Life or Death
“Amelia, look at me... Amelia.” She was in a state of panic. Her eyes wide, pupils dilated. Tears balancing on her eyelid attempting to not fall. Sweat began pouring from the pores on her forehead. Her eyelids steady, not blinking. Spaced out of the blood pouring from her brother’s body drenching every inch of my skin.
I knew she had no problem dealing with death. No one in this family did. Usually. I mean, after all they caused plenty of death by their hands. But now her brother’s life was on the line held together by the pressure of my hands on his chest. I needed her to get it together. He may have been her brother by blood. But he was mine by choice. I couldn’t save his life without her.
Her eyes blinked abruptly for the first time in minutes. Her head shook from side to side bringing her consciousness back into reality.
“Ye-yeah?” Her voice stuttered meekly.
“Look at me Amelia.” Her wide eyes faced back towards me still terrified. “Does Adrian still have the medical kit upstairs?” She didn’t respond. She just focused on his body as Alex faded in and out of consciousness. “Damn it Amelia. Does Adrian still have the fucking kit or not. We don’t have the damn time for you to keep panicking.”
“Ye-yes. In… In his… bathroom cabinet.”
“Okay. Listen to me Amelia. Look at me.” I made eye contact with her panicked eyes. I tried to stay as calm as possible. She was a deer in the headlights and what I was about to ask her to do was going to cause her to scamper away if I didn’t ask gently. “I need you to put pressure on his wound Amelia. I need you to trade spots with me okay?”
“Wh-what. No. I-I… Addi I can’t…”
“Amelia, you need to. I can’t do this without you. He’s going to die Amelia if you don’t step in and help. Please.”
The tears that teetered on her eyelids finally broke like water overspilling a dam, drawing wet lines down her pink tinted cheeks. She inched closer to me hesitantly like an animal afraid of the human standing in front of them. Her breathing quickened causing her to start hyperventilating. Her face turned pale all the color slipping away in an instant. When she finally reached the table I could see her jaw muscles twitch back and forth and she took one last inhale in and exhaled calming herself and sucking any tears she had left back inside of her. She drew up the strength I needed her to have. She stood erect in front of me, her shoulders back, chest out and her arms by her side. I could see her nails digging into the skin on her palms as she closed her eyes to steady herself for what she was about to get involved in.
With one whisper of the word “okay” she climbed up onto the table next to me leaning her weight onto her knees waiting for instructions.
“What do I do?”
“I need you to but pressure on him to slow the bleeding. Can you see how I am pushing down on one of my hands with the other?”
“Okay. Cover up his wound with one hand, push down with the other. Lean forward putting your body weight onto both hands covering the wound. It’s not going to feel comfortable for you or him. But you can do this Amelia.”
“On the count of three I’m going to lift my hands up and you need to switch and push down. Okay?” She gave a simple nod her eyes still wide as she swallowed down any remaining fear she had left. “One…two… THREE.”
Effortlessly she pushed down as my hands raised above my head to make room for her body. The fear that riddled her body seconds previously no longer took hold of her. Instead determination held her together. I could see in her eyes her repeating the words I can do this, I can do this, I can do this.
Blood still poured from his body. It didn’t matter how fast the exchange between Amelia and I had been any small movement caused blood to ooze from any crack and crevice it could find.
I could afford to waste any more time. I jumped off of the table and sprinted up the stairs to Adrian’s room. Leaving a trail of blood behind me from my soaked clothes. It was the least of my concern.
I made it to Adrian’s bathroom, which looked almost identical to mind. Cupboard, look in the cupboards. I quickly ran to the sink throwing the doors of the cabinet underneath wide open. A medium sized black leather bag fit neatly under the pipes. I slide it onto the floor ripping the zipper from one side to the other lifting the top up to look inside. Perfect.
Without much hesitation I sprinted back down the stairs expecting everything to be how I left it. But Amelia’s body was riddled with terror once more.
“Addi…” tears started rolling down her cheeks once more. “Addi, he stopped breathing.”
Fuck. Stay calm. Stay. fucking. Calm…..
“Okay. Keep holding pressure.” where the fuck was Dr. Clarks?
