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Stroked part:: 4

ICU Unit


Mulder returned to the unit after the CAT scan and was very 
restless even with the strong drugs. He was tugging at his 
restraints and his fever was hovering at one hundred and 
four to one hundred and five. He was kicking at the sheet 
and the cooling blanket, which had been placed on him upon 
his return to the unit. He was sweaty and pale. And he 
seemed to be in a lot of pain due to his leg.

Scully was trying to calm and comfort her partner but was 
having no affect. Her frustration at Mulder's worsening 
condition worried and concerned her.

Dr Harriman entered the cubicle and shook his head. "Mulder, 
what are you doing?" But no response came from his patient. 
He took his stethoscope and placed it on Mulder's chest and 
after a few minutes he placed it on his abdomen. He listened 
intently for several minutes but could not hear any 
worsening of his lungs and his bowel sounds were fine. He 
then decided to recheck the wound. He pushed the sheet back 
but due to Mulder's writhing in the bed he felt that he needed 
to get him settled before trying to assess the wound again. 
He also wanted to check on the blood cultures too. He looked 
over to a very tired looking Dr. Scully and shook his head 
again, "I'm going to check on Mulder's blood cultures and 
order him an extra dose of pain medicine. He seems to be 
having a lot of pain, more than I would expect."

" Do you think his wound is infected?" She asked, her voice 
almost a whisper. She did not want Mulder to hear her 
worrying, it would only make his condition worse.

" I'm going downstairs to lab to check on his wound cultures 
and if it looks suspicious then I will reassess the wound again." 
He paused as he walked back to the cubicle door. " Frankly, 
I feel that the wound is probably the cause of the higher 
fever. They did another chest xray while he was down for his 
CAT scan, I'll take a look at both of them while I'm down in 
radiology."

After Harriman left Scully took her position beside of 
Mulder again. He was not lucid and he struggled against the 
restraints and anything within reach of his restrained hands 
and his now restrained feet.

One hour later

Dr Harriman reentered the cubicle with the nurse following. 
She had a sterile tray and dressings. They were both gowned 
and the expression on their faces told her that it was not 
good news. "He's growing staph in the wound and I need to 
debride and treat with antibiotics. He is not going to do 
well during this procedure but it's necessary." Dr Harriman 
spoke softly.

Mulder had become quiet after the extra dose of pain 
medication and the tepid bath that Scully and the nurse had 
administered. His fever had come down after the Tylenol to 
one hundred point two aurally. He seemed to be resting but his 
body was broke out in a fevered sweat and he was not in a 
comfortable position due to his recent struggles.

Before gloving for the procedure Dr. Harriman walked over 
and gently rubbed Mulder's sternum. " Listen Mulder. What I 
have to do is going to be painful and may require some more 
surgery. I want to take a look and see what I am dealing 
with since I looked at the wound yesterday. If this becomes 
too uncomfortable I will take you to surgery and complete 
the procedure to get that leg better, to get you 
better."

Mulder did not respond due to the heaviness of the drugs. 
Dr. Harriman placed the bed in a high position and again 
removed the brace and the primary dressing. As soon as he 
saw the wound he knew why Mulder had been in such pain. 
Within a twenty-four hour period the wound was now seeping 
thick yellow drainage and was red around the outer edges. He 
gently removed the packing and again noted that the drainage 
was thick. The wound looked worse the further he got down 
into the wound. He knew that he needed to take Mulder back 
to surgery. He hated to do this but he needed Mulder in a 
deep sleep to do the debridement that would be necessary to 
the healing of the wound and assessment of the femur. He 
quickly poured the antibiotic into the wound and covered it 
with a sterile dressing. His main concern would be the 
pneumonia and giving him more drugs to suppress his 
respirations but the wound was worrisome.

Scully was standing beside the doctor with mask and gown and 
her eyes spoke volumes for her concern for her partner. 
Within a few minutes he was giving orders for surgery and 
more lab work and another breathing treatment prior to 
surgery with suctioning. He redressed the wound and placed a 
sterile dressing over the wound. He was then out of the unit 
to prepare for surgery. The nurse entered the cubicle 
with a permit for surgery and the thermometer. She handed 
the paperwork to Scully as she started to hook up the 
breathing treatment and rechecked his temperature. And with 
paperwork finished and the premeds also given Mulder was 
ready to be taken to the surgical suite. The staff assisted 
in getting a very unconscious patient onto the gurney and 
the ambu bag was placed onto the intubation tube and he 
was quickly rolled down to surgery.

