sudden, profound stillness was deafening. Only the frantic hammering inside my own ribs filled the void – a frantic, irregular drum solo against the cage of my bones. My lungs burned, gulping air that tasted like cold metal and relief. Her weight settled fully onto me, her heat a solid anchor against the lingering tremors. Her forehead pressed against mine, slick skin sticking together. Beneath the exhaustion, beneath the fading adrenaline tremor in her limbs, I felt it: the unmistakable thickening, the renewed pulse deep within her warmth. My body, stupidly, treacherously alive, was already responding. Her breath hitched against my cheek, a tiny, surprised sound.

"You," she murmured, her voice thick and rough, scraping against the silence like gravel. Her hips shifted infinitesimally, a slow, deliberate roll that drew a choked groan from me. The friction was electric, amplified tenfold by the sheer impossibility of the moment. "You're *back*." Not a question. A declaration. Fierce. Possessive. Her hand, still braced against my sternum where she’d hammered life back into me, slid upwards. Fingers tangled in the sweat-damp hair at my temple, holding my gaze prisoner. Her eyes, dark and fathomless inches from mine, held a terrifying blend of triumph and raw, unvarnished need. "Already?" A ghost of that wild grin touched her lips. "Greedy bastard."

— Patting the victim on the cheek while they are half/fully unconscious;

— Putting an ear to the mouth/chest to listen for breathing;

— Methodically unbuttoning the shirt before performing CPR;

— Touching the abdomen to locate the spot for the Heimlich;

— Wiping saliva from slightly parted lips;

— Taking a few seconds to check the pulse;

— Parting limp lips with the tongue/holding the "kiss" a moment longer than necessary;

— Patting the back or chest (not for the purpose of providing real help);

— Looking down the throat (preferably by pressing down on/pulling out the tongue);

— Teasing cold, gasping lips with hot breath;

— pick up the victim to move it to another surface;

— straddle the thighs/place a knee between the thighs;

"You are under my control now, my instruction."

"I'm firm, but fair. You will do what I say when I say it."

"You've been cleared for training, but I not going to push you to the breaking point."

"Not yet."

"Give me a lap and we'll see what we are working with."

"Good form, keep breathing."

"Readout says you're at 140, oxygen at 93. You wanna quit?"

"That's good. Keep pushing, keep moving."

"Easy, easy, take a second. Catch your breath."

"You're shaking. Sit down, sit."

"Hey, hey, no. Shit, no, don't do that. Stay with me."

"Rook? Dammit, no pulse."

"Call the med team. Now."

"1, 2, 3... come on, Rook. Wake up."

"Their mouth tastes like blood."

"You swore they were ready to work."

"I'm clear."

"I can keep going."

"Rook, come on. Come on back."

"They're aren't just your experiment. They are my soldier, too. I'm not giving up."

"Shock them again. Please, they can do it."

"Oh, thank the Gods. That's it, Rook. Stay here."

they're intubated and vented and on the LUCAS. still in the chaotic wreck of a trauma bay. life suspended without a flurry of hands. there is nothing else that can be done. all else has been tried.

the team of doctors and nurses and medical staff have al but given up. still holding out hope, but part of them knows it is hopeless. they stand a pace away from the body on the table. waiting. watching the monitor. watching as the only activity is the violent beating of the LUCAS on the poor patient's heart.

the patients chest caves in, ribs shattered and sternum cracked under dozens of rounds of compressions from hands and the LUCAS alike. the piston is relentless. beating in the patients poor sternum to pump the heart. their belly bulges with each one, violently slow, even in the most toned of patients, just because of how forceful the compressions are on such a slack body.

their eyes are staring at nothing. all the light has left. their mouth is held open by tubes and airways and gauze ties. their throat pulses with agonal gasps and gags and spasms, that and the harsh pulsing of the LUCAS. their chest shifts with each breath given.

they're shirtless. abandoned on the gurney. chest, bruised and broken, on display. perhaps glossy from conductive jelly. or maybe AED pads cling uselessly to the lifeless chest.

their arms strewn out and hanging with IV lines from when efforts were still being made, when there were efforts that could be made. there's fluids hanging to one. a syringe of epi still connected to another, about to fall from the bed and hang from the hub line.

there's a sheet over their legs, it's soiled with urine, as a catheter was first an afterthought, and now placing one feels like one last insult to the patient's dignity. hours of resuscitative work, from this code and the codes prior, have kept their struggling kidneys producing fluids that the bladder has failed to retain during the ins and outs of their weak heartbeat.

their skin has lost all warmth. it's greying and cold. their lips are a shade ranging from crimson purple to nearly white, depending on their prior complexion. their eyes have sunken in. there is no life to be found in their face.

and yet still. the LUCAS pumps pumps and pumps away. the ventilator hissssss. click. hissssss. clicks over and over. the two in tandem.

the doctor eyes the clock. one more minute. then his watch. just one more, they can do it. a nurse looks back.

- when the resusee coughs or gasps during mouth to mouth. the resuscitator feeling it against their own mouth. in a drowning victim, they may get water in their own mouth.

- agonal gasping, in the same vein as the above, but it's regardless of mouth of mouth.

- the resusees mouth going gray-ish and slack. so hot hot hot. especially if the resuscitator has to work in their mouth or clear their airway or place a tube.

- manipulation of the jaw and tongue. the resuscitator hooking their fingers in a resusee's slack mouth, taking hold on their jaw, forcing the jaw forward. or pulling the tongue forward.

- over-complicating mouth to mouth in general. being extra thorough to ensure a clear airway. so forcing the jaw and tongue forward. frequently tipping the head back more. propping the resusee's head and neck in a arched position. using airways while still doing mouth to mouth (particularly OPA's). pinching the nose tightly. giving the breath until they feel a lot of resistance and then some. holding the seal even after the breath, to force the air to stay in their lungs longer.

same with compressions. taking extra time to prop their chest on something firm, maybe using one of those firm pillows to arch their chest and back and still give firm, deep compressions. straddling their resusee's hips. placing their hands in an alternative position for compressions, like putting both heels of their palms of their hands on the resusee's sternum and spreading their hands over their ribs, compressing their whole chest. or straying crossed palms to the left of their ribs, right over their heart.

even if any of it's not actually helpful, it's the desperation and thoroughness that's just 🤤💖

- the sound of breath leaving the resusee's chest (especially through an airway, the plastic causing a whistley sound)

- the way chest compressions make the resusee's tummy bulge. if the resuscitator is straddling, they get to feel it under them.

- hands clenching during defibs

- continuing compressions, or slightly gentler chest/cardiac massage, on a resusee. just cause or cause they have a weak little heart that needs some extra help. bonus points if they're slightly conscious.

- airways on a, currently, conscious resusee. watching them be helplessly gagged.

- irritation on wrists from restraints.

- having to give tummy thrusts to clear the airway.

- using lots of gear and having to work around it. using all sorts of monitors. like. the dream, chest wise, is 12 lead + long-term cardiac monitor + central line + thermometer patch). add BP cuffs (love when they have one o the arm and one on the leg. extra thorough), EEG tabs, pulse-ox clips (especially one on the tongue, cause that's just. so so unbelievable hot to me), other IV lines, etc.. all the tubes and wires. just getting in the way, even while serving an important job? the resuscitator having to weave between them? having to temporarily take some off and quickly put it back cause there's a tangle or it's in the way? yes yes yes yes 🤭🤭🤭

- getting conductive gel all over the chest prior to defibs. putting deep pressure on the chest with the paddles, keeping the paddles firmly pressed to the chest throughout the whole shock. using those orange gel pads. all of it. so good.