“Why did he stop breathing? Addi, why isn’t he breathing? Please help him.” Her gently tears turned rounds of heavy sobbing.
In a single second I lifted myself back on top of the table placing my two fingers on the side of his neck. Damn it… there’s no pulse.
“Listen to me Amelia. I need to start CPR. You need to hold it together and keep holding pressure no matter what. Do you understand?” My eyes glared at her seriously. There was no time to say things to her softly or to coddle her. Alex’s life was slipping away.
I placed my hands on his chest like I had done so many times before to other patients. My fingers interlaced themselves, my elbows locked. I looked down at his face one last time.
“Don’t you dare fucking die on me Alex DeLuca. It is not your time damn it.”
At the last word that slipped out of my mouth I pushed down feeling the crack of his ribs under my hands. I pushed down twenty nine more times before grabbing his chin with my hand tilting his head back, pinching his nose and opening his mouth. I breathed my life into him twice before positioning myself back over his chest to start the pattern all over again.
My arms were feeling like jello. I could feel my face flush. I could hear my own heartbeat in my ears as my body screamed that it was starting to get exhausted telling me I needed to stop. My mind screamed back at my body just one more, just one more.
In the midst of my third set of compressions, the latch on the door popped forcing my head to turn in its direction while simultaneously continuing to press down on Alex’s now broken ribs in attempt to bring him back to live. My body sighed a breath of relief when I saw him, Dr. Clarks, standing before me. In his arms he held at least three leather bags. Filled with what, I didn’t know. But he looked like he had come prepared for just about anything.
“Thank fucking God. It’s about fucking time you showed up. Single GSW to the abdomen. He’s lost a lot of blood. I started compressions about 8 minutes ago. I need you to take over.”
He simple nodded his head at me as he dropped the bags near the head of the table. I finished my thirtieth compression, tilted Alex’s head back one more time and continued to give him two breaths. Dr Clarks took over my spot near Alex’s chest locking his fingers over his chest.
I didn’t pay attention much to the two breathing individuals after that. I’m sure I heard Dr. Clarks yelling at me but everything seemed to go a little fuzzy as I rummaged through the bag from Adrian’s room until I found what I was looking for.
I ran to Alex’s side once more. I simply grabbed his arm, pulled the tourniquet around his bicep and jabbed the needle right where I knew the vein would be. I hooked up the line to the IV and continued to squeezed the bag of saline attempting to get as much fluid into Alex as fast as I could.
I could still hear the dull voices yelling out my name trying to get my attention. But my body didn’t seem to want to process them. Until finally I could hear my name as clear as day screaming right at me.
“W-WHAT?” I snapped back into reality seeing Dr. Clarks face look down on me in a serious tone.
“There’s an amp of epinephrine in my bag, grab it.”
I didn’t need to be told twice. I shuffled through his bags, dropped messily on the floor until I found the box I was looking for. I placed the two ends together locking them in place and twisting the end of the syringe on the end of the IV and slammed the fluid into it. I looked back down at the bags to see at least four units of blood. Without a second thought I bend down and grabbed one. Tearing off the saline bag that I had previously hooked up to the line, I replaced it with the blood letting it flow full force into his veins.
“Grab another amp Addi” and I did. For minutes while Dr Clarks continued with compressions I listened to his every command. I placed another IV letting saline trickle into his veins as well. I replaced one unit of blood with another. I slammed medication after medication into the ports of the IVs praying that this time Alex’s heart would start beating on its own. Until finally by some miracle it did.
“It’s faint but there’s a beat. Addi, I need you to intubate. I need to go in and find the damage.”
“Wait-what? You’re going to open him right here? We-you- you can’t do that here” Amelia finally spoke up, tears still streaming down her face.
“Amelia, I have no choice. He will never make it to the hospital. We either do this here or he dies.”
“Fuck…” Amelia’s head hung heavy letting tears drip on Alex’s body. All while I carefully intubated Alex’s barely conscious body.