Four hours later Surgical Waiting Area

They had waited patiently for Dr. Harrison to come and give 
them some news on Mulder. Scully and the Gunmen and Skinner 
were sitting in the area awaiting news on their friend. When 
Dr Harriman walked out of the surgical doors he looked 
exhausted. He walked over and sat down beside of Scully and 
shook his head. "It looked really bad but I feel that he 
will do fine. The wound will need to irrigated several 
times a day with antibiotic. He's going to be in a world of 
hurt when he wakes up though. I will keep him on his PCA 
pump infusing morphine a few more days."

Scully felt relieved but still had concerns, " Can I see 
him?"

" Sure, but respiratory is giving him another breathing 
treatment right now and then he is going to suction him. 
Let's give him a few minutes. I'm going to try to wean him 
off the ventilator tonight if possible. I want him to start 
bringing up some of the secretions himself."

" That's great." Skinner replied. The others also showed a 
look of relief except Scully, who seemed a bit more 
concerned. She knew that Mulder would not do well without 
the drugs to keep him sedated. He had a way of not 
cooperating.

0630am Next AM

They had finally extubated him at two in the morning and 
when the sedation had worn off the screams began. The fever 
was still elevated, the antibiotics had not had 
time to get a blood level and the pain meds were not 
touching the deep pain he was feeling. The nurse had paged 
Dr. Harriman several times for orders but the pain medicine 
was not enough even with the time released morphine through 
his PCA pump.

When Dr. Harriman walked into the ICU cubicle he saw Mulder 
fighting to get out of bed and screaming as loud as his 
hoarse voice would allow. The restraints were being tugged 
at and the blankets were in the floor. His face was covered 
in sweat and the leg was being held down by the restraints, 
the brace, the nurse and Scully.

Scully was attempting to calm him down but she was not 
getting through the thickness of the drugs. He seemed to be 
trying to get out of the bed. Dr Harriman walked over and 
looked down on his miserable patient. " Let's get 
anesthesia, maybe we can put in an epidural for the next 
twenty four hours. That might give the antibiotic time to 
kick in and give him a rest. He is in a lot of pain."

Scully agreed, her partner needed a rest. He was exhausted 
and so was she from being up all night and the day before. 
Mulder did not need anything else to suppress his 
respirations. He had also been bringing up thick green 
secretions between the screams, often choking on them. She 
hoped that the fever would improve and the pain would 
resolve.

The anesthesiologist entered the room and placed the 
catheter into Mulder's back. Within a few minutes of getting 
the epidural Mulder seemed to calm down. His body drifting 
into a restful, exhausted sleep. Scully waited for a while 
and decided to go home and grab a nap and take a shower. She 
needed a break, the past few days had been really stressful. 
She would call Skinner to see if he could stay with Mulder.

A few hours later

Mulder could hear the steady beat of the heart monitor and 
the hum of the O2 sat monitor. The other beeps and tones 
were familiar but he had no idea what they went to or even 
cared. His mouth was dry and he felt nauseated. He wanted to 
open his eyes but the drugs had made them crusty and heavy. 
He decided to lie still and take in the familiar feelings of 
different tubes. The first tube he noticed was the O2 nasal 
cannula and then he felt a small pressure in his chest, 
which had to be the central line for his intravenous drugs. 
The familiar O2 sat monitor clip attached to his finger and 
the many little sticky things attached to his chest and the 
blood pressure cuff around his arm. He was definitely 
attached. The smell alone could cause nausea. He tried to 
lift his hands but felt the restraints around his wrists and 
the heavy bandaging and brace around his leg made his leg 
feel heavy. Actually both of his legs felt heavy, maybe due 
to the drugs, but it was more a totally numb feeling below 
his waist. He felt that he should panic but somewhere in his 
drugged mind he knew that it was fine, it was suppose to 
feel numb. He also felt a new tube, one he had never had the 
pleasure of feeling but he did not like it, whatever it was 
snaking into his abdomen.

