Swollen Issues III - Chapter 110

Kevin hadn’t been specific about why Nick had been taken into the hospital and the panic in his cousin’s voice shook the younger man, but none the less, Brian found himself once again walking through the all too familiar main entrance of Tampa General Hospital.

Brian approached the front desk, “Nickolas Carter.”

The older woman nodded and keyed in the name. “I’m sorry, I don’t see a patient by that name.”

“I’m sorry, it’s Nickolas with a k,” Brian corrected as he rubbed the sleep from his eyes and spelled out Nick’s name for the receptionist.

“Oh, here he is, he’s on the sixth floor, Cardiac ICU….you’ll have to stop at the nurse’s station when you get up there, only family is allowed in with the patient.”

Brian felt a chill surge through his body. “Excuse me, where did you say he was again?”

“Sixth floor Cardiac ICU.”

With a nod, Brian thanked the woman and took the main elevator to the sixth floor. ’Cardiac ICU? Did Nick have a heart attack?’ Brian wondered as he waited for the elevator to stop.

Following the signs, Brian rushed toward the nurse’s station. Before he had a chance to talk to anyone, he saw his cousin walking down the hall toward him. Kevin immediately wrapped him in a tight hug.

“What the hell is going on?” Brian asked gently as he pulled away.

“He’s not doing well,” a teary eyed Kevin replied.

Brian’s mouth dropped open. “What do you mean?”

Placing an arm around his cousin’s shoulder, Kevin started guiding him toward a waiting room. “Let’s talk about it in here.”

As soon as Brian and Kevin entered the room, Howie stood up and pulled Brian into a quick hug.

The three men sat down and Brian studied his band brothers. Howie and Kevin’s faces looked drawn, tired and their eyes were red rimmed. They sat quietly for a few moments before Brian spoke.

“What happened?” Brian asked.

Howie looked toward Kevin to speak. The older man leaned forward and clenched his jaw. “Nicky…..” he sobbed for a moment, trying desperately to control his quivering voice. “He’s not doin…” Kevin broke down and covered his face with his hands.

Upon seeing his cousin cry, Brian’s eyes automatically welled up with tears. “What’s wrong with him?”

“Brian…..he’s not doing well,” Howie answered, his voice sounding constricted as he spoke.

“His doctor said his lungs are filling up with fluid,” Kevin said in a flat voice.

Brian stared at Kevin in disbelief. “Did she say how that happened?”

“Something about the medications he has been taking and the side effects from the chemo. He had been having problems with fluid,” Howie filled in.

“What your saying doesn’t make sense…..is Dr. Andersen here?” Brian asked.

“She’s suppose to come back in a little while,” Kevin mumbled.

The guys reactions had Brian shook up. “Where’s AJ?”

“Down with Nick,” Howie replied softly.

“Can I go and see Nick?”

“Yeah, I’ll take you down there,” Kevin said as he stood up.

The older man quietly led the way down a brightly lit hall that had glass walls with intensive care patient rooms. Kevin finally stopped outside the room labeled ICU 8. “Only two of us can be there at a time,” Kevin said as he gestured toward the doorway. Without saying another word, Kevin hugged his cousin again and then turned and quietly walked away.

Entering the room, he found AJ sitting beside the bed, holding Nick’s hand. AJ looked up and immediately put Nick’s hand down and stood up and rushed towards Brian and wrapped him in a tight hug.

“Thank God you’re here,” he whispered.

Tears sprung into Brian’s eyes when he heard the desperation in AJ’s voice. AJ pulled away from the hug and looked at the Kentuckian. He felt as if the situation would improve once Brian came down to Florida.

“I’ve been waiting for you to get here,” AJ said as he walked back to where he had been sitting.

Brian inched his way toward his baby brother, looking up at the monitors that were functioning at the head of the bed. Looking down at Nick, Brian drew a quick breath in. He was shocked at how much Nick had changed in the course of two months time. When had had left to go home two months ago, Nick had been so thin from the chemotherapy. Now he looked heavier; the face that had been so thin was now bloated from fluid retention.

AJ clued in to what Brian was thinking. “Nick had said he was gaining water weight or something like that.”

Brian felt a slight tinge of anger at how Nick’s care was neglected after he left for Georgia two months ago. “Did you say anything to his doctor about that?”

“Nick mentioned he did and he said Dr. Andersen told him that was normal with the meds he was on. You know he was only having check ups every two weeks.”

Looking down at Nick’s distended stomach and fluid filled hands, Brian narrowed his eyes. “And you believed him? You know how Nick is…”

Tears slipped down the rebel’s cheeks. “Yeah I know how Nick is, but you’re here now….he’ll be okay.”

Brian slipped a hand into Nick’s, shocked at the icy feeling of his skin. “Hey Nicky, wake up,” Brian urged as he rubbed his thumb on top of his best friend’s hand.

“They have him on morphine,” AJ mumbled.