“Amelia, what is about to happen I don’t want you seeing. But I need you to help us.” I began hooking up the ambu bag to the tube now currently sticking out of Alex’s mouth. “I’m going to be giving Alex medications that will keep him out while we go in, I need you to help him breath.” She looked up at me with fear in her eyes still holding pressure onto Alex’s fragile body.
“You need me to do what?” she was shocked.
“I need you to stand here, your back facing us so you don’t see Dr Clarks open him up. Squeeze this bag just like this, every five seconds.” I squeezed the ambu bag making it collapse giving Alex a breath while I told her what to do. “Come here, take my place. Dr Clarks is going to take over holding pressure.” They quickly switched spots as Amelia walked up to me hesitantly like a frightened child. “Here, stand here. Hold this just like this.” I grabbed her shoulders moving her to the spot I wanted her to stand and placed her hands around the bag. “Now squeeze. Good. See it’s not that difficult. Now keep going.” I spoke to her gently, trying to dull the panic in my voice as Dr Clarks looked at me telling me it was time.
I shuffled around the bags one more time finding a vial of Versed and Fentanyl along with another unit of blood and one more bag of saline. I effortlessly hung the bag of fluids one more time and drew up the medications in the correct doses that Dr Clarks wanted. Once the medications were in Dr Clarks lifted one hand off of Alex’s body grabbing gloves and the scalpel that I had left by his side minutes previously.
It was time. The part that I was dreading. This was my brother lying on the table. But I couldn’t think like that. I needed to think like the damn trauma nurse I was and not some frightened family member my body was screaming for me to be.
As Dr Clarks cut into Alex’s skin my body sent shivers up my spine. My stomach twisted in a knot causing bile to rise into the back of my mouth. Oh no, fuck oh no. It wasn’t just bile, no it was full on vomit.
My head twisted my body around, the knot in my stomach caused me to double over forcing the bitter fluid to come out of my mouth splattering over the floor. My bicep came up to my mouth wiping off the acid that dripped over my lips. I stayed bent over. Ashamed. Embarrassed.
I turned back around slowly to face the bloody show laying on the table in front of me. Breath Addi, breath.
“You okay Dear?” Dr Clarks said reassuringly continuing to look down at Alex’s organs that his hands now wrapped around searching for the bullet and the source of bleeding.
“Yep... Just not used to the patient being family on the table.” My voice was small. Shaky. My arm still covered my mouth attempting not to retch all over again.
“Well that’s why we aren’t allowed to treat family. Addi I need you to help. I know where the bleeding is coming from. You up to help retract?”
“Yes” My voice shook in response. My hands trembled. I couldn’t steady myself. I could no longer tell if it was from the puking or the adrenaline forcing me to shake. Damn it Addi get your shit together. Breath damn it.
My hands grabbed the flesh that Dr Clarks had separated while his hands dug into Alex’s body. He grabbed the forceps off the table with his free hand and carefully switched his hands placing the forceps into Alex’s body. Shortly after Dr Clarks retracted something shiny out of what I assumed was Alex’s liver.
“Well look at what I found.” Dr Clarks held a bullet in the air pinned between either side of the forcep. He looked at it with pride. One eyebrow raised as a small smirk came onto his face. “It was lodged into his liver. Nothing I can’t fix. Just a few stitches inside and some clean up of all the free blood and he’ll be as good as new.”
I never let out a sigh as large as I had at that moment. A sigh of relief. A sigh breathing all the fear and panic away from my body. The tremors in my hands began to fade. I could hear Amelia sob at the front of the table as she too was relieved at the prognosis.
Dr. Clarks finished his job sewing a few stitches inside, soaking up the remaining blood with lap pads and closed Alex’s soon to be new scar down the front of his body.
I had Amelia stop breathing for Alex with the bag and removed the tubes down his throat as soon as I was positive that he was going to breath on his own. I hung another bag of fluids and one more unit of blood for good measure hanging them on a hanger hooked on the light fixture above the table.
When I finally had a minute to think, think about everything that had just happened my sight looked down over my own body. Blood covered every inch of me. It was splattered all over my shirt, smeared down my pants, inching its way from my hands up to my elbows. I looked like a mess. A serial killer. But I could care less. He was alive. He was going to live. I grabbed a chair and sat down for the first time in what seemed like forever. My elbows leaning onto the table. My hand finding Alex’s just to hold on to him. You’re going to be okay Alex. I promise.