He felt fuzzy and slightly disoriented but he knew that it 
was the effects of the heavy drugs. This was par for the 
core with him and hospitals but something was different. He 
listened intently but could not hear the steady breathing of 
his partner. Was she asleep? Maybe she had stepped out for a 
few minutes. She had to be tired. How long had he been here 
and where was here?

The hallway though seemed quiet and he was beginning to get 
a little worried that maybe he had been abandoned when he 
heard the steady steps of someone entering the room. That 
feeling of abandonment that was starting to creep in was 
improved when the nurse started to touch and talk to him 
gently. " Mr. Mulder are you awake?" Rachel asked softly, 
loud enough for only her patient to hear.

He worked his gummy eyes apart and within a few seconds he 
could feel the warmth of a washcloth helping to remove the 
nasty goo that held them closed. His vision was blurred at 
first and he thought it might be Scully but after a few 
seconds when his vision improved he saw that it was his 
nurse. He recognized her during the time that he was 
intubated.

"Hey sleepy head. How are feeling?" She asked, her attention 
was fully on him.

He tried to clear his throat but when he spoke it sounded 
rusty from disuse, "Better." He must be doing 
better for Scully not to be at his bedside.

Immediately a straw was placed between his lips but his 
energy level was too low and he could not suck up the cool 
water. She realized fast the he was having difficulty and 
lifting his head and offered him ice chips. He took them 
greedily, the parchment of his throat relieved. After a few 
moments he was able to talk," Where is Scully?"

Rachel knew immediately that he was talking about his 
partner. "She went home. She has been here for days and when 
your fever broke tonight Dr. Harriman and I sent her home to 
get some sleep. But we promised her that you would be 
sleeping too. And Dr. Harriman will keep that promise."

" I don't want to go back to sleep right now, I just woke 
up." He moaned. He knew that sounding pitiful didn't work on 
nurses, they were too smart for such but it never hurt 
trying. He just wanted to be able to stay awake for a little 
while.

" I believe your boss was here just a little while ago but 
he got called back to work. Maybe he will be back tonight?"

Mulder nodded and closed his eyes for a few seconds, he 
wondered why Skinner would be called back to work. It was 
night, wasn't it? It had to have something to do with the 
baby killer, but what? He wanted some answers, he needed a 
phone. And why in the Hell did his legs feel so numb, he 
couldn't do anything with his legs so numb. He looked up at 
his nurse and tried to stay calm, "What did they do to my 
legs? I can't feel them."

" Don't worry, it's just the medicine they have infusing 
through the catheter in your back. When your medicines have 
had time to start working they will remove it, but for right 
now it is keeping your pain managed." She started checking 
the machines and pulled a mask off the wall," It's time for 
your breathing treatment, it will just take a few minutes. 
Then maybe you can rest again, your body had been through a 
lot in the past few days." She placed the mask over his nose 
and mouth and went about changing tubes and checking 
settings and read outs on the monitors.

He took the medicine in the mask and when it had finished 
Rachel removed it and placed the mask back into the bag and hung 
it on the wall. " Rinse your mouth out and I will brush your 
teeth for you then it will be time for you to rest again."

His dry mouth and throat welcomed the water and it felt good 
to have the taste of infection out of his mouth. Everytime 
he coughed he brought up thick green sputum. After she had 
finished she washed his face and took off the restraints. 
The actual movement of his arms felt good and he smiled up 
at his new friend. " Can I have a phone. I need to call 
Scully?"

She looked down at her patient and shook her head, " Mr. 
Mulder we do not have patient phones in ICU. It is against 
the hospital policy to have ICU patients stressing 
themselves out with outside interference. You will get a 
phone soon enough when you get transferred to the step down 
unit but for now you must rest."

His voice was wearing thin and he was finding himself 
getting agitated at all the rules. " I want a damn phone. 
I need to make a call." No sooner than the words had left 
his throat than he regretted saying them. He was going to 
tick off the nurse and that would not be good. Rachel left 
the room and was accompanied by Dr. Harriman when she 
reentered.

Dr. Harriman had a very agitated look, besides looking 
exhausted. Mulder could feel the tension in the room. He 
also noticed the syringe in his doctor's hand.