Brian took his other hand and stroked Nick’s cheek with his fingers, looking at the oxygen levels on the monitor. The saturation levels were jumping between 93 to 94%. He knew that this was not a good indication since he was on full oxygen. Brian remembered from the past that it usually stuck at 99 to 100% when Nick was on oxygen.

“Do you know what she’s doing for him?”

AJ shook his head. “She said she was giving him more lace something—“

“Lasix?” Brian questioned, knowing the name of the drug that helps ease fluids in the body.

“Yeah that was it, she was giving him Lasix and placed him on full oxygen and was also giving him morphine for pain.”

When AJ said pain, he studied Nick’s face again. His features looked less than peaceful to him so Brian could tell he was definitely feeling pain despite the morphine that was coursing through his veins.

“I need to talk with Dr. Andersen,” Brian muttered with a shake of his head as he continued to stroke his best friend’s cheek.

“Bri….why did you sign the orders not to revive Nick if his heart stops?” AJ sobbed.

Brian gasped. He had forgotten about that!

Clenching his jaw, Brian recounted the day he signed the papers. “It was right before I flew back home. Nick was having a bad day and he said he never wanted to go through the chemo like he had before. I guess he felt that if he had something happen to again, it would be from the cancer and he asked if I would sign with him the DNR orders…”

“Cancel them,” AJ spat.

He looked at the orders that had DNR posted above the headboard on Nick’s bed. “I-I don’t know if I can…”

“Do you want Nick to die?”

Brian shook his head, looking down at Nick. “That’s not gonna happen…he always pulls through.”

AJ started sobbing. “That’s not what Dr. Andersen said.”

“Maybe you didn’t hear her right,” Brian corrected.

The two stood silent, only the blip of the heart monitor pierced the tension that hung in the air.

********

Kevin Richardson stood in the doorway for a few moments, watching his two brothers standing silently in Nick’s room. “AJ, why don’t you take a break for a bit, I’d like to be in here with Brian,” he quietly asked the rebel.

AJ wiped the tears from his cheeks and nodded as he stood up. He leaned over and kissed Nick on the forehead. “I’ll be back in awhile buddy,” he whispered.

Kevin stepped back, allowing AJ to pass before he entered the room. He took the spot that AJ vacated. “Hey Nick,” he said as he rubbed the younger man’s shoulder. He looked up at Brian. “How was Jay doing?”

Brian shook his head. “The same ornery jerk that he’s always been. He brought up the DNR papers….I completely forgot about doing that,” he admitted.

Kevin slumped down into the chair that was next to the head of Nick’s bed. “Yeah, that was kind of a kick in the gut when Dr. Andersen brought that one up. So explain to me why this was done again.”

“It was Nick’s idea.”

“You’re his patient advocate, didn’t you explain to Nick what this meant?”

“He knew fully what that meant,” Brian defended.

“But that was for the cancer, right? Didn’t you specify that it was an order if the bone marrow rejected?”

Brian shook his head as tears started running down his face. “It was just an order not to resuscitate if his heart stopped. We didn’t specify.”

“We?”

“Yeah Nick signed below my name and we left it like that.”

Kevin rubbed his hands across his face. “It seems like that would void the contract since Nick gave you full rights to take care of him and he signed that paper with you.”

“I dunno Kevin, all I can say is that I’m scared.”

“Me too,” Kevin admitted.

”So what happened anyway? I get this call from you yesterday afternoon and no one has really told me the full story.”

Kevin ran a hand through his hair. “That whole day was messed up. I got a call first thing in the morning from AJ and he wondered if I could come over to Nick’s. He said he didn’t feel comfortable around him, thought he was acting different or looked different. I asked if he wanted me there right away, and he told me no, but just wanted me to come by. I told him I had some things going on but I would be able to come by afterwards. I never thought AJ would leave the house but when I showed up around 4:00 no AJ and Nick was upstairs in his bedroom.” The older man paused for a moment, visibly shaken by the events that he was leading up to. “I found Nick laying in bed and I couldn’t wake him up…he was wheezing and breathing weird. I just panicked and called 911.”

“Oh God,” Brian whispered. “Thank God you showed up when you did.”

Kevin looked over at Nick. “I don’t know how much difference it made. If AJ had stayed the fuck home we probably wouldn’t be sitting here right now, Nick would have been okay---“

This time it was Brian that defended AJ, “You don’t know that.”

“He probably would be dead if I hadn’t got there when I did,” Kevin sobbed.

“Did you get a hold of Nick’s family?”

“Yeah right after I called you.”

“I didn’t see them in the waiting room.”

“I have no idea where they are or what’s keeping them. I called Nick’s dad and he was going to call the rest of the family. Those people are spread across the country,” Kevin explained.

“You called me yesterday afternoon,” Brian thought out loud.

“Yeah I guess maybe they didn’t take me seriously.”

“Do you think maybe I should try and call them again?”

