ICU
Mulder remained quiet after being inflicted by the agonizing
pain that had just been caused to his leg, he was not going
to admit to pain. He wanted to spend some time with Scully,
not drugged to the gills again. The pain in the left leg was
overwhelming but he needed to see Scully. If they turned him
or touched the leg again he would have no choice but to
admit to the pain. The leg that had been numb was now
hurting but not so much at the sight of the wound but in his
lower calf. He felt not only pain but also extreme nausea.
He hoped that Scully would return to the room. He needed her
here.
Rachel pushed the call button and asked the front desk to
page Dr. Harriman stat. She again looked down at her patient
and tears were streaming down his face. " Mulder is your leg
hurting?" her voice filled with compassion for her hurting
patient. Then she realized that the catheter in his back may
have dislodged, she needed to check it but was afraid to
cause him anymore discomfort.
Mulder stayed quiet and held onto his emotions and the
emesis that was threatening to spill out. Where had Scully
gone? He needed her now.
Dr Harriman and Sheila entered the cubicle together. He
started to get very concerned that his patient had suffered
a setback due to the grimace on his face and the way he was
positioned in bed. His body was stiff and he was able to
move his lower extremities, the epidural was evidently out.
He quickly pulled his stethoscope from around his neck and
placed it into his ears and started listening to Mulder's
chest. The congestion from the Pneumonia was still evident
but no decreased breath sounds or increased congestion. He
then looked over to his patient, who had remained quiet.
"Mulder, what's going on? Is the pain in your upper leg bad
again?
He shook his head and gritted his teeth and spoke in a low
pained tone of voice," My lower leg is killing me. It feels
like it is about to fall off." Inside he was wishing that it
would. Dr. Harriman was ordering tests and extra pain
medicine. He reached over and pushed the PCA button and then
pulled back the sheet to look at the leg. The calf was red
and swollen and had all the makings of a blood clot. He then
turned and ordered a stat PTT and PT, tests that would show
if Mulder's blood thinner was working. His major concern was
that the clot might break off and go to Mulder's lung, heart
or brain. He needed to make sure that he did not throw one
to his lungs, with Mulder's recent Pneumonia he did not want
to take a chance. Again he was yelling out orders for a VQ
scan, a heparin bolus now a drip post VQ scan and an
arteriogram.
Mulder was lost in all of the medical terminology and felt
that he was dying and nobody was willing to tell him the
truth. Scully would tell him the truth but where was she and
why wasn't she here with him? He felt ignored and he needed
something else for pain or at least a sedative.
Scully walked in a few minutes later and went straight to
Mulder's side. He was now irritable, agitated and in a lot
of discomfort. While Dr. Harriman was trying to fill Scully
in on the details the vomiting that he had quelled went full
force. The emesis filled Mulder's bed clothing and he was
rolled onto his side to prevent aspiration, which broke his
quiet demeanor, the screams from his hoarse and ragged voice
went off and he was not any longer in control of the pain in
his leg. The feeding tube was again cut off and removed from
the G tube in his abdomen.
He was transferred quickly to a gurney as the nurses were
rushing to clean him and to change his gown. The emesis was
in his hair and on his bandage, it would be cleaned later
after the tests. Dr Harriman was whispering calmly to
Mulder, who was lost in a world of pain. "Mulder I am going
to drug you completely when I get the VQ scan, but I need
you awake a little bit longer. I promise. "Let's give him 50
mgs of Demerol IV now" he shouted out to the nurse.
Scully was trying to give comforting words and his full
focus was on her face and words, the tears and moans were
eased by her presence. He was happy to see her face, yet he
was unable to communicate in words to express what it meant
to have her beside him. He needed her and that was the
bottom line.
THREE HOURS LATER
The VQ scan ruled out the possibility of a blood clot to the
lungs and Mulder was medicated for his pain and was given
medicine to help him sleep. They finished the other test and
confirmed the diagnosis of a blood clot in the lower calf of
his left leg. A loading dose of heparin was given and a drip
was started at 1000 units an hour. The IV Med pump would
deliver the medicine to help thin his blood and to help
prevent a clot from being thrown to other major organs.
Unfortunately the blood thinner would not dissolve the clot
for a long while and the risks of it breaking off were
evident.
Mulder was sent back to the unit and was placed on O2 by
nasal cannula and placed back on the Haldol drip but at a
lower dose, he needed to be able to communicate with his
patient.
