#tracheostomy

Reenie approached the sliding glass doorway the unit secretary had directed her towards, knowing that on the other side of them was a sight she would have rather never seen. A curtain covered the doorway, and despite knowing there would be no response from the occupant in the room, Reenie knocked timidly on the glass. 

Timid, not a word she would ever use to describe herself before she had received the phone call from an emergency room doctor eight hours ago, informing her that Colter had been severely injured and needed surgery. They had asked her for consent to perform the surgery informing her that he needed it, otherwise he would die. Reenie had not even known until today that she was Colters healthcare proxy. In the same call, the provider had given her a quick run down of his condition and made her aware that he would be starting surgery at their hospital, attempting to stabilize his condition before a critical care transport team flew him out to a more comprehensive trauma center that would be far better equipped for the surgery. This was where Reenie was now, the comprehensive trauma center. Eight hours was how long it had taken her to drop everything, book a flight, catch it across the country, and uber to the hospital. Eight hours that she could only sit anxiously and hope Colter would still be alive when she landed. 

She marveled at the size of the hospital as she walked in, almost in a trance, to the reception desk. She checked in with them, having one of the worst photos of her life printed onto a sticker with her name, a room number and a small map of the hospital handed to her, a warm smile given to her by the young lady. 

Reenie couldn’t return it. 

Instead, she found her way through the mazes of elevators and long hallways and doorbells to units that she had never wanted to be in. She finally made in the front desk of the unit where a young man in scrubs pointed her to the room she had traveled eight hours to end up. Outside the room, a police officer stopped her, requesting her ID before she made him tell her what he knew. 

It wasn’t much, he had just been posted her for Colters safety, because whomever had been responsible for his condition was still out there. Nobody was sure if there would be anybody to finish the job. The officer, a sergeant Kyle, informed her that Colters brother had been at the other hospital but was in stable condition, possibly even on the way from being discharged. Kyle wasn’t sure though. Reenie tried not to hold the fact that he didn’t appear to be sure of anything against him. It wasn’t his fault that Reenie had also been in the dark about the case Colter had been working on, or where he had been the past three days. She kept having to remind herself that she wasn’t the bad friend, Colter just wasn’t somebody that you could keep track of easily sometimes. She imagines that had more to do with his upbringing than her friendship with the man. 

Finally she entered the room, and her eyes immediately transfixed to the bed, staring at the sole person in the room. Seeing his supine form caused the grief and anxiety that had been swirling around in her head all day to grow heavy in her stomach,  nausea stealing her breath away. 

He was on a ventilator, the machine breathing for him through the tube that disappeared into his throat. There was a small bandage on his temple from what she could only imagine was some sort of injury. She tried to think back to what the doctor in the other emergency room had described his injuries as being. She remembered there was severe damage to his chest wall which caused issues with his breathing and his heart beating, and whoever had caused the injuries had caused severe damage to his neck and throat. He had never mentioned a head injury as far as Reenie could recall. She hoped the injury on his forehead here was superficial. There was a hard collar that wrapped around his neck as well as a bandage underneath it that covered where someone had cut his throat and placed the tube that was breathing for him. It also covered the damage that had been caused prior to any medical intervention. For that, Reenie was grateful. 

Reenie looked further down Colter’s body and felt her heart twist again as she took in the large bandage that ran down the center length of his chest, small circles of blood apparent in several spots on the white bandage but none of them growing as she stood and watched them briefly. Three different tubes ran from his chest and down the sides of the bed to little reservoir apparatuses that stood on the floor. His arms were at his sides, tubes and wires coming from them, restraints holding them to the sides of the bed. There was another large bandage that covered the left side of his abdomen, probably where they repaired some of the internal bleeding that she had been warned about. The blanket started at his navel, but more tubes ran up from his groin area, these tubes had blood running into them as well as medications and fluids, all coming from the IV pump. She couldn’t see anymore of him, but she did catch a glimpse of the catheter bag that sat hanging from the foot of the bed, ruddy urine in the bag. 

Reenie couldn’t help it, the sob escaping her lips before she could stop it, the tears running down her face quicker than she could wipe them away. A soft hand was laid on the small of her back as she swiveled to face whomever it was. Another young woman, hair tied up neatly in a bun on top of her head, her scrubs adorned with tiny anatomically correct hearts, a badge label RN in blue. “My name is Kara, I’m going to be one of the people taking care of Colter while he’s here in the CVT-ICU. I know this is a lot to take in, do you have any questions, have you spoken to the doctors?”

Reenie nodded her head, but no words came out. She wanted to tell the nurse that every doctor she had spoken to on the phone today had been cold and informative, which had made it difficult for Reenie to understand the information. The doctor terminology not a language she understood very well on a good day. Much less a day like today. 

“It’s ok, let me kind of talk you through where we are in his care right now, is that ok?” Reenie nodded her head meekly as the nurse led her to a chair right next to the bed. “So, I’m sure the doctors told you that he sustained quite a bit of damage in the attack. I’m going to run through it, but if its too much information, tell me to stop, ok?” Another nod before the woman kneeled down beside Reenie, holding her hand. Another nurse had come into the room and was adjusting the medications and watching the vitals on the monitor before staring at the ventilator settings. “So Colter’s injuries required long surgeries, and will require more. His spleen was removed, his liver was repaired, and part of his stomach had to be removed. He also had severe damage to both of his kidneys, the right kidney was removed because of that damage. Because of this, he’s in acute renal failure, so he is receiving something called CRRT, which is a machine that is doing the work of his kidneys while his kidneys recover. The damage to his chest has caused his heart and lungs to stop working on multiple occasions, but he has been able to be resuscitated quickly each time, because of this, Colter is also on ECMO which is taking the job of his heart and lungs while he recovers.”

She pauses for a beat, watching for any signs from Reenie that she is more overwhelmed than she was, but Reenie doesn’t show it. Instead, hearing the nurse speak is giving her racing mind something to hold onto. 

“He had something called a central line in his groin, which allows us four different IV accesses, which we’re giving medication to support him right now, such as blood because he lost quite a bit of it prior to arriving here. Due to the severe injuries in his neck, he’s in that collar to stabilize it. His arteries were surprisingly untouched, but the damage was extensive in his trachea so he has a breathing tube that was inserted below the damage. He has three chest tubes, one in the right and two on the left side of his chest.”

Reenie clears her throat, “How is his brain?” 

The nurse frowns a little, thinking for a moment before looking at Reenie. “It’s hard to say right now. His initial head CT scans when he came here were promising. No signs of any damage to his brain, no signs of lack of oxygen. But we really won’t know until we start trying to wake him up. But right now we are keeping him heavily sedated until we can get him more stable.”

“Is he getting anything for nutrients?” Reenie asked quietly, staring past the nurse at Colter. 

“Yes, we have him on something called TPN, which are nutrients that we’re putting in his blood stream because of the damage to his digestive tract and throat.”

Reenie watched as the second nurse lifted the blanket and peered at Colter’s groin area before placing it back down. Reenie winced as she thought of how mortified Colter would be when he woke up. 

If he woke up. Staring at him, the way he was now, it wasn’t hard to think that Colter could never wake up again. 

A knock at the door. 

Reenie looks behind her and watches as Russell crutches in, his left leg in a splint, the rest of his seen body covered in bruises and welts. He looks shocked as he looks at his brother and then over at Reenie. It's all Reenie can do to stand up and give the older Shaw a hug.