He was minutes away from death an hour ago. Everything that just happened didn’t seem real. My adrenaline rush began to crash down causing my eyelids to get heavy. I just need to close my eyes for a second. But that one second was quickly interrupted by the door slamming open with a very unhappy looking Adam shoving a bound Franco in front of him Riccardo following behind.
The wave of relief that I had just started to come down off of was quickly replaced by rage once more. I stood up at attention. My blood coursed through my veins causing my head to feel like it was going to explode. My chest filled with fire. My teeth gritted together at the sight of the monster that had caused this family so much pain, the monster that had caused a living hell for me.
Franco saw Alex on the table, and my body covered with blood. In one second his sadistic laugh filled the room. I started to lung forward. I wanted to rip his eyeballs from their damn sockets. But Adam moved swiftly seeing my reaction shoving Franco down the stairs to the place that was once my own hell.
Once he was out of my sight my boiling blood began to calm only slightly. Until I realized that one person was missing. Adam and RIccardo had come home. Where the hell was Adrian?
I kept thinking he was going to be seconds behind coming in last. But he never did.I looked outside through the doorway to see if he was in the driveway. To see if there were any cars coming up the road to our house. Nothing. There was nothing except for the stars in the dark midnight sky.
I turned back around my arms folding over themselves covering my chest. I began pacing back and forth next to the table that Alex laid on. Heavy footsteps rushed up the stairwell near the kitchen revealing Adam’s broken face.
He rushed to Alex’s side practically ramming into the table. Adam grabbed Alex’s hand and glanced down at his peacefully, drug induced, sleeping face.
“How is he?” Adam’s voice was laced with such terror, fear, heartache. I didn’t think this side of him even existed. He was always so stoic. Quiet.
“He’s going to be okay Adam. But someone needs to watch him the next couple of days. He’s lost a lot of blood. And he’s going to have a lot of pain. But he’s a fighter. He’ll be okay. He has to be.”
“Thank fucking God.” His head hung down as his breathing slowed to a normal pace.
As much as I didn’t want to interrupt this moment between Adam, Alex and I. I had to know. I had to know where he was, what happened. It wasn’t like him to not come home. He promised me he would come home to me. But he was nowhere to be found.
“Where is he Adam?”
“Who?” He looked back up to my face. My face was littered with concern, fear. My mind raced to the worst possible outcome. Please don’t be dead. With one look Adam knew who I was referring to. “As soon as we had Franco he said he wasn’t coming home. He said he needed to be alone.”
“What the hell?” my face contorted with confusion. Needed to be alone? What the hell does that mean? “Where is he Adam? I won’t ask again.”
“You know where he went.” yeah the loft. What the fuck was he thinking. Like Adam could read my inner thoughts he quickly spoke once more. “He’s a mess Addi. Just leave him be for the night.”
The hell I will. “Stay with him Adam.” I said flatly pointing down to Alex.
“Addi, don’t… You don’t want to be around him when he’s like this, trust me.”
“I could care less what he was like right now Adam.” Adam knew better at this point to stop me from doing whatever my mind was set on doing. He just simply shook his head at me giving me a disappointed look.
I snatched the keys off the table from the glass bowl they lay in near the front door and marched to the car. I barely knew where I was going, but I didn’t care. I would find my way one way or another.
I slid the keys into the ignition and backed out of the driveway, flooring the gas. My eyes caught the rearview mirror as I drove down the paved back roads that took me to the city. The look in my eyes was a look I had never seen in me before. Wild, crazy, determined.
All I knew was that I did not just save his damn brother for him to not come home to me. He fucking promised me. I didn’t care how pissed off he was. I didn’t care how much of a mess he was. I didn’t care how pissed off I was. I was a mess all night thinking about him. I thought I was going to lose him tonight and instead almost lost a brother. I needed to see him, to make sure he was okay. I needed to know what happened tonight. He needed to know that Alex was okay. Damn it, I just fucking needed him.
The last thing any of us fucking needed after a night like this was to be alone.