Scully sat in her chair beside her partner. She had a lot of
concerns but the main concern was the blood clot in his left
leg. She wanted to scream for her partner. He had never
experienced so much discomfort in a hospitalization that she
was aware of in his medical history. He was moaning even
through the heavy pain medication and sedatives. She would
reach over and push the button on the PCA pump and give him
enough relief to rest a little bit more comfortably. The
nurse had applied a pillow underneath the leg and wrapped a
heating pad for comfort to the tender calf. The epidural
catheter that had been dislodged was removed. They needed to
better assess the leg without the numbness.
1600pm ICU
Scully was awakened by someone's touch on her hair. Her head
was lying next to Mulder's hand. She had fallen asleep with
her head on his bed. She looked up to see bright eyes,"
Hey." She spoke softly and reached over and pushed away his
hair from his face.
" Scullllly." His voice was hoarse and weak.
"Shhhh Mulder. You are doing much better. How is the pain in
your leg?"
He closed his eyes and for a second Scully thought he might
have fallen back to sleep but he spoke quietly, " It still
hurts but is doing better. It's a Tylenol kind of hurt."
She reached over and picked up the water pitcher and poured
out a small amount of water and placed a straw into his
mouth. He sipped cautiously, the tube in his nose was
irritating his throat and it hurt going down. After he
finished he pushed the cup away. She wiped his mouth with a
tissue and gently brushed his cheek. " It's been a long
week."
That statement got him to open his eyes again and he looked
up with sad eyes, " It's been a week?"
She nodded her head and smiled slightly, "Time passes
quickly when you are having fun."
He nodded, " Then I must be having a party." He smiled and
looked up with tired eyes at half mast. " When do I get to
go home?"
She actually anticipated the question and knew that she
could not ignore it. " Dr Harriman has you medicated to the
gills and your on constant sedation due to restlessness and
agitation produced by the pain in your leg. You are feeling
better due to the drugs and you have a while to go before
you can get rehabilitation for your leg. And with the nature
of your wound, even rehab will take a while."
" Months or weeks Scully?" His full attention focused on his
partner.
She knew that honesty was the best policy, "Mulder, a few
months I'm afraid."
He nodded but did not say anything else. He closed his eyes
and within a few minutes he was sleeping.
Two days later
After two days Mulder was transferred to the step down unit.
He had a lot less tubes and monitors but still he had his
share. The nurse had finished irrigating his wound but he
still could not look at the open wound but the nurse was
encouraged by the decreased drainage and pinker tissue and
that he was having decreased pain. They had positioned him
close to the desk due to his prior medical condition, he
still needed a lot of medicine for pain.
When Scully walked into the room Mulder was sitting up in
the bed with a breakfast tray in front of him and a scowl on
his face. He had been out of it for the last two days but
this morning his hair was combed and his face was shaved.
But the expression on her face told her that he was not in a
good mood. "Mornin Mulder."
Her partner did not return the greeting but instead sat with
a look of disgust on his face, " I hate jello. And I
definitely hate it for breakfast." He growled. His bad mood
showing no end in sight.
" Mulder. It's clear liquids, what Dr. Harriman wants you on
for a few days." She was putting her things on the chair and
putting his pajamas into the drawers that she had brought
from his apartment.
" Well I'm not going to eat it, especially when it is orange
and goopy. I want eggs, toast and coffee. I want to go
home." He pushed the table away and flipped on the
television. After a few more grunts he looked up and in a
small childlike voice he spoke, " Hey Scully."
She smiled at his boyish manner and replied, " Hey Mulder."
She hesitated a few seconds and decided he needed a Scully
lecture. "Mulder if you don't eat then you will keep the
feeding tube and the intravenous fluids. You want to go home
soon don't you?"
He turned and he gave her a defeated stare and he almost
started to argue but he knew that she was right from all the
previous hospitalizations. He knew that Dr. Harriman would
not let him get rid of anything until he started to eat.
Unfortunately his stomach was doing flips after drinking a
small amount of apple juice he had forced himself to drink.
He felt nauseated but he was not going to tell anybody. He
did not want any more drugs. He would rather suffer than be
out of it again. " Maybe later Scully." He lied to his
friend without making eye contact, she would see the lie a
mile away, he just hoped that he did not hear it in his
voice.
Scully knew that she should pursue the conversation but
instead she dropped it and focused on taking away the tray
and getting Mulder comfortable. She was concerned that he
was not eating but she did not want to get him upset, she
would just see what he did for lunch. She reached over and
picked up the tray and took it out to the nurse's desk. They
needed to tally the input and output to keep up with his
hydration status. She voiced her concerns to the nurse on
the unit and soon returned to Mulder's room. He was curled
up as much as he could without bending his left leg. The
brace aided in keeping the leg straight. He was snoring
quietly. She reached over and pushed up the siderail and he
opened his sleepy eyes.