" Listen Mulder, Dr. Scully went home to get some rest. She 
is exhausted and I want you to sleep too. You need the rest, 
your leg is still healing and your fever is still running 
low grade. To say the least you have been through quite a 
bit in the last few days and finally we are getting over the 
hump but if you start trying to overdo it then you will not 
get better. I can not have you stressing out over your 
partner." He paused for a few minutes then reached over and 
adjusted Mulder's leg brace. "Maybe the best thing to do is 
to medicate you now so both I and Dr. Scully can get some 
rest." He had a 'do not screw with your doctor or I'll drug 
you into submission' look on his face.

Mulder knew that his physician meant every word and the fear 
was instilled. He nodded his head and smiled like a good 
little patient. " I'll rest, promise." His sore throat 
croaked out.

Dr Harriman shook his head and smiled, " Why don't I believe 
you Mulder?" He chuckled.  He paused for a second as if in 
deep thought, staring down at his recalcitrant patient then 
proceeded to uncap the syringe and before Mulder could voice 
his objections the needle was being emptied into his IV. 
When he finished he turned to a very shocked patient and 
spoke softly," listen, I will let you stay awake when Dr. 
Scully comes back in the morning but tonight we are going to 
rest."

Mulder did not have time to respond, the drug was working 
fast and he was unable to fight this time. Dr Harriman 
looked over to Rachel, " Let's keep him sedated until his 
partner comes back in the morning. He has a habit of getting 
into trouble when she is not around." He left the cubicle to 
go back to the doctor's lounge.

0300am

When Mulder aroused again the room was dark and the hand 
restraints were back on both wrists. The heaviness of the 
drugs were preventing too much movement and he felt so 
thirsty, his mouth felt like cotton. His eyes felt crusty 
and sticky and he wanted to ask for some ice or water but 
did not want anymore medicine. Scully had not returned and 
he was beginning to miss her terribly, he could not remember 
seeing her while the fevers were high but he remembered her 
calming voice. He needed to see his friend or at least talk 
to her for a little while. His movements must have alerted 
the nurse to his alert status because the door opened 
suddenly and she had a syringe in hand. He quickly shut his 
eyes.

" Mr. Mulder are you awake?" she asked quietly. She waited 
for a few seconds and did not get an answer from her 
patient. " Mr. Mulder, would you like some ice chips?" She 
had seen the increase in her patient's heartrate and knew 
that he was awake, she had been informed of his stubbornness 
and his desire not to be drugged again.

He slowly opened his matted eyes and nodded. She had offered 
ice and he was so thirsty. She held up the spoon of cold ice 
chips and he took them greedily. He wanted more and she gave 
him another spoon full. After a few spoons of ice she 
started to place the syringe into the port. " Please don't 
give me any drugs for a few minutes." His voice was deep and 
hoarse and his face was pleading.

She pulled back the medicine and stared down at her patient. 
"Doctor's orders, he wants you to rest."

Mulder knew that she was doing her job but he needed to talk 
to someone. " Can we talk for just a few minutes? It seems 
like I have been asleep forever, I just want to have a 
little company now that I am feeling better."

She acquiesced and placed the syringe on the bedside table. 
She walked over to the sink and wet a washcloth and brought 
it back over to the bed and washed his gummy eyes. He 
relaxed under her ministrations and almost fell back to 
sleep. " Hey I thought you wanted to talk." She whispered 
into his ear.

He quickly opened his eyes," Sorry. I do want to talk. What 
time is it?"

" It's about three fifteen." She answered as she returned the 
washcloth to the sink.

He nodded, and after a few minutes he looked over to see his 
nurse pouring out some more ice chips. " Can I have some 
juice?"

" I think he put you on clear liquids. But if you will drink 
some prune juice then I feel that we can get by with it 
tonight." She smiled at the smirk on her patient's face.

He nodded and rolled his eyes. He would drink anything if it 
would delay being put down by the drugs again.

" Be good while I'm gone. By the way my name is Sheila. Hit 
your call button if you need me before I get back." She 
placed the light within reach and left the room.

Mulder looked down at his numb leg and saw the heavy 
bandaging and the brace that embraced the bandage. He then 
looked up and saw the multitude of different bags hanging 
over his bed. He was on a lot of different medicines. The 
ventilator still stood by his bed, a cautionary thing he 
assumed. There was a new tube that snaked under the blankets 
attached to a bag of white fluid. He pushed back his gown 
and saw that it was inserted into his abdomen through a red 
rubber tubing. A feeding tube he assumed, that would be the 
first thing to be removed. He did not like the feeling in 
his stomach. He quickly pushed the gown down when he heard 
his nurse approaching.