Before Kevin replied, a weary Dr. Andersen entered Nick’s room, placing a gentle hand on Brian’s shoulder and nodding at Kevin. Brian quickly moved over by Kevin while the doctor set about her task of re-evaluating Nick. Both men watched the woman as she punched the buttons on the IVAC machine, setting the intravenous rate to a higher level and then slipping the stethoscope into her ears.

Brian studied Dr. Andersen’s face as she listened to Nick’s heart and lungs to see if it revealed any news. The woman’s expression remained unchanged while she listened. Looping the stethoscope around her shoulders, she sighed.

“Well?” Brian asked.

“I was hoping that his lungs would sound clearer since we had him on 100% oxygen but there is more crackling and wheezing when I listen to his chest.”

“What are you doing for him?” Brian questioned.

“I’ve done everything I can possibly do for him, now it’s up to God.”

The words spoken felt like a punch in the stomach to Brian and Kevin.

“Can’t you do more? I need to cancel that DNR notice,” Brian pleaded as he pointed to the notice on the wall above Nick’s bed.

Dr. Andersen shook her head. “Even if I cancelled that, it wouldn’t make any difference. Nick has pulmonary edema, he is basically drowning in his own fluids”

“How did that happen?” Brian sobbed.

Dr. Andersen looked at the two men. “I believe it was the medication he had been on to stop his body from rejecting the bone marrow that his brother donated.”

“If you knew that why did you keep him on that?” Kevin snapped. Brian quickly placed his hand on his cousin’s forearm to settle him.

“This happened to Nick so fast we couldn’t predict this from happening. He knew all of the risks in the beginning before I even started him on anything that he had done, chemotherapy or bone marrow transplant. Nick knew there would be risks and that medicine isn’t predictable. I think that the pulmonary edema attacked him in a matter of a day or two.”

“So you’re saying that Nick probably was having trouble but neglected to tell anyone?” Kevin asked.

Dr. Anderson nodded. “With Nick I would say yes.”

“Why the hell didn’t he tell anyone?” Brian wondered out loud. He looked down at Nick. “Why are you so stupid?” he sobbed, tears streaming down his face. “Why didn’t you tell anyone?” he demanded.

Kevin wrapped his arms around Brian, crying along with him.

A shrill alarm sounded in the ICU room. Dr. Andersen looked up at the oxygen monitor above the bed. The saturation rates had dipped down to 87%. She reached up and muted the alarm noting that it rose a degree only to fall down two more after that.

“Is the other two in the waiting room?” she quickly asked.

“I-I think they are,” Kevin stammered quietly.

“I’ll have one of the nurses go find them.”

The woman quickly left the room. Brian grabbed Nick’s hand. “Don’t….you….leave….us,” he begged his baby brother. “Nicky….don’t you go….it’s not your time.”

Kevin was on the other side, grabbing Nick’s other free hand. “Please,” he sobbed. He looked at Nick’s face and then up to the oxygen monitor noting that it had fallen even more since Dr. Andersen silenced the alarm. No sound was coming from the unit on the wall, but the alarm was flashing continuously.

The next alarm to go off was the heart monitor.

“Jesus,” Kevin breathed as he saw the green lines jumping erratically.

Brian threw his body across Nick’s chest, weeping openly. Kevin cried along with his cousin. He jerked when the monitor went into a long steady signal.

Reaching up, Brian hit to code button on the wall. “They can stop this,” he kept sobbing over and over. He ripped the DNR sign off the wall. “They can stop this from happening.”

Dr. Andersen rushed into the room with nurses, responding to the Code Blue that Brian had signaled.

“Hon, he’s gone,” Dr. Andersen said as she placed a motherly hand on Brian’s shoulder.

Brian shook the woman’s hand off his shoulder. “He can still pull out of this, start doing CPR,” he begged.

“Nick wanted this, you have to respect his wishes,” the woman said a gentle but firm voice. “I’m calling this….time of death…..3.43 a.m.”

Turning toward Brian, the older woman tried to hug him, but Brian turned away, he didn’t want any contact with her.

“You can stay with Nick as long as you need to,” Dr. Andersen said to Kevin as she prepared to leave. I’ll keep checking the waiting room for the others.”

“He didn’t say goodbye,” Brian sobbed as he kept stroking Nick’s cheek. “He didn’t say goodbye…..he wasn’t suppose to die like this. We agreed he wasn’t going to die in a hospital. I promised him he wouldn’t die….”

AJ and Howie froze when they came to the ICU room, hearing Brian’s cries. Kevin looked up at the two and announced the reality. “He’s gone….” He managed to say before breaking into fitful cries.

THE END

Author's Note: I wanted to thank all of you for hanging in there and reading this series for the past 5 years! Wow, this has taken me a long time for the story to come to an end. This last chapter had been thought about for the past year so this wasn't something that I had taken lightly, but I guess in the real world happy endings don't always happen and although it was shocking, it can and does happen every day.

Readers, please remember this is FICTION and none of this was true!