" What's wrong?" he asked sleepily and added a big yawn to
the end of the question.
" You're fine Mulder. I'm here if you need me." She reached
up and cut off the bright overhead light. " Just sleep. I'll
be here when you wake up."
He nodded and closed his eyes, within just a few short
seconds he was sleeping again. Scully sat down and removed a
journal of medicine from her bag and started reading by the
small bedside light.
Mulder had been asleep for less than thirty minutes when he
started retching and all he could bring up was the small
amount of apple juice and some gastric secretions. His skin
was diaphoretic and his face was pale. He could not control
his fragile emotions and he started to cry. He was so sick
of being sick. Scully was holding the emesis basin under his
chin and his nasogastric tube was again hooked up to the
intermittent suction. She also reached over and cut off the
feeding tube infusing into his abdomen. She was trying to
give him comfort, she knew that he was emotionally drained
but the tears were a surprise and her heart felt for her
friend. Scully hit the Nurse's call light and instructed the
nurse to bring Mulder something for nausea.
The nurse entered with a syringe, turning on the bright
lights above his head and quickly emptied the contents of
the syringe into his IV port. She then looked over and saw
the Dr. Scully had turned on the intermittent suction on his
nasogastric tube and cut off the feeding pump. She quickly
motioned for the assistant to take Scully's position on the
other side of the bed and they proceeded to run some warm
water and clean up their distraught patient, afterwards they
changed his gown and linen. They placed a cool cloth on
their sleeping patient's forehead and left the room. Again
Scully pulled her chair close to his bed and picked up
Mulder's limp hand. The lights were dimmed again and he
slept due to the drugs.
The nurse had contacted Dr. Harriman. He was in the room
just minutes later. " I was admitting a patient to ICU. How
is he doing?" he asked from the door. He was definitely in a
hurry and had just dropped by to check on him on his way
back to the office.
"He's doing better now. Sleeping." She answered in almost a
whisper, not wanting to disturb him from his sleep.
Dr. Harriman lost the impatient, I'm in a hurry look and
walked towards his patient. He listened again to his
sleeping patient's abdomen and replaced his stethoscope back
around his neck. He looked over to Scully, " Did he try to
eat anything for breakfast?"
She shook her head, " He was complaining about the jello and
refused to eat it. He has lost a lot of weight in the past
week. I'm really concerned."
" Let's see what he does for lunch." He paused for a few
seconds and looked over to Scully. " What kind of case was
Mulder working on before he was admitted?"
" It was a child killer. He was kidnapping small children
and killing them. It was a really bad case." Her voice was
almost inaudible. " A small girl was killed by the killer at
the house we followed him to ,it was really bad."
" I'll write an order for the staff psychologist to drop by
tomorrow and see if Mulder would like to talk. Sometimes he
keeps a lot to himself, maybe a stranger could help."
Scully nodded and Harriman left to write the orders.
2100pm Mulder's room
Mulder had slept through lunch and dinner. He was restless
but a dose of pain medicine was given and he had settled
down to a comfortable sleep. Scully felt that he might be
able to sleep through the night and she needed to run by the
office before going home. She left a message with the nurse
to call if Mulder asked for her and then she gathered her
things and left for the evening. Before she left she kissed
him sweetly on the cheek.
Mulder's night was quiet and the drugs helped him sleep
comfortable. He did not have any more episodes of nausea or
vomiting. He awakened to the morning sounds and realized
right away that Scully was not present. He missed her and
felt alone without her by his side. He was a little fuzzy on
what had happened last but he was not nauseated any longer.
His leg did not have any pain now and that was a good thing
and he did not feel the tight bandage that fit around his
leg with the heavy brace. Actually he noticed something very
strange and he started to panic. He felt numb on his left
side, his entire left side. His mouth even felt numb and he
was unable to move his left arm. He concentrated on the
numbness in his face and started to become scared and very
agitated. What else could go wrong? He thought to himself as
the panic continued to build. He tried to make a sound but
nothing would come out except the drool that ran down his
right cheek.
The day nurse entered to make her morning assessments and
was about to take his vital signs when she noticed that
something was very wrong with her patient. Quickly she
realized that she was dealing with a patient with a possible
stroke.
Part Six