" I warmed it up for you." She smiled as she handed him the 
warm glass.

This was gross and his desire for juice was almost 
destroyed, "This is warm prune juice. This is nasty." He 
grimaced at the thought of having to take a sip of the nasty 
stuff.

She shook her head and smiled, " Let me put it to you this 
way, you need to have a bowel movement the normal way, or I 
will be forced to help it along."

He made a sour face but took the straw into his mouth, he 
took the entire drink and held out the cup." Now can I have 
some real juice?"

She smiled and produced a small cup of apple juice. She felt 
he needed a reward and he accepted with a big grin on his 
face. She then gave him his bath and changed his gown and 
the linens on his bed with the help of the nursing 
assistant. She noticed that he was grimacing a lot 
throughout the procedure and looked to see if the catheter 
in his back was still secure. She would have anesthesia come 
and make sure he was getting the appropriate dose. When they 
turned him back on his back he let out a low groan. " Mr. 
Mulder are you okay?"

" My stomach is cramping. It's bad." He moaned.

She reached up and cut off the feeding and then gave him the 
emesis bowl." Do you want the bedpan?"

He nodded and they rolled him onto the pan and left the room 
for a few minutes. After a few minutes she returned to find 
her patient with a sheen of sweat on his face but he wasn't 
feeling better and he wanted to go back to sleep. " Can I go 
to sleep now?" his gravely voice begged.

The pan was empty and he was obviously in misery. " Can I 
have an enema or something, please." He begged. Never 
thought I would ask for that but now is not the time to be 
childish or too manly. The cramping and rectal pressure were 
too much. The stomach cramps were severe now and he was 
hurting so badly.

Shiela left and returned with an enema in hand. She then 
placed her stethoscope on his abdomen and listened for a 
couple of minutes. " You may have an impaction. You have 
been on the tube feeding for a couple of days. I am going to 
check and if so I will remove it then I will give you some 
more time on the pan." She instructed as they rolled him to 
his side. The assistant soothed his face as Sheila worked at 
removing the impaction. She was whispering apologies as she 
continued to remove the stool. Afterwards she looked over to 
her almost asleep patient and noted that he was snoring. He 
was exhausted from all the activity. She knew that he needed 
to sit on the bedpan for a few minutes to finish getting rid 
of the stool. " Hey, one more thing and I will let you 
sleep."

Without opening his eyes he moaned, " What?"

"I need for you to try and see if you can get rid of the 
rest of the stool, just sit on the pan for a few minutes." 
She instructed to her very weary, sleepy eyed patient.

After he expelled the stool he felt a lot better but he 
wanted to go to sleep. " I want to sleep now." He requested 
of his shocked nurse.

Sheila nodded and placed the syringe into the port and 
emptied the contents. She would remind him of this tomorrow. 
Within a few minutes he was sleeping again at times Sheila 
observed him grimacing and fidgeting and she pushed the PCA 
button and within minutes he was relaxed and resting 
comfortably. She then exited the room and left her now 
favorite patient to sleep.

0700am

Scully entered Mulder's cubicle to find a sleeping Mulder. 
She wondered if he had been asleep all night. She placed her 
things in the chair and reached over and gave him a tender 
kiss on his cheek. She then brushed away his sweaty hair 
from his face. His skin was still cool to touch and he 
seemed to be sleeping restfully. She decided to go out to 
the nurse's desk to find a cup of coffee.

Rachel entered Mulder's cubicle to do her morning assessment 
when she caught her patient's watchful gaze. " Hey your 
partner just got here but I thinks she went to get a cup of 
coffee." Her voice was full of excitement for her sick 
patient.

Mulder nodded but did not speak. A few minutes later she 
noticed him grimacing and the sweat on his forehead was 
beading up. She immediately stopped what she was doing, " 
Are you alright Mulder?" she asked as he nodded in 
affirmation. " Quit being tough Mr. FBI man, what's wrong?"

After not getting an answer she pulled back the sheet and 
readjusted his brace and the scream that came from him was 
almost deafening." Mulder you have an epidural, what the 
Hell is going on with your leg?" Then it dawned on her the 
multiple possibilities.

Part Five

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